Pub Date : 2021-05-05DOI: 10.5114/wiitm.2021.105851
T. Wiatr, Lukasz Belch, K. Gronostaj, Dominik Choragwicki, A. Czech, L. Curylo, J. Fronczek, M. Przydacz, P. Dudek, P. Chłosta
Introduction The quality of vesicourethral anastomosis (VUA) in laparoscopic radical prostatectomy (LRP) is associated with complications that could significantly affect quality of life. Aim To compare different types of sutures (Chlosta’s versus Van Velthoven versus V-Loc), used for VUA in LRP in terms of complication rates and continence recovery. Material and methods Patients who underwent LRP between 2014 and 2018 in a tertiary center were enrolled in the study. Data were extracted from medical records. Urinary continence was assessed at 3, 6, 12 and 18 months after LRP. Propensity score weighted regression models were used to estimate the effect of sutures on outcomes. Results A sample of 504 patients was analyzed, of which 109 patients underwent Chlosta’s suture VUA, 117 patients had Van Velthoven suture VUA, and 278 patients had V-Loc VUA. Median time of anastomosis was 13 (IQR – interquartile range: 10–16) min using Chlosta’s suture, 28 (IQR: 24–30) using Van-Velthoven suture and 12 (IQR: 11–16) min using V-Loc suture (p < 0.001). There were no significant differences between groups concerning complications and urinary continence at 12 and 18 months after surgery. The time of urinary continence recovery was on average 19 days (95% CI: 5–33) and 31 days (95% CI: 16–45) shorter during 1 year of observation when the V-Loc suture was used compared to the Van-Velthoven and Chlosta’s suture, respectively. Conclusions The study showed comparable results considering urinary continence recovery at 12 and 18 months after LRP in all VUA groups. Van Velthoven VUA was more time-consuming and continence recovery was faster in the V-Loc group.
{"title":"Van Velthoven single-knot running suture versus Chlosta’s running suture versus single barbed suture V-Loc for vesicourethral anastomosis in laparoscopic radical prostatectomy: a retrospective comparative study","authors":"T. Wiatr, Lukasz Belch, K. Gronostaj, Dominik Choragwicki, A. Czech, L. Curylo, J. Fronczek, M. Przydacz, P. Dudek, P. Chłosta","doi":"10.5114/wiitm.2021.105851","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105851","url":null,"abstract":"Introduction The quality of vesicourethral anastomosis (VUA) in laparoscopic radical prostatectomy (LRP) is associated with complications that could significantly affect quality of life. Aim To compare different types of sutures (Chlosta’s versus Van Velthoven versus V-Loc), used for VUA in LRP in terms of complication rates and continence recovery. Material and methods Patients who underwent LRP between 2014 and 2018 in a tertiary center were enrolled in the study. Data were extracted from medical records. Urinary continence was assessed at 3, 6, 12 and 18 months after LRP. Propensity score weighted regression models were used to estimate the effect of sutures on outcomes. Results A sample of 504 patients was analyzed, of which 109 patients underwent Chlosta’s suture VUA, 117 patients had Van Velthoven suture VUA, and 278 patients had V-Loc VUA. Median time of anastomosis was 13 (IQR – interquartile range: 10–16) min using Chlosta’s suture, 28 (IQR: 24–30) using Van-Velthoven suture and 12 (IQR: 11–16) min using V-Loc suture (p < 0.001). There were no significant differences between groups concerning complications and urinary continence at 12 and 18 months after surgery. The time of urinary continence recovery was on average 19 days (95% CI: 5–33) and 31 days (95% CI: 16–45) shorter during 1 year of observation when the V-Loc suture was used compared to the Van-Velthoven and Chlosta’s suture, respectively. Conclusions The study showed comparable results considering urinary continence recovery at 12 and 18 months after LRP in all VUA groups. Van Velthoven VUA was more time-consuming and continence recovery was faster in the V-Loc group.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"214 - 225"},"PeriodicalIF":1.7,"publicationDate":"2021-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44831726","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 : 2021-04-30DOI: 10.5114/wiitm.2021.105724
T. Song, D. Kang
Introduction There have been a few clinical studies on the use of three-dimensional (3D) laparoscopy with different results. Aim To compare the surgical outcomes of 3D versus two-dimensional (2D) laparoscopic hysterectomy for benign or premalignant gynecologic diseases. Material and methods In this double-blind trial, 68 patients were randomly assigned to either the 3D or 2D groups at a 1 : 1 ratio. The only difference between the two groups was the laparoscopic vision system used. The primary outcome was operative blood loss and operative time. The other surgical outcomes including failure of the intended surgery, length of hospital stay, and operative complications were also assessed. Results The baseline characteristics did not statistically significantly differ between the groups. The mean operative blood loss was not significantly different between the 3D group (74.4 ±51.6 ml) and the 2D group (79.2 ±55.4 ml) (p = 0.743). The operative time was similar in both groups (84.5 ±20.5 min vs. 87.8 ±24.4 min, p = 0.452). Moreover, no differences were observed between the groups in other surgical outcomes. Conclusions The 3D imaging system had no surgical advantage in laparoscopic hysterectomy for benign or premalignant gynecologic diseases. However, 3D laparoscopy did not have any negative effects on surgical outcomes and did not increase the surgical risk.
{"title":"A randomized, controlled trial comparing the clinical outcomes of 3D versus 2D laparoscopic hysterectomy","authors":"T. Song, D. Kang","doi":"10.5114/wiitm.2021.105724","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105724","url":null,"abstract":"Introduction There have been a few clinical studies on the use of three-dimensional (3D) laparoscopy with different results. Aim To compare the surgical outcomes of 3D versus two-dimensional (2D) laparoscopic hysterectomy for benign or premalignant gynecologic diseases. Material and methods In this double-blind trial, 68 patients were randomly assigned to either the 3D or 2D groups at a 1 : 1 ratio. The only difference between the two groups was the laparoscopic vision system used. The primary outcome was operative blood loss and operative time. The other surgical outcomes including failure of the intended surgery, length of hospital stay, and operative complications were also assessed. Results The baseline characteristics did not statistically significantly differ between the groups. The mean operative blood loss was not significantly different between the 3D group (74.4 ±51.6 ml) and the 2D group (79.2 ±55.4 ml) (p = 0.743). The operative time was similar in both groups (84.5 ±20.5 min vs. 87.8 ±24.4 min, p = 0.452). Moreover, no differences were observed between the groups in other surgical outcomes. Conclusions The 3D imaging system had no surgical advantage in laparoscopic hysterectomy for benign or premalignant gynecologic diseases. However, 3D laparoscopy did not have any negative effects on surgical outcomes and did not increase the surgical risk.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"127 - 133"},"PeriodicalIF":1.7,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46128737","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 : 2021-04-26DOI: 10.5114/wiitm.2021.105683
Mininkova Ai, Jian Xu
Introduction Currently, different methods and materials are used to localize pulmonary nodules (PNs) but most are used only to locate a single pulmonary nodule (PN). Aim To evaluate the feasibility and safety of simultaneously localizing multiple PNs with a coil under computed tomography (CT) guidance before video-assisted thoracoscopic surgery (VATS). Material and methods A total of 166 patients underwent VATS preoperative-assisted localization of pulmonary nodules in our hospital in the period from January 2, 2020 to July 7, 2020, namely 40 patients in the multiple-PN-simultaneous-localization group (A) and 126 patients in the single-PN-localization group (B). We compared the epidemiology, localization procedure, and complications between the two groups. Results The technical success rates in group A and Group B were 96.5% and 97.6%, respectively, with no statistical difference (p = 0.623). In group A, the success rate of the first nodule localization was 100%, and the subsequent nodule localization success rate was 93.3%; 3 patients had one nodule localization failure owing to pneumothorax after the first nodule localization. The number of pleural punctures was higher in group A than in group B (p < 0.001), and the localization procedure time was longer than in group B (p < 0.001). Regarding complications, the pneumothorax rate in group A was higher than that in group B (p < 0.001), and the bleeding rate was higher than that in group B (p < 0.001). However, pneumothorax and bleeding in group A did not require special treatment. Conclusions The incidence of pneumothorax and pulmonary hemorrhage with simultaneous coil localization of multiple PNs was higher than that with localization of a single PN, but this method was safe and feasible.
{"title":"Computed tomography-guided simultaneous coil localization of multiple pulmonary nodules before video-assisted thoracoscopic surgery","authors":"Mininkova Ai, Jian Xu","doi":"10.5114/wiitm.2021.105683","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105683","url":null,"abstract":"Introduction Currently, different methods and materials are used to localize pulmonary nodules (PNs) but most are used only to locate a single pulmonary nodule (PN). Aim To evaluate the feasibility and safety of simultaneously localizing multiple PNs with a coil under computed tomography (CT) guidance before video-assisted thoracoscopic surgery (VATS). Material and methods A total of 166 patients underwent VATS preoperative-assisted localization of pulmonary nodules in our hospital in the period from January 2, 2020 to July 7, 2020, namely 40 patients in the multiple-PN-simultaneous-localization group (A) and 126 patients in the single-PN-localization group (B). We compared the epidemiology, localization procedure, and complications between the two groups. Results The technical success rates in group A and Group B were 96.5% and 97.6%, respectively, with no statistical difference (p = 0.623). In group A, the success rate of the first nodule localization was 100%, and the subsequent nodule localization success rate was 93.3%; 3 patients had one nodule localization failure owing to pneumothorax after the first nodule localization. The number of pleural punctures was higher in group A than in group B (p < 0.001), and the localization procedure time was longer than in group B (p < 0.001). Regarding complications, the pneumothorax rate in group A was higher than that in group B (p < 0.001), and the bleeding rate was higher than that in group B (p < 0.001). However, pneumothorax and bleeding in group A did not require special treatment. Conclusions The incidence of pneumothorax and pulmonary hemorrhage with simultaneous coil localization of multiple PNs was higher than that with localization of a single PN, but this method was safe and feasible.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"245 - 251"},"PeriodicalIF":1.7,"publicationDate":"2021-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47684664","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 : 2021-04-22DOI: 10.5114/wiitm.2021.105572
Xin Wang, Youlu Lu, Zhouting Tuo, Liangkuan Bi
Introduction Radical cystectomy (RC) remains the gold standard for the treatment of recurrent high-risk non-muscle-infiltrating bladder cancer (BC) and muscle-infiltrating BC. Currently, there is no uniform standardized procedure for laparoscopic radical cystectomy (LRC). Aim To share our initial experience with the three layers with three-port approach for laparoscopic radical cystectomy (TLTPA-LRC) and to investigate its safety and effectiveness. Material and methods Between April 2017 and March 2020, 32 patients with bladder tumors underwent TLTPA-LRC, pelvic lymph node dissection, and extracorporeal construction of the Studer neobladder. The basic characteristics of the patients, clinical pathology, and perioperative and follow-up data were analyzed. We also describe our step-by-step surgical technique for TLTPA-LRC. Results The median operation time was 278.5 min (range: 221–346 min), and the mean estimated blood loss was 233.4 ml (102–445 ml). The rates of intraoperative blood transfusion and postoperative transportation to the intensive care unit after surgery were 12.5% and 100%, respectively. Postoperative pathology showed 7 cases of T1, 20 cases of T2, and 5 cases of T3. Lymph node dissection and surgical margins were both negative. During a median follow-up of 13.5 months, 4 patients had early complications (< 30 days) and no patients had major complications (grade ≥ 3). The patients are now alive without local metastasis and with satisfactory urinary control ability day and night. Conclusions Although the TLTPA-LRC approach requires a certain level of surgical proficiency, it is feasible and serves as a minimally invasive method for selected patients.
{"title":"Our initial experience with the three layers with three-port approach for laparoscopic radical cystectomy","authors":"Xin Wang, Youlu Lu, Zhouting Tuo, Liangkuan Bi","doi":"10.5114/wiitm.2021.105572","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105572","url":null,"abstract":"Introduction Radical cystectomy (RC) remains the gold standard for the treatment of recurrent high-risk non-muscle-infiltrating bladder cancer (BC) and muscle-infiltrating BC. Currently, there is no uniform standardized procedure for laparoscopic radical cystectomy (LRC). Aim To share our initial experience with the three layers with three-port approach for laparoscopic radical cystectomy (TLTPA-LRC) and to investigate its safety and effectiveness. Material and methods Between April 2017 and March 2020, 32 patients with bladder tumors underwent TLTPA-LRC, pelvic lymph node dissection, and extracorporeal construction of the Studer neobladder. The basic characteristics of the patients, clinical pathology, and perioperative and follow-up data were analyzed. We also describe our step-by-step surgical technique for TLTPA-LRC. Results The median operation time was 278.5 min (range: 221–346 min), and the mean estimated blood loss was 233.4 ml (102–445 ml). The rates of intraoperative blood transfusion and postoperative transportation to the intensive care unit after surgery were 12.5% and 100%, respectively. Postoperative pathology showed 7 cases of T1, 20 cases of T2, and 5 cases of T3. Lymph node dissection and surgical margins were both negative. During a median follow-up of 13.5 months, 4 patients had early complications (< 30 days) and no patients had major complications (grade ≥ 3). The patients are now alive without local metastasis and with satisfactory urinary control ability day and night. Conclusions Although the TLTPA-LRC approach requires a certain level of surgical proficiency, it is feasible and serves as a minimally invasive method for selected patients.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"207 - 213"},"PeriodicalIF":1.7,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44710067","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 : 2021-04-22DOI: 10.5114/wiitm.2021.105574
S. Yılmaz, T. Donmez, S. Ferahman, C. Akarsu, Sezer Bulut, H. Ozcevik, H. Aydin, M. Karabulut
Introduction The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra- and post-operative complications were evaluated. Results The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.
{"title":"Partial cecum resection using endostapler in acute complicated appendicitis with appendiceal base necrosis","authors":"S. Yılmaz, T. Donmez, S. Ferahman, C. Akarsu, Sezer Bulut, H. Ozcevik, H. Aydin, M. Karabulut","doi":"10.5114/wiitm.2021.105574","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105574","url":null,"abstract":"Introduction The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra- and post-operative complications were evaluated. Results The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"143 - 149"},"PeriodicalIF":1.7,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42280544","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 : 2020-12-11DOI: 10.5114/wiitm.2021.105725
Yi Zhang, Ze Fu, Te Fang, Kexin Wang, Zimeng Liu, Hongqing Li, Wenwen Jiang, Xuezhao Cao
Introduction Patients who undergo video-assisted thoracic surgery (VATS) frequently experience moderate to severe postoperative pain. Serratus anterior plane block (SAPB) is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve. Aim To evaluate the analgesic efficiency of deep serratus plane block (DSPB) and superficial serratus anterior plane block (SSPB) as well as paravertebral nerve block (PVB) in patients undergoing VATS. Material and methods A total of 74 patients aged 16–80 undergoing VATS were randomized to receive either DSPB or SSPB as well as PVB. Ultrasound (US) guided DSPB or SSPB as well as PVB was performed preoperatively on the patients according to their groups. All patients were provided with patient-controlled intravenous analgesia (PCIA) for postoperative analgesia. The primary outcomes were the levels of postoperative pain at rest and on coughing evaluated by the visual analog scale (VAS), and intraoperative and postoperative opioid consumption. The secondary outcomes included PCIA pressing times, side effects and satisfaction with analgesia, duration of nerve block, intraoperative hemodynamic changes and vasoactive drug dosage. Results No significant differences of VAS score were found. During the operation, PVB reduced consumption of opioids (27.23 ±5.10 mg) compared to DSPB (31.20 ±3.80 mg) and SSPB (32.61 ±5.28 mg). The effective pressing times of PCIA in the SSPB group (0.18 ±0.65) were significantly lower compared to the PVB group (1.09 ±1.50) at 12 h postoperatively. Accordingly, SSPB also reduced the dosage of PCIA (26.55 ±4.72 ml) compared to PVB (31.45 ±7.60 ml). Time of the PVB procedure was longer (11.14 ±1.66 min) than DSPB (5.68 ±1.10 min) and SSPB (4.77 ±1.04 min). Conclusions DSPB and SSPB are easy to perform and can serve as a promising alternative technique to PVB that may offer comparable analgesic effectiveness for patients undergoing VATS.
{"title":"A comparison of the analgesic efficacy of serratus anterior plane block vs. paravertebral nerve block for video-assisted thoracic surgery: a randomized controlled trial","authors":"Yi Zhang, Ze Fu, Te Fang, Kexin Wang, Zimeng Liu, Hongqing Li, Wenwen Jiang, Xuezhao Cao","doi":"10.5114/wiitm.2021.105725","DOIUrl":"https://doi.org/10.5114/wiitm.2021.105725","url":null,"abstract":"Introduction Patients who undergo video-assisted thoracic surgery (VATS) frequently experience moderate to severe postoperative pain. Serratus anterior plane block (SAPB) is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve. Aim To evaluate the analgesic efficiency of deep serratus plane block (DSPB) and superficial serratus anterior plane block (SSPB) as well as paravertebral nerve block (PVB) in patients undergoing VATS. Material and methods A total of 74 patients aged 16–80 undergoing VATS were randomized to receive either DSPB or SSPB as well as PVB. Ultrasound (US) guided DSPB or SSPB as well as PVB was performed preoperatively on the patients according to their groups. All patients were provided with patient-controlled intravenous analgesia (PCIA) for postoperative analgesia. The primary outcomes were the levels of postoperative pain at rest and on coughing evaluated by the visual analog scale (VAS), and intraoperative and postoperative opioid consumption. The secondary outcomes included PCIA pressing times, side effects and satisfaction with analgesia, duration of nerve block, intraoperative hemodynamic changes and vasoactive drug dosage. Results No significant differences of VAS score were found. During the operation, PVB reduced consumption of opioids (27.23 ±5.10 mg) compared to DSPB (31.20 ±3.80 mg) and SSPB (32.61 ±5.28 mg). The effective pressing times of PCIA in the SSPB group (0.18 ±0.65) were significantly lower compared to the PVB group (1.09 ±1.50) at 12 h postoperatively. Accordingly, SSPB also reduced the dosage of PCIA (26.55 ±4.72 ml) compared to PVB (31.45 ±7.60 ml). Time of the PVB procedure was longer (11.14 ±1.66 min) than DSPB (5.68 ±1.10 min) and SSPB (4.77 ±1.04 min). Conclusions DSPB and SSPB are easy to perform and can serve as a promising alternative technique to PVB that may offer comparable analgesic effectiveness for patients undergoing VATS.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"17 1","pages":"134 - 142"},"PeriodicalIF":1.7,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41599698","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 : 2019-07-25DOI: 10.5114/wiitm.2019.86919
Mininkova Ai, G. Lu, Jian Xu
Introduction Severe acute pancreatitis (SAP) has a high mortality rate of 20% to 30%, with death often resulting from hemorrhage. Aim To investigate the role of digital subtraction angiography (DSA) and endovascular embolization in the management of arterial bleeding in SAP patients. Material and methods Seventy-six patients with SAP admitted to our hospital between January 2010 and May 2016 underwent DSA. DSA revealed arterial bleeding in 22 of these patients, who were treated with transcatheter endovascular embolization with coils and/or gelfoam particles. Patient demographics, angiographic features of vascular abnormalities, and outcomes of embolization were assessed. Results Arterial bleeding was the most common vascular abnormality (22/76 patients; 28.9%). DSA enabled the identification of 27 bleeding arteries in 22 patients. The splenic artery was the most commonly affected vessel (11/27; 40.7%). Among the 27 arteries treated with endovascular embolization, successful hemostasis was achieved in 96.3% (26/27). Two patients developed major complications (hepatic and splenic abscess). These patients were treated with abdominal catheter drainage and anti-infection measures and ultimately recovered. The mean interval between initial onset of SAP and angiographic diagnosis of arterial bleeding was 56 days. Rebleeding was diagnosed in 5 patients (5/22; 22.7%) during repeat angiography, with bleeding from new sites in four of these patients. The mean interval between successive angiography treatments was 38 days. Conclusions Endovascular embolization is a safe and effective method to localize bleeding arteries and achieve complete hemostasis in patients with SAP-related arterial bleeding.
{"title":"Endovascular embolization of arterial bleeding in patients with severe acute pancreatitis","authors":"Mininkova Ai, G. Lu, Jian Xu","doi":"10.5114/wiitm.2019.86919","DOIUrl":"https://doi.org/10.5114/wiitm.2019.86919","url":null,"abstract":"Introduction Severe acute pancreatitis (SAP) has a high mortality rate of 20% to 30%, with death often resulting from hemorrhage. Aim To investigate the role of digital subtraction angiography (DSA) and endovascular embolization in the management of arterial bleeding in SAP patients. Material and methods Seventy-six patients with SAP admitted to our hospital between January 2010 and May 2016 underwent DSA. DSA revealed arterial bleeding in 22 of these patients, who were treated with transcatheter endovascular embolization with coils and/or gelfoam particles. Patient demographics, angiographic features of vascular abnormalities, and outcomes of embolization were assessed. Results Arterial bleeding was the most common vascular abnormality (22/76 patients; 28.9%). DSA enabled the identification of 27 bleeding arteries in 22 patients. The splenic artery was the most commonly affected vessel (11/27; 40.7%). Among the 27 arteries treated with endovascular embolization, successful hemostasis was achieved in 96.3% (26/27). Two patients developed major complications (hepatic and splenic abscess). These patients were treated with abdominal catheter drainage and anti-infection measures and ultimately recovered. The mean interval between initial onset of SAP and angiographic diagnosis of arterial bleeding was 56 days. Rebleeding was diagnosed in 5 patients (5/22; 22.7%) during repeat angiography, with bleeding from new sites in four of these patients. The mean interval between successive angiography treatments was 38 days. Conclusions Endovascular embolization is a safe and effective method to localize bleeding arteries and achieve complete hemostasis in patients with SAP-related arterial bleeding.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"401 - 407"},"PeriodicalIF":1.7,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.86919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43387761","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 : 2019-05-23DOI: 10.5114/wiitm.2019.85350
H. E. Sıkar, Kenan Çetin
Introduction Recurrent hernias can be treated by laparoscopy without the need for mesh removal. However, shrinkage of the mesh following recurrence affects most of the patients, and leaving a partially floating and rigid foreign body could be discussed. Aim To compare the outcomes of patients regarding the removal of previous mesh during laparoscopic repair of recurrent abdominal wall hernias. Material and methods Patients who underwent laparoscopic repair for recurrent ventral hernias between August 2012 and March 2015 were included in the study. The patients with complete removal of the mesh were included in the MR group and the patients with partial removal or without removal of the previous mesh were included in the non-MR group. Patient characteristics and demographics, previous hernia repair, defect size, mesh size, operative time, mean hospital stay, complications, recurrences, numeric pain rating scale (NRS), early termination of analgesics and prolonged use of analgesics were compared. Results A total of 112 patients with a mean age of 53.2 and mean body mass index of 31.1 kg/m2 underwent laparoscopic repair. There were 47 patients in the MR group and 54 patients in the non-MR group. Operative time was shorter in the non-MR group (p < 0.05), whereas symptomatic seroma and NRS scores on postoperative day 10 and at the 6th week were higher in comparison with the MR group (p < 0.05). Conclusions Mesh removal during laparoscopic repair of recurrent ventral hernias has an association with the reduction of pain and symptomatic seroma. However, further prospective comparative studies are required to verify this view.
{"title":"The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome","authors":"H. E. Sıkar, Kenan Çetin","doi":"10.5114/wiitm.2019.85350","DOIUrl":"https://doi.org/10.5114/wiitm.2019.85350","url":null,"abstract":"Introduction Recurrent hernias can be treated by laparoscopy without the need for mesh removal. However, shrinkage of the mesh following recurrence affects most of the patients, and leaving a partially floating and rigid foreign body could be discussed. Aim To compare the outcomes of patients regarding the removal of previous mesh during laparoscopic repair of recurrent abdominal wall hernias. Material and methods Patients who underwent laparoscopic repair for recurrent ventral hernias between August 2012 and March 2015 were included in the study. The patients with complete removal of the mesh were included in the MR group and the patients with partial removal or without removal of the previous mesh were included in the non-MR group. Patient characteristics and demographics, previous hernia repair, defect size, mesh size, operative time, mean hospital stay, complications, recurrences, numeric pain rating scale (NRS), early termination of analgesics and prolonged use of analgesics were compared. Results A total of 112 patients with a mean age of 53.2 and mean body mass index of 31.1 kg/m2 underwent laparoscopic repair. There were 47 patients in the MR group and 54 patients in the non-MR group. Operative time was shorter in the non-MR group (p < 0.05), whereas symptomatic seroma and NRS scores on postoperative day 10 and at the 6th week were higher in comparison with the MR group (p < 0.05). Conclusions Mesh removal during laparoscopic repair of recurrent ventral hernias has an association with the reduction of pain and symptomatic seroma. However, further prospective comparative studies are required to verify this view.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"366 - 373"},"PeriodicalIF":1.7,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.85350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47822572","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 : 2019-05-15DOI: 10.5114/wiitm.2019.81305
Tiezhu Chen, Yi‐sheng Wang, Xiaosheng Li
Introduction Anterior cruciate ligament (ACL) injury always leads to knee pain and dysfunction for which surgical reconstruction is recommended, with good clinical results, but decreased postoperative proprioception also tends to occur. ACL stump (ACLS)-retaining ACL reconstruction and non-ACLS-retaining ACL reconstruction are the two surgical options. Aim To investigate the efficacy of retaining the ACLS in allograft reconstruction. Material and methods Thirty patients were retrospectively assigned to group A, ACLS-retaining ACL reconstruction; and group B, non-ACLS-retaining ACL reconstruction, and their data were analyzed. The knee function (Lysholm score and Tegner motion score) and proprioceptive function of the two groups were assessed and compared by postoperative reconstruction angle. Results The 30 patients were followed up for a mean 20 months. The mean Lysholm score in group A increased from 55.7 ±11.6 points preoperatively to 95.2 ±5.7 points postoperatively; that in group B increased from 56.7 ±11.3 points preoperatively to 94.6 ±7.2 points postoperatively. The mean Tegner motion score in group A was increased from 2.4 ±0.7 points preoperatively to 6.0 ±0.7 points postoperatively; that in group B increased from 2.73 ±0.96 points preoperatively to 6.24 ±0.48 points postoperatively; the postoperative scores did not differ significantly between the two groups. The proprioception was better in group A than in group B at 3, 6, and 12 months postoperatively (p < 0.05). Conclusions ACLS-retaining ACL reconstruction has good efficacy and the retained ACLS can benefit postoperative proprioception recovery at an early stage.
{"title":"Anterior cruciate ligament reconstruction using an anterior cruciate ligament stump","authors":"Tiezhu Chen, Yi‐sheng Wang, Xiaosheng Li","doi":"10.5114/wiitm.2019.81305","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81305","url":null,"abstract":"Introduction Anterior cruciate ligament (ACL) injury always leads to knee pain and dysfunction for which surgical reconstruction is recommended, with good clinical results, but decreased postoperative proprioception also tends to occur. ACL stump (ACLS)-retaining ACL reconstruction and non-ACLS-retaining ACL reconstruction are the two surgical options. Aim To investigate the efficacy of retaining the ACLS in allograft reconstruction. Material and methods Thirty patients were retrospectively assigned to group A, ACLS-retaining ACL reconstruction; and group B, non-ACLS-retaining ACL reconstruction, and their data were analyzed. The knee function (Lysholm score and Tegner motion score) and proprioceptive function of the two groups were assessed and compared by postoperative reconstruction angle. Results The 30 patients were followed up for a mean 20 months. The mean Lysholm score in group A increased from 55.7 ±11.6 points preoperatively to 95.2 ±5.7 points postoperatively; that in group B increased from 56.7 ±11.3 points preoperatively to 94.6 ±7.2 points postoperatively. The mean Tegner motion score in group A was increased from 2.4 ±0.7 points preoperatively to 6.0 ±0.7 points postoperatively; that in group B increased from 2.73 ±0.96 points preoperatively to 6.24 ±0.48 points postoperatively; the postoperative scores did not differ significantly between the two groups. The proprioception was better in group A than in group B at 3, 6, and 12 months postoperatively (p < 0.05). Conclusions ACLS-retaining ACL reconstruction has good efficacy and the retained ACLS can benefit postoperative proprioception recovery at an early stage.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"461 - 467"},"PeriodicalIF":1.7,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41850344","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 : 2019-02-18DOI: 10.5114/wiitm.2019.83001
T. Szmuda, S. Kierońska, P. Słoniewski, J. Dzierżanowski
Introduction Standard craniotomy (SC) and burr hole craniostomy (BHC) are regarded as the standard approaches to chronic subdural haematoma (CSDH). Bedside twist drill craniostomy (TDC), performed at the patient’s bedside, was introduced as an alternative to the standard methods. However, clinical and radiological features of patients treated with TDC and BHC/SC have not been compared. Aim To demonstrate the specific features of CSDH that affect the surgeons’ preferences when selecting patients for TDC. Material and methods A retrospective analysis of 32 patients treated due to CSDH in the year 2017 at a single institution was performed. Baseline radiological characteristics, clinical status at admission, complication rate and clinical outcomes were compared between BHC/SC and TDC. Results Of the 32 patients, 5 (15.6%) were treated using TDC and 27 (84.4%) by SC or BHC. The duration of the TDC procedure was significantly shorter than the time of standard therapies (p < 0.01). There were no differences between TDC and BHC/SC in terms of baseline clinical characteristics, including age, gender, head trauma history, diabetes, hypertension, antiplatelet drug use, clinical manifestation and the Glasgow Coma Scale score (all p > 0.05). Patients treated with TDC had a significantly thicker haematoma (TDC vs. BHC/SC: mean 25.3 mm vs. 14.6 mm) (p < 0.01) and demonstrated a smaller midline shift (TDC vs. BHC/SC: mean 0.5 mm vs. 4.0 mm) (p = 0.01) compared to those treated with BHC/SC. Conclusions Twist drill craniostomy is a more effective method for CSDH evacuation compared to SC and BHC. This procedure is considered as the first line treatment for patients with a thicker and non-septated haematoma, and with a smaller midline shift.
{"title":"Modified bedside twist drill craniostomy for evacuation of chronic subdural haematoma","authors":"T. Szmuda, S. Kierońska, P. Słoniewski, J. Dzierżanowski","doi":"10.5114/wiitm.2019.83001","DOIUrl":"https://doi.org/10.5114/wiitm.2019.83001","url":null,"abstract":"Introduction Standard craniotomy (SC) and burr hole craniostomy (BHC) are regarded as the standard approaches to chronic subdural haematoma (CSDH). Bedside twist drill craniostomy (TDC), performed at the patient’s bedside, was introduced as an alternative to the standard methods. However, clinical and radiological features of patients treated with TDC and BHC/SC have not been compared. Aim To demonstrate the specific features of CSDH that affect the surgeons’ preferences when selecting patients for TDC. Material and methods A retrospective analysis of 32 patients treated due to CSDH in the year 2017 at a single institution was performed. Baseline radiological characteristics, clinical status at admission, complication rate and clinical outcomes were compared between BHC/SC and TDC. Results Of the 32 patients, 5 (15.6%) were treated using TDC and 27 (84.4%) by SC or BHC. The duration of the TDC procedure was significantly shorter than the time of standard therapies (p < 0.01). There were no differences between TDC and BHC/SC in terms of baseline clinical characteristics, including age, gender, head trauma history, diabetes, hypertension, antiplatelet drug use, clinical manifestation and the Glasgow Coma Scale score (all p > 0.05). Patients treated with TDC had a significantly thicker haematoma (TDC vs. BHC/SC: mean 25.3 mm vs. 14.6 mm) (p < 0.01) and demonstrated a smaller midline shift (TDC vs. BHC/SC: mean 0.5 mm vs. 4.0 mm) (p = 0.01) compared to those treated with BHC/SC. Conclusions Twist drill craniostomy is a more effective method for CSDH evacuation compared to SC and BHC. This procedure is considered as the first line treatment for patients with a thicker and non-septated haematoma, and with a smaller midline shift.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"442 - 450"},"PeriodicalIF":1.7,"publicationDate":"2019-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.83001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45845973","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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