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}
Introduction Due to more complex anatomical features, right laparoscopic adrenalectomy (RLA) could be more challenging than left laparoscopic adrenalectomy (LLA). However, this opinion remains elusive. Aim To evaluate the perioperative and postoperative outcomes of RLA versus LLA. Material and methods A systematic literature research of the PubMed, Ovid, Scopus databases (up to March 2021) and citation lists were performed to identify eligible studies. All studies comparing RLA versus LLA were included. Data were analysed using RevMan 5.4 software. Results Overall, 5 studies including 780 patients (RLA 361; LLA 419) were included. The operative time was similar in both groups (WMD –9.38 min, 95% CI: –21.04 to 2.28; p = 0.11). Compared with LLA, RLA showed greater volume of estimated blood loss (EBL) (WMD 13.82 ml, 95% CI: 3.77, 23.88; p = 0.007) and higher conversion rate (OR = 3.45, 95% CI: 1.12 to 10.57; p = 0.03). RLA had comparable complications (OR = 0.88, 95% CI: 0.44 to 1.76; p = 0.71), Clavien Dindo score ≥ 3 complications (OR = 0.38, 95% CI: 0.09 to 1.65; p = 0.20), and length of hospital stay (WMD –0.07 days, 95% CI: –0.35 to 0.21; p = 0.61). The transperitoneal approach analysis showed consistent results. Conclusions RLA is associated with a higher risk of bleeding and higher conversion rate.
{"title":"Right laparoscopic adrenalectomy vs. left laparoscopic adrenalectomy: a systematic review and meta-analysis","authors":"Yaxuan Wang, Zhan Yang, Xue-liang Chang, Jingdong Li, Yan-ping Zhang, Zhihai Teng, Zhenwei Han","doi":"10.5114/wiitm.2021.108212","DOIUrl":"https://doi.org/10.5114/wiitm.2021.108212","url":null,"abstract":"Introduction Due to more complex anatomical features, right laparoscopic adrenalectomy (RLA) could be more challenging than left laparoscopic adrenalectomy (LLA). However, this opinion remains elusive. Aim To evaluate the perioperative and postoperative outcomes of RLA versus LLA. Material and methods A systematic literature research of the PubMed, Ovid, Scopus databases (up to March 2021) and citation lists were performed to identify eligible studies. All studies comparing RLA versus LLA were included. Data were analysed using RevMan 5.4 software. Results Overall, 5 studies including 780 patients (RLA 361; LLA 419) were included. The operative time was similar in both groups (WMD –9.38 min, 95% CI: –21.04 to 2.28; p = 0.11). Compared with LLA, RLA showed greater volume of estimated blood loss (EBL) (WMD 13.82 ml, 95% CI: 3.77, 23.88; p = 0.007) and higher conversion rate (OR = 3.45, 95% CI: 1.12 to 10.57; p = 0.03). RLA had comparable complications (OR = 0.88, 95% CI: 0.44 to 1.76; p = 0.71), Clavien Dindo score ≥ 3 complications (OR = 0.38, 95% CI: 0.09 to 1.65; p = 0.20), and length of hospital stay (WMD –0.07 days, 95% CI: –0.35 to 0.21; p = 0.61). The transperitoneal approach analysis showed consistent results. Conclusions RLA is associated with a higher risk of bleeding and higher conversion rate.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"9 - 19"},"PeriodicalIF":1.7,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42172548","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 : 2021-07-13DOI: 10.5114/wiitm.2021.107752
T. Higuchi, Kanichiro Shimizu, K. Enoki, K. Motohashi, Yoshihiko Kameoka, N. Kurata, J. Miki, H. Sekiguchi, S. Sadaoka
Introduction Percutaneous cryoablation (PCA) is increasingly recognized as a feasible minimally invasive, nephron-sparing treatment for renal cell carcinomas, with comparable efficacy to nephrectomy. The development of abdominal wall pseudohernia (AWP) is a rare complication of PCA for renal masses, which can negatively impact patients’ quality of life. Aim To retrospectively evaluate the risk factors and prognosis for AWP after PCA and, based on these results, to discuss strategies to lower the risk of AWP associated with image-guided PCA for renal masses. Material and methods We retrospectively studied 117 PCAs performed for renal masses in 92 patients, between 2016 and 2019, at our hospital. We compared the following clinical characteristics (age, sex, body mass index, tumour diameter, RENAL nephrometry score, procedural details, transcatheter arterial embolization, dissection techniques, number of cryoneedles used, location of needles, and location of ice ball) between those who developed AWP and those who did not. Results Of the 117 PCAs (92 patients) included in our study group, AWP complications were observed in 6 (5.1%) procedures. Puncture through the erector spinae muscle (p < 0.01) and non-use of hydro- or pneumo-dissection (p = 0.01) were identified as risk factors for AWP. Conclusions Although PCA is relatively safe to perform and the occurrence of an associated AWP is a rare and infrequent complication, the risk for AWP could be further decreased by avoiding punctures through the erector spinae muscle and using hydro- or pneumo-dissection.
{"title":"Risk factors for abdominal wall pseudohernia after percutaneous cryoablation of renal cell carcinoma","authors":"T. Higuchi, Kanichiro Shimizu, K. Enoki, K. Motohashi, Yoshihiko Kameoka, N. Kurata, J. Miki, H. Sekiguchi, S. Sadaoka","doi":"10.5114/wiitm.2021.107752","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107752","url":null,"abstract":"Introduction Percutaneous cryoablation (PCA) is increasingly recognized as a feasible minimally invasive, nephron-sparing treatment for renal cell carcinomas, with comparable efficacy to nephrectomy. The development of abdominal wall pseudohernia (AWP) is a rare complication of PCA for renal masses, which can negatively impact patients’ quality of life. Aim To retrospectively evaluate the risk factors and prognosis for AWP after PCA and, based on these results, to discuss strategies to lower the risk of AWP associated with image-guided PCA for renal masses. Material and methods We retrospectively studied 117 PCAs performed for renal masses in 92 patients, between 2016 and 2019, at our hospital. We compared the following clinical characteristics (age, sex, body mass index, tumour diameter, RENAL nephrometry score, procedural details, transcatheter arterial embolization, dissection techniques, number of cryoneedles used, location of needles, and location of ice ball) between those who developed AWP and those who did not. Results Of the 117 PCAs (92 patients) included in our study group, AWP complications were observed in 6 (5.1%) procedures. Puncture through the erector spinae muscle (p < 0.01) and non-use of hydro- or pneumo-dissection (p = 0.01) were identified as risk factors for AWP. Conclusions Although PCA is relatively safe to perform and the occurrence of an associated AWP is a rare and infrequent complication, the risk for AWP could be further decreased by avoiding punctures through the erector spinae muscle and using hydro- or pneumo-dissection.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"188 - 193"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47311217","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 : 2021-07-13DOI: 10.5114/wiitm.2021.107763
Xiaobo Zhang, Zhenyu Liu, Xiong Chen, Dongjie Li, Zhiming Yang, Jie Gu, Sheng Hu, Yuxin Li
Introduction Postoperative infection is still one of the most common complications following flexible ureteroscopy lithotripsy (FURL). However, whether a combination of negative pressure ureteroscopy (and Soton ureteroscopy) is superior to FURL in lithotripsy with regard to intraoperative pressure and possibly the incidence of postoperative infection remains to be validated. Aim To explore the effect of a Soton ureteroscope on infection following flexible ureteroscope lithotripsy. Material and methods Sixty patients with kidney stones were randomly divided equally into study and control groups. The operation duration, stone-free rate, postoperative blood routine, procalcitonin, C-reactive protein, and other data between the two groups were then analysed and compared. Results There were no statistically significant differences between the study group and the control group regarding the average operation time and the average number of hospitalization days. The mean stone-free rate 1 week after surgery and mean VAS pain score 1 day after surgery for the study group and the control group were 91.3% and 0.27 vs. 76.9% and 0.61, respectively. Notably, the average body temperature after the first day of the operation was 36.4°C in the study group and 36.7°C in the control group. More importantly, concerning postoperative infection index, white blood cells (WBCs), percentage of neutrophils, C-reactive protein, and procalcitonin were all lower in the study group than in the control group. Conclusions Compared with flexible ureteroscopy alone, combined use of Soton ureteroscopy is associated with fewer substantially infection following lithotripsy.
{"title":"The effect of application of a Soton ureteroscope on infection after flexible ureteroscopy lithotripsy","authors":"Xiaobo Zhang, Zhenyu Liu, Xiong Chen, Dongjie Li, Zhiming Yang, Jie Gu, Sheng Hu, Yuxin Li","doi":"10.5114/wiitm.2021.107763","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107763","url":null,"abstract":"Introduction Postoperative infection is still one of the most common complications following flexible ureteroscopy lithotripsy (FURL). However, whether a combination of negative pressure ureteroscopy (and Soton ureteroscopy) is superior to FURL in lithotripsy with regard to intraoperative pressure and possibly the incidence of postoperative infection remains to be validated. Aim To explore the effect of a Soton ureteroscope on infection following flexible ureteroscope lithotripsy. Material and methods Sixty patients with kidney stones were randomly divided equally into study and control groups. The operation duration, stone-free rate, postoperative blood routine, procalcitonin, C-reactive protein, and other data between the two groups were then analysed and compared. Results There were no statistically significant differences between the study group and the control group regarding the average operation time and the average number of hospitalization days. The mean stone-free rate 1 week after surgery and mean VAS pain score 1 day after surgery for the study group and the control group were 91.3% and 0.27 vs. 76.9% and 0.61, respectively. Notably, the average body temperature after the first day of the operation was 36.4°C in the study group and 36.7°C in the control group. More importantly, concerning postoperative infection index, white blood cells (WBCs), percentage of neutrophils, C-reactive protein, and procalcitonin were all lower in the study group than in the control group. Conclusions Compared with flexible ureteroscopy alone, combined use of Soton ureteroscopy is associated with fewer substantially infection following lithotripsy.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"232 - 239"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42311300","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 : 2021-07-13DOI: 10.5114/wiitm.2021.107756
Nihat Gulaydin, F. Ersoz, Necdet Derici, Aylin Hande Gokce, A. Ozkan, Feridun Suat Gokce
Introduction The use of Transit Bipartition with Sleeve Gastrectomy (SG + TB) to treat obesity and type 2 diabetes related to it has been increasing, but there are many challenges related to the procedure. The anastomosis diameter of gastroileostomy (GI) performed using linear staplers is an important factor affecting the postoperative metabolic status. Aim We aimed to compare linear-stapled (LS) and circular-stapled (CS) GI in SG + TB in terms of early and late perioperative and postoperative status. Material and methods This retrospective study included 24 patients who had undergone SG + TB between January 2018 and June 2019 to treat obesity and/or type 2 diabetes. GI was performed using linear staplers in 13 (SG + TB-LS group) and circular staplers in 11 patients (SG + TB-CS group). Operative time, hospitalization duration, complications, body mass index, haemoglobin A1c, albumin, haemoglobin, etc. were compared between the 2 groups before and 12 months after the surgery. Results The operation time was shorter in the SG + TB-CS group than in the SG + TB-LS group. The surgical treatments were successful in both groups in terms of weight loss and diabetes remission. Although not statistically significant, malnutrition and anaemia were slightly higher in the SG+TB-LS group than in the SG + TB-CS group during the follow-up process. Conclusions Both anastomosis types were found to be safe for SG+TB, and the risks of postoperative complications were low and comparable in both groups. However, the diameter of the anastomosis should always be the gold standard in the CS technique, while it may be too wide or too narrow in the LS technique.
{"title":"Comparative evaluation of efficiency for gastroileostomy anastomosis in laparoscopic transit bipartition with sleeve gastrectomy between linear and circular staplers","authors":"Nihat Gulaydin, F. Ersoz, Necdet Derici, Aylin Hande Gokce, A. Ozkan, Feridun Suat Gokce","doi":"10.5114/wiitm.2021.107756","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107756","url":null,"abstract":"Introduction The use of Transit Bipartition with Sleeve Gastrectomy (SG + TB) to treat obesity and type 2 diabetes related to it has been increasing, but there are many challenges related to the procedure. The anastomosis diameter of gastroileostomy (GI) performed using linear staplers is an important factor affecting the postoperative metabolic status. Aim We aimed to compare linear-stapled (LS) and circular-stapled (CS) GI in SG + TB in terms of early and late perioperative and postoperative status. Material and methods This retrospective study included 24 patients who had undergone SG + TB between January 2018 and June 2019 to treat obesity and/or type 2 diabetes. GI was performed using linear staplers in 13 (SG + TB-LS group) and circular staplers in 11 patients (SG + TB-CS group). Operative time, hospitalization duration, complications, body mass index, haemoglobin A1c, albumin, haemoglobin, etc. were compared between the 2 groups before and 12 months after the surgery. Results The operation time was shorter in the SG + TB-CS group than in the SG + TB-LS group. The surgical treatments were successful in both groups in terms of weight loss and diabetes remission. Although not statistically significant, malnutrition and anaemia were slightly higher in the SG+TB-LS group than in the SG + TB-CS group during the follow-up process. Conclusions Both anastomosis types were found to be safe for SG+TB, and the risks of postoperative complications were low and comparable in both groups. However, the diameter of the anastomosis should always be the gold standard in the CS technique, while it may be too wide or too narrow in the LS technique.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"199 - 206"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46691423","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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