Laparoscopic resections in the treatment of children with liver tumors: the first experience

2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Techniques ◽  
Resection Volume ◽  
Selection Of

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child (4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.

scholarly journals Laparoscopic resections in the treatment of children with liver tumors: the first experience

2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Techniques ◽  
Resection Volume ◽  
Selection Of

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child(4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.

Minimally Invasive Surgical Treatment of Lumbar Synovial Cysts

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Faheem A. Sandhu ◽  
Paul Santiago ◽  
Richard G. Fessler ◽  
Sylvain Palmer
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Synovial Cyst ◽  
Complete Excision ◽  
Tubular Retractor ◽  
Minimally Invasive Surgical ◽  
Average Patient ◽  
Synovial Cysts

Abstract OBJECTIVE Synovial cysts are a rare cause of lumbar radiculopathy and back pain. Surgical treatment is directed at complete excision of the cyst. We used minimally invasive surgical techniques for a series of patients, to assess the effectiveness of this approach for resection of synovial cysts. METHODS Seventeen patients (10 female and 7 male patients) with presumed synovial cysts, as indicated on magnetic resonance imaging scans, underwent surgical resection with the 18-mm METRx tubular retractor system (Medtronic Sofamor Danek, Memphis, TN). A unilateral approach was used, with either an operating microscope (13 cases) or a magnifying endoscope (4 cases), depending on the preference of the surgeon. Outcomes were reported by using modified MacNab criteria. RESULTS The average patient age was 64 years (range, 46–82 yr). The L4–L5 level was most commonly affected (82% of cases). Grade 1 spondylolisthesis at the level harboring the synovial cyst was observed for 47% of the patients; all cases of spondylolisthesis involved the L4–L5 level. The mean operative time was 97 minutes, and the average blood loss was 35 ml. Excellent or good results were achieved for 94% of the patients. A dural tear that did not violate the arachnoid membrane occurred during surgery for one patient but did not require further treatment. CONCLUSION Synovial cysts can be effectively treated with a tubular retractor system in conjunction with an endoscope or microscope. Use of the tubular retractor minimizes soft-tissue trauma, incision length, blood loss, and disruption of ligamentous and bony structures. This may be particularly significant when synovial cysts are associated with spondylolisthesis, minimizing the risk of progressive instability and the need for fusion.

Energy Sources for the Surgical Treatment of Atrial Fibrillation

2019 ◽  
Vol 14 (6) ◽  
pp. 503-508
Author(s):  
Robert M. MacGregor ◽  
Spencer J. Melby ◽  
Richard B. Schuessler ◽  
Ralph J. Damiano
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Tissue Injury ◽  
Surgical Techniques ◽  
Maze Procedure ◽  
Energy Sources ◽  
Surgical Approaches ◽  
Surgical Ablation ◽  
The Past ◽  
Minimally Invasive Surgical

The surgical treatment of atrial fibrillation has evolved over the past 2 decades due to the advent of ablation technology, and the introduction of less invasive surgical approaches. Current devices produce ablation lines that aim to replace the incisions of traditional surgical ablation strategies, such as the Cox-Maze procedure. This has helped to simplify and shorten surgical ablation procedures and has allowed for the development of minimally invasive surgical techniques. This review discusses surgical ablation energy sources and devices, providing background on device characteristics, mechanism of tissue injury, and success in creating transmural lesions.

scholarly journals History of surgical treatment of obesity and metabolic disorders

2018 ◽  
Vol 9 (4) ◽  
pp. 87-104
Author(s):  
Dmitrij I. Vasilevsky ◽  
Yuri I. Sedletsky ◽  
Kristina A. Anisimova ◽  
Leysan I. Davletbaeva
Keyword(s):  
Bariatric Surgery ◽  
Surgical Treatment ◽  
Cultural Values ◽  
Medical Science ◽  
Surgical Techniques ◽  
Main Idea ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Negative Side Effects ◽  
Stomach Volume

Surgery of obesity (bariatric surgery) as a separate area of medical science dates back its history from the middle of the previous century. The foundation for its development was based on the ideas of physiology of digestion, the causes and mechanisms of its disturbances that had been formed at that time. An important role was played by achievements in related areas of medicine: anesthesiology, transfusiology. Before that effective antibacterial drugs have already been created. Rich experience in various fields was brought for medicine by the Second World War. The return of society to pre-war cultural values became the impetus for bariatric surgery genesis. For two first decades, the main method of surgical treatment of overweight was shunting operations in the small intestine, aimed at reducing absorption of nutrients (malabsorption techniques). However, a significant number of negative side effects gradually forced to abandon this group of procedures and were the basis for the search for other options in surgical interventions. Since the late 60-es of the 20th century for two decades, methods have been actively developed that limited the flow of nutrients (restrictive approach). The main idea in the development of this group of operations was to reduce the volume of the stomach. At the same time, attempts were made to combine both malabsorptive and restrictive mechanisms in one technique. By the beginning of the 90-es, practically all the available variants of surgical interventions have been proposed and introduced into clinical practice. At the same time, minimally invasive surgical technologies began to be actively introduced into this area of medicine. By the beginning of the 21st century almost all surgical techniques have been adapted to endovideo- (laparoscopic-) surgery. Over the past decade, intraluminal (endoscopic) methods for reducing stomach volume and reducing nutrient absorption have been developed.

scholarly journals Intraoperative Anesthetic Management in an Asymptomatic and Biochemically Silent Pheochromocytoma

2021 ◽  
Vol 6 (10) ◽  
pp. 716-719
Author(s):  
Omar N. ◽  
Shahid M. ◽  
M. Bashir ◽  
Imran S. ◽  
Vipin K. ◽  
...  
Keyword(s):  
Adrenal Mass ◽  
Intraoperative Complications ◽  
Anesthetic Management ◽  
Preoperative Evaluation ◽  
Hypertensive Crisis ◽  
Surgical Techniques ◽  
Surgical Removal ◽  
Asymptomatic Patients ◽  
Laparoscopic Techniques ◽  
Chromaffin Tissue

Pheochromocytomas are tumors that originate from the chromaffin tissue of the adrenal medulla and commonly produce catecholamines. The diagnosis is typically established by the measurement of catecholamines or their metabolites in urine or plasma and tumors are localized with the use of radiographic and scintigraphic studies. Pheochromocytomas can occur in asymptomatic patients and the preferred treatment is surgical removal of the tumor. These chromaffin tissue tumors are not uncommon in anesthetic practice and have varied manifestations. The perioperative management of these tumors has improved remarkably over the yearsin conjunction with the evolution of surgical techniques (laparotomy to laparoscopic techniques and now to robotic approaches.). Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. We report an intraoperative anesthetic management of 32-year-old female with a left adrenal mass (pheochromocytoma) and left ovarian cyst. Throughout her entire course of treatment she was asymptomatic with normal blood pressure readings. Her biochemical screening was unremarkable. She underwent open surgical resection of the adrenal mass with confirmation of pheochromocytoma on histology. Pheochromocytoma represents very significant challenges to the anesthesiologist’s especially when undiagnosed. This case illustrates how paucity of literature on perioperative preparation of clinically and biochemically silent Pheochromocytomas led to serious intraoperative complications even in an asymptomatic, biochemically negative patient.

scholarly journals Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis

2021 ◽  
Vol 11 (4) ◽  
pp. 288-292
Author(s):  
V. A. Ananev ◽  
V. N. Pavlov ◽  
A. M. Pushkarev
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Cortical Layer ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Intraarterial Infusion ◽  
Minimally Invasive Surgical ◽  
Destructive Processes ◽  
Laparoscopic Techniques

Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.

scholarly journals Single-Incision Laparoscopic Liver Resection for Colorectal Metastasis through Stoma Site at Time of Reversal of Diversion Ileostomy: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Bård I. Røsok ◽  
Bjørn Edwin
Keyword(s):  
Liver Resection ◽  
Laparoscopic Liver Resection ◽  
Single Incision ◽  
Liver Tumors ◽  
Single Port ◽  
Surgical Techniques ◽  
Metastatic Lesion ◽  
Minimally Invasive Surgical ◽  
Malignant Liver Tumors ◽  
Malignant Liver

Minimally invasive surgical techniques for liver tumors are gaining increased acceptance as an alternative to traditional resections by laparotomy. In this article we describe a laparoscopic liver resection of a metastatic lesion in a patient primarily operated for colorectal cancer. The resection was conducted as a single port procedure through the stoma aperture at time of reversal of the diversion ileostomy. Sigle incision liver resections may be less traumatic than conventional laparoscopy and could be applied in selected patients with both benign and malignant liver tumors.

Methods of prevention and elimination of the most frequent intraoperative and postoperative complications in the surgical treatment of pulmonary and pleural tuberculosis using video-assisted surgical interventions

2021 ◽  
pp. 51-59
Author(s):  
M.S. Opanasenko ◽  
V.I. Lysenko ◽  
O.V. Tereshkovych ◽  
B.M. Konik ◽  
M.I. Kalenichenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Intraoperative Complications ◽  
Diagnostic Methods ◽  
Surgical Interventions ◽  
Pleural Tuberculosis ◽  
Preoperative Stage ◽  
Operation And Management ◽  
Selection Of

Objective — to identify and analyze methods of prevention and elimination of the most common intraoperative and postoperative complications in the surgical treatment of pulmonary tuberculosis and pleura using VATS. Materials and methods. In the Department of Thoracic Surgery and Invasive Diagnostic Methods of the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine for the period from 2008 to 2019 performed 169 VATS operations on patients with tuberculosis surgery, of which: 130 (79.3 ± 3.2) % VATS lung resections; 35 (20.7 ± 3.1) % VATS pleurectomy with decortication (PE with DC) of the lung; 4 (2.4 ± 1.2) % of patients underwent other VATS interventions. Results and discussions. The level of intraoperative complications among all 169 operated patients was recorded in 9 (5.3 %) cases. Postoperative complications were detected in 29 (17.1 %) patients.Methods of prevention of complications in VATS are the selection of patients at the preoperative stage, correction of hemostasis, safe areas of thoracoport and minitracotomy, lymph dissection, separate treatment of lung root elements, conversion to thoracotomy. Conclusions. VATS interventions are minimally invasive, effective and convenient methods of surgical treatment of patients with pulmonary and pleural tuberculosis. Adequate assessment of the possibility of performing VATS, methods of prevention of complications and their timely application provides a predictable course of the postoperative period and reduces the number of complications. Diagnosis of complications and timely use of various methods of their elimination allows you to effectively and reliably apply medical manipulations to resolve both intra­ and postoperative complications in this type of surgery. Understanding and using methods of prevention and elimination of complications, allows to determine the correct tactics of operation and management of the postoperative period.

Short-term result of laparoscopic pancreaticoduodenectomy in the treatment of periampullary carcinoma

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Tiến Mỹ Đoàn ◽  
Keyword(s):  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Open Surgery ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Operation Time ◽  
Periampullary Cancer ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Short Term ◽  
Short Term Result

Tóm tắt Đặt vấn đề: Phẫu thuật cắt khối tá tụy hiện nay vẫn là phương pháp điều trị triệt Vater, Phẫu thuật nội soi để nhất trong ung thư quanh bóng Vater. Vai trò của phẫu thuật nội soi đã được khẳng định là an toàn và có nhiều ưu điểm so với mổ mở. Cho đến nay đã có nhiều báo cáo về thành công của phẫu thuật này nhưng số lượng còn hạn chế và chưa được phổ biến rộng rãi. Chúng tôi thực hiện nghiên cứu này nhằm đánh giátính khả thi cũng như kết quả của phẫu thuật nội soi cắt khối tá tụy điều trị ung thư quanh bóng Vater. Phương pháp nghiên cứu: (1) Đánh giá tính khả thi của phẫu thuật nội soi cắt khối tá tụy. (2) Xác định tỉ lệ các biến chứng sớm của phẫu thuật cắt khối tá tụy. Nghiên cứu tiến cứu. Từ tháng 4/2017 đến tháng 9/2017 chúng tôi tiến hành phẫu thuật nội soi cắt khối tá tụy cho các người bệnh ung thư quanh bóng Vater tại khoa Ngoại gan mật tụy bệnh viện Chợ Rẫy. Chúng tôi ghi nhận kỹ thuật mổ, thời gian mổ, lượng máu mất, tai biến trong mổ và kết quả sau mổ. Kết quả: Trong thời gian 6 tháng, có 25 người bệnh được phẫu thuật nội soi cắt khối tá tụy. Tuổi trung bình là 52, tỉ lệ Nữ: Nam là 1,11:1. Ung thư bóng Vater chiếm 72%, ung thư đầu tụy chiếm 16%, ung thư đoạn cuối ống mật chủ 12%, không có trường hợp ung thư tá tràng D2. Thời gian mổ trung bình là 425 phút, lượng máu mất trung bình là 150 ml. Thời gian nằm viện 7 ngày. Không có trường hợp nào chuyển mổ mở. Biến chứng rò tụy 2 ca (8%), rò mật 1 ca (4%), viêm phổi 1 ca (4%), không có tử vong sau mổ. Kết luận: Phẫu thuật nội soi cắt khối tá tụy là phẫu thuật an toàn với tỉ lệ tử vong thấp và biến chứng chấp nhận được. Đây là một trong những phẫu thuật khó nhưng vẫn có thể thực hiện được với kỹ năng mổ nội soi tốt và có kinh nghiệm mổ mở cắt khối tá tụy. Lựa chọn người bệnh cẩn thận giúp mang lại thành công cho phẫu thuật. Abstract Introduction: Pancreaticoduodenectomy is the radical treatment of periampullary cancer. Laparoscopic surgery has been considered safe and more optimal than open surgery. Although success of this approach has been reported, the number is still limited and it has not been widely popular. Material and Methods: We conducted this study to investigate the feasibility and the short-term outcome of laparoscopic Pancreaticoduodenectomy in treatment of periampullary cancer. Prospective study. From April 2017 to September 2017, we performed laparoscopic Pancreaticoduodenectomy for periampullary cancer at Department of Hepatobiliary and Pancreatic Surgery, Cho Ray hospital. We recorded surgical techniques, operations time, blood loss, intraoperative complications and postoperative results. Results: 25 patients underwent laparoscopic Pancreaticoduodenectomy. Mean age was 52, female: male ratio is 1.11: 1. Ampullary cancer accounts for 72%, head of pancreatic cancer accounts for 16% and distal common bile duct cancer is 12%. There is no case of duodenal cancer. Average operation time was 425 minutes. Average blood loss was 150 ml. Average duration of hospital stay was 7 days. There was no conversion to open surgery. The complications included pancreatic fistula in 2 cases (8%), biliary fistula in 1 case (4%) and pneumonia in 1 case (4%). There was no mortality after surgery. Conclusion: Laparoscopic Pancreaticoduodenectomy is safe with low mortality and acceptable complication rate. This is one of the most difficult operations, but still be feasible with good laparoscopic surgical skills and experience of Pancreaticoduodenectomy. Careful selection for suitable patient helps bringing success for the surgery. Keyword: Pancreaticoduodenectomy, Periampullary cancer, Laparoscopic Surgery

scholarly journals The choice of surgical treatment in patients with infected pancreonecrosis

2018 ◽  
Vol 177 (6) ◽  
pp. 20-26
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
A. A. Averkina ◽  
D. N. Ustinov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Group Comparison ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical

The objectiveis to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.Material and methods.The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.Results.It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).Conclusion.Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.

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