Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"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":"Validation of a Pulsatile Model for Laparoscopic Partial Nephrectomy: NEFPAR Model.","authors":"Jose Antonio Campos Sañudo, Saul Higuera Pardo, Roberto Ballestero Diego","doi":"10.1089/lap.2025.0026","DOIUrl":"10.1089/lap.2025.0026","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic and robotic-assisted partial nephrectomy are the gold standard for treating small renal tumors. To improve training while adhering to animal welfare regulations, the NEFPAR pulsatile model was developed as a nonliving alternative for surgical simulation. This study aimed to validate NEFPAR as a realistic and effective training tool. <b><i>Methods:</i></b> The NEFPAR model was constructed using porcine tissue used in other simulations, a pulsatile pump, and standard laparoscopic instruments. Eleven participants (4 urologists and 7 urology residents) were recruited for validation. They performed simulated laparoscopic partial nephrectomies using the model, and their performance was evaluated through a survey assessing the realism, educational impact, and comparison to other simulation models. Data were analyzed using Fisher's exact test, with significance set at <i>P</i> < .05. <b><i>Results:</i></b> Most participants (72.7%) rated the NEFPAR model as realistic for key procedural steps, such as tumor resection and renal hilum dissection. The bleeding component was deemed essential for learning by 100% of participants. The NEFPAR model was superior to nonpulsatile animal models in replicating surgical bleeding and was comparable to cadaveric models in external appearance and tissue texture. However, cadaveric models were rated higher for replicating all procedural steps. No significant differences in responses were found between urologists and residents. <b><i>Conclusions:</i></b> The NEFPAR model effectively simulates key aspects of laparoscopic partial nephrectomy and offers an ethical, cost-effective alternative for surgical training. It was well-received for its educational value, especially for simulating surgical bleeding. Further refinements could enhance tissue consistency and tumor positioning, but the model has strong potential to be integrated into urology training programs to improve surgical skills and reduce reliance on animal models.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"401-405"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774568","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 Nomogram for Predicting Anastomotic Stricture after Laparoscopic Radical Resection of Rectal Cancer.","authors":"Yanhao Sun, Yilong Hu, Yuanfang Sun","doi":"10.1089/lap.2024.0401","DOIUrl":"10.1089/lap.2024.0401","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anastomotic stricture is a common complication following laparoscopic radical resection of rectal cancer, affecting up to 30% of patients and significantly impacting quality of life. This study aimed to develop a predictive model to identify high-risk patients and characterize stricture subtypes. <b><i>Methods:</i></b> Retrospective analysis of 304 patients undergoing laparoscopic rectal cancer resection (August 2019-April 2024) identified independent risk factors through multivariate logistic regression. A nomogram was developed and validated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Subtype analysis compared Type I (dilatable, <i>n</i> = 51) and Type II (refractory, <i>n</i> = 38) strictures. <b><i>Results:</i></b> The nomogram incorporated five independent predictors: preoperative radiotherapy (odd ratio [OR] = 4.13), diverting stoma creation (OR = 6.98), lack of left colic artery preservation (OR = 3.95), anastomotic leakage (OR = 16.53), and anastomotic distance ≤3 cm (OR = 4.02), achieving an area under the curve (AUC) of .827. Type I strictures were significantly associated with diverting stoma creation (82.4% versus 39.5%, <i>P</i> = .004) and an anastomotic distance >3 cm (70.6% versus 36.8%, <i>P</i> = .001). The refined nomogram for Type II strictures demonstrated superior discrimination (AUC = .883, <i>P</i> < .001). <b><i>Conclusion:</i></b> This dual-phase nomogram effectively predicts overall anastomotic stricture risk and identifies refractory subtypes, enabling personalized postoperative management.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"365-372"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702071","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":"Postmyotomy Esophageal Diverticulum-A Unique Entity Mimicking Achalasia Recurrence.","authors":"Gad Marom, Ronit Brodie, Ram Elazary, Alon Pikarsky, Avraham I Rivkind, Brigitte Helou, Yuri Fishman, Yoav Mintz","doi":"10.1089/lap.2025.0023","DOIUrl":"10.1089/lap.2025.0023","url":null,"abstract":"<p><p><b><i>Background:</i></b> Recurrence of dysphagia following myotomy for achalasia poses clinical and diagnostic challenges. Postmyotomy esophageal diverticula is a rare disorder, usually developing due to inadequate myotomy, resulting in dysphagia. We herein present a new entity of esophageal diverticula developing after successful complete myotomy, which causes dysphagia and mimics recurrence of achalasia. <b><i>Methods:</i></b> A review of the prospectively maintained database of all patients with achalasia and diverticula between January 2012 and June 2024 was performed. Demographic, clinical data, diagnosis, treatment, and outcomes were collected and analyzed. <b><i>Results:</i></b> A total of 9 patients underwent esophageal diverticulectomy in our institution. Five patients had achalasia and myotomy either by per-oral endoscopic myotomy, laparoscopic Heller myotomy, or pneumatic dilation. All patients suffered from a recurrence of symptoms, with an open lower esophageal sphincter confirmed by manometry or EndoFLIP™. The time from myotomy to diagnosis was 31-117 months. Four were males and 1 was female between the ages of 33 and 58 years, with an average body mass index of 22.4 kg/m². All patients underwent esophageal diverticulectomy with no additional myotomy. Median preoperative and postoperative Eckardt scores were 5 and 0 respectively, with complete resolution of symptoms. <b><i>Conclusions:</i></b> Epiphrenic diverticula is a rare cause of postmyotomy dysphagia in achalasia patients. Previously, this entity was described in the context of insufficient myotomy; however, we present here a case series of patients with epiphrenic diverticula following adequate myotomy with no distal obstruction. Following diverticulectomy, their dysphagia was resolved. We suggest an algorithm for the diagnosis and treatment of dysphagia following myotomy for achalasia.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"388-393"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732934","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 Uniportal Subxiphoid Lung Cancer Surgery Using Multi-Joint Wristed Instruments and Uniportal Lung Cancer Surgery Technique: Evaluation of Early Outcomes.","authors":"Celal Buğra Sezen, Melike Ülker, Oğuzhan Bayraktar, Dilekhan Kizir, Mustafa Vedat Doğru, Cemal Aker, Özkan Saydam, Muzaffer Metin","doi":"10.1089/lap.2024.0378","DOIUrl":"https://doi.org/10.1089/lap.2024.0378","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aims to compare the early outcomes of the surgeon-powered robotic uniportal subxiphoid resection technique with conventional uniportal techniques. <b><i>Methods:</i></b> A retrospective analysis was conducted on patients operated on for lung cancer between January 2022 and December 2023, comparing those who underwent uniportal lung resection with those who received the uniportal subxiphoid surgical technique. <b><i>Results:</i></b> Out of 90 patients in the study, 31 underwent subxiphoid resection while 59 underwent the uniportal surgical technique. When comparing the average lengths of hospital stay, the subxiphoid group had an average stay of 3.8 ± 1.2 days while the uniportal surgery group had an average stay of 4.8 ± 1.9 days (<i>P</i> = .004). At the 1-hour postoperative evaluation, the visual analog scale score for the subxiphoid group averaged 2.2 ± 1, while the uniportal surgery group averaged 3.2 ± 1.6 (<i>P</i> = .002). Complications were observed in four patients (12.9%) in the subxiphoid group and eight patients (13.5%) in the uniportal surgery group (<i>P</i> = .927). <b><i>Conclusion</i></b>: Uniportal subxiphoid video-assisted thoracoscopic surgery resections are safe and provide advantages such as less postoperative pain and shorter hospital stays for patients.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 5","pages":"394-400"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054454","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":"An Ongoing Dilemma Amid Obesity Pandemic: Is Obesity Surgery Feasible in Turkish Adolescents? A Multicenter Study.","authors":"Osman Anil Savas, Caghan Peksen, Muhammed Kadir Yıldırak, Ozan Sen, Talar Vartanoglu Aktokmakyan, Ergin Arslan, Varlik Erol, Ahmet Turkcapar, Oktay Banlı, Aziz Sumer","doi":"10.1089/lap.2024.0086","DOIUrl":"https://doi.org/10.1089/lap.2024.0086","url":null,"abstract":"<p><p><b><i>Background:</i></b> A significant percentage of the adolescent population suffers from obesity and its related comorbidities in the modern era. However, the alteration of intestinal anatomy, lack of scientific evidence regarding its safety and efficacy, and various ethical obstacles make surgical intervention to treat obesity in this age group controversial. To address the short-term efficacy and safety of bariatric surgery in adolescent patients, we present the results of 170 adolescent patients with obesity in this study. <b><i>Materials and Methods:</i></b> The clinical data of 170 adolescent patients who underwent various bariatric surgeries from March 2012 to January 2020 were evaluated. The presented data include demographics, preoperative and postoperative 6-month body mass index (BMI), excess weight loss (EWL), total weight loss (TWL), comorbidities, pre- and postoperative medications, length of hospital stay (LoHS), and complications. <b><i>Results:</i></b> The mean age of the patients was 17 years. The mean BMI was 43.9. In addition, 21.2% of the patients had an obesity-related comorbidity. Laparoscopic sleeve gastrectomy was the most preferred surgical method (94.1%). The LoHS ranged between 3 and 12 days, with an average of 4 days, and no patients required intensive care unit admission. The mean postoperative 6-month BMI, EWL, and TWL were 30.17 kg/m², 77.7% [17.5%-139.1%], and 31.32% [7.6%-55.8%], respectively. The change in mean BMI values was found to be statistically significant (<i>P</i> < .05). Perioperative and postoperative complications occurred in 1.8% of the patients. <b><i>Conclusion:</i></b> Obesity surgery can be safely performed in adolescents, yielding desirable short-term outcomes and acceptable perioperative complication rates when conducted by adult bariatric and metabolic surgeons.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 5","pages":"431-435"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059664","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":"Natural Orifice Extraction Techniques (Natural Orifice Specimen Extraction and Natural Orifice Transluminal Endoscopic Surgery) for Left-Sided Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Bernardo Fontel Pompeu, Luiza Soares Guerra, Lucas Soares de Souza Pinto Guedes, Julia Hoici Brunini, Lucas Monteiro Delgado, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1089/lap.2025.0003","DOIUrl":"10.1089/lap.2025.0003","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Minimally invasive surgery is the standard approach for colorectal cancers and requires an abdominal incision for specimen removal. Natural orifice specimen extraction (NOSE) may improve outcomes, reducing trauma, and speeding postoperative recovery. This study compares both techniques regarding postoperative complications, operative outcomes, and recurrence. <b><i>Methods:</i></b> We searched PubMed, Scopus, and Cochrane Central Register of Clinical Trials for studies published up to November 2024. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model, and heterogeneity was assessed with <i>I</i>² statistics. Statistical analyses were conducted using R Software version 4.4.1 (R Foundation for Statistical Computing). <b><i>Results:</i></b> Four randomized controlled trials involving 439 patients with colorectal cancer were included, with 212 (48.2%) undergoing NOSE and 227 (51.7%) undergoing conventional laparoscopic specimen extraction. NOSE significantly reduced postoperative pain (visual analog scale score: mean difference [MD] -1.8; 95% confidence interval [CI] -2.5 to -1.1; <i>P</i> = .01), time to pass flatus (MD -0.8; 95% CI -1.1 to -0.6; <i>P</i> < .01), and surgical site infection rates (OR 0.15; 95% CI 0.03-0.69; <i>P</i> = .015) but was associated with a longer operative time (MD 11.1 minutes; 95% CI 1.5-20.6; <i>P</i> = .02). No significant differences were observed between the groups in bowel leaks, lymph nodes harvested, intraoperative blood loss, hospital stay duration, or local recurrence rates. <b><i>Conclusion:</i></b> NOSE was associated with reduced postoperative pain, faster time to pass flatus, and lower infection rates but required longer operative time than conventional laparoscopic specimen extraction. Other outcomes, including complications, operative characteristics, and recurrence, showed no significant differences between the techniques.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"379-387"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732925","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":"Benefits and Radiological Preference Criteria of Hybrid-Video-Assisted Thoracic Surgery in the Treatment of Pancoast Tumor. A Comparative Study with Open Approaches.","authors":"Melike Ülker, Volkan Erdoğu, Merve Ekinci Fidan, Celal Buğra Sezen, Ayşegül Çiftçi, Ece Yasemin Demirkol, Abdul Samed Alp, Reşit Akyel, Özgür İşgörücü, Muzaffer Metin","doi":"10.1089/lap.2024.0369","DOIUrl":"https://doi.org/10.1089/lap.2024.0369","url":null,"abstract":"<p><p><b><i>Background:</i></b> We tried to demonstrate the use and benefits of hybrid-video-assisted thoracic surgery (VATS) in Pancoast tumors by comparing it with open surgical approaches. <b><i>Methods:</i></b> Between January 2022 and January 2024, 29 patients operated for Pancoast tumor were retrospectively evaluated. Hybrid-VATS approach was used in 14 cases, while open surgery was used in 15 cases. The two groups were compared regarding demographic characteristics, preoperative and postoperative findings. Preoperative thoracic computed tomography findings were analyzed by an experienced radiologist to guide the choice of surgical approach. <b><i>Results:</i></b> The hybrid-VATS technique was statistically significantly superior to the thoracotomy group in terms of operative time and preoperative bleeding amount (<i>P</i>: .027, .012, respectively). There were statistically significantly fewer postoperative complications in the hybrid-VATS group (66.6% versus 21.4%, <i>P</i>:. 04). In preoperative thorax CT evaluation, the longest distance (>77 mm) at which the tumor invaded the chest wall was found to be statistically predictive in the choice of surgical approach (odds ratio: 7.3, <i>P</i>:. 01). <b><i>Conclusions:</i></b> Hybrid-VATS can be used in Pancoast tumor surgery in experienced centers with shorter operation time, less preoperative bleeding, and low postoperative complication rates compared with open surgery without compromising oncological principles. Preoperative thoracic CT may guide the choice of surgical approach.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":"35 5","pages":"412-418"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Gastrostomy Tube Placement: Avoid the Incision to Avoid the Complications.","authors":"Audra J Reiter, Faraz Longi, Benjamin L Thomae, Michela M Carter, Courtney J Harris, Caitlin Jacobs, Gwyneth A Sullivan, Timothy B Lautz, Mehul V Raval","doi":"10.1089/lap.2024.0036","DOIUrl":"10.1089/lap.2024.0036","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tremendous practice variation exists for placing gastrostomy tubes. The objective of this study was to determine if the operative approach is associated with 30-day complication rates. <b><i>Methods:</i></b> This single-center retrospective cohort study identified pediatric patients who underwent gastrostomy tube placement from June 2019 to April 2022. Gastrostomy approaches included laparoscopic, laparoscopic-assisted (incision at gastrostomy site), modified open (incision at gastrostomy site), and percutaneous endoscopic gastrostomy (PEG). Multivariable logistic regression models were performed to evaluate the association of 30-day complications and operative approach after controlling for prematurity and weight. <b><i>Results:</i></b> Among 521 gastrostomy patients, the median age was 10 months (interquartile range: 4-33 months), and 181 (34.9%) had a history of prematurity. Weight categories included 217 (41.6%) underweight, 272 (52.2%) normal weight, and 32 (6.1%) overweight. Patients underwent laparoscopic (<i>n</i> = 386, 74.1%), laparoscopic-assisted (<i>n</i> = 73, 14.0%), modified open (<i>n</i> = 33, 6.3%), and PEG (<i>n</i> = 27, 5.2%). Complications included reoperation (<i>n</i> = 17, 3.3%), readmission (<i>n</i> = 12, 2.3%), wound infection (<i>n</i> = 30, 5.8%), wound breakdown (<i>n</i> = 21, 4.0%), tube dislodgement (<i>n</i> = 23, 4.4%), granulation tissue (<i>n</i> = 107, 20.5%), and leakage (<i>n</i> = 33, 6.3%). Following adjustment, laparoscopic-assisted gastrostomy was associated with higher odds of any complication. Laparoscopic-assisted and modified open were associated with higher odds of wound breakdown. Laparoscopic-assisted and modified open were associated with higher odds of leakage. The operative approach was not associated with reoperation, readmission, wound infection, or tube dislodgement. <b><i>Conclusions:</i></b> Techniques for gastrostomy placement, which include an incision around the tube, were associated with higher rates of complications. To improve complication profiles for patients, surgeons should consider laparoscopic or percutaneous endoscopic gastrostomies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"419-424"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience With an Innovative Surgical Treatment Option for Gastroesophageal Reflux Disease: Results of 28 Patients in a Retrospective Analysis.","authors":"Moustafa Elshafei","doi":"10.1089/lap.2024.0390","DOIUrl":"10.1089/lap.2024.0390","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Standard-of-care gastroesophageal reflux disease (GERD) procedures are associated with adverse events (AEs) (i.e., dysphagia, gas-bloating). RefluxStop has been developed to circumvent these outcomes. This study presents the results of 28 patients managed with RefluxStop in Germany. <b><i>Methods:</i></b> Between July 2021 and November 2023, 28 patients with GERD underwent RefluxStop surgery, a novel laparoscopic antireflux procedure. Retrospective chart analysis with patient-informed consent was conducted to determine clinical outcomes, such as GERD Health-Related Quality of Life (GERD-HRQL) score, proton pump inhibitors (PPI) use, symptomatology, patient satisfaction, and perioperative AEs. <b><i>Results:</i></b> Baseline characteristics (<i>n</i> = 28): age 47 ± 13.1 years; 67.9% female; body mass index (BMI) 27.3 ± 4.1 kg/m²; 93% PPI use for 5.6 ± 2.7 years; and hiatal hernia in 100% of cases of mean (standard deviation [SD]) size 3.4 (0.8) cm, whereof 35.7% were large hiatal hernia (4-6 cm). At a mean (SD) follow-up of 14.1 (4.7) months, patients experienced 88.6% improvement in median (IQR) total GERD-HRQL score from a baseline of 35 (7.7) to 4 (4.2) at follow-up (<i>P</i> < .05). Preoperative dysphagia (35.7%) resolved completely in all patients (<i>P</i> < .001). The mean (SD) GERD-HRQL heartburn subdomain decreased by 90.6% from a baseline of 18.1 (6.1) to 1.7 (1.2) at follow-up and all patients (100%) had scores <5. Similarly, the mean (SD) regurgitation subdomain decreased from a baseline of 13.2 (4.7) to 2 (1.6) at follow-up and all patients (100%) had scores <5. Patient satisfaction was achieved in 96.4% of patients with no PPI use required in 93% of patients (<i>P</i> < .001); only one patient required PPIs for persistent GERD symptoms. No cases of reoperation or esophageal dilatation were performed. Minor intraoperative AEs occurred in seven patients (i.e., neck emphysema). <b><i>Conclusion:</i></b> RefluxStop provides excellent safety and effectiveness outcomes for GERD treatment. Dysphagia completely resolved (0%) with 88.6% improvement in median GERD-HRQL score and satisfaction achieved in 96.4% of patients. These promising results reproduced the outcomes noted in the RefluxStop CE trial in real-world settings.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"357-364"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732868","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}