Videosurgery and Other Miniinvasive Techniques最新文献_第10页

Safety and efficacy of enhanced recovery after surgery in elderly patients after therapeutic endoscopic retrograde cholangiopancreatography 老年患者经内镜逆行胰胆管造影术后加强术后恢复的安全性和有效性

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-02-14 DOI: 10.5114/wiitm.2019.82871

F. Niu, Yu-Di Liu, Rong-Xia Chen, Y. Niu

{"title":"Safety and efficacy of enhanced recovery after surgery in elderly patients after therapeutic endoscopic retrograde cholangiopancreatography","authors":"F. Niu, Yu-Di Liu, Rong-Xia Chen, Y. Niu","doi":"10.5114/wiitm.2019.82871","DOIUrl":"https://doi.org/10.5114/wiitm.2019.82871","url":null,"abstract":"Introduction The number of elderly patients with biliary and pancreatic diseases has increased significantly. The characteristics of biliary and pancreatic diseases in the elderly increase the risk of treatment. Aim To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases with the concept of enhanced recovery after surgery (ERAS). Material and methods Patients receiving ERCP under ERAS were grouped into an elderly group (group A, n = 58, aged 75 years or above) and a young and middle-aged group (group B, n = 202, aged less than 60 years). The clinical parameters before, during and after the operation of the two groups were compared. Results Before the operation, the incidences of cholangiocarcinoma and complications, nutritional screening score ≥ 3, ASA degree III and Child-Pugh grade A in group A were significantly higher than those in group B (p < 0.05), while the incidences of nausea and vomiting, abdominal pain, nutritional screening < 3 and ASA grade I in group A were significantly lower than those in group B (p < 0.05). Intraoperatively, the incidence of juxta-ampullary duodenal diverticulum (JAD) in internal or bottom papilla in the elder patients with difficult selective biliary cannulation (DSBC) was significantly higher than that in the young and middle-aged group (p < 0.05). In addition, the continuous ECG monitoring duration and the first exhaust time in group A were significantly longer than those in group B (p < 0.05). Conclusions Endoscopic retrograde cholangiopancreatography under ERAS in elderly patients is as safe and effective as in young patients.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"394 - 400"},"PeriodicalIF":1.7,"publicationDate":"2019-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.82871","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43441509","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}

引用次数: 6

Transanal versus laparoscopic total mesorectal excision for mid and low rectal cancer: a meta-analysis of short-term outcomes 经肛门与腹腔镜全肠系膜切除术治疗中低位直肠癌:短期结果的荟萃分析

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-02-08 DOI: 10.5114/wiitm.2019.82798

D. Lin, Zhaoliang Yu, Wenpei Chen, Jiancong Hu, Xu-hua Huang, Zhen He, Y. Zou, Xianjuan Yu, Xue-feng Guo, Xiaojian Wu

{"title":"Transanal versus laparoscopic total mesorectal excision for mid and low rectal cancer: a meta-analysis of short-term outcomes","authors":"D. Lin, Zhaoliang Yu, Wenpei Chen, Jiancong Hu, Xu-hua Huang, Zhen He, Y. Zou, Xianjuan Yu, Xue-feng Guo, Xiaojian Wu","doi":"10.5114/wiitm.2019.82798","DOIUrl":"https://doi.org/10.5114/wiitm.2019.82798","url":null,"abstract":"Introduction The benefit of transanal total mesorectal excision (TaTME) for mid and low rectal cancer is conflicting. Aim To assess and compare the short-term outcomes of TaTME with conventional laparoscopic total mesorectal excision (LaTME) for middle and low rectal cancer. Material and methods We searched PubMed, Embase and Cochrane Library databases for studies addressing TaTME versus conventional LaTME for rectal cancer between 2008 and December 2018. Randomized controlled trials (RCTs) and retrospective studies which compared TaTME with LaTME were included. Results Twelve retrospective case-control studies were identified, including a total of 899 patients. We did not find significant differences in overall intraoperative complications, blood loss, conversion rate, operative time, overall postoperative complication, anastomotic leakage, ileus, or urinary morbidity. Also no significant differences in oncological outcomes including circumferential resection margin (CRM), positive CRM, distal margin distance (DRM), positive DRM, quality of mesorectum, number of harvested lymph nodes, temporary stoma or local recurrence were found. Although the TaTME group had better postoperative outcomes (readmission, reoperation, length of hospital stay) on average, the difference did not reach statistical significance. Conclusions Transanal total mesorectal excision offers a safe and feasible alternative to LaTME although the clinicopathological features were not superior to LaTME in this study. Currently, with the lack of evidence on benefits of TaTME, further evaluation of TaTME requires large randomized control trials to be conducted.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"353 - 365"},"PeriodicalIF":1.7,"publicationDate":"2019-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.82798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46866572","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}

引用次数: 16

Application of methylene blue as an improvement of the injection technique of botulinum toxin A in the treatment of refractory idiopathic overactive bladder: prospective, single-blind (patient-blind), randomized trial 亚甲蓝作为A型肉毒毒素注射技术的改进在治疗难治性特发性膀胱过动症中的应用:前瞻性、单盲(患者盲)、随机试验

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-02-06 DOI: 10.5114/wiitm.2019.82763

M. Szczypior, W. Połom, P. Wąż, M. Matuszewski

{"title":"Application of methylene blue as an improvement of the injection technique of botulinum toxin A in the treatment of refractory idiopathic overactive bladder: prospective, single-blind (patient-blind), randomized trial","authors":"M. Szczypior, W. Połom, P. Wąż, M. Matuszewski","doi":"10.5114/wiitm.2019.82763","DOIUrl":"https://doi.org/10.5114/wiitm.2019.82763","url":null,"abstract":"Introduction Refractory idiopathic overactive bladder (RIOAB) is a common condition with a significant negative impact on quality of life. Intravesical injection of botulinum toxin A (BTX-A) is widely used as an intervention for these cases. In the standard method the drug solution is colorless. The addition of dye such as methylene blue (MB) facilitates visualization during the procedure and may have a beneficial effect. Aim To evaluate the injection of BTX-A with the addition of methylene blue (MB) against a standard method in the treatment of RIOAB. Material and methods In this 1-center, single-blinded, randomized controlled trial, we recruited 80 patients with RIOAB. A total of 39 were assigned to injection into the bladder wall of 100 U BTX-A with MB (in 9.5 ml normal saline + 0.5 ml MB), and 41 were assigned to BTX-A 100 U alone (in 10 ml normal saline). Cystoscopy with a submucosal injection of the solution was performed systematically, including the bladder triangle. Participants were assessed 6 and 12 weeks after the treatment using a Likert scale and OABSS questionnaire. Results Significant improvement was similar (result of 1 or 2 on the Likert scale) and was achieved in 66.7% and 69.2% after 6 weeks and in 63.9% and 64.1% after 12 weeks in the BTX-A + MB group and only-BTX-A group, respectively. There was a significant difference between the two groups (p = 0.049) in the total number of patients with complications: 2 (5.6%) vs. 9 (23.1%). Conclusions The addition of MB to BTX for treatment of RIOAB patients does not influence treatment efficacy, while it limits the risk of complications.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"420 - 426"},"PeriodicalIF":1.7,"publicationDate":"2019-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.82763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516837","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}

引用次数: 2

Internal optical urethrotomy is the treatment of choice in stenosis of the bladder neck after open prostate adenectomy 尿道内窥镜切开术是前列腺公开切除术后膀胱颈狭窄的首选治疗方法

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-02-05 DOI: 10.5114/wiitm.2019.82686

T. Borkowski, J. Michalec, B. Kuzaka, A. Borkowski, P. Radziszewski

{"title":"Internal optical urethrotomy is the treatment of choice in stenosis of the bladder neck after open prostate adenectomy","authors":"T. Borkowski, J. Michalec, B. Kuzaka, A. Borkowski, P. Radziszewski","doi":"10.5114/wiitm.2019.82686","DOIUrl":"https://doi.org/10.5114/wiitm.2019.82686","url":null,"abstract":"Introduction Open adenomectomy of the prostate, although performed less frequently, is still indicated in patients with prostate adenoma > 100 ml. Aim This study assessed the frequency of isolated bladder neck stenosis after surgery and the effectiveness of internal optical urethrotomy as monotherapy and in combination with transurethral resection in the treatment of this complication. Material and methods One thousand five hundred thirty-eight Millin’s operations and 381 trans-vesical adenomectomies were performed in patients with prostate adenoma. In 50 patients, the circular hemostatic suture was applied using the de la Peña technique because of bleeding after surgery. The retrospective analysis compared the incidence of isolated bladder neck stenosis depending on the type of surgery. Results Isolated bladder neck stenosis or narrowing of the neck combined with partial stenosis of the site after adenomectomy occurred in 0.52% (8/1539) of patients after Millin’s operation and in 1.05% of patients (4/381) after trans-vesical adenomectomy. All strictures of the bladder after trans-vesical surgery occurred within 12 month after the procedure, and 25% of stenoses after Millin’s operation occurred many years after the surgery. Internal optical urethrotomy as monotherapy or in combination with scar resection resulted in recovery after one treatment in 16 out of 17 patients. Conclusions Internal optical urethrotomy as monotherapy or in combination with scar resection was effective in nearly all patients with bladder neck stenosis.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"427 - 432"},"PeriodicalIF":1.7,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.82686","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46496187","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}

引用次数: 0

Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy – single center experience 腹腔镜右半结肠切除术的腔内与腔外吻合-单中心经验

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-30 DOI: 10.5114/wiitm.2019.81725

A. Kwiatkowski, G. Stępińska, E. Stanowski, K. Paśnik, M. Janik

{"title":"Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy – single center experience","authors":"A. Kwiatkowski, G. Stępińska, E. Stanowski, K. Paśnik, M. Janik","doi":"10.5114/wiitm.2019.81725","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81725","url":null,"abstract":"Introduction Nowadays laparoscopic right hemicolectomy is widely accepted as the standard of care for benign and malignant colon disease. There are wide variations among laparoscopic techniques. One of the most discussed topics is the ileocolic anastomosis. There are two different techniques: intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA). Aim To compare short-term outcomes of performing intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy. Material and methods A retrospective chart review was performed of 92 consecutive patients who underwent laparoscopic right hemicolectomy, with either an IA or EA, from January 2013 to December 2016. Results Eighty-five patients were included in the analysis. There were 53 males and 32 females with a mean age of 67.1 ±13.2 years. Mean body mass index (BMI) was 27.7 ±4.8 kg/m2. An intracorporeal anastomosis was performed in 51 patients, while an extracorporeal anastomosis was performed in 34. The duration of operations was significantly longer when intracorporeal anastomosis was performed, taking 154 ±58 min compared to 95 ±34 min (p < 0.001), in the extracorporeal group. No mortality was observed in the IA group. The postoperative mortality in the EA group was 8.8% (p = 0.060). The rate of reoperation in the intracorporeal anastomosis group was 7.8%, whereas in the extracorporeal anastomosis group it was 14.7% (p = 0.474). Length of hospital stay in the IA group was shorter in comparison to the EA group (5.3 ±3.7 vs. 11.2 ±19.8 days, p = 0.022). Conclusions Our results are encouraging to consider the intracorporeal approach as the better way to fashion the anastomosis after laparoscopic right hemicolectomy.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"381 - 386"},"PeriodicalIF":1.7,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43784871","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}

引用次数: 8

Retroperitoneoscopic distal pancreatectomy: a new surgical approach 后腹腔镜胰远端切除术：一种新的手术方法

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-22 DOI: 10.5114/wiitm.2019.81442

Long-Zhi Zheng, Guobin Lin, C. Zheng, Jian Guo, Bin Zu, Jian-Xin Huang, Wei Lin

{"title":"Retroperitoneoscopic distal pancreatectomy: a new surgical approach","authors":"Long-Zhi Zheng, Guobin Lin, C. Zheng, Jian Guo, Bin Zu, Jian-Xin Huang, Wei Lin","doi":"10.5114/wiitm.2019.81442","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81442","url":null,"abstract":"Introduction The traditional laparoscopic surgery is difficult to deal with the deep lesions of the body and tail of the pancreas, which may damage the visceral organs of the abdominal cavity and cause abdominal adhesion and other related complications. Aim This paper introduces the operation procedure of retroperitoneoscopy in pancreatic surgery, and evaluates its feasibility in clinical application. Material and methods Retrospective analysis was performed on patients with retroperitoneal pancreatectomy in our hospital. The anatomical features of the fascia, surgical plane composition and surgical pathway of the fascia of the retroperitoneoscopic pancreatectomy were observed during the operation, and the surgical safety and feasibility were analyzed. The following parameters were evaluated: operation time, blood loss, pancreatic fistula, postoperative gastro-intestinal recovery, hospital stay. Results All 3 patients had a smooth operation and no serious complications occurred. During retroperitoneal laparoscopic pancreatectomy, there is a vascularized plane between the posterior fascia of the pancreas and the prerenal fascia, which can avoid injury of the visceral organs and retroperitoneal vessels. The anterior renal fascia should be used as the posterior boundary of the safe separation plane. Conclusions The surgical plane based on the anatomy of the fascia and interstitial dissection is the theoretical basis of modern surgery, which is safe, fast and effective. The inter-prerenal fascia plane is the correct and safe anatomical plane of posterior laparoscopic surgery.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"374 - 380"},"PeriodicalIF":1.7,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43625943","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}

引用次数: 1

Urology resident training in laparoscopic surgery – results of the first national survey in Poland 腹腔镜手术中的泌尿外科住院医师培训——波兰首次全国调查结果

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-22 DOI: 10.5114/wiitm.2019.81439

B. Brzoszczyk, T. Milecki, P. Jarzemski, A. Antczak, A. Antoniewicz, A. Kołodziej

{"title":"Urology resident training in laparoscopic surgery – results of the first national survey in Poland","authors":"B. Brzoszczyk, T. Milecki, P. Jarzemski, A. Antczak, A. Antoniewicz, A. Kołodziej","doi":"10.5114/wiitm.2019.81439","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81439","url":null,"abstract":"Introduction For many urological procedures the open approach is being replaced by the laparoscopic approach. Laparoscopy technique requires special training conditions. A well-designed, step-by step training program is significantly important for shortening the learning curve. Aim The purpose of the study was to evaluate urology residents’ (UR) experience in laparoscopic procedures, training patterns and facilities available in departments of urology in Poland. Material and methods The survey developed by the authors included 18 questions concerning laparoscopy training and was distributed among UR who participated in 2 courses in laparoscopic surgery for UR in Poland in 2017. The survey consisted of questions regarding the number of laparoscopic procedures, acquired laparoscopic experience, laparoscopic simulation training and motivation for further learning. Results Of the 2017 invited UR in Poland, 108 (34%) completed the survey. Seventy-two (78%) UR from the study group have access to laparoscopic surgery in their department. Only 20 (25%) of urology departments are equipped with a laparoscopy box and a small number of UR perform regular training. As a primary operator basic (varicocele repair) and advanced (e.g. radical nephrectomy, radical prostatectomy, nephron-sparing surgery) laparoscopic procedures are performed respectively by 55 (71%) UR and 8 (10%) UR. Most residents evaluated their laparoscopic skills as poor (15, 19%), very poor (31, 40%) or absent (10, 13%), while only 22 (28%) evaluated them as at least satisfactory. Conclusions Laparoscopic technique is available in most Polish training centers. However, the majority of UR consider their skills unsatisfactory. Additionally, a large number of Polish UR do not have access to intensive training. UR considered that their availability of training courses and fellowships is low. Surgical exposure among Polish UR comprises mainly minor laparoscopic procedures.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"433 - 441"},"PeriodicalIF":1.7,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46475350","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}

引用次数: 5

Setting realistic expectations for weight loss after laparoscopic sleeve gastrectomy 设定腹腔镜袖状胃切除术后体重减轻的现实预期

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-22 DOI: 10.5114/wiitm.2019.81661

M. Janik, T. Rogula, Rami R. Mustafa, A. A. Saleh, Mujjahid Abbas, L. Khaitan

{"title":"Setting realistic expectations for weight loss after laparoscopic sleeve gastrectomy","authors":"M. Janik, T. Rogula, Rami R. Mustafa, A. A. Saleh, Mujjahid Abbas, L. Khaitan","doi":"10.5114/wiitm.2019.81661","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81661","url":null,"abstract":"Introduction Despite the clinical benefits of bariatric surgery, some patients have experienced disappointment with their weight loss. Setting realistic expectations is the key to success. Aim To develop a specific prediction calculator to estimate the expected body mass index (BMI) at 1 year after laparoscopic sleeve gastrectomy (LSG). Material and methods A retrospective analysis was performed to study 211 patients after primary LSG. Nine baseline variables were analyzed. Least angle regression (LARS) was employed for variable selection and to build the predictive model. External validation was performed on a dataset of 184 patients. To test the accuracy of the model, a Wilcoxon signed-rank test was performed between BMI estimates and the observed BMI. A linear logistic equation was used to construct the online predictive calculator. Results The model included three variables – preoperative BMI (β = 0.023, p < 0.001), age (β = 0.005, p < 0.001), and female gender (β = 0.116, p = 0.001) – and demonstrated good discrimination (R2 = 0.672; adjusted R2 = 0.664) and good accuracy (root mean squared error of estimate, RMSE = 0.124). The difference between the observed BMI and the estimated BMI was not statistically significant (median = 0.737 (–2.676, 3.254); p = 0.223). External validation confirmed good performance of the model. Conclusions The study revealed a useful predictive model for estimating BMI at 1 year after LSG. The model was used for development of the PREDICT BMI calculator. This tool allows one to set realistic expectations of weight loss at one year after LSG.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"415 - 419"},"PeriodicalIF":1.7,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44621594","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}

引用次数: 12

Etiological analysis of parastomal hernia by computed tomography examination 造口旁疝的计算机断层检查病因分析

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-21 DOI: 10.5114/wiitm.2019.81409

Yuwei Pu, X. Yang, Wei Gong, C. Xing

{"title":"Etiological analysis of parastomal hernia by computed tomography examination","authors":"Yuwei Pu, X. Yang, Wei Gong, C. Xing","doi":"10.5114/wiitm.2019.81409","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81409","url":null,"abstract":"Introduction Parastomal hernia is a common complication after stoma formation. The definitive risk factors for parastomal hernia development remain unclear. Aim This study evaluated the risk factors through computed tomography (CT) scan of patients with parastomal hernia. Material and methods All patients who underwent an operation at our institution from January 2008 to February 2014 were included. We recorded patient-related and operation-related variables, and CT scans were checked. All the variables were analyzed with SPSS 19 to identify the risk factors for parastomal hernia formation. Results Of the 128 patients who underwent colostomy, 49 (38.3%) developed a parastomal hernia during a median follow-up period of 20.1 months (range: 4–84 months). Hernia development was significantly associated with the thickness of subcutaneous fat in the abdominal wall, the location of the stoma, anteroposterior diameter and horizontal diameter of the body. The defect size of the abdominal wall is another risk factor. The larger the defect size of the abdominal wall, the larger is the parastomal stoma (3.79 ±1.51 vs. 2.13 ±0.74 cm horizontally and 4.90 ±2.25 vs. 2.94 ±0.73 cm vertically, p < 0.001). The hernia contents protrude into the hernial sac through the path of the inner side more than the outer side (77.6% vs. 12.2%). Conclusions Our findings in Chinese patients with parastomal hernia match those from Western countries: obesity, the location of the stoma, and the defect size of the abdominal wall are significant risk factors for parastomal hernia formation. The mesenteric region is a weak area, which is a site prone to parastomal hernia, and should be protected.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"387 - 393"},"PeriodicalIF":1.7,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48545661","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}

引用次数: 6

Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment 前交通动脉瘤血管内治疗的血管造影及临床结果

IF 1.7 4区医学

Videosurgery and Other Miniinvasive Techniques Pub Date : 2019-01-21 DOI: 10.5114/wiitm.2019.81406

P. Brzegowy, I. Kucybała, K. Krupa, Bartłomiej Łasocha, A. Wilk, P. Latacz, A. Urbanik, T. Popiela

{"title":"Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment","authors":"P. Brzegowy, I. Kucybała, K. Krupa, Bartłomiej Łasocha, A. Wilk, P. Latacz, A. Urbanik, T. Popiela","doi":"10.5114/wiitm.2019.81406","DOIUrl":"https://doi.org/10.5114/wiitm.2019.81406","url":null,"abstract":"Introduction The anterior communicating artery (ACoA) is the most common location of intracranial aneurysms, observed in 35% of cases. Endovascular treatment has become an alternative to surgical clipping and the primary method of choice. Aim To assess the treatment results of ruptured and unruptured ACoA aneurysms and to assess the incidence of intraprocedural complications and various factors influencing these aspects. Material and methods One hundred and eleven embolizations of ACoA aneurysms (80.7% ruptured and 19.3% unruptured) were retrospectively analysed. The methods of embolization were: coiling, balloon-assisted coiling, stent-assisted coiling. Morphology and dimensions of aneurysms were assessed on 3D digital subtraction angiography (DSA) images. Medical records were analysed for patient’s clinical status at admission, intraprocedural complications, follow-up examination and modified Rankin Scale (mRS) score 1 month after discharge. Results Immediately after the procedure 56.9% of patients had Raymond-Roy Occlusion Classification (RROC) class I, 37.6% class II and 5.5% class III. The overall intraprocedural complication rate was 6.6%. There were significantly more cases of bleeding (p = 0.012) and coil prolapse (p = 0.012) during the procedures ending with higher packing density. Twenty-eight (25.7%) patients died during hospital stay, 27 (96.4%) with ruptured aneurysm. In the follow-up of 41 patients, RROC was the same or improved in 73.2% of cases and recanalization occurred in 26.8%. Six patients with aneurysm recanalization underwent repeat embolization. Conclusions Endovascular embolization of ACoA aneurysms is an effective and safe treatment method. The most powerful factor influencing the incidence of complications is packing density. Superior orientation of the dome, initial incomplete embolization and poor outcome in mRS scale are factors predisposing to ACoA aneurysm recurrence.","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"14 1","pages":"451 - 460"},"PeriodicalIF":1.7,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2019.81406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44600712","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}

引用次数: 11