Mini-invasive surgery最新文献

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Current controversies with active surveillance management of small renal masses. 目前对小肾肿块积极监测管理的争议。

Mini-invasive surgery Pub Date : 2026-01-01 Epub Date: 2026-05-12 DOI: 10.20517/2574-1225.2025.151

Shane Kronstedt, Gal Saffati, Benjamin Yu, David E Hinojosa-Gonzalez, David Dothan, Muammer Altok, Eric A Singer, Eric C Kauffman

{"title":"Current controversies with active surveillance management of small renal masses.","authors":"Shane Kronstedt, Gal Saffati, Benjamin Yu, David E Hinojosa-Gonzalez, David Dothan, Muammer Altok, Eric A Singer, Eric C Kauffman","doi":"10.20517/2574-1225.2025.151","DOIUrl":"10.20517/2574-1225.2025.151","url":null,"abstract":"Active surveillance (AS) management for patients with small renal masses (SRMs) is increasing globally, but questions remain regarding optimal AS practice. This review provides an evidence-based perspective on current controversies in SRM AS management. Considerable variation in AS utilization likely reflects non-standardization of patient selection criteria and differences among providers and healthcare settings. While most expert-consensus guidelines still restrict AS candidacy to patients with very small (< 1-2cm) renal tumors or significant health issues, increasing research supports AS to be an acceptable option for tumors up to 4 cm and a preferred option for many tumors up to 2 cm. For younger patients, AS appears oncologically safe but efficacy for long-term avoidance of delayed intervention (DI) remains unknown. Progression definitions for triggering DI still lack standardization, but there is general consensus for including thresholds based on some or all \"GLASS\" criteria [Growth rate; Longest tumor diameter; Adverse biopsy histology; Stage (≥ cT3a); Symptomatology]. SRM biopsy during AS can diagnose benign neoplasm with high accuracy to negate the need for DI, particularly when corroborated by computed tomography (CT) enhancement-based approaches such as tumor:cortex Peak Early Enhancement Ratio (PEER) scoring. In contrast, the value for biopsy in adverse histology detection remains more controversial. Advanced imaging modalities, including 99mTc-sestamibi single photon emission computed tomography (SPECT)/CT and [89Zr]Zr-girentuximab positron emission tomography (PET)/CT, may serve as useful adjuncts to biopsy during AS, while providing limited accuracy alone when biopsy is deferred. Future investigative efforts should focus on standardizing AS protocols, refining progression criteria for intervention, and addressing uncertainties about longer-term outcomes, particularly in younger patients.","PeriodicalId":521019,"journal":{"name":"Mini-invasive surgery","volume":"10 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698748","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}

引用次数: 0

Robotic-assisted minimally invasive esophagectomy: experience at the University of Pittsburgh Medical Center. 机器人辅助微创食管切除术：匹兹堡大学医学中心的经验。

Mini-invasive surgery Pub Date : 2025-01-01 Epub Date: 2025-06-24 DOI: 10.20517/2574-1225.2025.51

Marissa A Matto, Evan T Alicuben, Samuel Luketich, Sangmin Kim, Nicholas Baker, Inderpal S Sarkaria, James D Luketich

{"title":"Robotic-assisted minimally invasive esophagectomy: experience at the University of Pittsburgh Medical Center.","authors":"Marissa A Matto, Evan T Alicuben, Samuel Luketich, Sangmin Kim, Nicholas Baker, Inderpal S Sarkaria, James D Luketich","doi":"10.20517/2574-1225.2025.51","DOIUrl":"https://doi.org/10.20517/2574-1225.2025.51","url":null,"abstract":"Robotic-assisted minimally invasive esophagectomy (RAMIE) is increasingly used in the treatment of resectable esophageal cancer. This is a report on the current technique of RAMIE at University of Pittsburgh Medical Center (UPMC), including a summary of early data on 65 patient outcomes reported in an ongoing esophageal cancer database. To date, we have performed over 200 cases of RAMIE at UPMC from September 2013 to July 2024, and the analysis of the data will be presented soon. The practice has evolved into a near-total RAMIE experience for several surgeons, while others remain in a learning curve. It is our experience that the initial performance of RAMIE requires strong mentoring by an experienced robotic surgeon. However, at this time, we are unable to provide guidelines for specific case numbers to achieve proficiency. As more patients with esophageal cancer are treated with robotic-assisted minimally invasive esophagectomy (MIE) at UPMC, data have shown that patient outcomes are not compromised compared with that of traditional MIE. In fact, RAMIE may demonstrate superiority in the median number of lymph nodes harvested, which could contribute to increased accuracy in pathologic staging. This approach has developed a strong surgeon preference for both new graduates and experienced MIE surgeons alike.","PeriodicalId":521019,"journal":{"name":"Mini-invasive surgery","volume":"9 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987228","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}

引用次数: 0

Gastroesophageal reflux disease related to laparoscopic sleeve gastrectomy. 与腹腔镜袖式胃切除术相关的胃食管反流病。

Mini-invasive surgery Pub Date : 2025-01-01 Epub Date: 2025-08-26 DOI: 10.20517/2574-1225.2024.105

Anisa Shaker, Edy Soffer

引用次数: 0