scholarly journals Initial experience with laparoscopic posterior retroperitoneal adrenalectomy in single tertiary center

2021 ◽  
Vol 17 (2) ◽  
pp. 90-95
Author(s):  
Jeong Hee Han ◽  
Byoung Chul Lee ◽  
Young Mok Park ◽  
Hyuk Jae Jung ◽  
Dong-il Kim ◽  
...  
Keyword(s):  
Adrenal Tumor ◽  
Cushing Syndrome ◽  
Operating Time ◽  
University Hospital ◽  
Adrenal Tumors ◽  
Initial Experience ◽  
Surgical Method ◽  
Tertiary Center ◽  
Retroperitoneal Adrenalectomy ◽  
The Mean

Purpose: Laparoscopic posterior retroperitoneal adrenalectomy (LPRA) is a surgical method that accesses the adrenal gland through the back. The aim of this study was to report initial experience of LPRA and evaluate possibilities for surgical application.Methods: From March 2018 to December 2019, a total of 30 consecutive patients diagnosed with adrenal tumor underwent surgical treatment at Pusan National University Hospital were enrolled. Clinicopathologic features and various peri- and postoperative parameters were analyzed by retrospective medical record review. The mean age of the patients was 48.20 ± 13.66 years.Results: The mean body mass index (BMI) was 25.50 ± 4.30 kg/m2 . Primary hyperaldosteronism was the most frequently preoperative diagnosed disease (n = 13, 43.4%), followed by adrenal incidentaloma (n = 8, 26.6%), Cushing syndrome (n = 5, 16.6%) and pheochromocytoma (n = 4, 13.3%). The mean size of postoperative adrenal tumor was 2.72 ± 1.76 cm. The mean operating time was 162 ± 58.14 minutes. Among the 30 patients, 28 patients underwent total adrenalectomy (93.3%) and two patients underwent cortical sparing adrenalectomy (6.7%). When LPRA was performed for patients with BMI > 23.16 kg/m2 , the operating time was longer than the average (P = 0.016).Conclusion: LPRA was suitable and safe for patients with benign adrenal tumors. BMI, retroperitoneal fat density and postoperative adrenal weight may be related to the operating time, so they should be considered when deciding on a surgical method for adrenalectomy.

scholarly journals Contralateral adrenal thinning as a distinctive feature of mild autonomous cortisol excess of the adrenal tumors

2020 ◽  
Vol 183 (3) ◽  
pp. 325-333
Author(s):  
Sung Hye Kong ◽  
Jung Hee Kim ◽  
Chan Soo Shin
Keyword(s):  
Adrenal Gland ◽  
Cushing Syndrome ◽  
Volumetric Analysis ◽  
Cross Sectional Study ◽  
Ct Scans ◽  
Adrenal Tumors ◽  
Cross Sectional ◽  
Suppression Test ◽  
The Mean ◽  
Radiologic Features

Objective: To identify radiologic features that correlate with mild autonomous cortisol excess using planar and volumetric analysis. Design: Cross-sectional study. Methods: In the study, 64 patients with overt Cushing syndrome (CS), 59 patients with mild autonomous cortisol excess (MACE), and 64 patients with nonfunctioning adrenal tumors (NFAT) with evaluable CT scans were included. Patients with NFAT and MACE were BMI-matched with those with overt CS. Planar and volumetric analyses of CT scans were performed in DICOM images using OsiriX software. Results: The mean age was 56.6 ± 1.01 years, and 123 patients (65.1%) were female. In the order of NFAT, MACE, and overt CS, the diameters and volumes of the adenoma increased, while limb widths and volumes of the contralateral adrenal gland decreased. Patients with MACE or overt CS were more likely to have osteoporosis than those with NFAT (P = 0.006), and patients with overt CS were more likely to experience a fragility fracture than those with NFAT or MACE (P = 0.002). Among radiologic features, the limb width of the contralateral adrenal gland correlated with the cortisol level after overnight dexamethasone suppression test (r = −0.583, P < 0.001). Conclusions: The study showed that the contralateral adrenal limb thinning was a distinctive radiologic feature of autonomous cortisol excess in the planar and volumetric analysis.

scholarly journals Feasibility and Safety of Laparoscopic Radical Colectomy for T4b Colon Cancer at a University Hospital in Vietnam

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Thinh H. Nguyen ◽  
Hung X. Tran ◽  
Truc T. Thai ◽  
Duc M. La ◽  
Huy D. Tran ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Lymph Node Metastases ◽  
Operating Time ◽  
University Hospital ◽  
Colon Cancers ◽  
Node Metastases ◽  
The Mean

Background. The choice of optimal treatment strategies for T4b colon cancers has still been discussed, particularly the initiation of neoadjuvant therapy or surgery. We conducted this study to evaluate the safety and feasibility of laparoscopic multivisceral resection for T4b colon cancers. Methods. We used the retrospective design to include all 43 patients with T4b colon cancer at a university hospital in Vietnam from March 2017 to March 2019. All patients were followed 30 days after the surgery, and information about the day of the first flatus, length of hospital stay, iatrogenic complications, postoperative morbidity, mortality, and adjuvant chemotherapy was collected. Results. The mean operating time was 187 minutes (ranging from 80 to 310), the mean blood loss was 64.3 ml (5-200), and the conversion rate was 2.3%. The mean number of lymph nodes harvested was 15.5 ( SD = 8.06 ), and 33 patients (76.7%) had at least 12 lymph nodes harvested. A total of 21 patients (48.8%) had lymph node metastases with a mean number of lymph node metastases of 1.89 ( SD = 3.4 ). The radial resection margin was R0 in all 43 patients (100%). The median time until the first flatus and hospital stay were 3 days (2–5) and 7.1 (6–11) days, respectively. There was no mortality at 30 days postoperatively, and one patient had iatrogenic complication (2.3%). Conclusion. Laparoscopic radical colectomy was feasible and safe for patients with T4b colon cancer except those requiring major and complicated reconstruction.

scholarly journals Endoscopic Retroperitoneal Adrenalectomy for Adrenal Metastases

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gintaras Simutis ◽  
Givi Lengvenis ◽  
Virgilijus Beiša ◽  
Kęstutis Strupas
Keyword(s):  
Perioperative Complications ◽  
Survival Rates ◽  
Retroperitoneal Approach ◽  
Oncologic Outcomes ◽  
Adrenal Tumors ◽  
Adrenal Metastases ◽  
Port Site Metastases ◽  
Retroperitoneal Adrenalectomy ◽  
The Mean

Objectives. To evaluate whether retroperitoneal approach for adrenalectomy is a safe and effective treatment for adrenal metastases (AM).Methods. From June 2004 to January 2014, nine consecutive patients with AM were treated with endoscopic retroperitoneal adrenalectomy (ERA). A retrospective study was conducted, and clinical data, tumor characteristics, and oncologic outcomes were acquired and analyzed.Results. Renal cancer was the primary site of malignancy in 44.4% of cases. The mean operative time was 132 ± 10.4 min. There were 5 synchronous and 4 metachronous AM. One patient required conversion to transperitoneal laparoscopic procedure. No mortality or perioperative complications were observed. The median overall survival was 11 months (range: 2–42 months). Survival rates of 50% and 25% were identified at 1 and 3 years, respectively. At the end of the study, 4 patients were alive with a mean observed follow-up of 20 months. No patients presented with local tumor relapse or port-site metastases.Conclusions. This study shows that ERA is a safe and effective procedure for resection of AM and advances the surgical treatment of adrenal disease. The use of the retroperitoneal approach for adrenal tumors less than 6 cm can provide very favorable surgical outcomes.

scholarly journals Comparison of Robotic Posterior Retroperitoneal Adrenalectomy over Laparoscopic Posterior Retroperitoneal Adrenalectomy: A Single Tertiary Center Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Won Woong Kim ◽  
Yu-mi Lee ◽  
Ki-Wook Chung ◽  
Suck Joon Hong ◽  
Tae-Yon Sung
Keyword(s):  
Tumor Size ◽  
Adrenal Tumor ◽  
Early Period ◽  
Operation Time ◽  
Male Gender ◽  
Laparoscopic Technique ◽  
Factors Affecting ◽  
Tertiary Center ◽  
Significant Difference ◽  
Retroperitoneal Adrenalectomy

Background. The aim of this study is to compare the clinical outcomes of laparoscopic posterior retroperitoneal adrenalectomy (LPRA) and robotic posterior retroperitoneal adrenalectomy (RPRA) and determine the differences that could affect the outcomes. Methods. We retrospectively analyzed 230 adrenalectomy cases from 2014 to 2017. There were 169 LPRA and 61 RPRA cases, and their clinicopathological features and surgical outcomes were compared. Results. In LPRA, there was a positive relationship between operation time and male gender, early period of experience, adrenal tumor size, and pheochromocytoma. In RPRA, adrenal tumor size and pheochromocytoma were the factors affecting the operation time. When the adrenal tumor size was ≤5.5 cm, the operation time of LPRA was shorter than that of RPRA (p=0.001). When the tumor size was >5.5 cm, there was no significant difference in the operation times of LPRA and RPRA (p=0.102). Conclusions. RPRA is a feasible and technically safe approach for benign adrenal diseases. The use of RPRA could benefit patients and provide comfort by overcoming the factors contributing to a longer operation time in the laparoscopic technique, such as male gender and high BMI.

scholarly journals Laser treatment of twin-to-twin transfusion syndrome (TTTS): preliminary findings from a tertiary center in Greece

2019 ◽  
Vol 18 (4) ◽  
pp. 147-154
Author(s):  
Georgios Papaioannou ◽  
Nikolaos Evangelinakis ◽  
Nikolaos Papantoniou
Keyword(s):  
Laser Photocoagulation ◽  
Prospective Observational Study ◽  
Standard Of Care ◽  
University Hospital ◽  
Study Materials ◽  
Tertiary Center ◽  
New Instrumentation ◽  
The Mean ◽  
Twin Pregnancies ◽  
Photocoagulation Therapy

Background: Twin- to-twin transfusion syndrome (TTTS) affects approximately 15% of monochorionic twin pregnancies with an estimated incidence of 1 in 1,600 pregnancies. The gold standard of care is considered to be Fetoscopic Laser Photocoagulation Therapy (FLPT). Objective: To present our experience with FLPT in a preliminary prospective observational study. Materials and methods: Fourteen patients who underwent FLPT in the Fetal Maternal Medicine Unit of Attikon University Hospital, between January 2017 and August 2018. Fetoscopic laser photocoagulation was offered to all patients with pregnancies complicated by TTTS (Quintero stage >2), before the completion of 26 weeks of gestation. Results: The mean gestational age at diagnosis was 22.2 ± 2.6 weeks, at surgery 23.1±1.9 weeks and at birth 29.8±3.3 weeks. Mean interval from surgery to delivery was 6.6±3.1 weeks and mean neonatal birthweight was 1426±408 grams. Mean recipient’s weight at delivery was 1652±283gr, whereas mean donor’s weight at delivery was 1299 ± 402gr. Concerning fetal viability, ten (71,4%) donor fetuses survived to full term whereas 4 (28,6%) donor fetuses died in utero. The survival rate of recipient fetuses reached 85,7% which is very good according to the literature. In total 22 fetuses (78,6%) were alive at birth and survived the first 6 months of life and in 6 cases an intrauterine demise occurred (21,4%). In 10 pregnancies (71,4%) both fetuses survived, in 2 (14,3%) both died and in 12 pregnancies (85,7%) there was at least one survivor. Conclusion: These preliminary results support the use of FPLT in Greece as the percentage of live neonates that was reached is comparable to those published in larger studies in the international literature. We are confident that with increasing experience and new instrumentation, these results will become even better and this service will accept more cases all over Greece.

Ten years of laparoscopic sleeve gastrectomy at the Military University Hospital in Prague

2021 ◽  
Vol 100 (5) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
The Mean ◽  
Type Two Diabetes ◽  
The Military

Introduction: The aim of this study was to evaluate a group of bariatric patients operated at the Military University Hospital in Prague during the last 10 years (2011−2020), in whom laparoscopic sleeve gastrectomy was performed. Methods: Retrospective survey of the internal operation database. The search used the following combination of keywords: “sleeve“, “LSG“ and the diagnosis “E6*“. A total of 279 operated patients were enrolled. We evaluated the sex, age at the time of surgery, complications, need for drainage, weight, BMI, presence of type two diabetes mellitus and any effect of the surgery on its improvement, length of hospital stay, follow-up duration and % excess weight loss. Results: A total of 279 patients, including 195 women and 84 men, underwent laparoscopic sleeve gastrectomy in the period of 10 years. The mean age was 44.46 years. The average operating time was 111 minutes. The mean BMI of the patients before surgery was 42.24 and the weight was 123.4 kg. The mean BMI one year after the surgery corresponded to a decrease of approximately 10 and the mean weight of 93.8 kg. Rather severe acute postoperative complications occurred in 2.87% patients. An improvement or complete cure of type two diabetes mellitus was observed in 57.8% patients. Conclusion: Currently, laparoscopic sleeve gastrectomy is the most common bariatric operation at the Military University Hospital in Prague. This study demonstrates a satisfactory effect of bariatric surgery in terms of long-term significant weight loss and an improvement or even cure of associated diseases such as type two diabetes mellitus, arterial hypertension and others.

scholarly journals Comparison of Emergency Medical Services Duration amid Routine Service for COVID-19 Patients

2021 ◽  
Vol 9 (E) ◽  
pp. 289-292
Author(s):  
Korakot Apiratwarakul ◽  
Takaaki Suzuki ◽  
Ismet Celebi ◽  
Kamonwon Ienghong ◽  
Thanat Tangpaisarn ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Operating Time ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Medical Services ◽  
Cross Sectional ◽  
Routine Service ◽  
Emergency Medical ◽  
Number Of Patients ◽  
The Mean

BACKGROUND: Concerning the COVID-19 outbreak in Thailand, the number of patients has been increasing. Emergency medical services (EMS) operating duration differs from normal services due to equipment preparation, number of personnel, and on-board ambulance procedures. Notably, there have been no studies examining EMS duration regarding COVID-19 patients. AIM: The aim of this study was to compare the EMS time for COVID-19 patients and routine services. METHODS: This cross-sectional study was conducted in a tertiary university hospital in Khon Kaen, Thailand. Information gathering was carried out by employing the Srinagarind Hospital EMS database throughout January 1, 2020, and February 10, 2021. RESULTS: A total of 2420 EMS operations were examined, of which five tested positive for COVID-19 (0.21%). The mean age of the COVID-19 patients was 35.6 ± 7.2 years, with the activation interval for COVID-19 and routine services at 64.20 ± 10.14 and 1.42 ± 0.42 min, respectively (p < 0.001). The on-scene time for COVID-19 and routine services was 3.20 ± 0.44 and 5.20 ± 2.20 min, respectively. CONCLUSIONS: EMS operating time amid the activation interval for COVID-19 patients was significantly longer than in the normal group. However, on-scene time for COVID-19 patients was less time than in normal operations.

Advantages and limitations of the endoscopic tympanoscopy a prospective study

2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Middle Ear ◽  
Operating Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Invasive Approach ◽  
Intraoperative Bleeding ◽  
Advantages And Disadvantages ◽  
Early Return ◽  
The Mean ◽  
Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

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