Surgical Outcomes of Interval Laparoscopic Appendectomy for Appendiceal Abscess and Predictors of Conversion to Open Surgery

2021 ◽  
Author(s):  
Yuuki Sekine ◽  
Hiroyuki Sugo ◽  
Shozo Miyano ◽  
Ikuo Watanobe ◽  
Michio Machida ◽  
...  
Keyword(s):  
Laparoscopic Appendectomy ◽  
Surgical Outcomes ◽  
Open Surgery ◽  
Appendiceal Abscess ◽  
Conversion To Open Surgery

scholarly journals A study of pre-operative predictors for conversion to open surgery in emergency laparoscopic appendectomy

2020 ◽  
Vol 7 (8) ◽  
pp. 2499
Author(s):  
Harsha B. Kodliwadmath ◽  
B. Srinivas Pai ◽  
K. Sphurti Kamath
Keyword(s):  
Laparoscopic Appendectomy ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Complicated Appendicitis ◽  
Total Leucocyte Count ◽  
Conversion To Open Surgery ◽  
Male Preponderance ◽  
The Mean ◽  
One Year ◽  
Open Surgical Approach

Background: Acute appendicitis is one of the most common emergencies encountered by surgeons. Although laparoscopic appendectomy is the preferred approach complicated appendicitis with a mass, abscess or perforation do present with a challenge to the operating surgeon compelling him to convert to open surgery. Our study aimed at identifying pre-operative factors that would help us predict the risk of conversion to open surgery.Methods: This was a prospective analytical study. All cases admitted over a period of one year undergoing emergency appendectomy were included in the study. The duration of history, clinical presentation, laboratory and radiological investigations were noted. The reason for conversion to open surgery was recorded. The post-operative stay and complications were analyzed.Results: A total of 160 patients fulfilling the inclusion criteria were included in the study. The mean age was 33.78 years with a male preponderance of 58%. The duration of history, clinical and radiological evidence of complicated appendicitis and peritonitis, total leucocyte count and serum bilirubin levels were identified as pre-operative predictors for risk of conversion to open surgery from laparoscopic appendectomy.Conclusions: These predictors are useful in predicting conversion to open surgery in laparoscopic emergency appendectomy. In these cases, proceeding with an open surgical approach may be beneficial to the patient in reducing operative time, cost, hospital stay and complications as laparoscopic approach may prove to be unsuccessful. This would help in enhanced communication between the surgeon and the patient with respect to the outcome and prognosis. 

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

scholarly journals Laparoscopic Appendectomy Versus Open Appendectomy in Children: Evolution over Time

2021 ◽  
Vol 26 (1) ◽  
pp. 44-46
Author(s):  
Laura Dumitrică ◽  
Luminiţa Dobrotă ◽  
Bogdan Neamţu
Keyword(s):  
Laparoscopic Appendectomy ◽  
Comparative Evaluation ◽  
Open Surgery ◽  
Postoperative Ileus ◽  
Open Appendectomy ◽  
Safe Procedure ◽  
The World ◽  
Clinical Benefits ◽  
Meta Analyses ◽  
Reduced Risk

Abstract Laparoscopic appendicitis surgery is accepted in more and more centers around the world. Studies and meta-analyses of studies have shown that laparoscopic appendicitis is a feasible and safe procedure with numerous clinical benefits, such as shorter postoperative ileus, lower incidence of wound infection, lower postoperative pain and duration, recurrence faster to activities. Because laparoscopic appendectomy has been associated with a reduced risk of surgical complications, it may provide a better alternative versus open surgery. A review of data relevant to the evaluation of laparoscopic appendectomy versus open appendectomy as reflected in the literature of the last 2 decades would be relevant for the growing progressive interest of laparoscopic surgery for acute appendicitis and for its comparative evaluation with classical open appendicitis intervention.

Emergency Cholecystectomy for Patients on Antiplatelet Therapy

2017 ◽  
Vol 83 (5) ◽  
pp. 486-490 ◽  
Author(s):  
Keiichi Akahoshi ◽  
Takanori Ochiai ◽  
Ayumi Takaoka ◽  
Takuya Kitamura ◽  
Daisuke Ban ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Acute Cholecystitis ◽  
Antiplatelet Therapy ◽  
Open Surgery ◽  
Massive Hemorrhage ◽  
Intraoperative Blood Loss ◽  
Local Inflammation ◽  
Conversion To Open Surgery ◽  
Difficult Decision ◽  
Emergency Cholecystectomy

The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACTis still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014. Treatment outcomes among 13 patients who underwent cholecystectomy without discontinuing APT (the cAPT group), 11 patients who discontinued APT and ACT (the D group), and 89 patients who did not receive preoperative APT and/or ACT (the No APT group) were compared. There were no significant differences in intraoperative blood loss, conversion to open surgery, and bleeding-related complications. However, the incidence of intraoperative blood transfusion was higher in the cAPT group (P = 0.04). They presented with severe local inflammation; thus, it was difficult to stop bleeding from the gallbladder bed. Hemostatic tools for liver surgery were used to control bleeding. Emergency cholecystectomy was tolerable for patients with acute cholecystitis while continuing APT. However, in case of severe local inflammation, there is a greater risk for massive hemorrhage.

Conversion to open surgery during minimally invasive esophagectomy portends worse short-term outcomes: an analysis of the National Cancer Database

2019 ◽  
Vol 34 (8) ◽  
pp. 3470-3478
Author(s):  
Alison L. Halpern ◽  
Chloe Friedman ◽  
Robert J. Torphy ◽  
Mohammed H. Al-Musawi ◽  
John D. Mitchell ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Surgery ◽  
Minimally Invasive Esophagectomy ◽  
National Cancer Database ◽  
Short Term ◽  
Conversion To Open Surgery ◽  
Invasive Esophagectomy

Clinical Characteristics and Surgical Outcomes of Sinonasal Lesions Associated With Tumor-Induced Osteomalacia

2020 ◽  
pp. 019459982097543
Author(s):  
Zhenzhen Zhu ◽  
Weibo Xia ◽  
Fang Qi ◽  
Weiqing Wang ◽  
Xiaowei Wang ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Outcomes ◽  
Recovery Rate ◽  
Open Surgery ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Case Series ◽  
Ethmoid Sinus ◽  
Tertiary Center ◽  
Significant Difference

Objective To investigate the clinical characteristics and surgical outcomes of sinonasal tumors associated with tumor-induced osteomalacia (TIO). Study Design Retrospective case series. Setting Single tertiary center. Methods We studied the clinical characteristics and surgical outcomes of 43 patients (22 male, 21 female) who had lesions in the nasal cavity and paranasal sinus associated with TIO and underwent surgery between August 2006 and November 2019. Results The mean ± SD duration between the onset of symptoms and surgery was 3.9 ± 2.6 years. The most common tumor site was the ethmoid sinus (76.7%), and the skull base was involved in 12 cases. Phosphaturic mesenchymal tumors were diagnosed in 41 patients, among whom there was 1 multifocal case. Another 2 cases involved odontogenic fibroma and hemangiofibroma, respectively. Serum phosphorus normalized in 39 cases within 4.4 ± 2.3 days, and serum fibroblastic growth factor 23 normalized within 1 day; clinical symptoms, however, gradually improved within several months after the first operation. There was no significant difference in the recovery rate between endoscopic and open surgery ( P = 0.639). Two patients with recurrent cases and 2 with nonremission cases recovered after a sinonasal reoperation. The patient with a multifocal case recovered after the resection of the tumors in the ethmoid sinus and mandible. The overall recovery rate was 97.7%. Conclusion Most sinonasal tumors associated with TIO are located in the ethmoid sinus, and the skull base is involved in some cases. Complete excision of the tumor leads to recovery, and endoscopic surgery could achieve recovery rates similar to those of open surgery.

scholarly journals Conversion to open surgery remains minimal despite growing use of laparoscopic or robotic nephrectomy

2020 ◽  
Vol 20 ◽  
pp. S113
Author(s):  
M. Paciotti ◽  
D. Nguyen ◽  
D. Modonutti ◽  
P. Casale ◽  
R. Hurle ◽  
...  
Keyword(s):  
Open Surgery ◽  
Conversion To Open Surgery ◽  
Robotic Nephrectomy
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