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A Novel Method Using Gadolinium-Ethoxybenzyl Diethylenetriamine Pentaacetate Acid-Enhanced Magnetic Resonance Imaging for Predicting Post-Hepatectomy Liver Failure in Hepatocellular Carcinoma Patients with a Major Portal Vein Tumor Thrombus. 利用钆-乙氧基苄基二乙烯三胺五乙酸增强磁共振成像预测伴有主要门静脉肿瘤血栓的肝细胞癌患者肝切除术后肝功能衰竭的新方法。
IF 2.7 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI: 10.1159/000536157
Kosuke Nishio, Shohei Komatsu, Keitaro Sofue, Masahiro Kido, Kaori Kuramitsu, Hidetoshi Gon, Kenji Fukushima, Takeshi Urade, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto
{"title":"A Novel Method Using Gadolinium-Ethoxybenzyl Diethylenetriamine Pentaacetate Acid-Enhanced Magnetic Resonance Imaging for Predicting Post-Hepatectomy Liver Failure in Hepatocellular Carcinoma Patients with a Major Portal Vein Tumor Thrombus.","authors":"Kosuke Nishio, Shohei Komatsu, Keitaro Sofue, Masahiro Kido, Kaori Kuramitsu, Hidetoshi Gon, Kenji Fukushima, Takeshi Urade, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto","doi":"10.1159/000536157","DOIUrl":"10.1159/000536157","url":null,"abstract":"<p><strong>Introduction: </strong>The usefulness of gadolinium-ethoxybenzyl diethylenetriamine pentaacetate acid-enhanced magnetic resonance imaging (EOB-MRI) in assessing the functional future remnant liver volume (fFRLV) to predict post-hepatectomy liver failure (PHLF) has been previously reported. Herein, we evaluated the efficacy of this technique in patients with hepatocellular carcinoma (HCC) with a major portal vein tumor thrombus (PVTT).</p><p><strong>Methods: </strong>This study included 21 patients with PVTT in the ipsilateral first-order branch (Vp3) and 30 patients with PVTT in the main trunk/contralateral branch (Vp4). To evaluate fFRLV, the signal intensity (SI) of the remnant liver was determined on T1-weighted images, using both conventional and newly developed methods. The fFRLV was calculated using the SI of the remnant liver and muscle, remnant liver volume, and body surface area. Preoperative factors predicting PHLF (≥grade B) in HCC patients with Vp3/4 PVTT were evaluated.</p><p><strong>Results: </strong>In the Vp3 group, we found fFRLV area under the receiver-operating characteristic curves (AUCs) above 0.70 (AUC = 0.875, 0.750) using EOB-MRI results calculated using either the plot or whole method. None of the parameters in the Vp4 group had an AUC greater than 0.70.</p><p><strong>Conclusion: </strong>The fFRLV calculated by EOB-MRI using the whole method can be as useful as the conventional method in predicting PHLF (≥grade B) for HCC patients with Vp3 PVTT.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"30-36"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vagal Sparing Gastrectomy: A Systematic Review and Meta-Analysis. 迷走神经保留胃切除术:系统回顾和荟萃分析。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-02-27 DOI: 10.1159/000536472
Ashraf M Tokhi, Sam V George, Carlos S Cabalag, David S Liu, Cuong P Duong
{"title":"Vagal Sparing Gastrectomy: A Systematic Review and Meta-Analysis.","authors":"Ashraf M Tokhi, Sam V George, Carlos S Cabalag, David S Liu, Cuong P Duong","doi":"10.1159/000536472","DOIUrl":"10.1159/000536472","url":null,"abstract":"<p><strong>Introduction: </strong>Radical gastrectomy is associated with significant functional complications. In appropriate patients may be amenable to less invasive resection aimed at preserving the vagal trunks. The aim of this systematic review and meta-analysis was to assess the functional consequences and oncological safety of vagal sparing gastrectomy (VSG) compared to conventional non-vagal sparing gastrectomy (CG).</p><p><strong>Methods: </strong>A systematic review of four databases in accordance with PRISMA guidelines was undertaken for studies published between January 1, 1990, and December 15, 2021, comparing patients who underwent VSG to CG. We meta-analysed the following outcomes: operative time, blood loss, nodal yield, days to flatus, body weight changes, as well as the incidence of post-operative cholelithiasis, diarrhoea, delayed gastric emptying, and dumping syndrome.</p><p><strong>Results: </strong>Thirty studies were included in the meta-analysis with a selection of studies qualitatively analysed. VSG was associated with a lower rate of cholelithiasis (OR: 0.25, 95% CI: 0.15-0.41, p &lt; 0.010) and early dumping syndrome (OR: 0.42, 95% CI: 0.21-0.86; p = 0.02), less blood loss (mean difference [MD]: -51 mL, 95% CI: -89.11 to -12.81 mL, p = 0.009), less long-term weight loss (MD: 2.03%, 95% CI: 0.31-3.76%, p = 0.02) and a faster time to flatus (MD: -0.42 days, 95% CI: -0.48 to 0.36, p &lt; 0.001). There was no significant difference in nodal harvest, overall survival, and all other endpoints.</p><p><strong>Conclusion: </strong>VSG significantly reduces the incidence of post-operative cholelithiasis and dumping syndrome, decreases weight loss, and facilitates an earlier return of gut motility. Although technically more challenging, VSG should be considered for prophylactic surgery.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"147-160"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
N3 Disease in Esophageal Cancer: Results from a Nationwide Registry. 食管癌中的 N3 疾病:来自全国登记处的结果。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-08-03 DOI: 10.1159/000540468
Charlène J van der Zijden, Pim B Olthof, Pieter C van der Sluis, Bas P L Wijnhoven, Maria Erodotou, Henk H Hartgrink, Boudewijn van Etten, Stijn van Esser, Sjoerd M Lagarde, Jan Willem T Dekker
{"title":"N3 Disease in Esophageal Cancer: Results from a Nationwide Registry.","authors":"Charlène J van der Zijden, Pim B Olthof, Pieter C van der Sluis, Bas P L Wijnhoven, Maria Erodotou, Henk H Hartgrink, Boudewijn van Etten, Stijn van Esser, Sjoerd M Lagarde, Jan Willem T Dekker","doi":"10.1159/000540468","DOIUrl":"10.1159/000540468","url":null,"abstract":"<p><strong>Background: </strong>Patients with extensive lymph node metastases have a poor prognosis. Clinical staging of lymph node metastases poses significant challenges given the limited sensitivity and specificity of imaging techniques. The aim of this study was to investigate the overall survival (OS) of patients with N3 disease in a real-world Dutch population and the added value of surgery in these patients.</p><p><strong>Methods: </strong>Patients with cN3M0 esophageal or gastroesophageal cancer were identified from the Netherlands Cancer Registry (2012-2019). Treatment consisted of neoadjuvant chemo(radio)therapy followed by resection or chemo(radio)therapy, radiotherapy, or esophagectomy alone. OS was calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Some 21,566 patients were diagnosed with esophageal cancer of whom 359 (1.7%) had cN3M0 disease. Median OS of these patients was 12.5 months (95% CI: 10.7-14.3). Median OS following chemoradiotherapy alone and neoadjuvant therapy plus surgery was 13.3 months (95% CI: 10.7-15.9) and 23.7 months (95% CI: 18.3-29.2), respectively. Of all patients who underwent esophagectomy, 391 (2.8%) had (y)pN3 disease, and median OS was 16.1 months (95% CI: 14.8-17.4). Twenty-one patients (5.4%) were correctly classified as cN3, and 3-year OS was 21%.</p><p><strong>Conclusion(s): </strong>Clinical staging appears to be difficult, apparently in patients with N3 esophageal cancer. Surgery seems to be of benefit to these patients. More research is required to address the ongoing challenges in clinical staging and the best neoadjuvant therapy.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"133-140"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Albumin-Lymphocyte-Globulin-C-Reactive Protein Index as a Novel Prognostic Biomarker for Hepatocellular Carcinoma after Hepatectomy. 白蛋白-淋巴细胞-球蛋白-C-反应蛋白指数作为肝切除术后肝细胞癌的新型预后生物标志物
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-07-22 DOI: 10.1159/000540067
Masashi Utsumi, Masaru Inagaki, Koji Kitada, Naoyuki Tokunaga, Kosuke Yunoki, Yuya Sakurai, Hiroki Okabayashi, Ryosuke Hamano, Hideaki Miyaso, Yosuke Tsunemitsu, Shinya Otsuka
{"title":"Albumin-Lymphocyte-Globulin-C-Reactive Protein Index as a Novel Prognostic Biomarker for Hepatocellular Carcinoma after Hepatectomy.","authors":"Masashi Utsumi, Masaru Inagaki, Koji Kitada, Naoyuki Tokunaga, Kosuke Yunoki, Yuya Sakurai, Hiroki Okabayashi, Ryosuke Hamano, Hideaki Miyaso, Yosuke Tsunemitsu, Shinya Otsuka","doi":"10.1159/000540067","DOIUrl":"10.1159/000540067","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the performance of the albumin-lymphocyte-globulin-C-reactive protein (CRP) (ALGC) index as a novel prognostic biomarker for hepatocellular carcinoma (HCC) after hepatectomy.</p><p><strong>Methods: </strong>Patients (n = 178) who underwent hepatectomy for HCC (July 2010-December 2021) were analyzed. The ALGC index was calculated as ([albumin × lymphocyte]/[CRP × globulin × 104]). Patients were divided into a low ALGC group (&lt;1.82; n = 81) and a high ALGC group (≥1.82; n = 97). The association of the ALGC index with survival was assessed by univariate and multivariate analyses.</p><p><strong>Results: </strong>The median overall survival (OS) was 100 (range: 1-149) months with 1-, 3-, and 5-year OS rates of 91.6%, 81.2%, and 64.2%, respectively. In univariate analysis, ALGC index (&lt;1.82), alpha-fetoprotein (≥25 ng/mL), tumor size (≥3.5 cm), microvascular invasion, and multiple tumors were associated with shorter OS. ALGC index (&lt;1.82) (hazard ratio [95% confidence interval]) (2.48 [1.407-4.513]; p = 0.001) and multiple tumors (1.92 [1.070-3.356]; p = 0.029) were independent predictors of OS in multivariate analysis.</p><p><strong>Conclusion: </strong>ALGC index is a novel prognostic biomarker for HCC after hepatectomy. It may assist in treatment stratification and better management of patients with HCC.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"161-170"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advantage of Postoperative Inflammatory Status after Laparoscopic Distal Pancreatectomy. 腹腔镜胰腺远端切除术后炎症状态的优势。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-10-09 DOI: 10.1159/000541449
Saori Funakoshi, Yutaka Suzuki, Masao Yoshida, Hirokazu Momose, Ryota Matsuki, Masaharu Kogure, Nobutsugu Abe, Eiji Sunami, Yoshihiro Sakamoto
{"title":"Advantage of Postoperative Inflammatory Status after Laparoscopic Distal Pancreatectomy.","authors":"Saori Funakoshi, Yutaka Suzuki, Masao Yoshida, Hirokazu Momose, Ryota Matsuki, Masaharu Kogure, Nobutsugu Abe, Eiji Sunami, Yoshihiro Sakamoto","doi":"10.1159/000541449","DOIUrl":"10.1159/000541449","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic distal pancreatectomy (LDP) is a safe and effective procedure; however, its impact on perioperative inflammatory reactions compared with open distal pancreatectomy (ODP) remains unclear. This study aimed to assess short-term outcomes following LDP and ODP regarding inflammatory reactions.</p><p><strong>Methods: </strong>This retrospective study of 77 consecutive patients who underwent distal pancreatectomy for low-grade malignancies between 2005 and 2022 compared white blood cell (WBC) count, C-reactive protein (CRP) level, serum albumin level, and CRP/albumin ratio (CAR) between LDP and ODP. Complications, especially postoperative pancreatic fistula (POPF), recovery program, and hospital stay period, were also compared.</p><p><strong>Results: </strong>POPF (17.1% vs. 38.7%, p = 0.039) and surgical morbidity (≥Clavien-Dindo grade III, 12.2% vs. 32.3%, p = 0.038) were significantly lower in LDP than in ODP, as for the difference in postoperative inflammatory response, including CRP and CAR, was just temporary. By multivariate analysis, CAR ≥6.94 on POD 3 was significant predictor of POPF (42.1% vs. 13.2%, odds ratio 4.828, p = 0.030).</p><p><strong>Conclusion: </strong>LDP has lower POPF and earlier postoperative recovery. CAR could be a predictor of POPF.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"213-223"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anatomical Variants of the Jejunal Veins and Their Technical Implications in Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis. 空肠静脉的解剖变异及其对胰十二指肠切除术的技术影响:系统回顾和荟萃分析。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-10-16 DOI: 10.1159/000541417
Roberto Cirocchi, Matteo Matteucci, Justus Randolph, Carlo Boselli, Justin Davies, Gabriele Scarselletti, Alessandro Gemini, Antonia Rizzuto, Giovanni Domenico Tebala
{"title":"Anatomical Variants of the Jejunal Veins and Their Technical Implications in Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.","authors":"Roberto Cirocchi, Matteo Matteucci, Justus Randolph, Carlo Boselli, Justin Davies, Gabriele Scarselletti, Alessandro Gemini, Antonia Rizzuto, Giovanni Domenico Tebala","doi":"10.1159/000541417","DOIUrl":"10.1159/000541417","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most common causes of bleeding during pancreaticoduodenectomy is a dissection of the pancreatic head from the superior mesenteric vein and superior mesenteric artery. Knowledge of the anatomical variants of the veins draining the proximal jejunum may allow better control of bleeding during detachment of the uncinate process and pancreatic head from the mesenteric pedicle and division of the mesopancreas. The aim of this systematic review and meta-analysis was to evaluate the anatomical variations of the first jejunal vein (FJV) and jejunal trunk (FJT).</p><p><strong>Methods: </strong>Fourteen studies (1,888 patients) were included. We performed a systematic review of the available literature according to PRISMA guidelines.</p><p><strong>Results: </strong>The analysis has shown that the posterior course of the FJT and FJV represents the most frequent topographical location (pooled prevalence estimate [PPE] 79.6%) with the anterior jejunal trunk having a lower rate (PPE 20.4%). Few articles reported the variations with separate trunks for the first and second jejunal veins.</p><p><strong>Conclusions: </strong>A thorough preoperative radiological assessment of the anatomical variation of FJT and FJV may confer some advantage to establish the best therapeutic strategy and the best surgical approach in case of pancreatic head carcinoma as it can allow a better estimate of the extent of the neoplasm and improve the accuracy of surgical dissection with potential for reduced bleeding.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"245-255"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Liver Resection in Synchronous Bilobar versus Unilobar Colorectal Liver Metastases: A Retrospective Analysis of Oncological Outcomes and Patient Survival. 同步双叶与单叶结直肠肝转移的肝切除术:肿瘤结果和患者生存期的回顾性分析。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-05-03 DOI: 10.1159/000538359
Christian Stoess, Benjamin Mirschinka, Johanna Ollesky, Marcella Steffani, Nick Seyfried, Benedikt Kaufmann, Helmut Friess, Norbert Hüser, Ulrich Nitsche, Daniel Hartmann
{"title":"Liver Resection in Synchronous Bilobar versus Unilobar Colorectal Liver Metastases: A Retrospective Analysis of Oncological Outcomes and Patient Survival.","authors":"Christian Stoess, Benjamin Mirschinka, Johanna Ollesky, Marcella Steffani, Nick Seyfried, Benedikt Kaufmann, Helmut Friess, Norbert Hüser, Ulrich Nitsche, Daniel Hartmann","doi":"10.1159/000538359","DOIUrl":"10.1159/000538359","url":null,"abstract":"<p><strong>Introduction: </strong>Resection of colorectal liver metastasis has emerged as the standard treatment. Our study compares oncological outcomes of patients with resected synchronous bilobar versus unilobar colorectal liver metastasis.</p><p><strong>Methods: </strong>This retrospective study presents long-term follow-up data of 105 consecutive patients with primary colorectal cancer and synchronous liver metastasis. All patients underwent primary tumor and metastasis resections between 2007 and 2019.</p><p><strong>Results: </strong>Fifty-five patients with bilobar and 50 patients with unilobar colorectal liver metastases were included. No significant difference in overall, tumor-specific, or recurrence-free survival was observed between patients with bilobar and unilobar metastases. After case-control matching, the results were confirmed in patients with similar tumor burdens. In the multivariate analysis, chemotherapy following liver metastasis resection was a significant prognostic factor associated with improved overall survival (hazard ratio 0.518, 95% confidence interval: 0.302-0.888, p = 0.017).</p><p><strong>Conclusion: </strong>Overall survival, as well as tumor-specific and recurrence-free survival, did not differ between patients with unilobar and bilobar liver metastasis. These findings contribute to the understanding that primary tumor and metastasis resection in eligible patients improve long-term outcomes.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"103-110"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intracorporeal versus Extracorporeal Anastomosis in Laparoscopic Right Hemicolectomy: An Updated Systematic Review and Meta-Analysis of Randomized Control Trials. 腹腔镜右半结肠切除术中的体腔内吻合与体外吻合:随机对照试验的最新系统回顾和 Meta 分析》。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-09-27 DOI: 10.1159/000541373
Pengyu Wei, Yang Li, Jiale Gao, Si Wu, Wenlong Shu, Hongwei Yao, Zhongtao Zhang
{"title":"Intracorporeal versus Extracorporeal Anastomosis in Laparoscopic Right Hemicolectomy: An Updated Systematic Review and Meta-Analysis of Randomized Control Trials.","authors":"Pengyu Wei, Yang Li, Jiale Gao, Si Wu, Wenlong Shu, Hongwei Yao, Zhongtao Zhang","doi":"10.1159/000541373","DOIUrl":"10.1159/000541373","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic right hemicolectomy has become the standard surgical procedure for the treatment of right colon disease; however, the choice of anastomosis remains controversial. This study aimed to compare the safety and efficacy of intracorporeal anastomosis and extracorporeal anastomosis in laparoscopic right hemicolectomy.</p><p><strong>Methods: </strong>A systematic literature search was performed in PubMed, Embase, Web of Science, and Cochrane Library. Randomized controlled trials that compared intracorporeal anastomosis with extracorporeal anastomosis in patients with laparoscopic right hemicolectomy until June 4, 2023, are selected. The primary outcomes measured were incidence of anastomotic leakage within 30 days post-operation. Statistical analyses were performed using Review Manager (version 5.4.1).</p><p><strong>Results: </strong>Seven RCTs, including 720 patients, were eligible for the meta-analysis. The incidence of anastomotic leakage showed no significant difference between the intracorporeal anastomosis group and the extracorporeal anastomosis group (RR 0.93, 95% CI: 0.49, 1.76, p = 0.83, and I2 = 0%). However, the intracorporeal anastomosis group had significantly lower rates of postoperative ileus (RR 0.67, 95% CI: 0.45-0.99, p = 0.04, I2 = 46%) and surgical site infections (RR 0.34, 95% CI: 0.16-0.74, p = 0.007, I2 = 0%) compared to the extracorporeal anastomosis group. Additionally, patients in the intracorporeal anastomosis group experienced earlier postoperative passage of gas and stool (WMD -0.39, 95% CI: -0.60, -0.19, p = 0.0002, and I2 = 67%; WMD -0.53, 95% CI: -0.85, -0.21, p = 0.001, and I2 = 75%), as well as shorter hospital stays (WMD -0.46, 95% CI: -0.74, -0.18, p = 0.001, and I2 = 34%).</p><p><strong>Conclusion: </strong>In laparoscopic right hemicolectomy, intracorporeal anastomosis does not increase the incidence of anastomotic leakage within 30 days post-operation compared to extracorporeal anastomosis. In addition, intracorporeal anastomosis resulted in faster recovery of bowel function. This suggests that intracorporeal anastomosis is safe and effective.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"224-244"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis? 急性憩室炎患者值得重新评估计算机断层扫描报告吗?
IF 2.7 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI: 10.1159/000536158
Leena-Mari Mäntymäki, Juha Grönroos, Anu Aronen, Jukka Karvonen, Mika Ukkonen
{"title":"Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?","authors":"Leena-Mari Mäntymäki, Juha Grönroos, Anu Aronen, Jukka Karvonen, Mika Ukkonen","doi":"10.1159/000536158","DOIUrl":"10.1159/000536158","url":null,"abstract":"<p><strong>Introduction: </strong>Since the assessment of the disease severity in acute diverticulitis (AD) is of utmost importance to determine the optimal treatment and the need for follow-up investigations, we wanted to investigate whether the first CT report is compatible with daytime reassessment report and whether the value of initial report changes according to the experience of the radiologist.</p><p><strong>Methods: </strong>Consecutive patients from tertiary referral centre with AD were included. CT images done in the emergency department were initially analysed by either resident radiologists or consultant radiologists and then later reanalysed by consultant abdominal radiologists. Discrepancies between reports were noted.</p><p><strong>Results: </strong>Of total of 562 patients with AD, CT images were reanalysed in 439 cases. In 22 reports (5.0%) the final report was significantly different from the initial report and management changed in 20 cases. In reports of uncomplicated acute diverticulitis, reanalysis changed initial assessment in 4.0% of the cases and in complicated acute diverticulitis (CAD) in 9.1%. When consultant and resident radiologists were compared, there was no significant difference.</p><p><strong>Conclusion: </strong>Although no statistical difference could be noted between residents and consultants, the final report was significantly different in overall 5% of the cases when reanalysed at normal working hours by an experienced consultant abdominal radiologist. Therefore, we conclude that reassessment of CT reports is worthwhile in AD.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"37-41"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colonic Diverticulosis at Colonoscopy in Africa: A Systematic Review and Meta-Analysis of Pooled Estimates. 非洲结肠镜检查中的结肠憩室病:系统综述和汇总估算的荟萃分析。
IF 1.8 3区 医学
Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.1159/000536587
Emeka Ray-Offor, Stella-Maris Egboh, Rex F O A Ijah, Sameh Hany Emile, Steven D Wexner
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