The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.
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http://dx.doi.org/10.21037/hbsn.2019.07.08 | DOI Listing |
J Clin Periodontol
January 2025
Department of Pediatric Surgery, Children's Medical Center, The First Hospital of Jilin University, Changchun, China.
Background: Although evidence suggests that dental floss contains perfluoroalkyl and polyfluoroalkyl substances (PFASs), it is still uncertain whether the use of dental floss contributes to an increased risk of PFAS exposure.
Methods: We analysed data on serum PFAS concentrations and dental floss usage in a cohort of 6750 adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. In our study, we used logistic regression, a survey-weighted linear model, item response theory (IRT) scores, inverse probability weights (IPWs) and sensitivity analysis to assess the potential impact of dental floss usage on human serum PFAS levels.
J Clin Med
December 2024
Department of Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
/: The aim of this study is to evaluate the impact of modified Blumgart anastomosis methods during pancreaticojejunostomy (PJ) on the incidence of clinically relevant postoperative pancreatic fistula (POPF) after laparoscopic pancreaticoduodenectomy (LPD). : This is a retrospective cohort study analyzing data of patients who underwent LPD from 2018 to 2022. The primary endpoint was the incidence of grade B and C POPF based on the International Study Group on Pancreatic Fistula criteria and PJ anastomosis time.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, 69120 Heidelberg, Germany.
Despite the significant advancements of liver surgery in the last few decades, the survival rate of patients with liver and pancreatic cancers has improved by only 10% in 30 years. Precision medicine offers a patient-centered approach, which, when combined with machine learning, could enhance decision making and treatment outcomes in surgical management of ihCC. This study aims to develop a decision support model to optimize treatment strategies for patients with ihCC, a prevalent primary liver cancer.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Republic of Korea.
This study utilized a genome-wide association study (GWAS) to investigate the genetic variations linked to the risk of hepatitis B virus (HBV) reactivation in patients who have undergone liver transplantation (LT), aiming to enhance understanding and improve clinical outcomes. Genotyping performed on a selected patients from the Korean Organ Transplantation Registry (KOTRY) data using high-throughput platforms with the Axiom Korea Biobank array 1.1.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Animal Physiology, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, 05-110 Jabłonna, Poland.
The aim of this study was to elucidate the impact of porcine pancreatic enzymes (Creon pancrelipase) in comparison to microbial-derived alpha amylase (MD amylase) on the small intestine wall structure, mucosal glycogen accumulation, and enterocyte turnover. The impact of enzyme supplementation on the small intestine was explored in 18 pigs with surgically induced exocrine pancreatic insufficiency (EPI). Four healthy pigs served as the control group.
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