Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Comparison of da Vinci Robot-Assisted and Conventional Laparoscopic Surgery for Hiatal Hernia in Children after Repair for Esophageal Atresia.","authors":"Yujia Zhuang, Xiaoyu Tang, Wenjie Wu, Weihua Pan, Jun Wang","doi":"10.1089/lap.2024.0357","DOIUrl":"https://doi.org/10.1089/lap.2024.0357","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To compare the effectiveness and safety of da Vinci robot-assisted and conventional laparoscopic surgery for hiatal hernia (HH) treatment in children after repair of esophageal atresia (EA). <b><i>Methods:</i></b> A retrospective analysis was conducted of 54 children with EA who underwent either conventional or robot-assisted laparoscopic HH repair between January 2018 and December 2023 in our center. Clinical characteristics and postoperative outcomes were compared to explore the effectiveness and safety of both surgical methods. <b><i>Results:</i></b> Fifty-four patients (conventional surgery, <i>n</i> = 32; robot-assisted surgery, <i>n</i> = 22) met the inclusion criteria. No significant difference was found in gender, age, EA repair method, main symptoms, HH type, and previous HH repair between the two groups. Type A EA accounted for more proportion in conventional surgery group (43.8% versus 13.6%, <i>P</i> < .05). There was a higher use of Nissen fundoplication in robot-assisted surgery group (78.1% versus 100%, <i>P</i> < .05). No significant difference was found in terms of operation length, blood loss, time to start enteral nutrition, conversion to open and total, or postoperative length of stay. The incidence of recurrent symptoms, especially reflux during nighttime, was significantly higher in conventional surgery group (31.3% versus 0%, <i>P</i> < .05). No severe complication or death was reported in either group. <b><i>Conclusions:</i></b> Robot-assisted laparoscopic surgery can be performed safely and effectively for HH repair in EA patients, which made Nissen fundoplication more feasible and showed superior control of reflux symptoms than conventional laparoscopic surgery.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651652","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":"Pediatric Gastrostomy Tube Placement: Avoid the Incision to Avoid the Complications.","authors":"Audra J Reiter, Faraz Longi, Benjamin L Thomae, Michela M Carter, Courtney J Harris, Caitlin Jacobs, Gwyneth A Sullivan, Timothy B Lautz, Mehul V Raval","doi":"10.1089/lap.2024.0036","DOIUrl":"https://doi.org/10.1089/lap.2024.0036","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tremendous practice variation exists for placing gastrostomy tubes. The objective of this study was to determine if the operative approach is associated with 30-day complication rates. <b><i>Methods:</i></b> This single-center retrospective cohort study identified pediatric patients who underwent gastrostomy tube placement from June 2019 to April 2022. Gastrostomy approaches included laparoscopic, laparoscopic-assisted (incision at gastrostomy site), modified open (incision at gastrostomy site), and percutaneous endoscopic gastrostomy (PEG). Multivariable logistic regression models were performed to evaluate the association of 30-day complications and operative approach after controlling for prematurity and weight. <b><i>Results:</i></b> Among 521 gastrostomy patients, the median age was 10 months (interquartile range: 4-33 months), and 181 (34.9%) had a history of prematurity. Weight categories included 217 (41.6%) underweight, 272 (52.2%) normal weight, and 32 (6.1%) overweight. Patients underwent laparoscopic (<i>n</i> = 386, 74.1%), laparoscopic-assisted (<i>n</i> = 73, 14.0%), modified open (<i>n</i> = 33, 6.3%), and PEG (<i>n</i> = 27, 5.2%). Complications included reoperation (<i>n</i> = 17, 3.3%), readmission (<i>n</i> = 12, 2.3%), wound infection (<i>n</i> = 30, 5.8%), wound breakdown (<i>n</i> = 21, 4.0%), tube dislodgement (<i>n</i> = 23, 4.4%), granulation tissue (<i>n</i> = 107, 20.5%), and leakage (<i>n</i> = 33, 6.3%). Following adjustment, laparoscopic-assisted gastrostomy was associated with higher odds of any complication. Laparoscopic-assisted and modified open were associated with higher odds of wound breakdown. Laparoscopic-assisted and modified open were associated with higher odds of leakage. The operative approach was not associated with reoperation, readmission, wound infection, or tube dislodgement. <b><i>Conclusions:</i></b> Techniques for gastrostomy placement, which include an incision around the tube, were associated with higher rates of complications. To improve complication profiles for patients, surgeons should consider laparoscopic or percutaneous endoscopic gastrostomies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651655","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":"Comparison of Surgical Outcomes of Emergent Laparoscopic Cholecystectomy for Acute Cholecystitis Between Attending Surgeons and Residents: A Retrospective Study in Single Medical Center.","authors":"Ching-Wei Tu, Ding-Ping Sun, Khaa-Hoo Ong, Jie-Pu Chen, Chung-Han Ho, Chih-Ying Lu","doi":"10.1089/lap.2024.0393","DOIUrl":"https://doi.org/10.1089/lap.2024.0393","url":null,"abstract":"<p><p><b><i>Background:</i></b> With improvements in skills and evidence of safety, emergent laparoscopic cholecystectomy is routinely performed for acute cholecystitis, if indicated, at our hospital. However, resident operations are concerned with the dilemmas of training programs and patient safety. Hence, our aim was to clarify the safety and feasibility of emergency laparoscopic cholecystectomy performed by attending surgeons and residents. <b><i>Materials and Methods:</i></b> Our study was a retrospective review of 923 patients, who underwent laparoscopic cholecystectomy between January 2021 and June 2022 at our hospital. We excluded combined surgery, single-port methods, laparoscopic common bile duct exploration, elective surgery, and patients with Mirizzi symptoms. Of the 191 patients who underwent emergency laparoscopic cholecystectomy, 118 were operated on by residents, and 73 were operated on by attending surgeons. Patient demographics, surgical and postoperative outcomes, and length of hospital stay were compared between the groups. <b><i>Results:</i></b> No significant differences were observed in sex, age, body mass index (BMI), or surgical history. Older age (60 versus 52 years) and higher BMI (26.29 versus 25.46) were observed in the attending group, and the severity was greater than that in the resident group. No significant differences were observed in the operative results, including mortality (both groups, <i>n</i> = 0), morbidity, blood loss, or length of stay. However, the operation time was significantly shorter in the attending group obviously (86.41 versus 117.89 minutes, <i>P</i> < .0001) significantly. <b><i>Conclusion:</i></b> Emergent laparoscopic cholecystectomy for acute cholecystectomy performed by a resident under supervision appears feasible and safe. The resident operator was associated with increased operative times, however, not complications. This study confirms that residents can also finish surgery in precisely selected cases, and the more important concept is knowing the limits of asking for help.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626642","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":"Robot-Assisted Pull-Through for Anorectal Malformations: Comparative Observational Study of Functional Outcomes with an Open Approach.","authors":"Quentin Ballouhey, Pierre Meignan, Pauline Lopez, Karim Braik, Jenna Houari, Laurent Fourcade, Alexis Belgacem, Hubert Lardy","doi":"10.1089/lap.2024.0215","DOIUrl":"https://doi.org/10.1089/lap.2024.0215","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Robotic surgery has gained acceptance in the field of pediatric surgery but is still under assessment. Some limitations of this device are particularly encountered when performing specific tasks in small cavities, such as neonatal pelvis. The aim of this study was to compare the functional results of robot-assisted anorectal pull-through (RAARP) with posterior sagittal anorectoplasty (PSARP) in children with \"high\" types of anorectal malformations (ARMs). <b><i>Materials and Methods:</i></b> In this multicenter experience, we reviewed the patients operated for ARMs using the da Vinci® system between 2007 and 2020 in our national robotic program. Two groups of patients according to the surgical technique (robotic versus open) were compared based on the postoperative outcomes and long-term functional results using Kelly and Krickenbeck scores at 3 years of age. <b><i>Results:</i></b> Ten patients operated using RAARP were compared with 10 patients operated using PSARP (mean weight 8.1 ± 1.2 kg versus 8.6 ± 1.1 kg, respectively). The two groups were comparable in terms of the ARM classification and patient demographics. The clinical Kelly score was significantly lower for the PSAAP group (<i>P</i> = .012). The Krickenbeck constipation score was significantly lower for the RAARP group (<i>P</i> = .02), whereas no statistical difference was found for the soiling score and voluntary bowel movements. <b><i>Conclusions:</i></b> A concomitant laparoscopic approach using a robotic platform appears to be an alternative technique to the criterion standard for performing anorectal malformation surgery with satisfactory functional results. The enhanced potential of preserving perirectal nerves requires confirmation through longer follow-up studies focusing on functional assessment.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626645","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":"The Impact of Enhanced Recovery After Surgery Compliance in Colorectal Surgery for Cancer.","authors":"Ana Sarah Portilho, Maria Luiza Viana Olivé, Rodrigo Moisés de Almeida Leite, Francisco Tustumi, Victor Edmond Seid, Lucas Soares Gerbasi, Rafael Vaz Pandini, Lucas de Araújo Horcel, Sérgio Eduardo Alonso Araujo","doi":"10.1089/lap.2024.0317","DOIUrl":"https://doi.org/10.1089/lap.2024.0317","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to assess the impact of Enhanced Recovery After Surgery (ERAS) compliance and to identify which components of this protocol are most likely to affect postoperative outcomes in patients undergoing colorectal cancer surgery. <b><i>Methods:</i></b> This is a retrospective cohort evaluating patients who underwent elective colon resection. ERAS compliance was assessed based on adherence to the protocol components. The study examined the following outcomes: postoperative complications, readmission rates, mortality, conversion to open surgery, stoma creation, and length of hospital stay. <b><i>Results:</i></b> Of the 410 patients studied, 59% achieved ≥75% compliance. Comparison between compliance groups (<75% versus ≥75%) showed significant differences in overall complications (<i>P</i> = .002), severe complications (<i>P</i> = .001), and length of hospital stay (<i>P</i> < .001). The area under the receiver operating characteristic curve for predicting the absence of severe complications based on ERAS compliance was 0.677 (95% confidence interval: 0.602-0.752). Logistic regression analyses demonstrated that ERAS compliance was significantly associated with a reduced risk of severe complications (<i>P</i> < .001), as well as that the following items: avoiding prophylactic drains (<i>P</i> < .001), minimal use of postoperative opioids (<i>P</i> = .045), avoidance of postoperative salt and water overload (<i>P</i> < .001), postoperative nutritional support (<i>P</i> = .048), and early mobilization (<i>P</i> = .025). <b><i>Conclusion:</i></b> High ERAS compliance is associated with improved postoperative outcomes in colorectal cancer surgery. Key protocol components for preventing severe complications include avoiding prophylactic drains, minimal postoperative opioid use, avoiding salt and water overload, nutritional support, and early mobilization.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558639","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":"Abdominoperineal Resection in Prone Versus Supine Position: A Systematic Review and Meta-Analysis.","authors":"Bernardo Fontel Pompeu, Eric Pasqualotto, Beatriz D'Andrea Pigossi, Matheus Reginato Araujo, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1089/lap.2024.0372","DOIUrl":"https://doi.org/10.1089/lap.2024.0372","url":null,"abstract":"<p><p><b><i>Background:</i></b> Abdominal perineal resection (APR) remains the gold standard for lower rectal cancer involving the anal sphincter. However, the optimal patient position remains unclear. While lithotomy or Lloyd-Davies are commonly used, APR and extra-levator abdominal perineal excision (ELAPE) in a prone jackknife position have been linked to better oncological outcomes. <b><i>Methods:</i></b> We searched PubMed, Embase, the Central Register of Clinical Trials, and Web of Science for randomized controlled trials (RCTs) and observational studies published up to February 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using <i>I</i>² statistics. Statistical analysis was performed with R Software version 4.4.1. <b><i>Results:</i></b> Two RCTs and 26 observational studies, including 4529 patients, were analyzed. Among them, 2249 (49.7%) underwent APR or ELAPE in the prone position and 2280 (50.3%) in the supine position. The prone position was associated with reduced surgical specimen perforation (5.3% versus 9.4%; OR: 0.44; 95% CI: 0.39-0.78; <i>P</i> < .001), lower positive circumferential resection margins (CRMs) rates (9.8% versus 14.3%; OR: 0.69; 95% CI: 0.53-0.89; <i>P</i> < .001), and decreased intraoperative bleeding (mean difference: -63.7 mL; 95% CI: -104.5, -22.8; <i>P</i> < .01). No significant differences were observed in operative time, urinary retention, urinary injury, wound infections, perineal dehiscence, Clavien-Dindo ≥3, reoperation, local recurrence, distal recurrence, or overall survival. <b><i>Conclusion:</i></b> The prone position during APR is associated with reduced specimen perforation, lower positive CRM rates, and less intraoperative bleeding without significant differences in other clinical outcomes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558634","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":"Rare Congenital Lung Lesions in Even Rarer Locations: A Single-Institution Experience with Extrathoracic Congenital Lung Lesions.","authors":"Yeu Sanz Wu, Juan Garcia, Nicholas Schmoke, Christopher Nemeh, Mark C Liszewski, Vincent Duron","doi":"10.1089/lap.2024.0384","DOIUrl":"https://doi.org/10.1089/lap.2024.0384","url":null,"abstract":"<p><p><b><i>Background:</i></b> Extrathoracic congenital lung lesions (CLLs) are a rare anomaly of lung development. Management and surgical approach are variable. We present our institutional experience with extrathoracic CLLs for the past 18 years. <b><i>Methods:</i></b> We retrospectively reviewed all patients younger than 18 years diagnosed with a CLL from January 2005 to June 2023. Only patients with suspected extrathoracic CLLs on prenatal imaging were included. <b><i>Results:</i></b> A CLL was identified in 381 patients and was extrathoracic in 25 patients (6.6%). Six patients (24%) with other congenital anomalies were excluded, and 3 were lost to follow-up. The prenatal course and delivery of the 16 study patients were unremarkable and all were asymptomatic. Larger lesions, both prenatally and postnatally, were more likely to undergo surgical resection (11.8 ± 8.2 cm³ versus 3.9 ± 3.3 cm³, <i>P</i> = .05; 6.1 ± 5.1 cm³ versus 2.5 ± 2.5 cm³, <i>P</i> = .10, respectively). Seven patients (7/16; 44%) underwent resection-5 thoracoscopic and 2 laparoscopic. Thoracoscopic transdiaphragmatic approach was favored for lesions extending >50% above the diaphragm. Five lesions were intradiaphragmatic, one infradiaphragmatic, and one intrathoracic. Four lesions (4/7; 57%) were hybrid lesions on pathology. No malignancy was identified. Nine patients (9/16; 56%) underwent surveillance. Imaging modality for surveillance varied. Duration of follow-up ranged from 0.5 to 83 months. <b><i>Conclusions:</i></b> We provide the largest case series to date describing both operative and nonoperative management of extrathoracic CLLs. Surveillance appears to be appropriate for small lesions. If surgical excision is pursued, the thoracoscopic approach is safe and preferred if diaphragmatic involvement is suspected.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524862","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 Common Bile Duct Exploration for Choledocholithiasis in the Elderly: A Systematic Review and Meta-Analysis.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Caio Mendonça Magalhães, Eric Pasqualotto, Gabriel Henrique Acedo Martins, Abraão Alcantara de Medeiros Filho, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo","doi":"10.1089/lap.2024.0382","DOIUrl":"https://doi.org/10.1089/lap.2024.0382","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Laparoscopic common bile duct exploration (LCBDE) is a well-established and effective minimally invasive surgical approach for managing choledocholithiasis. However, its safety in the elderly population is not well established. Therefore, this study compares surgery-related outcomes in elderly patients undergoing LCBDE. <b><i>Methods:</i></b> We systematically searched PubMed, Embase, and Cochrane Library for studies comparing elderly and young patients undergoing LCBDE. Binary outcomes were compared using odds ratios (ORs), with 95% confidence intervals (CIs). Heterogeneity was assessed with <i>I</i>² statistics. Statistical analysis was performed using Software R, version 4.3.3. <b><i>Results:</i></b> Twelve studies comprising 3791 patients were included, of whom 1411 patients (37%) were from the elderly group. Elderly patients were associated with an increase in mortality (OR: 3.42; 95% CI: 1.08-10.85; <i>P</i> = .04; <i>I</i>² = 0%), overall postoperative complications (OR: 1.60; 95% CI: 1.11-2.22; <i>P</i> = .01; <i>I</i>² = 52%), and pneumonia (OR: 4.37; 95% CI: 2.00-9.55; <i>P</i> < .01; <i>I</i>² = 0%) rates. However, there were no significant differences between groups in remnant stones (OR: 1.37; 95% CI: 0.70-2.68; <i>P</i> = .36; <i>I</i>² = 0%) and recurrent stones (OR: 1.37; 95% CI: 0.64-2.95; <i>P</i> = .42; <i>I</i>² = 0%) pancreatitis (OR: 0.98; 95% CI: 0.16-5.95; <i>P</i> = .98; <i>I</i>² = 0%) and bile leakage (OR: 1.24; 95% CI: 0.75-2.07; <i>P</i> = .40; <i>I</i>² = 0%). <b><i>Conclusion:</i></b> In this meta-analysis, elderly patients who underwent LCBDE experienced increased mortality, overall complications, and pneumonia rates compared with young patients. Furthermore, there were no significant differences between the groups in remnant and retained stones, pancreatitis, and bile leakage.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505778","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":"Evaluation of Risk Factors Leading to Conversion from Laparoscopic Cholecystectomy to Open Surgery: A Retrospective Controlled Study.","authors":"Burak Dinçer, Sinan Ömeroğlu, Aydın Eray Tufan, Mehmet Ali Uzun","doi":"10.1089/lap.2024.0366","DOIUrl":"https://doi.org/10.1089/lap.2024.0366","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic cholecystectomy (LC) is one of the most frequently performed operations in surgical practice. Despite increasing experience and technological advances, conversion to open surgery is still necessary in some cases. Although several studies have identified factors associated with increased risk of conversion, debates continue in the literature. This study aimed to evaluate the factors affecting the risk of conversion to open cholecystectomy. <b><i>Materials and Methods:</i></b> Patients who underwent surgery for cholelithiasis between 2020 and 2023 were analyzed retrospectively. Patients who underwent open cholecystectomy, those who had cholecystectomy as part of another surgical procedure, and patients with gallbladder malignancy (except incidental cases) were excluded from the study. Patients were analyzed based on demographic, clinical, laboratory, radiological, and histopathological data. This study was registered at ClinicalTrials.gov (NCT06244589). <b><i>Results:</i></b> A total of 1695 patients were included in the study. The median age was 50 years, and 66.6% of patients were female. Conversion from LC to open surgery occurred in 44 patients (2.6%). Multivariate analysis identified male sex, a history of major abdominal surgery, the need for emergency surgery due to acute cholecystitis, an elevated leukocyte count, and gallbladder wall thickening on abdominal ultrasonography as independent risk factors for conversion to open cholecystectomy. <b><i>Conclusion:</i></b> Male gender, previous major abdominal surgery, emergency surgery due to acute cholecystitis, high leukocyte count, and gallbladder wall thickening on abdominal ultrasonography are independent risk factors for conversion from LC to open surgery. It should be kept in mind in the treatment of patients planned for LC.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484570","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":"Open Versus Laparoscopic Incisional Hernia Repair Following Liver Transplantation: An Updated Systematic Review and Meta-Analysis.","authors":"Valberto Sanha, João P G Kasakewitch, Diego L Lima, Raquel Nogueira, Leandro Totti Cavazzola, Prashanth Sreeramoju, Flavio Malcher","doi":"10.1089/lap.2024.0273","DOIUrl":"https://doi.org/10.1089/lap.2024.0273","url":null,"abstract":"<p><p><b><i>Background:</i></b> Incisional hernias (IHs) represent a frequently encountered postoperative complication in patients undergoing liver transplantation. Traditionally, these hernias have been addressed through open surgical techniques. However, laparoscopic repair has been increasingly recognized for its association with a reduced complication rate in the management of ventral hernias. Our objective is to conduct a comparative analysis of the outcomes associated with open versus laparoscopic repair techniques in liver transplant recipients. <b><i>Methods:</i></b> We conducted a comprehensive literature review across multiple databases, including PubMed, Cochrane, LILACS, SciELO, and EMBASE, to identify studies that compare the efficacy of open and laparoscopic repair methods for IHs postliver transplantation. For the statistical analysis of gathered data, we used the Review Manager software, version 5.4. To evaluate the variability among the study outcomes, we assessed heterogeneity using the <i>I</i>² statistic. <b><i>Results:</i></b> After an initial screening of 334 studies, 6 studies with a combined total of 338 patients fulfilled our inclusion criteria. Our analysis revealed that laparoscopic repair tends to be associated with longer operation times, with a mean difference of 20.30 minutes (confidence interval [CI]: 2.14-38.46; <i>P</i> = .03). We observed no significant differences between laparoscopic and open repair regarding infection rates, recurrence rates, overall surgical complications, or hospital stay duration. <b><i>Conclusion:</i></b> Both surgical approaches yield comparable postoperative outcomes. However, laparoscopic repair is associated with an increased operation time duration. To substantiate these findings, further research involving prospective, randomized studies is necessary.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484571","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}