Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"High-Quality Indocyanine Green Florescence Cholangiography with Single-Shot Intravenous 0.025 mg Injection in Cholecystectomy.","authors":"Kai Ming Lai, Pak Long Cheung, Cho Kwan Law, Wui Bun Wong, Tang Yu Lam, Ching Ching Lee, Wai Man Wong","doi":"10.1089/lap.2025.0032","DOIUrl":"10.1089/lap.2025.0032","url":null,"abstract":"<p><p><b><i>Background:</i></b> Indocyanine green (ICG) florescence cholangiography is a method to help recognize biliary structures during cholecystectomy. However, the optimal dosage and timing of ICG injection are still under investigation, and there is no consensus internationally. Previous studies revealed the use of various dosages of ICG, ranging from 0.05 mg/kg to 7.5 mg regardless of body weight, while it was revealed that the majority of the quality of ICG cholangiography was suboptimal, i.e., grade B/C. Recently, it has been advocated the use of much diluted ICG, as a higher dose might result in over-detection of adjacent structures, making the biliary tract more difficult to distinguish from its surroundings. This study aimed to investigate the efficacy and safety of a super-diluted intravenous dose, 0.025 mg, given on induction of general anesthesia, for ICG cholangiography in cholecystectomy. <b><i>Methods:</i></b> From 19th December 2024 to 14th February 2025, ICG cholangiography was performed with intravenous ICG .025 mg on induction of general anesthesia in all cholecystectomies in a hepatobiliary team. Grading of ICG cholangiography was observed. <b><i>Results:</i></b> Totally 18 patients underwent cholecystectomy with ICG cholangiography performed. Sixteen out of 18 (88.9%) ICG cholangiographies were grade A. Two (11.1%) ICG cholangiograpies were grade B. Two (11.1%) patients required conversion to open surgery. There was no bile duct injury. <b><i>Conclusions:</i></b> High-quality ICG cholangiography can be safely performed in cholecystectomy with a single-shot intravenous 0.025 mg ICG on induction of general anesthesia.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"489-493"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048846","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":"Sutureless Inguinal Hernia Repair Techniques: A Comparison Between Laparoscopic and Open Methods.","authors":"Stefano Olmi, Alessandro Delcarro, Francesca Ciccarese, Adelinda Angela Giulia Zanoni, Matteo Uccelli, Giovanni Cesana","doi":"10.1089/lap.2025.0039","DOIUrl":"10.1089/lap.2025.0039","url":null,"abstract":"<p><p><b><i>Background:</i></b> The study is designed to compare laparoscopic and anterior sutureless techniques for repairing inguinal hernia. <b><i>Methods:</i></b> For several years, our group has performed both laparoscopic and anterior sutureless inguinal hernia repairs. This retrospective cohort study analyzed 160 patients with inguinal hernias who underwent sutureless surgical alloplasty between July 2018 and July 2019. Eighty patients were treated laparoscopically (transabdominal preperitoneal approach) with a polypropylene mesh secured with fibrin glue (Tisseel®; Baxter Health, Deerfield, IL). The remaining 80 patients underwent open alloplasty using a preformed double-layered polypropylene mesh (Folded-Mesh; Angiologica, Italy) that did not require suture or glue fixation. Clinical follow-up data were collected for a period of 60 months. <b><i>Results:</i></b> The two groups were comparable in terms of age, gender, and ASA score. There was no statistically significant difference in operative time between the laparoscopic and open techniques (34.16 ± 8.50 versus 40.17 ± 7.92 minutes; <i>P</i> > .05). No laparoscopic procedure required conversion to open surgery. No perioperative complications were reported in either group. A significant difference was observed in postoperative neuralgia, with 0 cases in the laparoscopic group versus 8 cases in the open group (<i>P</i> < .05). Persistent pain (lasting more than 6 months) was reported in only 2 patients in the open group (<i>P</i> > .05). Relapse was only observed in the open repair group. <b><i>Conclusions:</i></b> Sutureless inguinal hernia repair is a safe and effective procedure with minimal complications. The laparoscopic approach appears to be superior, offering a faster recovery and fewer postoperative issues, making it the preferred choice for sutureless hernia repair.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"451-457"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056190","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 Role of Artificial Intelligence Large Language Models in Literature Search Assistance to Evaluate Inguinal Hernia Repair Approaches.","authors":"Joao P G Kasakewitch, Diego L Lima, Carlos A Balthazar da Silveira, Valberto Sanha, Ana Caroline Rasador, Leandro Totti Cavazzola, Julio Mayol, Flavio Malcher","doi":"10.1089/lap.2024.0277","DOIUrl":"10.1089/lap.2024.0277","url":null,"abstract":"<p><p><b><i>Aim:</i></b> This study assesses the reliability of artificial intelligence (AI) large language models (LLMs) in identifying relevant literature comparing inguinal hernia repair techniques. <b><i>Material and Methods:</i></b> We used LLM chatbots (Bing Chat AI, ChatGPT versions 3.5 and 4.0, and Gemini) to find comparative studies and randomized controlled trials on inguinal hernia repair techniques. The results were then compared with existing systematic reviews (SRs) and meta-analyses and checked for the authenticity of listed articles. <b><i>Results:</i></b> LLMs screened 22 studies from 2006 to 2023 across eight journals, while the SRs encompassed a total of 42 studies. Through thorough external validation, 63.6% of the studies (14 out of 22), including 10 identified through Chat GPT 4.0 and 6 via Bing AI (with an overlap of 2 studies between them), were confirmed to be authentic. Conversely, 36.3% (8 out of 22) were revealed as fabrications by Google Gemini (Bard), with two (25.0%) of these fabrications mistakenly linked to valid DOIs. Four (25.6%) of the 14 real studies were acknowledged in the SRs, which represents 18.1% of all LLM-generated studies. LLMs missed a total of 38 (90.5%) of the studies included in the previous SRs, while 10 real studies were found by the LLMs but were not included in the previous SRs. Between those 10 studies, 6 were reviews, and 1 was published after the SRs, leaving a total of three comparative studies missed by the reviews. <b><i>Conclusions:</i></b> This study reveals the mixed reliability of AI language models in scientific searches. Emphasizing a cautious application of AI in academia and the importance of continuous evaluation of AI tools in scientific investigations.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"437-444"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006292","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 Short-Term Results of Total Extraperitoneal Repair Using Balloon Dissection with Mesh Fixation Versus Telescopic Dissection Without Mesh Fixation.","authors":"Cumhur Ozcan, Muhanned Alkhatıb, Sami Benli, Erkan Güler, Mustafa Berkesoglu, Tahsin Colak, Hakan Canbaz, Hilmi Bozkurt","doi":"10.1089/lap.2025.0044","DOIUrl":"10.1089/lap.2025.0044","url":null,"abstract":"<p><p><b><i>Background:</i></b> Total extraperitoneal (TEP) hernia repair is a minimally invasive method for the treatment of inguinal hernia. In this study, one group with balloon dissection and mesh fixation was compared with another group that underwent telescopic dissection without mesh fixation. This study aims to compare both methods in terms of effectiveness, complications, pain scores, and clinical outcomes. <b><i>Material and methods:</i></b> This study is a retrospective evaluation of prospectively acquired data from patients in a single-center setting. Patients were divided into two groups: Group 1, who underwent balloon dissection with mesh fixation, and Group 2, who underwent direct telescopic dissection without mesh fixation. All operations were performed by the same surgical team. Predefined data for both groups were compared statistically. <b><i>Results:</i></b> Among the 115 patients, 66 (57.4%) were in Group 1 and 49 (42.6%) in Group 2. No significant difference was found between demographic characteristics and clinical features for two groups. Surgical times for unilateral and bilateral repairs were similar between the groups. Hospital stay duration was also comparable. The conversion rates to transabdominal preperitoneal were 4.5% in Group 1 and 8.2% in Group 2. Postoperative complications were similar between the groups. However, significant differences were found in pain scores, with Group 1 experiencing higher pain levels on the first day, after 1 week, and after 6 months compared to Group 2. <b><i>Conclusion:</i></b> Both balloon dissection with mesh fixation and direct telescopic dissection without mesh fixation are safe and effective techniques for TEP hernia repair with similar short-term outcomes. However, balloon dissection and mesh fixation may result in higher postoperative pain levels and incur higher costs. The choice of technique should be guided by available resources, surgeon experience, and patient-specific factors. Further studies are needed to evaluate the long-term outcomes and cost-effectiveness of both approaches.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"458-462"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041212","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":"Primary Closure Versus T-Tube Drainage on Common Bile Duct Exploration for Choledocholithiasis: An Updated Systematic Review and Meta-Analysis.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Eric Pasqualotto, Gabriel Henrique Acedo Martins, Clara de Jesus Moraes, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo","doi":"10.1089/lap.2025.0048","DOIUrl":"10.1089/lap.2025.0048","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Laparoscopic common bile duct exploration (LCBDE) is a critical procedure for managing choledocholithiasis, with primary closure (PC) and T-tube drainage (TTD) as common methods for common bile duct closure. However, the substantial number of new studies comparing PC and TTD underscores the need for an updated meta-analysis. Therefore, this study aims to compare surgery-related outcomes in PC and TTD for biliary duct closure following LCBDE. <b><i>Methods:</i></b> We searched PubMed, Embase, and Cochrane Library databases on June 20, 2024. Mean differences (MDs) and risk ratios with 95% confidence intervals (CIs) were pooled for continuous and binary outcomes, respectively. 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> A total of 31 studies comprising 4432 patients were included. A total of 2301 (51.9%) were submitted to PC and 2131 (48.1%) were submitted to TTD. The mean age of patients ranged from 39 to 69.8 years and 44.3% were male. Compared with TTD, PC significantly reduced retained stones (odds ratio [OR] 0.57; 95% CI 0.35-0.93; <i>P</i> = .02; <i>I</i>² = 0%), biliary peritonitis (OR 0.22; 95% CI 0.08-0.60; <i>P <</i> .01; <i>I</i>² = 0%), operative time (MD -21.07 minutes; 95% CI -27.68-14.46; <i>P <</i>. 01; <i>I</i>² = 97%) and postoperative hospital stay (MD -2.20 days; 95% CI -2.80-1.60; <i>P <</i>. 01; <i>I</i>² = 96%). However, there were no significant differences between the groups in recurrent stones (OR 0.57; 95% CI 0.32-1.02; <i>P</i> = .06; <i>I</i>² = 0%), bile leakage (OR 0.89; 95% CI 0.65-1.23; <i>P</i> = .49; <i>I</i>² = 0%), bile duct stricture (OR 2.08; 95% CI 0.36-12.11; <i>P</i> = .42; <i>I</i>² = 0%), pneumonia (OR 1.38; 95% CI 0.66-2.88; <i>P</i> = .39; <i>I</i>² = 0%), and pancreatitis (OR 0.64; 95% CI 0.29-1.38; <i>P</i> = .25; <i>I</i>² = 0%). <b><i>Conclusion:</i></b> In this meta-analysis, PC was associated with decreased retained stones, biliary peritonitis, operative time, and postoperative hospital stay. However, no significant differences were observed for the other outcomes. These findings underscore PC as a safe and reliable method for bile duct closure following LCBDE.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"463-475"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006290","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 Analgesic Impact of Erector Spinae Plane Block in Inguinal Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Camila N B de Oliveira, Augusto Graziani E Sousa, Carlos A Balthazar da Silveira, João P G Kasakewitch, Diego Camacho, Flavio Malcher, Diego L Lima","doi":"10.1089/lap.2025.0020","DOIUrl":"10.1089/lap.2025.0020","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The analysis of postoperative pain has gained prominence as an important outcome following inguinal hernia repair (IHR), and various strategies have been employed. However, the use of erector spinae plane block (ESPB) in IHR is debated. Therefore, this systematic review and meta-analysis evaluates their efficacy. <b><i>Methods:</i></b> We searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs), comparing the impact of ESPB on pain outcomes following IHR. Outcomes included pain using the visual analog scale (VAS) at 2, 6, 12, and 24 hours after surgery and postoperative nausea and vomiting (PONV) rates. Statistical analyses were performed using R software and trial sequential analysis. <b><i>Results:</i></b> We included three RCTs comprising 145 patients, of which 66 (45.5%) were submitted to ESPB. Between the included studies, two analyzed minimally invasive IHR, while one analyzed the open Lichtenstein technique. We found no differences in VAS pain scores at 2 hours (MD: -0.56; 95% CI: [-3.53; 2.42]; <i>P</i> = .71) and at 6 hours (MD: -1.13; 95% CI: [-2.50; 0.23]; <i>P</i> = .1) postoperatively. Also, no clinically or statistically significant differences were found in the VAS score for ESPB at 12 hours (MD: -0.96; 95% CI: [-1.94; -.02]; <i>P</i> = .051) and 24 hours postoperatively (MD: -0.19; 95% CI: [-0.53; .15]; <i>P</i> = .28). No statistically significant differences were found in PONV rates between the groups (7.6% versus 20.3%; RR 0.38; 95% CI: [0.14; 1.0]; <i>P</i> = .05). <b><i>Conclusion:</i></b> This meta-analysis found no differences in postoperative pain scores or PONV between the ESPB and control groups. Further studies are necessary to better understand the role of ESPB in inguinal hernia repair.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"445-450"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050760","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 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":"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":"501-505"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","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":"Single-Port Laparoscopic Choledochal Cyst Radical Surgery Using Mucosal Eversion Technique in Small-Diameter Hepaticojejunostomy.","authors":"Wen-Feng Tang, Xi-Si Guan, Xiao-Li Xie, Jia-Kang Yu, Wei Zhong, Zhe Wang","doi":"10.1089/lap.2024.0379","DOIUrl":"10.1089/lap.2024.0379","url":null,"abstract":"<p><p><b><i>Background:</i></b> Single-port laparoscopic choledochal cyst (CDC) excision and Roux-en-Y hepaticoenterostomy (SPCH) exhibits several advantages over conventional laparoscopic techniques in the management of CDCs. However, performing small-diameter hepaticojejunostomy during single-port laparoscopy presents significant challenges, thereby increasing the risk of anastomotic complications. In this study, we employed the mucosal eversion (ME) technique to alleviate the difficulties associated with executing small-diameter hepaticojejunostomy during SPCH and report the preliminary outcome of a prospective case cohort. <b><i>Methods:</i></b> Patients diagnosed with CDC and found common hepatic duct diameter was smaller than 5 mm during SPCH were included. ME was performed on these patients. Clinical information, Magnetic resonance imaging image data, and surgical information data were collected, and patients were followed up for at least 1 year to assess surgical outcomes and postoperative complications. <b><i>Results:</i></b> A consecutive cohort of 16 patients was included from August 2020 to July 2023. All 16 patients successfully underwent ME during SPCH. The median age at surgery was 14.25 months, with an average hepaticojejunostomy diameter of 6.75 mm (ranging from 5 to 8 mm). The mean operation time was 266.25 minutes, and the average posthospital stay was 6.31 days (ranging from 4 to 9 days). During a follow-up period of 12-47 months, no cases of anastomotic leakage or stenosis were observed in this cohort. <b><i>Conclusions:</i></b> The ME technique is easy to execute and outcomes are reliable. It constitutes an efficacious approach to enhancing the prognosis of small-diameter biliary-enteric anastomosis in patients with CDCs undergoing SPCH.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"506-511"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473154","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":"Comparative Outcomes of Laparoscopic, Retroperitoneoscopic, and One-Trocar-Assisted-Pyeloplasty in Pediatric Ureteropelvic Junction Obstruction: A Scoping Review of Literature.","authors":"Fabiola Cassaro, Pietro Impellizzeri, Angela Simona Montalto, Santi D'Antoni, Vincenzo Bagnara, Carmelo Romeo, Salvatore Arena","doi":"10.1089/lap.2025.0007","DOIUrl":"https://doi.org/10.1089/lap.2025.0007","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Ureteropelvic junction obstruction (UPJO) is a common condition in pediatric urology, with various surgical techniques employed for treatment, including laparoscopic pyeloplasty (LP), retroperitoneoscopic pyeloplasty (RP), and One-Trocar-Assisted-Pyeloplasty (OTAP). This review compares intraoperative and postoperative complications, recurrence rates, and outcomes among these methods. <b><i>Materials and Methods:</i></b> A scoping review of the literature from 2000 to 2024 was conducted, analyzing studies on LP, RP, and OTAP in pediatric UPJO patients. We included studies in English and excluded those involving other surgical techniques and mixed adult-pediatric cases. Data extracted from eligible studies included the number of cases, patient age, operative time, complications, recurrence rates, and conversion to open surgery. <b><i>Results:</i></b> A review of 81 studies involving 3549 pediatric patients compared three surgical techniques: LP (2719 patients), RP (399 patients), and OTAP (476 patients). OTAP had the highest rates of minor intraoperative complications (8%) and conversions to open surgery (7.6%). LP and RP showed lower intraoperative complication rates (1.8% and 4.3%) and conversion rates (0.81% and 4.24%). Postoperative complications and recurrence rates were similar across all techniques, with OTAP having the fewest minor postoperative complications (0.8%) and the shortest surgical times (111.5 minutes). <b><i>Conclusions:</i></b> LP, RP, and OTAP are all effective treatments for pediatric UPJO, with comparable success rates and low recurrence rates. OTAP offers fewer minor postoperative complications in confront of LP and faster surgical times but has a higher conversion rate. LP and RP are more suitable for older patients, whereas OTAP seems to be more appropriate for younger patients.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152752","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":"Simple Versus Radical Cholecystectomy for Pathological Stage T1B Gallbladder Cancer: A Systematic Review and Meta-Analysis.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Gabriel Henrique Acedo Martins, Caio Mendonça Magalhães, Sérgio Mazzola Poli de Figueiredo","doi":"10.1089/lap.2025.0049","DOIUrl":"https://doi.org/10.1089/lap.2025.0049","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Gallbladder cancer (GBC) is the sixth most common gastrointestinal malignancy and the most prevalent cancer of the biliary tract. Although recent studies suggest that extended resection may be the optimal approach for managing T1b GBC, there is no clear consensus on whether simple cholecystectomy (SC) or radical cholecystectomy (RC) offers better outcomes. Therefore, we conducted this systematic review and meta-analysis to compare these two surgical techniques in the treatment of T1b GBC. <b><i>Methods:</i></b> We systematically searched PubMed, Embase, and the Cochrane Library through June 20, 2024. We pooled odds ratios (ORs) with 95% confidence intervals (CIs) for binary outcomes and assessed heterogeneity using the <i>I</i>² statistic. <b><i>Results:</i></b> We included 10 studies comprising 2,964 patients, of whom 51.5% underwent SC and 48.5% underwent RC. RC was associated with significantly higher 2 year (OR: 0.46; 95% CI: 0.28-0.77; <i>P</i> < .01; <i>I</i>² = 51%) and five-year overall survival rates (OR: 0.79; 95% CI: 0.64-0.98; <i>P</i> = .03; <i>I</i>² = 0%), and higher 5-year disease-specific survival (OR: 0.59; 95% CI: 0.35-0.99; <i>P</i> = .04; <i>I</i>² = 0%) compared with SC. However, we found no significant differences in 10-year overall survival (OR: 0.71; 95% CI: 0.45-1.13; <i>P</i> = .15; <i>I</i>² = 43%) or recurrence rates (OR 1.44; 95% CI: 0.72-2.88; <i>P</i> = .30; <i>I</i>² = 0%). <b><i>Conclusion:</i></b> RC provides a short- to medium-term survival advantage over SC in patients with T1b gallbladder cancer, but this benefit appears to diminish over time.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144246","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}