Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Laparoscopic Liver Resection for Small, Solitary, Peripheral-Type Intrahepatic Cholangiocarcinoma, Based on Preoperative Prediction of Lymph Node Metastasis.","authors":"Hirotoshi Takayama, Shogo Kobayashi, Kunihito Gotoh, Kazuki Sasaki, Yoshifumi Iwagami, Daisaku Yamada, Yoshito Tomimaru, Hirofumi Akita, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Hidenori Takahashi, Masahiro Tanemura, Yuichiro Doki, Hidetoshi Eguchi","doi":"10.1089/lap.2025.0031","DOIUrl":"https://doi.org/10.1089/lap.2025.0031","url":null,"abstract":"<p><p><b><i>Aim:</i></b> Laparoscopic liver resection (LLR) for intrahepatic cholangiocarcinoma (ICC) is not as widespread as LLR for hepatocellular carcinoma or liver metastasis, mainly because ICC may require a lymph node dissection (LND). However, small, solitary, peripheral-type ICC rarely have lymph node metastasis (LNM). The aim of the current study is to examine the usefulness of LLR for ICC and determine whether our criteria for applying LLR without LND to small, solitary, peripheral-type ICC was appropriate. <b><i>Methods:</i></b> We retrospectively selected 78 patients that underwent liver resections for ICC at Osaka University Hospital between 2003 and 2020. We compared LLR (<i>n</i> = 13) to open liver resection (OLR, <i>n</i> = 65) for short-term and long-term outcomes. We also analyzed a subgroup (<i>n</i> = 29) with small, solitary, peripheral-type ICC. <b><i>Results:</i></b> The LLR group had less blood loss (<i>P</i> < .001), shorter postoperative stays (<i>P</i> < .001), and significantly higher 5-year recurrence-free survival (RFS, 74.0%), compared to the OLR group (29.6%, <i>P</i> = .030). However, the OLR group included a higher proportion of patients with advanced ICC. Among patients with small, solitary, peripheral-type ICC, LLR (<i>n</i> = 10) was associated with less blood loss (<i>P</i> = .004) and shorter postoperative stays (<i>P</i> = .002), compared to OLR (<i>n</i> = 19). These groups had similar pathological findings, similar 5-year RFS (75.0% versus 56.8%; <i>P</i> = .433), and similar 5-year overall survival (75.0% versus 80.4%; <i>P</i> = .530). No patients that underwent LLR without LND for ICC experienced lymph node recurrence. <b><i>Conclusions:</i></b> Among patients with ICC, LLR provided better intraoperative and short-term outcomes than OLR, and comparable oncological outcomes. Furthermore, no patients that underwent LLR without LND for ICC experienced lymph node recurrence. LLR without LND for ICC can be performed safely and feasibly by selecting patients with small, solitary, peripheral-type ICC.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Long-Term Complication with Increasing Incidence: Intravesical Hem-o-Lok® Clip Migration after Robot-Assisted Laparoscopic Radical Prostatectomy.","authors":"Bulent Onal, Ahmet Vural, Kadir Can Sahin, Feyyaz Irmak, Huseyin Kocan, Elif Altınay Kırlı, Emre Akkus","doi":"10.1089/lap.2025.0089","DOIUrl":"10.1089/lap.2025.0089","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hem-o-lok® clips (HOLC) (Weck Surgical Instruments, Teleflex Medical, Durham, NC) are commonly used to achieve athermal hemostasis and control the lateral vascular pedicles of the prostate, especially in nerve-sparing surgery during robot-assisted laparoscopic radical prostatectomy (RALP). However, an increasing number of studies have demonstrated intravesical HOLC migrations. This study aims to describe the clinical presentation, symptoms, management, and outcomes of intravesical HOLC migration to the vesicourethral anastomotic site (VUAS). <b><i>Methodology:</i></b> A retrospective analysis was conducted on 386 RALP procedures performed by an experienced surgeon at a tertiary care center between November 2017 and November 2024. The data of all patients who have experienced intravesical HOLC migration during long-term follow-up and were treated for this reason were compiled. Cystoscopy findings, HOLC localizations, the number of HOLCs removed, procedures, and patient follow-up data were analyzed. <b><i>Results:</i></b> Of 386 patients, 5 (1.2%) experienced intravesical HOLC migration at follow-up. Two of these patients received adjuvant radiotherapy. The mean time to identify HOLC migration was 27.8 ± 18.3 months. Following a single cystoscopic intervention, none of the patients' HOLC migration-related symptoms recurred, and no further procedures were required. During follow-up, bladder neck stenosis occurred in 2 patients. <b><i>Conclusion:</i></b> In long-term follow-up of RALP, the lower urinary tract symptoms and persistent dysuria may be related to intravesical HOLC migration. In surgical practice, avoiding using HOLC close to the VUAS and reducing the number of HOLC utilized may help prevent complications.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334336","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":"Dehiscence of Cruroplasty after Gastric Sleeve: Prevention Based on Proper Surgical Technique.","authors":"Yeray Trujillo Loli, Camila Luna Centeno, Armando Romeo, William Kondo, Juan Pablo Aparco, Alexandra Puruguay Haro","doi":"10.1089/lap.2025.0097","DOIUrl":"https://doi.org/10.1089/lap.2025.0097","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To identify the safest and most effective knot-tying sequences for cruroplasty after gastric sleeve surgery, aiming to reduce recurrence risk. <b><i>Materials and Methods:</i></b> A total of 38 knot-tying sequences were tested using a dynamometer and nonabsorbable sutures. These were divided into four groups: Silk 0 (8 sequences), Silk 2/0 (12), Nylon 1 (12), and Polypropylene 2/0 (14). Each sequence was randomly selected and evaluated based on the average tensile strength of 10 tied knots. <b><i>Results:</i></b> For Silk 2/0, the strongest sequences were H3H2a (46.39 N) and H2H1aH1aH1aH1a (45.89 N); the weakest were SSbSb (22.28 N) and SSbSbSb (24.18 N). For Silk 0, H3H2a (72.44 N) and H3H2s (70.48 N) were most resistant, while H1H1sH1sH1sH1s (56.6 N) had the lowest strength. With Nylon 1, H2H1sH1sH1sH1sH1s and H2H1aH1aH1aH1aH1aH1a had the highest strengths; SSbSbSb (29.38 N) was weakest. Polypropylene 2/0 sequences showed consistent strength, with H2H1aH1aH1aH1a (48.91 N) being the strongest. <b><i>Conclusions:</i></b> For Silks 0 and 2/0, at least three half-knots (H1H1H1) are recommended. Starting with a double knot (H2) offers no added benefit. Slip knots should include a minimum of five throws. For Nylon 1, six-throw sequences are optimal; fewer than four throws are not recommended. Polypropylene 2/0 showed uniform performance across sequences. Knot symmetry did not significantly affect strength in any group. All recommended sequences exceed the 43 N threshold needed to prevent cruroplasty dehiscence under normal intra-abdominal pressures.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486785","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":"Robotic Versus Laparoscopic Surgery for Colorectal Cancer: A Trial Sequential Meta-Analysis of Randomized Trials.","authors":"Bernardo Fontel Pompeu, Luís Eduardo Braz de Moraes Alves, Beatriz D'Andrea Pigossi, Gabriel Leal Barone, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1089/lap.2025.0088","DOIUrl":"https://doi.org/10.1089/lap.2025.0088","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic surgery (LS) is widely recognized as the standard minimally invasive method for colorectal cancer. Although robotic surgery (RS) has seen increased adoption, its clinical and economic advantages over LS remain uncertain. <b><i>Methods:</i></b> A systematic search was carried out across PubMed, Scopus, and the Cochrane Central Register up to March 2025. Only randomized controlled trials (RCTs) directly comparing RS and LS were included. Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed via the <i>I</i>² statistic. Trial sequential analysis (TSA) was applied to assess the robustness of the cumulative evidence. <b><i>Results:</i></b> Fourteen RCTs encompassing 2867 patients were included. Compared with LS, RS significantly lowered the conversion rate to open surgery (RR = 0.54; 95% CI: 0.36-0.80; <i>P</i> = .002), time to first stool (MD = -0.33 days; 95% CI: -0.60 to -0.06; <i>P</i> = .016), and positive circumferential resection margin (CRM) (RR = 0.65; 95% CI: 0.46-0.93; <i>P</i> = .017). Sensitivity analysis revealed a slight benefit for RS in time to first flatus (MD = -0.13 days; <i>P</i> = .03). RS was associated with a longer surgery duration (MD = +49.4 minutes; 95% CI: 18.0-80.7; <i>P</i> = .002). No significant differences were observed for intraoperative blood loss, postoperative complications, or cancer recurrence. TSA confirmed definitive findings for selected outcomes, while others remained underpowered. <b><i>Conclusions:</i></b> RS and LS showed equivalent results for postoperative complications and cancer-related outcomes. RS was advantageous in reducing conversion and CRM positivity, despite longer operative time.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310700","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 Early Results of Laparoscopic Transabdominal Preperitoneal and Total Extraperitoneal Repair in Recurrent Inguinal Hernia.","authors":"Cihan Atar, Emir Çapkınoğlu, Burak Yavuz, Ahmet Onur Demirel, Cihan Uras","doi":"10.1089/lap.2025.0067","DOIUrl":"https://doi.org/10.1089/lap.2025.0067","url":null,"abstract":"<p><p><b><i>Background:</i></b> The optimal surgical approach for recurrent inguinal hernia remains controversial. Among the commonly used laparoscopic techniques, transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) repairs are frequently performed, yet data comparing their short-term outcomes in recurrent cases are limited. This study aimed to compare early clinical outcomes of TAPP versus TEP in recurrent inguinal hernia repair. <b><i>Methods:</i></b> We retrospectively analyzed 48 patients who underwent laparoscopic surgery for recurrent inguinal hernia between January 2022 and April 2024 at two centers. Patients were assigned to TEP (<i>n</i> = 27) or TAPP (<i>n</i> = 21) groups based on surgeon preference. Demographics, intraoperative variables, and postoperative outcomes including recurrence, complications, visual analogue pain scores (visual analogue scale [VAS]), analgesic requirement, urinary retention, seroma formation, and testicular complications, were assessed. <b><i>Results:</i></b> Baseline characteristics were comparable except for age, which was significantly lower in the TAPP group (47.5 ± 14.1 versus 60.3 ± 10.2; <i>P</i> < .001). No significant differences were observed in operative time, VAS scores, or hospital stay. Although intraoperative bleeding, urinary retention, and seroma were more frequent in the TAPP group, these did not reach statistical significance. No conversions to open surgery occurred in the TEP group, while one was noted in the TAPP group. During a median follow-up of 22 months for TEP and 16 months for TAPP, a single recurrence was observed in the TAPP group (4.8%). Rates of chronic pain were similar between groups. <b><i>Conclusion:</i></b> Both TAPP and TEP are safe and effective for recurrent inguinal hernia repair, with low complication and recurrence rates. No clear superiority was demonstrated. Surgical technique should be selected based on individual patient and anatomical factors. Further randomized prospective studies are needed to better define the optimal approach in recurrent cases.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267779","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":"Risk Factors for Postoperative Complications of Ileostomy Reversal.","authors":"Si-Qi Li, Quan Lv, Zheng Xiang, Xiao-Su Hui","doi":"10.1089/lap.2025.0092","DOIUrl":"https://doi.org/10.1089/lap.2025.0092","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The aim of this study was to investigate the risk factors for postoperative complications following ileostomy reversal. <b><i>Materials and methods:</i></b> The databases PubMed, Embase, and Cochrane Library were independently searched by the two authors from inception to December 30, 2024. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled up for describing dichotomous variables. Stata 16 was performed for data. <b><i>Results:</i></b> After pooling up the data, a total of 19 studies involving 11108 patients were included in this study. The outcomes showed that any complication after primary procedure (OR = 2.51, 95% CI = 1.66 to 3.79, <i>I</i>² = 1.97%, <i>P</i> < .01) were associated with ileostomy reversal complications. In addition, obesity (OR = 1.45, 95% CI = 1.17 to 1.79, <i>I</i>² = 0.00%, <i>P</i> < .01), linear wound closure (OR = 6.63, 95% CI = 1.59 to 27.76, <i>I</i>² = 0.00%, <i>P</i> < .01), higher American Society of Anesthesiologists (ASA) scores (OR = 1.70, 95% CI = 1.33 to 2.18, <i>I</i>² = 3.33%, <i>P</i> < .01), and longer operative time (OR = 1.30, 95% CI = 1.11 to 1.53, <i>I</i>² = 97.32%, <i>P</i> < .01) were associated with wound infection. <b><i>Conclusion:</i></b> For patients with complications after the initial surgery, surgeons should be aware of the risks of complications following ostomy reversal. Obesity, longer operative time, and higher ASA scores were risk factors for wound infections. Purse-string skin closure had certain advantages over linear skin closure in reducing incision infections.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250611","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":"Abandoned Cholecystectomy: A Single-Center Retrospective Cross-Sectional Cohort Study, 2013-2024.","authors":"Raimundas Lunevicius, Stephen W Fenwick","doi":"10.1089/lap.2025.0028","DOIUrl":"https://doi.org/10.1089/lap.2025.0028","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. <b><i>Materials and Methods:</i></b> This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. <b><i>Results:</i></b> In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (<i>n</i> = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. <b><i>Conclusions:</i></b> AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217421","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":"Study on the Safety and Effectiveness of Using Modified Tubular Stomach for Sideoverlap Anastomosis in Laparoscopic Proximal Gastrectomy.","authors":"Zeshen Wang, Qiancheng Wang, Yuming Ju, Shiyang Jin, Pengcheng Sun, Yuzhe Wei, Guanyu Zhu, Kuan Wang","doi":"10.1089/lap.2024.0395","DOIUrl":"10.1089/lap.2024.0395","url":null,"abstract":"<p><p><b><i>Background:</i></b> The research on laparoscopic proximal gastrectomy has focused on effective methods of preventing reflux, few studies have focused on controlling the blood supply to the anastomosis site. Therefore, we introduced a modified approach to the vascular arch of the tubular stomach (TS) and conducted a preliminary examination of its safety and feasibility. <b><i>Methods:</i></b> Retrospective analysis of clinical data from 37 patients who underwent laparoscopic proximal gastrectomy at our center from March 2021 to June 2023, and comparison of clinical and pathological data, as well as intraoperative and short-term postoperative outcomes, between the modified TS group (<i>n</i> = 16) and the TS group (<i>n</i> = 21). <b><i>Results:</i></b> Compared with the TS, the modified TS had relatively longer operative times (170.63 ± 29.88 minutes versus 166.14 ± 27.49 minutes, <i>P</i> = .64) and anastomosis times (40.44 ± 6.60 minutes versus 36.14 ± 6.72 minutes, <i>P</i> = .06), and there was no significant difference in bleeding volume between the two groups (94.38 ± 75.19 mL versus 67.62 ± 44.15 mL, <i>P</i> = .14). There were 2 cases of postoperative anastomotic-related complications ((both of which were anastomotic bleeding) in the TS. No anastomotic-related complications were observed in the modified TS. There were a total of 6 cases in the postoperative gastroscopy modified TS, including 5 cases of LA-A and 1 case of LA-B; There are 10 cases of TS, including 7 cases of LA-A and 3 cases of LA-B. <b><i>Conclusions:</i></b> The modified TS during laparoscopic procedures is safe and feasible, decreasing to the maximal degree the potential blood supply disorders and bleeding risks at the anastomosis site while preventing reflux.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"482-488"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081579","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":"Clot Between a Rock and a Hard Place: Renal Cell Carcinoma with IVC Tumor Thrombus.","authors":"Kathryn Cavallo, Fredrick Brody","doi":"10.1089/lap.2024.0352","DOIUrl":"10.1089/lap.2024.0352","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is the most common renal cancer and constitutes a significant burden of disease. Tumor thrombus is present in approximately 10% of cases at initial diagnosis and impacts the morbidity and mortality of the disease. The primary treatment for RCC involves resection of the tumor. The presence of tumor thrombus, therefore, is not only important for prognosis but also for operative planning. Operative approach, including vascular control and caval closure are important consideration when resecting RCC with inferior vena cava (IVC) tumor thrombus and varies based on the patient presentation, extent of the tumor, and the surgeon's experience. This article presents a patient with RCC with IVC thrombus who ultimately underwent surgical resection with general surgery, vascular surgery, and urology to showcase the multidisciplinary care, surgical considerations, and current management and treatment strategies for RCC with tumor thrombus.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"476-481"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062977","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":"Stapled Neo-Malone Creation: A Simplified Technique with Comparable Outcomes for Antegrade Continence Enemas.","authors":"Ismael Elhalaby, Irene Isabel P Lim, John M Gatti, Joel F Koenig, Elizaveta Bokova, Wendy E Lewis, Christine N Feira, Rebecca M Rentea","doi":"10.1089/lap.2024.0365","DOIUrl":"10.1089/lap.2024.0365","url":null,"abstract":"<p><p><b><i>Background:</i></b> The Neo-Malone (neo-appendicostomy) is a modification of the antegrade continence enema (ACE) procedure that constructs a new appendix using a cecal flap from the mesenteric side of the colon. This technique is indicated in cases where the native appendix has either been previously resected or is insufficiently long for a standard Malone procedure. Recently, a linear GIA™ stapler use has been introduced to streamline and simplify the Neo-Malone creation. This study evaluates the outcomes of patients who underwent stapled Neo-Malone creation. <b><i>Methods:</i></b> A retrospective review of patients who underwent laparoscopic-assisted Neo-Malone creation from August 2021 to June 2024 at a single institution. Variables included demographics, surgical history, postoperative complications, and functional outcomes. Descriptive statistics were performed to analyze quantitative variables. <b><i>Results:</i></b> Six patients underwent stapled Neo-Malone creation at a mean age of 11 years (range 7-19). The underlying conditions included neurogenic bowel (<i>n</i> = 4, 67%) and cloacal malformation (<i>n</i> = 2, 33%). Four patients (67%) underwent concurrent ileovesicostomy or Mitrofanoff appendicovesicostomy. Complications included parastomal granulation tissue (<i>n</i> = 2, 33.3%), channel prolapse (<i>n</i> = 1, 17%), and leakage from the channel (<i>n</i> = 1, 17%). No stenosis or need for revision operations was reported. At a median follow-up of 14 months (IQR 12-20), all patients were clean for stool with successful Neo-Malone flushes. <b><i>Conclusion:</i></b> Stapled Neo-Malone creation appears to be a safe and technically simpler alternative to the traditional technique, potentially reducing operative time. The functional outcomes and rates of surgical complications are comparable to those of other ACE channel types.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"494-500"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043540","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}