scholarly journals Comparative study of open approach and laparoscopic surgery for emergent groin hernias

2019 ◽  
Vol 6 (4) ◽  
pp. 1047
Author(s):  
Yasuhiro Kurumiya ◽  
Keisuke Mizuno ◽  
Ei Sekoguchi ◽  
Gen Sugawara
Keyword(s):  
Laparoscopic Surgery ◽  
Patient Outcomes ◽  
Groin Hernia ◽  
Operation Time ◽  
Open Group ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Median Operation Time ◽  
Groin Hernias ◽  
Emergent Surgery

Background: The utilization of laparoscopic surgery for groin hernias is rapidly increasing in Japan even though a consensus for the use of the laparoscopic over the open approaches to surgery for emergent cases has yet to be determined. Therefore, we retrospectively examined patient outcomes from both open and laparoscopic surgeries.Methods: Emergent surgery for a strangulated groin hernia was performed on 63 patients at our hospital from January 2013 to December 2017. All laparoscopic surgeries were performed using the transabdominal preperitoneal repair (TAPP) approach. The choice of whether to perform an open approach (open) or laparoscopic surgery with the TAPP approach was made by doctors who were familiar with both surgical techniques.Results: There were 49 patients in the open group and 14 patients in the TAPP group. The median operation time (min) was 78 in the open group and 127 in the TAPP group. The median intraoperative blood loss (ml) was 21.0 in the open group and 3.0 in the TAPP group. There were 12 patients (24.5%) in the open group and 1 patient (7.1%) in the TAPP group who had postoperative complications. Surgical site infection did not occur in the TAPP group.Conclusions: TAPP is a useful technique in emergent surgery for incarcerated hernias.

scholarly journals Comparison of Laparoscopic and Open Emergency Surgery for Colorectal Perforation: A Retrospective Study

2021 ◽  
Author(s):  
Kensuke Kudou ◽  
Tetsuya Kusumoto ◽  
Sho Nambara ◽  
Yasuo Tsuda ◽  
Eiji Kusumoto ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Emergency Surgery ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Open Group ◽  
Emergency Setting ◽  
Intraoperative Blood Loss ◽  
Colorectal Perforation

Abstract Background This study aimed to clarify the safety and efficacy of laparoscopic surgery for colorectal perforation by comparing the clinical outcomes between laparoscopic and open emergency surgery for colorectal perforation. Methods We retrospectively reviewed the data of 100 patients who underwent surgery for colorectal perforation. The patients were categorized into two groups: the open group included patients who underwent laparotomy, and the laparoscopic group included those who underwent laparoscopic surgery. Clinical and operative characteristics and postoperative outcomes were evaluated. Results The open and laparoscopic groups included 58 and 42 patients, respectively. More than half of the patients in both groups developed perforation in the sigmoid colon (open, 55.2%; laparoscopic, 59.5%). The most common cause of perforation was diverticulum, followed by colorectal cancer. The mean intraoperative blood loss tended to be lower in the laparoscopic group than in the open group (78.8 mL versus 160.1 mL; P=0.0756). Hospital stay tended to be shorter in the laparoscopic group than in the open group (42.5 versus 55.7 days; P=0.0965). There were no significant differences in either the short- or long-term outcomes between the two groups. Univariate and multivariate analyses showed that the choice of surgical approach (open versus laparoscopic) did not affect overall survival in patients with colorectal perforation. Conclusions The laparoscopic approach for colorectal perforation in an emergency setting is a safe procedure compared with the open approach. The laparoscopic approach was associated with a decrease in intraoperative blood loss and a shorter length of hospital stay.

scholarly journals INGUINAL HERNIA – LAPAROSCOPIC VERSUS OPEN – A SINGLE CENTER EXPERIENCE

2019 ◽  
Vol 6 (3) ◽  
pp. 77-81
Author(s):  
Daniel Ion ◽  
Oana Ciocîrlan ◽  
V R Vornicu ◽  
D N Păduraru ◽  
Alexandra Bolocan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Gold Standard ◽  
Groin Hernia ◽  
Abdominal Muscles ◽  
Open Approach ◽  
Single Center Experience ◽  
Inguinal Hernias ◽  
Total Extraperitoneal ◽  
Lichtenstein Procedure ◽  
Groin Hernias

Inguinal hernia is one of the most common surgical pathologies, which appears mainly due to the weakening of the abdominal muscles. Currently, the gold standard in the repair of inguinal hernias by open approach is the Lichtenstein procedure, while the gold standard of laparo-endoscopic procedures are the pre-peritoneal transabdominal technique (TAPP) and the total extraperitoneal technique (TEP). The purpose of this study is to evaluate, for a period of 4 years, the cases of inguinal hernias operated both by laparoscopic and open procedures to analyze their characteristics, under the conditions in which none was imposed as absolute gold standard for groin hernias. The present study was retrospective and descriptive, including a number of 214 cases hospitalized with the diagnosis of inguinal hernia. In the surgery of the groin hernia, both laparoscopic and open procedures have demonstrated their feasibility. Our study shows the preference for open surgery in elderly patients and those with comorbidities, as well as a faster evolution, with earlier discharge in the case of laparoscopic interventions.

scholarly journals Comparison Benefit between Hydrogen Peroxide and Adrenaline in Tonsillectomy: A Randomized Controlled Study

2021 ◽  
Author(s):  
CHENG-YU HSIEH ◽  
Chuan-Jen Hsu ◽  
Hung-Pin Wu ◽  
Chuan-Hung Sun
Keyword(s):  
Hydrogen Peroxide ◽  
Blood Loss ◽  
Topical Application ◽  
Operation Time ◽  
Hemostatic Agent ◽  
Controlled Study ◽  
Clinical Effects ◽  
Intraoperative Blood Loss ◽  
Peroxide Group ◽  
Median Operation Time

Abstract This study aimed to further evaluate the benefit of topical hemostasis agents in tonsillectomy. Towards this goal, we compared the clinical effects of topical application between hydrogen peroxide and adrenaline in tonsillectomy. Overall, 60 patients (120 tonsils) were prospectively enrolled for tonsillectomy between February 2018 and December 2020. The patients were randomly assigned to either the hydrogen peroxide or adrenaline group. Then, tonsillectomy was performed using hydrogen peroxide as a hemostatic agent on the assigned side, while adrenaline was applied to the other side. All procedures were performed by a surgeon blinded to the randomization. Outcome measurements of operation time, intraoperative blood loss, postoperative pain, and hemorrhage events were analyzed.The intraoperative blood loss was significantly lower in the hydrogen peroxide group than in the adrenaline group (9.99 ± 4.51 ml vs 13.87 ± 6.32 ml, p = 0.0). The median operation time was also significantly lower in the hydrogen peroxide group (8.02 ± 3.59 min vs 9.22 ± 3.88 min, p = 0.019). Meanwhile, the visual analogue scale (VAS) scores were significantly higher in the hydrogen peroxide group (4.98 ± 1.94 vs 4.27 ± 1.97, p = 0.001). The topical application of hydrogen peroxide as a hemostatic agent effectively decreases the operation time and intraoperative blood loss. Thus, hydrogen peroxide can be used as a routine hemostatic agent for bleeding control in tonsillectomy.

scholarly journals Video-assisted Thoracic Surgery for Congenital Diaphragmatic Hernia Compared With Conventional Open Surgery in Infants

2021 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Xin Jin ◽  
...  
Keyword(s):  
Open Surgery ◽  
Thoracoscopic Surgery ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Open Group ◽  
Intraoperative Blood Loss ◽  
Admission Time ◽  
Mechanical Ventilation Time ◽  
Conventional Open Surgery ◽  
Postoperative Mechanical Ventilation

Abstract BackgroundThis study aimed to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of congenital diaphragmatic hernia (CDH) in a larger series compared with conventional open surgery. Additionally, we summarized the experience of thoracoscopic surgery in the treatment of CDH in infants.MethodsWe retrospectively analysed the clinical data of 109 children with CDH who underwent surgical treatment at the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2010 to January 2019. According to the surgical method, the children were divided into an open group (62 cases) and a thoracoscopy group (47 cases). We compared the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay, postoperative CCU admission time and other surgical indicators as well as the recurrence rate, mortality rate and complication rate of the two groups of children.ResultsThe index data on the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P<0.05). Compared with the number of incision infections, pulmonary infections, atelectasis, pleural effusion and chylothorax between the two groups, the number of children in the open group was greater than that in the thoracoscopy group, and the total postoperative complication rate (51.61%) was higher than that in the thoracoscopy group (44.68%). The recurrence rate of the thoracoscopy group (8.51%) was higher than that of the open group (3.23%). In the open group, 2 patients died of respiratory distress after surgery, and no patients died in the thoracoscopy group.ConclusionsThoracoscopic surgery and open surgery can effectively treat CDH. Open surgery has advantages in patients with unstable haemodynamics, large diaphragm defects and abdominal malformations. Compared with conventional open surgery, thoracoscopy has the advantages of shorter operation time, less trauma, faster recovery and fewer complications, but there is a risk of recurrence. The choice of surgical method should be determined by the characteristics of diaphragmatic lesions and the experience of the clinician.

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Tertiary Care ◽  
Groin Hernia Repair ◽  
Groin Hernias ◽  
Laparoscopic Groin Hernia Repair ◽  
Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Laparoscopic isolated caudate lobe resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maulik Parikh ◽  
Ho-Seong Han ◽  
Jai Young Cho ◽  
Mizelle D’Silva
Keyword(s):  
Survival Rate ◽  
Disease Free Survival ◽  
Operation Time ◽  
Caudate Lobe ◽  
Open Group ◽  
Caudate Lobectomy ◽  
Technological Advances ◽  
Estimated Blood Loss ◽  
Hospital Patients ◽  
National University

AbstractPreviously, isolated caudate lobectomy was rarely performed and the caudate lobe was usually resected along with other segments. Isolated caudate lobe resection is a challenging procedure even for an experienced surgeon. Our aim was to evaluate the feasibility, safety and outcomes of laparoscopic isolated caudate lobectomy and to compare these with the open technique. We retrospectively analyzed 21 patients who underwent isolated caudate lobectomy between January 2005 and December 2018 at Seoul National University Bundang Hospital. Patients who underwent either anatomical or non-anatomical resection of the caudate lobe were included. Patients were divided into two groups according to whether they underwent laparoscopic or open surgery. Intra-operative and postoperative outcomes were compared with a median follow-up of 43 months (4–149). A total of 21 patients were included in the study. Of these, 12 (57.14%) underwent laparoscopic and nine (42.85%) underwent open caudate lobectomy. Median operation time (204.5 vs. 200 minutes, p = 0.397), estimated blood loss (250 vs. 400 ml, p = 0.214) and hospital stay (4 vs. 7 days, p = 0.298) were comparable between laparoscopy and open group. The overall post operative complication rate was similar in both groups (p = 0.375). The 5-year disease free survival rate (42.9% vs 60.0%, p = 0.700) and the 5-year overall survival rate (76.2% vs 64.8%, p = 0.145) was similar between laparoscopy and open group. Our findings demonstrate that with increasing surgical expertise and technological advances, laparoscopic isolated caudate lobectomy can become a feasible and safe in selected patients.

scholarly journals Predictors of complications occurring after open and robot-assisted prostate cancer surgery: a retrospective evaluation of 1062 consecutive patients treated in a tertiary referral high volume center

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Blood Loss ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Tertiary Referral ◽  
Robot Assisted ◽  
The Third ◽  
Major Complications

AbstractTo investigate factors associated with the risk of major complications after radical prostatectomy (RP) by the open (ORP) or robot-assisted (RARP) approach for prostate cancer (PCa) in a tertiary referral center. 1062 consecutive patients submitted to RP were prospectively collected. The following outcomes were addressed: (1) overall postoperative complications: subjects with Clavien-Dindo System (CD) one through five versus cases without any complication; (2) moderate to major postoperative complications: cases with CD < 2 vs.  ≥ 2, and 3) major post-operative complications: subjects with CDS CD ≥  3 vs.  < 3. The association of pre-operative and intra-operative factors with the risk of postoperative complications was assessed by the logistic regression model. Overall, complications occurred in 310 out of 1062 subjects (29.2%). Major complications occurred in 58 cases (5.5%). On multivariate analysis, major complications were predicted by PCa surgery and intraoperative estimated blood loss (EBL). ORP compared to RARP increased the risk of major CD complications from 2.8 to 19.3% (OR = 8283; p < 0.0001). Performing ePLND increased the risk of major complications from 2.4 to 7.4% (OR = 3090; p < 0.0001). Assessing intraoperative blood loss, the risk of major postoperative complications was increased by BL above the third quartile when compared to subjects with intraoperative blood loss up to the third quartile (10.2% vs. 4.6%; OR = 2239; 95%CI: 1233–4064). In the present cohort, radical prostatectomy showed major postoperative complications that were independently predicted by the open approach, extended lymph-node dissection, and excessive intraoperative blood loss.

scholarly journals Laparoscopic Surgery for Intrahepatic Cholangiocarcinoma: A Focus on Oncological Outcomes

2021 ◽  
Vol 10 (13) ◽  
pp. 2828
Author(s):  
Francesca Ratti ◽  
Andrea Casadei Gardini ◽  
Federica Cipriani ◽  
Guido Fiorentini ◽  
Federica Pedica ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Intrahepatic Cholangiocarcinoma ◽  
Disease Free Survival ◽  
Resection Margins ◽  
Open Approach ◽  
Invasive Approach ◽  
Free Survival ◽  
Tertiary Referral Center ◽  
Oncological Outcomes ◽  
Disease Free

Background: The aim of the present study was to analyze the long-term outcomes of laparoscopic and open surgery for intrahepatic cholangiocarcinoma (iCCA) in a series, collected in a tertiary referral center with a high annual volume of laparoscopic activity. Methods: Between January 2004 and June 2020, 446 liver resections (LR) were performed for iCCA: of these, 179 were performed by laparoscopic surgery (LS) and 267 with the open approach. The two groups were matched through a 1:1 propensity score using covariates representative of patient and disease characteristics. The study and control groups were compared, with specific attention given to oncological outcomes (rate of R0, depth of resection margins, overall and disease-free survival, rate, and site of recurrence). Results: The number of retrieved nodes, rate, and depth of negative resection margins were comparable between the two groups. The interval time between surgery and subsequent adjuvant treatments was significantly shorter in LS patients. No differences were shown even in the comparison between the LS and the open group in terms of median disease-free and overall survival. Moreover, the disease recurrence rate was comparable between the LS and the open groups (45.2% versus 56.7%), and the recurrence pattern was similar. Conclusions: The minimally invasive approach for iCCA was once again confirmed to be associated with advantages in terms of intraoperative and short-term outcomes, but was also proven to be oncologically non-inferior to the open counterpart. In the present study, overall and disease-free survival were found to be similar between the two approaches.

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