Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Minimally Invasive Colon Surgery for Colon Cancer: Long-Term Oncologic Results from a 10-Year Follow-Up Study.","authors":"Niyaz Shadmanov, Vusal Aliyev, Baris Bakir, Suha Goksel, Oktar Asoglu","doi":"10.1097/SLE.0000000000001378","DOIUrl":"10.1097/SLE.0000000000001378","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the outcomes of minimally invasive surgery (MIS) for colon cancer and analyze the impact of tumor localization on survival.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 842 consecutive patients who underwent curative MIS (laparoscopic and robotic) for stage I to III colon adenocarcinoma between 2001 and 2024. The surgical technique adhered to oncological principles, ensuring adequate resection margins and proper lymph node dissection. Patient characteristics, operative data, perioperative outcomes, histopathologic findings, and oncological outcomes were analyzed.</p><p><strong>Results: </strong>The study included 842 patients (59.4% male, 40.6% female) with a median age of 60.3 years. Tumor localization was right colon in 29.5%, transverse colon in 6.5%, and left colon in 64% of cases. In our study, 814 cases (96.7%) were performed using laparoscopic surgery, while 28 cases (3.3%) were performed using robotic surgery. The mean operative time was 135 minutes, with a mean hospital stay of 6 days. Conversion to open surgery occurred in 3% of cases. The mean number of lymph nodes removed was 35 (range: 8 to 72). Pathologic examination revealed that 65% of cases were node-positive stage III. During a mean follow-up of 10 years, local recurrence (LR) was observed in 2.8% of patients, with no significant difference based on tumor localization. Distant metastases (DM) occurred in 12.7% of patients. The 10-year disease-free survival (DFS) rate for all patients was 75%, and the overall survival (OS) rate was 78.7%. The 10-year DFS rates for right colon, transverse colon, and left colon cancers were 74%, 71%, and 76%, respectively. Similarly, the OS rates for the same groups were 78.9%, 75%, and 79%, respectively. Statistical analysis revealed no significant differences in DFS ( P =0.851) or OS ( P =0.789) among the 3 tumor localization groups.</p><p><strong>Conclusion: </strong>Our study demonstrated that MIS is a promising approach for achieving favorable long-term oncological outcomes in colon cancer patients. Consequently, MIS is established as the standard approach in colon cancer surgery. Although right colon tumors are often associated with poorer disease-free and overall survival rates, this study found no significant differences in DFS or OS among left, transverse, and right colon tumors.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267243","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":"Reintervention After Endoscopic Ultrasound-Guided Choledochoduodenostomy for Distal Malignant Biliary Obstruction.","authors":"Suprabhat Giri, Bhavik Shah, Jimmy Narayan, Radhika Chavan, Viswanath R Donapati, Shivam Khare, Jijo Varghese, Bipadabhanjan Mallick, Aditya Kale, Sridhar Sundaram","doi":"10.1097/SLE.0000000000001382","DOIUrl":"10.1097/SLE.0000000000001382","url":null,"abstract":"<p><strong>Introduction: </strong>Studies analyzing the factors associated with reintervention after endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) are limited. We aimed to analyze the incidence and predictors of reintervention in patients with malignant biliary obstruction undergoing EUS-CDS.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients with malignant distal biliary obstruction undergoing EUS-CDS from 8 tertiary care centers in India. The study's primary outcome was reintervention due to stent migration or blockage. The secondary outcomes included clinical success and adverse events. Multivariate analysis using the logistic regression model was used to identify the independent predictors of reintervention.</p><p><strong>Results: </strong>A total of 134 patients were included in the study. The technical and clinical success rates were 97.8% (131/134) and 93.9% (123/131), respectively. Periprocedural adverse events (AE) were seen in 6% (8/134) cases. Over a median follow-up of 20 weeks, reintervention was required in 8.4% of the cases after a median interval of 11 weeks. On multivariate analysis, cholangitis at presentation (odds ratio [OR] 6.26) and the absence of coaxial stent with concomitant duodenal stent (OR: 7.41) were independent predictors of reintervention in the overall cohort. On subgroup analysis of patients undergoing EUS-CDS with self-expanding metallic stent (SEMS), the absence of a coaxial stent with concomitant duodenal stent (OR: 10.15) was an independent predictor of reintervention.</p><p><strong>Conclusion: </strong>Reintervention on follow-up after EUS-CDS is required in around 8.4% of cases. The absence of coaxial stent with concomitant duodenal stent was an independent predictor of reintervention in the overall cohort as well as in those undergoing EUS-CDS with SEMS.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267254","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":"A National, Multicenter, Survey-based Analysis of Clinical Practice and Utilization of Bougie in Metabolic and Bariatric Surgery.","authors":"Jinshan Zhang, Youna Lin, Zhiyong Dong, Cunchuan Wang, Weixin Huang, Zhong Cheng, Zefeng Xia, Yingxu Li, Zhuoqi Wei, Wah Yang","doi":"10.1097/SLE.0000000000001385","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>Bougie is critical for achieving the optimal sleeve size or pouch creation in metabolic and bariatric surgery (MBS). This study investigates the clinical application and challenges of specialized bougie in MBS within China, aims to identify targeted solutions, and seeks to guide clinical practice.</p><p><strong>Methods: </strong>A survey questionnaire, developed in collaboration with MBS experts through a webinar, was distributed online to MBS centers across China from March 9 to 15, 2023. Statistical analysis was used to evaluate the survey responses.</p><p><strong>Results: </strong>The survey collected 183 valid responses from 28 provinces, including autonomous regions and municipalities. Of these, 86.34% of centers reported using specialized bougie for MBS, with 79.23% using it frequently. Among those frequently using bougie, 40.51% reused bougie postdisinfection due to the high costs of new bougies. The most common bougie sizes used were 36Fr for laparoscopic sleeve gastrectomy and laparoscopic gastric bypass, with other sizes ranging from 30Fr to 38Fr. However, 41.53% of centers reported complications related to bougie use, with tension rupture and esophageal injury being the most frequent.</p><p><strong>Conclusions: </strong>This nationwide survey offers insights into the clinical application and challenges of specialized bougie in Chinese MBS centers. There is a need for enhanced education, standardization, and training to mitigate complications and improve patient outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249700","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":"Patient-controlled Analgesia Using Ropivacaine (0.25%) Through Transversus Abdominis Plane vs. Epidural Route for Postoperative Pain Relief Following Midline Laparotomy: A Single Center Open-label Randomized Control Trial (Wireless Trial).","authors":"Pankaj Kumar, Kallol Kumar Das Poddar, Upendra Hansda, Swagata Tripathy, Bhaskar Rao, Tushar Subhadarshan Mishra, Dillip Muduly, Prakash Kumar Sasmal","doi":"10.1097/SLE.0000000000001384","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001384","url":null,"abstract":"<p><strong>Introduction: </strong>The WIRELESS trial compared the postoperative analgesic effect of the bilateral transversus abdominis plane patient-controlled analgesia (TAP-PCA) with that of epidural patient-controlled analgesia (E-PCA) using ropivacaine 0.25%.</p><p><strong>Methodology: </strong>A hundred patients aged between 18 and 85 years and planned for upper midline laparotomy (Class I and II wounds) under general anesthesia were randomized into TAP-PCA (50) and E-PCA (50) groups. The PCA pump used for the study was designed to deliver a baseline infusion rate of 5 mL/hour (0.25%). The patients were instructed to press the PCA button, as and when required to deliver an additional dose of 2 mL, with 15-minutes lockout period. Both groups received 1 g of paracetamol infusion every 8 hours. The pain score was evaluated at 3, 6, 12, and 24 hours and then every 12 hours till 72 hours postoperatively. The requirements of rescue analgesia (injection tramadol), out-of-bed mobilization, and recovery of bowel function were recorded. Drug-related side effects and catheter-related complications were also noted.</p><p><strong>Results: </strong>Five (10%) patients in the TAP arm and 17 (34%) patients in the epidural arm could not complete the study due to complications/failure. The intention-to-treat analysis indicates that VAS scores were similar in both groups (47 in the epidural PCA group and 48 in the TAP-PCA group) at 3, 12, 24, 36, 48, 60, and 72 hours. Rescue analgesia (tramadol) was similar in both groups (0.21, 0.58 vs. 0.13, 0.44). There were no significant differences observed between the 2 groups in terms of out-of-bed mobilization and pulmonary complications. Nonetheless, the TAP arm showed the earlier passage of the first flatus and a shorter hospital stay compared with the epidural arm.</p><p><strong>Conclusion: </strong>PCA through the TAP route is not inferior to the epidural route for managing postoperative pain. Because of fewer contraindications and complications, TAP-PCA can be considered an alternative to epidural PCA.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249701","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":"Transcystic Duct Gallbladder-preserving Cholecystolithotomy by ERCP: Efficacy in Managing Cholecystolithiasis With or Without Common Bile Duct Stones.","authors":"Jing-Feng Du, Gong-Li Yang, Zhong-Ming Dai, Xun-Chao Cai, Hai-Yan Zhong, Lu Liu, Yun Qian, Long Xu","doi":"10.1097/SLE.0000000000001379","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001379","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the efficacy of transcystic duct gallbladder-preserving cholecystolithotomy by endoscopic retrograde cholangiopancreatography (TDGPCE) in patients diagnosed with cholecystolithiasis, both in the presence and absence of common bile duct stones (CBDS).</p><p><strong>Methods: </strong>A total of 54 patients with cholecystolithiasis, including those with and without CBDS, who underwent TDGPCE between March 2021 and May 2024 at the Endoscopy Center of Shenzhen University General Hospital were enrolled in this study. Clinical data and follow-up results were documented for all patients.</p><p><strong>Results: </strong>Gallbladder stones were successfully removed in 45 patients (83.3%) by TDGPCE. Comparisons of the success rate of stone removal, operative time, and full-covering metal stent (FCMS) placement time revealed no significant differences between patients with cholecystolithiasis, regardless of CBDS presence (P>0.05). Post-ERCP pancreatitis (n=3, 6.7%) and hyperamylasemia (n=21, 46.7%) were resolved with subsequent interventions. Notably, the 3 patients who developed post-ERCP pancreatitis did not receive pancreatic duct stent insertion due to the presence of an accessory pancreatic duct. Concomitant CBDS did not correlate with an increased risk of post-ERCP pancreatitis or hyperamylasemia in patients undergoing TDGPCE (P>0.05). During the follow-up period, among the patients (n=45) who underwent this procedure, one reported residual gallbladder stones, and 2 experienced recurrence of gallbladder stones.</p><p><strong>Conclusion: </strong>TDGPCE is a safe and effective approach for the removal of gallbladder stones in patients with cholecystolithiasis, offering the advantage of preserving gallbladder function without the need for incisions to the abdominal wall or gastrointestinal tract.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200013","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":"Effects of Different Endoscopic Treatment Methods on Bleeding Complications in Pedunculated Colorectal Polyps.","authors":"Xuan Li, Liang Bu, Xin Ye, Qing Han, Xi Yang, Lei Chen, Mingliang Yuan","doi":"10.1097/SLE.0000000000001362","DOIUrl":"10.1097/SLE.0000000000001362","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic resection of colorectal polyps offers several advantages, including ease of performance, reduced surgical time, and preservation of anatomic structures. However, bleeding remains a common complication of the endoscopic treatment of colorectal polyps, particularly with a higher incidence of postprocedural bleeding in pedunculated colorectal polyps. Currently, there is no optimal method for the resection of pedunculated colorectal polyps. The aim of this study was to compare the postresection bleeding outcomes of 3 different techniques for the removal of pedunculated colorectal polyps.</p><p><strong>Methods: </strong>A retrospective analysis of postresection bleeding following the use of 3 techniques-endoscopic mucosal resection, endoscopic submucosal dissection (ESD), and prophylactic clips was conducted on pedunculated colorectal polyps.</p><p><strong>Results: </strong>The incidence of delayed hemorrhage after endoscopic mucosal resection resection of pedunculated colorectal polyps was highest (18.9%). In contrast, the incidence rates of delayed bleeding in the ESD and prophylactic clip groups were 4.3% and 5.9%, respectively ( P <0.05). The intraoperative bleeding rate was highest in the ESD group (6.5%), while no intraoperative bleeding occurred in the other 2 groups, indicating a statistically significant difference among the 3 groups ( P <0.05). However, the need for endoscopic hemostasis due to delayed bleeding was not significantly different among the groups ( P >0.05).</p><p><strong>Conclusion: </strong>Employing endoscopic submucosal dissection (ESD) and clamping the stalk of pedunculated polyps before removal can effectively reduce the risk of postpolypectomy bleeding. Furthermore, ESD offers distinct advantages for the removal of larger polyps, both at the stalk and the head.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587124","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":"Extraperitoneal Colostomy Versus Transperitoneal Colostomy After Laparoscopic Abdominoperineal Resection for Rectal Cancer: A Systematic Review and Meta-analysis.","authors":"Xin Jin, Yong Li, Bingchen Chen, Boan Zheng","doi":"10.1097/SLE.0000000000001365","DOIUrl":"10.1097/SLE.0000000000001365","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare extraperitoneal colostomy (EPC) with transperitoneal colostomy (TPC) after laparoscopic abdominoperineal resection (APR) for rectal cancer regarding postoperative complications.</p><p><strong>Method: </strong>A literature search was performed on PubMed, Ovid, and Cochrane Databases for studies comparing EPC with TPC after laparoscopic APR for rectal cancer. The last search was performed on June 4, 2024. The primary outcome was the incidence of parastomal hernia. The Review Manager (version 5.3) was used for data analysis.</p><p><strong>Results: </strong>A total of 9 studies with 1002 patients were included in this meta-analysis. Among the enrolled literatures, one was randomized clinical trials, and others were retrospectively case-control designed. EPC showed significant efficiency in preventing parastomal hernia ( P <0.001, OR=0.16, 95% CI: 0.09-0.28, I2 =0%). Besides, the results indicated that the EPC group was associated with significantly less incidence of stoma retraction ( P =0.02, OR=0.23, 95% CI: 0.06-0.81, I2 =0%), stoma prolapse ( P =0.002, OR=0.18, 95% CI: 0.06-0.54, I2 =0%), and total stoma-related complications ( P <0.001, OR=0.50, 95% CI: 0.33-0.74, I2 =26%). In addition, no significant difference was observed between the 2 groups in terms of the total operative time or the time for colostomy creation.</p><p><strong>Conclusion: </strong>Current data demonstrated the significant efficiency of EPC in preventing parastomal hernia after laparoscopic APR for rectal cancer. Besides, the clinical safety and feasibility of EPC were also indicated. The EPC procedure could be widely recommended for permanent colostomy in clinical practice.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781078","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":"Transcystic Laparoscopic Common Bile Duct Exploration: When to Bail.","authors":"Victoria Jenkins, David Bird, Nezor Houli, Tuck Yong, Russell Hodgson","doi":"10.1097/SLE.0000000000001374","DOIUrl":"10.1097/SLE.0000000000001374","url":null,"abstract":"<p><strong>Background: </strong>Transcystic laparoscopic common bile duct exploration (LCBDE) is a procedure considered in the management of common bile duct stones. In many ways it is superior to alternatives such as endoscopic retrograde cholangiopancreatography (ERCP); however, surgeons who have limited experience in CBDE are often reluctant to persist in difficult cases with concerns regarding increasing complication rates and waste of theater time. This study aims to provide an evidence-based approach to identify points to aid early abandonment (\"bail\").</p><p><strong>Methods: </strong>Review of all LCBDE performed in a single center from September 2008 to September 2022 was performed. Statistical analysis was performed on success and failure groups, with relevant undesirable outcomes chosen for further analysis to identify factors to be used as a guide to bail.</p><p><strong>Results: </strong>A total of 952 patients were identified for analysis. Females represented 63.8% (609) of the cohort. Success was reported in 89.2% (849) of procedures. Those in whom the cystic duct could not be cannulated with the choledochoscope, those that progressed to choledochotomy, those with a prolonged operative time, and those who had adverse outcomes were selected as undesired outcomes. Factors of age, higher ASA, preoperative ERCP, and those with preoperatively identified stones or larger stones at operation were associated with higher rates of an undesired outcome.</p><p><strong>Conclusion: </strong>Older and more comorbid patients, those who underwent preoperative ERCP, and those with preoperatively or operatively identified large stones are factors that should prompt those surgeons who are developing their LCBDE experience to consider bailing early.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032435","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":"Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis.","authors":"Zachary Malaussena, Brody Smith, Ila Sethi, Paige DeBlieux, Rahul Mhaskar, Joseph Sujka, Christopher DuCoin, Salvatore Docimo","doi":"10.1097/SLE.0000000000001364","DOIUrl":"10.1097/SLE.0000000000001364","url":null,"abstract":"<p><strong>Background: </strong>Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.</p><p><strong>Results: </strong>Seven comparative non-randomized studies enrolling 669 \"one-stage LCBDE patients\" and 724 \"two-stage ERCP patients\" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.</p><p><strong>Conclusion: </strong>One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754574","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":"Posterior Retroperitoneoscopic Approach to Extra-Adrenal Paragangliomas: A Single Center Experience.","authors":"Nihat Aksakal, Berke Sengun, Yalin Iscan, Ismail C Sormaz, Fatih Tunca, Yasemin Giles Senyurek","doi":"10.1097/SLE.0000000000001367","DOIUrl":"10.1097/SLE.0000000000001367","url":null,"abstract":"<p><strong>Background: </strong>Resections performed using the commonly applied minimally invasive transperitoneal approach for extra-adrenal paragangliomas (ePGLs) require a broader dissection area compared with the posterior retroperitoneoscopic approach (PRA) due to the location of the masses, which can elongate the operative time and increase the risk of injury to the adjacent structures. The aim of this case series was to evaluate the feasibility and safety of the PRA method, which has very few examples reported in the literature, for the treatment of abdominal paragangliomas.</p><p><strong>Methods: </strong>Eight patients who underwent ePGL resection with PRA in a tertiary center between April 2018 and August 2024 were included. Demographic data, localization relative to the renal vein, operative time, tumor size, perioperative and postoperative complications, and length of hospital stay were assessed.</p><p><strong>Results: </strong>Of the patients, 4 were male, and 4 were female. The mean age was 49±10.3 years, and the mean body mass index was 27±2.7 kg/m². Tumors were located on the left side in 6 patients and on the right side in 2 patients. Relative to the renal vein, 6 tumors were located superiorly and 2 inferiorly. One patient who had previously undergone surgery through an open anterior approach underwent PRA due to recurrence. The mean operative time was 108.4±20.5 minutes, with perioperative hypotensive episodes observed in 2 patients. No complications were noted during the postoperative follow-up. The mean length of hospital stay was 3.6±1.4 days. The mean tumor size was 34.9±18.6 mm, and the mean follow-up period was 30.5±25.5 months. Disease-related mortality was observed in 1 patient.</p><p><strong>Conclusion: </strong>PRA is a safe and feasible minimally invasive method for the treatment of ePGLs.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027538","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}