Background: The efficacy of laparoscopic multivisceral resection (Lap-MVR) has been reported by several experienced high-volume centers. The Endoscopic Surgical Skill Qualification System (ESSQS) was established in Japan to improve the skill of laparoscopic surgeons and further develop surgical teams. We examined the safety and feasibility of Lap-MVR in general hospitals, and evaluated the effects of the Japanese ESSQS for this approach.
Methods: We retrospectively reviewed 131 patients who underwent MVR between April 2016 and December 2019. Patients were divided into the laparoscopic surgery group (LAC group, n = 98) and the open surgery group (OPEN group, n = 33). The clinicopathological and surgical features were compared between the groups.
Results: Compared with the OPEN group, BMI was significantly higher (21.9 vs 19.3 kg/m, p = 0.012) and blood loss was lower (55 vs 380 ml, p < 0.001) in the LAC group. Operation time, postoperative complications, and postoperative hospital stay were similar between the groups. ESSQS-qualified surgeons tended to select the laparoscopic approach for MVR (p < 0.001). In the LAC group, ESSQS-qualified surgeons had superior results to those without ESSQS qualifications in terms of blood loss (63 vs 137 ml, p = 0.042) and higher R0 resection rate (0% vs 2.0%, p = 0.040), despite having more cases of locally advanced tumor. In addition, there were no conversions to open surgery among ESSQS-qualified surgeons, and three conversions among surgeons without ESSQS qualifications (0% vs 15.0%, p = 0.007). Multivariate analysis revealed blood loss (odds ratio 1.821; 95% CI 1.324-7.654; p = 0.010) as an independent predictor of postoperative complications. Laparoscopic approach was not a predictive factor.
Conclusions: The present multicenter study confirmed the feasibility and safety of Lap-MVR even in general hospitals, and revealed superior results for ESSQS-qualified surgeons.
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http://dx.doi.org/10.1007/s00464-021-08605-9 | DOI Listing |
J Craniofac Surg
December 2024
Konkuk University School of Medicine, Chungju City, Republic of Korea.
Purpose: To determine the association between the preoperative shape of the lacrimal sac and the postoperative shape of a rhinostomy in patients undergoing endoscopic dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction.
Material And Methods: This retrospective study involved 180 cases among 129 patients. Preoperative dacryocystography (DCG) classified lacrimal sacs into constricted or cylindrical types based on their width relative to the nasolacrimal duct.
J Vet Intern Med
December 2024
School of Veterinary Science, Faculty of Science, University of Queensland, Gatton, Queensland 4343, Australia.
Background: Current methods to measure intragastric pH in horses have limitations. A wireless capsule has been designed for continuous esophageal pH monitoring in humans.
Objectives: To (1) determine the feasibility and describe the methodology of measuring intragastric pH wirelessly in horses; and (2) determine attachment duration of the capsules.
Int J Surg
December 2024
Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Padova, Italy.
Background: The aim of this prospective, controlled study was to assess the 5-year follow-up of Laparoscopic Heller-Dor (LHD) in patients with esophago-gastric junction outflow obstruction (EGJOO), compared with achalasia patients (ACH). The management of EGJOO reflects the experience gained with esophageal achalasia, for which LHD has been proven to be an effective long-term treatment. Prospective long-term results of LHD in EGJOO patients are still lacking.
View Article and Find Full Text PDFObjective: Aim: To evaluate the early postoperative results of surgical treatment of patients with inguinal hernias after laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) using invasive and non-invasive methods of fixation of prosthetic material.
Patients And Methods: Materials and Methods: The study included 76 patients (average age 61,4±15,3 years; 69 [91 %] males, 7 [9 %] females) with primary uncomplicated unilateral inguinal hernias who underwent TAPP. Patients were divided into two groups: group 1 - 52 patients in whom the AbsorbaTack fixation device was used to secure the mesh; group 2 - 24 patients in whom the LiquiBand FIX8 cyanoacrylate adhesive was used.
Wiad Lek
December 2024
BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; CNE ≪KYIV CITY CLINICAL HOSPITAL OF EMERGENCY CARE≫, KYIV, UKRAINE.
Objective: Aim: To identify and evaluate the risk factors affecting the success of single-stage laparoscopic treatment for choledocholithiasis.
Patients And Methods: Materials and Methods: We performed a retrospective analysis of treatment of 139 patients who underwent single-stage laparoscopic CBD exploration and cholecystectomy from 2018 to 2024. Data were analysed by the use of multivariate logistic regression to identify significant predictors of negative outcomes.
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