Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Nasogastric Tube Versus Surgical Enterostomy in Obstructed Esophageal Cancer: A Comparison of Time-to-Treatment, Costs, and Nutritional Outcomes.","authors":"Papawee Chennavasin, Thitiporn Chobarporn, Chadin Tharavej, Dudsadee Mesiri","doi":"10.1097/SLE.0000000000001503","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001503","url":null,"abstract":"<p><strong>Background: </strong>Locally advanced esophageal cancer often presents with dysphagia and malnutrition, necessitating enteral feeding during chemoradiotherapy (CRT). This study compares the outcomes of pretreatment nasogastric tube (NGT) versus surgical enterostomy (SE) feeding.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at King Chulalongkorn Memorial Hospital evaluating 98 patients with high-grade obstruction. To minimize selection bias, propensity score matching was utilized. Primary outcomes analyzed included time to treatment, health care costs for intervention, complications associated with enteral access, and nutritional outcomes.</p><p><strong>Results: </strong>This study evaluated 97 patients (NGT: n=78, SE: n=19). To account for baseline differences, propensity score matching was executed using T-stage and pretreatment BMI. NGT patients had a significantly shorter waiting time to start CRT (16.2 vs. 36.7 d, P=0.033, 95% CI: [1.72, 39.20]), a lower cost of enteral access (11,194 THB vs. 28,250 THB, P<0.001, 95% CI: [13,237.06, 20,058.26]), a shorter length of hospital stay (2.3 vs. 5.9 d, P<0.001, 95% CI: [2.06, 5.06]), and a higher rate of resuming oral intake posttreatment (68% vs. 15.8%, P=0.001, 95% CI: [1.55, 13.43]). Nutritional outcomes were comparable between both groups, while both cohorts experienced significant declines in body weight and prognostic nutritional index (PNI) during CRT and then recovered within 3 months of completing treatment. Key limitations of this study include a small sample size and potential selection bias from the retrospective design.</p><p><strong>Conclusion: </strong>NGT feeding may be a favorable option compared to open enterostomy for obstructed esophageal cancer patients in a limited resource setting, enabling faster treatment initiation and lower health care costs without compromising nutritional outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921053","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":"Cranioventral Approach for Bleeding Control and Operative Outcomes in Laparoscopic Hemihepatectomy: A Single-Surgeon Comparative Study.","authors":"Yuta Ushida, Ken Hayashi, Akinari Miyazaki, Goshi Fujimoto, Satomi Miura, Kazuki Sekine, Yuto Kawate, Hiroshi Kusanagi","doi":"10.1097/SLE.0000000000001505","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001505","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the clinical advantages of the cranioventral (CVA) approach compared with the caudodorsal approach (CDA) in laparoscopic hemihepatectomy. Specifically, we assessed whether early cranial access to the middle hepatic vein (MHV) improves perioperative outcomes, such as intraoperative blood loss and operative efficiency, by addressing the challenges of parenchymal transection and preservation of anatomic orientation.</p><p><strong>Methods: </strong>This retrospective analysis included 23 patients who underwent laparoscopic hemihepatectomy performed by a single surgeon between April 2016 and October 2021. Perioperative outcomes, including operative time, blood loss, Pringle time, and complications, were compared between the caudodorsal (CDA) (early; n=13) and cranioventral (CVA) (later; n=10) groups. Independent factors associated with high intraoperative blood loss (>240 mL) were investigated using exploratory multivariable Firth penalized logistic regression analysis.</p><p><strong>Results: </strong>The baseline patient characteristics were generally comparable between the 2 groups. Compared with CDA, CVA resulted in significantly less blood loss (82.5 vs. 315 mL, P=0.001), shorter operative time (370 vs. 436 min, P=0.026), and shorter Pringle time (109 vs. 147 min, P=0.047). No 90-day mortality or severe complications occurred in either group. High intraoperative blood loss (>240 mL) occurred in 11 of the 23 patients (47.8%). In the exploratory multivariable Firth penalized logistic regression analysis, left hepatectomy (OR: 0.066, 95% CI: 0.004-0.525, P=0.008) and CVA (OR: 0.114, 95% CI: 0.008-0.860, P=0.034) were independently associated with lower odds of high intraoperative blood loss.</p><p><strong>Conclusion: </strong>The CVA was associated with reduced intraoperative blood loss and improved operative efficiency during laparoscopic hemihepatectomy. Improved visualization of the MHV from the cranial side may facilitate stable parenchymal transection and better bleeding control. Further validation in larger multicenter studies is warranted.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931053","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":"Safety and Efficacy of Magnetic Compression Anastomosis for Treatment of Complete Benign Biliary Strictures: A Systematic Review and Meta-Analysis.","authors":"Aamir Saeed, Saira Yousuf, Hina Akbar, Sultan Mahmood, Leonard Baidoo, Janak Shah, Mark Radlinski, Claudio R Tombazzi, Mansour A Parsi, Mustafa Arain, Faisal Kamal","doi":"10.1097/SLE.0000000000001502","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001502","url":null,"abstract":"<p><strong>Background and aims: </strong>Completely obstructed benign biliary strictures (BBS) are difficult to treat. Magnetic compression anastomosis (MCA) has recently been used in such cases with reportedly low complication rates. This study aimed to evaluate the safety and efficacy of MCA in the management of complete benign biliary obstruction.</p><p><strong>Methods: </strong>Multiple databases were searched to identify studies evaluating the safety and efficacy of MCA in complete BBS from inception to December 26, 2025. Outcomes of interest included technical success (recanalization), stricture recurrence, procedure-related adverse events, and cholangitis. Pooled estimates with 95% CIs were calculated using a Mantel-Haenszel random-effects model. Heterogeneity was assessed using the I2 statistic.</p><p><strong>Results: </strong>Six studies comprising 182 patients met the inclusion criteria. The pooled technical success rate of MCA was 92.6% (95% CI: 87.5%-95.7%). The pooled stricture recurrence rate was 18.5% (95% CI: 10.7%-30.2%). The pooled rate of procedure-related adverse events was 7.6% (95% CI: 1.9%-25.9%), and the pooled rate of postprocedure cholangitis was 3.8% (95% CI: 1.5%-9.2%).</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that MCA is a safe and effective treatment for complete benign biliary strictures. MCA appears to be a highly effective and minimally invasive therapeutic option for refractory biliary strictures, achieving high technical success rates even in patients who have failed conventional interventions. However, the current evidence base is limited by small, nonrandomized studies. Larger, preferably randomized, studies are needed to define optimal clinical indications, standardize treatment protocols, and clarify MCA's role as a potential standard-of-care therapy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906985","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":"Statistical and Methodological Nuances in Interpreting Diet and Sennoside for Colonoscopy Preparation: A Commentary.","authors":"Ruiying Huang, Li Zhou","doi":"10.1097/SLE.0000000000001501","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001501","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906995","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":"Management of Mirizzi Syndrome Type II.","authors":"Ivan Mamontov, Tamara Tamm, Kostiantyn Kramarenko, Valentyn Nepomniashchyi, Erika Bilousova, Daryna Pryimak","doi":"10.1097/SLE.0000000000001496","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001496","url":null,"abstract":"<p><strong>Background: </strong>Mirizzi syndrome (MS) with cholecystobiliary fistula (type II McSherry classification) is a rare complication of cholelithiasis. Accurate diagnosis is important in the management of MS type II. ERCP provides biliary decompression, and in some cases, endoscopic lithoextraction can be achieved. Surgery is the primary method in the management of MS type II. The aim of this study was to report and assess our experience of MS type II management in terms of different treatment modalities, such as endoscopic lithoextraction, open surgery, and laparoscopy.</p><p><strong>Methods: </strong>A retrospective review of a prospectively maintained database of 30 patients with MS type II between January 2009 and May 2025 was performed. Demographic, clinical, laboratory, visualization, operative, and postoperative data were recorded.</p><p><strong>Results: </strong>ERCP was done in all 30 cases. Complete endoscopic stone removal was achieved in 9 (30%). Endoscopic decompression was not successful in 1 (3.3%) case. Adverse events after ERCP occurred in 4 (13.3%) cases. Nineteen patients were operated on, 8 (42%) by laparoscopy. Partial cholecystectomy with choledochoplasty by remaining gallbladder tissue in 8 cases; cholecystofistulolithotomy in 8; partial cholecystectomy with choledocholithotomy in 2; partial cholecystectomy with fistulolithotomy in 1. Minor adverse events were reported in 3 (15.6%) cases: wound infection in 2 after open procedures and pneumonia in 1 after laparoscopy.</p><p><strong>Conclusion: </strong>Precise visualization data are the key to MS type II management. ERCP allows restoration of the bile outflow, and in a subset of patients, complete endoscopic stone extraction can be achieved. Surgical management of MS type II consists of stone removal through the gallbladder and/or fistula incision. With sufficient experience, laparoscopy can be applied. Cholecystofistulolithotomy without gallbladder removal may be a procedure of choice in MS type II management.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866523","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":"Impact of Robotic Surgery on Esophagogastric Gap During Modified Side Overlap With Fundoplication by Yamashita Reconstruction After Proximal Gastrectomy.","authors":"Mao Tsuru, Yusuke Taki, Erina Nagai, Masato Nishida, Shinsuke Sato, Masaya Watanabe, Ko Ohata, Hideyuki Kanemoto","doi":"10.1097/SLE.0000000000001500","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001500","url":null,"abstract":"<p><strong>Introduction: </strong>Modified side overlap with fundoplication by Yamashita (mSOFY) reconstruction is an antireflux procedure after proximal gastrectomy. Precise alignment between the esophageal and gastric entry holes is important for maintaining an appropriate anastomotic configuration. We evaluated the impact of robotic surgery on the esophagogastric gap (EGG), a novel intraoperative parameter reflecting anastomotic alignment.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 42 patients who underwent proximal gastrectomy with mSOFY reconstruction between June 2019 and August 2025. EGG was defined as the distance between the esophageal and gastric entry holes during stapled anastomosis and was measured retrospectively from the recorded surgical videos (Supplemental Digital Content 1, https://links.lww.com/SLE/A563). Outcomes were compared between laparoscopic (L, n=23) and robotic (R, n=19) approaches. The association between EGG and anastomotic stricture was evaluated as an exploratory analysis.</p><p><strong>Results: </strong>Patient characteristics were generally comparable, although the proportion of male patients was higher in the L group (82.6% vs. 52.6%, P=0.049). EGG was significantly smaller in the R group (0 vs. 8 mm, P<0.001). The number of retrieved lymph nodes was significantly higher in the R group (31 vs. 22, P=0.022). Operative time, blood loss, anastomosis time, and postoperative outcomes were comparable. EGG tended to be larger in patients with stricture (8.5 vs. 3.0 mm, P=0.174).</p><p><strong>Conclusions: </strong>Robotic surgery was associated with a significantly smaller EGG during mSOFY reconstruction after proximal gastrectomy. EGG may serve as a novel intraoperative parameter reflecting anastomotic alignment, although its association with anastomotic stricture requires further validation.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819504","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":"Methodological Considerations and Statistical Concerns Regarding the Use of Laparoscopic-Assisted TAP Block in Laparoscopic Cholecystectomy.","authors":"Ruiying Huang, Li Zhou","doi":"10.1097/SLE.0000000000001499","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001499","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819473","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":"Modified SCOLA Repair for Large Incisional Hernia With Rectus Diastasis.","authors":"Moshe Dudai, Marah Ganiem, Rut Meruham","doi":"10.1097/SLE.0000000000001494","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001494","url":null,"abstract":"<p><strong>Background: </strong>Postoperative incisional ventral hernias (POIH) can sometimes be avoided and are challenging to repair. If the underlying rectus diastasis (RD) is left untreated, the attenuated linea alba predisposes to hernia formation and recurrence. Guidelines recommend concomitant repair of hernia and RD using mesh, but data on endoscopic subcutaneous onlay techniques for large or complex POIH defects remain scarce. This study reports long‑term outcomes of a modified subcutaneous onlay endoscopic approach (SCOLA) combined with bilateral rectus fascia release (RFR), triple‑action seroma prevention (TASP), and preoperative Botulinum toxin A (BOTOX) injection when needed for large POIH combined with RD.</p><p><strong>Materials and methods: </strong>A retrospective review included adults undergoing SCOLA‑RFR between 2016 and 2024. Forty-five patients met the eligibility criteria for POIH with concomitant RD. Forty-two patients (93.3%) completed the structured telephone survey and constituted the analytic cohort. Endoscopic subcutaneous dissection, bilateral relaxing incisions in the anterior rectus sheath, midline plication, and onlay mesh glue reinforcement were performed. Quilting sutures, hypertonic saline irrigation, and fibrin sealant limited seroma. BOTOX was injected preoperatively for wide or rigid defects. Functional outcomes and satisfaction were assessed by telephone survey with 6 to 108 months of follow‑up.</p><p><strong>Results: </strong>The cohort (24 males, 18 females; mean age: 55±12 y) had hernia widths of 2 to 12.5 cm and RD widths of 6 to 13.5 cm. Nearly half of hernias (47.6%) followed minimally invasive surgery, and 52.4% followed open surgery. Functional level improved in 88.1%, core strength was preserved or improved in 95.2%, and 95.2% reported no residual pain or urinary/bowel symptoms. The overall complication rate was 21.4% and was limited to seromas occurring before the introduction of the triple‑action protocol; no seromas were noted thereafter. Recurrence occurred in one patient (2.4%). High satisfaction was reported by 88.1%.</p><p><strong>Conclusions: </strong>Untreated RD may contribute to POIH, including after minimally invasive surgery. SCOLA-RFR combined with TASP and selective BOTOX use may provide a durable, minimally invasive extraperitoneal approach for large POIH with RD, avoiding peritoneal re-entry and muscle transection, with low recurrence and high patient satisfaction.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797998","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":"Biomaterials in Tissue Regeneration Following Surgically Induced Bile Duct Injuries: A Systematic Review.","authors":"Héctor González Rosas, Luis de J Márquez Bohor Rugerio, Carlos J Solis-Oviedo, Fernando Pérez-Escamirosa","doi":"10.1097/SLE.0000000000001498","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001498","url":null,"abstract":"<p><strong>Objective: </strong>Bile duct injury (BDI) following cholecystectomy represents a significant surgical complication, often associated with hepatobiliary dysfunction, increased morbidity, and the need for complex reconstruction. Advances in tissue engineering and biomaterials have introduced novel strategies aimed at bile duct regeneration. This systematic review evaluates current evidence on biomaterial-based approaches for the treatment of BDI in experimental animal models.</p><p><strong>Methods: </strong>A systematic search was conducted between October 2025 and January 2026 in PubMed, Web of Science, and Ovid, following the PRISMA 2020 checklist. The selected studies explored a range of regenerative strategies applied to experimental animal models, including polymeric scaffolds, decellularized grafts, bioabsorbable stents, hydrogels, and bioactive systems incorporating growth factors or stem cells.</p><p><strong>Results: </strong>A total of 1141 records were identified from Web of Science (578), PubMed (459), and Ovid (104). After removal of 413 duplicates, 667 records were excluded during title and abstract screening. Fifty-eight articles underwent full text assessment, and 20 studies met the inclusion criteria for data extraction. These studies explored diverse biomaterial-based strategies aimed at promoting biliary regeneration and functional repair in experimental models. These approaches include decellularized and autologous grafts, polymeric scaffolds, bioactive systems, stents, and other natural materials, each with a unique set of advantages.</p><p><strong>Conclusion: </strong>Current evidence highlights the growing potential of biomaterial-based and bioactive platforms for bile duct regeneration in experimental models, underscoring the importance of continued research to optimize these strategies and facilitate their future translation to clinical approaches.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797773","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":"Re: Patient-Controlled Analgesia Using Ropivacaine (0.25%) Through Transversus Abdominis Plane Versus Epidural Route for Postoperative Pain Relief Following Midline Laparotomy.","authors":"Ruiying Huang, Li Zhou","doi":"10.1097/SLE.0000000000001495","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001495","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685502","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}