scholarly journals Clinical application of one-position complete retroperitoneal laparoscopic radical resection of renal pelvis and ureteral carcinoma

2020 ◽  
Author(s):  
Yongshuang Xiao ◽  
Wei Du ◽  
Yulong Hou ◽  
Hailong Li ◽  
Shuofeng Li ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Renal Pelvis ◽  
Operating Time ◽  
Radical Resection ◽  
Postoperative Hospital Stay ◽  
Intraoperative Bleeding ◽  
Operating Room Nurses ◽  
The Mean ◽  
Ureteral Carcinoma

Abstract Background: To explore the surgical technique and the clinical efficacy of complete retroperitoneal laparoscopic radical resection in patients with upper tract urothelial carcinoma (UTUC).Methods: A total of 11 patients (6 males and 5 females) newly diagnosed with UTUC with T1/T2 were enrolled in this study who underwent one-position complete retroperitoneal laparoscopic radical resection in our hospital from March 2016 to December 2018. Among them, 8 cases were of renal pelvis carcinoma and 3 cases were of ureteral carcinoma. The average age was 57.5 years (range, 44-78 years). All patients were presented with painless gross hematuria. CTU and ureteroscopy were used to diagnose.Results All the 11 patients had successful operations without open transition. The mean operating time was 85 min (range 60 to 115 min). The mean amount of intraoperative bleeding was below 90 ml. The postoperative hospital stay was 3-7 days, with an average of 5 days. There was no obvious complication after operation. No local tumor recurrence or new bladder implantation metastasis has already been observed with the postoperative follow-up time in 8 to 40 months.Conclusion One-position complete retroperitoneal laparoscopic radical resection of UTUC is safe and feasible. The curative effect is affirmative. It has the conspicuous advantages in less bleeding during operation, minimally invasive, no posture change, quicker recovery with little disturbance of abdominal organ and shorter postoperative hospital stay, which could particularly reduce workload of operating room nurses, without any extra postoperative complications.

scholarly journals Laparoscopic splenectomy in children with sickle cell disease younger than 5 years old

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Taha Alkhatrawi ◽  
Radi Elsherbini ◽  
Waheed Turkistani
Keyword(s):  
Sickle Cell Disease ◽  
Hospital Stay ◽  
Sickle Cell ◽  
Laparoscopic Splenectomy ◽  
Operating Time ◽  
Cell Disease ◽  
Conversion To Open Surgery ◽  
Concomitant Cholecystectomy ◽  
The Mean

Abstract Background The purpose of this paper is to evaluate the feasibility, safety, efficacy, benefits, and outcome of elective laparoscopic splenectomy for children younger than 5 years with sickle cell disease (SCD) who needed splenectomy. We conducted a retrospective review for a prospective data on patients younger than 5 years with SCD requiring splenectomy from January 2007 to June 2019. Patients were evaluated with regard to patient demographics, operative time, presence of accessory spleens, blood loss, length of hospital stay, morbidity, mortality, and clinical outcome. Results A total of 71 patients younger than 5 years with SCD underwent laparoscopic splenectomy (LS) at our institution from January 2007 to June 2019. There were 28 boys and 43 girls. The age at LS is from 2 years to less than 5 years (mean 3.2 years). The mean operating time was 65 min. There was no conversion to open surgery; all the cases were successfully performed laparoscopically. Twelve patients (17%) underwent a concomitant cholecystectomy. The hospital stay ranged from 2 to 6 days (median, 3 days). The mean follow-up was 86 months (range, 17 to 161 months). Postoperative follow-up revealed no cases of overwhelming postsplenectomy sepsis infection (OPSI). Conclusion Laparoscopic splenectomy in young children less than 5 years of age with sickle cell disease is a safe and effective treatment. When patients are given preoperative vaccination and penicillin prophylaxis, OPSI rarely occurs.

Effectiveness of laparoscopic surgery in patients with large gastric GIST (diameter > 5cm).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 35-35
Author(s):  
Fei Li ◽  
Chongchong Gao
Keyword(s):  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Postoperative Hospital Stay ◽  
Gastric Gist ◽  
Tumor Rupture ◽  
Stromal Tumors ◽  
Estimated Blood Loss

35 Background: Recently, the application of laparoscopic or DaVinci surgery in relatively small gastrointestinal stromal tumors (GIST) has been increasingly recognized. However, the use in large stromal tumors, especially with a diameter greater than 5 cm, remains controversial for fear of tumor rupture. The aim of our study is to observe the effectiveness of laparoscopic approach in treatment of large gastric GIST. Methods: Patients who were diagnosed with gastric GIST (diameter > 5cm) at Xuanwu Hospital, China and underwent laparoscopic surgery from May 2011 to May 2018 were assessed. We set intraoperative tumor rupture as primary outcome. Secondly outcomes were conversion rate, operating time, estimated blood loss, length of postoperative hospital stay and recurrence rate at the end of the follow-up. Results: Fourty patients were included in our study with tumor size (7.54 ty-tw) cm (range, 5.0~13.8 cm). There was no intraoperative tumor rupture occurred. The median duration of operation was (76.3±29.9) minutes with estimated blood loss (28.7±15.2) mL. The median time for length of postoperative hospital stay was (5.8±4.1) days. The follow-up period for all the patients was 23.1 months (range, 2.4~51months). No local or distant recurrence was observed. Conclusions: Laparoscopic resection for large gastric GIST is feasible and effective. Laparoscopic surgery can substitute for open surgery as standard approach for gastric stromal tumors.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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.

EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 79-85
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Hospital Stay ◽  
Perioperative Complications ◽  
University Hospital ◽  
Anal Pain ◽  
Stapled Hemorrhoidectomy ◽  
Fourth Degree ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

scholarly journals Pancreas-Preserving Total Duodenectomy: A Systematic Review

2021 ◽  
pp. 1-12
Author(s):  
Miguel Cantalejo-Díaz ◽  
José Manuel Ramia-Ángel ◽  
Ana Palomares-Cano ◽  
Mario Serradilla-Martín
Keyword(s):  
Systematic Review ◽  
Postoperative Morbidity ◽  
Operating Time ◽  
Pancreatic Head ◽  
Cochrane Library ◽  
Morbidity Rate ◽  
Intraoperative Bleeding ◽  
Risks And Benefits ◽  
Duodenal Lesions ◽  
The Mean

<b><i>Background:</i></b> The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. <b><i>Summary:</i></b> A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo &#x3c;IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was &#x3e;97.8%. <b><i>Key Messages:</i></b> PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.

scholarly journals Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaohe Wang ◽  
Yang Yue ◽  
Wenjie Zhang ◽  
Qiaoyu Liu ◽  
Beicheng Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Hepatic Vein ◽  
Pringle Maneuver ◽  
Caudate Lobe ◽  
Postoperative Hospital Stay ◽  
Dorsal Approach ◽  
Glissonian Approach ◽  
The Mean ◽  
Major Hepatic Vein

Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.

scholarly journals Minimal Invasive Surgery for Gastroesophageal Reflux Disease and Hiatus Hernia—Our Experience: A Case Series with Review of Literature

2021 ◽  
Author(s):  
Rafique Umer Harvitkar ◽  
Abhijit Joshi
Keyword(s):  
Retrospective Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Operating Time ◽  
Type I ◽  
Type Ii ◽  
The Mean ◽  
Gerd Symptoms

Abstract Introduction Laparoscopic fundoplication (LF) has almost completely replaced the open procedure performed for gastroesophageal reflux disease (GERD) and hiatus hernia (HH). Several studies have suggested that long-term results with surgery for GERD are better than a medical line of management. In this retrospective study, we outline our experience with LF over 10 years. Also, we analyze the factors that would help us in better patient selection, thereby positively affecting the outcomes of surgery. Patients and Methods In this retrospective study, we identified 27 patients (14 females and 13 males) operated upon by a single surgeon from 2010 to 2020 at our institution. Out of these, 25 patients (12 females and 13 males) had GERD with type I HH and 2 (both females) had type II HH without GERD. The age range was 24 to 75 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy). A total of 25 patients had various degrees of esophagitis. Two patients had no esophagitis. These patients were analyzed for age, sex, symptoms, preoperative evaluation, exact procedure performed (Nissen’s vs. Toupet’s vs. cruroplasty + gastropexy), morbidity/mortality, and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications, and recurrent symptoms on follow-up. Symptoms were assessed objectively with a score for six classical GERD symptoms preoperatively and on follow-up at 1-, 4- and 6-weeks postsurgery. Further evaluation was performed after 6 months and then annually for 2 years. Results 14 females (53%) and 13 males (48%) with a diagnosis of GERD (with type I HH) and type II HH were operated upon. The mean age was 46 years (24–75 years) and the mean body mass index (BMI) was 27 (18–32). The range of duration of the preoperative symptoms was 6 months to 2 years. The average operating time dropped from 130 minutes for the first 12 cases to 90 minutes for the last 15 cases. The mean hospital stay was 3 days (range: 2–4 days). In the immediate postoperative period, 72% (n = 18) of the patients reported improvement in the GERD symptoms, while 2 (8%) patients described heartburn (grade I, mild, daily) and 1 (4%) patient described bloating (grade I, daily). A total of 5 patients (20%) reported mild dysphagia to solids in the first 2 postoperative weeks. These symptoms settled down after 2 to 5 weeks of postoperative proton-pump inhibitor (PPI) therapy and by adjusting consistency of oral feeds. There was no conversion to open, and we observed no perioperative mortality. There were no patients who underwent redo surgeries in the series. Conclusion LF is a safe and highly effective procedure for a patient with symptoms of GERD, and it gives long-term relief from the symptoms. Stringent selection criteria are necessary to optimize the results of surgery. Experience is associated with a significant reduction of operating time.

185 Vascular Hitch Procedure for Accessory Lower Pole Vessels

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Fashina ◽  
A Rajimwale
Keyword(s):  
Hospital Stay ◽  
Standard Procedure ◽  
Royal Infirmary ◽  
Lower Pole ◽  
Pelvic Wall ◽  
Stable Renal Function ◽  
The Mean ◽  
Leicester Royal Infirmary ◽  
Functional Magnetic Resonance Urography

Abstract Introduction The gold standard procedure for pelvi-ureteric junction obstruction has been the Anderson-Hynes dismembered pyeloplasty; involving the repositioning of the ureter and ureteropelvic anastomosis. However, the Hellstroem 'Vascular Hitch Procedure’ dictates the superior translocation of the accessory vessel and its fixation to the anterior pelvic wall. The latter has an estimated success rate &gt;90%. Method During 2016-2020, at Leicester Royal Infirmary, 16 operations occurred on paediatric patients with pelvi-ureteric junction obstruction. The dismembered pyeloplasty was performed on 5 patients, 9 patients underwent the vascular hitch procedure, and 2 patients are currently awaiting the latter operation. All patients had a pre-operative functional magnetic resonance urography (fMRU) to identify and localise the accessory lower pole vessel. Results The mean hospital stay for the vascular hitch procedure was 1.5 days (range=1-2) in comparison to 4 days (range=3-5) for the dismembered pyeloplasty. The follow-up period ranged from 6 months to 3 years. Overall, it was noted that the patients were asymptomatic, had markedly reduced hydronephrosis on imaging as well as stable renal function noted on the MAG 3 renogram scan. Conclusions The laparoscopic vascular hitch procedure appears to be the superior operation for the management of pelvi-uteric junction obstruction as the patients had notably reduced hospital stay lengths.

Five-year outcome after conversion of a hemiarthroplasty when used for the treatment of a proximal humeral fracture to a reverse total shoulder arthroplasty

2018 ◽  
Vol 100-B (6) ◽  
pp. 761-766 ◽  
Author(s):  
M. Holschen ◽  
M-K. Siemes ◽  
K-A. Witt ◽  
J. Steinbeck
Keyword(s):  
Shoulder Arthroplasty ◽  
Proximal Humeral Fracture ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Operating Time ◽  
Humeral Fracture ◽  
Reverse Total Shoulder Arthroplasty ◽  
The Mean ◽  
Reverse Total Shoulder

Aims The reasons for failure of a hemirthroplasty (HA) when used to treat a proximal humeral fracture include displaced or necrotic tuberosities, insufficient metaphyseal bone-stock, and rotator cuff tears. Reverse total shoulder arthroplasty (rTSA) is often the only remaining form of treatment in these patients. The aim of this study was to evaluate the clinical outcome after conversions from a failed HA to rTSA. Material and Methods A total of 35 patients, in whom a HA, as treatment for a fracture of the proximal humerus, had failed, underwent conversion to a rTSA. A total of 28 were available for follow-up at a mean of 61 months (37 to 91), having been initially reviewed at a mean of 20 months (12 to 36) postoperatively. Having a convertible design, the humeral stem could be preserved in nine patients. The stem was removed in the other 19 patients and a conventional rTSA was implanted. At final follow-up, patients were assessed using the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score, and plain radiographs. Results At final follow-up, the mean ASES was 59 (25 to 97) and the mean adjusted Constant Score was 63% (23% to 109%). Both improved significantly (p < 0.001). The mean forward flexion was 104° (50° to 155°) and mean abduction was 98° (60° to 140°). Nine patients (32%) had a complication; two had an infection and instability, respectively; three had a scapular fracture; and one patient each had delayed wound healing and symptomatic loosening. If implants could be converted to a rTSA without removal of the stem, the operating time was shorter (82 minutes versus 102 minutes; p = 0.018). Conclusion After failure of a HA in the treatment of a proximal humeral fracture, conversion to a rTSA may achieve pain relief and improved shoulder function. The complication rate is considerable. Cite this article: Bone Joint J 2018;100-B:761–6.

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