Pub Date : 2022-03-25DOI: 10.5114/wiitm.2022.114943
W. Tarnowski, K. Barski, P. Jaworski, A. Binda, Emilia Kudlicka, M. Wąsowski, P. Jankowski
Introduction Single anastomosis sleeve ileal (SASI) bypass is a recently introduced bariatric procedure that combines the advantages of restrictive and malabsorptive operations, at the same time reducing the risk of nutrient deficiencies by maintaining passage through all the alimentary tract. Aim To present the outcomes of the first group of patients that underwent the SASI bypass in our clinic and assess the safety and efficiency of the procedure. Material and methods We analyzed patients qualified for SASI bypass between January 2020 and February 2021. Retrospective analysis was performed and outpatient treatment results were evaluated. Results A group of nineteen patients (18 women) underwent SASI bypass. The mean preoperative body mass index was 40.3 ±3.74 kg/m2, mean age: 43.3 ±7.83. The mean excess weight loss (% EWL) after 3, 6, 9 and 12 months of follow-up was 43%, 56%, 72.5%, 88.83% respectively. Remission of obesity related diseases was as followed: hypertension in 8 patients (80%, p < 0.05), type II diabetes in 6 patients (100%, p < 0.05), pre-diabetes in 4 patients (50%, p = 0.13). Complications occurred in 4 cases: hematemesis, dysphagia, diarrhea, short bowel syndrome. A patient who developed symptoms of short bowel syndrome was reoperated on and gastrointestinal anastomosis was disconnected. Postoperatively, unwanted symptoms resolved and a good bariatric effect was preserved. Conclusions Our first experience is consistent with that reported in previous studies: very good EWL and a rapid resolution of obesity related diseases after SASI bypass as well as safety of the procedure.
{"title":"Single anastomosis sleeve ileal bypass (SASI): a single-center initial report","authors":"W. Tarnowski, K. Barski, P. Jaworski, A. Binda, Emilia Kudlicka, M. Wąsowski, P. Jankowski","doi":"10.5114/wiitm.2022.114943","DOIUrl":"https://doi.org/10.5114/wiitm.2022.114943","url":null,"abstract":"Introduction Single anastomosis sleeve ileal (SASI) bypass is a recently introduced bariatric procedure that combines the advantages of restrictive and malabsorptive operations, at the same time reducing the risk of nutrient deficiencies by maintaining passage through all the alimentary tract. Aim To present the outcomes of the first group of patients that underwent the SASI bypass in our clinic and assess the safety and efficiency of the procedure. Material and methods We analyzed patients qualified for SASI bypass between January 2020 and February 2021. Retrospective analysis was performed and outpatient treatment results were evaluated. Results A group of nineteen patients (18 women) underwent SASI bypass. The mean preoperative body mass index was 40.3 ±3.74 kg/m2, mean age: 43.3 ±7.83. The mean excess weight loss (% EWL) after 3, 6, 9 and 12 months of follow-up was 43%, 56%, 72.5%, 88.83% respectively. Remission of obesity related diseases was as followed: hypertension in 8 patients (80%, p < 0.05), type II diabetes in 6 patients (100%, p < 0.05), pre-diabetes in 4 patients (50%, p = 0.13). Complications occurred in 4 cases: hematemesis, dysphagia, diarrhea, short bowel syndrome. A patient who developed symptoms of short bowel syndrome was reoperated on and gastrointestinal anastomosis was disconnected. Postoperatively, unwanted symptoms resolved and a good bariatric effect was preserved. Conclusions Our first experience is consistent with that reported in previous studies: very good EWL and a rapid resolution of obesity related diseases after SASI bypass as well as safety of the procedure.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"365 - 371"},"PeriodicalIF":1.7,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45003204","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 : 2022-03-16DOI: 10.5114/wiitm.2022.114539
Gan Chen, Min Li, Bao-qiang Cao, Qing Xu, Zhigong Zhang
Introduction In some cases, laparoscopic cholecystectomy (LC) may be very difficult and easily converted to laparotomy, causing many complications to patients and prolonging the prognosis time. Thus, to evaluate the difficulty of LC before operation is extremely important. Aim To explore the risk factors of difficult cholecystectomy (DC) and to establish a risk prediction model of DC. Material and methods The data of 201patients who underwent cholecystectomy from 1 January 2018 to 10 November 2019 were analysed retrospectively. The highest quartile (P75) of cholecystectomy operation time was used as a cutting point of DC (≥ P75) and NLC (< P75). Logistic regression was used to analyse the influencing factors of DC, and its risk model was constructed for prediction. Results Multivariate logistic regression analysis showed that body mass index (BMI) > 25 kg/m2, white blood cell (WBC) > 10 × 109/l, calculus incarcerated in neck of gallbladder, frequency of acute cholecystitis in the last 2 months > 4 times, thickness of gallbladder wall > 0.5 cm, and maximum diameter of gallstone > 2 cm were independent risk factors for DC. The prediction efficiency of the logistic regression equation was 0.879 (χ2 = 1.457, p > 0.05). Conclusions Based on analysis of risk factors, a logistic risk prediction model for difficult cholecystectomy was established. This model can be used to predict the difficulty of cholecystectomy.
{"title":"Risk prediction models for difficult cholecystectomy","authors":"Gan Chen, Min Li, Bao-qiang Cao, Qing Xu, Zhigong Zhang","doi":"10.5114/wiitm.2022.114539","DOIUrl":"https://doi.org/10.5114/wiitm.2022.114539","url":null,"abstract":"Introduction In some cases, laparoscopic cholecystectomy (LC) may be very difficult and easily converted to laparotomy, causing many complications to patients and prolonging the prognosis time. Thus, to evaluate the difficulty of LC before operation is extremely important. Aim To explore the risk factors of difficult cholecystectomy (DC) and to establish a risk prediction model of DC. Material and methods The data of 201patients who underwent cholecystectomy from 1 January 2018 to 10 November 2019 were analysed retrospectively. The highest quartile (P75) of cholecystectomy operation time was used as a cutting point of DC (≥ P75) and NLC (< P75). Logistic regression was used to analyse the influencing factors of DC, and its risk model was constructed for prediction. Results Multivariate logistic regression analysis showed that body mass index (BMI) > 25 kg/m2, white blood cell (WBC) > 10 × 109/l, calculus incarcerated in neck of gallbladder, frequency of acute cholecystitis in the last 2 months > 4 times, thickness of gallbladder wall > 0.5 cm, and maximum diameter of gallstone > 2 cm were independent risk factors for DC. The prediction efficiency of the logistic regression equation was 0.879 (χ2 = 1.457, p > 0.05). Conclusions Based on analysis of risk factors, a logistic risk prediction model for difficult cholecystectomy was established. This model can be used to predict the difficulty of cholecystectomy.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"303 - 308"},"PeriodicalIF":1.7,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44069716","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 : 2022-03-16DOI: 10.5114/wiitm.2022.114525
P. Major, P. Zarzycki, Justyna Rymarowicz, M. Wysocki, Michał Łabul, H. R. Hady, Paulina Głuszyńska, P. Myśliwiec, Grzegorz Kowalski, M. Orłowski, J. Szeliga, Wojciech Kupczyk, W. Tarnowski, Paweł Lech, Natalia Dowgiałło-gornowicz, M. Proczko-Stepaniak, M. Walędziak, P. Szymanski, T. Stefura, M. Pędziwiatr
Introduction Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) – 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) – 289 (36.17%) patients and sleeve gastrectomy (SG) – 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common – 117 (14.64%) patients. Conclusions RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.
{"title":"Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS)","authors":"P. Major, P. Zarzycki, Justyna Rymarowicz, M. Wysocki, Michał Łabul, H. R. Hady, Paulina Głuszyńska, P. Myśliwiec, Grzegorz Kowalski, M. Orłowski, J. Szeliga, Wojciech Kupczyk, W. Tarnowski, Paweł Lech, Natalia Dowgiałło-gornowicz, M. Proczko-Stepaniak, M. Walędziak, P. Szymanski, T. Stefura, M. Pędziwiatr","doi":"10.5114/wiitm.2022.114525","DOIUrl":"https://doi.org/10.5114/wiitm.2022.114525","url":null,"abstract":"Introduction Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) – 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) – 289 (36.17%) patients and sleeve gastrectomy (SG) – 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common – 117 (14.64%) patients. Conclusions RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"372 - 379"},"PeriodicalIF":1.7,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43987506","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 : 2022-03-16DOI: 10.5114/wiitm.2022.114526
Yingjian Wang, T. Bao, Kunkun Li, Xiao-long Zhao, W. Guo
Introduction The prognostic value of high body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC) is still controversial. Aim To evaluate the impact of high BMI on postoperative complications and survival after minimally invasion esophagectomy (MIE) for ESCC patients. Material and methods Three hundred and fourteen consecutive ESCC patients were used to analyze the potential association between high BMI and postoperative complications and survival. Results Patients were divided into two groups. There was no significant difference between high and low BMI groups in terms of postoperative complications, including respiratory disease (p = 0.8362), pneumothorax (p = 0.6058), anastomotic leakage (p = 0.8678), chylothorax (p = 0.9062), cardiovascular disease (p = 0.5763), vocal cord paresis (p = 0.8349), wound infection (p = 0.5763) and perioperative death (p = 0.7179). Patients in the high BMI group had a longer operative time (p = 0.003) and more blood loss (p = 0.002) than in the low BMI group. There was no difference in number of retrieved lymph nodes between the two groups (p = 0.728). Patients could not benefit from high BMI in overall survival (OS) (p = 0.2459). High BMI was not an independent prognostic factor for survival (p = 0.1735, HR = 0.776 and 95% CI: 0.5386–1.1180). Conclusions High BMI is associated with prolonged operative time and increased blood loss in MIE. However, high BMI is not associated with postoperative complications and not an independent prognostic factor for survival in ESCC patients who undergo MIE.
{"title":"Does high body mass index influence the postoperative complications and long-term survival in patients with esophageal squamous cell carcinoma after minimally invasive esophagectomy?","authors":"Yingjian Wang, T. Bao, Kunkun Li, Xiao-long Zhao, W. Guo","doi":"10.5114/wiitm.2022.114526","DOIUrl":"https://doi.org/10.5114/wiitm.2022.114526","url":null,"abstract":"Introduction The prognostic value of high body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC) is still controversial. Aim To evaluate the impact of high BMI on postoperative complications and survival after minimally invasion esophagectomy (MIE) for ESCC patients. Material and methods Three hundred and fourteen consecutive ESCC patients were used to analyze the potential association between high BMI and postoperative complications and survival. Results Patients were divided into two groups. There was no significant difference between high and low BMI groups in terms of postoperative complications, including respiratory disease (p = 0.8362), pneumothorax (p = 0.6058), anastomotic leakage (p = 0.8678), chylothorax (p = 0.9062), cardiovascular disease (p = 0.5763), vocal cord paresis (p = 0.8349), wound infection (p = 0.5763) and perioperative death (p = 0.7179). Patients in the high BMI group had a longer operative time (p = 0.003) and more blood loss (p = 0.002) than in the low BMI group. There was no difference in number of retrieved lymph nodes between the two groups (p = 0.728). Patients could not benefit from high BMI in overall survival (OS) (p = 0.2459). High BMI was not an independent prognostic factor for survival (p = 0.1735, HR = 0.776 and 95% CI: 0.5386–1.1180). Conclusions High BMI is associated with prolonged operative time and increased blood loss in MIE. However, high BMI is not associated with postoperative complications and not an independent prognostic factor for survival in ESCC patients who undergo MIE.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"317 - 325"},"PeriodicalIF":1.7,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49615390","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 : 2022-03-16DOI: 10.5114/wiitm.2022.114538
Cao Yan, Zeyuan Qiang, S. Jin, Haibo Yu
Introduction Laparoscopy splenectomy has been a preferred choice over open surgery, but limited studies dealing with laparoscopy splenectomy plus pericardial devascularization (LSPD) for elderly patients are available. Aim To assess the safety and long-term efficacy of spleen bed LSPD for elderly patients with portal hypertension. Material and methods A total of 132 elderly patients (age > 60 years) suffering from portal hypertension were operated on in the department. The patients were divided into 2 groups: those undergoing LSPD, and those undergoing open splenectomy plus pericardial devascularization (OSPD). Results and outcomes were compared retrospectively. Results The clinical characteristics of the patients belonging to the two groups were studied. No significant difference between the characteristics of patients was reported and the clinical data revealed similarities in their characteristics. There was no significant difference in time taken for performing the operation (p > 0.05). The LSPD group showed less blood loss; started oral intake early; and the duration of post-operative hospital stay was also shorter (p < 0.05). Incidence rates of portal vein thrombosis; pancreatic leakage; pleural effusion; pulmonary infection; and delayed wound healing were also found to be lower in the LSPD group as compared to the OSPD group (p < 0.05). During a follow-up period of 6–70 months, no significant differences were found in the data for the two methods with respect to the incidence of rebleeding; hepatic encephalopathy; and survival (p > 0.05). Conclusions It was concluded that spleen bed LSPD is a safe and feasible procedure for treating elderly patients. It had a better clinical effect than that of OSPD.
{"title":"Spleen bed laparoscopic splenectomy plus pericardial devascularization for elderly patients with portal hypertension","authors":"Cao Yan, Zeyuan Qiang, S. Jin, Haibo Yu","doi":"10.5114/wiitm.2022.114538","DOIUrl":"https://doi.org/10.5114/wiitm.2022.114538","url":null,"abstract":"Introduction Laparoscopy splenectomy has been a preferred choice over open surgery, but limited studies dealing with laparoscopy splenectomy plus pericardial devascularization (LSPD) for elderly patients are available. Aim To assess the safety and long-term efficacy of spleen bed LSPD for elderly patients with portal hypertension. Material and methods A total of 132 elderly patients (age > 60 years) suffering from portal hypertension were operated on in the department. The patients were divided into 2 groups: those undergoing LSPD, and those undergoing open splenectomy plus pericardial devascularization (OSPD). Results and outcomes were compared retrospectively. Results The clinical characteristics of the patients belonging to the two groups were studied. No significant difference between the characteristics of patients was reported and the clinical data revealed similarities in their characteristics. There was no significant difference in time taken for performing the operation (p > 0.05). The LSPD group showed less blood loss; started oral intake early; and the duration of post-operative hospital stay was also shorter (p < 0.05). Incidence rates of portal vein thrombosis; pancreatic leakage; pleural effusion; pulmonary infection; and delayed wound healing were also found to be lower in the LSPD group as compared to the OSPD group (p < 0.05). During a follow-up period of 6–70 months, no significant differences were found in the data for the two methods with respect to the incidence of rebleeding; hepatic encephalopathy; and survival (p > 0.05). Conclusions It was concluded that spleen bed LSPD is a safe and feasible procedure for treating elderly patients. It had a better clinical effect than that of OSPD.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"338 - 343"},"PeriodicalIF":1.7,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48673083","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 : 2022-02-18DOI: 10.5114/wiitm.2022.113567
Jianlu Zhang, Weiqing Li, Y. Li, Buhe Amin, Nengwei Zhang, Zhipeng Sun, Bin Zhu
Introduction To date, long-term safety including functional outcomes of transanal natural orifice specimen extraction surgery (NOSES) for colorectal cancer resection has not been confirmed. Aim To explore the short- and long-term outcomes as well as anal function of transanal NOSES versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection. Material and methods A retrospective review of data from a prospectively maintained database was performed to analyze the data of 69 patients who underwent transanal NOSES for sigmoid colon or rectal cancer resections and another 69 matched patients who underwent conventional laparoscopic (CL) surgery. Anal function of patients was evaluated using the Wexner fecal incontinence scale postoperatively. Results Transanal NOSES resulted in faster recovery of intestinal function, shorter postoperative length of stay, less incisional pain, fewer postoperative complications and shorter scars than CL surgery (p < 0.05). The two groups had similar overall survival (p = 0.863) and disease-free survival (p = 0.961). Wexner scores of the NOSES group at 1, 3 and 6 months after surgery were higher than in the CL group (p < 0.05), and there was no difference between the two groups at 12, 18 and 24 months after surgery. Conclusions Transanal NOSES achieves similar survival outcomes to CL surgery. Transanal NOSES has the advantages of faster recovery, shorter postoperative hospital stay, less incisional pain, shorter scars, etc. However, transanal NOSES can indeed impair anal function, needing more attention.
{"title":"Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up","authors":"Jianlu Zhang, Weiqing Li, Y. Li, Buhe Amin, Nengwei Zhang, Zhipeng Sun, Bin Zhu","doi":"10.5114/wiitm.2022.113567","DOIUrl":"https://doi.org/10.5114/wiitm.2022.113567","url":null,"abstract":"Introduction To date, long-term safety including functional outcomes of transanal natural orifice specimen extraction surgery (NOSES) for colorectal cancer resection has not been confirmed. Aim To explore the short- and long-term outcomes as well as anal function of transanal NOSES versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection. Material and methods A retrospective review of data from a prospectively maintained database was performed to analyze the data of 69 patients who underwent transanal NOSES for sigmoid colon or rectal cancer resections and another 69 matched patients who underwent conventional laparoscopic (CL) surgery. Anal function of patients was evaluated using the Wexner fecal incontinence scale postoperatively. Results Transanal NOSES resulted in faster recovery of intestinal function, shorter postoperative length of stay, less incisional pain, fewer postoperative complications and shorter scars than CL surgery (p < 0.05). The two groups had similar overall survival (p = 0.863) and disease-free survival (p = 0.961). Wexner scores of the NOSES group at 1, 3 and 6 months after surgery were higher than in the CL group (p < 0.05), and there was no difference between the two groups at 12, 18 and 24 months after surgery. Conclusions Transanal NOSES achieves similar survival outcomes to CL surgery. Transanal NOSES has the advantages of faster recovery, shorter postoperative hospital stay, less incisional pain, shorter scars, etc. However, transanal NOSES can indeed impair anal function, needing more attention.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"344 - 351"},"PeriodicalIF":1.7,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46331896","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 : 2022-02-18DOI: 10.5114/wiitm.2022.113568
X. Qiu, C. Zheng, Yantao Liang, Long-Zhi Zheng, Bin Zu, Hanmin Chen, Zhi-yong Dong, Li-Mei Zhu, Wei Lin
Introduction With the development of minimally invasive surgery in recent years, totally laparoscopic total gastrectomy (TLTG) has attracted more attention. Aim To introduce the more comprehensive “enjoyable space” approach coupled with the self-pulling and latter transaction (SPLT) reconstruction technique to perform TLTG and investigate its safety and feasibility. Material and methods Ninety-seven patients with primary upper gastric cancer underwent laparoscopic radical total gastrectomy between January 2020 and December 2020. Among these patients, 46 underwent laparoscopic-assisted total gastrectomy (LATG), and 51 underwent TLTG. We compared the clinicopathological characteristics, surgical outcomes and postoperative complications between the two groups. Results There were no significant differences in the clinicopathological characteristics between the two groups (p > 0.05). However, the TLTG group had a slightly lower mean operative time and mean blood loss than the LATG group (p < 0.05 each). Although there were similarities in the mean times to first flatus, liquid diet, and soft diet, the duration of hospital stay was significantly reduced in the TLTG group (p < 0.05). No significant differences in overall complications and E-J-related complications were found between the two groups (15.2% vs. 25.4%, p > 0.05). Conclusions TLTG is a safe and feasible procedure for treating upper gastric cancer. The enjoyable space approach in conjunction with SPLT reconstruction is an appropriate comprehensive technique with several advantages over LATG.
随着近年来微创外科技术的发展，全腹腔镜全胃切除术(TLTG)越来越受到人们的关注。目的介绍更全面的“享受空间”方法结合自拉后交易(SPLT)重建技术进行TLTG，并探讨其安全性和可行性。材料与方法2020年1月至12月，97例原发性上胃癌患者行腹腔镜根治性全胃切除术。其中46例行腹腔镜辅助全胃切除术(LATG)， 51例行tlg。比较两组患者的临床病理特点、手术结果及术后并发症。结果两组患者的临床病理特征比较差异无统计学意义(p < 0.05)。tlg组平均手术时间和平均出血量均低于LATG组(p < 0.05)。虽然在首次胀气、流食和软食的平均时间上有相似之处，但tlg组的住院时间明显缩短(p < 0.05)。两组患者总并发症及e - j相关并发症发生率差异无统计学意义(15.2% vs. 25.4%， p < 0.05)。结论TLTG是一种安全可行的治疗上胃癌的手术方法。与SPLT重建相结合的令人愉快的空间方法是一种适当的综合技术，与LATG相比具有几个优势。
{"title":"Totally laparoscopic total gastrectomy using the “enjoyable space” approach coupled with self-pulling and latter transection reconstruction versus laparoscopic-assisted total gastrectomy for upper gastric cancer: short-term outcomes","authors":"X. Qiu, C. Zheng, Yantao Liang, Long-Zhi Zheng, Bin Zu, Hanmin Chen, Zhi-yong Dong, Li-Mei Zhu, Wei Lin","doi":"10.5114/wiitm.2022.113568","DOIUrl":"https://doi.org/10.5114/wiitm.2022.113568","url":null,"abstract":"Introduction With the development of minimally invasive surgery in recent years, totally laparoscopic total gastrectomy (TLTG) has attracted more attention. Aim To introduce the more comprehensive “enjoyable space” approach coupled with the self-pulling and latter transaction (SPLT) reconstruction technique to perform TLTG and investigate its safety and feasibility. Material and methods Ninety-seven patients with primary upper gastric cancer underwent laparoscopic radical total gastrectomy between January 2020 and December 2020. Among these patients, 46 underwent laparoscopic-assisted total gastrectomy (LATG), and 51 underwent TLTG. We compared the clinicopathological characteristics, surgical outcomes and postoperative complications between the two groups. Results There were no significant differences in the clinicopathological characteristics between the two groups (p > 0.05). However, the TLTG group had a slightly lower mean operative time and mean blood loss than the LATG group (p < 0.05 each). Although there were similarities in the mean times to first flatus, liquid diet, and soft diet, the duration of hospital stay was significantly reduced in the TLTG group (p < 0.05). No significant differences in overall complications and E-J-related complications were found between the two groups (15.2% vs. 25.4%, p > 0.05). Conclusions TLTG is a safe and feasible procedure for treating upper gastric cancer. The enjoyable space approach in conjunction with SPLT reconstruction is an appropriate comprehensive technique with several advantages over LATG.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"352 - 364"},"PeriodicalIF":1.7,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43567389","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 : 2022-02-17DOI: 10.5114/wiitm.2022.113565
E. Piriyev, S. Schiermeier, T. Römer
Introduction The advantage of transcervical radiofrequency ablation (TRFA) is that it is minimally invasive, incision-free, and treats a wide spectrum of fibroids, including those that are not accessible by surgical hysteroscopy (FIGO 3, 4, 5, 6, and 2-5). However, there are no publications describing a combined procedure of operative hysteroscopy and TRFA yet, so it was still unknown whether a combined procedure is associated with additional risks. Aim To report the combined technique of transcervical intrauterine radiofrequency ablation of fibroids and surgical hysteroscopy. Material and methods Our study was designed to show the results of our case series with 21 patients. The retrospective study included only patients who were treated with the combined procedure of surgical hysteroscopy with fibroid and/or endometrial resection and fibroid ablation using the Sonata System. Results The combined procedure was performed without any complications in all cases. Two days after surgery, no increased morbidity was observed compared to only conventional surgical hysteroscopy and/or therapy with the TRFA. All patients were satisfied with the procedure. No late complications were observed within the first 6 months postoperatively. Seventeen patients with bleeding symptoms were asked about their subjective assessment of improvement. Fifteen patients reported significant improvement in symptoms and 1 patient reported only minimal improvement. Only 1 patient, who underwent TRFA and endometrial resection, did not report any improvement. No increase in symptoms was observed. Conclusions Although TRFA is an approved method, it is not yet widely used worldwide. The combined procedure has been rarely used. The aim of our work is to show through our case series that transcervical radiofrequency ablation can be combined with surgical hysteroscopy for fibroid and/or endometrial resection without any additional risk.
{"title":"Combined procedure of the transcervical radiofrequency ablation (TRFA) system and surgical hysteroscopy. Increased risk or safe procedure?","authors":"E. Piriyev, S. Schiermeier, T. Römer","doi":"10.5114/wiitm.2022.113565","DOIUrl":"https://doi.org/10.5114/wiitm.2022.113565","url":null,"abstract":"Introduction The advantage of transcervical radiofrequency ablation (TRFA) is that it is minimally invasive, incision-free, and treats a wide spectrum of fibroids, including those that are not accessible by surgical hysteroscopy (FIGO 3, 4, 5, 6, and 2-5). However, there are no publications describing a combined procedure of operative hysteroscopy and TRFA yet, so it was still unknown whether a combined procedure is associated with additional risks. Aim To report the combined technique of transcervical intrauterine radiofrequency ablation of fibroids and surgical hysteroscopy. Material and methods Our study was designed to show the results of our case series with 21 patients. The retrospective study included only patients who were treated with the combined procedure of surgical hysteroscopy with fibroid and/or endometrial resection and fibroid ablation using the Sonata System. Results The combined procedure was performed without any complications in all cases. Two days after surgery, no increased morbidity was observed compared to only conventional surgical hysteroscopy and/or therapy with the TRFA. All patients were satisfied with the procedure. No late complications were observed within the first 6 months postoperatively. Seventeen patients with bleeding symptoms were asked about their subjective assessment of improvement. Fifteen patients reported significant improvement in symptoms and 1 patient reported only minimal improvement. Only 1 patient, who underwent TRFA and endometrial resection, did not report any improvement. No increase in symptoms was observed. Conclusions Although TRFA is an approved method, it is not yet widely used worldwide. The combined procedure has been rarely used. The aim of our work is to show through our case series that transcervical radiofrequency ablation can be combined with surgical hysteroscopy for fibroid and/or endometrial resection without any additional risk.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"380 - 384"},"PeriodicalIF":1.7,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44736857","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 : 2022-01-19DOI: 10.5114/wiitm.2021.112680
Dong Wang, Zhang Zhang, R. Dong, Jianguo Lu, Jikai Yin
Introduction Laparoscopic splenectomy and esophagogastric devascularization (LSED) is becoming increasingly popular in the treatment of esophageal-fundic variceal bleeding with portal hypertension (PHT) in China, and its high safety and minimal trauma have been proven. Fast-track (FT) surgery improves patient recovery and decreases postoperative complications. Aim To determine whether LSED with fast-track principles can provide better outcomes than traditional treatment for patients with PHT. Material and methods A total of 140 patients who underwent LSED with either traditional treatment or fast-track principles in our department were retrospectively analyzed. The postoperative outcomes, complications, inflammatory mediators, portal vein thrombosis (PVT) and recurrent esophagogastric variceal bleeding rate were recorded. Results No significant differences were found in the patients’ preoperative characteristics. The FT group had better outcomes than the non-FT group with respect to gastrointestinal function recovery, resumption of oral intake, and postoperative hospitalization. The incidence of postoperative complications, including pneumonia, severe ascites, and urinary tract infection, were significantly lower in the FT than the non-FT group. The C-reactive protein and interleukin 6 concentrations and the incidence of PVT were significantly lower in the FT than the non-FT group. The overall recurrent bleeding rate is 11.5% and no significant difference was found between the two groups in the follow-up period. Conclusions LSED with fast-track principles was superior to LSED with traditional treatment in terms of postoperative outcomes, complications, postoperative inflammatory reactions, and the incidence of PVT. This strategy is safe and effective for the treatment of PHT.
{"title":"Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension","authors":"Dong Wang, Zhang Zhang, R. Dong, Jianguo Lu, Jikai Yin","doi":"10.5114/wiitm.2021.112680","DOIUrl":"https://doi.org/10.5114/wiitm.2021.112680","url":null,"abstract":"Introduction Laparoscopic splenectomy and esophagogastric devascularization (LSED) is becoming increasingly popular in the treatment of esophageal-fundic variceal bleeding with portal hypertension (PHT) in China, and its high safety and minimal trauma have been proven. Fast-track (FT) surgery improves patient recovery and decreases postoperative complications. Aim To determine whether LSED with fast-track principles can provide better outcomes than traditional treatment for patients with PHT. Material and methods A total of 140 patients who underwent LSED with either traditional treatment or fast-track principles in our department were retrospectively analyzed. The postoperative outcomes, complications, inflammatory mediators, portal vein thrombosis (PVT) and recurrent esophagogastric variceal bleeding rate were recorded. Results No significant differences were found in the patients’ preoperative characteristics. The FT group had better outcomes than the non-FT group with respect to gastrointestinal function recovery, resumption of oral intake, and postoperative hospitalization. The incidence of postoperative complications, including pneumonia, severe ascites, and urinary tract infection, were significantly lower in the FT than the non-FT group. The C-reactive protein and interleukin 6 concentrations and the incidence of PVT were significantly lower in the FT than the non-FT group. The overall recurrent bleeding rate is 11.5% and no significant difference was found between the two groups in the follow-up period. Conclusions LSED with fast-track principles was superior to LSED with traditional treatment in terms of postoperative outcomes, complications, postoperative inflammatory reactions, and the incidence of PVT. This strategy is safe and effective for the treatment of PHT.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"326 - 337"},"PeriodicalIF":1.7,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49197346","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 : 2022-01-19DOI: 10.5114/wiitm.2021.112679
Yingjian Wang, Xiao-long Zhao, Kunkun Li, Xue-Hai Liu, T. Bao, W. Guo
Introduction Lymphovascular invasion (LVI) is reported to be a potential prognostic predictor in esophageal squamous cell carcinoma (ESCC) patients. Aim To investigate the prognostic value of LVI in ESCC node-negative patients after minimally invasive esophagectomy (MIE). Material and methods 1406 consecutive ESCC patients who underwent MIE were reviewed retrospectively. After exclusion, 880 patients were enrolled, and 298 node-negative patients were used for the further analysis. The Kaplan-Meier method was used to examine the survival difference. Univariate and multivariate analyses were performed to identify prognostic predictors. Results LVI was observed in 29.4% of all patients. Totally, the proportion of LVI was increased with advanced T (p < 0.01) and N (p < 0.01) stage and poor tumor differentiation (p < 0.01). In the node-negative patients, a similar result was obtained in T stage (p = 0.0252) and tumor differentiation (p = 0.0080). In survival analysis, the disease-specific survival (DSS) (p = 0.0146) rate was significantly lower in node-negative patients with LVI than in those without. The difference was absent when calculating disease-free survival (DFS) (p = 0.0796). Additionally, the presence of LVI was associated with lower DSS (p = 0.0187) but not DFS (p = 0.0785) in univariate analysis in node-negative patients. Moreover, in multivariate Cox regression analysis, the presence of LVI was identified as an independent prognostic factor only in DSS (p = 0.0496) but not in DFS (p = 0.5670) in node-negative patients. Conclusions LVI is associated with shorter DSS and an independent prognostic factor in ESCC node-negative patients after MIE.
{"title":"Lymphovascular invasion predicts disease-specific survival in node-negative esophageal squamous cell carcinoma patients after minimally invasive esophagectomy","authors":"Yingjian Wang, Xiao-long Zhao, Kunkun Li, Xue-Hai Liu, T. Bao, W. Guo","doi":"10.5114/wiitm.2021.112679","DOIUrl":"https://doi.org/10.5114/wiitm.2021.112679","url":null,"abstract":"Introduction Lymphovascular invasion (LVI) is reported to be a potential prognostic predictor in esophageal squamous cell carcinoma (ESCC) patients. Aim To investigate the prognostic value of LVI in ESCC node-negative patients after minimally invasive esophagectomy (MIE). Material and methods 1406 consecutive ESCC patients who underwent MIE were reviewed retrospectively. After exclusion, 880 patients were enrolled, and 298 node-negative patients were used for the further analysis. The Kaplan-Meier method was used to examine the survival difference. Univariate and multivariate analyses were performed to identify prognostic predictors. Results LVI was observed in 29.4% of all patients. Totally, the proportion of LVI was increased with advanced T (p < 0.01) and N (p < 0.01) stage and poor tumor differentiation (p < 0.01). In the node-negative patients, a similar result was obtained in T stage (p = 0.0252) and tumor differentiation (p = 0.0080). In survival analysis, the disease-specific survival (DSS) (p = 0.0146) rate was significantly lower in node-negative patients with LVI than in those without. The difference was absent when calculating disease-free survival (DFS) (p = 0.0796). Additionally, the presence of LVI was associated with lower DSS (p = 0.0187) but not DFS (p = 0.0785) in univariate analysis in node-negative patients. Moreover, in multivariate Cox regression analysis, the presence of LVI was identified as an independent prognostic factor only in DSS (p = 0.0496) but not in DFS (p = 0.5670) in node-negative patients. Conclusions LVI is associated with shorter DSS and an independent prognostic factor in ESCC node-negative patients after MIE.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"309 - 316"},"PeriodicalIF":1.7,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49417855","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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