Introduction: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients.
Materials And Methods: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn).
Results: In total, 1757 patients were identified. Due to low rates of obesity in children <9 years old, analyses were limited to those 9-17 (n = 1611, 43% obese). Among obese children, 80.6% were girls. A higher proportion of obese patients had diabetes (3.0% versus 1.0%, P < .01) and contaminated or dirty/infected wounds (15.1% versus 9.4%, P < .01). Complication rates were low. The most frequent indications for surgery were cholelithiasis/biliary colic (34.3%), chronic cholecystitis (26.9%), and biliary dyskinesia (18.2%). On multivariable analysis, obesity was an independent predictor of OT >90 (odds ratio [OR] 2.02; 95% confidence interval [95% CI] 1.55-2.63), and DOAn >140 minutes (OR 1.86; 95% CI 1.42-2.43).
Conclusions: Obesity is an independent risk factor for increased OT in children undergoing LC. Pediatric surgeons and anesthesiologists should be prepared for the technical and physiological challenges that obesity may pose in this patient population.
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http://dx.doi.org/10.1089/lap.2016.0167 | DOI Listing |
Asian Pac J Cancer Prev
January 2025
Department of Pathology, Phramongkutklao College of Medicine, Thailand.
Objective: To determine the correlation among five different types of tumor regression grading (TRG) systems. Test-retest reliability analyses were conducted at two time points to assess the internal validity and consistency of these five TRG systems.
Methods: A test-retest study was performed in 34 pathologically confirmed rectal adenocarcinoma specimens.
Purpose: This brief report aims to summarize and discuss the methodologies of eXplainable Artificial Intelligence (XAI) and their potential applications in surgery.
Methods: We briefly introduce explainability methods, including global and individual explanatory features, methods for imaging data and time series, as well as similarity classification, and unraveled rules and laws.
Results: Given the increasing interest in artificial intelligence within the surgical field, we emphasize the critical importance of transparency and interpretability in the outputs of applied models.
Int Urogynecol J
January 2025
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06511, USA.
Introduction And Hypothesis: Perineorrhaphy with levator myorrhaphy is considered a standard part of colpocleisis. Typically, this is done through a separate incision after colpocleisis is completed. We present a video to demonstrate a modified approach to LeFort colpocleisis incorporating perineorrhaphy into the procedure.
View Article and Find Full Text PDFActa Orthop Traumatol Turc
December 2024
Department of Orthopedics, !e Second People's Hospital of Xiangcheng District, Suzhou, China.
Objective: The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR).
Methods: The databases of PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched for all types of studies examining the e"cacy of TXA for arthroscopic RCR. Twelve studies, 10 randomized controlled trials (RCTs), and 2 retrospective studies were considered eligible.
Urol Res Pract
January 2025
Department of Urology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye.
Objective: Laparoscopic nephron sparing surgery (NSS) can be performed by mainly 2 methods, offclamp or on-clamp. Continuous bleeding during the off-clamp method may impair the clear visualization of the border between the tumor and parenchyma, even though it is done safely in experienced hands. Therefore, some surgical modifications may be needed during mass excision and renorraphy.
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