Enhanced recovery after surgery program in the patients undergoing hepatectomy for benign liver lesions

Publication date: Available online 15 January 2020Source: Hepatobiliary &Pancreatic Diseases InternationalAuthor(s): Jia-Min Zhou, Xi-Gan He, Miao Wang, Yi-Ming Zhao, Lian Shu, Long-Rong Wang, Lu Wang, An-Rong MaoAbstractBackgroundEnhanced recovery after surgery (ERAS) has shown effectiveness in terms of reducing the hospital stay and cost. However, the benefit of ERAS in patients underwent hepatectomy for benign liver lesions is still unclear.MethodsERAS was implemented in our center since March 1st, 2018. From September 2016 to February 2018, 109 patients were enrolled into the control group, and from March 2018 to June 2019, 124 patients were enrolled into the ERAS group. All the indicators related to operation, liver functions, and postoperative outcomes were included in the analysis.ResultsThe clinicopathologic baselines were similar in these two groups. A significantly higher proportion of patients underwent laparoscopic surgery in the ERAS group. On the whole, intraoperative blood loss (100.00 mL vs. 200.00 mL, P
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research

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ConclusionsThe single-port approach has advantages as easier surgical planning and transition for combined and multi-quadrants surgeries: faster recovery, minimal postoperative pain and need for opioids, and excellent cosmetic outcome. We suggest that combined procedures should be performed only in high volume institutions by surgeons with vast experience in robotic surgery in selected patients.ResumenIntroducciónPresentar el primer caso de cirugía multicuadrante concomitante —prostatectomía radical robótica y nefrectomía parcial robótica izquierda— realizadas con t&eac...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
CONCLUSIONS: Current evidence indicates that minimally invasive approaches could be considered as a feasible and safe alternative to ORC when performed by experienced surgeons in selected patients. Notably, RARC may be more suitable for RC with extracorporeal urinary diversion. Larger well-designed trials are still needed to confirm these findings due to the observational nature of most studies. PMID: 32083418 [PubMed - as supplied by publisher]
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
ConclusionsWhen compared to ORC, LRC improves perioperative transfusion rates, complications and hospital stay from its implementation period, maintaining oncological safety. On the contrary, longer operative times during implementation and development were observed. However, in our series, we observed a trend toward shorter operative times than ORC approach in the consolidation period. We have validated the laparoscopic approach for radical cystectomy in our service.ResumenIntroducción y objetivosLas Guidelines de la AEU de 2017, consideran el acceso laparoscópico o asistido por robot como procedimientos en ...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
ConclusionsPeri-operative transfusions at our centre were low. No patients required intra-operative blood transfusions dependent on a pre-operative T&S sample. Patients requiring transfusion were predictable from their pre-operative clinical status. We propose that a highly selective T&S policy is safe and can reduce costs.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
ConclusionsClavien –Dindo complication grading was readily applicable to laparoscopic removal of endometriosis of all stages. Higher Clavien–Dindo grades correctly reflected clinically relevant complications and were associated with deep infiltrating endometriosis, stage IV endometriosis, bowel surgery, or hystere ctomy. Clavien–Dindo classification can be recommended for evaluation of laparoscopic endometriosis surgery outcome.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
Conclusion: Both robotic and laparoscopic DP are safe and feasible. Although robotic DP increases the operation cost, the spleen-preserving rate is much higher. Robotic surgery may be an alternative approach to DP. PMID: 31975614 [PubMed - as supplied by publisher]
Source: Journal of Comparative Effectiveness Research - Category: General Medicine Tags: J Comp Eff Res Source Type: research
In this study, we propose such a procedure (laparoscopic ligation of splenic vessels, L-LSV) for the treatment of HS in children and investigate its effectiveness and feasibility.Materials and methodsA total of 17 children with HS who underwent the L-LSV at our hospital between May 2015 and Apr 2018 were enrolled in the current study. All patients were followed-up for 3 –38 months (mean 19.8 months). The volume of spleen was preoperatively and postoperatively measured using the AW VolumeShare5. The size of functional spleen and the condition of splenic infarction were evaluated using ultrasound and computed...
Source: Pediatric Surgery International - Category: Surgery Source Type: research
AbstractOmental flap was introduced for breast reconstruction after mastectomy either alone or as an adjunct to prosthetic reconstruction. Laparoscopically harvested omental flap was used successfully for this issue. Most of reports had described its use after partial mastectomy, skin or nipple areola sparing mastectomies. In this case, we used the thoracodorsal artery perforator (Tdap) flap as a cover for the omental flap in a patient who underwent modified radical mastectomy. Modified radical mastectomy was done in the usual fashion. The descending branch of the thoracodorsal vessel was traced till its main perforator in...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Open surgery was most often indicated for large tumors or those located in the inter-aortocaval region. Most such procedures require large incisions and possible hepatic mobilization on the right side. The procedures can be safely completed with few complications.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
ConclusionHemobilia should be considered as a cause of upper GI bleeding and acute pancreatitis, especially if both are concurrent. Treatment is directed to the cause, with bleeding control and restoration of bile flow, which can be accomplished by a single minimally invasive surgery.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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