scholarly journals Minimally Invasive Scoliosis Surgery Is a Feasible Option for Management of Idiopathic Scoliosis and Has Equivalent Outcomes to Open Surgery: A Meta-Analysis

2021 ◽  
pp. 219256822098826
Author(s):  
Abduljabbar Alhammoud ◽  
Yahya Alborno ◽  
Abdul Moeen Baco ◽  
Yahya Azhar Othman ◽  
Yoji Ogura ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Idiopathic Scoliosis ◽  
Operative Time ◽  
Meta Analysis ◽  
Scoliosis Surgery ◽  
Curve Correction ◽  
Estimated Blood Loss ◽  
Feasible Option

Study Design: Meta-analysis. Objective: To compare outcomes between minimally invasive scoliosis surgery (MISS) and traditional posterior instrumentation and fusion in the correction of adolescent idiopathic scoliosis (AIS). Methods: A literature search was performed using MEDLINE, PubMed, EMBASE, Google scholar and Cochrane databases, including studies reporting outcomes for both MISS and open correction of AIS. Study details, demographics, and outcomes, including curve correction, estimated blood loss (EBL), operative time, postoperative pain, length of stay (LOS), and complications, were collected and analyzed. Results: A total of 4 studies met the selection criteria and were included in the analysis, totaling 107 patients (42 MIS and 65 open) with a mean age of 16 years. Overall there was no difference in curve correction between MISS (73.2%) and open (76.7%) cohorts. EBL was significantly lower in the MISS (271 ml) compared to the open (527 ml) group, but operative time was significantly longer (380 min for MISS versus 302 min for open). There were no significant differences between the approaches in pain, LOS, complications, or reoperations. Conclusion: MISS was associated with less blood loss but longer operative times compared to traditional open fusion for AIS. There was no difference in curve correction, postoperative pain, LOS, or complications/reoperations. While MISS has emerged as a feasible option for the surgical management of AIS, further research is warranted to compare these 2 approaches.

Efficacy of Routine Intraoperative Cranio-Femoral Traction in Surgical Treatment of Adolescent Idiopathic Scoliosis Curves Measuring Between 50° and 90°

2021 ◽  
pp. 219256822110529
Author(s):  
Jacob R. Carl ◽  
Gurpal Pannu ◽  
Evan Cherng-Yeh Chua ◽  
Adam Bacon ◽  
Blythe Durbin-Johnson ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Revision Surgery ◽  
Operative Time ◽  
Curve Correction ◽  
Major Curve ◽  
Estimated Blood Loss ◽  
Retrospective Comparative Study

Study Design Retrospective Comparative Study, Level III. Objective In patients with scoliosis >90°, cranio-femoral traction (CFT) has been shown to obtain comparable curve correction with decreased operative time and blood loss. Routine intraoperative CFT use in the treatment of AIS <90° has not been established definitively. This study investigates the effectiveness of intraoperative CFT in the treatment of AIS between 50° and 90°, comparing the magnitude of curve correction, blood loss, operative time, and traction-related complications with and without CFT. Methods 73 patients with curves less than 90° were identified, 36 without and 37 with cranio-femoral traction. Neuromuscular scoliosis and revision surgery were excluded. Age, preoperative Cobb angles, bending angles, and curve types were recorded. Surgical characteristics were analyzed including number of levels fused, estimated blood loss, operative time, major curve correction (%), and degree of postoperative kyphosis. Results Patients with traction had significantly higher preoperative major curves but no difference in age or flexibility. Lenke 1 curves had significantly shorter operative time and improvement in curve correction with traction. Among subjects with 5 to 8 levels fused, subjects with traction had significantly less EBL. Operative time was significantly shorter for subjects with 5-8 levels and 9-11 levels fused. Curves measuring 50°-75° showed improved correction with traction. Conclusion Intraoperative traction resulted in shorter intraoperative time and greater correction of major curves during surgical treatment of adolescent idiopathic scoliosis less than 90°. Strong considerations should be given to use of intraoperative CFT for moderate AIS.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

Minimally Invasive Video-Assisted Thyroidectomy: Almost a Decade of Experience at an Academic Center

2016 ◽  
Vol 82 (10) ◽  
pp. 949-952
Author(s):  
Ethan Frank ◽  
Joshua Park ◽  
Alfred Simental ◽  
Christopher Vuong ◽  
Yuan Liu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Total Thyroidectomy ◽  
Operative Time ◽  
Vocal Cord Dysfunction ◽  
Completion Thyroidectomy ◽  
Video Assisted ◽  
Academic Center ◽  
Estimated Blood Loss ◽  
Study Population

Minimally invasive video-assisted thyroidectomy (MIVAT) has gained acceptance as an alternative to conventional thyroidectomy. This technique results in less bleeding, postoperative pain, shorter recovery time, and better cosmetic results without increasing morbidity. We retrospectively assessed outcomes in 583 patients having MIVAT from May 2005 to September 2014. The study population was divided into groups according to periods: 2005 to 2009 and 2010 to 2014. Operative data, complications, and length of stay were collected and compared. Total thyroidectomy was undertaken in 185, completion thyroidectomy in 49, and hemithyroidectomy in 349. Malignancy was present in 127 (21.8%). Mean incision was 3.4 ± 0.7 cm and estimated blood loss was 23.7 ± 21.7 mL. Mean operative time was 86.5 ± 39.3 minutes for all operations, 78.5 ± 37.0 minutes for hemithyroidectomy, 70.9 ± 30.1 minutes for completion thyroidectomy, and 106.8 ± 41.3 minutes for total thyroidectomy. Postoperatively, 56 (9.6%) had unilateral vocal cord dysfunction, which resolved except for one case (0.17%). Fifty-nine patients (10.1%) developed hypocalcemia, but only three cases (0.51%) became permanent. Only one patient required readmission. In conclusion, MIVAT results in short operative times, minimal blood loss, and few complications and is safely performed in an academic institution.

scholarly journals Surgical Outcomes for Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion

Neurosurgery ◽  
2015 ◽  
Vol 77 (6) ◽  
pp. 847-874 ◽  
Author(s):  
Nickalus R. Khan ◽  
Aaron J. Clark ◽  
Siang Liao Lee ◽  
Garrett T. Venable ◽  
Nicholas B. Rossi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Operative Time ◽  
Meta Analysis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Complication Rates ◽  
Lumbar Interbody Fusion

BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (TLIF)—or MI-TLIF—has been increasing in prevalence compared with open TLIF (O-TLIF) procedures. The use of MI-TLIF is an evolving technique with conflicting reports in the literature about outcomes. OBJECTIVE: To investigate the impact of MI-TLIF in comparison with O-TLIF for early and late outcomes by using the Visual Analog Scale for back pain (VAS-back) and the Oswestry Disability Index (ODI). Secondary end points include blood loss, operative time, radiation exposure, length of stay, fusion rates, and complications between the 2 procedures. METHODS: During August 2014, a systematic literature search was performed identifying 987 articles. Of these, 30 met inclusion criteria. A random-effects meta-analysis was performed by using both pooled and subset analyses based on study type. RESULTS: Our meta-analysis demonstrated that MI-TLIF reduced blood loss (P &lt; .001), length of stay (P &lt; .001), and complications (P = .001) but increased radiation exposure (P &lt; .001). No differences were found in fusion rate (P = .61) and operative time (P = .34). A decrease in late VAS-back scores was demonstrated for MI TLIF (P &lt; .001), but no differences were found in early VAS-back, early ODI, and late ODI. CONCLUSION: MI-TLIF is associated with reduced blood loss, decreased length of stay, decreased complication rates, and increased radiation exposure. The rates of fusion and operative time are similar between MI-TLIF and O-TLIF. Differences in long-term outcomes in MI-TLIF vs O-TLIF are inconclusive and require more research, particularly in the form of large, multi-institutional prospective randomized controlled trials.

Genitofemoral Nerve Protection During the Lateral Retroperitoneal Transpsoas Approach

2013 ◽  
Vol 73 (2) ◽  
pp. ons192-ons197 ◽  
Author(s):  
Gabriel C. Tender ◽  
Daniel Serban
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Operative Time ◽  
Femoral Nerve ◽  
Psoas Muscle ◽  
Lateral Approach ◽  
Direct Visualization ◽  
Genitofemoral Nerve ◽  
Estimated Blood Loss

Abstract BACKGROUND: The minimally invasive lateral retroperitoneal approach for lumbar fusions is a novel technique with good results, but also with significant sensory and motor complications. OBJECTIVE: To present the early results of a modified surgical technique, in which the psoas muscle is dissected under direct visualization. METHODS: Thirteen consecutive patients with L4-5 or L3-4 pathology were prospectively followed after being treated using a minimally invasive lateral approach with direct exposure of the psoas muscle before dissection. There were 7 woman and 6 men with a mean age of 52.3 years. Perioperative parameters like operative time, estimated blood loss, and length of stay, were noted. Pain, paresthesia, and motor weakness, as well as any other complications, were evaluated at 2 weeks and 3 months postoperatively. RESULTS: The mean operative time, estimated blood loss, and length of stay were 163 minutes, 126 mL, and 3 days, respectively. One patient exhibited anterior thigh pain and paresthesia at 2 weeks, both of which resolved by 3 months. Two patients experienced superficial wound infections that healed with antibiotics. The genitofemoral nerve was identified and protected in 7 patients; in 4 patients, it had a more posterior anatomic location than expected. The femoral nerve was not exposed or detected in the operative field by neuromonitoring, nor were there any symptoms related to a femoral nerve injury in any patient. CONCLUSION: Dissection of the psoas muscle under direct visualization during the minimally invasive lateral approach may provide increased safety to the genitofemoral and femoral nerves.

scholarly journals Perioperative morbidity of different operative approaches in early cervical carcinoma: a systematic review and meta-analysis comparing minimally invasive versus open radical hysterectomy

2021 ◽  
Author(s):  
J. Kampers ◽  
E. Gerhardt ◽  
P. Sibbertsen ◽  
T. Flock ◽  
H. Hertel ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Radical Hysterectomy ◽  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Operation Time ◽  
Mean Difference ◽  
Inclusion Criteria ◽  
Estimated Blood Loss

Abstract Purpose Radical hysterectomy and pelvic lymphadenectomy is the standard treatment for early cervical cancer. Studies have shown superior oncological outcome for open versus minimal invasive surgery, but peri- and postoperative complication rates were shown vice versa. This meta-analysis evaluates the peri- and postoperative morbidities and complications of robotic and laparoscopic radical hysterectomy compared to open surgery. Methods Embase and Ovid-Medline databases were systematically searched in June 2020 for studies comparing robotic, laparoscopic and open radical hysterectomy. There was no limitation in publication year. Inclusion criteria were set analogue to the LACC trial. Subgroup analyses were performed regarding the operative technique, the study design and the date of publication for the endpoints intra- and postoperative morbidity, estimated blood loss, hospital stay and operation time. Results 27 studies fulfilled the inclusion criteria. Five prospective, randomized-control trials were included. Meta-analysis showed no significant difference between robotic radical hysterectomy (RH) and laparoscopic hysterectomy (LH) concerning intra- and perioperative complications. Operation time was longer in both RH (mean difference 44.79 min [95% CI 38.16; 51.42]), and LH (mean difference 20.96 min; [95% CI − 1.30; 43.22]) than in open hysterectomy (AH) but did not lead to a rise of intra- and postoperative complications. Intraoperative morbidity was lower in LH than in AH (RR 0.90 [0.80; 1.02]) as well as in RH compared to AH (0.54 [0.33; 0.88]). Intraoperative morbidity showed no difference between LH and RH (RR 1.29 [0.23; 7.29]). Postoperative morbidity was not different in any approach. Estimated blood loss was lower in both LH (mean difference − 114.34 [− 122.97; − 105.71]) and RH (mean difference − 287.14 [− 392.99; − 181.28]) compared to AH, respectively. Duration of hospital stay was shorter for LH (mean difference − 3.06 [− 3.28; − 2.83]) and RH (mean difference − 3.77 [− 5.10; − 2.44]) compared to AH. Conclusion Minimally invasive radical hysterectomy appears to be associated with reduced intraoperative morbidity and blood loss and improved reconvalescence after surgery. Besides oncological and surgical factors these results should be considered when counseling patients for radical hysterectomy and underscore the need for new randomized trials.

scholarly journals Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ran Harel ◽  
Omer Doron ◽  
Nachshon Knoller
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Operative Time ◽  
Medical Condition ◽  
Tumor Resection ◽  
Spinal Metastases ◽  
Medical Emergency ◽  
Tubular Retractor ◽  
Estimated Blood Loss ◽  
Index Level

Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients’ medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS) approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS) and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients’ quality of life and enable the treatment of patients with comorbidities.

scholarly journals Comparison of Clinical and Radiologic Outcome of Adolescent Idiopathic Scoliosis Treated with Hybrid Hook-Screw Instrumentation versus Universal Clamp System

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Ebrahim Ghayem Hassankhani ◽  
Farzad Omidi-Kashani ◽  
Shahram Moradkhani ◽  
Golnaz Ghayem Hassankhani ◽  
Mohammad Taghi Shakeri
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Operative Time ◽  
Intraoperative Blood Loss ◽  
Curve Correction ◽  
Universal Clamp ◽  
Outcome Scores ◽  
Group A ◽  
Group B

Background. In surgical treatment of adolescent idiopathic scoliosis (AIS), hybrid universal clamp system has been used by some authors. We aimed to compare the clinical and radiologic outcome of hybrid universal clamp with hybrid thoracic hook lumbar screw. Methods. A prospective study was performed on 56 consecutive patients with AIS, who had alternatively undergone a posterior spinal fusion and instrumentation with hybrid thoracic hook lumbar screw system (28 patients: group A) and hybrid universal clamp system (28 patients: group B) between June 2006 and January 2014 at Imam Reza University Hospital and had been followed up for more than two years. The comparison was according to radiographic changes, operative time, intraoperative blood loss, complications, and Scoliosis Research Society (SRS-22) outcome scores. Results. The preoperative mean curve Cobb angle was 58°±7° (42°–74°) in group A and 60°±9° (46°–75°) in group B. The mean final coronal curve correction was 60.4% and 75.5% in groups A and B, respectively (P=0.001). Postoperative SRS outcome scores were also comparable. Conclusion. Universal clamp instrumentation had a significantly better curve correction and lower complication rate compared with hybrid thoracic hook lumbar screw. Both instrumentation methods had similar operative time, intraoperative blood loss, and postoperative SRS outcome scores.

scholarly journals Minimally invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis: a comparison with standard open approach spinal instrumentation

2017 ◽  
Vol 19 (4) ◽  
pp. 472-478 ◽  
Author(s):  
Weiguo Zhu ◽  
Weixiang Sun ◽  
Leilei Xu ◽  
Xu Sun ◽  
Zhen Liu ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Minimally Invasive ◽  
Idiopathic Scoliosis ◽  
Spinal Instrumentation ◽  
Deformity Correction ◽  
Scoliosis Surgery ◽  
Open Approach ◽  
Additional Surgery ◽  
Estimated Blood Loss

OBJECTIVE Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS. METHODS The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014. Levels of fusion, density of implants, operation time, and estimated blood loss (EBL) were recorded. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. The accuracy of pedicle screw placement was assessed according to postoperative axial CT images in both groups. The 22-item Scoliosis Research Society questionnaire (SRS-22) results and complications were collected during follow-up. RESULTS The authors retrospectively reviewed the records of 45 patients with Lenke Type 5C AIS, 15 who underwent posterior MISS under O-arm navigation and 30 who underwent posterior spinal fusion (PSF). The 2 treatment groups were matched in terms of baseline characteristics. Comparison of radiographic parameters revealed no obvious difference between the 2 groups immediately after surgery or at the final follow-up; however, the MISS patients had significantly less EBL (p < 0.001) and longer operation times (p = 0.002). The evaluation of pain and self-image using the SRS-22 showed significantly higher scores in the MISS group (p = 0.013 and 0.046, respectively) than in the PSF group. Postoperative CT showed high accuracy in pedicle placement in both groups. No deep wound infection, pseudarthrosis, additional surgery, implant failure, or neurological complications were recorded in either group. CONCLUSIONS Minimally invasive scoliosis surgery is an effective and safe alternative to open surgery for patients with Lenke Type 5C AIS. Compared with results of the open approach, the outcomes of MISS are promising, with reduced morbidity. Before the routine use of MISS, however, long-term data are needed.

scholarly journals Better Outcomes With Minimally Invasive Thyroidectomy Than Conventional Thyroidectomy

Acta Medica ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 8-13
Author(s):  
Nilda Sütay Süslü ◽  
Cagri Kulekci ◽  
Selcuk Dagdelen ◽  
Nafiye Yildiz ◽  
Tomris Erbas
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Operative Time ◽  
Demographic Data ◽  
Surgical Morbidity ◽  
Minimally Invasive Thyroidectomy ◽  
Invasive Group ◽  
Permanent Hypocalcemia ◽  
Invasive Techniques

Introduction Aim of this study was to evaluate our results from conventional and minimally invasive thyroidectomy and compare their outcomes. Materials and Methods 137 patients undergone conventional and minimally invasive thyroidectomy (video-assisted and open technique with mini-cervicotomy) were reviewed. Demographic data, blood loss, operative time, postoperative pain, cosmetic outcome and complications were examined and compared. Results Minimally invasive group consists of 53 cases(39%) and conventional group is composed of 84 cases(61%). No conversion from minimally invasive to conventional techniques was observed. In minimally invasive group, 25 patients(47%) had differantiated thyroid carcinoma and 28 patients(53%) had benign pathologies. Postoperative complications include transient hypocalcemia in 5 patients(3.6%) (4 in conventional, 1 in minimally invasive group), permanent hypocalcemia in 4 patients(3%) (3 in conventional, 1 in minimally invasive group), unilateral vocal cord paralysis in 2 patients(2%) (1 in conventional, 1 in minimally invasive group). Operative time was similar in both groups; however blood loss during surgery, postoperative pain was significantly lower in minimally invasive group. Conclusion Minimally invasive techniques could be implemented on selected carcinoma patients and results in equal safety and less surgical morbidity. Keywords: minimally invasive thyroidectomy, thyroid cancer, MIVAT

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