The fourth space surgery: endoscopic subserosal dissection for upper gastrointestinal subepithelial tumors originating from the muscularis propria layer
ConclusionESSD seems to be an efficacious, safe, and minimally invasive treatment for patients with upper GI SETs originating from the MP layer, making it possible to resect deep lesions, provide precise pathological diagnosis, and maintain the integrity of serosa.
In a recent  retrospective analysis in 325 non-valvular atrial fibrillation (NVAF) patients treated with novel oral anticoagulants (NOAC), authors suggested a higher risk of thrombosis in obese/overweight vs. other patients, particularly those treated with dabigatran; and a higher risk of bleeding, particularly related to factor Xa inhibitors (rivaroxaban, apixaban). They proposed that obesity moderated the NOAC effects, differently for different NOACs. However a) the study did not test for moderation [(warfarin vs.
CONCLUSION: We report that the use of mid-cycle tranexamic acid in patients with recurrent haemorrhagic cysts can lower ovulation-associated pain. PMID: 32482469 [PubMed - as supplied by publisher]
ConclusionAWRC is a useful technique for safe and efficient bile duct cannulation for therapeutic ERCP in the setting of choledocholithiasis at the time of CCY. Despite supine (rather than the traditional prone) positioning, total ERCP times were short and we eliminated any manipulation of the pancreatic duct. No patients in our series developed PEP or post-sphincterotomy bleeding.
ConclusionRobotically assisted Heller myotomy and POEM are safe and efficacious treatments for achalasia with lower rates of technical complications compared to laparoscopic Heller myotomy. With the advancements in endoscopic instruments and robotic surgery, POEM and robotically assisted Heller myotomy should be considered in the treatment of achalasia and esophageal dysmotility disorders.
ConclusionsOur study of published trials indicates that using low, as opposed to standard, IAP during laparoscopic cholecystectomy may reduce patients ’ post-operative pain, including shoulder pain, and length of hospital stay. Heterogeneity in the pooled estimates and high risk of bias of the included trials suggest the need for high-quality, adequately powered RCTs to confirm these findings.
ConclusionsLaparoscopy is effective in treating SBOs due to various etiologies including single band or multiple adhesions, hernias, or masses. Other than BMI, there was no single predictor of success or failure with laparoscopy. Therefore, we conclude that perhaps all patients requiring operative treatment for SBO deserve consideration for a diagnostic laparoscopy.
ConclusionMILE can be performed with low perioperative mortality, and favorable long-term overall and disease-free survival.
AbstractBackgroundAdnexal surgery is believed to be more complex in patients with prior hysterectomy; however, there is little data regarding surgical outcomes. Understanding of individualized risks improves counseling, informed consent, and preoperative planning.MethodsWe performed a retrospective cohort study with a control group; we evaluated 744 patients undergoing laparoscopic adnexal surgery at an academic tertiary care center from 2011 to 2015. Comparisons were made using Chi square, Fisher ’s exact, or Wilcoxon-rank sum tests. We used log-binomial regression to calculate risk ratio and 95% confidence interval...
ConclusionsIrrelevant conversation in the OR is a modifiable factor that was independently associated with surgeon ’s perception of distraction.
ConclusionsThis is the first study to demonstrate a procedural factor that increases post-POEM esophagitis. Gastric myotomy > 2.5 cm results in increased rates of moderate esophagitis without improving clinical efficacy. Some patients developed esophagitis in a delayed fashion, emphasizing the importance of ongoing surveillance. We also believe that preserving the gastric sling fibers may help to reduce reflux rates. T he double-scope method may help to control myotomy length (2.0–2.5 cm) and direction (lesser curve to avoid the gastric sling) to help maximize clinical efficacy while mini...