Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"The Effects of Having Surgeon's Hands in Line of Vision During Single-Incision Laparoscopic Surgery: A Feasibility Study.","authors":"Balkis Zaitoun, Abdulrahman Maziek, Emad Eddin Dalla, Muhammad Eyad Ba'Ath","doi":"10.1089/lap.2025.0005","DOIUrl":"https://doi.org/10.1089/lap.2025.0005","url":null,"abstract":"<p><p><b><i>Aim:</i></b> Single-incision laparoscopic surgery (SILS) provides improved cosmesis compared with multiport laparoscopy. However, it involves hand-clashing and cross-triangulation, making it challenging even for experienced surgeons to adopt in their practice. This study aims to assess the effect of providing an additional view of the surgeon's hands on task performance in SILS. <b><i>Methods:</i></b> Surgically naive participants were recruited via volunteer sampling and instructed to perform tasks using a laparoscopic trainer set and a singular triport access device. A head-mounted camera was worn by the participant and angulated inferiorly to provide an additional view of the operators' hands. Both views were displayed on a 90″ monitor. Tasks were performed with and without the additional view in an alternating manner. Attempts were recorded and assessed blindly for duration and success. Chi-squared and Mann-Whitney <i>U</i> tests were applied as required. A <i>P</i> value <.05 was considered significant. <b><i>Results:</i></b> A total of 467 attempts were conducted by 30 volunteers. The pass rates were 79.09% and 69.23% for the additional and traditional views, respectively (<i>P</i> = .015). A trend toward shorter durations was seen in attempts using the additional view (<i>P</i> = .128). Males (<i>P</i> = .003) and PC video game players (<i>P</i> = .022) were more likely to pass and mobile video game players were more likely to fail (<i>P</i> = .003). <b><i>Conclusion:</i></b> The use of a head-mounted camera to directly visualize surgeon's hands enhances performance in an <i>ex vivo</i> setting. More research is needed to assess clinical impact.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517090","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":"Does the Lens Deflection Angle Affect Laparoscopic Camera Navigation?","authors":"Yi Luo, Ziyan Chen, Bin Luo, Jacques Hubert, Xinghuan Wang, Ming Xu, Kun Yang","doi":"10.1089/lap.2024.0021","DOIUrl":"10.1089/lap.2024.0021","url":null,"abstract":"<p><p><b><i>Background:</i></b> In laparoscopic surgery, a 30° lens is frequently used to obtain a wider field of view. However, it is difficult for inexperienced surgeons to maintain the horizontal state of the image in laparoscopic camera navigation (LCN). If there is a great deviation in the camera's horizontal axis, it may result in ambiguous anatomical recognition, which could impair patient safety. Scientific assessment of the degree of camera's horizontal axis deflection in camera holders with differing proficiencies is necessary for improving novice surgeons' fundamentals of laparoscopic surgery. This study aims to develop an evaluation and training system based on the deflection angle (refers to the change in the angle of the camera axis from its preset vertical position) and assess its potential value in the training and clinical application of laparoscopic surgery. <b><i>Methods:</i></b> A total of 15 postgraduates without laparoscopic surgery experience and 15 skilled senior attending physicians with an experience in more than 50 cases of laparoscopic surgery were recruited. The participants completed an LCN exercise. An inclinometer module was used to measure the camera's horizontal axis deflection angle and the difference in the deviation angle was compared between the two groups. <b><i>Results:</i></b> A deflection angle greater than ±15° was found in 57.98% and 31.76% of participants in the novice group and skilled group, respectively, whereas a deflection angle greater than ±30° was found in 18.4% and 7.58% of participants in the novice group and the skilled group, respectively. The thresholds (we designate 15°, 30°, 45°, and 60° as the checkpoints) for all angles were significantly different for the two groups. <b><i>Conclusions:</i></b> There was a significant difference in the technique of maintaining the camera's horizontal axis within an acceptable range between the novice and the skilled participants. Training that focuses on this deflection angle may be helpful for novice camera holders.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"124-130"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796421","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":"Identifying Responsible Factors for Poor Surgical Visibility in Pediatric Laparoscopic Fundoplication: A Retrospective Single-Center Study.","authors":"Yohei Sanmoto, Yudai Goto, Kouji Masumoto","doi":"10.1089/lap.2024.0254","DOIUrl":"10.1089/lap.2024.0254","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic fundoplication is commonly performed in patients with neurological impairment. However, these patients often have spinal deformities that can complicate achieving a clear surgical view. This study aimed to identify factors associated with poor visibility in pediatric laparoscopic fundoplication. <b><i>Methods:</i></b> Operative videos, medical records, and radiographs of patients who underwent laparoscopic fundoplication between 2015 and 2023 were retrospectively reviewed. The videos were reviewed by two pediatric surgeons and classified into good or poor visibility groups. Age, sex, height, weight, history of abdominal surgery, lordosis, operative time, blood loss, and intraoperative complications were compared between the two groups. Lordosis was evaluated using the sagittal view of computed tomography images, and the anterior vertebral depth and abdominal thickness were measured to calculate the ratio. <b><i>Results:</i></b> Forty-one patients were included in this study. Based on the video review, the patients were classified into good (20 patients) and poor (21 patients) visibility groups. The median age, height, and weight were 6 years, 110 cm, and 16.1 kg, respectively. In the poor visibility group, 23.8% of patients had a history of abdominal surgery (<i>P</i> = .048). Additionally, the anterior vertebral depth to abdominal thickness ratios at the first and third lumbar vertebrae were significantly lower in the poor visibility group (<i>P</i> = .016 and <i>P</i> = .0018, respectively). There were no significant differences in the operative time, blood loss, or intraoperative complications between the two groups. <b><i>Conclusions:</i></b> Lordosis and a history of abdominal surgery may be risk factors for poor visibility in pediatric laparoscopic fundoplication.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"178-183"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781368","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":"Is It Necessary to Endoscopically Evaluate the Anastomosis in Robotic or Laparoscopic Surgical Procedures for Colorectal Cancer?","authors":"Rıdvan Yavuz, Orhan Aras, Hüseyin Çiyiltepe, Onur Dinçer, Ömer Kürklü, Erhan Özyurt, Zinet Asuman Onuk, Tebessüm Çakır","doi":"10.1089/lap.2024.0347","DOIUrl":"10.1089/lap.2024.0347","url":null,"abstract":"<p><p><b><i>Background:</i></b> In the surgical treatment of colorectal cancers, disease-free survival and life expectancy are inversely proportional to the increase in complications. We evaluated the superiority of colonoscopy and air and water tests in detecting anastomotic leaks in sigmoid and rectosigmoid junction colon cancers. <b><i>Methods:</i></b> Data of patients who underwent robotic/laparoscopic surgical procedures for sigmoid and rectosigmoid junctional colon cancers at a single center between January 2018 and February 24 were retrospectively evaluated. The anastomoses were evaluated by intraoperative colonoscopy (IOC) and intraoperative air leak test (IALT), and two groups were formed. Intraoperative leaks, intraoperative repair techniques, and postoperative anastomotic leaks were evaluated. <b><i>Results:</i></b> In our study, there were 125 patients in the IOC group and 148 patients in the IALT group, totaling 273 patients. Leakage was detected in 7 patients (4.7%) in the IALT group and 14 patients (11.2%) in the IOC group (<i>P</i> = .06). In the IALT group, 5 of 7 patients were repaired primary, and the anastomosis was reconstructed in 2 patients. In the IOC group, 10 of 14 patients were repaired primary, 2 patients underwent reanastomosis, and 2 patients needed colostomy. Of these 15 patients with postoperative leakage, 4 had intraoperative leakage (2 patients in the IALT group and 2 patients in the IOC group), and all of them underwent primary repair. <b><i>Conclusion:</i></b> In the anastomotic evaluation of sigmoid colon and rectosigmoid junction tumors, we found that IOC detected more leaks than IALT, but in these leaks, reanastomosis and/or diversion ostomy was superior to primary repair.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"118-123"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606960","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":"Minimally Invasive Surgery for Adrenal Masses in Children: Results of a Two European Centers Survey and Literature Review.","authors":"Francesca Nascimben, Amane Lachkar, Francois Becmeur, Consuelo Maldonado, Francesco Molinaro, Rossella Angotti, Ciro Andolfi, Stephan Geiss, Isabelle Talon","doi":"10.1089/lap.2024.0046","DOIUrl":"https://doi.org/10.1089/lap.2024.0046","url":null,"abstract":"<p><p><b><i>Background:</i></b> Minimally invasive surgery (MIS) for adrenal pathologies in children is still developing because of its low incidence in pediatric population and the discrepancy between the big volume of the masses and the reduced child's size especially in younger patients. In the literature, there are no guidelines about the use of laparoscopic andrenalectomy in children. The aim of this study is to evaluate the outcomes of MIS through a bicenter data analysis in order to propose a standardized protocol. <b><i>Materials and Methods:</i></b> Children who underwent minimally invasive adrenalectomy performed at two European Departments of Pediatric Surgery between 2000 and 2020 were included in this study. Data were collected and analyzed using X-square, Fisher tests, and multiple regression model. <b><i>Results:</i></b> Thirty-four patients (38 adrenal masses) were included. Mean age was 52 months (3-176). Median lesion diameter was 60 mm (40-125 mm). Histological examination revealed 24 neuroblastomas (NBs), 11 pheochromocytomas, 1 teratoma, 1 adrenal cyst, and 1 myelolipoma. Laterality was 52.6% left, 36.8% right, and 10.5% bilateral. Surgical access was transperitoneal in all patients. Mean operative time was 108 minutes for unilateral lesions and 270 minutes for bilateral ones. Mean hospital stay was 4.4 days. No major intraoperative complications were observed. 21.05% NBs were preemtively approached with a laparoscopic access and were converted to open surgery. Median follow-up was 88 months (24-264). Four patients affected by neuroblastoma reported metastatic dissemination and three died. <b><i>Conclusions:</i></b> Pediatric minimally invasive adrenalectomy is a safe and effective procedure, allowing surgeons to reduce the size of incision starting the dissection of the masses, and it has low rate of complication if we consider small masses. The only absolute contraindication is persistent image-defined risk factors for NBs. It should be considered as the first-line treatment for selected adrenal masses in centers with good experience in laparoscopy.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 2","pages":"170-177"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460355","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":"Barbed Versus Conventional Sutures in Laparoscopic-Assisted Colorectal Surgery: A Systematic Review and Meta-Analysis.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Eric Pasqualotto, Caio Mendonça Magalhães, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1089/lap.2024.0324","DOIUrl":"10.1089/lap.2024.0324","url":null,"abstract":"<p><p><b><i>Background:</i></b> Minimally invasive surgery is the preferred method for treating colorectal disease. Laparoscopic suturing is complex, and barbed sutures (BS) can improve the process by eliminating the need for surgical knots and constant traction on the suture line. This study compares intraoperative and postoperative outcomes in patients undergoing laparoscopic-assisted colorectal surgery (LCS) with anastomosis using BS and conventional sutures (CS). <b><i>Methods:</i></b> PubMed, Scopus and Cochrane Library were systematically searched for studies comparing BS to CS in patients undergoing LCS. Continuous outcomes were compared using mean differences (MDs), and odds ratios (ORs) were computed for binary endpoints with 95% confidence intervals (CIs). Heterogeneity was assessed with <i>I</i>² statistics. Statistical analysis was performed using Software R, version 4.2.3. <b><i>Results:</i></b> A total of four studies comprising 285 patients were included, of whom 143 patients (50.17%) underwent BS. Compared with CS, BS significantly reduced the total operative time (MD -16.25 minutes; 95% CI: -25.94, -6.56; <i>P</i> < .01; <i>I</i>² = 0%). However, there were no significant differences between groups in the occurrence of intraoperative complications (OR .74; 95% CI: .26-2.12; <i>P</i> = .58; <i>I</i>²=0%), anastomotic leakage (OR 1.00; 95% CI: .14-7.26; <i>P</i> = 1.00), and Clavien-Dindo ≥III complications (OR 1.80; 95% CI: .41-7.95; <i>P</i> = .44, <i>I</i>² = 0%). <b><i>Conclusion:</i></b> In this meta-analysis, BS significantly reduced the operative time in the anastomotic closure compared to CS in LCS. Furthermore, there were no significant differences between the groups in anastomotic leakage, intraoperative complications, and severe postoperative complications.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"138-144"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796257","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":"Short-Term Efficacy of LCBDE+LC Versus ERCP/EST+LC in the Treatment of Cholelithiasis Combined with Common Bile Duct Stones: A Retrospective Cohort Study.","authors":"Fuguo Liu, Lunhe Ye, Yongkun Wang, Zinan Zhao, Muladili Mutailipu, Xujing Wang, Qiqi Zhang, Bo Chen, Ran Cui","doi":"10.1089/lap.2024.0345","DOIUrl":"10.1089/lap.2024.0345","url":null,"abstract":"<p><p><b><i>Background:</i></b> Minimally invasive treatments for cholelithiasis have gained popularity. The complexity of diagnosing and treating choledocholithiasis offers multiple surgical options, including laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE+LC) and endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy plus laparoscopic cholecystectomy (ERCP/EST+LC). <b><i>Objective:</i></b> To compare outcomes in patients with typical signs, symptoms, laboratory, and imaging features of cholelithiasis combined with common bile duct stones, we retrospectively analyzed the short-term outcomes of LCBDE+LC and ERCP/EST+LC. <b><i>Methods:</i></b> We analyzed 318 patients with gallbladder stones treated between January 2022 and May 2024. Of these, 152 underwent LCBDE+LC, and 166 underwent ERCP/EST+LC. We compared patients' baseline characteristics, perioperative outcomes, and short-term complications between the two groups. The primary outcome was the effectiveness of choledochal stone removal, while secondary outcomes included length of stay, hospitalization costs, and patient satisfaction. <b><i>Results:</i></b> Patients' baseline characteristics were similar between the LCBDE+LC and ERCP/EST+LC groups. Stone clearance rates were comparable (97.37% versus 95.18%, <i>P</i> = .306), with a slight advantage in the LCBDE+LC group. The length of hospitalization was significantly shorter in the LCBDE+LC group (6.49 ± 1.18 days versus 6.77 ± 1.11 days, <i>P</i> < .05). The LCBDE+LC group also had lower total hospitalization costs ($5188.78 ± 861.26 versus $6498.76 ± 1190.58 <i>P</i> < .01). Additionally, the incidence of pancreatitis was lower in the LCBDE+LC group (0.66% versus 6.02%, <i>P</i> < .01). There were no significant differences between the groups in other short-term complications such as abdominal infection, cholangitis, biliary bleeding, or bile leakage. Postoperative follow-up indicated higher patient satisfaction and acceptance in the LCBDE+LC group (SSQ-8, 85.84 ± 4.31 points versus 81.20 ± 4.54 points, <i>P</i> < .01). <b><i>Conclusion:</i></b> Our findings suggest that the LCBDE+LC holds promise as a safe and efficacious approach for the management of cholelithiasis combined with common bile duct stones. However, further prospective clinical trials are essential to corroborate these results and confirm their broader applicability.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"145-151"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631555","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":"Gastric Bypass with and Without Gastric Ring for the Treatment of Morbid Obesity: Results from Retrospective Analysis of a Prospective Database.","authors":"Ana Carolina Andrade Canut, Rodrigo Moisés de Almeida Leite, Willy Petrini Souza, Danilo de Marchi, Bruno Zilberstein","doi":"10.1089/lap.2024.0299","DOIUrl":"10.1089/lap.2024.0299","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To assess the medium-term weight loss and maintenance of lean body mass (ideal weight/weight loss maintenance) following the Roux-en-Y gastric bypass (RYGB) surgical procedure with or without the use of a rigid gastric ring. <b><i>Method:</i></b> An observational cohort study with a retrospective approach was conducted to evaluate the effectiveness of RYGB with and without a band in patients with morbid obesity. The outcomes were assessed by analyzing data obtained from medical records, including pre- and postoperative data. <b><i>Results:</i></b> A total of 239 patients who underwent surgery between 2001 and 2018 were included, with 150 undergoing RYGB without a ring and 89 using a ring. The group subjected to the intervention with a rigid ring showed a significantly higher average body mass index loss than the ringless group (coefficient -2.45; 95% confidence interval [CI]: [-3.92 to -0.97], <i>P</i> < .001) at 1 year. After a follow-up period of 5 years, the use of a gastric ring was still associated with significant improvement in weight loss, even after multivariate adjustment (coefficient 6.62, 95% CI: [+ 4.30 ± 8.95], <i>P</i> < .001). Less than 5% of patients needed gastric band removal during the follow-up period. <b><i>Conclusion:</i></b> In this retrospective cohort of 239 patients, using a ring in RYGB was associated with a significant increase in weight loss and maintenance of lean body mass.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"156-161"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of HIV Infection on Hepatocellular Carcinoma: A Long-Term Prognostic Analysis.","authors":"Yu-Hang Diao, Fa-Ping Gong, Yong Cheng","doi":"10.1089/lap.2024.0191","DOIUrl":"https://doi.org/10.1089/lap.2024.0191","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aims to explore the influence of human immunodeficiency virus (HIV) infection on the prognosis of patients with hepatocellular carcinoma (HCC). <b><i>Methods:</i></b> According to the search strategy, we searched all relevant articles in the three databases (PubMed, Embase, and the Cochrane Library) up to February 18, 2024. All data available for analysis were extracted. Continuous variables were expressed as mean difference (MD) with standard deviation (SD). The categorical variables were expressed as odds ratio (OR) with 95% confidence intervals (CIs). Forest plots were used to illustrate the analysis results, and funnel plots were used to assess publication bias. <b><i>Results:</i></b> The study included a total of 4544 subjects. HIV patients were significantly younger compared to those without HIV (MD = -16.13, 95% CI = -17.24 to -15.01, I² = 91, <i>P</i> < .01), but there were no significant differences in other relevant clinical characteristics between the groups. Survival analysis indicated that HIV patients exhibited a poorer long-term prognosis compared with HIV-negative patients (HR = 0.71, 95% CI = 0.63 to 0.79, I<i>²</i> = 29%, <i>P</i> < .01). <b><i>Conclusion:</i></b> HIV infection, which compromises immune function and liver health, predisposes individuals to earlier onset of HCC and is associated with a poorer prognosis.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 2","pages":"109-117"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460415","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":"Out-of-Hours Laparoscopic Appendectomy: A Risk Factor for Postoperative Complications in Acute Appendicitis?","authors":"Hanbaro Kim, Byung Mo Kang","doi":"10.1089/lap.2024.0268","DOIUrl":"10.1089/lap.2024.0268","url":null,"abstract":"<p><p><b><i>Background:</i></b> The surgical environment can influence the clinical outcomes of procedures and patient conditions. This retrospective study aimed to evaluate how surgical timing affects short-term outcomes in emergency laparoscopic appendectomy for acute appendicitis. <b><i>Methods:</i></b> A total of 647 patients with acute appendicitis who underwent emergency laparoscopic appendectomy at Chuncheon Sacred Heart Hospital between January 2018 and June 2021 were included in this study. The study cohort was divided into the following two groups based on the timing of surgery: work hours and out-of-hours (weekends, holidays, or weekday nights). Clinical outcomes were then compared between the groups. <b><i>Results:</i></b> Work-hour and out-of-hours appendectomies were performed in 282 and 365 patients, respectively. Baseline characteristics and types of appendicitis were similar between the groups (complicated appendicitis: 26.6% in the work-hours group versus 30.4% in the out-of-hours group, <i>P</i> = .288). Operation times were comparable (35.10 minutes versus 34.33 minutes, <i>P</i> = .620), with no cases requiring conversion to open appendectomy in either group. The overall rate of 30-day postoperative complications did not differ significantly between the groups (7.8% versus 10.4%, <i>P</i> = .849). The severity of postoperative complications, categorized by the modified Clavien-Dindo classification, did not show significant differences between the groups (<i>P</i> = .849). In addition, the time to functional recovery was similar in both groups. <b><i>Conclusions:</i></b> The clinical outcomes of out-of-hours laparoscopic appendectomy were similar to those of procedures performed during working hours. Therefore, scheduling emergency surgery can be determined based on the patient's condition and the hospital's capacity to manage acute appendicitis.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"103-108"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774489","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}