Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Minimizing Omental Bleeding Risk Following Sleeve Gastrectomy: Assessing the Double-line Sealing Technique.","authors":"Muhammed Said Dalkiliç, Mehmet Gençtürk, Merih Yilmaz, Hasan Erdem, Abdullah Şişik","doi":"10.1097/SLE.0000000000001323","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001323","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic sleeve gastrectomy (LSG) has become the most commonly performed bariatric procedure due to its technical simplicity and effectiveness. While stapler line reinforcement has significantly reduced hemorrhagic complications, postoperative bleeding remains a concern, particularly from omentum or unidentified sources. The LigaSure device, known for sealing vessels successfully up to 7 mm in diameter, may face challenges in obese patients due to excessive omental fat. This study introduces a double-sealing technique as a simple solution aimed at reducing postoperative bleeding related to patient-specific factors.</p><p><strong>Methods: </strong>This study conducts a retrospective analysis to evaluate the double-line omental sealing technique in LSG, an intervention aimed at reducing the incidence of postoperative bleeding. We compared outcomes from 222 patients using the double-line sealing (DLS) technique and 297 patients with standard dissection. DLS technique involves creating 2 adjacent rows of seals on the omentum during dissection, aiming to minimize bleeding risks. Patient demographics, including age, sex, body mass index, and comorbidities, were examined, alongside operative time, length of hospital stay, and instances of reoperation. Special attention was given to identifying cases of severe postoperative bleeding, primarily determined by the need for blood transfusion.</p><p><strong>Results: </strong>No demographic differences emerged between the groups. The study group, which utilized DLS, demonstrated a significantly lower incidence of intraperitoneal severe bleeding (0.45%) compared with the control group (3%). Reoperations were significantly reduced, with only 2 cases (0.67%) in the control group and none in the DLS group. It also correlates with reduced length of hospital stay but increased operative time.</p><p><strong>Conclusions: </strong>DLS in LSG shows promise in reducing severe postoperative bleeding. Despite these positive initial findings, further studies with larger sample sizes are recommended to fully ascertain the efficacy and safety of this technique.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rouvière's Sulcus as a Landmark for a Safe Laparoscopic Cholecystectomy: An Interim Analysis of a Multicenter Cross-sectional Study on the Prevalence and Morphologic Type of Rouvière's Sulcus in the Italian Population.","authors":"Roberto Cirocchi, Luca Properzi, Matteo Matteucci, Marco Artico, Nereo Vettoretto, Jacopo Desiderio, Antonio Di Cintio, Domenico Di Nardo, Federico Farinacci, Alessandro Gemini, Lorenzo Guerci, Stefano Mazzetti, Francesco Ricci, Stefano Trastulli, Stefano Avenia, Carlo Boselli, Bruno Cirillo, Gioia Brachini, Piergiorgio Fedeli, Giulia Montori, Pietro Ursi, Ruggero Iandoli, Carlo Bergamini, Alessio Giordano, Alberto Santoro, Andrea Mingoli, Pavlos Antipas, Giovanni Domenico Tebala","doi":"10.1097/SLE.0000000000001351","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001351","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy is the gold standard in the treatment of symptomatic gallstones. The large number of gallbladders removed every year is not fully consistent with the excessively high incidence of iatrogenic bile duct injury (IBDI). Several strategies have been suggested to reduce this risk. Among them, the use of extra biliary anatomic structures, such as the Rouvière's sulcus, as a landmark to guide the surgeon during dissection has been proposed as a means to prevent IBDI. The main aim of the present paper is the evaluation of the prevalence of Rouvière's sulcus (RS) and its anatomic variants in a given population.</p><p><strong>Materials and methods: </strong>This observational, cross-sectional, and multicenter study has been conducted at the Department of Digestive and Emergency Surgery of the \"Azienda Ospedaliera Santa Maria,\" Terni (Italy), at the Department of Surgical Sciences of the \"Azienda Ospedaliera Perugia,\" Perugia (Italy) and at the Department of Emergency and Trauma Surgery of the \"Policlinico Umberto I,\" Rome (Italy). Intraoperative images of 111 patients undergoing laparoscopic cholecystectomy were analyzed to identify the presence and type of RS, according to the Singh-Prasad classification and the Dahmane classification.</p><p><strong>Results: </strong>RS was present in 93 (83.8%) patients. Singh-Prasad type 1A is present in 48.4% of patients, type 1B in 25.8%, type 2 in 12.9% and type 3 in 12.9%. Dahmane's open type is present in 48.4% of patients and fused type in 51.6%.</p><p><strong>Conclusion: </strong>Due to its high prevalence, RS can be used as an anatomic landmark and probably reduces the incidence of IBDI during laparoscopic cholecystectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Liver Function Abnormalities After Laparoscopic Esophageal Hiatal Hernia Repair.","authors":"Jin Wu, Hao Feng, Zhen-Yuan Wang, Jie Li","doi":"10.1097/SLE.0000000000001350","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001350","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we investigated the factors related to abnormal liver function in patients undergoing laparoscopic esophageal hiatal hernia repair.</p><p><strong>Methods: </strong>The clinical data of 347 patients who underwent elective laparoscopic esophageal hiatal hernia repair at Beijing Chao-yang Hospital of Capital Medical University between January 2018 and November 2023 were retrospectively collected. The patients comprised 131 males and 216 females, ranging in age from 24 to 87 years, and were assessed using the ASA grading system between grades I and III. The patients were divided into 2 groups based on the presence or absence of liver function abnormalities on the first day after surgery: a normal liver function group (NLA group) and an abnormal liver function group (LA group). Patients with elevation in any of the following indicators were included in the LA group: alanine aminotransferase >40 U/L, glutamine aminotransferase >40 U/L, γ-glutamyltransferase >49 U/L, alkaline phosphatase >135 U/L, total bilirubin >17.1 μmol/L, or direct bilirubin >6.8 μmol/L. The clinical data of the 2 groups of patients were compared, and only the indicators with a P-value <0.15 were included in a binary logistic regression model analysis.</p><p><strong>Results: </strong>There were 238 patients (68.6%) who developed liver function abnormalities on the first postoperative day. In comparison to the NLA group, the LA group had a significantly higher proportion of patients with esophageal hiatal hernia type II, type III, and type IV, hypotension, and high PETCO2. Furthermore, the LA group had a significantly lower proportion of patients receiving blood transfusions. The maximum length and maximum cross-sectional area of the esophageal hiatal hernia were also significantly larger in the LA group. In addition, the operation time was significantly longer in the LA group. (all P-values are <0.15). The binary logistic regression analysis revealed that prolonged operation time (OR=1.017, 95% CI: 1.007-1.028) was the only risk factor associated with postoperative liver function abnormalities.</p><p><strong>Conclusions: </strong>The sole risk factor for postoperative liver function abnormalities was prolonged surgical time.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Pauli Parastomal Hernia Repair.","authors":"Francesco Guerra, Giuseppe Giuliani, Lucia Salvischiani, Alfredo Genovese, Andrea Coratti","doi":"10.1097/SLE.0000000000001332","DOIUrl":"10.1097/SLE.0000000000001332","url":null,"abstract":"<p><strong>Background: </strong>Although originally described as an open procedure, the application in the setting of minimally invasive surgery of the Pauli technique for parastomal hernia repair is gaining interest among surgeons owing to encouraging early results. We aimed at combining and analyzing the results of minimally invasive Pauli repair by assessing the available evidence.</p><p><strong>Methods: </strong>A literature search in Pubmed, Embase, and Web of Science was undertaken to include all articles reporting on minimally invasive repair of parastomal hernias using the Pauli technique.</p><p><strong>Results: </strong>Data regarding a total of 75 patients across 11 articles published between 2019 and 2023 were included. Patients received surgery either by a laparoscopic (27%) or robotic (73%) approach. A transabdominal route was chosen in 62 patients (83%), while an extraperitoneal technique was employed in the remaining 13 patients. The rate of postoperative morbidity was 34%, with 10% being the incidence of grade >II complications. The reported overall rate of recurrence was 7% at a median follow-up of 1 to 43 months.</p><p><strong>Conclusions: </strong>The available evidence derived from a growing number of centers suggests that minimally invasive Pauli repair is a viable option to treat parastomal hernias. Despite robust, high-level data still lacking, preliminary experiences indicate promising results.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"647-651"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Options for Retained Gallstones After Cholecystectomy.","authors":"Ali Mohtashami, William A Ziaziaris, Chris S H Lim, Nazim Bhimani, Steven Leibman, Thomas J Hugh","doi":"10.1097/SLE.0000000000001333","DOIUrl":"10.1097/SLE.0000000000001333","url":null,"abstract":"<p><strong>Background: </strong>Retained gallstones are the most common cause of postcholecystectomy pain. They may be in a long remnant cystic duct (CD), the common bile duct (CBD), or within a remnant gallbladder (GB) post subtotal cholecystectomy. Although endoscopic management is often attempted, occasionally surgical clearance is required. Rates of preoperative surgery to remove stones in a remnant GB are rising due to the increased practice of subtotal cholecystectomy during a problematic laparoscopic cholecystectomy. This study aims to review the surgical management of symptomatic retained stones at a tertiary hepatobiliary referral center in Sydney, Australia.</p><p><strong>Patients and methods: </strong>This retrospective analysis of prospectively collected data was performed on patients who underwent an operation for retained stones after a previous cholecystectomy over 18 years (2004-2022). All of the patients with residual CBD stones had failed endoscopic retrograde cholangiopancreatogram (ERCP) attempts or could not have an ERCP because of prior foregut surgery. All patients underwent a systematic preoperative workup confirming the biliary anatomy and pathology.</p><p><strong>Results: </strong>Fourteen patients had surgical intervention for retained stones. All cases were attempted laparoscopically and were successful in 11/14 patients (78%). Retained stones were found within a remnant GB (29%, n=4), a remnant CD (36%, n=5), or the CBD (36%, n=5). Conversion to an open procedure in 3 patients was for dense fibrosis associated with a long low-insertion of the CD, necessitating a hepatico-jejunostomy, failure to delineate the biliary anatomy, and inability to clear CBD stones, respectively. One patient developed a minor postoperative complication (superficial wound infection), and all patients were free of symptoms at a median follow-up of 33.5 months.</p><p><strong>Conclusion: </strong>This study demonstrates favorable outcomes in patients undergoing laparoscopic intervention for retained gallstones. A systematic approach to the workup and surgical management of patients with retained stones is essential.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"625-629"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shorter Drainage Tube to the Pancreatic Stump Reduces Pancreatic Fistula After Distal Pancreatectomy.","authors":"Tomoyuki Nagaoka, Katsunori Sakamoto, Kohei Ogawa, Takahiro Hikida, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Mikiya Shine, Yusuke Nishi, Mio Uraoka, Masahiko Honjo, Kei Tamura, Yasutsugu Takada","doi":"10.1097/SLE.0000000000001318","DOIUrl":"10.1097/SLE.0000000000001318","url":null,"abstract":"<p><strong>Background: </strong>We investigated the relationship between the length of a prophylactic closed-suction drainage tube and clinically relevant postoperative pancreatic fistula (CR-POPF) in distal pancreatectomy (DP).</p><p><strong>Materials and methods: </strong>The clinical data of 76 patients who underwent DP using a reinforced stapler for the division of the pancreas at Ehime University Hospital between December 2017 and May 2023 were retrospectively analyzed. Laparoscopic DP was performed in 41 patients (53.9%). Closed-suction drainage was performed using a 19 Fr ExuFlow Round Drain with a vacuum bulb. The drainage tube length was defined as the distance between the peripancreatic stump site and the abdominal wall insertion site using abdominal radiography.</p><p><strong>Results: </strong>CR-POPF was observed in 12 patients (15.8%). Univariate analyses demonstrated that male sex ( P =0.020), American Society of Anesthesiologists Physical Status ( P =0.017), current smoking ( P =0.005), and drainage tube length ( P <0.001) were significantly associated with CR-POPF. The optimal cut-off value of drainage tube length for CR-POPF was 220 mm (area under the receiver operating characteristic curve=0.80). In multivariate analyses, drainage tube length (≥220 mm) was the sole independent predictor for CR-POPF (odds ratio, 6.59; P =0.023). According to computed tomography performed ∼1 week after surgery, the median volume of peripancreatic fluid collection was significantly higher in the long drainage tube group than in the short drainage tube group ( P <0.001).</p><p><strong>Conclusion: </strong>A drainage tube inserted at a shorter distance to the pancreatic stump may reduce the incidence of CR-POPF after DP.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"571-577"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Colonoscopy in Reducing Incidence of Late-stage Colorectal Cancer Within an Opportunistic Screening Program.","authors":"Maria A Casas, Lisandro Pereyra, Cristian A Angeramo, Manuela Monrabal Lezama, Francisco Schlottmann, Nicolás A Rotholtz","doi":"10.1097/SLE.0000000000001326","DOIUrl":"10.1097/SLE.0000000000001326","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of colonoscopy in preventing colorectal cancer (CRC) within opportunistic screening programs has not been clearly established. The aim of this study was to analyze the effectiveness of colonoscopy within an opportunistic screening program using nested case-control study.</p><p><strong>Methods: </strong>Subjects who received a diagnosis of CRC (CG) between the ages of 50 and 90 years were included and matched by age and gender in a 1:5 ratio with patients without CRC diagnosis (COG) during the period 2015 to 2023. Using conditional regression analyses, we tested the association between screening colonoscopy and CRC. Subgroup analyses were then performed for CRC location, endoscopist specialty, and colonoscopy quality.</p><p><strong>Results: </strong>Of the 134 patients in CG, 19 (14.18%) had a colonoscopy in the preceding 5 years compared with 258 out of 670 (38.51%) in COG (AOR, 0.24; 95% CI: 0.14-0.41). Any colonoscopy was strongly associated with decreased odds for left-sided CRC (AOR, 0.09; 95% CI: 0.04-0.24) but not for right-sided CRC (AOR, 0.58; 95% CI: 0.29-1.17). Only complete colonoscopy (AOR, 0.41; 95% CI: 0.19-0.89) and colonoscopy with satisfactory bowel preparation (AOR, 0.38; 95% CI: 0.15-0.98) were associated with decreased odds for right-sided CRC. No significant differences in colonoscopy outcomes were found when stratifying by endoscopist specialty.</p><p><strong>Conclusions: </strong>In the setting of an opportunistic screening program, exposure to any colonoscopy significantly reduced left-sided CRC incidence; however, only high-quality colonoscopy was associated with a lower incidence of right-sided CRC. Therefore, every possible effort should be made to optimize the quality and cost-effectiveness of colonoscopy within an opportunistic screening program.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"590-595"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection on Colonic Polyp Resection and Factors Influencing Recurrence.","authors":"Binnan Li, Wanqiong Zheng","doi":"10.1097/SLE.0000000000001329","DOIUrl":"10.1097/SLE.0000000000001329","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the effectiveness of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the endoscopic resection of colonic polyps and investigate the factors influencing polyp recurrence.</p><p><strong>Methods: </strong>A total of 174 patients with colorectal polyps admitted to the Gastroenterology Department during the same period were included in this prospective randomized controlled study. The patients were randomly allocated to the EMR group and ESD group (72 cases in each group) using a random number table. The clinical efficacy, quality of life, adverse reactions, and 1-year postoperative recurrence rate were compared between the 2 groups. In addition, factors influencing polyp recurrence were analyzed.</p><p><strong>Results: </strong>No significant differences were observed between the EMR and ESD groups in terms of clinical efficacy, postoperative quality of life, and postoperative complications. However, the postoperative recurrence rate in the ESD group was significantly lower than that in the EMR group. Multifactorial logistic regression analysis revealed that the number of polyps ≥3, maximum polyp diameter ≥2 cm, and family history of colorectal cancer were independent risk factors for colonic polyp recurrence.</p><p><strong>Conclusion: </strong>ESD and EMR demonstrate similar efficacy and safety in patients with colonic polyps. However, the recurrence rate after ESD is significantly lower than after EMR. Furthermore, multifactorial analysis indicates that a larger polyp diameter, a more significant number of polyps, and a family history of colorectal cancer are independent risk factors for the recurrence of colonic polyps following resection.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":"34 6","pages":"607-613"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventral Hernia Repair With a Hybrid Absorbable-permanent Preperitoneal Mesh.","authors":"Matthew I Goldblatt, Matthew Reynolds, Carl R Doerhoff, Karl LeBlanc, Mario Leyba, Eric J Mallico, John G Linn","doi":"10.1097/SLE.0000000000001327","DOIUrl":"10.1097/SLE.0000000000001327","url":null,"abstract":"<p><strong>Objective: </strong>To analyze device safety and clinical outcomes of ventral hernia repair with the GORE SYNECOR Preperitoneal Biomaterial (PRE device), a permanent high-strength mesh with bioabsorbable web scaffold technology.</p><p><strong>Materials and methods: </strong>This multicenter retrospective review analyzed device/procedure endpoints and patient-reported outcomes in patients treated for hernia repair ≥1 year from study enrollment.</p><p><strong>Results: </strong>Included in this analysis were 148 patients with a mean age of 56 years; 66.2% met the Ventral Hernia Working Group grade 2 classification. Median hernia size was 30.0 cm 2 and 58.8% of patients had an incisional hernia. Repairs were primarily a robotic (53.4%) or open approach (41.9%). All meshes were placed extraperitoneal. Procedure-related adverse events within 30 days occurred in 13 (8.8%) patients and included 7 (4.8%) patients with surgical site infection, 2 (1.4%) with surgical site occurrence (SSO), 4 (2.7%) requiring readmission, and 3 (2.0%) who had reoperation. The rate of SSO events requiring procedural intervention was 2.7% (4 patients) through 30 days and 3.4% (5 patients) at 12 months. The rate of procedure-related surgical site infection remained at 4.8% through 12 months (no further reports after 30 d) and 3.4% for SSO (2 reports after 30 d). There were no site-reported clinically diagnosed hernia recurrences throughout the study. Median patient follow-up including in-person visit, physical examination, reported adverse event, explant, death, and questionnaire response was 28 months (n = 148). Median patient follow-up with patient questionnaire was 36 months (n = 88).</p><p><strong>Conclusions: </strong>Use of the PRE device, which incorporates the proven advantages of both an absorbable synthetic mesh and the long-term durability of a permanent macroporous mesh, is safe and effective in complex ventral hernia repairs. When used in the retromuscular space, the combination of these 2 materials had lower wound complications and recurrence rates than either type of material alone.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"596-602"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Reduction of Severe Anastomotic Leakage by Evaluation of Blood Perfusion Using Indocyanine Green After Minimally Invasive Esophagectomy Followed by Narrow Gastric Tube Reconstruction.","authors":"Junya Kitadani, Keiji Hayata, Taro Goda, Shinta Tominaga, Naoki Fukuda, Tomoki Nakai, Shotaro Nagano, Toshiyasu Ojima, Manabu Kawai","doi":"10.1097/SLE.0000000000001331","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001331","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) is a major complication after esophagectomy and gastric tube reconstruction. This retrospective study aims to reveal the factors in prevention of AL and in reduction of its severity.</p><p><strong>Methods: </strong>Enrolled in this study were the 183 patients diagnosed with esophageal cancer who underwent minimally invasive esophagectomy followed by narrow gastric tube reconstruction at Wakayama Medical University Hospital between January 2018 and March 2023. Evaluation of blood perfusion using indocyanine green began in September 2020.</p><p><strong>Results: </strong>AL occurred in 42 patients (22%) and did not occur in 141 patients (78%). Patient characteristics were not significantly different between patients with and without AL. Evaluation of blood perfusion of the gastric tube was performed in 69 of the 183 patients (37.7%), and after its introduction the rates of AL decreased from 28.0% to 14.4%. Blood perfusion was less evaluated in the AL group than in the non-AL group (23.8% vs. 41.8%, P=0.034). Multivariate analysis demonstrated that non-evaluation of blood perfusion using indocyanine green (odds=3.115) was an independent risk factor for AL. For the patients with AL, active interventions (eg, tube insertion into the gastric tube through the nose or fistula, embolization of cyanoacrylate) were performed significantly more often in the group without evaluation of blood perfusion than in the group with evaluation. Without evaluation of blood perfusion, there was significantly longer time from onset to resumption of diet and significantly longer postoperative hospital stays.</p><p><strong>Conclusions: </strong>Evaluation of qualitative blood perfusion can lead to both risk reduction and prevention of severe AL after narrow gastric tube reconstruction for esophageal cancer.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":"34 6","pages":"619-624"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}