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}
Pub Date : 2021-07-13DOI: 10.5114/wiitm.2021.107754
I. Liakh, M. Proczko-Stepaniak, M. Śledziński, Adriana Mika
Introduction One anastomosis gastric bypass (OAGB) leads to improvement in glucose homeostasis; however, the mechanism of this beneficial effect is not fully understood. Increased serum free fatty acid (FFA) concentrations in obese subjects contribute to the development of insulin resistance and type 2 diabetes. Aim The authors hypothesized that improvement in glucose homeostasis after OAGB may be associated with a decrease in FFA concentration. Material and methods Serum FFA levels were measured by gas chromatography-mass spectrometry before and 3 months after OAGB and, for comparison, in patients who underwent laparoscopic sleeve gastrectomy (LSG). Serum insulin was assayed by immunoenzymatic method, and other parameters by standard laboratory methods. Results OAGB resulted in a large decrease in FFA levels and great improvement in insulin sensitivity. These effects in patients after LSG were less prominent. Conclusions Results suggest that decreased serum FFA levels after OAGB contribute to resolution of insulin sensitivity after this type of bariatric surgery.
{"title":"Serum free fatty acid levels and insulin resistance in patients undergoing one-anastomosis gastric bypass","authors":"I. Liakh, M. Proczko-Stepaniak, M. Śledziński, Adriana Mika","doi":"10.5114/wiitm.2021.107754","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107754","url":null,"abstract":"Introduction One anastomosis gastric bypass (OAGB) leads to improvement in glucose homeostasis; however, the mechanism of this beneficial effect is not fully understood. Increased serum free fatty acid (FFA) concentrations in obese subjects contribute to the development of insulin resistance and type 2 diabetes. Aim The authors hypothesized that improvement in glucose homeostasis after OAGB may be associated with a decrease in FFA concentration. Material and methods Serum FFA levels were measured by gas chromatography-mass spectrometry before and 3 months after OAGB and, for comparison, in patients who underwent laparoscopic sleeve gastrectomy (LSG). Serum insulin was assayed by immunoenzymatic method, and other parameters by standard laboratory methods. Results OAGB resulted in a large decrease in FFA levels and great improvement in insulin sensitivity. These effects in patients after LSG were less prominent. Conclusions Results suggest that decreased serum FFA levels after OAGB contribute to resolution of insulin sensitivity after this type of bariatric surgery.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"194 - 198"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42178996","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.2021.107758
Emrullah Sogutdelen, Ş. Tonyalı
Introduction The number of social media users is gradually increasing, and they are spending their time gathering a lot of useful information for themselves. Here, we analysed the quality of Holmium Laser Enucleation of Prostate (HoLEP) surgery videos on YouTube. Aim To assess the quality of the most viewed HoLEP videos on YouTube using validated questionnaires and scoring systems developed to evaluate the significant features. Material and methods The most viewed 98 videos were included in this study by the search for ‘Holep’ keyword on YouTube. The Journal of American Medical Association Benchmark Score (JAMAS) and Global Quality Score (GQS) were used to analyse the videos after the validated HoLEP Scoring System Score (HSSS) was performed by 3 HoLEP trained surgeons to evaluate the technical quality of videos. Results The videos including surgical technique (76.5%) and uploaded by urologists (63.3%) constituted the majority of videos. The median of JAMAS, GQS, and HSSS were 1 (0–3), 2 (0–4), and 1.5 (0–11), respectively. The mean GQS and JAMAS of videos uploaded by academic centres was higher than those uploaded by commercial centres and urologists (p = 0.01; p = 0.01, respectively). The mean HSSS was lower in the videos uploaded in the last 5 years, while JAMAS was higher (p = 0.03, p = 0.005, respectively). The mean GQS and HSSS of videos with higher likes were found statistically significantly higher (p = 0.01; p = 0.02, respectively). Conclusions HoLEP videos on YouTube are not adequate to obtain proper information about the surgery. Videos uploaded by academic centres and in recent years provide more valid information for patients and urologists. To increase the value of information, online materials need to be checked, for patients to access accurate, reliable, and appropriate healthcare information.
{"title":"Analyzing the quality and validity of holmium laser enucleation of prostate (HoLEP) videos on social media","authors":"Emrullah Sogutdelen, Ş. Tonyalı","doi":"10.5114/wiitm.2021.107758","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107758","url":null,"abstract":"Introduction The number of social media users is gradually increasing, and they are spending their time gathering a lot of useful information for themselves. Here, we analysed the quality of Holmium Laser Enucleation of Prostate (HoLEP) surgery videos on YouTube. Aim To assess the quality of the most viewed HoLEP videos on YouTube using validated questionnaires and scoring systems developed to evaluate the significant features. Material and methods The most viewed 98 videos were included in this study by the search for ‘Holep’ keyword on YouTube. The Journal of American Medical Association Benchmark Score (JAMAS) and Global Quality Score (GQS) were used to analyse the videos after the validated HoLEP Scoring System Score (HSSS) was performed by 3 HoLEP trained surgeons to evaluate the technical quality of videos. Results The videos including surgical technique (76.5%) and uploaded by urologists (63.3%) constituted the majority of videos. The median of JAMAS, GQS, and HSSS were 1 (0–3), 2 (0–4), and 1.5 (0–11), respectively. The mean GQS and JAMAS of videos uploaded by academic centres was higher than those uploaded by commercial centres and urologists (p = 0.01; p = 0.01, respectively). The mean HSSS was lower in the videos uploaded in the last 5 years, while JAMAS was higher (p = 0.03, p = 0.005, respectively). The mean GQS and HSSS of videos with higher likes were found statistically significantly higher (p = 0.01; p = 0.02, respectively). Conclusions HoLEP videos on YouTube are not adequate to obtain proper information about the surgery. Videos uploaded by academic centres and in recent years provide more valid information for patients and urologists. To increase the value of information, online materials need to be checked, for patients to access accurate, reliable, and appropriate healthcare information.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"226 - 231"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42678199","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.2021.107764
Lei Du, Zhan Yang, Jinchun Qi, Yaxuan Wang
Introduction The application of robotic adrenalectomy (RA) has been increasing. However, there is still controversy about whether RA is more feasible than laparoscopic adrenalectomy (LA) for pheochromocytoma (PHEO). Aim To evaluate the efficacy and safety of RA vs. LA for PHEO. Material and methods A literature search of the PubMed, Ovid, and Scopus databases was performed to identify eligible studies up to April 2021. All studies comparing RA versus LA for PHEO were included. Data were analysed using the Cochrane Collaboration’s Review Manager (RevMan) 5.4 software. Results Overall, 4 studies including 386 patients (RA 155; LA 231) were included. RA might have larger tumour size (WMD = 0.72 cm, 95% CI: 0.31 to 1.13; p < 0.001). There were no statistically significant differences in operative time (WMD = –12.49 min, 95% CI: –29.50 to 4.52; p = 0.15), estimated blood loss (EBL) (WMD = –28.48 ml, 95% CI: –58.92, 1.95; p = 0.07), transfusion rate (OR = 0.70, 95% CI: 0.07 to 7.07; p = 0.77), or conversion rate (OR = 0.44, 95% CI: 0.07 to 2.88; p = 0.39). There were no significant differences between the 2 groups in terms of postoperative complications (OR = 1.06, 95% CI: 0.62 to 1.82; p = 0.84) and Clavien Dindo score ≥ 3 complications (OR = 1.15, 95% CI: 0.39 to 3.41; p = 0.80). Patients from the RA group could benefit from shorter length of hospital stay (WMD = –0.51 days, 95% CI –0.91 to –0.12; p = 0.01). Conclusions RA is a feasible, safe, and comparable treatment option for PHEO.
{"title":"Robotic adrenalectomy versus laparoscopic adrenalectomy for pheochromocytoma: a systematic review and meta-analysis","authors":"Lei Du, Zhan Yang, Jinchun Qi, Yaxuan Wang","doi":"10.5114/wiitm.2021.107764","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107764","url":null,"abstract":"Introduction The application of robotic adrenalectomy (RA) has been increasing. However, there is still controversy about whether RA is more feasible than laparoscopic adrenalectomy (LA) for pheochromocytoma (PHEO). Aim To evaluate the efficacy and safety of RA vs. LA for PHEO. Material and methods A literature search of the PubMed, Ovid, and Scopus databases was performed to identify eligible studies up to April 2021. All studies comparing RA versus LA for PHEO were included. Data were analysed using the Cochrane Collaboration’s Review Manager (RevMan) 5.4 software. Results Overall, 4 studies including 386 patients (RA 155; LA 231) were included. RA might have larger tumour size (WMD = 0.72 cm, 95% CI: 0.31 to 1.13; p < 0.001). There were no statistically significant differences in operative time (WMD = –12.49 min, 95% CI: –29.50 to 4.52; p = 0.15), estimated blood loss (EBL) (WMD = –28.48 ml, 95% CI: –58.92, 1.95; p = 0.07), transfusion rate (OR = 0.70, 95% CI: 0.07 to 7.07; p = 0.77), or conversion rate (OR = 0.44, 95% CI: 0.07 to 2.88; p = 0.39). There were no significant differences between the 2 groups in terms of postoperative complications (OR = 1.06, 95% CI: 0.62 to 1.82; p = 0.84) and Clavien Dindo score ≥ 3 complications (OR = 1.15, 95% CI: 0.39 to 3.41; p = 0.80). Patients from the RA group could benefit from shorter length of hospital stay (WMD = –0.51 days, 95% CI –0.91 to –0.12; p = 0.01). Conclusions RA is a feasible, safe, and comparable treatment option for PHEO.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"1 - 8"},"PeriodicalIF":1.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49349449","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 : 2021-06-30DOI: 10.5114/wiitm.2021.107816
A. Karpitski, Andrej Shestiuk, S. Panko, Henadzi Zhurbenka, Denis Vakulich, A. Ihnatsiuk
Introduction Iatrogenic injuries to the trachea and main bronchi present one of the most dramatic complications traditionally treated by thoracotomy and transcervical-transtracheal approaches but almost never by video-assisted thoracic surgery. Aim To evaluate our experience in a video-assisted thoracic surgery repair of iatrogenic tracheal lacerations. Material and methods The group under analysis consisted of 5 consecutive patients (1 male, mean age: 52 years, range: 32–56 years) who were treated for postintubation and intraoperative damage to the tracheobronchial tree using video-assisted thoracic surgery within the period 2015–2018. Thoracic computed tomography and fibreoptic tracheobronchoscopy were used to confirm iatrogenic tracheal ruptures before surgery. The membranous rupture of the trachea was closed with interrupted absorbable sutures, which were additionally sutured through the oesophageal wall or the wall of the gastric conduit to strengthen the suture line. Postoperative treatment included broad-spectrum antibiotic therapy and control tracheobronchoscopy. Results The average duration of thoracoscopic tracheal rupture repair with suture line reinforcement was 103 min (range: 60–180 min). All patients were treated thoracoscopically without resorting to open surgery and were discharged without any postoperative complications within 16 days (range: 8–22 days). Conclusions The minimally invasive thoracoscopic approach may be the method of choice for the treatment of intraoperative and post-intubation injuries of the tracheobronchial tree.
{"title":"Thoracoscopic treatment of iatrogenic injuries of the tracheobronchial tree: a retrospective analysis of 5 cases and review of the literature","authors":"A. Karpitski, Andrej Shestiuk, S. Panko, Henadzi Zhurbenka, Denis Vakulich, A. Ihnatsiuk","doi":"10.5114/wiitm.2021.107816","DOIUrl":"https://doi.org/10.5114/wiitm.2021.107816","url":null,"abstract":"Introduction Iatrogenic injuries to the trachea and main bronchi present one of the most dramatic complications traditionally treated by thoracotomy and transcervical-transtracheal approaches but almost never by video-assisted thoracic surgery. Aim To evaluate our experience in a video-assisted thoracic surgery repair of iatrogenic tracheal lacerations. Material and methods The group under analysis consisted of 5 consecutive patients (1 male, mean age: 52 years, range: 32–56 years) who were treated for postintubation and intraoperative damage to the tracheobronchial tree using video-assisted thoracic surgery within the period 2015–2018. Thoracic computed tomography and fibreoptic tracheobronchoscopy were used to confirm iatrogenic tracheal ruptures before surgery. The membranous rupture of the trachea was closed with interrupted absorbable sutures, which were additionally sutured through the oesophageal wall or the wall of the gastric conduit to strengthen the suture line. Postoperative treatment included broad-spectrum antibiotic therapy and control tracheobronchoscopy. Results The average duration of thoracoscopic tracheal rupture repair with suture line reinforcement was 103 min (range: 60–180 min). All patients were treated thoracoscopically without resorting to open surgery and were discharged without any postoperative complications within 16 days (range: 8–22 days). Conclusions The minimally invasive thoracoscopic approach may be the method of choice for the treatment of intraoperative and post-intubation injuries of the tracheobronchial tree.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"240 - 244"},"PeriodicalIF":1.7,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48794552","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 : 2021-05-14DOI: 10.5114/wiitm.2021.106126
Zhen Zeng, Jia Liu, Tao Lv, Zonghao Feng, Lei Zhang, Q. Liao
Introduction Laparoscopic-assisted radical vaginal hysterectomy (LARVH) and abdominal radical hysterectomy (ARH) are commonly used for cervical cancer treatment. However, the clinical application of LARVH versus ARH in treating cervical cancer remains controversial. Aim To investigate the efficacy of LARVH versus ARH in treating cervical cancer via comparing several inductors by pooling related studies. Material and methods Eligible articles from PubMed, Embase, and the Cochrane library were screened using established search terms. Consecutive variables were pooled using weighted mean difference (WMD) and 95% confidence interval (CI). Categorical variables were pooled using odds ratio (OR) and 95% CI. Results A total of 13 articles were included in this meta-analysis, comprising 579 patients who underwent LARVH and 810 who underwent ARH. LARVH required a longer operation time (WMD = 50.97, 95% CI: 38.34, 63.59, p < 0.001) than ARH. However, compared to patients who underwent ARH, those who underwent LARVH had less bleeding volume (WMD = −311.21, 95% CI: −482.77, −139.64, p < 0.001), required a shorter hospital stay (WMD = −3.38, 95% CI: −5.00, −1.76, p < 0.001), and had a lower risk of urinary tract infection (OR = 0.34, 95% CI: 0.13, 0.89, p = 0.028). Additionally, patients who underwent LARVH showed a slightly lower recurrence rate (OR = 0.549, 95% CI: 0.302, 0.998, p = 0.049) than patients who underwent ARH. However, subgroup analysis results were not in agreement with the pooled results and indicated an unstable outcome. Conclusions Owing to these reasons, LARVH has more application prospects than ARH in treating cervical cancer.
{"title":"Evaluation of the efficacy of laparoscopic-assisted radical vaginal hysterectomy and abdominal radical hysterectomy for treating cervical cancer: a meta-analysis","authors":"Zhen Zeng, Jia Liu, Tao Lv, Zonghao Feng, Lei Zhang, Q. Liao","doi":"10.5114/wiitm.2021.106126","DOIUrl":"https://doi.org/10.5114/wiitm.2021.106126","url":null,"abstract":"Introduction Laparoscopic-assisted radical vaginal hysterectomy (LARVH) and abdominal radical hysterectomy (ARH) are commonly used for cervical cancer treatment. However, the clinical application of LARVH versus ARH in treating cervical cancer remains controversial. Aim To investigate the efficacy of LARVH versus ARH in treating cervical cancer via comparing several inductors by pooling related studies. Material and methods Eligible articles from PubMed, Embase, and the Cochrane library were screened using established search terms. Consecutive variables were pooled using weighted mean difference (WMD) and 95% confidence interval (CI). Categorical variables were pooled using odds ratio (OR) and 95% CI. Results A total of 13 articles were included in this meta-analysis, comprising 579 patients who underwent LARVH and 810 who underwent ARH. LARVH required a longer operation time (WMD = 50.97, 95% CI: 38.34, 63.59, p < 0.001) than ARH. However, compared to patients who underwent ARH, those who underwent LARVH had less bleeding volume (WMD = −311.21, 95% CI: −482.77, −139.64, p < 0.001), required a shorter hospital stay (WMD = −3.38, 95% CI: −5.00, −1.76, p < 0.001), and had a lower risk of urinary tract infection (OR = 0.34, 95% CI: 0.13, 0.89, p = 0.028). Additionally, patients who underwent LARVH showed a slightly lower recurrence rate (OR = 0.549, 95% CI: 0.302, 0.998, p = 0.049) than patients who underwent ARH. However, subgroup analysis results were not in agreement with the pooled results and indicated an unstable outcome. Conclusions Owing to these reasons, LARVH has more application prospects than ARH in treating cervical cancer.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"69 - 82"},"PeriodicalIF":1.7,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47959933","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 : 2021-05-05DOI: 10.5114/wiitm.2021.105823
Ying Zhang, Yingjun Zhu
Introduction Many recent studies have conducted laparoscopic single-site surgery (LESS) using single-port laparoscopy (SPL), which combines conventional laparoscopy (CL) with a novel multichannel port. However, to implement SPL, several obstacles must be overcome. Aim To study the clinical value of SPL in the surgical treatment of gynecological diseases. Material and methods Twenty-five patients with ectopic pregnancy (EP) and 11 with uterine leiomyoma (UL) were randomly assigned to undergo either LESS by SPL or CL. The CL was performed routinely, while the SPL was performed through a single port using a self-made, multi-channel laparoscopic approach based on CL. The following parameters were compared between the SPL and CL groups: intraoperative conditions (operation time and blood loss), postoperative conditions (exhaustion and hospital stay time), and visual analog scale. Patients with EP and those with UL were analyzed separately in this regard. In patients with UL, hemoglobin changes, complications, and long-term physical recovery within 6 months of surgery were also compared. Results The operation time was significantly longer in the SPL group than in the CL group (p < 0.001). However, blood loss, postoperative exhaustion, and hospital stay time were significantly lower (p < 0.05 in all cases). In patients with UL, intraoperative and postoperative conditions did not differ significantly between the groups. At the follow-up within 6 months, patients with UL in the SPL group had recovered, with better cosmetic effects and more satisfaction. No cases of umbilical incisional hernia occurred in the SPL group. Conclusions SPL showed clinical efficacy, with minimal invasion, rapid recovery, and cost-effectiveness in patients with EP or UL.
{"title":"Comparison of conventional versus single port laparoscopy for surgical treatment of gynecological diseases: a pilot study","authors":"Ying Zhang, Yingjun Zhu","doi":"10.5114/wiitm.2021.105823","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105823","url":null,"abstract":"Introduction Many recent studies have conducted laparoscopic single-site surgery (LESS) using single-port laparoscopy (SPL), which combines conventional laparoscopy (CL) with a novel multichannel port. However, to implement SPL, several obstacles must be overcome. Aim To study the clinical value of SPL in the surgical treatment of gynecological diseases. Material and methods Twenty-five patients with ectopic pregnancy (EP) and 11 with uterine leiomyoma (UL) were randomly assigned to undergo either LESS by SPL or CL. The CL was performed routinely, while the SPL was performed through a single port using a self-made, multi-channel laparoscopic approach based on CL. The following parameters were compared between the SPL and CL groups: intraoperative conditions (operation time and blood loss), postoperative conditions (exhaustion and hospital stay time), and visual analog scale. Patients with EP and those with UL were analyzed separately in this regard. In patients with UL, hemoglobin changes, complications, and long-term physical recovery within 6 months of surgery were also compared. Results The operation time was significantly longer in the SPL group than in the CL group (p < 0.001). However, blood loss, postoperative exhaustion, and hospital stay time were significantly lower (p < 0.05 in all cases). In patients with UL, intraoperative and postoperative conditions did not differ significantly between the groups. At the follow-up within 6 months, patients with UL in the SPL group had recovered, with better cosmetic effects and more satisfaction. No cases of umbilical incisional hernia occurred in the SPL group. Conclusions SPL showed clinical efficacy, with minimal invasion, rapid recovery, and cost-effectiveness in patients with EP or UL.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"252 - 260"},"PeriodicalIF":1.7,"publicationDate":"2021-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44265038","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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