Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"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":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Low Prognostic Nutritional Index Level, an Independent Predictor for Postoperative Intra-abdominal Abscess After Laparoscopic Appendectomy.","authors":"Yijian Yuan, Yanhua Tang, Yubin Liu, Pengcheng Ren","doi":"10.1097/SLE.0000000000001328","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001328","url":null,"abstract":"<p><strong>Background: </strong>Intra-abdominal abscess (IAA) is a very common postoperative complication after laparoscopic appendectomy and is associated with poor prognosis.</p><p><strong>Materials and methods: </strong>This study retrospectively analyzed elderly patients who underwent laparoscopic appendectomy from 2015 to 2024, examining demographic, clinical, and laboratory data to identify IAA risk factors. Independent risk factors for IAA were screened and finally identified by multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 37 patients developed IAA within postoperative 30 days, with an incidence of 9.6% (37/385). Receiver operating characteristic (ROC) curve analysis indicated white blood cell (cut-off value: 13.35, sensitivity: 54.60%, specificity: 70.27%, P=0.003) and Prognostic Nutritional Index (PNI) (cut-off value: 41.95, sensitivity: 72.41%, specificity: 59.46%, P<0.0001) were 2 predictors for IAA with an area under the curve of 0.649 and 0.727, respectively. Based on the multivariate analysis, perforated appendicitis (odds ratio: 2.48, 95% CI: 1.15-5.32, P=0.021) and a lower PNI score (odds ratio: 3.44, 95% CI: 1.49-7.58, P=0.002) were 2 independent risk factors for IAA in elderly patients after laparoscopic appendectomy.</p><p><strong>Conclusions: </strong>Elderly patients with perforated appendicitis and a PNI score <41.95 have higher risks for IAA after laparoscopic appendectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366599","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":"Laparoscopic Pancreaticoduodenectomy With Open Reconstruction: The Buddha's Middle Path.","authors":"Ameet Kumar, Sumesh Kaistha, Rajesh Gangavatiker","doi":"10.1097/SLE.0000000000001311","DOIUrl":"10.1097/SLE.0000000000001311","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic pancreaticoduodenectomy (LPD) is not universally adopted because of its steep learning curve. Its technical complexity discourages many surgeons. We believe that laparoscopic pancreaticoduodenectomy with open reconstruction (LPOR) has all the benefits of LPD without its drawbacks and combines the ease of open surgery with the benefits of minimal access surgery. We assessed the feasibility and safety of LPOR and compared it with open pancreaticoduodenectomy (OPD), with the objectives being perioperative and short-term clinical/oncologic outcomes.</p><p><strong>Methods: </strong>Retrospective review of prospectively maintained database; study period from January 2013 to December 2019. Till 2015, we did only OPD. In 2016, we started with LPD but soon switched to LPOR. The resection part was done laparoscopically and the reconstruction part was done through a 8-cm mini-laparotomy.</p><p><strong>Results: </strong>We did 19 OPDs and 15 LPORs. Demographic data of the 2 groups were comparable. The duration of surgery was significantly longer in the LPOR group (360 vs. 410 min; P =0.01), whereas the blood loss and hospital stay were longer in the OPD group (520 vs. 360 mL; P =0.03 and 13 vs. 11 d; P =0.08, respectively). Clinically significant complication rates, including delayed gastric emptying and postoperative pancreatic fistulas, were not different in either group. No patients in the LPOR group had wound-related/pulmonary complications. Lymph node yield was similar in both groups (20 vs. 22) and we had 100% R0 resections.</p><p><strong>Conclusions: </strong>LPOR was better than OPD in terms of short-term outcomes and was not inferior to OPD in terms of complications/oncologic outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"511-517"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627736","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":"Long-Term Outcomes of the Treatment for Gastric Tube Cancer After Esophagectomy for Esophageal Cancer.","authors":"Junya Kitadani, Keiji Hayata, Taro Goda, Akihiro Takeuchi, Shinta Tominaga, Naoki Fukuda, Tomoki Nakai, Shotaro Nagano, Toshiyasu Ojima, Manabu Kawai","doi":"10.1097/SLE.0000000000001310","DOIUrl":"10.1097/SLE.0000000000001310","url":null,"abstract":"<p><strong>Background: </strong>The long-term outcomes of gastric tube cancer (GTC) are unclear. This study therefore aimed to clarify clinicopathologic features and the long-term outcomes of patients with GTC.</p><p><strong>Methods: </strong>The 25 patients who were diagnosed with GTC between April 2003 and December 2022 at our hospital were eligible for inclusion in this retrospective study, and this included 27 lesions. We retrospectively evaluated clinicopathologic factors based on hospital records.</p><p><strong>Results: </strong>In our cohort, 88% of incidences of GTC were located in the middle or lower gastric tube. As the treatment of GTC, we used endoscopic submucosal dissection, gastrectomy, chemoradiotherapy, chemotherapy, and best supportive care for 16 (59%), 6 (22%), 1 (4%), 1 (4%), and 3 (11%) lesions, respectively. Perforation after endoscopic submucosal dissection was observed in 6 of the 16 lesions. Partial gastric tube resection was performed for 3 patients and total gastric tube resection was performed for 3 patients. One patient who underwent total gastric tube resection died due to acute respiratory distress syndrome. In survival analysis, the 3-year overall survival rate was 52% and the 3-year disease-specific survival rate was 74%. Five patients (20%) died of aspiration pneumonia, 2 patients (8%) of another disease, and 1 patient (4%) of another type of cancer. According to multivariate analysis, independent prognostic factors for overall survival were cN status (HR, 18.021; P =0.004) and complication of aspiration pneumonia (HR, 8.373; P =0.004).</p><p><strong>Conclusions: </strong>The occurrence of aspiration pneumonia and cN status were prognostic factors after the treatment for GTC. Assessment of dysphagia and surveillance after treatment for GTC are important to improve the prognosis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"504-510"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555494","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 Study on the Effectiveness, Safety, and Economic Costs of Endoscopic Submucosal Dissection for Colorectal Tumors Under Conscious Sedation and General Anesthesia.","authors":"Yanrong Li, Jing Wang, Ye Hong, Qi Wu","doi":"10.1097/SLE.0000000000001308","DOIUrl":"10.1097/SLE.0000000000001308","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) is a minimally invasive surgical procedure used for en bloc removal of colorectal tumors. Although colorectal ESD is ideally conducted under conscious sedation, it is often performed under general anesthesia because of its complexity and lengthy duration. Currently, there is limited research on colorectal ESD performed under conscious sedation. The purpose of this study was to evaluate the effectiveness, safety, and economic cost of colorectal ESD under conscious sedation compared to general anesthesia.</p><p><strong>Materials and methods: </strong>Retrospective analysis of 301 patients who underwent ESD treatment for colorectal tumors at the Endoscopy Center of Peking University Cancer Hospital from January 2018 to November 2020. Patients were divided into the sedation group (group S, n=88) and the general anesthesia group (group A, n=213) based on the anesthetic method. To balance the confounding factors between the 2 groups, 75 matched pairs were obtained after using propensity score matching (PSM). Intraoperative and postoperative parameters were then compared between the matched groups.</p><p><strong>Results: </strong>After PSM, there was no statistically significant difference between group S and group A in terms of the surgical time, en bloc resection rate, and complete resection rate. There was also no statistically significant difference in the occurrence rates of bleeding, perforation, and post-ESD electrocoagulation syndrome (PEECS) between the 2 groups. However, the length of hospital stay was significantly shorter in group S (1.23±0.89d) than in group A (5.92±3.05d) ( P <0.05). The hospitalization costs were also significantly lower in group S (16482.34±13154.32 yuan) compared with group A (34743.74±13779.40 yuan) (P < 0.05 ).</p><p><strong>Conclusions: </strong>Compared to general anesthesia, performing ESD for colorectal tumors under conscious sedation has equivalent effectiveness and safety while shortening the hospital stay and reducing the economic costs.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"491-496"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789086","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","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":"Outcomes of Daytime and Night-Time Appendectomies: A Systematic Review and Meta-Analysis.","authors":"Lifang Shen, Liangfeng Zhang, Huili Shi","doi":"10.1097/SLE.0000000000001317","DOIUrl":"10.1097/SLE.0000000000001317","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a common surgical emergency characterized by appendix inflammation. Surgery remains the gold standard for treatment with laparoscopy gaining in popularity. However, the optimal timing for appendectomy remains unclear. We are not aware of studies evaluating potential differences in clinical outcomes among appendectomies performed during the daytime and at night.</p><p><strong>Methods: </strong>We followed the PRISMA guidelines and searched the ScienceDirect, Medline, and Google Scholar databases for studies published in English before June 2023. We included prospective and retrospective studies reporting appendectomy outcomes. We categorized the appendectomy procedure times as daytime or night-time based on each study's definitions. We extracted baseline characteristics and outcomes and assessed the quality of the studies included using the Newcastle-Ottawa Scale. We calculated pooled risk ratios (RRs) and weighted mean differences (WMDs) using random-effects models; and, we assessed heterogeneity using the I2 statistic.</p><p><strong>Results: </strong>We analyzed data from 12 studies for systematic review ( n =19,183) including daytime ( n =11,839) and night-time ( n =7344) appendectomies. For the meta-analysis, we included 9 studies, that evaluated outcomes such as mortality (pooled RR, 0.44; 95% CI, 0.09-2.01; I2 =43.7%; P =0.11), hospital stay (WMD, -0.02; 95% CI, -0.24 to 0.20; I2 =93.3%; P <0.001), and complications (pooled RR, 0.96; 95% CI, 0.64-1.45; I2 =65.1%; P =0.02). We found similar mortality rates, hospital stay lengths, and complications for the appendectomies, regardless of the time of day of the operation. The baseline characteristics of the patients were also similar, except for the duration of symptoms and the presence of an appendiceal abscess.</p><p><strong>Conclusion: </strong>Our results showed that the timing of an appendectomy (daytime vs. night-time) does not significantly affect its outcomes. Surgeon availability or fatigue, and patient severity may not significantly impact the operation results. Standardized protocols and perioperative care ensure consistent outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"541-549"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056587","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":"Results of Laser-assisted Closure (SiLaC) Surgery in Pilonidal Sinus Disease: Factors Associated With Success.","authors":"Murat Yildirim, Bulent Koca","doi":"10.1097/SLE.0000000000001316","DOIUrl":"10.1097/SLE.0000000000001316","url":null,"abstract":"<p><strong>Background: </strong>Pilonidal sinus treatment with sinus laser-assisted closure (SiLaC) method has produced promising results in a limited number of studies conducted in recent years. We aimed to examine the efficacy and safety of this method in a tertiary care training hospital to reveal the factors affecting failure and to share our first experiences.</p><p><strong>Methods: </strong>All adult patients treated with this procedure between March 2020 and December 2023 were included in the study. Demographic and clinical data, complications, and recurrence rates of the patients were compared. Univariate analysis was performed between recovered and non-recovered patients to find the factors influencing successful treatment. Logistic regression analysis was performed using significant factors in the single variable analysis.</p><p><strong>Results: </strong>The study cohort consisted of 64 patients. The mean follow-up period was 17.0±8.06 months (range: 3 to 36), and the mean time for return to work was 2.4±2.78 days (range: 0 to 14). Our recovery rate was 85.9%. The complication rate was 14%, and the majority (50%) were wound infections. High BMI and advanced disease were significant factors for recurrence in the comparison of patients with successful and unsuccessful treatment ( P <0.01 and 0.013, respectively). The same situation persisted in multivariate analysis ( P =0.026, 95% CI: 1.36-7.81, and P =0.004, 95% CI: 1.36-1.78, respectively). In the ROC Curve analysis for BMI, the cutoff point was 29 (sensitivity: 66.9%, specificity: 77.4%, AUC 0.809). Other parameters were not significant ( P >0.05).</p><p><strong>Conclusions: </strong>The SiLaC procedure may be the treatment of choice for pilonidal sinus disease as a safe and effective method with mild complications and reasonable recurrence rates. The success rate decreased in obese patients and patients with advanced disease.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"524-528"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976662","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 Footbath on Pain, Anxiety, Sleep, and Comfort Levels in Patients With Postlaparoscopic Cholecystectomy: A Randomized Controlled Study.","authors":"Dilek Gürçayir, Neziha Karabulut","doi":"10.1097/SLE.0000000000001306","DOIUrl":"10.1097/SLE.0000000000001306","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study is to determine the effect of of hot footbaths on the pain, anxiety, sleep, and comfort levels of patients who underwent laparoscopic cholecystectomy.</p><p><strong>Design: </strong>The study is a randomized controlled designed.</p><p><strong>Methods: </strong>This study was conducted in surgery clinic of a university hospital between January 2022 and November 2022. The research was completed with 54 patients in the experimental group and 54 patients in the control group.</p><p><strong>Findings: </strong>The mean state anxiety score and VAS-Sleep score of the patients in the experimental group 120 minutes after the application was 31.07±4.70 and 612.62±82.37, respectively, which was statistically significantly lower than that of the patients in the control group ( P <0.05). On the other hand, at the 120th minutes after the application, the mean VAS-Comfort scores of the patients in the experimental group were statistically significantly higher than those of the patients in the control group ( P <0.05). A positive relationship was found between the mean VAS-Pain and VAS-Sleep scores of the patients in the experimental group, and a significant negative relationship was found between the mean VAS-Comfort and state anxiety scores.</p><p><strong>Conclusions: </strong>Foot bath is effective in reducing the pain and anxiety levels of patients undergoing laparoscopic cholecystectomy surgery.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"452-458"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499075","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":"Superiority of Robotic Over Laparoscopic Spleen-Preserving Distal Pancreatectomy With Warshaw Procedure for Reducing the Incidence of Postoperative Splenic Infarction.","authors":"Yasuhiro Murata, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Yusuke Iizawa, Takehiro Fujii, Akihiro Tanemura, Naohisa Kuriyama, Masashi Kishiwada, Shugo Mizuno","doi":"10.1097/SLE.0000000000001289","DOIUrl":"10.1097/SLE.0000000000001289","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive spleen-preserving distal pancreatectomy with Warshaw procedure (MI-WP), has gained widespread recognition for the treatment of benign and low-grade malignant tumors of the pancreatic body and tail. However, the comparative advantages of the robotic Warshaw procedure (R-WP) over the laparoscopic Warshaw procedure (L-WP) remain uncertain. This study aimed to compare the surgical outcomes between R-WP and L-WP.</p><p><strong>Materials and methods: </strong>Among the 146 cases of MI-DP conducted between October 2020 and December 2023 (L-DP:115, R-DP:31), 33 cases of MI-WP were subjected to analysis, comprising the R-WP group (n=10) and the L-WP group (n=23).</p><p><strong>Results: </strong>R-WP successfully completed all procedures under a purely laparoscopic approach, whereas L-WP necessitated conversion to open surgery in 2 cases (8.7%). Despite the significantly prolonged operative time in R-WP compared with L-WP (R-WP vs. L-WP: 421vs. 300 min), there was no significant difference in estimated blood loss between the 2 groups (R-WP vs. L-WP: 19 vs. 20 mL). Although the rate of major complications did not significantly differ between the 2 groups, 2 cases (8.7%) of L-WP required reoperation, including splenectomy in 1 instance. Furthermore, the incidence of postoperative splenic infarction was significantly higher in L-WP than in R-WP (R- vs. L-WP:0 vs. 43.5%, P =0.015). The length of hospital stay after surgery did not exhibit a significant difference between the 2 groups (R-WP vs. L-WP: 11 vs. 12 d).</p><p><strong>Discussion: </strong>R-WP demonstrated superiority to L-WP for reducing the incidence of postoperative splenic infarction, potentially contributing to enhancing the spleen preservation rate.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"472-478"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580835","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}