scholarly journals Robotic Duodenopancreatectomy

2020 ◽  
Vol 8 (F) ◽  
pp. 37-39
Author(s):  
Danilo Coco ◽  
Silvana Leanza
Keyword(s):  
Pancreatic Cancer ◽  
Hospital Stay ◽  
Conversion Rate ◽  
Median Overall Survival ◽  
Open Laparoscopy ◽  
Medical Databases ◽  
The Past ◽  
Medical Facilities ◽  
Hospital Stays ◽  
Oncological Results

INTRODUCTION: Advanced methods of treating pancreatic cancer are being explored to minimize some of the adversities associated with traditional laparoscopy. One of the most promising procedures is robotic duodenopancreatectomy, which appears to reduce morbidity, mortality, conversion rate, hospital stay, and improve oncological results among patients. As such, the procedure is gaining popularity in several medical facilities. AIM: The article describes robotic duodenopancreatectomy, improved surgical treatment of pancreatic cancer that involves the use of augmented reality. MATERIALS AND METHODS: The study involves a systematic review of existing literature on robotic duodenopancreatectomy. A total of 16 scholarly articles, published within the past 5 years, are used to synthesize information designed to provide a conclusive summary of evidence related to robotic duodenopancreatectomy. All the materials are retrieved from two medical databases, MEDLINE and ProQuest. RESULTS/OUTCOME: Morbidity: The rate of morbidity associated with the procedure is relatively high, up to 40%, but slightly lower compared to open laparoscopy, which exhibits morbidity rates of approximately 75%. Mortality: There is evidence of incidences of mortality in robotic duodenopancreatectomy, ranging between 1 and 12.5%. The main cause of death associated with the procedure is post-pancreatic hemorrhage. Conversion rate: The conversion rate in robotic surgery is relatively lower compared to open laparoscopy, ranging between 0 and 37.5%. However, it can decrease to 33.3% after subsequent surgeries. Hospital stay: The procedure is associated with a shorter hospital stays (13.7–24 days) compared to open laparoscopy (25.8 days). Oncological outcomes: Robotic duodenopancreatectomy lacks clear oncological results. However, few studies have established a median overall survival of 15 months. CONCLUSION: Given that robotic duodenopancreatectomy reduces the rates of mortality, morbidity, conversion rate, and length of hospital stays, it appears to be an ideal treatment of pancreatic cancer.

scholarly journals Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

2016 ◽  
Vol 43 (1) ◽  
pp. 2-5 ◽  
Author(s):  
Cássio Padilha Rubert ◽  
Roberta Alves Higa ◽  
Fabiano Vilas Boas Farias
Keyword(s):  
Hospital Stay ◽  
Conversion Rate ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Mato Grosso ◽  
Significant Difference ◽  
Stay Time ◽  
Hospital Stays ◽  
The Mean ◽  
Mato Grosso Do Sul

Objective: to analyze the differences in mortality rates, length of hospital stay, time of surgery and the conversion rate between elective open cholecystectomies (OC) and laparoscopic ones (LC) in elderly patients. Methods : we evaluated medical records of patients 65 years of age or older undergoing open or laparoscopic cholecystectomy at the Hospital Regional de Mato Grosso do Sul between January 2008 and December 2011. We excluded individuals operated in non-elective scenarios or who underwent intraoperative cholangiography. Results : we studied 113 patients, of whom 38.1% were submitted to the OC and 61.9%, to LC. Women accounted for 69% of patients and men, for 31%. The conversion rate was 2.9%. The mean age and duration of the procudure was 70.1 and 84 minutes, respectively, with no significant difference between OC and LC. Patients undergoing LC had shorter hospital stays (2.01 versus 2.95 days, p=0.0001). We identified operative complications in sixpatients (14%) after OC and in nine (12%) after LC, with no statistical difference. Conclusion : there was no difference in morbidity and mortality when comparing OC with LC. The laparoscopic approach led to shorter hospital stay. Operative time did not differ between the two access routes. The conversion rate was similar to other studies.

The Diagnosis of Viral Disease by Electron Microscopy

1982 ◽  
Vol 40 ◽  
pp. 270-273
Author(s):  
William B. McCombs ◽  
Cameron E. McCoy
Keyword(s):  
Electron Microscopy ◽  
Hospital Stay ◽  
Viral Infections ◽  
Medical Profession ◽  
Bacterial Pathogens ◽  
Viral Disease ◽  
Viral Pathogens ◽  
Academic Interest ◽  
The Past

Recent years have brought a reversal in the attitude of the medical profession toward the diagnosis of viral infections. Identification of bacterial pathogens was formerly thought to be faster than identification of viral pathogens. Viral identification was dismissed as being of academic interest or for confirming the presence of an epidemic, because the patient would recover or die before this could be accomplished. In the past 10 years, the goal of virologists has been to present the clinician with a viral identification in a matter of hours. This fast diagnosis has the potential for shortening the patient's hospital stay and preventing the administering of toxic and/or expensive antibiotics of no benefit to the patient.

A study on the design of a wardrobe, for patients bed-ridden with cancer, applying the knowledge of anonymous design

Impact ◽  
2020 ◽  
Vol 2020 (7) ◽  
pp. 45-47
Author(s):  
Naoko Fujii
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Healthcare Professionals ◽  
The Other ◽  
Human Beings ◽  
Prolonged Hospital Stay ◽  
Hospital Patients ◽  
Hospital Gowns ◽  
Hospital Stays ◽  
Prolonged Hospital

The majority of human beings will be admitted to hospital at some point over the course of their lives. For the more fortunate among us, these hospital stays will be brief and will barely register as a significant experience. However, for others, being admitted for weeks or months at a time will be necessary in order to combat and recover from whatever it was that made admittance to hospital necessary. While it is easy to think of many reasons why a prolonged hospital stay might be undesirable, one that may escape our attention is the clothes that are worn by patients during their stay. Once a patient has been assigned a bed, they are often given a gown which they put on without thought and then lie down. The gowns that are given to patients are generally designed with healthcare professionals in mind. For example, in Japan pyjamas and yukata (bathrobes) are used as hospital gowns because they have a front opening that is easy to use during treatment and nursing care. In addition, the other gowns can be opened from the ankle to the crotch using the zip. Dr Naoko Fujii has focused her career on designing clothes for hospital patients and believes that there is a way to satisfy the practical needs of a hospital and the care it gives at the same time as satisfying the requirements of patients. She is now focusing her attention on this challenge.

Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

1970 ◽  
Vol 3 (4) ◽  
pp. 9-20
Author(s):  
José Henrique Gomes Torres ◽  
Rosyane Rena De Freitas
Keyword(s):  
Pancreatic Cancer ◽  
Retrospective Study ◽  
Survival Rates ◽  
Periampullary Tumor ◽  
The Past ◽  
Palliative Procedure ◽  
Surgical Palliation ◽  
Head Of The Pancreas ◽  
Keywords Pancreatic Cancer ◽  
Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente.  Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos.  Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication.  Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care  

scholarly journals Source of Purchased Medications and Its Impact on Medication Mistakes and Hospitalizations: The NHATS 2017

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 793-793
Author(s):  
Martha Coates ◽  
Janeway Granche ◽  
Rose Ann DiMaria-Ghalili
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Hospital Stays ◽  
Related Harm

Abstract Older adults self-administer prescribed medication regimens to treat chronic diseases which can lead to mismanagement, medication related harm and hospitalizations. We examined the extent to which source of purchased medications influenced the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently (N= 3899). The majority (65%) picked-up medications, 18% had medications delivered, and 17% used both (picked-up and delivery). Compared to those picking up their medications, those using delivery only were less likely to have a hospital stay (OR=0.691 [95% CI 0.507-0.943]) and no difference in odds of medication mistakes (OR=1.051 [95% CI 0.764-1.445]), while those using both methods were more likely to report hospital stays (OR=1.429 [95% CI 1.106-1.846]) and medication mistakes (OR = 1.576[95% CI 1.078-2.304]). Older adults who picked-up medications from a local pharmacy and had medications delivered were more likely to report medication mistakes and hospitalizations.

scholarly journals The art of robotic colonic resection: a review of progress in the past 5 years

2021 ◽  
Author(s):  
Hongyi Liu ◽  
Maolin Xu ◽  
Rong Liu ◽  
Baoqing Jia ◽  
Zhiming Zhao
Keyword(s):  
Robotic Surgery ◽  
Hospital Stay ◽  
Intraoperative Complications ◽  
Intestinal Anastomosis ◽  
Length Of Hospital Stay ◽  
Colonic Resection ◽  
Surgical Performance ◽  
Conversion To Open Surgery ◽  
Minimal Invasiveness ◽  
The Past

AbstractSurgery is developing in the direction of minimal invasiveness, and robotic surgery is becoming increasingly adopted in colonic resection procedures. The ergonomic improvements of robot promote surgical performance, reduce workload for surgeons and benefit patients. Compared with laparoscopy-assisted colon surgery, the robotic approach has the advantages of shorter length of hospital stay, lower rate of conversion to open surgery, and lower rate of intraoperative complications for short-term outcomes. Synchronous robotic liver resection with colon cancer is feasible. The introduction of the da Vinci Xi System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) has introduced more flexibility to colonic operations. Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection. Single-port robotic colectomy reduces the number of robotic ports for better looking and faster recovery. Intestinal anastomosis methods using totally robotic surgery result in shorter time to bowel function recovery and tolerance to a solid diet, although the operative time is longer. Indocyanine green is used as a tracer to assess blood supplementation in the anastomosis and marks lymph nodes during operation. The introduction of new surgical robots from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes. The present article reviews recent advances in robotic colonic resection over the past five years.

Use of nab-paclitaxel and gemcitabine in pancreatic cancer without granulocyte colony-stimulating factor: A multicenter real-world experience

2021 ◽  
pp. 107815522110386
Author(s):  
Angela Chen ◽  
Vincent H Ha ◽  
Sunita Ghosh ◽  
Carole R Chambers ◽  
Michael B Sawyer
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Progression Free Survival ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Free Survival ◽  
Colony Stimulating Factors ◽  
Median Progression Free Survival ◽  
Stimulating Factor

Introduction The metastatic pancreatic adenocarcinoma clinical trial (MPACT) trial established gemcitabine (gem) and nab-paclitaxel (nab) as a standard treatment for pancreatic cancer utilizing granulocyte colony-stimulating factors to manage neutropenia. This was a challenge for jurisdictions that do not use granulocyte colony-stimulating factors in palliative settings. We developed dosage guidelines to dose modify gem and nab without granulocyte colony-stimulating factors. We undertook a retrospective review to determine the efficacy and safety of these dose adjustment guidelines in the real world. Methods A multi-centered, retrospective chart review was performed on pancreatic patients between December 1, 2014, and August 21, 2018. Provincial electronic medical health records were reviewed. Using Log-rank statistics we determined the patient's progression-free survival and overall survival. Results Of 248 patients, 209 met patient selection criteria. Patients were excluded if they were lost to follow-up, on gem alone prior to nab/gem combination therapy or did not receive nab or gem. Patients who received nab/gem as first-line therapy had a median progression-free survival of 6.3 months (95% CI, 5.1–7.4), and median overall survival of 11.1 months (95% CI, 9.5–12.8). Those who received gem/nab in the second line had a median progression-free survival of 4.6 months (95% CI, 2.8–6.5), and median overall survival of 19.3 months (95% CI, 12.6–26.0). Conclusions The patient’s progression-free survival and overall survival taking nab/gem using our dose modification algorithm were equivalent or superior to the MPACT trial's progression-free survival and overall survival. Gem/nab can be given by our dose modification scheme without granulocyte colony-stimulating factor.

CORDIAL CYBORG

2021 ◽  
pp. 29-31
Author(s):  
Saumya Jaiswal ◽  
Shivangi Tiwari ◽  
Vivek Kumar Tripathi ◽  
Ajay Sharma
Keyword(s):  
Direct Contact ◽  
Medical Robotics ◽  
Medical Applications ◽  
Collaborative Robotics ◽  
Medical Robots ◽  
The Past ◽  
Medicine Prescription ◽  
Hospital Stays ◽  
Return Home ◽  
Spread Of Infection

1. What are robots used in healthcare? Areas within healthcare which are starting to use robots include: telepresence, rehabilitation, medical transportation, sanitization and prescription dispensing. But we are most interested in collaborative robotics. We will be discussing the COBOT(Cordial Robot) applications. Most modern healthcare robots are especially designed for their target applications. 2. Is it possible to use robotics in medicine? Robotics in medicine can happen in many ways, here are some. Healthcare has been predicted as “a promising industry for robotics” for the past 45 years or more. Since as far back as 1974, researchers have been looking for ways to incorporate robotics into medical applications. 3. Is there a need for more surgery/telepresence/rehabilitation/medical transportation/sanitation and disinfection/medicine prescription dispensing robots? There is denitely a need for many more surgery robots, laparoscopic, endoscopic and nanorobots, as the technology allows more functionalities with miniature propulsion mechanisms. M.A. Zenati, M. Mahvash, from the science of medical robotics, 2012. 4. How are medical robots used to treat patients, reduce contact, and cure pain? Using the medical robots reduces the direct contact between the doctor and the patient, helps in reducing pain, by minimizing the need for more medication and longer hospital stays, allowing the person to return home by the therapy sooner without any spread of infection.

Epithelial-Stromal Interactions in Pancreatic Cancer

2019 ◽  
Vol 81 (1) ◽  
pp. 211-233 ◽  
Author(s):  
Yaqing Zhang ◽  
Howard C. Crawford ◽  
Marina Pasca di Magliano
Keyword(s):  
Pancreatic Cancer ◽  
Extracellular Matrix ◽  
Immune Cells ◽  
Lymphatic Vessels ◽  
Cancer Microenvironment ◽  
Cancer Stroma ◽  
The Past ◽  
Overwhelming Evidence ◽  
Cancer Initiation ◽  
Active Research

Pancreatic cancer is characterized by an extensive fibroinflammatory reaction that includes immune cells, fibroblasts, extracellular matrix, vascular and lymphatic vessels, and nerves. Overwhelming evidence indicates that the pancreatic cancer microenvironment regulates cancer initiation, progression, and maintenance. Pancreatic cancer treatment has progressed little over the past several decades, and the prognosis remains one of the worst for any cancer. The contribution of the microenvironment to carcinogenesis is a key area of research, offering new potential targets for treating the disease. Here, we explore the composition of the pancreatic cancer stroma, discuss the network of interactions between different components, and describe recent attempts to target the stroma therapeutically. We also discuss current areas of active research related to the tumor microenvironment.

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