Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques最新文献

{"title":"Multiple occlusions in extracranial arteries in patients with aortic arch syndrome: is minimally invasive treatment still possible? Technical aspects of the treatment based on our own experience and a review of the literature.","authors":"Piotr K Kaszczewski,&nbsp;Tomasz Ostrowski,&nbsp;Rafał Maciąg,&nbsp;Michał Elwertowski,&nbsp;Witold Chudziński,&nbsp;Zbigniew Gałązka","doi":"10.5114/wiitm.2020.94517","DOIUrl":"https://doi.org/10.5114/wiitm.2020.94517","url":null,"abstract":"<p><p>Takayasu arteritis is a large vessel vasculitis of granulomatous nature and unknown aetiology affecting predominantly the aorta and its major branches, which may lead to ischaemic symptoms of many organs including the central nervous system. To decrease the risk of neurological complications and improve the quality of life, an arterial revascularisation may be necessary. The treatment options include pharmacotherapy as well as both open surgical and endovascular procedures, which has to be carefully chosen to obtain clinical success. There is an ongoing debate on the advantages, possibilities, and indications for implementing endovascular and open surgical methods, especially in high-risk patients. In this article we present our own experience in the treatment of an unusually complex and high-risk patient with multiple occlusion of supra-aortic branches, focusing on the technical aspects of the procedures and the decision-making process, as well as to confront with contemporary medical knowledge.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"183-190"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2020.94517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25534517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoas density - an optimal sarcopaenic indicator associated with postoperative complications after colorectal resection for cancer?","authors":"Anna Pekařová,&nbsp;Matej Pekař,&nbsp;Marek Soltes,&nbsp;Lucia Havrlentová,&nbsp;Tereza Chovancová","doi":"10.5114/wiitm.2020.100880","DOIUrl":"https://doi.org/10.5114/wiitm.2020.100880","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopaenia seems to be predictive factor for postoperative morbidity and mortality after colorectal resection for cancer. Nevertheless, an ideal sarcopaenic indicator is still to be identified.</p><p><strong>Aim: </strong>To evaluate computed tomography (CT) measured total abdominal muscle area (TAMA), total psoas muscle area (TPA), and psoas density (PD) - previously described sarcopaenia indicators - as possible risk factors for postoperative complications in patients after curative colon and rectal resections for colorectal cancer.</p><p><strong>Material and methods: </strong>Consecutive patients after elective curative colon or rectal resection for cancer at a single institution were divided into cohorts with uncomplicated postoperative course or complications Clavien-Dindo grade I-II (Cl-Di 0-II) and complications Clavien-Dindo grade III-V (Cl-Di III-V). Cohorts were statistically tested for significant differences in TAMA, TPA, and PD calculated from preoperative staging CT scans at the level of the third lumbar vertebra.</p><p><strong>Results: </strong>Data of 112 patients were analysed from a prospectively run database; 65 underwent colon and 47 rectal resections. PD was significantly higher in the Cl-Di 0-II cohort compared to the Cl-Di III-V for both colon (42.67 ±6.52 vs. 40.11 ±7.57 HU, p = 0.002) and rectal resections (44.08 ±5.86 vs. 43.03 ±5.70HU, p = 0.016). TAMA and TPA failed to show significant differences.</p><p><strong>Conclusions: </strong>Psoas density is significantly decreased in patients with Clavien-Dindo grade III-V complications after curative resection for colon and rectal cancer. Due to the simplicity and affordability of its assessment from preoperative staging CT scan, it might be considered an optimal sarcopaenic indicator to be utilised in everyday practice.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"91-97"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/ac/WIITM-16-42413.PMC7991955.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How we prepared our operating theatre for patients with SARS-CoV-2 virus.","authors":"Justyna Rymarowicz,&nbsp;Michał Pędziwiatr,&nbsp;Piotr Major,&nbsp;Michał Nowakowski","doi":"10.5114/wiitm.2020.95090","DOIUrl":"https://doi.org/10.5114/wiitm.2020.95090","url":null,"abstract":"<p><p>The COVID-19 disease continues to cause a global pandemic. The University Hospital in Krakow has been designated as one of the COVID-19 hospitals. To prepare for the pandemic we needed to implement strategies that would protect the health care workers, reduce in-hospital transmission, and provide optimal care for the patients. In the operating department, these preparations involve the cooperation of multiple teams and can pose significant difficulties. Here, we describe measures taken in response to the COVID-19 outbreak. These include, adjustments made in OR set-ups, modification of workflow and processes, and the introduction of adequate personal protective equipment. We believe that these containment measures are required in order to provide an adequate quality of care to COVID-19 patient and to minimise the risk of cross-infection to staff members and other patients.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"117-122"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2020.95090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25533158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendation for cholecystectomy protocol based on intraoperative ultrasound - a single-centre retrospective case-control study.","authors":"Maciej Sebastian,&nbsp;Jerzy Rudnicki","doi":"10.5114/wiitm.2020.93999","DOIUrl":"https://doi.org/10.5114/wiitm.2020.93999","url":null,"abstract":"<p><strong>Introduction: </strong>There is a strong need to make laparoscopic cholecystectomy as safe as possible, but sometimes complications in the form of bile duct and/or vascular injury occur. The safe plane of dissection can be precisely identified with intraoperative ultrasound, ensuring reduction of the complication rate to a minimum.</p><p><strong>Aim: </strong>To evaluate the advantages of the cholecystectomy protocol based on the use of intraoperative ultrasound during laparoscopic and open cholecystectomy.</p><p><strong>Material and methods: </strong>The study group consisted of 700 patients with symptomatic cholecystolithiasis, which was divided into two subgroups: with the critical view of safety only (312 patients) and with the critical view of safety + laparoscopic/open cholecystectomy ultrasound (388 patients). Laparoscopic cholecystectomy and conversion in patients from the second subgroup were performed under the control of intraoperative ultrasound.</p><p><strong>Results: </strong>We did not observe any biliary complications, and the visualization of the common bile duct, the proper hepatic artery and the portal vein was obtained in every patient from the critical view of safety + laparoscopic/open cholecystectomy ultrasound group. The mean time of the operation was significantly shorter and the conversion, biliary injury and intraoperative bleeding rates were significantly lower in this group of patients.</p><p><strong>Conclusions: </strong>Intraoperative ultrasound is a very efficient and safe method of guidance, and its use should be standard along with the critical view of safety during cholecystectomy.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"54-61"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/bf/WIITM-16-40215.PMC7991927.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A grey zone of hyperamylasemia following endoscopic retrograde cholangiopancreatography: follow-up and differential diagnosis from acute pancreatitis.","authors":"Mikail Cakir,&nbsp;Adnan Hut,&nbsp;Okan Murat Akturk,&nbsp;Busra Ekinci Biçkici,&nbsp;Dogan Yildirim","doi":"10.5114/wiitm.2020.94545","DOIUrl":"https://doi.org/10.5114/wiitm.2020.94545","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a tool often used for treating and diagnosing pancreaticobiliary diseases. One of the important complications of ERCP is pancreatitis. Even though transient hyperamylasemia is a more common and benign situation, it must be distinguished from post-ERCP pancreatitis.</p><p><strong>Aim: </strong>To define the risk factors associated with post-ERCP pancreatitis (PEP) and tried to identify a cutoff about laboratory findings for positive or negative prediction.</p><p><strong>Material and methods: </strong>We reviewed the medical files of patients who underwent ERCP for choledocholithiasis in a retrospective cohort study. The primary outcome is the risk factors associated with PEP. Receiver operator characteristics analysis was carried out for determination of cut-offs for laboratory parameters.</p><p><strong>Results: </strong>The presence of cholangitis (p = 0.018), Wirsung cannulation (p = 0.008), presence of abdominal pain at 12^th and 24^th h (p < 0.001), amylase level at 12^th h (p < 0.001), C-reactive protein (CRP) levels at 6^th and 12^th h (p = 0.001 and p < 0.001), white blood cells (WBC) levels at 6^th and 12^th h (p = 0.001 and p < 0.001) were significant for development of PEP. CRP levels above 8 mg/l and WBC above 10 × 10³ had negative predictive values over 70% and 90% respectively.</p><p><strong>Conclusions: </strong>Physical examination and inflammatory parameters are important in diagnosis of PEP. CRP and WBC have high negative predictivity and sensitivity. Amylase level increase was most apparent 12 h after ERCP and significantly higher (p < 0.001) for the development of PEP. The first abdominal pain evaluation is meaningful at the 12^th h timepoint because insufflation during the procedure and other causes of abdominal pain may result in misinterpretation.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"38-44"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2020.94545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"En-bloc resection of urinary bladder tumour - a prospective controlled multicentre observational study.","authors":"Sławomir Poletajew,&nbsp;Wojciech Krajewski,&nbsp;Paweł Stelmach,&nbsp;Jan Adamowicz,&nbsp;Łukasz Nowak,&nbsp;Marco Moschini,&nbsp;Piotr Zapała,&nbsp;Tomasz Drewa,&nbsp;Andrzej Paradysz,&nbsp;Piotr Radziszewski,&nbsp;Romuald Zdrojowy,&nbsp;Piotr Kryst","doi":"10.5114/wiitm.2020.95399","DOIUrl":"https://doi.org/10.5114/wiitm.2020.95399","url":null,"abstract":"<p><strong>Introduction: </strong>Transurethral resection of bladder tumour (TURBT) is one of the most commonly performed urologic procedures. Because of the shortcomings of conventional TURBT, the en-bloc resection concept was created.</p><p><strong>Aim: </strong>To analyse the influence of en-bloc technique on surgical and oncological outcomes of TURBT performed with electric current.</p><p><strong>Material and methods: </strong>This non-randomized, prospective controlled multicentre study enrolled 427 consecutive patients undergoing TURBT performed by five experienced endourologists in five academic institutions. Choice of procedure was at the discretion of the surgeon. The vast majority of patients underwent monopolar resection. The en-bloc procedure was performed with Collin's knife or the classic resection loop. Study end-points were surgery, catheterization and hospitalization time, presence of muscularis propria (MP) in the specimen and 3-month recurrence-free survival (RFS).</p><p><strong>Results: </strong>The study included 427 (274 conventional TURBT vs. 153 en-bloc) patients with mean age of 69 years (range: 18-99). There were more cases with MP present in the specimen in the en-bloc group (91.3% vs. 75.5%; p < 0.001). Surgery and hospitalization times were statistically shorter in the en-bloc group (both p < 0.05). A borderline significant difference was noted when the number of residual tumours in reTURBTs was analysed, with fewer cases of residual tumour in the en-bloc group (p = 0.051). RFS at 3 months was higher in the en-bloc group (88.4% vs. 80.1%; p = 0.027). After propensity score matching, differences in MP presence, hospitalization time and 3-month RFS status remained statistically significant.</p><p><strong>Conclusions: </strong>When compared to conventional TURBT, en-bloc resection of bladder tumour is associated with higher percentage of MP presence in histopathological specimen, higher 3-month RFS and shorter hospitalization time.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"145-150"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/96/WIITM-16-40689.PMC7991935.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25533545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel technique for identification of the pulmonary intersegmental plane using manual jet ventilation during pulmonary segmentectomy.","authors":"Shima Taguchi,&nbsp;Noboru Saeki,&nbsp;Atsushi Morio,&nbsp;Ryuji Nakamura,&nbsp;Satoshi Kamiya,&nbsp;Tsuyoshi Ikeda,&nbsp;Kyoko Oshita,&nbsp;Hiroshi Hamada,&nbsp;Yoshihiro Miyata,&nbsp;Morihito Okada,&nbsp;Yasuo M Tsutsumi","doi":"10.5114/wiitm.2020.95919","DOIUrl":"https://doi.org/10.5114/wiitm.2020.95919","url":null,"abstract":"<p><strong>Introduction: </strong>For successful pulmonary segmentectomy, the identification of boundaries between segments is important. Previous measures include tracing the intersegmental vessels by staining with a dye via the affected pulmonary artery or bronchus and inflating with oxygen via a high frequency ventilator. However, problems with these methods have been reported.</p><p><strong>Aim: </strong>We developed a novel method using a manual jet ventilator (MJV) and investigated its efficacy in identification of the pulmonary intersegmental plane.</p><p><strong>Material and methods: </strong>Patients underwent MJV for pulmonary segmentectomy in the period from January 2013 to December 2017 at our institution. The patients' characteristics, resected segments, availability of clear resection planes, and complications associated with MJV from medical records were investigated. A questionnaire survey was conducted with the surgeons on the effectiveness of lung segment identification using MJV.</p><p><strong>Results: </strong>Of 199 cases of planned pulmonary segmentectomy, 171 cases with descriptions of identified intersegmental planes were analyzed. Of these, 152 (89%) cases showed a clear boundary. There were 19 cases where the exact boundaries were not clearly identified, but segmentectomy was still performed. Furthermore, we found that identification of the right upper lobes was difficult (p = 0.0028). A subjective questionnaire was answered by the 12 surgeons who performed the procedures. All 12 responded that MJV was very effective or effective regarding clarity, safety, shorter identification time, and shorter resection time.</p><p><strong>Conclusions: </strong>MJV enabled surgeons to more easily and safely identify the pulmonary intersegmental plane, thereby suggesting that MJV has clinical significance during pulmonary segmentectomy.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"169-174"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/19/WIITM-16-40820.PMC7991954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25534515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experience with laparoscopic treatment of liver tumors using a separable cluster electrode with a no-touch technique.","authors":"Hyun Pyo Hong,&nbsp;Jee Youn Lee,&nbsp;Mi Yeon Lee,&nbsp;Kyung Uk Jung,&nbsp;Byung Ik Kim,&nbsp;Byung Ho Son,&nbsp;Jun Ho Shin,&nbsp;Sung Ryol Lee","doi":"10.5114/wiitm.2020.95065","DOIUrl":"https://doi.org/10.5114/wiitm.2020.95065","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation (RFA) is one of the best curative treatments for hepatocellular carcinoma in selected patients, and this procedure can be applied either percutaneously or laparoscopically. Laparoscopic RFA has the benefit of direct visual control of the RFA procedure. Cluster electrodes (Octopus RF electrodes) can create a common ablation zone.</p><p><strong>Aim: </strong>Using these two methods (laparoscopic approach and no touch technique), this present study evaluated the technical and clinical outcomes of early experience with laparoscopic RFA and a no-touch technique.</p><p><strong>Material and methods: </strong>Between November 2015 and November 2018, 21 patients underwent laparoscopic RFA for hepatocellular carcinoma with a no-touch technique using cluster electrodes. Laparoscopic RFA is recommended for patients with a contraindication for surgical resection, patients wants and a relative contraindication for conventional percutaneous RFA, such as lesions adjacent to the gastrointestinal tract, gallbladder, bile duct, or heart.</p><p><strong>Results: </strong>In the 21 tumors, 2 were treated with a single electrode, 12 with 2 electrodes, and 7 tumors with 3 electrodes. The mean time of ablation per lesion was 20.43 ±8.77 min. There was no mortality, local tumor progression, delayed destructive biliary damage, or liver abscess at the follow-up computed tomography. No technical failures occurred.</p><p><strong>Conclusions: </strong>Laparoscopic RFA can access lesions for which percutaneous RFA is contraindicated or risky. Cluster electrodes can create sufficient ablation zones without contact and can achieve a sufficient margin with a low complication rate and no tumor dissemination. Therefore, laparoscopic RFA with a no-touch technique might be a safe and feasible treatment for HCC tumor in selected patients.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"76-82"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/08/WIITM-16-40573.PMC7991943.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic management of early GI tract bleeding in a group of bariatric patients undergoing a fast track protocol.","authors":"Michał Szymański,&nbsp;Iwona Marek,&nbsp;Andrzej Hellmann,&nbsp;Agastya Patel,&nbsp;Justyna Bigda,&nbsp;Łukasz Kaska,&nbsp;Monika Proczko-Stepaniak","doi":"10.5114/wiitm.2020.99146","DOIUrl":"https://doi.org/10.5114/wiitm.2020.99146","url":null,"abstract":"<p><strong>Introduction: </strong>Enhanced recovery after bariatric surgery (ERABS) and other fast track protocols are currently being implemented in bariatric surgery. This approach has several benefits. However, early complications may occur and require urgent re-hospitalization and management. Gastrointestinal (GI) bleeding following bariatric surgery remains one of the most serious complications requiring endoscopic treatment.</p><p><strong>Aim: </strong>To evaluate the potential influence of early endoscopic intervention on bariatric patients' management.</p><p><strong>Material and methods: </strong>A clinical database was searched for patients undergoing endoscopic treatment because of GI tract bleeding following bariatric surgery under the ERABS protocol. 14 out of 1431 patients operated on were identified and their data were extracted for the purposes of this study. Patients readmitted to the hospital due to developing GI tract bleeding (group 2) were compared with patients undergoing endoscopic intervention during the initial stay (group 1), for the same purpose.</p><p><strong>Results: </strong>We found no statistically significant differences in hemoglobin level or length of hospital stay before endoscopy between groups. Based on the analyzed data, the percentage of GI bleeding in patients operated on under the ERABS protocol in our center is 0.97% (n = 14). The rate of early (up to 30 days) readmissions due to GI tract bleeding is 0.4% (n = 5) with an overall early readmission rate of 0.91% (n = 13) in the study period since the ERABS protocol was implemented.</p><p><strong>Conclusions: </strong>Long-term effects (% total weight loss, %TWL) of bariatric surgery do not depend on the need of early endoscopic intervention and rehospitalization. Endoscopic intervention is a safe treatment modality, not associated with risk of reoperation or complications.</p>","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"139-144"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/5f/WIITM-16-41823.PMC7991939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25533543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative imaging evaluation of the absolute indication criteria for endoscopic submucosal dissection in early gastric cancer patients.","authors":"Hong-Peng Shi,&nbsp;Wei Wu,&nbsp;Ben-Yan Zhang,&nbsp;Maneesh-Kumarsing Beeharry,&nbsp;Tie-Nan Feng,&nbsp;Zheng-Gang Zhu,&nbsp;Fei Yuan,&nbsp;Zheng-Lun Zhu","doi":"10.5114/wiitm.2020.94270","DOIUrl":"https://doi.org/10.5114/wiitm.2020.94270","url":null,"abstract":"Introduction Gastric cancer (GC) is a common malignant tumor with a high mortality rate. Aim To determine the accuracy of preoperative imaging information obtained from the combined use of general gastroscopy (GS), endoscopic ultrasonography (EUS), and multi-detector computed tomography (MDCT) regarding absolute indication of endoscopic submucosal dissection (ESD) in early gastric cancer (EGC). Material and methods The relationship between clinical features of 794 EGC patients and lymph node metastasis (LNM) was analyzed. Multivariate logistic regression analysis was used to investigate the risk factors for LNM. Additionally, the accuracy of diagnosis of imaging techniques for ESD indications was determined by receiver operating characteristic (ROC) analysis. Results Data showed that tumor size > 2 cm (p = 0.0071), T1b stage (p < 0.0001), undifferentiated histology (p < 0.0001), and vascular invasion (p = 0.0007) were independent risk factors for LNM in patients with EGC. Indications for ESD have a specificity of 100% for the diagnosis of patients with LNM. Additionally, the diagnostic efficacy of the use of GS, EUS, and MDCT in identifying node positive status, T1a disease, tumor size ≤ 2 cm, and ulceration was found to be moderate with area under the curve (AUC) of receiver operating characteristic curve (ROC) of 0.71, 0.64, 0.72, and 0.68, respectively. Furthermore, the use of imaging techniques for overall indication criteria for ESD had a moderate utility value with an AUC of 0.71. Conclusions Our data suggested that, based on the combined use of GS, EUS, and MDCT, a high specificity of patient selection for ESD treatment can be achieved.","PeriodicalId":520827,"journal":{"name":"Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques","volume":" ","pages":"45-53"},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/wiitm.2020.94270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}