Annals of Surgical Treatment and Research最新文献

{"title":"Predictive factors for postoperative ileus after elective right hemicolectomy performed on over 80% Enhanced Recovery After Surgery-adherent patients: a retrospective cohort study.","authors":"Mohamud Aden,Tom Scheinin,Shamel Ismail,Antti J Kivelä,Suvi Rasilainen","doi":"10.4174/astr.2024.107.3.158","DOIUrl":"https://doi.org/10.4174/astr.2024.107.3.158","url":null,"abstract":"PurposeLaparoscopic right hemicolectomy is the standard surgical approach for treatment of right-sided colonic neoplasms. Although performed within a strict Enhanced Recovery After Surgery (ERAS) program, patients still develop postoperative ileus. The aim of this study was to describe the factors responsible for postoperative ileus after right hemicolectomy in a patient population with over 80% ERAS adherence.MethodsIn this retrospective study, we analyzed 499 consecutive patients undergoing elective right-sided colectomy for neoplastic disease in a single high-volume center. All patients followed an updated ERAS program.ResultsThe overall median ERAS adherence was 80%. Patients with ≥ 80% adherence (n = 271) were included in further analysis. Their median ERAS adherence was 88.9% (interquartile range, 80-90; range, 80-100). Twenty-four of 271 patients (8.9%) developed postoperative ileus. A univariate regression analysis revealed carcinoma situated in the transverse colon, duration of operation over 200 minutes, and opiate consumption over 10 mg on the second postoperative day (POD) to be associated with a significantly higher risk of postoperative ileus. Multivariate regression analysis revealed that duration of surgery over 200 minutes (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.0-5.8; P = 0.045) and opiate consumption over 10 mg on POD 2 (OR, 4.8; 95% CI, 1.6-14.3; P = 0.005) independently predict a higher risk for postoperative ileus. The median length of hospital stay was significantly longer in patients with postoperative ileus (8 days vs. 3 days, P < 0.001). None of the 271 patients died during a 30-day follow-up.ConclusionLong duration of surgery, even minor postoperative opiate use, predict a higher risk for postoperative ileus in strictly ERAS-adherent patients undergoing laparoscopic right hemicolectomy.","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"10 1","pages":"158-166"},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269470","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":"Exposure to postoperative hypothermia and its association with complications after major abdominal surgery: a retrospective cohort study.","authors":"Saeyeon Kim, In-Ae Song, Tak Kyu Oh","doi":"10.4174/astr.2024.107.2.120","DOIUrl":"10.4174/astr.2024.107.2.120","url":null,"abstract":"<p><strong>Purpose: </strong>Many patients who undergo major abdominal surgery experience inadvertent hypothermia during the perioperative period. This study aimed to identify risk factors related to postoperative hypothermia and their association with postoperative complications.</p><p><strong>Methods: </strong>This retrospective cohort study used data from Seoul National University Bundang Hospital, a tertiary university medical center in South Korea, between January 1, 2018 and December 31, 2022. We included patients aged ≥18 years who underwent elective major abdominal surgery for more than 2 hours in the operating room. The patients were categorized into the hypothermia (body temperature <36.5℃) and non-hypothermia (body temperature ≥36.5℃) groups.</p><p><strong>Results: </strong>The study sample comprised 30,194 patients, and we classified 21,293 and 8,901 into the hypothermic and non-hypothermic groups, respectively. Some factors associated with the occurrence of postoperative hypothermia included the type of surgery. In the multivariable logistic regression model, the incidence of postoperative complications was 9% higher in the hypothermia group than in the non-hypothermic group (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01-1.19; P = 0.040). Among postoperative complications, the hypothermic group showed a 14% higher incidence of acute kidney injury (OR, 1.14; 95% CI, 1.04-1.25; P = 0.007) than the non-hypothermic group.</p><p><strong>Conclusion: </strong>The appearance of postoperative hypothermia during the first 30 minutes of the recovery period was significantly associated with the appearance of postoperative complications, especially acute kidney injury. However, further studies are required to validate these findings.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"120-126"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surface treatment of artificial implants with hybrid nanolayers: results of antibacterial tests, leachates and scanning electron microscope analysis.","authors":"Jiřĺ Škach, Irena Šlamborová, Peter Hromádka, Petr Exnar, Robert Gürlich","doi":"10.4174/astr.2024.107.2.108","DOIUrl":"10.4174/astr.2024.107.2.108","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the antibacterial efficacy of surface-treated hernia implants modified by a hybrid nanolayer with incorporated Ag, Cu, and Zn cations using the sol-gel method.</p><p><strong>Methods: </strong>The materials (polypropylene, polyester, and polyvinylidene difluoride) were activated by vacuum plasma treatment or UV C radiation, then modified and tested for bacterial strains of <i>Escherichia coli</i> (gram-negative) and <i>Staphylococcus aureus</i> (gram-positive). The AATCC 100 (2019) method for quantitative and the ISO 20645 agar plate propagation method for qualitative evaluation of microbiological efficacy were used. The gradual release of incorporated ions was monitored over time in simulated body fluids (blood plasma, peritoneal fluid) and physiological saline using an inductively coupled plasma mass spectrometer. The thickness and the homogeneity of the layers were measured for individual random samples with scanning electron microscope analysis (SEMA) and evaluated with an elemental analysis.</p><p><strong>Results: </strong>Qualitative and quantitative microbiological tests clearly show the great suitability of vacuum plasma and UV C with sol AD30 (dilution 1:1) surface treatment of the implants. The absolute concentration of Ag, Cu, and Zn cations in leachates was very low. SEMA showed a high degree of homogeneity of the layer and only very rare nanocracks by all tested materials appear after mechanical stress.</p><p><strong>Conclusion: </strong>This study confirms that surface treatment of meshes using the sol-gel method significantly increases the antibacterial properties. The nanolayers are sufficiently mechanically resistant and stable and pose no threat to health.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"108-119"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracorporeal anastomosis in minimally invasive right hemicolectomy: a nationwide survey of the Korean Society of Coloproctology.","authors":"Song Soo Yang, Bong Hyeon Kye, Sang Hee Kang, Chang Hyun Kim, Ji Hoon Kim, Woo Ram Kim, Kil Yeon Lee, In Kyu Park","doi":"10.4174/astr.2024.107.2.59","DOIUrl":"10.4174/astr.2024.107.2.59","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the current practices and perceptions of colorectal surgeons in South Korea regarding intracorporeal ileocolic anastomosis (IIA) in minimally invasive right hemicolectomy (RHC).</p><p><strong>Methods: </strong>Members of the Korean Society of Coloproctology (KSCP) participated in an online survey encompassing demographic information, surgical experiences, methods for IIA, and advantages, barriers, and perceptions of IIA. We performed a statistical analysis of survey results.</p><p><strong>Results: </strong>Among the 1,074 KSCP members contacted, 178 responded to the survey. Most respondents were males aged 40-49 years with >10 years of experience who were affiliated with a tertiary healthcare facility. One hundred fifty-six respondents had performed <100 colorectal cancer surgeries annually. Fifty-nine respondents reported experiences of the IIA technique in minimally invasive RHC. Most respondents favored the isoperistaltic side-to-side (S-S) anastomosis and stapled S-S anastomosis, hand-sewn closure for the common channel, and the periumbilical area for primary specimen extraction. Respondents with IIA experience emphasized the reduction in postoperative complications as the primary reason for performing IIA, whereas respondents without IIA experience cited the lack of benefits as the main deterrent. Respondents commonly cited concerns regarding anastomotic leakage and intraabdominal contamination as the primary reasons for not performing IIA. Respondents with IIA experience demonstrated a more positive response towards attempting or transitioning to IIA than those without. Respondents with IIA experience prioritized self-sufficiency, whereas respondents without IIA experience prioritized proctorship and discussions of the initial cases.</p><p><strong>Conclusion: </strong>Measures to standardize the IIA technique and appropriate training programs must be implemented to enhance its use in minimally invasive RHC.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"59-67"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve analysis for hand-assisted laparoscopic living donor nephrectomy: an analysis of 96 consecutive cases performed by a trained gastrointestinal surgeon.","authors":"Chang In Choi, Kyeong Jun Lee, Min Joo Kim, Jae-Kyun Park, Da Woon Kim, Hyo Jin Kim, Harin Rhee, Sang Heon Song, Eun Young Seong, Dae-Hwan Kim, Tae Yong Jeon, Hyuk Jae Jung","doi":"10.4174/astr.2024.107.2.81","DOIUrl":"10.4174/astr.2024.107.2.81","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to analyze the learning curve of hand-assisted laparoscopic living donor nephrectomy (HLDN) conducted by a trained gastrointestinal surgeon.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the perioperative clinical data of 96 consecutive patients who underwent HLDN from May 2013 to March 2023. The learning curve was evaluated using the cumulative sum (CUSUM) test based on operation time and risk-adjusted CUSUM for postoperative complications. Patients were divided into three groups (novice, development, and competency phases) based on changes in operation time. Patient demographics and perioperative outcomes were compared between each group.</p><p><strong>Results: </strong>Among the patients, 35 were male, with a mean age of 48.9 ± 11.3 years and a mean body mass index (BMI) of 24.5 ± 3.2 kg/m². The novice phase (phase 1) included the first 30 cases, with the development phase (phase 2) up to the 65th case. Operation times were significantly different across phases, averaging 263.2 ± 33.4, 211.1 ± 34.4, and 161.1 ± 31.3 minutes for phases 1, 2, and 3, respectively (P < 0.001). Blood loss decreased gradually across phases (phase 1, 264.7 ± 144.4 mL; phase 2, 239.7 ± 166.3 mL; phase 3, 198.8 ± 103.5 mL), though not statistically significant. BMI impacted operation time only in phase 1. Overall postoperative complications occurred in 13 cases (Clavien-Dindo grade I, 4 cases; grade II, 9 cases), with no significant differences across phases.</p><p><strong>Conclusion: </strong>HLDN can be safely performed by a trained gastrointestinal surgeon, with approximately 30 cases needed to achieve proficiency.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"81-90"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of obesity on the outcomes of laparoscopic adrenal surgery in patients with Cushing syndrome.","authors":"Orkun Özbebit, Sedat Çarkıt, Mustafa Karaağaç, Mustafa Gök, Bahadır Öz, Serap Doğan, Figen Öztürk, Ahmet Öztürk, Alper Akcan","doi":"10.4174/astr.2024.107.2.100","DOIUrl":"10.4174/astr.2024.107.2.100","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to investigate the effect of obesity on the results of laparoscopic adrenal surgery in patients with Cushing syndrome.</p><p><strong>Methods: </strong>This retrospective study was performed in Department of General Surgery at Erciyes University School of Medicine between January 2010 and January 2023. Our analysis included Cushing syndrome patients who underwent unilateral laparoscopic adrenalectomy (LA) with the transabdominal lateral approach. All patients were evaluated in terms of age, sex, tumor diameter, body mass index (BMI), American Society of Anesthesiologists physical status classification, morbidities, surgery history, tumor side, operative time, conversion to open surgery, complications, and length of hospital stay.</p><p><strong>Results: </strong>A total of 90 patients (75 females and 15 males) underwent a transperitoneal LA. Patients were divided into 2 groups according to their BMI: obese group (≥30 kg/m²; n = 53, 58.8%) and nonobese group (<30 kg/m²; n = 37, 41.2%). All patients were classified into 3 subgroups: obese patient group, BMI ≥30-39 kg/m² (n = 23); morbidly obese patient group, BMI ≥40 kg/m² (n = 14); and nonobese patient group, BMI <30 kg/m² (n = 53). There was no significant difference in intraoperative complications, conversion to open surgery, operative time, or length of hospital stay between the groups. Only conversion to open surgery was a risk factor for postoperative complications in univariate and multivariate analyses (odds ratio, 15.4; 95% confidence interval, 1.277-185.599; P = 0.031).</p><p><strong>Conclusion: </strong>Our results showed that LA is safe and effective in patients with Cushing syndrome with morbid obesity, allowing acceptable morbidity and length of hospital stay.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"100-107"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low muscle mass-to-fat ratio is an independent factor that predicts worse overall survival and complications in patients with colon cancer: a retrospective single-center cohort study.","authors":"Jiabao Tang, Jingwen Xu, Xiaohua Li, Chun Cao","doi":"10.4174/astr.2024.107.2.68","DOIUrl":"10.4174/astr.2024.107.2.68","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to investigate influencing factors of preoperative muscle mass-to-fat ratio (MMFR) and its impact on overall survival and postoperative complications of colon cancer.</p><p><strong>Methods: </strong>Patients who underwent colectomy for stage I-III colon cancer at the Second Affiliated Hospital of Soochow University between January 2016 and December 2022 were included. The skeletal muscle and fat area at the third lumbar vertebra were measured with preoperative CT measurement. MMFR was defined as the ratio of skeletal muscle area to total fat area, and low MMFR was defined as the 2 lowest tertiles (≤0.585). Univariate and multivariable analyses were conducted to assess the impact of MMFR on overall complications and survival outcomes. Kaplan-Meier survival curves and log-rank test were used to compare the overall survival between high MMFR and low MMFR groups.</p><p><strong>Results: </strong>A total of 885 patients were analyzed. Female sex, older age, high body mass index, sarcopenia, and high cancer stage were more likely to result in low MMFR. Complications, including intestinal fistula, chylous fistula and organ space surgical site infection were significantly higher in the low MMFR group. Low MMFR was an independent factor associated with overall complications (odds ratio, 1.940; 95% confidence interval [CI], 1.252-3.007; P < 0.01) and long-term survival (hazard ratio, 2.222; 95% CI, 1.443-3.425; P < 0.01). Furthermore, patients with high MMFR had a higher survival rate than patients with low MMFR (P < 0.01).</p><p><strong>Conclusion: </strong>Low MMFR is an independent factor that predicts worse overall survival and complications in patients with colon cancer.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"68-80"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multivariable linear model for predicting graft weight based on 3-dimensional volumetry in regards to body weight change of living liver donor: an observational cohort study.","authors":"Seungwook Han, Jinsoo Rhu, Soyoung Lim, Gyu-Seong Choi, Jong Man Kim, Jae-Won Joh","doi":"10.4174/astr.2024.107.2.91","DOIUrl":"10.4174/astr.2024.107.2.91","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to build a prediction model for estimating graft weight about different graft volumetry methods combined with other variables.</p><p><strong>Methods: </strong>Donors who underwent living-donor right hepatectomy from March 2021 to March 2023 were included. Estimated graft volume measured by conventional method and 3-dimensional (3D) software were collected as well as the actual graft weight. Linear regression was used to build a prediction model. Donor groups were divided according to the 3D volumetry of <700 cm³, 700-899 cm³, and ≥900 cm³ to compare the performance of different models.</p><p><strong>Results: </strong>A total of 119 donors were included. Conventional volumetry showed R² of 0.656 (P < 0.001) while 3D software showed R² of 0.776 (P < 0.001). The R² of the multivariable model was 0.842 (P < 0.001) including for 3D volume (β = 0.623, P < 0.001), body mass index (β = 7.648, P < 0.001), and amount of weight loss (β = -7.252, P < 0.001). The median errors between different models and actual graft weight did not differ in donor groups (<700 and 700-899 cm³), while the median error of univariable linear model using 3D software (122.5; interquartile range [IQR], 61.5-179.8) was significantly higher than multivariable-adjusted linear model (41.5; IQR, 24.8-69.8; P = 0.003) in donors with estimated graft weight ≥900 cm³.</p><p><strong>Conclusion: </strong>The univariable 3D volumetry model showed an acceptable outcome for donors with an estimated graft volume <900 cm³. For donors with an estimated graft volume ≥900 cm³, the multivariable-adjusted linear model showed higher accuracy.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 2","pages":"91-99"},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the learning curve for laparoscopic pancreaticoduodenectomy based on a single surgeon's experience: a retrospective observational study.","authors":"Hee Joon Kim, Chol Kyoon Cho","doi":"10.4174/astr.2024.107.1.27","DOIUrl":"10.4174/astr.2024.107.1.27","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic pancreaticoduodenectomy (LPD) is a highly challenging procedure, which prevents its widespread adoption despite its advantages of being a minimally invasive procedure. This study analyzed the learning curve for LPD based on a single surgeon's experience.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of 111 consecutive patients who underwent LPD by a single surgeon between March 2014 and October 2022. The learning curve was assessed using cumulative summation (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. Surgical failure was defined as conversion to an open procedure or the occurrence of severe complications (Clavien-Dindo grade ≥III). Based on the learning curve analysis, we divided the learning curve into the early and late phases and compared the operative outcomes in each phase.</p><p><strong>Results: </strong>Based on the CUSUM analysis, the operation time decreased after the first 33 cases. Based on the RA-CUSUM analysis, the LPD technique stabilized after the 44th case. In the late phase, operation time, length of stay, and incidence of delayed gastric emptying, severe complications, and surgical failure were significantly lower than in the early phase.</p><p><strong>Conclusion: </strong>Our results indicate that 44 cases are required for stabilization of the LPD technique and improvement of operative outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 1","pages":"27-34"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of safety and operative time in tumescent-free robotic nipple-sparing mastectomy: a retrospective single-center cohort study.","authors":"Yung-Huyn Hwang, Hyun Ho Han, Jin Sup Eom, Tae-Kyung Robyn Yoo, Jisun Kim, Il Yong Chung, BeomSeok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sae Byul Lee","doi":"10.4174/astr.2024.107.1.8","DOIUrl":"10.4174/astr.2024.107.1.8","url":null,"abstract":"<p><strong>Purpose: </strong>Tumescent in nipple-sparing mastectomy (NSM) has been reported to increase the risk of necrosis by impairing blood flow to the skin flap and nipple-areolar complex. At our institution, we introduced a tumescent-free robotic NSM using the da Vinci single-port system (Intuitive Surgical, Inc.).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent tumescent-free robotic NSM between October 2020 and March 2023 at Asan Medical Center (Seoul, Korea). Clinicopathological characteristics, adverse events, and operative time were evaluated.</p><p><strong>Results: </strong>During the study period, 118 patients underwent tumescent-free robotic NSM. Thirty-one patients (26.3%) experienced an adverse event. Five patients (4.2%) were classified as grade III based on the Clavien-Dindo classification and required surgery. The mean total operative time was 467 minutes for autologous tissue reconstruction (n = 49) and 252 minutes for implants (n = 69). No correlation was found between the cumulative number of surgical cases and the breast operative time (P = 0.30, 0.52, 0.59 for surgeons A, B, C) for the 3 surgeons. However, a significant linear relationship (P < 0.001) was observed, with the operative time increasing by 13 minutes for every 100-g increase in specimen weight.</p><p><strong>Conclusion: </strong>Tumescent-free robotic NSM is a safe procedure with a feasible operative time and few adverse events.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 1","pages":"8-15"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}