scholarly journals Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case-control study

2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Oral Intake ◽  
Postoperative Hospital Stay ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Conventional Laparoscopic

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively ( t =3.07, P <0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d ( t =2.03, P <0.05), and the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 ( t =3.79, P <0.001). There were no significant differences in intraoperative blood loss (9.57±3.28 ml vs 8.2±1.13 ml, t =0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t =1.68, P =0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, c ² =0.07, P =0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.

scholarly journals Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case–control study

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fei Liu ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Oral Intake ◽  
Postoperative Hospital Stay ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Conventional Laparoscopic

Abstract Background To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results All 55 patients (TLH = 30, CLH = 25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57 ± 0.19 d and 4.56 ± 0.27 d, respectively (t = 3.07, P < 0.01), the postoperative hospital stay was 5.50 ± 0.28 d and 7.00 ± 0.74 d (t = 2.03, P < 0.05), and the hospitalization expenses were CNY 40,085 ± 2447 and CNY 26,084 ± 2776 (t = 3.79, P < 0.001). There were no significant differences in intraoperative blood loss (9.57 ± 3.28 ml vs 8.2 ± 1.13 ml, t = 0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5 ± 2.46 min vs 75.00 ± 2.04 min, t = 1.68, P = 0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, χ2 = 0.07, P = 0.79). Conclusions TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.

scholarly journals Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case-control study

2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Oral Intake ◽  
Postoperative Hospital Stay ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Conventional Laparoscopic

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively (t=3.07, P<0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d (t=2.03, P<0.05), and the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 (t=3.79, P<0.001). There were no significant differences in intraoperative blood loss (9.57±3.28 ml vs 8.2±1.13 ml, t=0.37, P=0.72) or time for jejunum-cojejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t=1.68, P=0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, c²=0.07, P=0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive. Keywords: Total laparoscopic; Choledochal cyst; Children; Congenital

scholarly journals Total Versus Conventional Laparoscopic Cyst Excision and Roux-en-Y Hepaticojejunostomy in Children with Choledochal Cysts: A Case-Control Study

2020 ◽  
Author(s):  
Fei Liu ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Oral Intake ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Conventional Laparoscopic

Abstract Background: To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs).Methods: Patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-co-jejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, postoperative complications and perioperative laboratory values were compared.Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively (t=3.07, P<0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d (t=2.03, P<0.05), the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 (t=3.79, P<0.001). There were no significant differences in intraoperative blood loss (9.57±3.28ml vs 8.2±1.13 ml, t=0.37, P=0.72) and time for jejunum-co-jejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t=1.68, P=0.10). The median follow-up periods of TLH and CLH group were 17 and 16 months respectively. Overall comlication rates were comparable between two groups (10% vs 8%, c²=0.07, P=0.79).Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and short hospitalization. However, hospitalization is relatively expensive.

scholarly journals Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case-control study

2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Oral Intake ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Conventional Laparoscopic

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-co-jejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively ( t =3.07, P <0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d ( t =2.03, P <0.05), the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 ( t =3.79, P <0.001). There were no significant differences in intraoperative blood loss (9.57±3.28ml vs 8.2±1.13 ml, t =0.37, P = 0.72) and time for jejunum-co-jejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t =1.68, P =0.10). The median follow-up periods of TLH and CLH group were 17 and 16 months respectively. Overall comlication rates were comparable between two groups (10% vs 8%, c ² =0.07, P =0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and short hospitalization. However, hospitalization is relatively expensive.

Ligation-free single scrotal incision orchiectomy with ultrasonic scalpel: Xinhua Zhang Procedure

2021 ◽  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Postoperative Complication ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Ultrasonic Scalpel ◽  
Surgery Group ◽  
Significant Difference

Background: To explore the efficacy and safety of a new type of testicular excision with ultrasonic dissector. Methods: A retrospective analysis was performed on 69 patients with advanced prostate cancer undergoing orchiectomy in our hospital between June 2017 and June 2019. All patients were divided into a traditional surgery group (n = 27) and an ultrasonic scalpel surgery group (n = 42). The operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rates were compared. Results: The ultrasonic scalpel surgery group had significantly shorter operation times and less intraoperative blood loss than the traditional surgery group (each P < 0.01). Moreover, the incidence of postoperative complication differed significantly between the traditional surgery group (18.52%) and the ultrasonic scalpel surgery group (0%) (P < 0.01). However, there was no significant difference in postoperative hospital stay between the two groups (P > 0.05). Conclusions: The surgery time for testicular excision using the ultrasonic knife is short, the operation is simple and the complications are few and thus it may become a form of replacement for traditional testicular excision.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Laparoscopy assisted minilaparotomy in the present uterine surgery

1998 ◽  
Vol 47 (3-4) ◽  
pp. 22-25
Author(s):  
G. A. Savitskiy ◽  
N. N. Volkov ◽  
R. D. Ivanova ◽  
S. M. Gorbushin
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
New Technology ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Coagulative Necrosis ◽  
Operative Method ◽  
Uterine Surgery

It has been created the new technology of uterine surgery based on laparoscopy assisted suprapubical middle minilaparotomy. This operative method allows to minimize the surgical injure in the cases when laparoscopy itself may be difficult because of some reasons and typical laparotomy is undesirable. The first experience of these operations has shown that using of this technology does allow to decrease intraoperative blood loss considerably, reduce very much postoperative hospital stay of patients in comparison with laparotomy, minimize the necessity of analgetics, optimize the suture of the uterus in myomectomy and diminish the zone of coagulative necrosis of tissues.

scholarly journals Comparison of Perioperative Outcomes in Open and Laparoscopic Radical Cystectomy with Modified Ureterosigmoidostomy (MainzII): A Retrospective Analysis

2021 ◽  
Author(s):  
Bin Zhang ◽  
Yang He ◽  
Duo Zheng ◽  
Junyao Liu ◽  
Peng Qi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Open Surgery ◽  
Operation Time ◽  
Laparoscopic Group ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss

Abstract Background: To analyze perioperative conditions and long-term efficacy of open modified ureterosigmoidostomy urinary diversion (OMUUD) in patients with bladder cancer who underwent open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC).Methods: In this retrospective study, the clinical data of patients who underwent open and laparoscopic radical cystectomy plus open modified ureterosigmoidostomy urinary diversion in our hospital were collected from January 2011 to December 2019. In addition, perioperative data of 56 patients who underwent ORC and OMUUD were compared with those of 118 patients who underwent laparoscopic radical cystectomy (LRC) plus OMUUD. A long-term follow-up was performed to compare the overall survival (OS) and progression-free survival (PFS) rate between the two groups.Results: Results showed that there was no significant difference between ORC+OMUUD group and LRC+OMUUD group in terms of gender, age, body index, pre-operative ASA grade, history of transurethral resection of bladder tumor (TURBT) before surgery, tumor T stage, lymph node dissection range, pathological grade, and positive postoperative surgical margin. The mean operation time in the open group was shorter than that in the laparoscopic group （P<0.001）. Moreover, the estimated intraoperative blood loss（P<0.001）and postoperative hospital stay（P=0.023）were better in the laparoscopic group than in the open group. The incidence of complications between 30 days (P=0.665) and 90 days (P=0.211) time-points after surgery was not significantly different. Similarly, the OS (P=0.237) and PFS (P=0.307) between the two groups were comparable.Conclusion: This study shows that the LRC group has long operation time, but less estimated intraoperative blood loss, short postoperative hospital stay, small trauma, and fast postoperative recovery compared to open surgery. Moreover, the incidence of complications at 30 - and 90-days postoperation, as well as the OS and PFS is not different between laparoscopy and open surgery.

scholarly journals LARAPOSCOPIC LIVER RESECTION IN SURGERY FOR COLORECTAL CANCER METASTASES

2019 ◽  
Vol 18 (1) ◽  
pp. 58-65
Author(s):  
N. R. Torchua ◽  
A. A. Ponomarenko ◽  
E. G. Rybakov ◽  
S. I. Achkasov
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Colorectal Liver Metastases ◽  
Postoperative Hospital Stay ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Liver Resections

BACKGROUND: nowadays laparoscopic liver resection (LapLR) in contrast to traditional open approach is more preferable because of reduction of intraoperative blood loss and postop morbidity, decrease of postop hospital stay. Unfortunately, the place of LapLR in surgery for colorectal liver metastases is still controversial because of small number of comparative studies. PATIENTS AND METHODS: between November 2017 and December 2018 fifty two patients with resectable colorectal liver metastases were included in our pilot study - 35 in the prospective group for laparoscopic liver resection and 17 patients in retrospective group of open-approach liver resections (selected group of historical control) (OLR). RESULTS: one patient was excluded from LapLR group because of absence of intraoperative evidence for metastatic disease (in spite of preop MRI). Two patients had lap-to-open conversion (in one case because of technical difficulties due to the location of the permanent ileostomy in the right mesogastric region; in the other case due to intraoperative bleeding). These patients were included into open group. Atypical liver resections were the most often procedures in both groups - 79% (23/32) and 76% (13/19), p=0.3 (LapLR and OLR, respectively). Duration of the procedure was shorter in the OLR group: 218+71 min vs. 237+101min in LapLR, p=0.6. The mediana for blood loss in LapLR was 100 ml (quartile 100; 200) vs. 320 ml (quartile 200;600) in OLR, p=0.0001. The rate of R0 resections was comparable in both groups (p=1.0). The patients of OLR group more often had >1 complication (16 vs. 13, p=0.01) and had higher frequency of bile fistulas, abscesses in the liver resection area and clostridial colitis. Postoperative hospital stay was shorter in the LapLR group: 11+3 vs. 14+5 days, p=0.008. CONCLUSION: laparoscopic liver resections for metastases of colorectal cancer were associated with less intraoperative blood loss, morbidity, and shorter postoperative hospital stay, with comparable rate of R0 resections.

scholarly journals Comparison of Therapeutic Effects of Laparoscopic and Open Operation for Congenital Choledochal Cysts in Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Yuan Liu ◽  
Xu Yao ◽  
Shuqiang Li ◽  
Wenhan Liu ◽  
Lei Liu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Adult Patients ◽  
Open Group ◽  
Therapeutic Effects ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Cyst Excision ◽  
Postoperative Stay

Background. Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for treating congenital choledochal cysts (CCCs) have proved to be efficacious in children. Its safety and efficacy in adult patients remain unknown. The purpose of this study was to determine whether the laparoscopic procedure was feasible and safe in adult patients.Methods. We reviewed 35 patients who underwent laparoscopic operation (laparoscopic group) and 39 patients who underwent an open procedure (open group). The operative time, intraoperative blood loss, time until bowel motion recovery, duration of drainage, postoperative stay, time until resumption of diet, postoperative complications, and perioperative laboratory values were recorded and analyzed in both groups.Results. The operative time was longer in the laparoscopic group and decreased significantly with accumulating surgical experience (P<0.01). The mean intraoperative blood loss was significantly lower in the laparoscopic group (P<0.01). The time until bowel peristalsis recovery, time until resumption of diet, abdominal drainage, and postoperative stay were significantly shorter in the laparoscopic group (P<0.01). The postoperative complication rate was not higher in the laparoscopic group than in the open group (P>0.05).Conclusions. Laparoscopic cyst excision and hepaticojejunostomy are a feasible, effective, and safe method for treating CCCs in adult patients.

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