scholarly journals Laparoscopic and open operations in the treatment of hepatic echinococcosis. Analysis of short- and long-term results

2021 ◽  
Vol 26 (4) ◽  
pp. 69-76
Author(s):  
M. G. Efanov ◽  
N. I. Pronina ◽  
R. B. Alikhanov ◽  
O. V. Melekhina ◽  
Y. V. Kulezneva ◽  
...  
Keyword(s):  
Open Surgery ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Patient Selection Criteria ◽  
Hepatic Echinococcosis

Aim: to evaluate the short- and long-term outcomes of laparoscopic and open operations in the treatment of hepatic echinococcosis.Materials and methods. The results of laparoscopic and open echinococcectomies performed from 2013 to 2020 were retrospectively studied. Laparoscopic operations were considered the method of choice. Open operations were performed in cases with contraindications to the laparoscopic approach.Results. In total, 57 patients were operated: 47 laparoscopically (including robotic approach in 4 cases), 9 patients underwent open surgery. Radical procedures prevailed among laparoscopic cystectomies: 46 (98%). In the groups of laparoscopic/open cystectomies, partial pericystectomy was performed in 1/3 of patients, subtotal – in 24/4, total – in 13/0, and liver resection – in 9/2 patients, respectively. Laparoscopic procedures were performed mainly for types 1 and 3 of cysts, open procedures – for type 2 (WHO), recurrent and extrahepatic abdominal cysts were indication for open surgery. The frequency of severe complications did not differ between the groups. In the laparoscopic group, 1 (2%) patient died. After laparoscopic cystectomies, the mean (median) hospital stay (8 vs 10 days) and duration of abdominal drainage (10 vs 12 days) were significantly shorter. Relapse occurred only after conservative cystectomies, in one patient in each group.Conclusion. Laparoscopic radical surgery for liver hydatid cysts may be the method of choice if performed in a specialized HPB center. Patient selection criteria should be based on the center's experience in laparoscopic liver surgery.

scholarly journals Open Replacement of the Thoracoabdominal Aorta: Short- and Long-term Outcomes at a Single Institution

2018 ◽  
Vol 27 (02) ◽  
pp. 114-120
Author(s):  
Davide Carino ◽  
Young Erben ◽  
Mohammad Zafar ◽  
Mrinal Singh ◽  
Adam Brownstein ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Open Surgery ◽  
Elective Surgery ◽  
Aortic Diseases ◽  
Long Term Outcomes ◽  
Thoracoabdominal Aorta ◽  
Primary Endpoints ◽  
Short And Long Term ◽  
Optimal Approach

Background Despite much progress in the surgical and endovascular treatment of thoracoabdominal aortic diseases (TAADs), there is no consensus regarding the optimal approach to minimize operative mortality and end-organ dysfunction. We report our experience in the past 16 years treating TAAD by open surgery. Methods A retrospective review of all TAAD patients who underwent an open repair since January 2000 was performed. The primary endpoints included early morbidity and mortality, and the secondary endpoints were overall death and rate of aortic reintervention. Results There were 112 patients treated by open surgery for TAAD. Mean age was 66 ± 10 years and 61 (54%) were male. Seventy-seven (69%) patients had aneurysmal degeneration without aortic dissection and the remaining 35 (31%) had a concomitant aortic dissection. There were 12 deaths (10.7%) and they were equally distributed between the aneurysm and dissection groups (p = 0.8). The mortality for elective surgery was 3.2% (2/61). The rate of permanent paraplegia and stroke were each 2.6% (3/112). The rate of cerebrovascular accident was significantly higher in the dissection group (8.5% vs. 1.2%, p = 0.05). The survival at 1, 5, and 10 years was 80.6, 56.1, and 32.7%, respectively. Conclusion Our data confirm that open replacement of the thoracoabdominal aorta can be performed in expert centers quite safely. Different aortic pathologies (degenerative aneurysm vs. dissection) do not influence the short- and long-term outcomes. Open surgery should still be considered the standard in the management of TAAD.

scholarly journals Comparative analysis of resection and draining interventions in patients with cystic pancreatic lesions

2020 ◽  
Vol 48 (3) ◽  
pp. 18-22
Author(s):  
A. P. Koshel ◽  
S. S. Klokov ◽  
T. V. Dibina ◽  
E. S. Drozdov ◽  
Yu. Yu. Rakina
Keyword(s):  
Long Term Results ◽  
Pancreatic Pseudocysts ◽  
Cystic Lesions ◽  
Long Term Outcomes ◽  
Duration Of Surgery ◽  
Short And Long Term ◽  
The Mean ◽  
Cystic Pancreatic Lesions ◽  
Length Of Hospitalization

Aim of study: to evaluate the results of draining and resection interventions in patients with pancreatic cystic lesions. Materials and methods. A retrospective analysis of the treatment of 50 patients with pancreatic cystic lesions of various etiologies was conducted. All patients included in the study underwent surgical treatment, namely 20 (40.0%) resection interventions (RI) and 30 (60.0%) draining interventions (DI). Comparison of short- and long-term outcomes of treatment between the two groups was carried out. Results. There were no statistically significant differences in body mass index in the compared groups. The average duration of surgery in DI group was significantly lower than in RI group (142.5±4.9 and 278.5±6.9, p<0.001). The mean intraoperative blood loss, as well as the length of hospitalization, was significantly lower in DI group as compared with RI (390±28.4 ml, 500±27.4 ml, p=0.008; 8.5±0.9 days, 13.8±3.9 days, p<0.001). The severity of postoperative complications was proved to be significantly higher in RI group (p<0.05). However, when analyzing long-term results, the attacks-free course of the disease was observed only in RI group. Conclusion. If technically possible, DI is more preferable than RI in patients with pancreatic pseudocysts. RI should be performed in patients with cystic neoplasia.

Propensity Score Adjusted Comparison of MIDCAB versus Full Sternotomy Left Anterior Descending Artery Revascularization

2015 ◽  
Vol 10 (3) ◽  
pp. 174-178 ◽  
Author(s):  
Shahzad G. Raja ◽  
Umberto Benedetto ◽  
Eman Alkizwini ◽  
Sapna Gupta ◽  
Mohamed Amrani
Keyword(s):  
Propensity Score ◽  
Standard Error ◽  
Artery Bypass ◽  
Length Of Hospital Stay ◽  
Coronary Intervention ◽  
Long Term Results ◽  
Attractive Alternative ◽  
Long Term Outcomes ◽  
Short And Long Term

Objective Minimally invasive direct coronary artery bypass (MIDCAB) has been proposed as an attractive alternative to full sternotomy (FS) revascularization in isolated left anterior descending (LAD) artery disease not suitable for percutaneous coronary intervention. However, surgeons are still reluctant to perform MIDCAB owing to concerns about early and late outcomes. We aimed to compare short- and long-term outcomes after MIDCAB versus FS revascularization. Methods Prospectively collected data from institutional database were reviewed. Data for late mortality were obtained from the General Register Office. MIDCAB was performed in 318 patients, whereas 159 had FS, according to the surgeon's preference, among 477 patients with isolated LAD disease. Inverse propensity score weighting was used to estimate treatment effects on short- and long-term outcomes. Results In the propensity score-adjusted analysis, FS revascularization versus MIDCAB was associated increased rate of surgical site infection [4 (2.8%) versus 1 (0.7%); P = 0.04]. The 2 groups did not significantly differ with regard to other complications including operative mortality. Mean length of hospital stay was similar for the 2 groups. After a mean follow-up time of 6.2 years (interquartile range, 3.5–9.7 years), compared to MIDCAB, FS was not associated with an improved late survival (β coef, −1.42; standard error, 1.65; P = 0.39) or risk reduction for repeat revascularization (β coef, 1.22; standard error, 1.41; P = 0.15). Conclusions MIDCAB was associated with a trend toward better short-term outcomes and excellent long-term results comparable to FS revascularization. According to these findings, surgeons should not be reluctant to perform MIDCAB in isolated LAD disease.

scholarly journals Laparoscopic and open surgery in rectal cancer patients in Germany: short and long-term results of a large 10-year population-based cohort

2019 ◽  
Vol 34 (3) ◽  
pp. 1132-1141 ◽  
Author(s):  
Valentin Schnitzbauer ◽  
Michael Gerken ◽  
Stefan Benz ◽  
Vinzenz Völkel ◽  
Teresa Draeger ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Cox Regression ◽  
Survival Rates ◽  
Relative Survival ◽  
Laparoscopic Group ◽  
Cancer Registries ◽  
Long Term Results

Abstract Background Rectal cancer is frequent in Germany and worldwide. Several studies have assessed laparoscopic surgery as a treatment option and most have shown favorable results. However, long-term oncologic safety remains a controversial issue. Methods The current dataset derives from 30 clinical cancer registries in Germany and includes 16,378 patients diagnosed with rectal cancer between 2007 and 2016. Outcomes were 90-day mortality, overall survival (OS), local recurrence-free survival (RFS) and relative survival of patients treated with either open or laparoscopic surgery. Multivariable logistic regression was used to evaluate factors that affected the probability of a patient undergoing laparoscopic surgery as well as to evaluate short-term mortality. OS and RFS were analyzed by Kaplan–Meier plots and multivariable Cox regression conducted separately for UICC stages I–III, tumor location, and sex as well as by propensity score matching followed by univariable and multivariable survival analysis. Results Of 16,378 patients, 4540 (27.7%) underwent laparoscopic surgery, a trend which increased during the observation period. Patients undergoing laparoscopy attained better results for 90-day mortality (odds ratio, OR 0.658, 95% confidence interval, CI 0.526–0.822). The 5-year OS rate in the laparoscopic group was 82.6%, vs. 76.6% in the open surgery group, with a hazard ratio (HR) of 0.819 in multivariable Cox regression (95% CI 0.747–0.899, p < 0.001). The laparoscopic group showed a better 5-year RFS, with 81.8 vs. 74.3% and HR 0.770 (95% CI 0.705–0.842, p < 0.001). The 5-year relative survival rates were also in favor of laparoscopy, with 93.1 vs. 88.4% (p = 0.012). Conclusion Laparoscopic surgery for rectal cancer can be performed safely and, according to this study, is associated with an oncological outcome superior to that of the open procedure. Therefore, in the absence of individual contraindications, it should be considered as a standard approach.

scholarly journals P161 EMERGENCY LAPAROSCOPIC REPAIR OF A PARASTOMAL HERNIA

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
María Jose Cuevas ◽  
Diego Pinilla ◽  
Alejandro Sánchez ◽  
José Tinoco ◽  
Luis Tallón ◽  
...  
Keyword(s):  
Ct Scan ◽  
Parastomal Hernia ◽  
Laparoscopic Approach ◽  
Synthetic Mesh ◽  
Long Term Results ◽  
Short And Long Term ◽  
One Year ◽  
The One ◽  
Sugarbaker Technique

Abstract Aim The aim of this video is to present the laparoscopic approach to an incarcerated parastomal hernia, using the modified Sugarbaker technique. Material and Methods A 50-year-old man with a definitive terminal colostomy after undergoing an abdominoperineal resection due to a rectal cancer, consulted in the emergency room with abdominal pain and an incarcerated mass below the colostomy, without evidence of intestinal obstruction. A CT scan was performed, with the finding of infarcted epiploic appendages inside the parastomal hernia. After evaluation of the case, emergency surgery was decided, opting for a laparoscopic approach to the parastomal hernia, employing the modified Sugarbaker technique. Results Following the dissection of the hernial sac and resection of the necrotic fat content, a partial closure of the hernial orifice was done. A hernioplasty was performed using a composite synthetic mesh, that was fixated with helical sutures. After surgery, the patient evolved favorably and was discharged 72 hours after the procedure. In the one year of follow-up, the patient was asymptomatic and there were no data of recurrence either on the clinical examination or the control CT scan. Conclusions The laparoscopic approach to an incarcerated parastomal hernia is possible and safe when performed in well-selected cases by the hands of experienced surgeons, offering good short and long-term results.

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