Pub Date : 2024-04-24DOI: 10.5114/wiitm.2024.139175
Guangjiang Wu, Can Cui, Qingkun Song
Introduction The current study aimed to compare the outcomes of endoscopic and minimally invasive surgical treatment for infected necrotizing pancreatitis.
Material and methods A meta-analysis of clinical studies on minimally invasive operations for necrotic infection was conducted. A systematic review and study inclusion were done on multiple databases. English-language prospective comparison studies were included. Random design was used to analyze research with continuous and dichotomous variables.
Results Ten studies were included in the current study. When compared to minimally invasive surgery, endoscopic procedures showed significant beneficial outcomes regarding low post-operative complication rates (p = 0.006), new onset organ failure (p < 0.001), and pancreatic fistula (p < 0.001). However, there was no significant difference between the two interventions regarding hospital stay, postoperative bleeding, incisional hernia, endocrine insufficiency, and perforation of a visceral organ.
Conclusions Endoscopic therapy appears to have potential advantages over minimally invasive surgery. However, there is no difference between interventions regarding several parameters.
{"title":"Minimally invasive surgery compared to endoscopic intervention for treating infected pancreatic necrosis. A meta-analysis","authors":"Guangjiang Wu, Can Cui, Qingkun Song","doi":"10.5114/wiitm.2024.139175","DOIUrl":"https://doi.org/10.5114/wiitm.2024.139175","url":null,"abstract":"<b>Introduction</b><br/>The current study aimed to compare the outcomes of endoscopic and minimally invasive surgical treatment for infected necrotizing pancreatitis.<br/><br/><b>Material and methods</b><br/>A meta-analysis of clinical studies on minimally invasive operations for necrotic infection was conducted. A systematic review and study inclusion were done on multiple databases. English-language prospective comparison studies were included. Random design was used to analyze research with continuous and dichotomous variables.<br/><br/><b>Results</b><br/>Ten studies were included in the current study. When compared to minimally invasive surgery, endoscopic procedures showed significant beneficial outcomes regarding low post-operative complication rates (p = 0.006), new onset organ failure (p < 0.001), and pancreatic fistula (p < 0.001). However, there was no significant difference between the two interventions regarding hospital stay, postoperative bleeding, incisional hernia, endocrine insufficiency, and perforation of a visceral organ.<br/><br/><b>Conclusions</b><br/>Endoscopic therapy appears to have potential advantages over minimally invasive surgery. However, there is no difference between interventions regarding several parameters.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"16 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141512660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.5114/wiitm.2024.138767
Lin Li, Yi Liu, Shaoqing Wang
Introduction Uterine artery embolization (UAE) and hysterectomy are often used to treat uterine myoma. Nevertheless, the impact of these two treatments on postoperative ovarian function remains uncertain.
Aim To compare the postoperative ovarian function in individuals with uterine myoma who had UAE against hysterectomy.
Material and methods Searches were conducted in the Wanfang, Web of Science, and PubMed databases to find qualifying studies. The data were combined and analyzed.
Results Seven publications were included in this meta-analysis. Uterus and uterine myoma volume were dramatically decreased by UAE (p < 0.00001 for both). The combined preoperative levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were similar in both groups. Three months postoperatively, the combined FSH (p = 0.28) and LH (p = 0.64) levels were similar in both groups, while the combined E2 level was notably higher in the UAE group compared to the hysterectomy group (p < 0.00001). Six months postoperatively, the combined postoperative FSH and LH levels were considerably lower in the UAE group compared to the hysterectomy group (p = 0.002 for both). However, the combined E2 levels were similar between the two groups (p = 0.07). Also, 12 months after surgery, the combined postoperative FSH and LH levels were remarkably lower in the UAE group compared to the hysterectomy group (p = 0.02 and p < 0.00001, respectively). However, the combined E2 levels were similar in both groups (p = 0.15).
Conclusions UAE may provide superior preservation of postoperative ovarian function compared to hysterectomy in individuals with uterine myoma.
导言子宫动脉栓塞术（UAE）和子宫切除术通常用于治疗子宫肌瘤。材料和方法在万方、Web of Science 和 PubMed 数据库中搜索符合条件的研究。结果本荟萃分析纳入了七篇文献。子宫和子宫肌瘤的体积通过 UAE 显著减少（两者的 p 均为 0.00001）。两组患者术前卵泡刺激素（FSH）、黄体生成素（LH）和雌二醇（E2）的综合水平相似。术后三个月，两组患者的卵泡刺激素（FSH）（p = 0.28）和黄体生成素（LH）（p = 0.64）的综合水平相似，而 UAE 组的 E2 综合水平明显高于子宫切除组（p < 0.00001）。术后六个月，与子宫切除术组相比，UAE 组的术后 FSH 和 LH 综合水平明显降低（均为 p = 0.002）。不过，两组的 E2 综合水平相似（P = 0.07）。此外，术后 12 个月，与子宫切除术组相比，UAE 组的术后 FSH 和 LH 水平明显降低（分别为 p = 0.02 和 p <0.00001）。结论 与子宫切除术相比，超导可更好地保护子宫肌瘤患者的术后卵巢功能。
{"title":"Uterine artery embolization versus hysterectomy for uterine myoma: a meta-analysis of postoperative ovarian function","authors":"Lin Li, Yi Liu, Shaoqing Wang","doi":"10.5114/wiitm.2024.138767","DOIUrl":"https://doi.org/10.5114/wiitm.2024.138767","url":null,"abstract":"<b>Introduction</b><br/>Uterine artery embolization (UAE) and hysterectomy are often used to treat uterine myoma. Nevertheless, the impact of these two treatments on postoperative ovarian function remains uncertain.<br/><br/><b>Aim</b><br/>To compare the postoperative ovarian function in individuals with uterine myoma who had UAE against hysterectomy.<br/><br/><b>Material and methods</b><br/>Searches were conducted in the Wanfang, Web of Science, and PubMed databases to find qualifying studies. The data were combined and analyzed.<br/><br/><b>Results</b><br/>Seven publications were included in this meta-analysis. Uterus and uterine myoma volume were dramatically decreased by UAE (p < 0.00001 for both). The combined preoperative levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were similar in both groups. Three months postoperatively, the combined FSH (p = 0.28) and LH (p = 0.64) levels were similar in both groups, while the combined E2 level was notably higher in the UAE group compared to the hysterectomy group (p < 0.00001). Six months postoperatively, the combined postoperative FSH and LH levels were considerably lower in the UAE group compared to the hysterectomy group (p = 0.002 for both). However, the combined E2 levels were similar between the two groups (p = 0.07). Also, 12 months after surgery, the combined postoperative FSH and LH levels were remarkably lower in the UAE group compared to the hysterectomy group (p = 0.02 and p < 0.00001, respectively). However, the combined E2 levels were similar in both groups (p = 0.15).<br/><br/><b>Conclusions</b><br/>UAE may provide superior preservation of postoperative ovarian function compared to hysterectomy in individuals with uterine myoma.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"26 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141512662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.5114/wiitm.2024.138785
Michał Kisielewski, Tomasz Wojewoda, Karolina Richter, Michał Wysocki, Michał Jankowski, Wiktor Krawczyk, Jakub Wantulok, Karolina Jeleńska-Bieńkowska, Michał Stańczak, Ewa Grudzińska, Bartosz Molasy, Andrzej Komorowski, Michał Zdrojewski, Tomasz Sachańbiński, Paulina Franczak, Mateusz Wierdak, Natalia Dowgiałło-Gornowicz, Wojciech M. Wysocki
Introduction Creation of colostomy is still a commonly performed procedure in emergency settings, when intestinal anastomosis cannot be performed safely. Reversing a stoma has been linked with high rates of morbidity and also mortality.
Aim The primary goal of the study was to identify the risk of postoperative complications in patients undergoing colostomy liquidation. The secondary goal was to assess perioperative care parameters.
Material and methods The LIquidation of COlostomy (LICO) study is an open multicenter prospective cohort study that began in October 2022 and will continue until December 2023. Data from 20 Polish surgical departments were collected. Overall 45 patients were reported over the initial 3 months; based on that group we performed a preliminary analysis.
Results Mean operative time was 163 min. Patients were operated on by specialists in 93.3% of cases. Complications occurred in 15 (33.3%) patients. Wound infection was the most common complication (17.8%). In 3 (6.7%) cases anastomotic leakage was diagnosed, and in 2 of those cases reoperation was required. The overall mortality rate was 2.2%. The mean length of hospital stay was 10.1 days. Preoperative fasting was used in 53.3% of patients, and the mechanical bowel preparation rate was 75.6%. Only in 8.9% of cases was laparoscopic access used for stoma reversal, and only in 1 out of 45 cases was mesh used for incisional peristomal hernia prophylactics. The stoma site was closed by single sutures in 73.3%, and negative pressure assisted closure was performed in 6.7% of patients.
Conclusions Colostomy liquidation is associated with significant morbidity and minor mortality in the Polish population. Standardized perioperative care should be established for stoma reversal surgery.
{"title":"Preliminary results of Polish national multicenter study on colostomy reversal – LICO (Liquidation of Colostomy) study","authors":"Michał Kisielewski, Tomasz Wojewoda, Karolina Richter, Michał Wysocki, Michał Jankowski, Wiktor Krawczyk, Jakub Wantulok, Karolina Jeleńska-Bieńkowska, Michał Stańczak, Ewa Grudzińska, Bartosz Molasy, Andrzej Komorowski, Michał Zdrojewski, Tomasz Sachańbiński, Paulina Franczak, Mateusz Wierdak, Natalia Dowgiałło-Gornowicz, Wojciech M. Wysocki","doi":"10.5114/wiitm.2024.138785","DOIUrl":"https://doi.org/10.5114/wiitm.2024.138785","url":null,"abstract":"<b>Introduction</b><br/>Creation of colostomy is still a commonly performed procedure in emergency settings, when intestinal anastomosis cannot be performed safely. Reversing a stoma has been linked with high rates of morbidity and also mortality.<br/><br/><b>Aim</b><br/>The primary goal of the study was to identify the risk of postoperative complications in patients undergoing colostomy liquidation. The secondary goal was to assess perioperative care parameters.<br/><br/><b>Material and methods</b><br/>The LIquidation of COlostomy (LICO) study is an open multicenter prospective cohort study that began in October 2022 and will continue until December 2023. Data from 20 Polish surgical departments were collected. Overall 45 patients were reported over the initial 3 months; based on that group we performed a preliminary analysis. <br/><br/><b>Results</b><br/>Mean operative time was 163 min. Patients were operated on by specialists in 93.3% of cases. Complications occurred in 15 (33.3%) patients. Wound infection was the most common complication (17.8%). In 3 (6.7%) cases anastomotic leakage was diagnosed, and in 2 of those cases reoperation was required. The overall mortality rate was 2.2%. The mean length of hospital stay was 10.1 days. Preoperative fasting was used in 53.3% of patients, and the mechanical bowel preparation rate was 75.6%. Only in 8.9% of cases was laparoscopic access used for stoma reversal, and only in 1 out of 45 cases was mesh used for incisional peristomal hernia prophylactics. The stoma site was closed by single sutures in 73.3%, and negative pressure assisted closure was performed in 6.7% of patients.<br/><br/><b>Conclusions</b><br/>Colostomy liquidation is associated with significant morbidity and minor mortality in the Polish population. Standardized perioperative care should be established for stoma reversal surgery.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"112 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141512663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.5114/wiitm.2024.138769
Liang Chen, Yunxiao Lyu
Introduction The effectiveness and safety of low pneumoperitoneum in laparoscopic pediatric inguinal hernia repair is unclear and required to explore.
Aim To evaluate the benefits of low (LPP) vs. standard pneumoperitoneum pressure (SPP) in laparoscopic pediatric inguinal hernia repair.
Material and methods We performed a retrospective cohort analysis of patients with pediatric inguinal hernia. The patients were divided into LPP and SPP groups. Anesthesia and postoperative characteristics were analyzed.
Results We enrolled 169 eligible patients in this study. Anesthesia and postanesthesia care unit times in the LPP group were lower than those in the SPP group (p = 0.00, p = 0.01, respectively). The LPP group had lower values for peak partial pressure of end-tidal carbon dioxide (PETCO2; mm Hg) (33.37 ±4.09 vs. 36.56 ±4.08), trough PETCO2 (38.33 ±5.04 vs. 40.46 ±4.14), and PETCO2 at the end of surgery (35.29 ±4.59 vs. 38.76 ±4.22). The LPP group required less sufentanil citrate (8.76 ±4.07 ml vs. 18.03 ±16.04 ml) and midazolam (1.56 ±0.45 ml vs 1.79 ±0.59 ml) vs. the SPP group, respectively. There was no significant difference between the groups regarding postoperative complications.
Conclusions LPP was associated with shorter anesthesia and postanesthesia care unit times, and lower PETCO2 values compared with SPP. Compared with the SPP group, the LPP group had comparable operation times and postoperative complications. However, long-term outcome studies are needed.
目的评估腹腔镜小儿腹股沟疝修补术中低气腹压力（LPP）与标准气腹压力（SPP）的益处。患者被分为 LPP 组和 SPP 组。分析了麻醉和术后特征。LPP 组的麻醉时间和麻醉后护理单元时间低于 SPP 组（分别为 p = 0.00 和 p = 0.01）。LPP 组的潮气末二氧化碳分压峰值（PETCO2；mm Hg）（33.37 ±4.09 vs. 36.56 ±4.08）、PETCO2 谷值（38.33 ±5.04 vs. 40.46 ±4.14）和手术结束时的 PETCO2 值（35.29 ±4.59 vs. 38.76 ±4.22）均低于 SPP 组。与 SPP 组相比，LPP 组所需的枸橼酸舒芬太尼（8.76 ±4.07 ml vs. 18.03 ±16.04 ml）和咪达唑仑（1.56 ±0.45 ml vs. 1.79 ±0.59 ml）分别较少。结论 LPP与SPP相比，麻醉时间和麻醉后护理单元时间更短，PETCO2值更低。与 SPP 组相比，LPP 组的手术时间和术后并发症相当。不过，还需要进行长期的结果研究。
{"title":"Comparison of low and standard pneumoperitoneum pressure in laparoscopic pediatric inguinal hernia repair","authors":"Liang Chen, Yunxiao Lyu","doi":"10.5114/wiitm.2024.138769","DOIUrl":"https://doi.org/10.5114/wiitm.2024.138769","url":null,"abstract":"<b>Introduction</b><br/>The effectiveness and safety of low pneumoperitoneum in laparoscopic pediatric inguinal hernia repair is unclear and required to explore.<br/><br/><b>Aim</b><br/>To evaluate the benefits of low (LPP) vs. standard pneumoperitoneum pressure (SPP) in laparoscopic pediatric inguinal hernia repair.<br/><br/><b>Material and methods</b><br/>We performed a retrospective cohort analysis of patients with pediatric inguinal hernia. The patients were divided into LPP and SPP groups. Anesthesia and postoperative characteristics were analyzed.<br/><br/><b>Results</b><br/>We enrolled 169 eligible patients in this study. Anesthesia and postanesthesia care unit times in the LPP group were lower than those in the SPP group (p = 0.00, p = 0.01, respectively). The LPP group had lower values for peak partial pressure of end-tidal carbon dioxide (PETCO2; mm Hg) (33.37 ±4.09 vs. 36.56 ±4.08), trough PETCO2 (38.33 ±5.04 vs. 40.46 ±4.14), and PETCO2 at the end of surgery (35.29 ±4.59 vs. 38.76 ±4.22). The LPP group required less sufentanil citrate (8.76 ±4.07 ml vs. 18.03 ±16.04 ml) and midazolam (1.56 ±0.45 ml vs 1.79 ±0.59 ml) vs. the SPP group, respectively. There was no significant difference between the groups regarding postoperative complications.<br/><br/><b>Conclusions</b><br/>LPP was associated with shorter anesthesia and postanesthesia care unit times, and lower PETCO2 values compared with SPP. Compared with the SPP group, the LPP group had comparable operation times and postoperative complications. However, long-term outcome studies are needed.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"45 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141530438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Rectal washout is proposed for eliminating free cancer cells, yet evidence on its efficacy in preventing local recurrence after anterior resection is inconclusive.
Material and methods Contrasting rectal washout (RW) and non-rectal washout (NRW) in rectal cancer, a prospective study of randomized control trials (RCT) and non-randomized control trials (NRCT) from January 2005 to July 2023 was conducted using PubMed, Cochrane Library, and MEDLINE databases. Meta-statistical analysis in RevMan 5.4 addressed heterogeneity.
Results In analysis involving 19,855 patients (15127 RW, 4728 NRW) from eight studies, RW significantly reduced local recurrence (OR = 0.48), intraoperative RW (OR = 0.65), radical resection margins (OR = 1.89), and neoadjuvant therapy (OR = 0.99) (all p < 0.05). Subgroup RCT analysis reinforced these findings.
Conclusions Rectal washout correlates with improved outcomes, while non-washout patients benefit more from neoadjuvant therapy. Notably, rectal washout without neoadjuvant remains efficacious.
{"title":"Impact of rectal washout in local recurrence: a meta-analysis and systemic review","authors":"Linhai Meng, Chen Zhuming, Huaiwen Xu, Chaohui Wang, Shuangjiu Hu, Zhe Kai","doi":"10.5114/wiitm.2024.138732","DOIUrl":"https://doi.org/10.5114/wiitm.2024.138732","url":null,"abstract":"<b>Introduction</b><br/>Rectal washout is proposed for eliminating free cancer cells, yet evidence on its efficacy in preventing local recurrence after anterior resection is inconclusive.<br/><br/><b>Material and methods</b><br/>Contrasting rectal washout (RW) and non-rectal washout (NRW) in rectal cancer, a prospective study of randomized control trials (RCT) and non-randomized control trials (NRCT) from January 2005 to July 2023 was conducted using PubMed, Cochrane Library, and MEDLINE databases. Meta-statistical analysis in RevMan 5.4 addressed heterogeneity.<br/><br/><b>Results</b><br/>In analysis involving 19,855 patients (15127 RW, 4728 NRW) from eight studies, RW significantly reduced local recurrence (OR = 0.48), intraoperative RW (OR = 0.65), radical resection margins (OR = 1.89), and neoadjuvant therapy (OR = 0.99) (all p < 0.05). Subgroup RCT analysis reinforced these findings.<br/><br/><b>Conclusions</b><br/>Rectal washout correlates with improved outcomes, while non-washout patients benefit more from neoadjuvant therapy. Notably, rectal washout without neoadjuvant remains efficacious.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"4 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141512665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-03DOI: 10.5114/wiitm.2024.138521
Natalia Dowgiałło-Gornowicz, Pawel Lech
Introduction Sleeve gastrectomy (SG) is currently the most frequently performed bariatric procedure in the world. However, the occurrence of gastroesophageal reflux disease (GERD) after SG remains controversial and questionable.
Aim To determine the occurrence of GERD after SG using a pH-monitoring study.
Material and methods This is a prospective study involving patients undergoing SG in one surgical centre. Inclusion criteria were eligibility for bariatric surgery, no symptoms of GERD, normal gastroscopy, and pH-monitoring before the surgery. Postoperative examinations were performed 6 months after surgery.
Results A total of 38 patients were analysed in the study. The mean age was 44.9 years, and the mean preoperative BMI was 42.6 kg/m2. Before surgery, all patients had normal pH values. After surgery, mean acid exposure time (AET), number of refluxes, and DeMeester score increased statistically significantly (p < 0.001). 27 (71.1%) patients each had AET > 6%, but only 9 (23.7%) reported GERD symptoms and the need for PPIs. The correlation between AET and %TWL was moderate positive, and the correlation between DeMeester score and %TWL was low positive (p = 0.011, p = 0.014, respectively).
Conclusions GERD after SG seems to be a significant problem. More than two-thirds of patients had de novo GERD after SG in pH-monitoring, but only one-quarter of them required PPIs.
{"title":"The real occurrence of gastroesophageal reflux disease after sleeve gastrectomy – a prospective pH-monitoring study","authors":"Natalia Dowgiałło-Gornowicz, Pawel Lech","doi":"10.5114/wiitm.2024.138521","DOIUrl":"https://doi.org/10.5114/wiitm.2024.138521","url":null,"abstract":"<b>Introduction</b><br/>Sleeve gastrectomy (SG) is currently the most frequently performed bariatric procedure in the world. However, the occurrence of gastroesophageal reflux disease (GERD) after SG remains controversial and questionable.<br/><br/><b>Aim</b><br/>To determine the occurrence of GERD after SG using a pH-monitoring study.<br/><br/><b>Material and methods</b><br/>This is a prospective study involving patients undergoing SG in one surgical centre. Inclusion criteria were eligibility for bariatric surgery, no symptoms of GERD, normal gastroscopy, and pH-monitoring before the surgery. Postoperative examinations were performed 6 months after surgery.<br/><br/><b>Results</b><br/>A total of 38 patients were analysed in the study. The mean age was 44.9 years, and the mean preoperative BMI was 42.6 kg/m2. Before surgery, all patients had normal pH values. After surgery, mean acid exposure time (AET), number of refluxes, and DeMeester score increased statistically significantly (p < 0.001). 27 (71.1%) patients each had AET > 6%, but only 9 (23.7%) reported GERD symptoms and the need for PPIs. The correlation between AET and %TWL was moderate positive, and the correlation between DeMeester score and %TWL was low positive (p = 0.011, p = 0.014, respectively).<br/><br/><b>Conclusions</b><br/>GERD after SG seems to be a significant problem. More than two-thirds of patients had de novo GERD after SG in pH-monitoring, but only one-quarter of them required PPIs.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"29 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141512664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-11DOI: 10.5114/wiitm.2024.136248
Marek Piwowarczyk, Mateusz Rubinkiewicz, Jerzy Krzywoń, Marcin Kołodziejski, Roger M. Krzyżewski, Katarzyna Zbierska-Rubinkiewicz
Introduction Endovascular aortic repair (EVAR) is nowadays a widespread method of managing abdominal aortic aneurysm (AAA). Low-profile stent grafts (LPSGs) enable treatment of patients with complex and anatomically challenging aneurysms, and facilitate a percutaneous and thus less invasive procedure.
Aim To assess the outcomes of EVAR with low-profile versus standard-profile stent grafts (SPSGs).
Material and methods Thirty-one patients with abdominal aortic aneurysms (AAA) were treated by endovascular aortic repair (EVAR) using LPSGs. The control group of patients treated with SPSGs was matched with MedCalc software. The clinical records and the preoperative and follow-up computed tomography angiography of patients who underwent endovascular treatment of AAA were included in this study.
Results Patients in the LPSG group had significantly more often low access vessel diameter (< 6 mm) compared to the SPSG group (38.7% vs. 6.7%, p = 0.003). In 1-year follow-up, there was no rupture, no infection, no conversion to open repair and no aneurysm-related death. Five secondary interventions were necessary in the SPSG group and only 1 in the LPSG group (p = 0.09). Type of stent graft was not a risk factor of perioperative complications, presence of endoleak or reintervention (p > 0.05). Risk factors for perioperative complications were COPD and conical neck (OR = 6.3, 95% CI: 1.5–25, p = 0.01 and OR = 6.2, 95% CI: 1–39.76, p = 0.04). The risk factor for endoleak was lower maximal aneurysm diameter. The risk factor for reintervention was proximal neck diameter (OR = 0.77, 95% CI: 0.–0.97, p = 0.03).
Conclusions Our study showed that use of LPSGs is a safe and viable method for patients with narrow access vessels who are not eligible for standard-profile systems.
{"title":"Low-profile versus standard-profile stent grafts in the treatment of abdominal aortic aneurysm: a case-matched study","authors":"Marek Piwowarczyk, Mateusz Rubinkiewicz, Jerzy Krzywoń, Marcin Kołodziejski, Roger M. Krzyżewski, Katarzyna Zbierska-Rubinkiewicz","doi":"10.5114/wiitm.2024.136248","DOIUrl":"https://doi.org/10.5114/wiitm.2024.136248","url":null,"abstract":"<b>Introduction</b><br/>Endovascular aortic repair (EVAR) is nowadays a widespread method of managing abdominal aortic aneurysm (AAA). Low-profile stent grafts (LPSGs) enable treatment of patients with complex and anatomically challenging aneurysms, and facilitate a percutaneous and thus less invasive procedure.<br/><br/><b>Aim</b><br/>To assess the outcomes of EVAR with low-profile versus standard-profile stent grafts (SPSGs).<br/><br/><b>Material and methods</b><br/>Thirty-one patients with abdominal aortic aneurysms (AAA) were treated by endovascular aortic repair (EVAR) using LPSGs. The control group of patients treated with SPSGs was matched with MedCalc software. The clinical records and the preoperative and follow-up computed tomography angiography of patients who underwent endovascular treatment of AAA were included in this study.<br/><br/><b>Results</b><br/>Patients in the LPSG group had significantly more often low access vessel diameter (< 6 mm) compared to the SPSG group (38.7% vs. 6.7%, p = 0.003). In 1-year follow-up, there was no rupture, no infection, no conversion to open repair and no aneurysm-related death. Five secondary interventions were necessary in the SPSG group and only 1 in the LPSG group (p = 0.09). Type of stent graft was not a risk factor of perioperative complications, presence of endoleak or reintervention (p > 0.05). Risk factors for perioperative complications were COPD and conical neck (OR = 6.3, 95% CI: 1.5–25, p = 0.01 and OR = 6.2, 95% CI: 1–39.76, p = 0.04). The risk factor for endoleak was lower maximal aneurysm diameter. The risk factor for reintervention was proximal neck diameter (OR = 0.77, 95% CI: 0.–0.97, p = 0.03).<br/><br/><b>Conclusions</b><br/>Our study showed that use of LPSGs is a safe and viable method for patients with narrow access vessels who are not eligible for standard-profile systems.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"39 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140297415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-04DOI: 10.5114/wiitm.2024.135977
Qiong Hu, Xuqi Yu, Ting Zhou
Introduction Epidural analgesia has been studied for its potential advantages after surgery in a number of randomized clinical trials, with most finding improvements in pain and secondary endpoints like the incidence of postoperative complications.
Aim To assess the relationship between use of epidural analgesia and adverse cardiac outcomes expressed by myocardial infarction (MI).
Material and methods Fifty-three studies were recruited to quantify the influence of different surgical-related analgesic methods on clinical parameters (mortality and adverse events). The results of these trials were analysed using a random effects model, which was then used to calculate the mean difference (MD) with 95 per cent confidence intervals (CIs).
Results Epidural analgesia resulted in preferred cardiac outcomes compared with traditional analgesia. These findings were supported by significantly lower MI events for the epidural analgesia group as follows: p = 0.005, p = 0,007, and p = 0.03 for the total number of included studies, studies with high risk of bias, and studies with low risk of bias, respectively. Studies with intermediate risk showed a non-significant difference between both groups (p = 0.7).
Conclusions Epidural analgesia has a significant protective cardiac effect through the reduction of postoperative MI events among surgery subjects.
{"title":"Epidural analgesia during surgery and its relation to postoperative myocardial infarction: meta-analysis","authors":"Qiong Hu, Xuqi Yu, Ting Zhou","doi":"10.5114/wiitm.2024.135977","DOIUrl":"https://doi.org/10.5114/wiitm.2024.135977","url":null,"abstract":"<b>Introduction</b><br/>Epidural analgesia has been studied for its potential advantages after surgery in a number of randomized clinical trials, with most finding improvements in pain and secondary endpoints like the incidence of postoperative complications.<br/><br/><b>Aim</b><br/>To assess the relationship between use of epidural analgesia and adverse cardiac outcomes expressed by myocardial infarction (MI).<br/><br/><b>Material and methods</b><br/>Fifty-three studies were recruited to quantify the influence of different surgical-related analgesic methods on clinical parameters (mortality and adverse events). The results of these trials were analysed using a random effects model, which was then used to calculate the mean difference (MD) with 95 per cent confidence intervals (CIs).<br/><br/><b>Results</b><br/>Epidural analgesia resulted in preferred cardiac outcomes compared with traditional analgesia. These findings were supported by significantly lower MI events for the epidural analgesia group as follows: p = 0.005, p = 0,007, and p = 0.03 for the total number of included studies, studies with high risk of bias, and studies with low risk of bias, respectively. Studies with intermediate risk showed a non-significant difference between both groups (p = 0.7).<br/><br/><b>Conclusions</b><br/>Epidural analgesia has a significant protective cardiac effect through the reduction of postoperative MI events among surgery subjects.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"27 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140297424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-04DOI: 10.5114/wiitm.2024.135997
Natalia Dowgiałło-Gornowicz, Paweł Jaworski, Maciej Walędziak, Pawel Lech, Alicja Kucharska, Piotr Major
Introduction In the era of an aging society and a growing number of obese people, an increasing number of older patients are consulting bariatric surgeons. The incidence of hypertension (HT) also rises with age and body weight, making the treatment of the elderly a significant challenge.
Aim To identify predictors of HT remission after bariatric surgery in patients over 65 years of age.
Material and methods A retrospective study analyzed patients over 65 years old with HT who underwent laparoscopic bariatric procedures in Poland between 2008 and 2022. The data came from 11 bariatric centers. Patients were categorized into two groups: responders (R) and non-responders (NR). A multivariate logistic regression analysis was conducted to identify significant independent risk factors.
Results The study analyzed 244 patients, with complete HT remission observed in 55 (22.5%) patients. Almost 90% of patients showed improvement in HT. The mean follow-up time was 47.4 months. Factors contributing to HT remission included HT duration of less than 5 years, the use of single medication, and a significant correlation with %EWL.
Conclusions Bariatric surgery in patients aged over 65 has a positive effect on HT remission. The chance of HT remission increases with fewer medications, shorter HT duration, and greater weight loss after surgery.
{"title":"Predictors of complete remission of hypertension in patients over 65 years of age after bariatric surgery – a multicenter study","authors":"Natalia Dowgiałło-Gornowicz, Paweł Jaworski, Maciej Walędziak, Pawel Lech, Alicja Kucharska, Piotr Major","doi":"10.5114/wiitm.2024.135997","DOIUrl":"https://doi.org/10.5114/wiitm.2024.135997","url":null,"abstract":"<b>Introduction</b><br/>In the era of an aging society and a growing number of obese people, an increasing number of older patients are consulting bariatric surgeons. The incidence of hypertension (HT) also rises with age and body weight, making the treatment of the elderly a significant challenge.<br/><br/><b>Aim</b><br/>To identify predictors of HT remission after bariatric surgery in patients over 65 years of age.<br/><br/><b>Material and methods</b><br/>A retrospective study analyzed patients over 65 years old with HT who underwent laparoscopic bariatric procedures in Poland between 2008 and 2022. The data came from 11 bariatric centers. Patients were categorized into two groups: responders (R) and non-responders (NR). A multivariate logistic regression analysis was conducted to identify significant independent risk factors.<br/><br/><b>Results</b><br/>The study analyzed 244 patients, with complete HT remission observed in 55 (22.5%) patients. Almost 90% of patients showed improvement in HT. The mean follow-up time was 47.4 months. Factors contributing to HT remission included HT duration of less than 5 years, the use of single medication, and a significant correlation with %EWL.<br/><br/><b>Conclusions</b><br/>Bariatric surgery in patients aged over 65 has a positive effect on HT remission. The chance of HT remission increases with fewer medications, shorter HT duration, and greater weight loss after surgery.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"143 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140297557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-27DOI: 10.5114/wiitm.2024.135810
Gang Shao, Shuwei Chen
Introduction A meta-analysis was performed to examine the effects of wound catheter (WC) local anaesthetic infiltration (LAI) and epidural analgesia (EA) in open hepatectomy (OH).
Material and methods A systematic literature review was performed, which found 350 subjects with OH at the baseline of the studies; 159 of them were treated with WC local anaesthetic infiltration, and 191 used EA.
Results WC LAI substantially reduced the functional recovery time (MD = –0.64; 95% CI, –1.02 to –0.26, p < 0.001) and increased the pain score on the second postoperative day (MD = 0.25; 95% CI: 0.10–0.40, p < 0.001) compared to EA in OH patients. WC LAI did not vary from EA in OH patients in second postoperative opiate use (MD = –14.86; 95% CI: –32.88 to 3.16, p = 0.11) or overall complication rate (OR = 0.66; 95% CI: 0.41–1.04, p = 0.07).
Conclusions WC LAI showed a non-significant difference in opiate consumption on the second postoperative day and in the overall complication rate, compared with EA, but it showed a lower functional recovery time and higher pain score.
材料和方法进行了系统性文献回顾，发现研究基线有350例OH患者，其中159例采用伤口导管局麻浸润治疗，191例采用硬膜外镇痛。结果 与 EA 相比，WC LAI 大幅缩短了 OH 患者的功能恢复时间（MD = -0.64；95% CI，-1.02 至 -0.26，p < 0.001），并增加了术后第二天的疼痛评分（MD = 0.25；95% CI：0.10-0.40，p < 0.001）。WC LAI 与 EA 相比，OH 患者术后第二天阿片类药物的使用量（MD = -14.86；95% CI：-32.88 至 3.16，p = 0.11）或总体并发症发生率（OR = 0.66；95% CI：0.41-1.04，p = 0.07）均无差异。
{"title":"Combined impact of local anaesthetic infiltration through wound catheter and epidural analgesia following surgical hepatectomy: a meta-analysis","authors":"Gang Shao, Shuwei Chen","doi":"10.5114/wiitm.2024.135810","DOIUrl":"https://doi.org/10.5114/wiitm.2024.135810","url":null,"abstract":"<b>Introduction</b><br/>A meta-analysis was performed to examine the effects of wound catheter (WC) local anaesthetic infiltration (LAI) and epidural analgesia (EA) in open hepatectomy (OH).<br/><br/><b>Material and methods</b><br/>A systematic literature review was performed, which found 350 subjects with OH at the baseline of the studies; 159 of them were treated with WC local anaesthetic infiltration, and 191 used EA.<br/><br/><b>Results</b><br/>WC LAI substantially reduced the functional recovery time (MD = –0.64; 95% CI, –1.02 to –0.26, p < 0.001) and increased the pain score on the second postoperative day (MD = 0.25; 95% CI: 0.10–0.40, p < 0.001) compared to EA in OH patients. WC LAI did not vary from EA in OH patients in second postoperative opiate use (MD = –14.86; 95% CI: –32.88 to 3.16, p = 0.11) or overall complication rate (OR = 0.66; 95% CI: 0.41–1.04, p = 0.07).<br/><br/><b>Conclusions</b><br/>WC LAI showed a non-significant difference in opiate consumption on the second postoperative day and in the overall complication rate, compared with EA, but it showed a lower functional recovery time and higher pain score.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"233 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140297420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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