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

2020 ◽  
Vol 36 (1) ◽  
pp. 41-47 ◽  
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.

scholarly journals P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joan Ricard Soler Frias ◽  
Anabel García León ◽  
Luis Tallon-Aguilar ◽  
Jose Tinoco González ◽  
Alejandro Sánchez Arteaga ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Elective Surgery ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Reoperation Rate ◽  
Open Group ◽  
Open Approach

Abstract Aim Analyze the evolution of the laparoscopic approach in emergent inguinal hernia repair at our center. Material and Methods Retrospective review of patients with emergent inguinal hernia repair in our center from January 2011 to June 2020. Demographic, clinical and postoperative data were analyzed as well as the evolution of the laparoscopic approach. Results 385 patients with incarcerated/strangulated inguinal hernia were registered. 58.96% were men, with a median age of 71. Of those, 22 patients (5.71%) were treated by laparoscopic approach and 363 (94.29%) by open approach. The open approach had a longer median hospitalization (4.82 vs 1.66 days), higher rate of surgical wound infection (5.51% vs. 0%), higher reoperation rate (3.31% vs 0%) and higher incidence of respiratory complications (1.97% vs 0%). 1 patient (4.54%) with laparoscopic approach required intestinal resection vs 48 patients (13.22%) of the open group, with a dehiscence rate of 0% vs 4.76% respectively. Mortality rate was 0% for the laparoscopic group and 2.75% in the open group. In the last 18 months, 28.98% of urgent hernias repaired have been performed laparoscopically, while previously from 2011 to 2017 only 0.95%, due to the learning curve obtained in elective surgery where the laparoscopic approach has had a major development in the last 3 years. Conclusions Despite the evident patient selection bias because the approach choice by the surgeon in emergent inguinal hernia repair, laparoscopic approach is feasible and has lower morbidity-mortality compared to open approach in our center. In specialized centers this may be a treatment option for selected patient groups.

scholarly journals Laparoscopic Surgery for Gastric Cancer: The European Point of View

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Mickael Chevallay ◽  
Minoa Jung ◽  
Felix Berlth ◽  
Chon Seung-Hun ◽  
Philippe Morel ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Odds Ratio ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Reoperation Rate ◽  
Mean Difference ◽  
Open Group ◽  
Open Gastrectomy ◽  
Short Term

Objective. Multiple Asian studies have proved the feasibility of laparoscopic approach for surgical treatment of gastric cancer. The difference between Asian and European patients could limit their application in Europe. We reviewed the literature for European studies comparing open gastrectomy with laparoscopic approach in the treatment of gastric cancer. Method. We searched the keywords gastric cancer and laparoscopy in MEDLINE and EMBASE. We included all studies published between 1990 and 2016 and conducted in Europe. Result. We found 1 randomized and 13 cohort studies which compared laparoscopic with open gastrectomy. We found no mean difference in the number of lymph nodes harvested between laparoscopic and open group (mean difference: -0.49; 95% CI: -2.42; 1.44, p=0.62) and no difference of short-term or long-term mortality (short-term odds ratio: 0.74, p=0.47; long-term odds ratio: 0.65, p=0.11). We found a longer operative time in the laparoscopic group (mean difference: 35.75 minutes, p<0.01) but lesser reoperation rate than the open group (odds ratio: 1.55 p=0.01). Conclusion. European based population studies found results comparable with their Asian counterpart. In the current state of evidence, minimally invasive surgery for gastric cancer is safe and can achieve the same oncological results.

PS01.070: EVALUATION OF THE EFFECTIVENESS OF ROBOTIC FUNDOPLICATIONS IN THE TREATMENT OF GERD

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 69-69
Author(s):  
Mikhail Koshkin ◽  
Oleg Vasnev ◽  
Alexandr Belousov ◽  
Mikhail Mikhnevich ◽  
Magomet Baychorov ◽  
...  
Keyword(s):  
Operative Time ◽  
Conflicts Of Interest ◽  
Nissen Fundoplication ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Short Term ◽  
Antireflux Operations ◽  
Davinci System ◽  
Invasive Techniques ◽  
Median Operative Time

Abstract Background Surgical treatment is one of the most effective options for treatment of gastroesofageal reflux disease. Laparoscopic approach became is a ‘gold standard’ over the time demonstrating all advantages of minimally invasive techniques over the open procedures. However the utility of robotic antireflux operations still remains controversial. Methods Since the January till the December of 2017 thirty operations were operated on. Mean age was 57,2 (35–76), among them 21 (70%) were female and 9 (30%) were males. Mean BMI was 29,4 (24,1–41,0). Laparoscopic procedures were performed in15 patients (1st group), robotic procedures with DaVinci system were performed in 15 patients of the second group. Chernousov modified Nissen fundoplication was performed in 25 patients, Toupet fundoplication was used for 4 patients, Nissen type was performed in 4 cases. Results The median operative time in laparoscopic group was 125 min (80–200 min), in robotic group - 124 min (90–210 min). There were no statistical differences between two groups (P = 0,93).Blood loss was minimal in both groups. Mean postoperative hospital stay was 4 days (2–7 days) in the 1st group and 4 days (2–6 days) in the second. There were no statistical differences between two groups (P = 0,19). Postoperative course was uneventful in all patients of both groups. Conclusion Robotic antireflux operations are safe and effective in treatment of patients with reflux-esophagitis. There were no statistically significant differences in short-term results of laparoscopic and robotic operations. Disclosure All authors have declared no conflicts of interest.

Evaluation of Minimally Invasive Surgical Therapies for Ulcerative Colitis

2020 ◽  
Vol 86 (7) ◽  
pp. 782-786 ◽  
Author(s):  
Salini Hota ◽  
Salvatore Parascandola ◽  
Richard Amdur ◽  
Vincent Obias
Keyword(s):  
Ulcerative Colitis ◽  
Minimally Invasive ◽  
Postoperative Outcomes ◽  
Open Group ◽  
Open Approach ◽  
Cardiac Events ◽  
Improvement Program ◽  
Robotic Assisted ◽  
Confounding Variables ◽  
Significant Difference

Introduction Ulcerative colitis (UC) is a chronic inflammatory intestinal disorder that can be managed surgically with a proctocolectomy. Minimally invasive techniques such as laparoscopic or robotic-assisted surgery are available based on the surgeon’s preference and familiarity. To date, there is a paucity of literature evaluating the safety of these techniques in comparison to the open approach in patients with UC. Methods We surveyed the National Surgical Quality Improvement Program (NSQIP) database to select patients with the diagnosis of UC who underwent either robotic, laparoscopic, or open proctocolectomy between 2012 and 2017. A total of 2129 patients were included in the study. The 30-day postoperative outcomes were compared using multivariable logistic regression models after adjusting for confounding variables. The confounding variables were defined as any preoperative variable that was associated with the type of procedure. Results The 30-day postoperative outcomes reported in the NSQIP database were reviewed for each of the treatment groups (open, laparoscopic, and robotic). The anastomotic leak rate was significantly higher in the open group ( P = .022). The robotic and laparoscopic groups had significantly fewer occurrences of postoperative ileus ( P = .0006) and wound infections ( P < .0001). There were significantly more strokes, cardiac events, and pulmonary events in the open surgical group. Operative time was significantly shorter in the open group ( P < .0001). Reintervention rates were not significantly different among the groups. Conclusions Minimally invasive proctocolectomy has significantly fewer postoperative complications compared with open proctocolectomy for UC. There is no significant difference in the postoperative outcomes between robotic-assisted and laparoscopic proctocolectomy.

scholarly journals Association of ileocolic pedicle division with postoperative complications after restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanouil Tzatzarakis ◽  
Florian Herrle ◽  
Wolfgang Reindl ◽  
Nora Altmayer ◽  
Dominik Minas ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Statistical Significance ◽  
Ileal Pouch Anal Anastomosis ◽  
Abscess Formation ◽  
Entire Study ◽  
Anastomotic Strictures ◽  
Anal Anastomosis

Abstract Background When performing a restorative proctocolectomy (RPC) with an ileal pouch-anal anastomosis (IPAA), it is common practice to divide the ileocolic artery (ICA) if the patient has a tumor or dysplasia, or in order to gain sufficient length to secure a tension-free anastomosis. However, it is unclear whether there is an association between division of the ICA and the rate of postoperative complications. Methods We retrospectively analysed all patients with ulcerative colitis who underwent RPC and IPAA in our department between January 2010 and December 2016. These were divided in two groups, with regard to the ICA being preserved (PRE group) or divided (DIV group). Complications such as stenosis or leakage of the IPAA, perianal fistulas, abscess formation within the lesser pelvis and pouchitis were analysed and compared between both groups. Results We identified 130 patients meeting the study inclusion criteria, 49 patients in the PRE and 81 patients in the DIV group. No statistical significance was observed in IPAA leakages (p = 0.71), anastomotic strictures (p = 0.33), fistulas (p = 0.19) and pouchitis (p = 0.72). Abscess formation frequency was similar in both groups (p > 0.99). Moreover, short-term (p = 0.53) and long-term complications (p = 0.11) were similar in both groups. A higher conversion rate was observed in obese (p = 0.006) and male (p = 0.02) patients. Within the entire study population, fistulas and IPAA leakages were associated with a higher rate of anastomotic strictures (p = 0.008 and p = 0.02 respectively). Conclusion Our data suggest similar IPAA related complications after either division or preservation of the ICA. Further trials are required in order to examine the trends observed in this study.

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

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.

scholarly journals Preventing Surgical Complications During Microscopic Fenestration in Middle Fossa Arachnoid Cysts: A Retrospective Study for 38 Cases and Literature Review

2021 ◽  
Author(s):  
Zheng LU ◽  
Wen jian ZHENG ◽  
Xu HAN ◽  
Jian Gong
Keyword(s):  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Postoperative Hemorrhage ◽  
Csf Leak ◽  
Middle Fossa ◽  
Short Term

Abstract Purpose Middle fossa arachnoid cyst (MFAC) is one of the most common cranial cysts in children. The various postoperative complications following cyst fenestration are still the major concern for most surgeons. We systemically review the short-term postoperative complications in the literature and introduce our experience in preventing these complications.Methods A retrospective survey was conducted on the 38 cases of patients having MFAC (<14 years old) who underwent microscopic fenestration from January 2019 to December 2020. Short-term postoperative complications including postoperative hemorrhage/hematoma, subdural hygroma (SH), cranial nerve palsy, and central nervous system infection (PCNSI), and cerebrospinal fluid (CSF) leak were collected. A systematic PubMed search for cohort studies of surgically treated MFAC published from 2000 was performed. The short-term postoperative complications in the included studies were illustrated.Results The overall complication rate in our series is 5.2%. Eight patients (21.1%) developed postoperative SH. One of them required reoperation. Patients who developed SH were significantly younger (4.1±1.6 versus 6.2±3.4 y.o., p=0.018). Binary logistic analysis showed that a lower age could be a risk factor for developing SH (P=0.115). No postoperative hemorrhage, cranial nerve palsy, or CSF leak was observed. In the systemic review, eighteen studies were included, comprising 649 cases of MFAC. The most common complication was SH (4.9%). The short-term postoperative complication rate between microscopic and endoscopic techniques was similar.Conclusion The complication rate in MFAC fenestration is low in children. SH is the most common postoperative complication, and it is prone to occur in young children.

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