İdris Avci, Kemal Paksoy, Melih Kapdan, Salim Şentürk, Hatice Hale Tüzün, Onur Yaman
We present a unique case of myoclonic seizures 36 h after endoscopic cervical disc surgery. A 48-year-old female patient underwent posterior endoscopic disc surgery for right C6-C7 disc herniation. The surgery finished without any complications. No dural tear could be detected. 36 h after the surgery the patient developed myoclonic seizures. The MRI did not reveal any mass effect or hemorrhage or any signs of intracranial hypotension, EEG did not show any pathologies. Generalized seizures after spinal procedures are extremely rare and are mostly associated with accidental durotomy-induced intracranial hypotension or pneumocephalus. No plausible cause for the seizure like disturbance of CSF flow, hypovolemia, anesthetic agents, or the irrigation water pressure could be found to explain this pathology. We believe that the cause of the seizure was multifactorial due to a combination of the presence of syringomyelia, surgical manipulation, and water pressure of the endoscope creating an epileptogenic focus on the proximal spinal cord creating a foundation for the later seizure.
{"title":"Myoclonic Seizures After Endoscopic Cervical Disc Surgery: A Rare Complication or Just Coincidence?","authors":"İdris Avci, Kemal Paksoy, Melih Kapdan, Salim Şentürk, Hatice Hale Tüzün, Onur Yaman","doi":"10.1111/ases.70027","DOIUrl":"https://doi.org/10.1111/ases.70027","url":null,"abstract":"<div>\u0000 \u0000 <p>We present a unique case of myoclonic seizures 36 h after endoscopic cervical disc surgery. A 48-year-old female patient underwent posterior endoscopic disc surgery for right C6-C7 disc herniation. The surgery finished without any complications. No dural tear could be detected. 36 h after the surgery the patient developed myoclonic seizures. The MRI did not reveal any mass effect or hemorrhage or any signs of intracranial hypotension, EEG did not show any pathologies. Generalized seizures after spinal procedures are extremely rare and are mostly associated with accidental durotomy-induced intracranial hypotension or pneumocephalus. No plausible cause for the seizure like disturbance of CSF flow, hypovolemia, anesthetic agents, or the irrigation water pressure could be found to explain this pathology. We believe that the cause of the seizure was multifactorial due to a combination of the presence of syringomyelia, surgical manipulation, and water pressure of the endoscope creating an epileptogenic focus on the proximal spinal cord creating a foundation for the later seizure.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limited evidence exists regarding differences in post-operative renal function and ileal conduit-related complications, including ureteroenteric anastomotic stricture (UAS) and parastomal hernia (PH), between radical cystectomy (RC) with extracorporeal urinary diversion (ECUD) and robot-assisted RC with intracorporeal UD (ICUD).
Methods
We retrospectively collected the baseline and post-RC follow-up data from 179 patients receiving RC with ileal conduit UD (152 ECUD and 27 ICUD). The estimated glomerular filtration rate (eGFR, mL/min/1.73 m2) and occurrence of UAS and PH were post-operatively monitored. Chronic kidney disease (CKD) stages were determined based on eGFR level. UD-related complications were evaluated using the Clavien-Dindo system. Time-course changes in eGFR level and CKD-related survival rates were compared in both the original and propensity score-matched cohorts.
Results
Although the original ECUD group had higher eGFR levels (median, 60.9 vs. 52.1), comparison of the adjusted cohorts revealed no significant difference at any time points, CKD upstaging-free survival, and CKD stage 3b-free survival. Out of 179 patients, three (1.7%), eight (4.5%), and 14 (7.8%) experienced grade I, II, and IIIa UAS, respectively. Thirteen (7.3%) developed PH during follow-up. No significant differences were observed in UAS rates (p = 0.38), PH rates (p = 0.69), CKD upstaging-free survival, and CKD stage 3b-free survival between two groups.
Conclusion
No significant difference was observed in post-operative renal function and UD-related complication rates among the different types of surgery in patients undergoing RC in our institute. Further research is needed to determine the optimal surgical approach for each patient to minimize risks of CKD upstaging, UAS, and PH.
{"title":"Comparison of Post-Radical Cystectomy Renal Function and Ileal Conduit-Related Complications Between Extracorporeal and Robot-Assisted Intracorporeal Urinary Diversion: A Single-Center Experience","authors":"Makito Miyake, Nobutaka Nishimura, Yuki Oda, Tatsuki Miyamoto, Mitsuru Tomizawa, Takuto Shimizu, Takuya Owari, Kota Iida, Kenta Ohnishi, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Takeshi Inoue, Satoshi Anai, Nobumichi Tanaka, Kiyohide Fujimoto","doi":"10.1111/ases.70033","DOIUrl":"https://doi.org/10.1111/ases.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Limited evidence exists regarding differences in post-operative renal function and ileal conduit-related complications, including ureteroenteric anastomotic stricture (UAS) and parastomal hernia (PH), between radical cystectomy (RC) with extracorporeal urinary diversion (ECUD) and robot-assisted RC with intracorporeal UD (ICUD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively collected the baseline and post-RC follow-up data from 179 patients receiving RC with ileal conduit UD (152 ECUD and 27 ICUD). The estimated glomerular filtration rate (eGFR, mL/min/1.73 m<sup>2</sup>) and occurrence of UAS and PH were post-operatively monitored. Chronic kidney disease (CKD) stages were determined based on eGFR level. UD-related complications were evaluated using the Clavien-Dindo system. Time-course changes in eGFR level and CKD-related survival rates were compared in both the original and propensity score-matched cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although the original ECUD group had higher eGFR levels (median, 60.9 vs. 52.1), comparison of the adjusted cohorts revealed no significant difference at any time points, CKD upstaging-free survival, and CKD stage 3b-free survival. Out of 179 patients, three (1.7%), eight (4.5%), and 14 (7.8%) experienced grade I, II, and IIIa UAS, respectively. Thirteen (7.3%) developed PH during follow-up. No significant differences were observed in UAS rates (<i>p</i> = 0.38), PH rates (<i>p</i> = 0.69), CKD upstaging-free survival, and CKD stage 3b-free survival between two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No significant difference was observed in post-operative renal function and UD-related complication rates among the different types of surgery in patients undergoing RC in our institute. Further research is needed to determine the optimal surgical approach for each patient to minimize risks of CKD upstaging, UAS, and PH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical procedures to avoid using artificial materials require ongoing discussion. We herein report a case of thoracoscopic repair for congenital diaphragmatic hernia (CDH) via anchor-shaped closure with the patient's own residual diaphragm using a loop needle device.
Patient and Surgical Technique
A 2-day-old boy prenatally diagnosed with CDH underwent thoracoscopic repair after his respiratory and circulatory conditions had stabilized. The defect was a typical Bochdalek CDH, approximately 2.5 × 4 cm. The herniated organs of the thoracic cavity were the stomach, small intestine, colon, spleen, and left kidney. After these organs had been gently returned to the abdominal cavity under artificial pneumothorax, the medial side of the defect was closed in the anterior and posterior directions with six stitches of Loeder's knot using 3–0 non-absorbable sutures. However, the lateral third of the defect was relatively large and difficult to close in the anterior and posterior directions. We therefore opted for closure by fixing the diaphragm to the chest wall and driving five external costal sutures using a loop needle device. The diaphragmatic defect was thus closed in an “anchor-shaped” fashion using the patient's own residual diaphragm. This technique allows artificial membranes to be avoided in infants.
Discussion
Considering the possibility of recurrence and complications, the indications for our procedure are limited; however, we believe that there are cases in which this procedure can provide a cure. Our proposed technique may be effective in closing relatively large diaphragmatic defects.
{"title":"Marginal Indication for Thoracoscopic Surgery for Neonatal Bochdalek Hernia: “Anchor-Shaped Closure” Technique for the Patient's Own Residual Diaphragm Using a Loop Needle Device","authors":"Chihiro Kedoin, Koshiro Sugita, Toshio Harumatsu, Yumiko Tabata, Yumiko Iwamoto, Masato Ogata, Lynne Takada, Ayaka Nagano, Yudai Tsuruno, Masakazu Murakami, Keisuke Yano, Shun Onishi, Takafumi Kawano, Satoshi Ieiri","doi":"10.1111/ases.70032","DOIUrl":"https://doi.org/10.1111/ases.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Surgical procedures to avoid using artificial materials require ongoing discussion. We herein report a case of thoracoscopic repair for congenital diaphragmatic hernia (CDH) via anchor-shaped closure with the patient's own residual diaphragm using a loop needle device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Surgical Technique</h3>\u0000 \u0000 <p>A 2-day-old boy prenatally diagnosed with CDH underwent thoracoscopic repair after his respiratory and circulatory conditions had stabilized. The defect was a typical Bochdalek CDH, approximately 2.5 × 4 cm. The herniated organs of the thoracic cavity were the stomach, small intestine, colon, spleen, and left kidney. After these organs had been gently returned to the abdominal cavity under artificial pneumothorax, the medial side of the defect was closed in the anterior and posterior directions with six stitches of Loeder's knot using 3–0 non-absorbable sutures. However, the lateral third of the defect was relatively large and difficult to close in the anterior and posterior directions. We therefore opted for closure by fixing the diaphragm to the chest wall and driving five external costal sutures using a loop needle device. The diaphragmatic defect was thus closed in an “anchor-shaped” fashion using the patient's own residual diaphragm. This technique allows artificial membranes to be avoided in infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Considering the possibility of recurrence and complications, the indications for our procedure are limited; however, we believe that there are cases in which this procedure can provide a cure. Our proposed technique may be effective in closing relatively large diaphragmatic defects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424212","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}
Seyed Nooredin Daryabari, Seyed Ali Jazaeri, Fahime Yarigholi
Introduction
Achalasia is a rare esophageal smooth muscle disorder. There is a global increase in the prevalence of obesity, so the coincidence of obesity and rare conditions like achalasia will more occur.
Materials and Surgical Technique
Here we present the Heller myotomy and Dor fundoplication using gastric remnant in patient with history of one anastomosis gastric bypass (OAGB).
Discussion
Heller myotomy and Dor fundoplication using gastric remnant is feasible with good results in patient with achalasia and history of OAGB.
{"title":"Heller Myotomy and Dor Fundoplication in a Patient With History of One Anastomosis Gastric Bypass","authors":"Seyed Nooredin Daryabari, Seyed Ali Jazaeri, Fahime Yarigholi","doi":"10.1111/ases.70031","DOIUrl":"https://doi.org/10.1111/ases.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Achalasia is a rare esophageal smooth muscle disorder. There is a global increase in the prevalence of obesity, so the coincidence of obesity and rare conditions like achalasia will more occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>Here we present the Heller myotomy and Dor fundoplication using gastric remnant in patient with history of one anastomosis gastric bypass (OAGB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Heller myotomy and Dor fundoplication using gastric remnant is feasible with good results in patient with achalasia and history of OAGB.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A man in his 40's presented with vomiting and numbness in the right thigh. Eight months earlier, he had undergone robot-assisted radical cystectomy and pelvic lymphadenectomy for bladder cancer. Computed tomography (CT) revealed a caliber change and a closed loop of the small intestine in the right pelvis, prompting emergency diagnostic laparoscopy. Intraoperative findings showed that the small intestine had herniated into the space between the right obturator nerve and pelvic wall, resulting in strangulated intestinal obstruction. The necrotic small intestine was resected and reconstructed, while preserving the obturator nerve. The hernia orifice was not repaired during the surgery. We encountered a rare case of an internal hernia involving the obturator nerve as the cord. In patients with abdominal distension and thigh symptoms following pelvic lymphadenectomy, internal hernia should be considered. The optimal approach for hernia repair involving the obturator nerve remains undetermined, necessitating a case-by-case approach.
{"title":"Internal Hernia Beneath the Obturator Nerve After Robot-Assisted Radical Cystectomy and Pelvic Lymphadenectomy: A Case Report With Literature Review","authors":"Zen Naito, Masataka Wada, Toshiaki Shichinohe, Ayu Yoshida, Takahiro Osawa, Takashige Abe, Satoshi Hirano","doi":"10.1111/ases.70030","DOIUrl":"https://doi.org/10.1111/ases.70030","url":null,"abstract":"<div>\u0000 \u0000 <p>A man in his 40's presented with vomiting and numbness in the right thigh. Eight months earlier, he had undergone robot-assisted radical cystectomy and pelvic lymphadenectomy for bladder cancer. Computed tomography (CT) revealed a caliber change and a closed loop of the small intestine in the right pelvis, prompting emergency diagnostic laparoscopy. Intraoperative findings showed that the small intestine had herniated into the space between the right obturator nerve and pelvic wall, resulting in strangulated intestinal obstruction. The necrotic small intestine was resected and reconstructed, while preserving the obturator nerve. The hernia orifice was not repaired during the surgery. We encountered a rare case of an internal hernia involving the obturator nerve as the cord. In patients with abdominal distension and thigh symptoms following pelvic lymphadenectomy, internal hernia should be considered. The optimal approach for hernia repair involving the obturator nerve remains undetermined, necessitating a case-by-case approach.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robotic surgery under condition of maintaining perioperative antiplatelet therapy (APT) is considered to have the risk of perioperative hemorrhagic events. We examined whether perioperative continuation of APT increased intraoperative blood loss and incidence of hemorrhagic complications in robot-assisted colorectal resection.
Methods
The medical records of patients who underwent robotic surgical resection of colorectal cancer at our hospital between September 2020 and December 2023 were enrolled. Intraoperative blood loss, incidence of blood transfusion, and postoperative hemorrhagic complications were evaluated after dividing the study population into an APT group (patients receiving perioperative APT) and a non-APT group.
Results
Twenty-seven patients were included in the APT group and 65 patients were the non-APT group. All patients in the APT group were continued aspirin monotherapy until the day before the surgery. There were more anticoagulated patients in the non-APT group than in the APT-group (27.7% vs. 7.4%, p = 0.0496). Median intraoperative blood loss in the APT and non-APT group were 14 and 15 mL, respectively (p = 0.802). The incidence of intraoperative blood transfusion and postoperative hemorrhagic complication in the respective group were 0% and 4.6% (p = 0.553) and 0% and 1.5% (p = 1.00).
Conclusion
The results of this study suggested that perioperative continuation of APT will be allowed in robot-assisted colorectal resection in terms of safety.
{"title":"The Safety Assessment of Continuation of Perioperative Antiplatelet Therapy in Elective Robotic Surgery for Colorectal Cancer: A Retrospective Study","authors":"Toshifumi Watanabe, Takahisa Fujikawa, Keiji Nagata, Keita Tanaka, Taisuke Matsuoka, Ippei Yamana, Yuichiro Kawamura","doi":"10.1111/ases.70029","DOIUrl":"https://doi.org/10.1111/ases.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robotic surgery under condition of maintaining perioperative antiplatelet therapy (APT) is considered to have the risk of perioperative hemorrhagic events. We examined whether perioperative continuation of APT increased intraoperative blood loss and incidence of hemorrhagic complications in robot-assisted colorectal resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The medical records of patients who underwent robotic surgical resection of colorectal cancer at our hospital between September 2020 and December 2023 were enrolled. Intraoperative blood loss, incidence of blood transfusion, and postoperative hemorrhagic complications were evaluated after dividing the study population into an APT group (patients receiving perioperative APT) and a non-APT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven patients were included in the APT group and 65 patients were the non-APT group. All patients in the APT group were continued aspirin monotherapy until the day before the surgery. There were more anticoagulated patients in the non-APT group than in the APT-group (27.7% vs. 7.4%, <i>p</i> = 0.0496). Median intraoperative blood loss in the APT and non-APT group were 14 and 15 mL, respectively (<i>p</i> = 0.802). The incidence of intraoperative blood transfusion and postoperative hemorrhagic complication in the respective group were 0% and 4.6% (<i>p</i> = 0.553) and 0% and 1.5% (<i>p</i> = 1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study suggested that perioperative continuation of APT will be allowed in robot-assisted colorectal resection in terms of safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uniportal video-assisted thoracic surgery (VATS) has gained global popularity as a minimally invasive surgical approach and has been increasingly adopted for various procedures in Japan. The current case report focuses on the uniportal VATS treatment of a 71-year-old female diagnosed with a lesion in the left S6 2 years after undergoing left lingulectomy. The surgery was challenging due to the presence of strong adhesions, particularly in the pulmonary hilum region, thereby increasing the risk of bleeding. Uniportal VATS treatment was conducted to reduce invasiveness and facilitate early ambulation. The patient's postoperative recovery was smooth, and she remained recurrence-free up to approximately 2 years after surgery. This case highlights the challenges of reoperation after anatomical lung resection and emphasizes the importance of surgical adaptability in uniportal VATS treatment for complex cases.
{"title":"Uniportal S6 Segmentectomy for Newly Developed Lung Cancer in the Residual Left Lower Lobe Following Left Lingulectomy","authors":"Sosei Abe, Fumihito Motokura, Yasuo Washida, Yoichi Hachitanda, Masaki Tateishi, Takanori Hazeyama, Junzo Yamaguchi, Yujo Kawashita, Takashi Ueda, Toshihiko Sato","doi":"10.1111/ases.70028","DOIUrl":"10.1111/ases.70028","url":null,"abstract":"<div>\u0000 \u0000 <p>Uniportal video-assisted thoracic surgery (VATS) has gained global popularity as a minimally invasive surgical approach and has been increasingly adopted for various procedures in Japan. The current case report focuses on the uniportal VATS treatment of a 71-year-old female diagnosed with a lesion in the left S<sup>6</sup> 2 years after undergoing left lingulectomy. The surgery was challenging due to the presence of strong adhesions, particularly in the pulmonary hilum region, thereby increasing the risk of bleeding. Uniportal VATS treatment was conducted to reduce invasiveness and facilitate early ambulation. The patient's postoperative recovery was smooth, and she remained recurrence-free up to approximately 2 years after surgery. This case highlights the challenges of reoperation after anatomical lung resection and emphasizes the importance of surgical adaptability in uniportal VATS treatment for complex cases.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Study Design</h3> <p>Retrospective cohort study.</p> </section> <section> <h3> Background</h3> <p>Sciatic scoliosis is attributed to non-structural scoliosis resulting from the irritation of spinal nerve roots. Although limited research has addressed the specific characteristics of sciatic scoliotic curve patterns, there is a lack of reported data on the pre- and post-radiographic outcomes of patients with sciatic scoliosis caused by lumbar disc herniation who have undergone full-endoscopic interlaminar discectomy (FEID).</p> </section> <section> <h3> Objectives</h3> <p>To analyze the distinctive pattern and compare the radiographic results in patients with sciatic scoliosis caused by lumbar disc herniation who have undergone FEID.</p> </section> <section> <h3> Methods</h3> <p>The medical records of patients with sciatic scoliosis caused by lumbar disc herniation who underwent FEID from 2016 to 2022 were gathered and analyzed. The study focused on the prevalence of sciatic scoliosis, the specific location of the lumbar disc herniation, the level of the curve in sciatic scoliosis, and the comparison of pre- and post-operative changes in radiographic outcomes.</p> </section> <section> <h3> Results</h3> <p>A total of 178 patients were analyzed, revealing a prevalence of sciatic scoliosis at 33.7% (60 out of 178). The predominant anatomical location of lumbar disc herniation in cases of sciatic scoliosis was found to be the L4-L5 level, accounting for 56.67% (34 out of 60). The observed lumbosacral curve exhibited a typical pattern with a mean Cobb angle of 14° (range: 2.5–35, standard deviation = 7.46). The mean C7PL-CSVL distance was also measured at 36.2 mm (range: 1–170, standard deviation = 32.5). The mean lumbar lordosis was 21° (range: −1.8–50, standard deviation = 12.96), while the mean Sagittal vertical axis was recorded at 40.9 mm (range: −85–160, standard deviation = 47.8). Notably, no statistically significant difference was observed in the anatomical location of lumbar disc herniation and the apical curve level of sciatic scoliosis. Furthermore, 68% of cases of sciatic scoliosis demonstrated improvement within 12 months, with the average time to improvement being 4 months following FEID.</p> </section> <section> <h3> Conclusion</h3> <p>The FEID procedure has the potential to lead to the natural resolution of sciatic scoliosis within a year. These findings suggest that sciatic scoliosis may not be a reliable indicator for determining the speci
{"title":"Characteristics of Sciatic Scoliosis in Lumbar Disc Herniation and Comparative Radiographic Outcomes After Treatment With Full-Endoscopic Interlaminar Discectomy","authors":"Tinnakorn Pluemvitayaporn, Suttinont Surapuchong, Sombat Kunakornsawat, Suppanut Tuntirungrojchai, Suwit Tangcharoenwathanakul, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Pritsanai Pruttikul, Chaiwat Piyasakulkaew, Piyabuth Kittithamvongs","doi":"10.1111/ases.70026","DOIUrl":"10.1111/ases.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sciatic scoliosis is attributed to non-structural scoliosis resulting from the irritation of spinal nerve roots. Although limited research has addressed the specific characteristics of sciatic scoliotic curve patterns, there is a lack of reported data on the pre- and post-radiographic outcomes of patients with sciatic scoliosis caused by lumbar disc herniation who have undergone full-endoscopic interlaminar discectomy (FEID).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To analyze the distinctive pattern and compare the radiographic results in patients with sciatic scoliosis caused by lumbar disc herniation who have undergone FEID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The medical records of patients with sciatic scoliosis caused by lumbar disc herniation who underwent FEID from 2016 to 2022 were gathered and analyzed. The study focused on the prevalence of sciatic scoliosis, the specific location of the lumbar disc herniation, the level of the curve in sciatic scoliosis, and the comparison of pre- and post-operative changes in radiographic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 178 patients were analyzed, revealing a prevalence of sciatic scoliosis at 33.7% (60 out of 178). The predominant anatomical location of lumbar disc herniation in cases of sciatic scoliosis was found to be the L4-L5 level, accounting for 56.67% (34 out of 60). The observed lumbosacral curve exhibited a typical pattern with a mean Cobb angle of 14° (range: 2.5–35, standard deviation = 7.46). The mean C7PL-CSVL distance was also measured at 36.2 mm (range: 1–170, standard deviation = 32.5). The mean lumbar lordosis was 21° (range: −1.8–50, standard deviation = 12.96), while the mean Sagittal vertical axis was recorded at 40.9 mm (range: −85–160, standard deviation = 47.8). Notably, no statistically significant difference was observed in the anatomical location of lumbar disc herniation and the apical curve level of sciatic scoliosis. Furthermore, 68% of cases of sciatic scoliosis demonstrated improvement within 12 months, with the average time to improvement being 4 months following FEID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The FEID procedure has the potential to lead to the natural resolution of sciatic scoliosis within a year. These findings suggest that sciatic scoliosis may not be a reliable indicator for determining the speci","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fistulization involving both the sigmoid colon and urachus is exceedingly rare. While previous cases have often necessitated laparotomy due to the involvement of multiple organs, only one instance of successful laparoscopic surgery has been reported. Here, we present the second documented case of laparoscopic resection of a sigmoid-urachal fistula. A 46-year-old male presented to our hospital with complaints of umbilical pain and discharge, subsequently diagnosed via CT scan as pyourachus, and conservatively managed with antibiotics. Approximately 1 year and 7 months later, a cutaneous ulcer developed below the left side of the umbilicus, accompanied by fecal discharge. Further investigation revealed a fistulous connection between the sigmoid colon and residual urachus as the underlying pathology. Utilizing laparoscopic techniques, we performed en bloc resection of the urachus, dome of the bladder, and sigmoid colon. The patient experienced an uneventful post-operative recovery and was discharged after 9 days.
{"title":"A Rare Case of Sigmoid-Urachal Fistula in an Adult Male Resected Laparoscopically","authors":"Akihiro Tomida, Masaoki Hattori, Akihiro Hirata, Jumpei Shibata, Hiromitsu Imataki, Marika Suzuki, Hideharu Shintomi, Keiya Aono, Motoi Yoshihara","doi":"10.1111/ases.70024","DOIUrl":"10.1111/ases.70024","url":null,"abstract":"<div>\u0000 \u0000 <p>Fistulization involving both the sigmoid colon and urachus is exceedingly rare. While previous cases have often necessitated laparotomy due to the involvement of multiple organs, only one instance of successful laparoscopic surgery has been reported. Here, we present the second documented case of laparoscopic resection of a sigmoid-urachal fistula. A 46-year-old male presented to our hospital with complaints of umbilical pain and discharge, subsequently diagnosed via CT scan as pyourachus, and conservatively managed with antibiotics. Approximately 1 year and 7 months later, a cutaneous ulcer developed below the left side of the umbilicus, accompanied by fecal discharge. Further investigation revealed a fistulous connection between the sigmoid colon and residual urachus as the underlying pathology. Utilizing laparoscopic techniques, we performed en bloc resection of the urachus, dome of the bladder, and sigmoid colon. The patient experienced an uneventful post-operative recovery and was discharged after 9 days.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Retzius-sparing technique for prostate cancer has shown favorable continence recovery outcomes. Magnetic resonance imaging after Retzius-sparing showed that the bladder anterior wall is widely connected to the abdominal wall, which contributes to urinary continence. We aimed to evaluate whether the Peritoneal Fixation technique, which involves suturing the anterior bladder wall onto the abdominal wall above the pubic bone, contributes to the recovery of urinary continence.
Methods
Patients who underwent robot-assisted laparoscopic radical prostatectomy between May and September 2023 were included in the study. We investigated urinary incontinence on the day of catheter removal and 1 month postoperatively. The posterior urethral angle was evaluated at rest and under abdominal pressure.
Results
A total of 54 patients who underwent the Peritoneal Fixation technique (n = 27) and conventional surgery (n = 27) were included. The continence acquisition rate on the day after catheter removal was significantly higher in the Peritoneal Fixation group (40.7%) than in the conventional group (7.4%) (p < 0.05). At 1 month postoperatively, the Peritoneal Fixation group showed favorable results, with a continence rate of 44.4% compared with 29.6% in the conventional group (p = 0.26). The change in the posterior urethral angle at rest and during abdominal pressure significantly differed between the Peritoneal Fixation and conventional groups (−3.0° vs. 2.7°; p < 0.05), indicating that the urethra is being pushed from the rectal side in the Peritoneal Fixation group.
Conclusion
The use of the Peritoneal Fixation technique for prostate cancer suggests the potential for achieving favorable urinary continence outcomes.
{"title":"Urinary Continence After Robot-Assisted Laparoscopic Radical Prostatectomy Using the Peritoneal Fixation Technique","authors":"Hideyuki Terao, Hirotaka Nagasaka, Shotaro Yamamoto, Atsuto Suzuki, Kimitsugu Usui, Takeshi Kishida, Noboru Nakaigawa","doi":"10.1111/ases.70000","DOIUrl":"10.1111/ases.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Retzius-sparing technique for prostate cancer has shown favorable continence recovery outcomes. Magnetic resonance imaging after Retzius-sparing showed that the bladder anterior wall is widely connected to the abdominal wall, which contributes to urinary continence. We aimed to evaluate whether the Peritoneal Fixation technique, which involves suturing the anterior bladder wall onto the abdominal wall above the pubic bone, contributes to the recovery of urinary continence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent robot-assisted laparoscopic radical prostatectomy between May and September 2023 were included in the study. We investigated urinary incontinence on the day of catheter removal and 1 month postoperatively. The posterior urethral angle was evaluated at rest and under abdominal pressure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 54 patients who underwent the Peritoneal Fixation technique (<i>n</i> = 27) and conventional surgery (<i>n</i> = 27) were included. The continence acquisition rate on the day after catheter removal was significantly higher in the Peritoneal Fixation group (40.7%) than in the conventional group (7.4%) (<i>p</i> < 0.05). At 1 month postoperatively, the Peritoneal Fixation group showed favorable results, with a continence rate of 44.4% compared with 29.6% in the conventional group (<i>p</i> = 0.26). The change in the posterior urethral angle at rest and during abdominal pressure significantly differed between the Peritoneal Fixation and conventional groups (−3.0° vs. 2.7°; <i>p</i> < 0.05), indicating that the urethra is being pushed from the rectal side in the Peritoneal Fixation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of the Peritoneal Fixation technique for prostate cancer suggests the potential for achieving favorable urinary continence outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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