scholarly journals Complications in Minimally Invasive Versus Open Surgery for Intermediate- to High-Grade Spondylolisthesis: A 10-Year Retrospective, Multicenter Experience

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Asad Mehmood Lak ◽  
Abdullah M Abunimer ◽  
Amina Rahimi ◽  
Ian Tafel ◽  
Hasan Aqdas Zaidi
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Open Reduction ◽  
Open Surgery ◽  
No Reduction ◽  
High Rate ◽  
High Grade ◽  
Neural Injury ◽  
Reduction Group

Abstract INTRODUCTION High-grade spondylolisthesis is a relatively uncommon condition. The optimal surgical approach for management remains debatable. Although in-situ fusion is preferred due to its lower risk of neural injury, it does not correct spinal alignment. In contrast, reduction corrects the deformity and provides a high rate of fusion, but has the potential for high rates of neural injury. We herein report our experience and surgical outcomes following minimally invasive versus open management of intermediate- to high-grade spondylolisthesis. METHODS A multicenter, retrospective cohort analysis of adult patients aged more than 18 yr with grade II or higher spondylolisthesis, who underwent surgery from January 2008 until February 2019, was performed. RESULTS Sixty-two patients were included in the final analysis. A total of 41 patients were treated with an open approach and 21 with a minimally invasive surgical approach (MIS). More specifically, 18 patients underwent in-situ fusion, 11 underwent MIS reduction, and 33 had an open reduction. The total rate of complications was 40.3%. The rate of complications in the MIS group was 52.3% compared to 34.1% in the open surgery group (P = .166). The rate of complications was 27.8% in the in-situ fusion group, 72.7% in the MIS-reduction group, and 36.4% in the open-reduction group. Our comparisons of the rate of complications in the no-reduction group vs the MIS-reduction group, and the MIS-reduction group vs the open-reduction group were statistically significant (P = .027 and P = .07, respectively). However, there was no statistically significant difference between the rate of complications in the no-reduction group vs the open-reduction group (P = .757), nor between the rate of complications in the MIS group vs the open surgery group (P = .166). CONCLUSION MIS reduction is associated with a high rate of complications in the management of high-grade spondylolisthesis.

scholarly journals Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christer Borgfeldt ◽  
Erik Holmberg ◽  
Janusz Marcickiewicz ◽  
Karin Stålberg ◽  
Bengt Tholander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Surgical Approach ◽  
Open Surgery ◽  
Gynecologic Cancer ◽  
Multivariable Analysis ◽  
Figo Stage

Abstract Background The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). Methods A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. Results In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. Conclusion The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.

Outcomes of Minimally Invasive versus Open Surgery for Intermediate to High-grade Spondylolisthesis

Spine ◽  
2020 ◽  
Vol 45 (20) ◽  
pp. 1451-1458
Author(s):  
Asad M. Lak ◽  
Abdullah M. Abunimer ◽  
Amina Rahimi ◽  
Ian Tafel ◽  
John Chi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Surgery ◽  
High Grade

scholarly journals Thoracoscopic recurrent tracheo-oesophageal fistula repair with mini endostapler: promising solution

2019 ◽  
Vol 12 (5) ◽  
pp. e229365
Author(s):  
Indalecio Cano Novillo ◽  
Belén Aneiros Castro ◽  
Araceli García Vázquez ◽  
Mónica De Miguel Moya
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Oesophageal Atresia ◽  
High Rate ◽  
Common Complication ◽  
Fistula Repair ◽  
Safe Alternative ◽  
Endoscopic Techniques ◽  
Promising Solution

Recurrent tracheo-oesophageal fistula (TOF) is a common complication in children who underwent oesophageal atresia repair. The traditional surgical approach performed either by thoracotomy or cervicotomy is associated with a high rate of morbidity, mortality and new recurrence. In the last decades, endoscopic techniques have emerged as the minimally invasive alternative. However, it seems that the optimal treatment is still unknown. We present a patient with a recurrent TOF who underwent thoracoscopic closure using a 5.8 mm endostapler. The patient was extubated at the end of the procedure, and he started feeding the day after surgery. At 15 months of follow-up, he is asymptomatic. Thoracoscopic closure of TOF using endostaplers seems to be a safe alternative with some possible benefits compared with traditional and endoscopic approach.

scholarly journals Minimally invasive treatment of gynecomastia by ultrasound-guided vacuum-assisted excision: report of a case series

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Henrique Lima Couto ◽  
Carolina Nazareth Valadares ◽  
Osmar Pellegrini Junior ◽  
Tereza Cristina Ferreira de Oliveira ◽  
Patricia Martins Gomes El Bacha ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Open Surgery ◽  
Breast Biopsy ◽  
Case Series ◽  
Ultrasound Guided ◽  
Invasive Treatment ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Patient Reported

Introduction: Gynecomastia (GM) is a benign proliferation of glandular breast tissue in men. Some cases need surgical intervention. Traditional open surgery by semicircular inferior periareolar incision is the most common surgical approach. In order to obtain better esthetic results, some alternatives to open surgery have been proposed, such as liposuction, endoscopic mastectomy, and vacuum-assisted excision (VAE). Objective: To describe the technical surgical approach of ultrasound-guided VAE of GM and its results from a case series. Method: This is an evaluation of seven GM cases submitted to ultrasound-guided VAE with a 10G needle using the ENCOR® BD whole circumference automated breast biopsy system in Redimasto – Redimama, a Brazilian breast center. The result was considered good or satisfactory when it showed minimal remaining gland, good symmetry, no retraction, necrosis, hypertrophic scar, or displacement of the nipple-areola complex. All patients answered a questionnaire to evaluate their satisfaction and perception of the procedure. Results: Seven (7) patients with Simon grade 1 and 2 bilateral GM underwent ultrasound-guided VAE. No case of displacement, necrosis, or retraction of the nipple-areola complex, post-procedure bleeding, infection, skin necrosis, or asymmetry was detected. No patient reported decrease or change in nipple sensation or erection. All patients had bruises and hematomas that spontaneously resolved within 30 days. All results were considered good or excellent by patients and surgeons. Conclusion: Minimally invasive ultrasound-guided VAE is an excellent alternative for the treatment of GM. It is better indicated for Simon grade 1 and 2 GM, with good and excellent esthetic results, small scar, and low rates of nipple and areolar complications. It allows an outpatient procedure with low morbidity (local anesthesia) and fast recovery.

scholarly journals Analysis of Spinopelvic Parameters with L5 as the New Sacrum after Fusion in High-Grade Spondylolisthesis: A Possible Explanation for Satisfactory Results with <italic>In-Situ</italic> Fusion

2018 ◽  
Vol 12 (1) ◽  
pp. 103-111
Author(s):  
Shanmuganathan Rajasekaran ◽  
Gurudip Das ◽  
Siddharth Narasimhan Aiyer ◽  
Rishi Mugesh Kanna ◽  
Ajoy Prasad Shetty
Keyword(s):  
Functional Outcomes ◽  
Short Form ◽  
Case Series ◽  
Sacral Slope ◽  
High Grade ◽  
Spinopelvic Parameters ◽  
Sagittal Vertical Axis ◽  
Surgical Methods ◽  
Reduction Group

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To correlate functional outcomes with spinopelvic parameters in patients with high-grade spondylolisthesis (HGS) treated with instrumented <italic>in-situ</italic> surgery or reduction and fusion.</p></sec><sec><title>Overview of Literature</title><p>Satisfactory functional outcomes are reported with reduction and <italic>in-situ</italic> fusion strategies in HGS. However, reasons for this are unclear. We hypothesize that following lumbosacral fusion, the L5 becomes part of the sacrum, which improves spinopelvic parameters, resulting in equivalent functional outcomes in both surgical methods.</p></sec><sec><title>Methods</title><p>Twenty-six patients undergoing HGS (reduction group A, 13; <italic>in-situ</italic> group B, 13) were clinically evaluated using the Oswestry Disability Index (ODI), short form-12 (SF-12), and Visual Analogue Scale (VAS) scores. Spinopelvic parameters, including pelvic incidence, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), lumbosacral kyphosis (LSK) angle, and sacrofemoral distance (SFD) were measured preoperatively from S1 and postoperatively from L5 as the new sacrum at 1 year follow-up. Sagittal alignment was assessed using the sagittal vertical axis.</p></sec><sec><title>Results</title><p>Both groups were comparable in terms of age, sex, severity of slip, and preoperative spinopelvic parameters (<italic>p</italic>&gt;0.05). Postoperative VAS, SF-12, and ODI scores significantly improved in both groups (<italic>p</italic>&lt;0.05). Compared with preoperative values, the mean postoperative PT, SFD, and LSK significantly changed in both groups. In reduction group, PT changed from 26.98° to 10.78°, SFD from 61.24 to 33.56 mm, and LSK from 74.76° to 109.61° (<italic>p</italic>&lt;0.05). In <italic>in-situ</italic> fusion group PT changed from 26.78° to 11.08°, SFD from 62.9 to 36.99 mm, and LSK from 67.23° to 113.38° (<italic>p</italic>&lt;0.05 for all). In both groups, SS and LL did not change significantly (<italic>p</italic>&gt;0.05).</p></sec><sec><title>Conclusions</title><p>After fusion, the L5 becomes the new sacrum and influences spinopelvic parameters to change favorably. This possibly explains why reduction and <italic>in-situ</italic> fusion achieve equivalent functional outcomes in HGS.</p></sec>

scholarly journals Surgical approach to solid pseudopapillary neoplasms of the proximal pancreas: minimally invasive vs. open

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Emmanuel II Uy Hao ◽  
Seoung Yoon Rho ◽  
Ho Kyoung Hwang ◽  
Jae Uk Chung ◽  
Woo Jung Lee ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Head And Neck ◽  
Surgical Approach ◽  
Tumor Size ◽  
Open Surgery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Minimally Invasive Surgical ◽  
Solid Pseudopapillary Neoplasms

Abstract Background Solid pseudopapillary neoplasms (SPN) of the pancreas are rare pancreatic neoplasms where complete resection is the cornerstone in management. It has been demonstrated in previous studies that minimally invasive surgical approaches are effective management options in treating SPNs of the distal pancreas. The purpose of this study is to evaluate the feasibility of minimally invasive surgery in treating SPNs of the uncinate, head, and neck of the pancreas. Methods Data from 2005 to 2017 at Severance Hospital of the Yonsei University Health systems in Seoul, South Korea, were retrospectively collected for 25 patients who were diagnosed with SPN of the uncinate, head, and neck of the pancreas and who underwent curative resection. Three groups of patients were considered, depending on the year of surgery, in order to determine trends in the surgical management of SPN. The patients were also divided into two groups corresponding to the type of operation done (minimally invasive surgery vs. open surgery). Perioperative patient data, including age, gender, body mass index (BMI), tumor size, and operation done, were compared and analyzed statistically. Long-term nutritional effects were measured using the Controlling Nutritional Status (CONUT) scoring system. Results There were no statistically significant differences in age, gender, BMI, symptomatic presentation, operation type, tumor size, and tumor stage between the three time periods. In comparing between minimally invasive and open surgery, there were no statistically significant differences in age, gender, symptomatic presentation, BMI, tumor size, preoperative stage, type of operation, operation time, pancreatic duct size, post-operative pancreatic fistula (POPF) grade, death associated with disease, recurrence, pathological parameters, and change in CONUT score. There was a significant difference in tumor size (4.5 ± 1.8 vs. 2.6 ± 1.0 cm, p = 0.004), blood loss (664.2 ± 512.4 vs. 277.7 ± 250.8 mL, p = 0.024), need to transfuse (33% vs. 0%, p = 0.023), hospital length of stay (27.4 ± 15.3 vs. 11.5 ± 5.3 days, p = 0.002), and complication rate (75% vs. 30.8%, p = 0.027) between the two groups. Conclusions In appropriately selected patients with SPNs of the uncinate, head, and neck of the pancreas, a minimally invasive surgical approach offers at least equal oncologic and nutritional outcomes, while demonstrating decreased complications and decreased hospital length of stay compared with that of an open surgical approach.

Oncologic kidney surgery in obese patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15039-e15039
Author(s):  
Mohab W. Safwat ◽  
Rebecca O'Malley ◽  
Attwood Kristopher ◽  
Diana Mehedint ◽  
Ramkishen Narayanan ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
World Health ◽  
High Grade ◽  
Obese Patients ◽  
Healthy Weight ◽  
Kidney Surgery ◽  
Conversion Rates ◽  
Estimated Blood Loss ◽  
The Impact

e15039 Background: Obesity adds significant operative challenge to kidney surgery. Its impact on minimally invasive kidney surgery has not been well defined. We evaluated the impact of obesity on open and minimally invasive kidney surgery (MIS) for kidney tumors. Methods: Patients in our prospectively collected IRB-approved kidney database were divided into 5 groups as determined by the World health organization Body mass index (BMI) classification: less than 25.0, 25.0-30.0, 30.0-35.0, 35.0-40.0, and more than 40.0 Kg/m2. Patient characteristics, and peri-operative data were recorded and compared between the different groups and between surgical approches(open vs. MIS) using the Kruskal Wallis and Chi Square tests for continuous and categorical data, respectively. The potential association between BMI and the continuous measures of OR time, Post op stay and EBL were assessed using spearman Correlations. Results: Of the 620 patients identified, 142 (22.9 %) had healthy weight, 180 (29.0%) were overweight, and 298 (48.1%) were obese. Most had grade 1 obesity (BMI 30-34, 167, 26.9%), grade 2 obesity (BMI 35-40, 76, 12.3%), and grade 3 obesity (BMI > 40, 55, 8.9%). As expected, the ASA score rose with degree of obesity (p=<.001). EBL (estimated blood loss), OR (operative time) time, Room time and post-operative stay differed significantly in the 5 groups of patients (p=0.001, p=0.003, p=<0.002, p= <.001, p=.002), respectively. While intra-operative complications did not differ between the obesity groups, obese patients had a higher rate of high grade Clavien complications (p=0.026). Interestingly, the surgical approach (open vs. MIS) and type of nephrectomy ( radical vs. partial) did not correlate with degree of obesity or complications, even when adjusted for stage. Conversion rates for MIS did not correlate with degree of obesity. Conclusions: Nephrectomy in obese patients results in incresed high grade of postoperative complications. Surgical approach does not appear to have any impact on peri-operative outcomes.

scholarly journals Staged Minimally Invasive Surgical Approach in the Management of Glandular Odontogenic Cyst

2018 ◽  
Vol 9 (1) ◽  
pp. 48-52
Author(s):  
Karuna Kumari ◽  
Kumar Vineeth ◽  
RM Lalitha ◽  
Marin Abraham
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Odontogenic Cyst ◽  
High Rate ◽  
Anterior Maxilla ◽  
Minimally Invasive Surgical Procedure ◽  
Minimally Invasive Surgical ◽  
Glandular Odontogenic Cyst ◽  
Jaw Cyst ◽  
Invasive Surgical Approach

ABSTRACT Aim The aim of the study was to report a unique case of glandular odontogenic cyst (GOC) in an unusual location of anterior maxilla. Materials and methods Considering the age, sex, and location of the lesion, a minimally invasive surgical procedure was opted considering esthetics, such as decompression followed by enucleation and fresh frozen bone (FFB) grafting. To arrive at the diagnosis, cytokeratin (CK)-19 was employed to differentiate from suspected intraosseous mucoepidermoid carcinoma. Results With the evidence of pre- and post treatment histopathological changes, the lesion appeared less aggressive justifying the treatment executed. Conclusion Glandular odontogenic cyst is a locally aggressive jaw cyst, which has a high rate of cortical perforation and recurrence that poses both diagnostic and therapeutic challenges. Clinical significance Treatment of decompression, followed by enucleation may be considered as an effective option in comparison to aggressive surgical intervention. How to cite this article Kumari K, Sowmya SV, Vineeth K, Rao RS, Lalitha RM, Augustine D, Haragannavar VC, Nambiar S, Abraham M. Staged Minimally Invasive Surgical Approach in the Management of Glandular Odontogenic Cyst. World J Dent 2018;9(1):48-52.

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