Pub Date : 2022-01-18DOI: 10.5114/wiitm.2021.112678
S. Bae, Woon Jegon, S. Baek
Introduction Recently, single plus one-port robotic surgery (SPORS) was introduced to overcome the limitations of single-port laparoscopic surgery for the treatment of various diseases. Aim To compare the clinical and cosmetic outcomes of SPORS with those of multi-port laparoscopic surgery (MPLS), which is presently the standard surgical treatment for colon cancer. Material and methods The study included 36 patients who underwent SPORS and 61 patients who underwent MPLS for left-sided colon cancer between August 2014 and January 2016. The Patient Scar Assessment Questionnaire (PSAQ) was used to assess cosmetic outcomes. Results SPORS involved a longer median operative time than MPLS (232 vs. 155 min, p = 0.009). There were no apparent differences in the time before diet tolerance, length of hospital stay, postoperative pain score, and postoperative complication rate. However, SPORS patients had a shorter total incision length (5.0 vs. 8.0 cm, p < 0.001). The median proximal and distal resection margins and the median number of harvested lymph nodes were comparable between the two groups. The PSAQ favored the SPORS approach, revealing significant differences in appearance (15 vs. 18, p < 0.001), consciousness (9 vs. 11, p < 0.001), satisfaction with appearance (14 vs. 17, p < 0.001), satisfaction with symptoms (9 vs. 10, p = 0.022), and overall score (47 vs. 55, p < 0.001). Conclusions The clinicopathologic outcomes of SPORS were comparable but its cosmetic outcomes were superior to those of MPLS for left-sided colon cancer.
{"title":"Single plus one-port robotic surgery using the da Vinci Single-Site Platform versus conventional multi-port laparoscopic surgery for left-sided colon cancer","authors":"S. Bae, Woon Jegon, S. Baek","doi":"10.5114/wiitm.2021.112678","DOIUrl":"https://doi.org/10.5114/wiitm.2021.112678","url":null,"abstract":"Introduction Recently, single plus one-port robotic surgery (SPORS) was introduced to overcome the limitations of single-port laparoscopic surgery for the treatment of various diseases. Aim To compare the clinical and cosmetic outcomes of SPORS with those of multi-port laparoscopic surgery (MPLS), which is presently the standard surgical treatment for colon cancer. Material and methods The study included 36 patients who underwent SPORS and 61 patients who underwent MPLS for left-sided colon cancer between August 2014 and January 2016. The Patient Scar Assessment Questionnaire (PSAQ) was used to assess cosmetic outcomes. Results SPORS involved a longer median operative time than MPLS (232 vs. 155 min, p = 0.009). There were no apparent differences in the time before diet tolerance, length of hospital stay, postoperative pain score, and postoperative complication rate. However, SPORS patients had a shorter total incision length (5.0 vs. 8.0 cm, p < 0.001). The median proximal and distal resection margins and the median number of harvested lymph nodes were comparable between the two groups. The PSAQ favored the SPORS approach, revealing significant differences in appearance (15 vs. 18, p < 0.001), consciousness (9 vs. 11, p < 0.001), satisfaction with appearance (14 vs. 17, p < 0.001), satisfaction with symptoms (9 vs. 10, p = 0.022), and overall score (47 vs. 55, p < 0.001). Conclusions The clinicopathologic outcomes of SPORS were comparable but its cosmetic outcomes were superior to those of MPLS for left-sided colon cancer.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"179 - 187"},"PeriodicalIF":1.7,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41496076","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 : 2022-01-09DOI: 10.5114/wiitm.2021.112479
Lihua Shi, Li Cai, Fen Wan, Yali Jiang, Rupshikha Choudhury, S. Rastogi
Introduction Surgical site infections (SSIs) occur after an operative procedure and can range from superficial to deep wound infections. The World Health Organization (WHO) and the Centers for Disease Control (CDC) have proposed guidelines recommending measures to prevent SSIs. Intraoperative measures are largely focused on decontamination of the skin and intraoperative wound irrigation using soap and antiseptics and are simple, efficient, and cost-effective measures to reduce SSIs. Povidone-iodine (PVI) is a topical antiseptic widely used for the reduction of SSIs. Aim A meta-analysis was conducted to determine the efficacy of preoperative or intraoperative use of PVI from randomized controlled trials (RCTs). Material and methods A systematic literature review was conducted using MEDLINE and Central databases for RCTs that involved PVI application versus saline or no treatment control groups across various surgical categories. The primary outcome was SSI or post-operative wound infections. A random-effects model was used to calculate the pooled risk ratio and subgroup analyses were performed. Results A total of 59 RCTs were included in the meta-analysis with information from 20,497 patients. A reduction in overall SSI incidence was found (RR = 0.70, 0.60–0.80, p = 0.0002, I2 = 44%). Subgroup analyses showed that the comparator treatment and type of procedure did not modify the effect of PVI on SSI incidence. However, inconsistent results on SSI incidence were obtained when the data were stratified by PVI application method and surgery category. Conclusions The results of the meta-analysis provide support for the preoperative or intraoperative use of PVI in decreasing the incidence of SSI.
{"title":"Does povidone-iodine application in surgical procedures help in the prevention of surgical site infections? An updated meta-analysis","authors":"Lihua Shi, Li Cai, Fen Wan, Yali Jiang, Rupshikha Choudhury, S. Rastogi","doi":"10.5114/wiitm.2021.112479","DOIUrl":"https://doi.org/10.5114/wiitm.2021.112479","url":null,"abstract":"Introduction Surgical site infections (SSIs) occur after an operative procedure and can range from superficial to deep wound infections. The World Health Organization (WHO) and the Centers for Disease Control (CDC) have proposed guidelines recommending measures to prevent SSIs. Intraoperative measures are largely focused on decontamination of the skin and intraoperative wound irrigation using soap and antiseptics and are simple, efficient, and cost-effective measures to reduce SSIs. Povidone-iodine (PVI) is a topical antiseptic widely used for the reduction of SSIs. Aim A meta-analysis was conducted to determine the efficacy of preoperative or intraoperative use of PVI from randomized controlled trials (RCTs). Material and methods A systematic literature review was conducted using MEDLINE and Central databases for RCTs that involved PVI application versus saline or no treatment control groups across various surgical categories. The primary outcome was SSI or post-operative wound infections. A random-effects model was used to calculate the pooled risk ratio and subgroup analyses were performed. Results A total of 59 RCTs were included in the meta-analysis with information from 20,497 patients. A reduction in overall SSI incidence was found (RR = 0.70, 0.60–0.80, p = 0.0002, I2 = 44%). Subgroup analyses showed that the comparator treatment and type of procedure did not modify the effect of PVI on SSI incidence. However, inconsistent results on SSI incidence were obtained when the data were stratified by PVI application method and surgery category. Conclusions The results of the meta-analysis provide support for the preoperative or intraoperative use of PVI in decreasing the incidence of SSI.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"261 - 278"},"PeriodicalIF":1.7,"publicationDate":"2022-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48869956","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 : 2021-11-01DOI: 10.5114/wiitm.2021.110411
Kamil Nurczyk, Chia-En Chan, T. Skoczylas, G. Wallner
Over the years, the rise in the obesity epidemic has led to an increasing demand for bariatric surgery. Considering the rapidly growing number of bariatric surgery procedures performed, intensive development of postoperative care and surveillance programs should be expected. However, the effectiveness of follow-up after bariatric surgery appears to be surprisingly low. The purpose of this review is to draw attention to the quality of follow-up programs and to encourage health care providers to make efforts to ensure adequate post-operative data collection. Awareness should be raised about inadequate data collection to strengthen the credibility and authenticity of treatment results, thus providing a clearer picture of treatment efficacy.
{"title":"Follow-up after bariatric surgery: are we effective enough?","authors":"Kamil Nurczyk, Chia-En Chan, T. Skoczylas, G. Wallner","doi":"10.5114/wiitm.2021.110411","DOIUrl":"https://doi.org/10.5114/wiitm.2021.110411","url":null,"abstract":"Over the years, the rise in the obesity epidemic has led to an increasing demand for bariatric surgery. Considering the rapidly growing number of bariatric surgery procedures performed, intensive development of postoperative care and surveillance programs should be expected. However, the effectiveness of follow-up after bariatric surgery appears to be surprisingly low. The purpose of this review is to draw attention to the quality of follow-up programs and to encourage health care providers to make efforts to ensure adequate post-operative data collection. Awareness should be raised about inadequate data collection to strengthen the credibility and authenticity of treatment results, thus providing a clearer picture of treatment efficacy.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"299 - 302"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44905938","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 : 2021-11-01DOI: 10.5114/wiitm.2021.110413
Xue-Ni Xie, Guoqiang Zhang, Ning Liu
Introduction Currently, unilateral biportal endoscopy (UBE) as a new minimally invasive technique has been applied to conventional arthroscopic systems for the treatment of spinal disease. Aim To analyze the clinical effect of UBE in the treatment of lumbar diseases. Material and methods A systematic review of the literature published up to May 2021 was performed in the English database PubMed, Embase, and the Chinese database CNKI, Wanfang. There were 9 studies included in this systematic review and meta-analysis. The outcomes measured included operative time, Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). Results A total of 528 patients were collected from the selected 9 articles. The random effects model showed that the value of pooled effect mean deviation (MD) in each study was 58.62 (95% CI (57.53, 59.72), p < 0.001). At the end of postoperative follow-up, the standard mean difference (SMD) VAS scores of legs –4.12 (95% CI (–5.15, –3.09), p < 0.001) and back -3.10 (95% CI (–4.35, –1.84), p < 0.001) were lower than the preoperative values. At the same time, the results of the random-effects model showed that the SMD of the ODI score was –7.07 (95% CI (–8.69, –5.46), p < 0.001) and at the end of follow-up was lower than preoperatively. Conclusions UBE surgery has a good clinical effect in the treatment of lumbar diseases, and can be widely used in the treatment of free prolapse lumbar disc herniation (LDH).
{"title":"Clinical effect of unilateral biportal endoscopy in the treatment of lumbar diseases: a systematic review and meta-analysis","authors":"Xue-Ni Xie, Guoqiang Zhang, Ning Liu","doi":"10.5114/wiitm.2021.110413","DOIUrl":"https://doi.org/10.5114/wiitm.2021.110413","url":null,"abstract":"Introduction Currently, unilateral biportal endoscopy (UBE) as a new minimally invasive technique has been applied to conventional arthroscopic systems for the treatment of spinal disease. Aim To analyze the clinical effect of UBE in the treatment of lumbar diseases. Material and methods A systematic review of the literature published up to May 2021 was performed in the English database PubMed, Embase, and the Chinese database CNKI, Wanfang. There were 9 studies included in this systematic review and meta-analysis. The outcomes measured included operative time, Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). Results A total of 528 patients were collected from the selected 9 articles. The random effects model showed that the value of pooled effect mean deviation (MD) in each study was 58.62 (95% CI (57.53, 59.72), p < 0.001). At the end of postoperative follow-up, the standard mean difference (SMD) VAS scores of legs –4.12 (95% CI (–5.15, –3.09), p < 0.001) and back -3.10 (95% CI (–4.35, –1.84), p < 0.001) were lower than the preoperative values. At the same time, the results of the random-effects model showed that the SMD of the ODI score was –7.07 (95% CI (–8.69, –5.46), p < 0.001) and at the end of follow-up was lower than preoperatively. Conclusions UBE surgery has a good clinical effect in the treatment of lumbar diseases, and can be widely used in the treatment of free prolapse lumbar disc herniation (LDH).","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"61 - 68"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45110006","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 : 2021-11-01DOI: 10.5114/wiitm.2021.110446
Jianghua Jia, Zhan Yang, Zhihai Teng, Zhenwei Han
Introduction Laparoendoscopic single-site adrenalectomy (LESSA) has the advantages of early recovery and better cosmetic appearance. However, there are still debates on the efficacy and safety of LESSA and conventional laparoscopic adrenalectomy (CLA). Aim To reevaluate the efficacy and safety of LESSA vs CLA for adrenal lesions. Material and methods A systematic literature research of PubMed, Ovid, Scopus (up to February 2021), and citation lists was performed to identify eligible studies. All studies comparing LESSA versus CLA were included. Data were analyzed using the RevMan 5.4 software. Results Overall, eighteen studies including 1307 patients (LESSA 520; CLA 787) were included. LESSA was associated with smaller mean tumor size (weighted mean difference (WMD) = 0.53 cm, 95% CI: –0.81 to –0.24; p < 0.001). The operative time for LESSA was longer than CLA (WMD = 13.86 min, 95% CI: 4.43 to 23.30; p = 0.004). LESSA had a better visual analog scale (VAS) score (WMD = –0.56, 95% CI: –1.01 to –0.11; p = 0.02), shorter return to diet time (WMD = –0.27 days, 95% CI: –0.52 to –0.03; p = 0.03), shorter length of hospital stay (WMD = –0.56 days, 95% CI: –1.01 to –0.11; p = 0.01), and comparable postoperative complications (OR = 0.98, 95% CI: 0.56 to 1.70; p = 0.93). The wound size of LESSA was definitely smaller (WMD = –2.72 cm, 95% CI: –3.50 to –1.94; p < 0.001). The subgroup analysis of studies via the transperitoneal approach showed reasonable results. Conclusions LESSA is significantly better in terms of postoperative pain, time to diet, length of hospital stay and wound size, but the operative time is significantly longer.
{"title":"Efficacy and safety of laparoendoscopic single-site adrenalectomy versus conventional laparoscopic adrenalectomy: an updated systematic review and meta-analysis","authors":"Jianghua Jia, Zhan Yang, Zhihai Teng, Zhenwei Han","doi":"10.5114/wiitm.2021.110446","DOIUrl":"https://doi.org/10.5114/wiitm.2021.110446","url":null,"abstract":"Introduction Laparoendoscopic single-site adrenalectomy (LESSA) has the advantages of early recovery and better cosmetic appearance. However, there are still debates on the efficacy and safety of LESSA and conventional laparoscopic adrenalectomy (CLA). Aim To reevaluate the efficacy and safety of LESSA vs CLA for adrenal lesions. Material and methods A systematic literature research of PubMed, Ovid, Scopus (up to February 2021), and citation lists was performed to identify eligible studies. All studies comparing LESSA versus CLA were included. Data were analyzed using the RevMan 5.4 software. Results Overall, eighteen studies including 1307 patients (LESSA 520; CLA 787) were included. LESSA was associated with smaller mean tumor size (weighted mean difference (WMD) = 0.53 cm, 95% CI: –0.81 to –0.24; p < 0.001). The operative time for LESSA was longer than CLA (WMD = 13.86 min, 95% CI: 4.43 to 23.30; p = 0.004). LESSA had a better visual analog scale (VAS) score (WMD = –0.56, 95% CI: –1.01 to –0.11; p = 0.02), shorter return to diet time (WMD = –0.27 days, 95% CI: –0.52 to –0.03; p = 0.03), shorter length of hospital stay (WMD = –0.56 days, 95% CI: –1.01 to –0.11; p = 0.01), and comparable postoperative complications (OR = 0.98, 95% CI: 0.56 to 1.70; p = 0.93). The wound size of LESSA was definitely smaller (WMD = –2.72 cm, 95% CI: –3.50 to –1.94; p < 0.001). The subgroup analysis of studies via the transperitoneal approach showed reasonable results. Conclusions LESSA is significantly better in terms of postoperative pain, time to diet, length of hospital stay and wound size, but the operative time is significantly longer.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"20 - 34"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46534095","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 Both side-by-side (SBS) and stent-in-stent (SIS) bilateral stenting have been used for patients with malignant hilar biliary obstruction (MHBO). However, it is unclear which technique is better. Aim This meta-analysis is conducted to investigate the clinical efficacy and safety of SBS and SIS bilateral stenting for patients with MHBO. Material and methods Relevant studies were searched in PubMed, Embase, Cochrane Library, Wanfang, VIP, and CINK databases. The timeline for the searches was from the establishment of the database to September 2021. The relative outcomes are pooled. Results A total of 7 studies fulfilled the inclusion criteria and entered into this meta-analysis. The pooled technical success rate was significant higher in the SIS group than that in the SBS group (p = 0.04). The pooled early complication rate was significantly lower in the SIS group than in the SBS group (p = 0.04). The pooled stent re-obstruction rate was significantly lower in the SBS group than in the SIS group (p = 0.04). The pooled stent patency duration was significantly longer in the SBS group than in the SIS group (p = 0.01). The pooled functional success rates (p = 0.79), total complication rates (p = 0.34), and overall survival duration (p = 0.27) were comparable between 2 groups. Egger test did not show any publication bias. Conclusions When comparing the SBS and SIS bilateral stenting for patients with MHBO, although SIS technique may have the superiorities of technical success and early complication rates, the longer stent patency was achieved by the SBS technique.
{"title":"Side-by-side versus stent-in-stent bilateral stenting for malignant hilar biliary obstruction: a meta-analysis","authors":"Liang Chen, Guo-Ming Gao, Dong-Lu Li, Zhong-Ke Chen","doi":"10.5114/wiitm.2021.112477","DOIUrl":"https://doi.org/10.5114/wiitm.2021.112477","url":null,"abstract":"Introduction Both side-by-side (SBS) and stent-in-stent (SIS) bilateral stenting have been used for patients with malignant hilar biliary obstruction (MHBO). However, it is unclear which technique is better. Aim This meta-analysis is conducted to investigate the clinical efficacy and safety of SBS and SIS bilateral stenting for patients with MHBO. Material and methods Relevant studies were searched in PubMed, Embase, Cochrane Library, Wanfang, VIP, and CINK databases. The timeline for the searches was from the establishment of the database to September 2021. The relative outcomes are pooled. Results A total of 7 studies fulfilled the inclusion criteria and entered into this meta-analysis. The pooled technical success rate was significant higher in the SIS group than that in the SBS group (p = 0.04). The pooled early complication rate was significantly lower in the SIS group than in the SBS group (p = 0.04). The pooled stent re-obstruction rate was significantly lower in the SBS group than in the SIS group (p = 0.04). The pooled stent patency duration was significantly longer in the SBS group than in the SIS group (p = 0.01). The pooled functional success rates (p = 0.79), total complication rates (p = 0.34), and overall survival duration (p = 0.27) were comparable between 2 groups. Egger test did not show any publication bias. Conclusions When comparing the SBS and SIS bilateral stenting for patients with MHBO, although SIS technique may have the superiorities of technical success and early complication rates, the longer stent patency was achieved by the SBS technique.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"279 - 288"},"PeriodicalIF":1.7,"publicationDate":"2021-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43722335","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 : 2021-09-01DOI: 10.5114/wiitm.2021.108811
X. Xue, G. Lin
Featuring some advantages of endoscopy and microsurgery, transanal endoscopic microsurgery (TEM) was first introduced in treating local early-stage rectal lesions in 1983. However, its applications to rectal surgery have remained virtually unchanged over the past 38 years. This review aims to describe some well-accepted indications for TEM and showcase other novel but successful applications. In this review, we conducted a thorough English literature review on the applications of transanal endoscopic microsurgery in the PubMed database. Published original articles, case reports, and letters from 1983 to 2020 were included. Retrieved articles were discussed and conclusions were made. The results showed that applications of TEM could be more flexible and extended, namely, TEM’s niche applications in advanced rectal cancer after neoadjuvant chemoradiotherapy, neuroendocrine tumor, gastrointestinal stromal tumor, fistula, solitary rectal ulcer syndrome, benign stricture, and transanal total mesorectal excision are promising, while prospective studies are needed.
{"title":"Transanal endoscopic microsurgery: exploring its indications and novel applications. A narrative review","authors":"X. Xue, G. Lin","doi":"10.5114/wiitm.2021.108811","DOIUrl":"https://doi.org/10.5114/wiitm.2021.108811","url":null,"abstract":"Featuring some advantages of endoscopy and microsurgery, transanal endoscopic microsurgery (TEM) was first introduced in treating local early-stage rectal lesions in 1983. However, its applications to rectal surgery have remained virtually unchanged over the past 38 years. This review aims to describe some well-accepted indications for TEM and showcase other novel but successful applications. In this review, we conducted a thorough English literature review on the applications of transanal endoscopic microsurgery in the PubMed database. Published original articles, case reports, and letters from 1983 to 2020 were included. Retrieved articles were discussed and conclusions were made. The results showed that applications of TEM could be more flexible and extended, namely, TEM’s niche applications in advanced rectal cancer after neoadjuvant chemoradiotherapy, neuroendocrine tumor, gastrointestinal stromal tumor, fistula, solitary rectal ulcer syndrome, benign stricture, and transanal total mesorectal excision are promising, while prospective studies are needed.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"95 - 103"},"PeriodicalIF":1.7,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49492319","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 : 2021-08-28DOI: 10.5114/wiitm.2021.108804
Weigang Zhang, J. Qiu, Wuyang Bian, Ding Sun, Yangguang Shi, L. Qin, Xiaofeng Xue
Introduction Solid pseudopapillary tumor of the pancreas (SPTP) is a rarely diagnosed, low-malignancy pancreatic neoplasm, which mostly can be cured by surgery. Aim To investigate the surgical effect and prognosis of SPTP. Material and methods The data of 39 patients diagnosed with SPTP and treated with surgery between 2013 and 2020 were analyzed retrospectively. The data included the clinical characteristics, surgical management, pathological findings and therapeutic outcome. Results The mean age of the patients was 34.0 ±12.1 years, and the female : male ratio was 32 : 7. Most of the patients were asymptomatic (48.7%). The mean diameter of the tumors was 4.81 ±2.36 cm. Operative procedures were conducted according to the location and size of the tumors. Laparoscopic surgery, especially laparoscopic distal pancreatectomy (LDP), provided a smaller incision, a shorter postoperative hospital stay and a shorter postoperative fasting time. There was no observed difference in the amount of blood loss or complication rate. The median follow-up was 24 months. One patient with 20% expression of Ki-67 developed liver metastasis after surgery. Conclusions SPTP is a rare disease with low malignancy. Minimally invasive surgery, especially LDP, has been proven to be a feasible and safe treatment method for SPTP with early recovery. The prognosis of SPTP is favorable. Lifetime surveillance is necessary especially in patients with a high expression rate of Ki-67.
{"title":"Clinical characteristics, surgical strategies, and outcome of solid pseudopapillary tumor of the pancreas: retrospective analysis in a single center","authors":"Weigang Zhang, J. Qiu, Wuyang Bian, Ding Sun, Yangguang Shi, L. Qin, Xiaofeng Xue","doi":"10.5114/wiitm.2021.108804","DOIUrl":"https://doi.org/10.5114/wiitm.2021.108804","url":null,"abstract":"Introduction Solid pseudopapillary tumor of the pancreas (SPTP) is a rarely diagnosed, low-malignancy pancreatic neoplasm, which mostly can be cured by surgery. Aim To investigate the surgical effect and prognosis of SPTP. Material and methods The data of 39 patients diagnosed with SPTP and treated with surgery between 2013 and 2020 were analyzed retrospectively. The data included the clinical characteristics, surgical management, pathological findings and therapeutic outcome. Results The mean age of the patients was 34.0 ±12.1 years, and the female : male ratio was 32 : 7. Most of the patients were asymptomatic (48.7%). The mean diameter of the tumors was 4.81 ±2.36 cm. Operative procedures were conducted according to the location and size of the tumors. Laparoscopic surgery, especially laparoscopic distal pancreatectomy (LDP), provided a smaller incision, a shorter postoperative hospital stay and a shorter postoperative fasting time. There was no observed difference in the amount of blood loss or complication rate. The median follow-up was 24 months. One patient with 20% expression of Ki-67 developed liver metastasis after surgery. Conclusions SPTP is a rare disease with low malignancy. Minimally invasive surgery, especially LDP, has been proven to be a feasible and safe treatment method for SPTP with early recovery. The prognosis of SPTP is favorable. Lifetime surveillance is necessary especially in patients with a high expression rate of Ki-67.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"163 - 169"},"PeriodicalIF":1.7,"publicationDate":"2021-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48941994","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 : 2021-07-30DOI: 10.5114/wiitm.2021.108214
Qi Zou, Yue Ding, Chun-Sheng Li, Xiaoping Yang
Introduction Emergency biliary drainage is the basic treatment for acute cholangitis caused by choledocholithiasis. Aim To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis. Material and methods A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 : 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared. Results The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). Conclusions Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.
{"title":"A randomized controlled trial of emergency LCBDE + LC and ERCP + LC in the treatment of choledocholithiasis with acute cholangitis","authors":"Qi Zou, Yue Ding, Chun-Sheng Li, Xiaoping Yang","doi":"10.5114/wiitm.2021.108214","DOIUrl":"https://doi.org/10.5114/wiitm.2021.108214","url":null,"abstract":"Introduction Emergency biliary drainage is the basic treatment for acute cholangitis caused by choledocholithiasis. Aim To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis. Material and methods A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 : 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared. Results The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). Conclusions Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"156 - 162"},"PeriodicalIF":1.7,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48169966","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 : 2021-07-30DOI: 10.5114/wiitm.2021.108216
X. Xue, Dong Wang, Z. Ji, Yi Xie
Introduction Enhanced recovery after surgery (ERAS) is a set of perioperative interventions to alleviate patients’ stress response and complications, and to promote rehabilitation. Data on its implementation in renal cell carcinoma treated by laparoscopic partial nephrectomy are lacking. Aim To evaluate the prospect of application of ERAS in laparoscopic partial nephrectomy based on real-world data. Material and methods Sixty patients with T1a staging renal cell carcinoma (RCC) were randomly classified as the ERAS group (31 patients) or traditional treatment group (29 patients). Relevant endpoints including postoperative length of stay, ambulation, fart, oral intake, pain at different movement and time points, postoperative nausea and vomiting, complications as well as hospitalization expenses in the two groups were analyzed and compared. Results The ERAS optimization group presented a shorter time of first-time ambulation (p = 0.008), less pain at rest and ankle movement (p < 0.05), and less feeling of nausea 2 and 4 h after surgery (p = 0.006 and 0.027, respectively). (Although the differences in hospitalization expenses, postoperative length of stay, and complications were not reached in our study (p > 0.05), they were significantly lower than those reported in other literature. Conclusions The idea of ERAS has had an imperceptible influence on clinical strategy making for over 20 years. This study shows that it could alleviate postoperative pain both at rest and movement, enable earlier walking, and reduce postoperative nausea in patients who have undergone laparoscopic partial nephrectomy. However, its efficacy is sometimes over-extended when compared to extreme conserative. Also, specific ERAS protocols and large-sample clinical trials are needed.
{"title":"Enhanced recovery after surgery in patients undergoing laparoscopic partial nephrectomy. Results from a real-world randomized controlled trial","authors":"X. Xue, Dong Wang, Z. Ji, Yi Xie","doi":"10.5114/wiitm.2021.108216","DOIUrl":"https://doi.org/10.5114/wiitm.2021.108216","url":null,"abstract":"Introduction Enhanced recovery after surgery (ERAS) is a set of perioperative interventions to alleviate patients’ stress response and complications, and to promote rehabilitation. Data on its implementation in renal cell carcinoma treated by laparoscopic partial nephrectomy are lacking. Aim To evaluate the prospect of application of ERAS in laparoscopic partial nephrectomy based on real-world data. Material and methods Sixty patients with T1a staging renal cell carcinoma (RCC) were randomly classified as the ERAS group (31 patients) or traditional treatment group (29 patients). Relevant endpoints including postoperative length of stay, ambulation, fart, oral intake, pain at different movement and time points, postoperative nausea and vomiting, complications as well as hospitalization expenses in the two groups were analyzed and compared. Results The ERAS optimization group presented a shorter time of first-time ambulation (p = 0.008), less pain at rest and ankle movement (p < 0.05), and less feeling of nausea 2 and 4 h after surgery (p = 0.006 and 0.027, respectively). (Although the differences in hospitalization expenses, postoperative length of stay, and complications were not reached in our study (p > 0.05), they were significantly lower than those reported in other literature. Conclusions The idea of ERAS has had an imperceptible influence on clinical strategy making for over 20 years. This study shows that it could alleviate postoperative pain both at rest and movement, enable earlier walking, and reduce postoperative nausea in patients who have undergone laparoscopic partial nephrectomy. However, its efficacy is sometimes over-extended when compared to extreme conserative. Also, specific ERAS protocols and large-sample clinical trials are needed.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"116 - 126"},"PeriodicalIF":1.7,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43827031","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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