Journal of laparoendoscopic & advanced surgical techniques. Part A最新文献

{"title":"Systematic Review and Bayesian Network Meta-Analysis Comparing Laparoscopic Heller Myotomy, Pneumatic Dilatation, and Peroral Endoscopic Myotomy for Esophageal Achalasia.","authors":"Alberto Aiolfi, Davide Bona, Carlo Galdino Riva, Giancarlo Micheletto, Emanuele Rausa, Giampiero Campanelli, Giorgia Olmo, Gianluca Bonitta, Luigi Bonavina","doi":"10.1089/lap.2019.0432","DOIUrl":"10.1089/lap.2019.0432","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic Heller myotomy (LHM), pneumatic dilatation (PD), and peroral endoscopic myotomy (POEM) are common treatments for esophageal achalasia. Literature evidence is restricted to pairwise analysis and PD versus POEM comparison is missing. The aim of this network meta-analysis (NMA) was to comprehensively compare outcomes within these three surgical approaches with those of esophageal achalasia. <b><i>Materials and Methods:</i></b> PubMed, EMBASE, and Web of Science databases were consulted. A systematic review and a fully Bayesian study level arm-based random effect NMA were performed. <b><i>Results:</i></b> Nineteen studies (14 observational and 5 randomized controlled trial) and 4407 patients were included. Overall, 50.4% underwent LHM, 42.8% PD, and 6.8% POEM. The postoperative dysphagia remission was statistically significantly improved in POEM compared with LHM and PD (risk ratio [RR] = 1.21; 95% credible intervals [CIs] = 1.04-1.47 and RR = 1.40; 95% CIs = 1.14-1.79, respectively). Postoperative gastroesophageal reflux disease (GERD) rate was higher in POEM than in LHM and PD (RR = 1.75; 95% CIs = 1.35-2.03 and RR = 1.36; 95% CIs = 1.18-1.68, respectively). Postoperative Eckardt score was significantly lower in POEM than in LHM and PD (standardized mean difference (smd) = -0.6; 95% CIs = -1.4 to -0.2 and smd = -1.2; 95% CIs = -2.3 to -0.2, respectively). No statistically significant differences were found comparing LHM and PD in any of the analyzed outcomes. <b><i>Conclusions:</i></b> In the short-term follow-up, POEM seems to be associated with better dysphagia improvement and higher postoperative GERD than LHM and PD. The choice of the ideal initial management should be left to multidisciplinary team discussion and personalized on each patient basis.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"147-155"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Study of Robotic Thyroidectomies Through a Bilateral Axillo-Breast Approach and a Transoral Approach.","authors":"Sumin Chae,&nbsp;Sun Young Min,&nbsp;Won Seo Park","doi":"10.1089/lap.2019.0585","DOIUrl":"https://doi.org/10.1089/lap.2019.0585","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Oncological and surgical safeties are pivotal issues of cancer operations. Robotic thyroidectomy adds cosmetic advantage to those safeties. We have performed bilateral axillo-breast approach robotic thyroidectomies (BABART) since 2009 and recently started transoral robotic thyroidectomy (TORT) in 2017. This study aimed to compare the surgical outcomes of a single surgeon's initial TORT and BABART. <b><i>Materials and Methods:</i></b> We retrospectively collected data of 103 patients who underwent robotic thyroid lobectomy for papillary thyroid cancer and analyzed the first 14 and 56 cases of TORT and BABART, respectively, after propensity score matching. The surgeon performed 224 BABARTs before starting TORT. <b><i>Results:</i></b> There were no significant differences between the BABART and TORT groups in mean age (40.02 ± 9.37 versus 38.69 ± 9.21 years, respectively; <i>P</i> = .7520), sex distribution (<i>P</i> = .3697), mean body mass index (23.60 ± 4.31 versus 23.87 ± 2.45 kg/m², respectively; <i>P</i> = .4737), and tumor size (0.75 ± 0.35 versus 0.76 ± 0.29 cm, respectively; <i>P</i> = .9969). The TORT group had a longer operative time than the BABART group by 78.04 minutes (<i>P</i> < .0001). The visual analog scale pain scores on postoperative day (POD) 2 and POD 3 were higher in the TORT than the BABART group by 0.59 and 0.77, respectively (<i>P</i> = .0227 and .0119, respectively). The number of retrieved lymph nodes and unintended parathyroidectomies was similar in the two groups. There were no severe complications such as tracheal injury, transection of recurrent laryngeal nerve, or surgical site infection. <b><i>Conclusion:</i></b> Our study suggests that both BABART and TORT are safe and feasible during the initial period. TORT can be undertaken without any adverse event if the operator is experienced with other robotic thyroidectomy. The patients may choose the surgical approach based on their preference.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"175-182"},"PeriodicalIF":1.3,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2019.0585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Sleeve Gastrectomy: How Do I Do It.","authors":"Mariano Palermo,&nbsp;Edgardo Serra","doi":"10.1089/lap.2019.0452","DOIUrl":"https://doi.org/10.1089/lap.2019.0452","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. LSG is a safe and effective primary bariatric procedure with durable weight loss. We believe LSG should not be called \"easy\" and should be performed only by surgeons trained in bariatric surgery. <b><i>Method:</i></b> We describe the technique, step by step, we use to perform a sleeve gastrectomy (SG). <b><i>Results:</i></b> The highlights of a safer SG systematization are based on minimum 36Fr bougie calibration, starting 4-5 cm from the pylorus, keeping ∼1 cm distance from esophagus. We routinely use staple line reinforcement by continuous suture. <b><i>Conclusions:</i></b> LSG is a safe and effective primary bariatric procedure with durable weight loss. It should be performed only by surgeons trained in bariatric surgery.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"2-5"},"PeriodicalIF":1.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2019.0452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Transluminal Necrosectomy for Acute Pancreatitis to Stent in Stent Therapy: Step-Up Approach Leads to Low Mortality and Morbidity Rates in 302 Consecutive Cases of Acute Pancreatitis.","authors":"Helwig V Wundsam,&nbsp;Georg O Spaun,&nbsp;Franziska Bräuer,&nbsp;Christoph Schwaiger,&nbsp;Ines Fischer,&nbsp;Reinhold Függer","doi":"10.1089/lap.2018.0768","DOIUrl":"https://doi.org/10.1089/lap.2018.0768","url":null,"abstract":"<p><p><b><i>Background:</i></b> The step-up approach, using either flexible endoscopy or a minimal invasive retroperitoneal access, has reduced mortality and morbidity in patients with acute pancreatitis. The use of fully covered self-expanding metal stents (FCSEMS) or lumen apposing metal stents (LAMS) facilitates endoscopic necrosectomy and drainage of walled-off necrosis (WON). The aim of our analysis was to investigate the 30/90/365-day mortality and morbidity rates of the subtypes of the revised Atlanta classification for acute pancreatitis. <b><i>Materials and Methods:</i></b> We conducted a retrospective analysis of all patients (<i>n</i> = 302) treated with acute pancreatitis in our institution from January 2014 to July 2017. Mortality, morbidity, management of fluid collections, interventions, complications, and new onset of diabetes were recorded. <b><i>Results:</i></b> In 30.8% (<i>n</i> = 93/302) of patients, pancreatic fluid collection developed. Out of these, 58.1% (54/93) required intervention, consisting of endoscopic treatment in 63% (34/54) or multidisciplinary approach in 37% (20/54). Overall, 90-day mortality rate according to Kaplan-Meier Estimator was 3.7%. Overall, 1-year mortality rate was 6.2%. One-year mortality for uncomplicated acute pancreatic fluid collection, pseudocyst, and WON were 5.4%, 2.6%, and 13.5%, respectively. Hemorrhage in case of metal stent treatment (FCSEMS/LAMS) occurred in 14.3%. If LAMS was combined with double pigtail stent-in-stent, bleeding was seen in 5.3%. No transperitoneal necrosectomy was needed. <b><i>Conclusions:</i></b> Treating acute pancreatitis with a step-up approach, including stent-in-stent procedures, leads to low mortality rates and few stent-associated bleeding complications and minimizes necessity for open transperitoneal surgical necrosectomy.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"891-899"},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40536859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Versus Open Pancreaticoduodenectomy: An Up-to-Date Meta-Analysis of Comparative Cohort Studies.","authors":"Yunxiao Lyu,&nbsp;Yunxiao Cheng,&nbsp;Bin Wang,&nbsp;Yueming Xu,&nbsp;Weibing Du","doi":"10.1089/lap.2018.0460","DOIUrl":"https://doi.org/10.1089/lap.2018.0460","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis were performed to summarize available evidence comparing totally minimally invasive pancreaticoduodenectomy (TMIPD) versus open pancreaticoduodenectomy (OPD) Materials and Methods: We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for comparative cohort studies published from January 1990 through April 2018 comparing TMIPD versus OPD. Outcomes evaluated were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postoperative hemorrhage, wound infection, estimated blood loss, transfusion rate, retrieved lymph nodes (RLNs), R0 rate, reoperation rate, length of hospital stay, and mortality. Statistical analysis was performed with Review Manager, version 5.3 (Cochrane Collaboration).</p><p><strong>Results: </strong>Sixteen comparative studies were included. Meta-analysis showed no significant difference between TMIPD and OPD in rates of POPF (risk ratio [RR] = 0.80; 95% confidence interval [CI]: 0.58-1.11; P = .18), DGE (RR = 0.80; 95% CI: 0.63-1.01; P = .06), postoperative hemorrhage (RR = 1.32; 95% CI: 0.87-2.00; P = .19), or reoperation (RR = 0.68; 95% CI: 0.45-1.05; P = .08). TMIPD resulted in fewer wound infections (RR = 0.49; 95% CI: 0.33-0.74; P = .0006), less blood loss (mean difference [MD] = 371.65 mL; 95% CI: -473.77 to -269.53; P < .00001), and lower transfusion rate (RR = 0.59; 95% CI: 0.48-0.72; P < .00001) than OPD. No significant differences were found in the rate of R0 resection (P = .32), RLNs (P = .09), hospital stay (P = .73), or mortality (P = .67). However, TMIPD had much longer operative times than OPD (MD = 80.78 minutes; 95% CI: 29.25-132.31; P = .002).</p><p><strong>Conclusion: </strong>TMIPD appears to be as safe and effective as OPD for periampullary disease. These findings need confirmation with large volume well-designed randomized controlled trials.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"449-457"},"PeriodicalIF":1.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laparoscopic Versus Open Gastrectomy for Treatment of Gastric Cancer: Analysis of a Textbook Outcome.","authors":"Pablo Priego,&nbsp;Marta Cuadrado,&nbsp;Araceli Ballestero,&nbsp;Julio Galindo,&nbsp;Eduardo Lobo","doi":"10.1089/lap.2018.0489","DOIUrl":"https://doi.org/10.1089/lap.2018.0489","url":null,"abstract":"<p><strong>Introduction: </strong>Open gastrectomy (OG) has long been the preferred surgical approach worldwide for treatment of gastric cancer (GC). Nowadays, several randomized prospective trials have confirmed improvements in postoperative outcomes for laparoscopic gastrectomy (LG) compared with open procedures, with similar oncologic outcomes. However, many of these studies come from Eastern countries.</p><p><strong>Materials and methods: </strong>A prospective nonrandomized study was conducted with all patients operated of GC at Ramón y Cajal University Hospital from January 2015 to December 2017. Of the 96 patients enrolled, 47 patients underwent LG and 49 OG. Textbook outcome was defined as the percentage of patients who underwent a complete tumor resection with at least 15 lymph nodes (LNs) in the resected specimen and an uneventful postoperative course, without hospital readmission.</p><p><strong>Results: </strong>A textbook outcome was achieved in 51.04% of patients operated of GC. The outcome parameter \"no severe postoperative complication\" had the greatest negative impact on the textbook outcome. A statistically higher number of patients with early cancer (40% versus 16.3%) and subtotal gastrectomy (57.5% versus 34.7%) were found in the laparoscopic group. No statistical differences were found between open and laparoscopic approaches regarding operating time, rate of microscopic margin positivity, hospital stay, number of retrieved LNs, complications, reinterventions, mortality, and readmissions. No statistical differences in textbook outcome were found between both groups (57.14% versus 45%; P = .25).</p><p><strong>Conclusions: </strong>LG for treatment of GC seems to be safe and feasible with similar textbook outcomes compared with OG.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"458-464"},"PeriodicalIF":1.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40444898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Operative Times and Mesh Utilization on Paraesophageal Hernia Repair: Analysis of 30-Day Outcomes from the American College of Surgeons National Surgical Quality Improvement Project Database.","authors":"Matthew Skancke,&nbsp;Fred Brody,&nbsp;Ivy N Haskins,&nbsp;Richard Amdur,&nbsp;Clint Schoolfield","doi":"10.1089/lap.2018.0369","DOIUrl":"https://doi.org/10.1089/lap.2018.0369","url":null,"abstract":"<p><strong>Background: </strong>Using mesh to buttress the crural repair following a paraesophageal hernia repair remains controversial. This article evaluates recent trends in laparoscopic paraesophageal hernia repairs and analyzes the impact of mesh and operative time on postoperative morbidity.</p><p><strong>Methods: </strong>The 2013-2015 American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database was queried for elective laparoscopic paraesophageal hernia repair with and without mesh. Operative times were grouped into quartiles and statistical analysis was performed using analysis of variance univariate with post hoc testing and multivariate regression modeling. The outcomes of interest were composite morbidity scores and readmission rates within 30 days of surgery.</p><p><strong>Results: </strong>The database identified a cohort of 6234 laparoscopic paraesophageal hernia repairs. Mesh was utilized in 42% of cases per year and did not change over the study period (P = .367). Mesh was used 37%, 40%, 43%, and 49% of the time within operative quartiles 1, 2, 3, and 4, respectively (P < .001). Postoperative morbidity and readmission rates for each operative time quartile were 2.8%, 4.1%, 5.42%, and 6.13% (P < .001) and 4.4%, 5%, 6.2%, and 7.6% (P = .001), respectively. Post hoc testing indicated statistically significant differences in postoperative morbidity and readmission rates between quartiles 1 and 3/4. Multivariate regression analysis documented operative time as a risk factor for postoperative morbidities and readmission. Simply using mesh was not directly associated with postoperative morbidity.</p><p><strong>Conclusion: </strong>Mesh utilization does not impact postoperative outcomes; however, as operative time increases, the incidence of postoperative morbidity also increases.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"303-308"},"PeriodicalIF":1.3,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40531738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Adnexal Torsion: A 13-Year Experience in Single Tertiary Center.","authors":"Osman Balci,&nbsp;Hasan Energin,&nbsp;Hüseyin Görkemli,&nbsp;Ali Acar","doi":"10.1089/lap.2018.0307","DOIUrl":"https://doi.org/10.1089/lap.2018.0307","url":null,"abstract":"<p><strong>Purpose: </strong>Adnexal torsion constitutes 2.7% of gynecological emergencies, it is more frequently seen in reproductive age. Delay in diagnosis and treatment may lead to loss of the ovary. In this study, we aimed to assess patients who had adnexal torsion and compare laparoscopy with laparotomy in the treatment of these patients and point the most appropriate surgery according to age groups of the patients and comparison of patient characteristics and management between adnexal torsion in postmenopausal and premenopausal patients.</p><p><strong>Materials and methods: </strong>This study was carried out in Necmettin Erbakan University, Meram Medicine Faculty, Department of Obstetrics and Gynecology. The study retrospectively analyzed 380 patients presented to our clinic with abdominal pain between January 2005 and December 2017 and had surgery for adnexal torsion.</p><p><strong>Results: </strong>The study included 380 patients who had surgery for adnexal torsion. A total of 220 patients had laparoscopy and 160 patients had laparotomy. Laparoscopy group consisted of young patients with low parity, whereas laparotomy group consisted of 160 patients of which 92 (57.5%) were in menopause. Teratomas were the most common pathological finding followed by follicular cysts. Fourteen ovarian malignancies and 11 borderline tumors had been reported. Eleven ovarian malignancies had been reported in postmenopausal patients and three in premenopausal patients.</p><p><strong>Conclusion: </strong>Laparoscopic surgery is preferred for young patients who want to preserve their fertility, but postmenopausal ovarian masses presenting with torsion should be analyzed with frozen section whenever possible, if not possible or not conclusive, staging surgery is more appropriate especially if there is suspicion of malignancy.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"293-297"},"PeriodicalIF":1.3,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40554745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Laparoscopic Surgery for T4 Colon Cancer Compared with Open Surgery: A Single Center's Experience.","authors":"Jiabao Lu,&nbsp;Boye Dong,&nbsp;Zhipeng Yang,&nbsp;Yixian Song,&nbsp;Yang Yang,&nbsp;Jie Cao,&nbsp;Wanglin Li","doi":"10.1089/lap.2018.0214","DOIUrl":"https://doi.org/10.1089/lap.2018.0214","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery for T4 colon cancer remains controversial according to many colorectal cancer guidelines. The aim of this study was to compare short- and long-term outcomes in patients who underwent T4 colon cancer resection by laparoscopy versus open surgery.</p><p><strong>Methods: </strong>Patients who underwent T4 colon cancer resection either by laparoscopy or by open surgery between January 2012 and January 2017 were included and used to perform a retrospective cohort analysis. Demographics, patient characteristics, short-term outcomes, and long-term oncological outcomes were compared between two groups. Multivariate analyses were used to define prognostic factors of overall survival.</p><p><strong>Results: </strong>Groups were comparable in terms of preoperative characteristics and demographics. Intraoperative blood loss (127.3 versus 226.1 mL, P = .001) and hospital stay (11.6 versus 14.8 days, P = .001) were significantly reduced in the laparoscopic group compared with the open group. Operative time, bowel movement, time to soft diet, and lymph nodes harvested did not significantly differ between the two groups. R0 resection achieved 100% in both the groups. Similarly, the overall survival rate and disease-free survival rate in stage II and stage III disease showed no significant differences. Multivariate analyses showed that intraoperative blood loss was a significantly independent factor related to a poor prognosis.</p><p><strong>Conclusions: </strong>This study suggests that laparoscopy for T4 colon cancer can be safely performed with superior short-term outcomes, such as less intraoperative blood loss and shorter time of hospital stay compared with open surgery, and with similar long-term oncological outcomes. Therefore, laparoscopic procedure could be a viable option in selected patients.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"333-339"},"PeriodicalIF":1.3,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40533805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Endoluminal Sharp Recanalization of Occluded Inferior Vena Cava in Budd-Chiari Syndrome.","authors":"Yonghua Bi,&nbsp;Zepeng Yu,&nbsp;Pengxu Ding,&nbsp;Jianzhuang Ren,&nbsp;Pengli Zhou,&nbsp;Xinwei Han","doi":"10.1089/lap.2018.0385","DOIUrl":"https://doi.org/10.1089/lap.2018.0385","url":null,"abstract":"<p><strong>Purpose: </strong>To report the long-term results of endoluminal sharp recanalization of occluded inferior vena cava (IVC) in patients with the Budd-Chiari syndrome (BCS).</p><p><strong>Patients and methods: </strong>Seventy-two consecutive patients with BCS and IVC occlusion underwent endoluminal recanalization of the IVC occlusion during a 6-year period. BCS with occlusive IVC was detected by reviewing patient history and color Doppler ultrasonography. Data on technical success, morbidity, mortality, complications, and color Doppler sonographic outcome were collected and analyzed.</p><p><strong>Results: </strong>Seventy-seven recanalizations were performed in 72 patients. Technical success (patent IVC with good blood flow) was achieved in 70 (97.4%) patients. No perioperative death was observed. Six complications were found during recanalization, and 10 complications were found for total interventional procedures. The complication rates were 7.8% and 7.3% for recanalization and total procedure, respectively. Bleeding of access veins was the most common complication, and 2 patients showed slight rupture of IVC. The postoperative IVC diameter and blood speed of IVC increased significantly. Fifty-seven patients (79.2%) were clinical cured, and 2 patients (2.8%) showed no improvement. The 1-year, 3-year, and 5-year primary patency rates were 92.5%, 86.8%, and 77.3%, respectively. The second patency rates were 100.0%, 97.8%, and 91.8% for 1, 3, and 5 years, respectively. There were 2 deaths during follow-up.</p><p><strong>Conclusion: </strong>Endoluminal sharp recanalization of occluded IVC in patients with BCS is safe and effective with good long-term outcomes.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"309-315"},"PeriodicalIF":1.3,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40531766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}