scholarly journals Single surgeon experience of surgical treatment of hilar cholangiocellular carcinoma – learning curve and surgical outcomes

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e465
Author(s):  
D.H. Han ◽  
G.H. Choi ◽  
J.H. Lee
Keyword(s):  
Surgical Treatment ◽  
Learning Curve ◽  
Surgical Outcomes ◽  
Cholangiocellular Carcinoma ◽  
Surgeon Experience

scholarly journals The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 241-250
Author(s):  
Marta Araujo-Castro ◽  
Eider Pascual-Corrales ◽  
Héctor Pian ◽  
Ignacio Ruz-Caracuel ◽  
Alberto Acitores Cancela ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Surgical Outcomes ◽  
Pituitary Adenomas ◽  
Somatostatin Analogues ◽  
Beneficial Effects ◽  
Key Factor ◽  
Long Acting ◽  
First Time ◽  
Endocrine Complications

Purpose: to determine whether pre-surgical treatment using long-acting somatostatin analogues (SSAs) may improve surgical outcomes in acromegaly. Methods: retrospective study of 48 patients with acromegaly operated by endoscopic transsphenoidal approach and for first time. Surgical remission was evaluated based on the 2010 criteria. Results: most patients, 83.3% (n = 40), harbored macroadenomas and 31.3% (n = 15) invasive pituitary adenomas. In this case, 14 patients were treated with lanreotide LAR and 6 with octreotide LAR, median monthly doses of 97.5 [range 60–120] and 20 [range 20–30] mg, respectively, for at least 3 months preoperatively. Presurgical variables were comparable between pre-treated and untreated patients (p > 0.05). Surgical remission was more frequent in those pre-treated with monthly doses ≥90 mg of lanreotide or ≥30 mg of octreotide than in untreated or pre-treated with lower doses (OR = 4.64, p = 0.025). However, no differences were found between pre-treated and untreated patients when lower doses were included or between those treated for longer than 6 months compared to those untreated or pre-treated for shorter than 6 months. Similarly, no differences were found either in terms of surgical or endocrine complications (OR = 0.65, p = 0.570), independently of the doses and the duration of SSA treatment (p > 0.05). Conclusions: the dose of SSAs is a key factor during pre-surgical treatment, since the beneficial effects in surgical remission were observed with monthly doses equal or higher than 90 mg of lanreotide and 30 mg of octreotide, but not with lower doses.

Learning Curve in Surgical Treatment of Odontoid Fixation for a Series of Type II C2 Fractures

2019 ◽  
pp. 325-327
Author(s):  
Rosario Maugeri ◽  
Domenico Gerardo Iacopino ◽  
Giuseppe Roberto Giammalva ◽  
Francesca Graziano ◽  
Carlo Gulì
Keyword(s):  
Surgical Treatment ◽  
Learning Curve ◽  
Type Ii

scholarly journals A New Proposal for Learning Curve of TEP Inguinal Hernia Repair: Ability to Complete Operation Endoscopically as a First Phase of Learning Curve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mustafa Hasbahceci ◽  
Fatih Basak ◽  
Aylin Acar ◽  
Orhan Alimoglu
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Learning Curve ◽  
Inguinal Hernia Repair ◽  
Exact Nature ◽  
Conversion To Open Surgery ◽  
Totally Extraperitoneal ◽  
Surgeon Experience ◽  
Repair Ability ◽  
Complete Operation

Background. The exact nature of learning curve of totally extraperitoneal inguinal hernia and the number required to master this technique remain controversial.Patients and Methods. We present a retrospective review of a single surgeon experience on patients who underwent totally extraperitoneal inguinal hernia repair.Results. There were 42 hernias (22 left- and 20 right-sided) in 39 patients with a mean age of48.8±15.1years. Indirect, direct, and combined hernias were present in 18, 12, and 12 cases, respectively. The mean operative time was55.1±22.8minutes. Peritoneal injury occurred in 9 cases (21.4%). Conversion to open surgery was necessitated in 7 cases (16.7%). After grouping of all patients into two groups as cases between 1–21 and 22–42, it was seen that the majority of peritoneal injuries (7 out of 9, 77.8%,P=0.130) and all conversions (P=0.001) occurred in the first 21 cases.Conclusions. Learning curve of totally extraperitoneal inguinal hernia repair can be divided into two consequent steps: immediate and late. At least 20 operations are required for gaining anatomical knowledge and surgical pitfalls based on the ability to perform this operation without conversion during immediate phase.

Learning curve and surgical outcomes for laparoscopic surgery, including pelvic lymphadenectomy, for early stage endometrial cancer

2019 ◽  
Vol 49 (6) ◽  
pp. 521-524 ◽  
Author(s):  
Shinichi Togami ◽  
Toshihiko Kawamura ◽  
Mika Fukuda ◽  
Shintaro Yanazume ◽  
Masaki Kamio ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Learning Curve ◽  
Surgical Outcomes ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Early Stage Endometrial Cancer

scholarly journals Surgical treatment of cleft lip

2014 ◽  
Vol 41 (3) ◽  
pp. 208-214 ◽  
Author(s):  
Mateus Domingues Miachon ◽  
Pedro Luiz Squilacci Leme
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Cleft Lip ◽  
Review Of The Literature ◽  
Electronic Library ◽  
Cross Sectional ◽  
Optimal Technique ◽  
Surgeon Experience

We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1) the severity of the cleft will indicate the technique presenting more advantages; 2) the different approaches indicate that there is no consensus on the optimal technique; and 3) the surgeon experience contributes to choosing the best option.

scholarly journals Surgical Treatment of Cervical Spondylosis in the Elderly: Surgical Outcomes, Risk Factors, and Complications

2008 ◽  
Vol 48 (9) ◽  
pp. 377-382 ◽  
Author(s):  
Kazutoshi HIDA ◽  
Shunsuke YANO ◽  
Izumi KOYANAGI ◽  
Minoru AKINO ◽  
Toshitaka SEKI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Surgical Outcomes ◽  
Cervical Spondylosis ◽  
The Elderly

scholarly journals Surgical Outcomes in Post-Traumatic Epilepsy: A Single Institutional Experience

2019 ◽  
Vol 18 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Frederick L Hitti ◽  
Matthew Piazza ◽  
Saurabh Sinha ◽  
Svetlana Kvint ◽  
Eric Hudgins ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Seizure Frequency ◽  
Surgical Outcomes ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Post Traumatic ◽  
Neocortical Epilepsy ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Abstract BACKGROUND Post-traumatic epilepsy (PTE) is a debilitating sequela of traumatic brain injury (TBI), occurring in up to 20% of severe cases. This entity is generally thought to be more difficult to treat with surgical intervention. OBJECTIVE To detail our experience with the surgical treatment of PTE. METHODS Patients with a history of head injury undergoing surgical treatment for epilepsy were retrospectively enrolled. Engel classification at the last follow-up was used to assess outcome of patients that underwent surgical resection of an epileptic focus. Reduction in seizure frequency was assessed for patients who underwent vagal nerve stimulator (VNS) or responsive neurostimulator (RNS) implantation. RESULTS A total of 23 patients met inclusion criteria. Nineteen (82.6%) had mesial temporal sclerosis, 3 had lesional neocortical epilepsy (13.0%), and 1 had nonlesional neocortical epilepsy (4.3%). Fourteen patients (60.9%) underwent temporal lobectomy (TL), 2 underwent resection of a cortical focus (8.7%), and 7 underwent VNS implantation (30.4%). Three patients underwent RNS implantation after VNS failed to reduce seizure frequency more than 50%. In the patients treated with resection, 11 (68.8%) were Engel I, 3 (18.8%) were Engel II, and 2 (12.5%) were Engel III at follow-up. Average seizure frequency reduction in the VNS group was 30.6% ± 25.6%. RNS patients had reduction of seizure severity but seizure frequency was only reduced 9.6% ± 13.6%. CONCLUSION Surgical outcomes of PTE patients treated with TL were similar to reported surgical outcomes of patients with nontraumatic epilepsy treated with TL. Patients who were not candidates for resection demonstrated variable response rates to VNS or RNS implantation.

Single-Incision Laparoscopic Cholecystectomy: A Combined Analysis of Resident and Attending Learning Curves at a Single Institution

2012 ◽  
Vol 78 (1) ◽  
pp. 119-124
Author(s):  
Mark Joseph ◽  
Michael Phillips ◽  
Christopher C. Rupp
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Learning Curve ◽  
Single Incision ◽  
Learning Curves ◽  
Patient Specific ◽  
Short Learning Curve ◽  
Significant Difference ◽  
Surgeon Experience ◽  
Standard Laparoscopic Cholecystectomy ◽  
Single Incision Laparoscopic Cholecystectomy

Single-incision laparoscopic cholecystectomy (SILC) is a recent technical modification on standard laparoscopic cholecystectomy that has been shown to be safe and feasible. Recent studies suggest that experienced laparoscopic surgeons have a short learning curve to become proficient in SILC. However, little is known about the interaction of the learning curves of residents and attending surgeons at academic programs. We prospectively evaluated various metrics of both attending and resident surgeons as they progressed in their experience with SILC. Patients were placed into cohorts of 25 based on teaching surgeon experience. Data recorded included patient-specific and operative variables along with complications, conversion to standard laparoscopic cholecystectomy, and outcomes. One hundred one patients underwent SILC. Twelve per cent of patients required conversion to standard laparoscopic cholecystectomy. No significant difference was found in operative times compared within the experience-based cohorts ( P = 0.21). A reduction in operative time was shown in residents who were proficient in standard laparoscopic cholecystectomy (SLC) along their learning curve. Operative times remained the same for the teaching surgeon regardless of experience of resident surgeon. SILC has a short learning curve for resident surgeons who are proficient in standard laparoscopic surgery. SILC can be effectively taught with few complications and outcomes similar to SLC with preservation of operative efficiency and safety. Further studies are warranted, however, at a national/international level to define the place and use for SILC as well as the incorporation of single-incision techniques into resident curriculum.

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