Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Learning Curve of Single-Port Robotic-Assisted Extraperitoneal Radical Prostatectomy: A CUSUM-Based Analysis.","authors":"Valerio Santarelli, Fabio Maria Valenzi, Muhannad Aljoulani, Hakan Bahadır Haberal, Luca A Morgantini, Arianna Biasatti, Stefano Salciccia, Giovanni Battista Di Pierro, Giorgio Franco, Riccardo Autorino, Simone Crivellaro","doi":"10.1089/lap.2025.0055","DOIUrl":"10.1089/lap.2025.0055","url":null,"abstract":"<p><p><b><i>Background:</i></b> Single-port robotic-assisted radical prostatectomy (SP-RARP) has been demonstrated to be a feasible and safe procedure. Nonetheless, the challenges of SP surgery could limit the transferability of skills from multi-port (MP) console. The aim of our study was to assess the learning curve of SP-RARP. <b><i>Methods:</i></b> SP-RARPs performed by a single experienced surgeon were reviewed. The surgical learning curve was assessed using risk-adjusted cumulative summation (CUSUM) methodology in terms of operative time, separately for SP-RARPs with pelvic lymphadenectomy (PLND) and without PLND. <b><i>Results:</i></b> 119 extraperitoneal SP-RARPs were evaluated, 83 with PLND and 36 without PLND. After CUSUM calculation, a cubic polynomial regression was performed to plot the learning curves. The inflection points, representing the number of cases required to achieve proficiency, corresponded to the 42^nd and 20^th procedure, respectively, for SP-RARP with and without PLND. The learning curves were subsequently divided into a learning phase and a proficiency phase to compare perioperative and postoperative outcomes of the two phases. In both groups, cases in the proficiency phase demonstrated significantly lower median operative times (<i>P</i> = .01 and <i>P</i> < .001) and hospital stays (<i>P</i> = .015 and <i>P</i> = .04). In the SP-RARP without the PLND group, patients in the proficiency phase demonstrated significantly lower postoperative pain scores (<i>P</i> = .04). No differences were found in terms of estimated blood loss, complication rates, and positive surgical margin rates (<i>P</i> > .05). <b><i>Conclusion:</i></b> Results from our analysis suggest that the learning curve of extraperitoneal SP-RARP is not longer than that reported for MP-RARP. Moreover, when cautiously approached, the learning process can be undertaken without compromising safety and oncological outcomes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"542-549"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081578","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}

{"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}