Journal of Minimal Access Surgery最新文献

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The way to live! 生活之道
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 DOI: 10.4103/jmas.jmas_3_24
Shrirang Vasant Kulkarni
{"title":"The way to live!","authors":"Shrirang Vasant Kulkarni","doi":"10.4103/jmas.jmas_3_24","DOIUrl":"10.4103/jmas.jmas_3_24","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494006","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}
引用次数: 0
An alternative combined revision of Roux-en-Y gastric bypass: Cover all aspects (of failure)! Roux-en-Y胃旁路术的另一种联合翻修方法:涵盖(失败的)所有方面!
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.4103/jmas.jmas_302_23
Muhammed Said Dalkılıç, Merih Yılmaz, Mehmet Gençtürk, Hasan Erdem, Abdullah Şişik
{"title":"An alternative combined revision of Roux-en-Y gastric bypass: Cover all aspects (of failure)!","authors":"Muhammed Said Dalkılıç, Merih Yılmaz, Mehmet Gençtürk, Hasan Erdem, Abdullah Şişik","doi":"10.4103/jmas.jmas_302_23","DOIUrl":"10.4103/jmas.jmas_302_23","url":null,"abstract":"<p><strong>Abstract: </strong>The revisional surgical techniques for managing weight regain after laparoscopic Roux-en-Y gastric bypass have lacked a clear gold standard. Various methods such as pouch minimising, gastroenterostomy narrowing and distalization have been described, but none have consistently achieved optimal success. This study introduces a combined revision technique that enables the reassessment of both alimentary limb and biliopancreatic limb lengths based on the individual patient's total bowel length. This approach aims to promote effective weight loss while minimising the pouch and gastroenterostomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"356-358"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761937","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}
引用次数: 0
Laparoscopic management of an ileal lipoma presenting with massive gastrointestinal haemorrhage. 腹腔镜手术治疗伴有消化道大出血的回肠脂肪瘤。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2023-03-14 DOI: 10.4103/jmas.jmas_152_22
Saket Kumar, A G Harisankar, Pankaj Kumar, Abhay Kumar, Rana Parween
{"title":"Laparoscopic management of an ileal lipoma presenting with massive gastrointestinal haemorrhage.","authors":"Saket Kumar, A G Harisankar, Pankaj Kumar, Abhay Kumar, Rana Parween","doi":"10.4103/jmas.jmas_152_22","DOIUrl":"10.4103/jmas.jmas_152_22","url":null,"abstract":"<p><strong>Abstract: </strong>Small bowel lipomas are benign submucosal neoplasm composed mainly of mature adipose tissue. Despite their rare occurrence, lipomas are the second most common benign tumour of the small intestine. These tumours are mostly small in size and remain clinically asymptomatic. However, larger lesions tend to be more symptomatic, presenting with complications such as intussusception, bleeding or obstruction. Definitive surgical or endoscopic intervention is indicated in such symptomatic lipomas. Herein, we describe a rare case of ileal lipoma presenting with ileo-ileal intussusception and a life-threatening haemorrhage that was managed by laparoscopic-assisted ileal resection.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"342-344"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584769","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}
引用次数: 0
Novel technique for laparoscopic common bile duct exploration using flexible videobronchoscope to study on clinical outcomes of single-stage (laparoscopic cholecystectomy and laparoscopic common bile duct exploration) versus dual-stage (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) for cholelithiasis with choledocholithiasis - Prospective study in a tertiary care centre (BRACE study - BRonchoscope Assisted Common bile duct Exploration Study). 使用柔性视频支气管镜进行腹腔镜胆总管探查的新技术,以研究单阶段(腹腔镜胆囊切除术和腹腔镜胆总管探查术)与双阶段(内镜逆行胰胆管造影术后进行腹腔镜胆囊切除术)胆石症合并胆总管结石的临床疗效--一项前瞻性研究。在一家三级医疗中心进行的前瞻性研究(BRACE 研究--BRonchoscope Assisted Common bile duct Exploration Study)。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-02-09 DOI: 10.4103/jmas.jmas_182_23
Pawan Kumar Singh, Kulbhushan Haldeniya, S R Krishna, Annagiri Raghavendra
{"title":"Novel technique for laparoscopic common bile duct exploration using flexible videobronchoscope to study on clinical outcomes of single-stage (laparoscopic cholecystectomy and laparoscopic common bile duct exploration) versus dual-stage (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) for cholelithiasis with choledocholithiasis - Prospective study in a tertiary care centre (BRACE study - BRonchoscope Assisted Common bile duct Exploration Study).","authors":"Pawan Kumar Singh, Kulbhushan Haldeniya, S R Krishna, Annagiri Raghavendra","doi":"10.4103/jmas.jmas_182_23","DOIUrl":"10.4103/jmas.jmas_182_23","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to study on clinical outcomes of single-stage (laparoscopic cholecystectomy [LC] and laparoscopic common bile duct [CBD] exploration using flexible videobronchoscope) versus dual-stage (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) for cholelithiasis with choledocholithiasis-prospective study in a tertiary care centre (BRACE STUDY-Bronchoscope-Assisted CBD Exploration [CBDE] Study).</p><p><strong>Patients and methods: </strong>Between April 2022 and April 2023, patients who underwent LC with laparoscopic CBDE and endoscopic retrograde cholangiopancreatography (ERCP) followed by LC participated in this single-centre prospective research. The Institute Ethics Committee granted its approval after receiving an ethical review. The primary endpoint of the proposed research was the removal of the gall bladder and CBD stones. The secondary outcomes studied were complications using the Clavien-Dindo score, cost-effectiveness, patient satisfaction score and post-procedure duration of hospital stay.</p><p><strong>Results: </strong>A total of 168 patients were included in the study. The success rate of LC with laparoscopic CBD exploration using a flexible videobronchoscope (Group 1) was significantly higher as compared to ERCP f/b LC (Group 2) (96.4% vs. 84.5%, P value = 0.02). Out of the 84 patients in Group 1, direct choledochotomies were performed on 83 of them. Group 1 had a considerably shorter hospital stay (4.6 ± 2.4 vs. 5.3 ± 6.2 days; P = 0.03). Both the cost ( P = 0.002) and the number of procedures per patient ( P < 0.001) were considerably higher in Group 2. Major complications (Clavien-Dindo grade 3 and above) were significantly higher in Group 2 ( P = 0.04). Patient satisfaction in Group 1 scored more favourably than those in Group 2 (2.26 ± 0.3 vs. 1.92 ± 0.7; P = 0.006).</p><p><strong>Conclusion: </strong>For concurrent gall bladder and CBD stones, single-stage management by LCBDE using a flexible videobronchoscope has a significantly better primary outcome and lower major complications than dual-stage management. The single-stage strategy also has advantages in terms of a shorter hospital stay, the need for fewer procedures, cost efficiency and patient satisfaction.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"278-287"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716548","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}
引用次数: 0
Comparative clinical experience of subcostal VATS versus conventional uniportal lateral VATS approach. 肋下 VATS 与传统单门侧向 VATS 方法的临床经验比较。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.4103/jmas.jmas_26_24
Volkan Kösek, Eyad Al Masri, Katina Nikolova, Björn Ellger, Shadi Wais, Bassam Redwan
{"title":"Comparative clinical experience of subcostal VATS versus conventional uniportal lateral VATS approach.","authors":"Volkan Kösek, Eyad Al Masri, Katina Nikolova, Björn Ellger, Shadi Wais, Bassam Redwan","doi":"10.4103/jmas.jmas_26_24","DOIUrl":"10.4103/jmas.jmas_26_24","url":null,"abstract":"<p><strong>Introduction: </strong>The present study reports the first clinical experience with subcostal uniportal VATS (suVATS) compared with the conventional lateral uniportal VATS (luVATS) approach.</p><p><strong>Patients and methods: </strong>All patients who underwent suVATS between January 2019 and April 2020 were included. Patients who had undergone luVATS for similar indications were included as the control group. The data were prospectively and retrospectively analysed.</p><p><strong>Results: </strong>The suVATS group included 38 patients with a mean age of 61 (30-83) years. The luVATS group included 33 patients (mean age, 69 years; range: 46-89 years). An intercostal block was performed intraoperatively in the luVATS group. Local infiltration under anaesthesia was performed around the incision in the suVATS group. The duration of the surgery was significantly longer in the suVATS group. However, the chest tube treatment and hospital stay duration were significantly shorter in the suVATS group. The routinely recorded Visual Analogue Scale scores on the first post-operative day and the day of discharge were significantly lower in the suVATS group.</p><p><strong>Conclusion: </strong>Subcostal uniportal VATS enables a shorter drainage treatment duration and hospital stay and significantly reduces post-operative pain. Thus, a faster patient recovery can be achieved.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"326-333"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761938","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}
引用次数: 0
The use of indocyanine green and near-infrared imaging in laparoscopic completion cholecystectomy for the management of stump cholecystitis: A case series. 吲哚菁绿和近红外成像在腹腔镜胆囊切除术中的应用:一系列病例。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2023-09-20 DOI: 10.4103/jmas.jmas_98_23
Sanatan Dattaram Bhandarkar, Vishakha Rajendra Kalikar, Advait Patankar, Roy Patankar
{"title":"The use of indocyanine green and near-infrared imaging in laparoscopic completion cholecystectomy for the management of stump cholecystitis: A case series.","authors":"Sanatan Dattaram Bhandarkar, Vishakha Rajendra Kalikar, Advait Patankar, Roy Patankar","doi":"10.4103/jmas.jmas_98_23","DOIUrl":"10.4103/jmas.jmas_98_23","url":null,"abstract":"<p><strong>Introduction: </strong>Stump cholecystitis is managed by performing a completion cholecystectomy, which can be done either laparoscopically or by an open method. The use of indocyanine green (ICG) is known to improve the identification of the biliary tree anatomy, facilitating Calot's triangle dissection and shortening surgery, thereby reducing the risk of bile duct injuries and making laparoscopic cholecystectomy safer.</p><p><strong>Patients and methods: </strong>A retrospective analysis was performed of prospectively collected data from 15 patients at our institution from March 2016 to March 2021. Magnetic resonance cholangiopancreatography was performed in all 15 cases, showing remnant gall bladder in all cases with calculi within. Four cases had a dilated common bile duct (CBD) with CBD calculi. Endoscopic retrograde cholangiopancreatography (ERCP) and stone removal followed by CBD stenting were performed in the four patients with CBD calculi. These four cases were scheduled for surgery 4 weeks post-ERCP. All 15 patients underwent laparoscopic completion cholecystectomy. The mean operating time was 80 min.</p><p><strong>Results: </strong>The post-operative period of all cases was uneventful, and the patients were discharged on post-operative day 2 or day 3. All patients remained asymptomatic during 1-5 years of follow-up.</p><p><strong>Conclusion: </strong>Laparoscopic completion cholecystectomy was performed safely in cases of stump cholecystitis and resulted in symptom relief during short-term follow-up. The use of ICG and near-infrared imaging in such cases helps identify the biliary anatomy, may contribute to the safety of laparoscopic completion cholecystectomy and might reduce the duration of surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"253-257"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240055","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}
引用次数: 0
Laparoscopic versus open pancreaticoduodenectomy: Long-term outcome from a tertiary care centre. 腹腔镜与开腹胰十二指肠切除术:一家三级医疗中心的长期疗效。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.4103/jmas.jmas_264_23
Sudheer Kanchodu, H T Nagarjun Rao, Shivaraj S Mangyal, M K Ganesh
{"title":"Laparoscopic versus open pancreaticoduodenectomy: Long-term outcome from a tertiary care centre.","authors":"Sudheer Kanchodu, H T Nagarjun Rao, Shivaraj S Mangyal, M K Ganesh","doi":"10.4103/jmas.jmas_264_23","DOIUrl":"10.4103/jmas.jmas_264_23","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic Whipple's pancreaticoduodenectomy (WPD) is one of the most advanced minimally invasive procedures. In recent years, with advancements in minimally invasive surgery, laparoscopic WPD has been increasingly adopted as a safe and feasible technique. This study aims to compare the short-term and long-term outcomes of laparoscopic WPD to open WPD in resectable ampullary, periampullary and head of pancreas malignancies.</p><p><strong>Patients and methods: </strong>A retrospective analysis of a prospectively maintained database of patients who underwent WPD from January 2015 to January 2021 at the department of surgical gastroenterology in a tertiary care medical college hospital was conducted. Patient demographics and pre-operative details, intraoperative parameters (operating time and blood loss), post-operative length of hospital stay, median intensive care unit (ICU) stay, time to resume oral diet, post-operative complications, interventional procedures, mortality, 3-year survival, 3 year recurrence-free survival and overall survival were analysed.</p><p><strong>Results: </strong>Forty-two patients underwent WPD during our study period; 14 patients underwent laparoscopic WPD and 28 patients underwent open WPD. None required conversion. The majority of the patients had periampullary carcinoma in both the groups. Laparoscopic WPD showed a trend towards shorter ICU stays, hospital stays and surgical site infections (SSIs) compared to open WPD. The median operating time was significantly longer in the laparoscopic WPD group (380 min) compared to the open group (285 min). However, median blood loss was significantly lower in the laparoscopic group (250 mL vs. 300 mL). The pancreas-specific post-operative complications like delayed gastric emptying, post-operative pancreatic fistula or post-operative pancreatic haemorrhage did not differ significantly between the groups. All patients had R0 resection and the mean lymph node yield was comparable between the two groups (14.92 vs. 13.42). The reoperation rate or mortality rate did not show any statistical significance between the two groups. The overall survival was 46 months in the open group and 48 months in the laparoscopic group. Three-year survival was 74.1% in the open WPD group and 69.2% in the laparoscopic group. Three-year recurrence-free survival was 55.5% in the open group and 69.23% in the laparoscopic group.</p><p><strong>Conclusion: </strong>Laparoscopic WPD appears to be safe and feasible, with similar short-term and long-term survival outcomes. With a trend favouring laparoscopic WPD in terms of blood loss, hospital and ICU stay and post-operative SSIs, it should be offered to selected patients when the expertise is available.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"311-317"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761964","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}
引用次数: 0
A comparative study of indocyanine green instillation in inguinal node versus foot web space using da Vinci indocyanine green FireFly™ technology in identifying thoracic duct during robotic-assisted transthoracic oesophagectomy. 在机器人辅助经胸食管切除术中,使用达芬奇吲哚青绿 FireFly™ 技术在腹股沟结和足蹼间隙灌注吲哚青绿以识别胸导管的比较研究。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-02-09 DOI: 10.4103/jmas.jmas_2_23
S P Somashekhar, Elroy Saldanha, Rohit Kumar, Ashma Monteiro, Sai Ram Pillarisetti, K R Ashwin
{"title":"A comparative study of indocyanine green instillation in inguinal node versus foot web space using da Vinci indocyanine green FireFly™ technology in identifying thoracic duct during robotic-assisted transthoracic oesophagectomy.","authors":"S P Somashekhar, Elroy Saldanha, Rohit Kumar, Ashma Monteiro, Sai Ram Pillarisetti, K R Ashwin","doi":"10.4103/jmas.jmas_2_23","DOIUrl":"10.4103/jmas.jmas_2_23","url":null,"abstract":"<p><strong>Introduction: </strong>Chyle leak is a serious complication following oesophagectomy with incidence varies from 1% to 9%. Near infra-red fluorescence imaging of thoracic duct (TD) can provide real-time dynamic imaging during the surgery. In this study, we intend to compare indocyanine green (ICG) dye instillation through inguinal node with subcutaneous first web space instillation for visualisation of TD during robotic-assisted minimally invasive oesophagectomy (RAMIE) procedure.</p><p><strong>Patients and methods: </strong>A prospective study of 50 patients underwent RAMIE with da Vinci X System. After general anaesthesia, patients were divided into inguinal node and foot first web space ICG instillation group. The former group had 1 ml of ICG dye instilled on bilateral inguinal nodes under ultrasound guidance and while the other group received 1 mL of ICG dye injected at bilateral foot first web space and then underwent surgery. TD was visualised using ICG FireFly™ fluorescence technology, first at the time of docking and subsequently for every 5 min until 60 min of instillation time and analysed.</p><p><strong>Results: </strong>Twenty-five patients were enrolled in each group. The mean docking time for thoracic phase was 13.76 ± 3.43 min. TD was visualised in 72% (18/25) of cases of first web space instillation group, whereas 100% in ultrasound guidance inguinal node instillation group. None of the patients had a chyle leak.</p><p><strong>Conclusion: </strong>ICG FireFly™ fluorescence technology for the identification of TD during oesophageal mobilisation is safe and effective and provides real-time dynamic visualisation with high accuracy in ultrasound-guided bilateral inguinal node instillation group. It is an effective method for the surgeons planning to negotiate their initial learning curve in RAMIE procedures.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"271-277"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716545","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}
引用次数: 0
Surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision in patients with rectal cancer. 直肠癌患者在腹腔镜引导下进行全直肠系膜切除术的手术效果和胃肠功能恢复情况。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-01-19 DOI: 10.4103/jmas.jmas_122_23
Xingli Jiang, Zhenfeng Cai, Xintao Dai, Luofeng Pan
{"title":"Surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision in patients with rectal cancer.","authors":"Xingli Jiang, Zhenfeng Cai, Xintao Dai, Luofeng Pan","doi":"10.4103/jmas.jmas_122_23","DOIUrl":"10.4103/jmas.jmas_122_23","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision (LGTME) in patients with rectal cancer.</p><p><strong>Patients and methods: </strong>A total of 150 rectal cancer patients who underwent surgical treatment in our hospital from July 2022 to July 2023 were selected and randomly divided into two groups using a random number table. There were 75 cases in the control group (CG) who underwent traditional open rectal total mesorectal excision surgery and 75 cases in the experimental group (EG) who underwent LGTME. The surgical effects of the two groups were compared, and the gastrointestinal and anal functional recovery of the two groups were compared before and after treatment.</p><p><strong>Results: </strong>Intraoperative bleeding, incision length, time to initial feeding and time to anal exhaust in the EG were significantly lower than those in the CG ( P < 0.05). Before treatment, there was no significant difference in gastrointestinal function and anal function between the two groups ( P > 0.05). After treatment, the levels of motilin, gastrin, neuropeptide Y and basic fibroblast growth factor in the EG were significantly higher than those in the CG, with statistical significance ( P < 0.05); the maximum anal systolic pressure and resting anal sphincter pressure in the EG were significantly lower than those in the CG ( P < 0.05); the rectal sensitivity threshold volume (RSTV) and rectal maximum volume threshold in the EG were significantly higher than those in the CG ( P < 0.05). There was no significant difference in most postoperative complications between the two groups ( P > 0.05).</p><p><strong>Conclusion: </strong>LGTME improves the surgical effects of rectal cancer patients, promotes the recovery of gastrointestinal function and has a small effect on anal function indicators, thereby reducing hospital stay.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"258-265"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492628","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}
引用次数: 0
The access and invasiveness-based classification of medical procedures to clarify non-invasive from different forms of minimally invasive and open surgery. 对医疗程序进行基于入路和创面的分类,以明确无创手术与不同形式的微创手术和开放手术。
IF 1 4区 医学
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.4103/jmas.jmas_240_23
Mark Steven Whiteley, Sienna Esme Davey, Gabriel Mark Placzek
{"title":"The access and invasiveness-based classification of medical procedures to clarify non-invasive from different forms of minimally invasive and open surgery.","authors":"Mark Steven Whiteley, Sienna Esme Davey, Gabriel Mark Placzek","doi":"10.4103/jmas.jmas_240_23","DOIUrl":"10.4103/jmas.jmas_240_23","url":null,"abstract":"<p><strong>Background: </strong>The rapid development of less invasive and traumatic medical procedures has resulted in a mixture of terms used to describe them, without any agreed definition for each. This is confusing to both medical professionals and patients and can lead to unrealistic patient expectations. The aim of this article is to show the current confused nomenclature and to suggest a new, simple classification based on access and invasiveness (AI) that can be applied to any medical procedure.</p><p><strong>Methods: </strong>We performed an online search for definitions for 'non-invasive', 'non-surgical', 'minimally invasive', 'minimal access', 'pinhole' and 'keyhole'. We then searched peer-reviewed medical papers (PRMPs) and patient facing websites (PFWs) for the following index procedures, to see which of the original 6 terms were used to describe them: transvaginal ultrasound, sclerotherapy for leg veins, botulinum toxin injections, dermal fillers, endovenous thermal ablation and laparoscopic gall bladder removal.</p><p><strong>Results: </strong>We found a wide variety of definitions for each of the initial terms. In both PRMPs and PFWs, there were a variety of terms used for each index procedure (i.e.: transvaginal ultrasound, injections of sclerotherapy, botulinum toxin or dermal fillers being both 'non-invasive' and 'minimally invasive') showing confusion in the classification of procedures. We suggested the 'AI classification' based on access (A - none, B - natural orifice or C - penetrating an epithelial surface) and invasiveness (1 - none, 2 - surface damage, 3 - needle = <21G, 4 - cannula >21G but not a surgical trocar, 5 - surgical trocars or small incisions and 6 - incisions).</p><p><strong>Conclusion: </strong>The current confusion of terms used for procedures that are less invasive than the open surgical alternatives leads to confusion and possible false patient expectations. We have proposed an AI classification that can be applied easily to any procedure, giving a uniform classification for medical professionals and patients to understand.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"301-310"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761967","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}
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