Pub Date : 2024-09-01DOI: 10.1016/j.lers.2024.03.003
{"title":"Gastric leiomyoma presenting as an endophytic growth of cardia of the stomach: A case report","authors":"","doi":"10.1016/j.lers.2024.03.003","DOIUrl":"10.1016/j.lers.2024.03.003","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 3","pages":"Pages 132-135"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000227/pdfft?md5=88441fdc21caa825c1d87d089feedd36&pid=1-s2.0-S2468900924000227-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.lers.2024.06.001
Objective
Traditionally tumors of the parapharyngeal space (PPS) are resected through transcervical approaches. More recent approaches include endoscopic approaches or transoral robotic surgery (TORS) without directions on when to use which approach. Our objective was to find objective parameters to choose the most suitable approach.
Methods
It is a retrospective study containing 6 patients from May 2019 to May 2021 with tumors of the PPS treated in the Department of Otolaryngology and Head-Neck Surgery at the Hospital of Lucerne, Switzerland.
Results
The data was analysed in average 53 months after surgery. Tumor resection was completed with TORS in 3 patients and endoscopically in 3 patients. Mean operation time was 114 min. No major complications occurred. No evidence of tumor was found in magnetic resonance imaging studies postoperatively in all patients.
Conclusion
We conclude that a resection via TORS or endoscopic technique is safe and effective. Furthermore, we postulate that the further a tumor is located in the upper lateral area of the PPS, an approach via TORS is less possible.
{"title":"Minimally invasive management of parapharyngeal space tumors: Introducing a decision-making algorithm and radiologic tool","authors":"","doi":"10.1016/j.lers.2024.06.001","DOIUrl":"10.1016/j.lers.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>Traditionally tumors of the parapharyngeal space (PPS) are resected through transcervical approaches. More recent approaches include endoscopic approaches or transoral robotic surgery (TORS) without directions on when to use which approach. Our objective was to find objective parameters to choose the most suitable approach.</p></div><div><h3>Methods</h3><p>It is a retrospective study containing 6 patients from May 2019 to May 2021 with tumors of the PPS treated in the Department of Otolaryngology and Head-Neck Surgery at the Hospital of Lucerne, Switzerland.</p></div><div><h3>Results</h3><p>The data was analysed in average 53 months after surgery. Tumor resection was completed with TORS in 3 patients and endoscopically in 3 patients. Mean operation time was 114 min. No major complications occurred. No evidence of tumor was found in magnetic resonance imaging studies postoperatively in all patients.</p></div><div><h3>Conclusion</h3><p>We conclude that a resection via TORS or endoscopic technique is safe and effective. Furthermore, we postulate that the further a tumor is located in the upper lateral area of the PPS, an approach via TORS is less possible.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 3","pages":"Pages 97-101"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000434/pdfft?md5=734927f574d1874fc4e1fcef6b962bbf&pid=1-s2.0-S2468900924000434-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the clinical efficacy of laparoscopic training using origami, a traditional Japanese papercraft, using laparoscopic forceps to create origami cranes.
Methods
In this retrospective study, 4 surgeons were randomly divided into 2 groups: The training group, consisting of surgeons 1 and 2, and the non-training group, consisting of surgeons 3 and 4. Over the course of a one-year study period, the training group regularly underwent laparoscopic surgery training with a dry box, wherein they folded a total of 1000 origami cranes using laparoscopic instruments. The non-training group periodically underwent common laparoscopic surgery training of techniques such as suturing and ligation. Each surgeon regularly performed the transabdominal preperitoneal approach for inguinal hernias. Each training was conducted concurrently with the surgeries. The procedure time (peritoneum detachment, mesh placement, and closure of the peritoneum), total operation time (time from peritoneum detachment to closure of the peritoneum), and surgical outcomes were examined.
Results
The training group showed greater improvement in the total operation time and more stable performance than the non-training group. Additionally, the time taken for peritoneum detachment was significantly shorter in the training group.
Conclusion
Laparoscopic training using origami has the potential to enhance laparoscopic surgical skills and improve surgical outcomes.
{"title":"Enhancing clinical proficiency through laparoscopic training using Japanese origami","authors":"Shunsuke Furukawa , Masatsugu Hiraki , Naoya Kimura , Ryota Sakurai , Ryo Kohata , Naohiko Kohya , Masashi Sakai , Akashi Ikubo , Ryuichiro Samejima","doi":"10.1016/j.lers.2024.07.001","DOIUrl":"10.1016/j.lers.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate the clinical efficacy of laparoscopic training using origami, a traditional Japanese papercraft, using laparoscopic forceps to create origami cranes.</p></div><div><h3>Methods</h3><p>In this retrospective study, 4 surgeons were randomly divided into 2 groups: The training group, consisting of surgeons 1 and 2, and the non-training group, consisting of surgeons 3 and 4. Over the course of a one-year study period, the training group regularly underwent laparoscopic surgery training with a dry box, wherein they folded a total of 1000 origami cranes using laparoscopic instruments. The non-training group periodically underwent common laparoscopic surgery training of techniques such as suturing and ligation. Each surgeon regularly performed the transabdominal preperitoneal approach for inguinal hernias. Each training was conducted concurrently with the surgeries. The procedure time (peritoneum detachment, mesh placement, and closure of the peritoneum), total operation time (time from peritoneum detachment to closure of the peritoneum), and surgical outcomes were examined.</p></div><div><h3>Results</h3><p>The training group showed greater improvement in the total operation time and more stable performance than the non-training group. Additionally, the time taken for peritoneum detachment was significantly shorter in the training group.</p></div><div><h3>Conclusion</h3><p>Laparoscopic training using origami has the potential to enhance laparoscopic surgical skills and improve surgical outcomes.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 3","pages":"Pages 102-106"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000471/pdfft?md5=60b2f17aa70d7a2162efe773f11d968d&pid=1-s2.0-S2468900924000471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.lers.2024.03.001
Giuleta Jamsari, James Wei Tatt Toh
{"title":"Case of abdominal whirl sign with small bowel obstruction and free gas successfully managed by conservative management instead of laparoscopic surgery","authors":"Giuleta Jamsari, James Wei Tatt Toh","doi":"10.1016/j.lers.2024.03.001","DOIUrl":"10.1016/j.lers.2024.03.001","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 3","pages":"Pages 128-131"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000203/pdfft?md5=965932ce5dccedf29b2388862fe3624a&pid=1-s2.0-S2468900924000203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.lers.2024.04.002
{"title":"A live birth resulting from a fourth cesarean scar pregnancy after combined hysteroscopic and laparoscopic uterine repair: A case report and literature review","authors":"","doi":"10.1016/j.lers.2024.04.002","DOIUrl":"10.1016/j.lers.2024.04.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 3","pages":"Pages 136-139"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000240/pdfft?md5=fa678e6630ad190a6bc58261ec4ce7dd&pid=1-s2.0-S2468900924000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.lers.2024.08.001
Jared Mount , Brandon Mount , Katherine Poruk , Mary Tice , John A. Stauffer
Objective
In previous studies, laparoscopic pancreaticoduodenectomy (LPD) has demonstrated safety and potential benefits over open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma (PDAC). After performing both LPD and OPD procedures interchangeably in routine practice for a decade, the outcomes of LPD versus OPD for PDAC were analyzed and compared at a single institution. Our primary aim was to compare features of LPD and OPD in PDAC patients so that the suitable surgical approach may be chosen for each individual.
Methods
From January 2010 through December 2020, all patients undergoing pancreaticoduodenectomy (PD) were identified, and information was collected prospectively. At a single institution, PD was performed on 589 patients, of whom 347 were OPD patients and 242 were LPD patients. After excluding those who underwent pancreatectomy for indications other than PDAC, total pancreatectomy, major vascular or concomitant organ resection, there were 237 patients (OPD = 157, LPD = 80). Then propensity score matching was completed to analyze 77 OPD patients versus 77 LPD patients to create a similar group of patients who underwent either LPD or OPD for PDAC. A comparison of perioperative data and 90-day outcomes with subsequent statistical analysis was performed.
Results
Operative time (491 min vs. 281 min, p < 0.001) was longer for LPD than OPD. The rates of pancreatic fistula (11.7% vs. 0.0%, p < 0.001) and delayed gastric emptying (15.6% vs. 3.9%, p = 0.027) were higher for LPD than OPD respectively but overall morbidity was similar. Blood loss, mortality and post-pancreatectomy hemorrhage were also similar for both groups, but total costs ($60,245 vs. $50,900, p = 0.002) were significantly higher for LPD than OPD. Recurrence and overall survival were similar for the two groups.
Conclusion
In our experience, LPD does not offer any advantages over OPD for PDAC and is associated with a higher rate of complications and costs.
{"title":"A comparison of laparoscopic to open pancreaticoduodenectomy for pancreatic adenocarcinoma by propensity score matching analysis","authors":"Jared Mount , Brandon Mount , Katherine Poruk , Mary Tice , John A. Stauffer","doi":"10.1016/j.lers.2024.08.001","DOIUrl":"10.1016/j.lers.2024.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>In previous studies, laparoscopic pancreaticoduodenectomy (LPD) has demonstrated safety and potential benefits over open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma (PDAC). After performing both LPD and OPD procedures interchangeably in routine practice for a decade, the outcomes of LPD versus OPD for PDAC were analyzed and compared at a single institution. Our primary aim was to compare features of LPD and OPD in PDAC patients so that the suitable surgical approach may be chosen for each individual.</div></div><div><h3>Methods</h3><div>From January 2010 through December 2020, all patients undergoing pancreaticoduodenectomy (PD) were identified, and information was collected prospectively. At a single institution, PD was performed on 589 patients, of whom 347 were OPD patients and 242 were LPD patients. After excluding those who underwent pancreatectomy for indications other than PDAC, total pancreatectomy, major vascular or concomitant organ resection, there were 237 patients (OPD = 157, LPD = 80). Then propensity score matching was completed to analyze 77 OPD patients versus 77 LPD patients to create a similar group of patients who underwent either LPD or OPD for PDAC. A comparison of perioperative data and 90-day outcomes with subsequent statistical analysis was performed.</div></div><div><h3>Results</h3><div>Operative time (491 min vs. 281 min, <em>p</em> < 0.001) was longer for LPD than OPD. The rates of pancreatic fistula (11.7% vs. 0.0%, <em>p</em> < 0.001) and delayed gastric emptying (15.6% vs. 3.9%, <em>p</em> = 0.027) were higher for LPD than OPD respectively but overall morbidity was similar. Blood loss, mortality and post-pancreatectomy hemorrhage were also similar for both groups, but total costs ($60,245 vs. $50,900, <em>p</em> = 0.002) were significantly higher for LPD than OPD. Recurrence and overall survival were similar for the two groups.</div></div><div><h3>Conclusion</h3><div>In our experience, LPD does not offer any advantages over OPD for PDAC and is associated with a higher rate of complications and costs.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 141-146"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique. However, discrepancies in the accuracy of screw placement between the 2 methods have been highlighted by some comparative studies. This meta-analysis was conducted to synthesize evidence comparing these techniques.
Methods
Searches were conducted in 5 electronic databases adhering to specific eligibility criteria for randomized and observational studies. The data were analyzed using RevMan software and the results are presented as odds ratios (ORs), mean differences, or standard mean differences (SMDs) with 95% confidence intervals (CIs). Our analysis included 12 studies (7 randomized trials and 5 observational studies, involving 883 patients and 4903 screws).
Results
The results demonstrated a higher rate of Grade A Gertzbein and Robbins pedicle placement score (OR: 1.77; 95% CI: 1.10–2.87), a lower rate of revision surgeries (OR: 0.21; 95% CI: 0.09–0.52), and a shorter radiation exposure duration (SMD = −1.38, 95% CI: −2.32 to −0.44) in the robot-assisted group compared with the free-hand group. Nonetheless, the length of hospital stay, volume of intraoperative blood loss, postoperative visual analogue scale scores for back pain, and rate of wound infection were similar between the 2 groups. Significant heterogeneity was observed in some outcomes.
Conclusion
Compared with the free-hand method, the robot-assisted technique provides greater accuracy and reduced radiation exposure. The efficacy of the robot-assisted technique is expected to improve further as experience with its use in surgery grows.
{"title":"Revised in-depth meta-analysis on the efficacy of robot-assisted versus traditional free-hand pedicle screw insertion","authors":"Sorayouth Chumnanvej , Branesh M. Pillai , Jackrit Suthakorn , Siriluk Chumnanvej","doi":"10.1016/j.lers.2024.08.002","DOIUrl":"10.1016/j.lers.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique. However, discrepancies in the accuracy of screw placement between the 2 methods have been highlighted by some comparative studies. This meta-analysis was conducted to synthesize evidence comparing these techniques.</div></div><div><h3>Methods</h3><div>Searches were conducted in 5 electronic databases adhering to specific eligibility criteria for randomized and observational studies. The data were analyzed using RevMan software and the results are presented as odds ratios (ORs), mean differences, or standard mean differences (SMDs) with 95% confidence intervals (CIs). Our analysis included 12 studies (7 randomized trials and 5 observational studies, involving 883 patients and 4903 screws).</div></div><div><h3>Results</h3><div>The results demonstrated a higher rate of Grade A Gertzbein and Robbins pedicle placement score (OR: 1.77; 95% CI: 1.10–2.87), a lower rate of revision surgeries (OR: 0.21; 95% CI: 0.09–0.52), and a shorter radiation exposure duration (SMD = −1.38, 95% CI: −2.32 to −0.44) in the robot-assisted group compared with the free-hand group. Nonetheless, the length of hospital stay, volume of intraoperative blood loss, postoperative visual analogue scale scores for back pain, and rate of wound infection were similar between the 2 groups. Significant heterogeneity was observed in some outcomes.</div></div><div><h3>Conclusion</h3><div>Compared with the free-hand method, the robot-assisted technique provides greater accuracy and reduced radiation exposure. The efficacy of the robot-assisted technique is expected to improve further as experience with its use in surgery grows.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 155-165"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16DOI: 10.1016/j.lers.2024.07.002
Partha Pratim Ray
This opinion paper explores the transformative potential of large language models (LLMs) in laparoscopic surgery and argues for their integration to enhance surgical education, decision support, reporting, and patient care. LLMs can revolutionize surgical education by providing personalized learning experiences and accelerating skill acquisition. Intelligent decision support systems powered by LLMs can assist surgeons in making complex decisions, optimizing surgical workflows, and improving patient outcomes. Moreover, LLMs can automate surgical reporting and generate personalized patient education materials, streamlining documentation and improving patient engagement. However, challenges such as data scarcity, surgical semantic capture, real-time inference, and integration with existing systems need to be addressed for successful LLM integration. The future of laparoscopic surgery lies in the seamless integration of LLMs, enabling autonomous robotic surgery, predictive surgical planning, intraoperative decision support, virtual surgical assistants, and continuous learning. By harnessing the power of LLMs, laparoscopic surgery can be transformed, empowering surgeons and ultimately benefiting patients.
{"title":"Large language models in laparoscopic surgery: A transformative opportunity","authors":"Partha Pratim Ray","doi":"10.1016/j.lers.2024.07.002","DOIUrl":"10.1016/j.lers.2024.07.002","url":null,"abstract":"<div><div>This opinion paper explores the transformative potential of large language models (LLMs) in laparoscopic surgery and argues for their integration to enhance surgical education, decision support, reporting, and patient care. LLMs can revolutionize surgical education by providing personalized learning experiences and accelerating skill acquisition. Intelligent decision support systems powered by LLMs can assist surgeons in making complex decisions, optimizing surgical workflows, and improving patient outcomes. Moreover, LLMs can automate surgical reporting and generate personalized patient education materials, streamlining documentation and improving patient engagement. However, challenges such as data scarcity, surgical semantic capture, real-time inference, and integration with existing systems need to be addressed for successful LLM integration. The future of laparoscopic surgery lies in the seamless integration of LLMs, enabling autonomous robotic surgery, predictive surgical planning, intraoperative decision support, virtual surgical assistants, and continuous learning. By harnessing the power of LLMs, laparoscopic surgery can be transformed, empowering surgeons and ultimately benefiting patients.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 174-180"},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1016/j.lers.2024.06.004
Gaoyang Cao , Songtao Wu , Li Zhang , Xinjie Zhang , Wei Zhou
Objective
To evaluate various treatment methods for benign rectal anastomotic stricture (AS) following surgery for colorectal cancer.
Method
A systematic review of the literature was conducted, focusing on studies that reported outcomes of different treatment modalities for benign AS. The PubMed, Embase, Scopus, China National Knowledge Infrastructure, and Cochrane Library databases were searched from January 2000 to December 2023. The inclusion criteria were studies involving human subjects, published in English, and reporting on therapeutic outcomes for benign AS.
Results
A total of 19 papers identified a range of therapeutic strategies, including nonoperative anastomotic dilation, endoscopic balloon dilation (EBD), transanal minimally invasive surgery (TAMIS), self-expandable metal stents (SEMS), endoscopic incision (EI) and newer techniques such as prostate resection instrumentation. Nonoperative anastomotic dilation can serve as an initial treatment for lower AS. EI demonstrated promise in cases where EBD was ineffective, providing an alternative method for managing AS. TAMIS and SEMS showed higher efficacy in refractory cases, with TAMIS being particularly effective for severe fibrotic or completely closed AS. The use of rigid instrumentation with an electric knife for transanal incisions demonstrated precision but lacked the flexibility needed for complex procedures.
Conclusion
While traditional methods such as nonoperative anastomotic dilation and EBD remain first-line treatments for benign AS, advanced techniques such as EI, TAMIS, and SEMS offer promising alternatives, particularly in refractory cases. The choice of treatment should be tailored to individual patient conditions, with consideration for the technical expertise required and the potential for complications.
目的 评估结直肠癌术后良性直肠吻合口狭窄（AS）的各种治疗方法。 方法 对文献进行了系统性回顾，重点关注报道良性 AS 不同治疗方法效果的研究。检索了 2000 年 1 月至 2023 年 12 月期间的 PubMed、Embase、Scopus、中国国家知识基础设施和 Cochrane 图书馆数据库。结果共有19篇论文确定了一系列治疗策略，包括非手术吻合口扩张术、内镜下球囊扩张术（EBD）、经肛门微创手术（TAMIS）、自膨胀金属支架（SEMS）、内镜下切开术（EI）以及前列腺切除器械等新技术。非手术吻合口扩张术可作为下部 AS 的初始治疗方法。在EBD无效的病例中，EI显示出良好的前景，为治疗强直性脊柱炎提供了另一种方法。TAMIS 和 SEMS 对难治性病例的疗效更高，其中 TAMIS 对严重纤维化或完全闭合的 AS 尤为有效。结论虽然非手术吻合口扩张术和 EBD 等传统方法仍是良性 AS 的一线治疗方法，但 EI、TAMIS 和 SEMS 等先进技术提供了前景广阔的替代方法，尤其是在难治性病例中。应根据患者的具体情况选择治疗方法，同时考虑到所需的专业技术和并发症的可能性。
{"title":"Therapy for benign rectal anastomotic stricture after surgery for colorectal cancer: A systematic review","authors":"Gaoyang Cao , Songtao Wu , Li Zhang , Xinjie Zhang , Wei Zhou","doi":"10.1016/j.lers.2024.06.004","DOIUrl":"10.1016/j.lers.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate various treatment methods for benign rectal anastomotic stricture (AS) following surgery for colorectal cancer.</div></div><div><h3>Method</h3><div>A systematic review of the literature was conducted, focusing on studies that reported outcomes of different treatment modalities for benign AS. The PubMed, Embase, Scopus, China National Knowledge Infrastructure, and Cochrane Library databases were searched from January 2000 to December 2023. The inclusion criteria were studies involving human subjects, published in English, and reporting on therapeutic outcomes for benign AS.</div></div><div><h3>Results</h3><div>A total of 19 papers identified a range of therapeutic strategies, including nonoperative anastomotic dilation, endoscopic balloon dilation (EBD), transanal minimally invasive surgery (TAMIS), self-expandable metal stents (SEMS), endoscopic incision (EI) and newer techniques such as prostate resection instrumentation. Nonoperative anastomotic dilation can serve as an initial treatment for lower AS. EI demonstrated promise in cases where EBD was ineffective, providing an alternative method for managing AS. TAMIS and SEMS showed higher efficacy in refractory cases, with TAMIS being particularly effective for severe fibrotic or completely closed AS. The use of rigid instrumentation with an electric knife for transanal incisions demonstrated precision but lacked the flexibility needed for complex procedures.</div></div><div><h3>Conclusion</h3><div>While traditional methods such as nonoperative anastomotic dilation and EBD remain first-line treatments for benign AS, advanced techniques such as EI, TAMIS, and SEMS offer promising alternatives, particularly in refractory cases. The choice of treatment should be tailored to individual patient conditions, with consideration for the technical expertise required and the potential for complications.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 166-173"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13DOI: 10.1016/j.lers.2024.06.002
{"title":"Assessing a complex patient with both colorectal cancer and diverticulitis of the sigmoid colon: A case report and literature review","authors":"","doi":"10.1016/j.lers.2024.06.002","DOIUrl":"10.1016/j.lers.2024.06.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 181-185"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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