Laparoscopic or open treatment for liver hydatid cyst? A single-institution experience: a prospective randomized control trial

The gold standard modality of management of cystic echinococcosis remains surgery. Regardless of the increased interest in nonsurgical techniques. The study aims to compare laparoscopic versus open methods of the hydatid cyst of the liver regarding complication rate, postoperative hospital stays, and effectiveness. A prospective randomized study. One hundred two patients with liver hydatid cyst in which 60 patients fulfil study requirements. Those undergone either open surgical or laparoscopic approaches under cover of albendazole treatment. The data divided into two groups, group 1 (28), group2 (32), we collected demographic data, surgical approach types, and postoperative data. The overall of 102 patients with hydatid cyst of the liver was randomized,60 patients full the study requirements, 28 patients (46.67%) had a laparoscopic procedure, and 32 patients (53.33%) had an open method. The total number of liver hydatid cysts was 70, and the operative time means 77 min (range,60–120 min) in the laparoscopic group and 55 min (range, 40–110 min) in the open group which is significant (P-value 0.0267). The postoperative hospital stay means time was 32 hours (range, 1–3 days) in the group of the laparoscopic procedure and 52 hours (range,2– 5days) in the group of open type. The postoperative surgical complication was significantly less in the laparoscopic group than the open group (p-value 0.014). A Hydatid liver cyst can be managed either by open surgical or laparoscopic techniques with comparable results. Still, the laparoscopic approach is superior in less postoperative pain, hospital stay and time, but it is essential in choosing the suitable patients.

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

10.21203/rs.3.rs-1058924/v1 ◽

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.

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Laparoscopic Compared with Open D2 Gastrectomy on Perioperative and Long-Term, Stage-Stratified Oncological Outcomes for Gastric Cancer: A Propensity Score-Matched Analysis of the IMIGASTRIC Database

Cancers ◽

10.3390/cancers13184526 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4526

Author(s):

Stefano Trastulli ◽

Jacopo Desiderio ◽

Jian-Xian Lin ◽

Daniel Reim ◽

Chao-Hui Zheng ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Propensity Score ◽

Hospital Stay ◽

Predictive Factors ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Open Group ◽

D2 Lymphadenectomy

Background: The laparoscopic approach in gastric cancer surgery is being increasingly adopted worldwide. However, studies focusing specifically on laparoscopic gastrectomy with D2 lymphadenectomy are still lacking in the literature. This retrospective study aimed to compare the short-term and long-term outcomes of laparoscopic versus open gastrectomy with D2 lymphadenectomy for gastric cancer. Methods: The protocol-based, international IMIGASTRIC (International study group on Minimally Invasive surgery for Gastric Cancer) registry was queried to retrieve data on patients undergoing laparoscopic or open gastrectomy with D2 lymphadenectomy for gastric cancer with curative intent from January 2000 to December 2014. Eleven predefined, demographical, clinical, and pathological variables were used to conduct a 1:1 propensity score matching (PSM) analysis to investigate intraoperative and recovery outcomes, complications, pathological findings, and survival data between the two groups. Predictive factors of long-term survival were also assessed. Results: A total of 3033 patients from 14 participating institutions were selected from the IMIGASTRIC database. After 1:1 PSM, a total of 1248 patients, 624 in the laparoscopic group and 624 in the open group, were matched and included in the final analysis. The total operative time (median 180 versus 240 min, p < 0.0001) and the length of the postoperative hospital stay (median 10 versus 14.8 days, p < 0.0001) were longer in the open group than in the laparoscopic group. The conversion to open rate was 1.9%. The proportion of patients with in-hospital complications was higher in the open group (21.3% versus 15.1%, p = 0.004). The median number of harvested lymph nodes was higher in the laparoscopic approach (median 32 versus 28, p < 0.0001), and the proportion of positive resection margins was higher (p = 0.021) in the open group (5.9%) than in the laparoscopic group (3.2%). There was no significant difference between the groups in five-year overall survival rates (77.4% laparoscopic versus 75.2% open, p = 0.229). Conclusion: The adoption of the laparoscopic approach for gastric resection with D2 lymphadenectomy shortened the length of hospital stay and reduced postoperative complications with respect to the open approach. The five-year overall survival rate after laparoscopy was comparable to that for patients who underwent open D2 resection. The types of surgical approaches are not independent predictive factors for five-year overall survival.

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Comparative Study between Laparoscopic versus Open Hernioplasty in Repair of Unilateral Non Recurrent Inguinal Hernia

QJM ◽

10.1093/qjmed/hcab097.053 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hesham Hassan Wagdy ◽

Mostafa Abdo Mohamed ◽

Ahmed Khalil ◽

Osama Mohamed Ali El Ebiedy

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Statistical Difference ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Group ◽

Open Group ◽

Recurrent Inguinal Hernia ◽

P Value ◽

Significant Statistical Difference

Abstract Background Laparoscopic surgery has led to many changes in the management of surgical patients and significantly reduced the incidence of complications associated with open surgical procedures 1. At present, laparoscopic hernia repair has gained clinical significance in patients with bilateral or recurrent hernia. 2 Objectives The aim of this study is to compare open hernioplasty and laparoscopic hernia repair in unilateral non recurrent inguinal hernia. The present study will be performed on 30 patients to compare the effectiveness of laparoscopic hernia repair and open hernioplasty and to assess the intra operative and post-operative complications, duration of surgery, hospital stay, postoperative morbidity, recurrence and patient satisfaction. Patients and Methods . Comparative studies on 30 patients were classified according the type of operative technique into 2 groups: Group A patients underwent laparoscopic technique (15 patients), group B patients underwent open technique (15 patients) to evaluate and compare the open and laparoscopic techniques in unilateral non recurrent inguinal hernia repair as regard operative time,post operative pain, hospital stay, urine retention, parathesia, numbness, seroma,, wound infection and recurrence Results Our study revealed highly significant increase in operative time in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value < 0.0001), highly significant decrease in post-operative pain score in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.00434),highly significant decrease in postoperative hospital stay in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.000003), significant decrease in post operative parathesia and numbness in laparoscopic group; compared to open group of patients; (p value =0.000414),highly significant decrease in post-operative urine retention in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value= 0.000267). Conclusion The laparoscopic technique is superior to the open technique of tensionfree repair, in terms of immediate post-operative complications and delayed pain and paresthesia also in terms of safety.

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Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?

Annals of Coloproctology ◽

10.3393/ac.2019.03.29 ◽

2020 ◽

Vol 36 (1) ◽

pp. 41-47 ◽

Cited By ~ 1

Author(s):

Jun Woo Bong ◽

Yong Sik Yoon ◽

Jong Lyul Lee ◽

Chan Wook Kim ◽

In Ja Park ◽

...

Keyword(s):

Ulcerative Colitis ◽

Postoperative Complications ◽

Restorative Proctocolectomy ◽

Complication Rate ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Bowel Function ◽

Open Group ◽

Open Approach ◽

Short Term

Purpose: This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).Methods: We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.Results: There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.Conclusion: Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

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Laparoscopic versus open surgical approach of cholecystectomy in patients with symptomatic cholelithiasis: a systematic review of comparative trials

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20210545 ◽

2021 ◽

Vol 7 (3) ◽

pp. 167

Author(s):

Omer A. Marzoug

Keyword(s):

Systematic Review ◽

Hospital Stay ◽

Operative Time ◽

Open Cholecystectomy ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

P Value ◽

Symptomatic Cholelithiasis ◽

Pain Duration ◽

Comparative Trials

<p class="abstract">Symptomatic cholelithiasis (gallstone disease) is the most common biliary pathology that affects women predominantly around the world. Earlier open cholecystectomy was the gold standard of treatment of this disease before introduction of laparoscopic cholecystectomy. The aim of this study is to systematically review the most recent published data that compared laparoscopic with open cholecystectomy in symptomatic cholelithiasis in terms of operative and post-operative morbidity, mortality, operative time, length of hospital stay, and conversion rates. The Medline, Cochrane library, Embase, and PubMed databases were vigorously searched for trials that compared laparoscopic with open cholectstectomy in patients with symptomatic cholelithiasis, a systematic review of these comparative trials was performed. No mortality was detected in both groups; the conversion rate was 6.75%. The laparoscopic approach associated with significantly shorter hospital stay (2.31 versus 4.42 days, p value>0.001), lower post-operative pain duration (30.5 versus 66.9 hours, p value>0.001) and lower rate of post-operative wound infection (2.8% versus 10.5%, p value>0.001). Regarding operative time it was significantly longer in laparoscopic approach (77.3 versus 67.1 min, p value>0.001), there were no significant differences in the rates of bile duct injury (0.84% versus 0.25%, p value=0.08) and intra-operative bleeding (4.2% versus 3.5%, p value=0.81) between the two procedures. Post-operative wound infection and pain duration in addition to length of hospital stay in patients with symptomatic cholelithiasis were reduced with laparoscopic cholecystectomy. However, the laparoscopic approach associated with longer duration of surgery. No significant differences between the two procedures in the rates of bile duct injury and intra-operative bleeding.</p>

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A retrospective study on laparoscopic appendectomy versus open appendectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20191127 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1144

Author(s):

P. Senthil Kumar ◽

S. Edwin Kin’s Raj ◽

Saranya Nagalingam

Keyword(s):

Retrospective Study ◽

Acute Appendicitis ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Operative Time ◽

Open Appendectomy ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Daily Activities ◽

Early Return

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Open appendectomy is the “gold standard” for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a retrospective study.Methods: The study was done as a retrospective study among 387 patients diagnosed with appendicitis for a period of 18 months in the Dept of General Surgery. All patients included were 16 years and above and followed up for 3 weeks. In this study, 130 patients diagnosed as acute appendicitis - underwent open appendectomy and 257 patients diagnosed as sub-acute cases of appendicitis - underwent laparoscopic appendectomy. These two groups (open & laparoscopic) were compared for operative time, length of hospital stay, postoperative pain, complication rate, early return to normal activity.Results: Laparoscopic appendectomy was associated with a shorter hospital stay (around 4.5 days), with a less need for analgesia and with an early return to daily activities (around 11.5 days). Operative time was significantly shorter in the open group (35 mins), when compared with laparoscopic group (around 59 mins). Total number of complications was less in the Laparoscopic group with a significantly lower incidence of post-op pain and complications.Conclusions: The laparoscopic approach is a safe and efficient operative procedure and it provides clinically beneficial advantages over open appendectomy (including shorter hospital stay, an early return to daily activities and less post-op complications).

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Comparison between Laparoscopic and Open Repair of Umbilical and Paraumbilical Hernia: A Randomized Controlled Trial Study

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031114 ◽

2021 ◽

pp. 127-135

Author(s):

Arti Mitra ◽

Unmed Chandak ◽

Shiv Kumar Sahu ◽

Yuvraj Pawaskar ◽

Akanksha Waldia

Keyword(s):

Laparoscopic Repair ◽

Open Repair ◽

Tertiary Care ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Open Group ◽

Paraumbilical Hernia ◽

Early Return ◽

Open Mesh Repair ◽

The Mean

Background: Laparoscopic repair of umbilical and paraumbilical hernia has largely replaced conventional (Open) repair. The purpose of the study was to compare the effectiveness of laparoscopic vs. open repair of umbilical & para umbilical hernia in a tertiary care government hospital. Methods: A total 50 patients of age >18 years diagnosed with umbilical and paraumbilical hernia who underwent laparoscopic and open hernia repair from May2018 to Nov 2020 were enrolled and divided into two groups of 25 patients in each. The patients were followed up in the post-operative period in the wards during daily rounds till the time of discharge; 1 and 6 months after discharge and yearly. Results: The mean age for open group was 44.24±7.68years while the mean age for laparoscopic group was 50.0±11.82years. Operative time was more in laparoscopic repair (81.68±18.37min) as compared to open (55.44±16.54min). Post-operative pain (VAS score) was greatest in the open group in comparison to lap group at 6 hr, 24 hr, day 8 and at 1month. Postoperative overall complication rate (Infection, seroma and recurrence) was 12% in the laparoscopic group and 28% in the open group. Recovery was faster with laparoscopic repair with a mean postoperative hospital stay of 3.28days as compared to 5.88days for open mesh repair. Patients treated with laparoscopic repair were early return to routine activity and work. Conclusion: The laparoscopic approach appears to be safe, effective and acceptable. It is a complex but very efficient method in experienced hands and it offered a significant advantage over open repair.

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Modified Sinotomy with Marsuplization versus Excision with Lay Open in Treatment of Pilonidal Sinus Disease

QJM ◽

10.1093/qjmed/hcab097.025 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ashraf Farouk Abdeer ◽

Amr Mohamed Elhefny ◽

Wadie Boshra Gerges ◽

John Sobhy Mamlouk Sawires

Keyword(s):

Pilonidal Sinus ◽

Wound Care ◽

Randomized Study ◽

Normal Activity ◽

The Body ◽

Open Group ◽

Pilonidal Sinus Disease ◽

P Value ◽

Sinus Disease ◽

Number Of Patients

Abstract Pilonidal sinus disease (PSD) is a common infection of the skin in the gluteal cleft, with a prevalence of 0.7% in the general population. Pilonidal sinus can occur in many different areas of the body but most are found in the sacrococcygeal area, in the natal cleft, approximately 5 cm from the anus. This is a prospective comparative randomized study conducted at Department of General Surgery, Imbaba General Hospital to compare the modified sinotomy with marsupialization versus excision with lay open in treatment of pilonidal sinus disease. Pre-study power analysis revealed that a sample size of 30 patients in each group would be sufficient with 80% power and a P value of 0.05. The perfect approach for the management of PNS should be simple, cause minimal pain, have best chance for success and least recurrence rate with low risk for complications, avoid general anesthesia, require minimal wound care, and ensure minimal inconvenience for the patient with rapid return to normal activity. Number of Patients participated in this study were n = 60 77% of the participants were males aged from 17-52 and 26.3 works as drivers. Operative time in modified sinotomy group ranged from 20-40 minutes and in lay open group ranged from 20-35 min (P-value: 0.07). Presence of hair in the back in the modified sinotomy group in 83.3% while in the lay open group 76.6% (P-value: 0.004). In conclusion, we believe that execution of a minimally invasive surgical technique for PSD can be among the most important methods for treating not only primary PSD but also complicated and recurrent PSD cases.

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Recurrent liver hydatid cyst and port site hydatid cyst in anterior abdominal wall in operated case of laparoscopic cystostomy for liver hydatid cyst: a rare complication

International Surgery Journal ◽

10.18203/2349-2902.isj20214403 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3495

Author(s):

Swamy P. T. ◽

Jayendra G. Vagadia ◽

Jatin G. Bhatt ◽

Jignesh P. Dave

Keyword(s):

Hydatid Cyst ◽

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Rare Complication ◽

Treatment Options ◽

Laparoscopic Approach ◽

Public Health Problem ◽

Animal Husbandry ◽

Port Site ◽

Liver Hydatid Cyst

Hydatid disease, or echinococcosis, is a widespread zoonotic parasitic disease caused by a tapeworm that continues to be a clinical and public health problem worldwide, especially in areas where animal husbandry and subsistence farming form an integral part of community life. Location of cyst in different organs of body changes the diagnostic and therapeutic management of the cyst. Four treatment options are currently available: radical surgery, conservative surgery, puncture-aspiration-injection-respiration (PAIR), and antiparasitic medical treatment. Surgery is gold standard for liver hydatid cyst and can be done by open/laparoscopic approach. We are reporting a case of recurrence of liver hydatid cyst with port site anterior abdominal wall hydatid cyst in a 40-year-old female patient operated previously for laparoscopic liver hydatid cystectomy. Port site hydatid cyst is a rare complication after laparoscopic hydatid cystotomy, but can occur due to lodgement of scolices at port site while removing daughter cyst at port site of laparoscopy.

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Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?

Minimally Invasive Surgery ◽

10.1155/2021/8828091 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

André Pereira ◽

Hugo Santos Sousa ◽

Diana Gonçalves ◽

Eduardo Lima da Costa ◽

André Costa Pinho ◽

...

Keyword(s):

Peptic Ulcer ◽

Hospital Stay ◽

Laparoscopic Repair ◽

Laparoscopic Approach ◽

Oral Intake ◽

Length Of Hospital Stay ◽

Perforated Peptic Ulcer ◽

Open Group ◽

New Paradigm ◽

Female Ratio

Introduction. Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. Methods. Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. Results. During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; p = 0.009 ) and in the presence of sepsis criteria (12.2% versus 38.3%, respectively; p = 0.001 ), while the Boey score showed no differences between the two groups. The operative time was longer in the laparoscopic group (median 100’ versus 80’, p = 0.01 ). Laparoscopy was associated with few early postoperative complications (18.4% versus 41.7%, p = 0.004 ), mortality (2.0% versus 14.2%; p = 0.02 ), shorter hospital stay (median 6 versus 7 days, p = 0.001 ), and earlier oral intake (median 3 versus 4 days, p = 0.021 ). Conclusion. Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.

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