High-pressure CO2 insufflation is a risk factor for postoperative ileus in patients undergoing TaTME
AbstractThe aim of this study is to evaluate the influence of high-pressure CO2 insufflation during TaTME on the occurrence of postoperative ileus. All patients undergoing elective transanal total mesorectal excision (TaTME) between April 2015 and March 2019 were included in a prospective database. Eligible patients were adults with mid and low-level rectal cancer undergoing elective TaTME with colorectal anastomosis and diverting ileostomy, following a standardized ERAS pathway. Patients were divided into a low-pressure (LP) group, where surgery was performed with an intrabdominal CO2 pressure of 12  mmHg, and a high...
Source: Updates in Surgery - November 21, 2021 Category: Surgery Source Type: research

Trans-vaginal repair of recurrent rectovaginal fistula with interposition of BIO-A Tissue Reinforcement
We present a case of a 51-year-old female with a multi-recurrent rectovaginal fistula that occurred since a laparoscopic sigmoidectomy was performed for a complicated diverticular disease in May 2015. An attempt to close the fistula was undertaken three times. In July 2019, a transvaginal repair was performed with interposition in the rectovaginal septum of GORE® BIO-A® Tissue Reinforcement. The postoperative course was uneventful. There was no recurrence and functional outcome was good at 24-months follow-up. Rectovaginal fistula can be successfully treated using the interposition of a GORE® BIO-A® Tissue ...
Source: Updates in Surgery - November 11, 2021 Category: Surgery Source Type: research

Outcomes comparison of Pancreato-Gastrostomy and Isolated Jejunal Loop Pancreato-Jejunostomy following Pancreato-Duodenectomy in patients with soft pancreas and at moderate-high risk for POPF: a retrospective multicenter experience-based analysis
AbstractFollowing pancreatoduodenectomy (PD), the modality of pancreato-enteric continuity restoration may impact on postoperative pancreatic fistula (POPF) risk. The aim of this study is to compare, among patients with soft pancreas and at moderate/high risk for POPF, the outcomes of PD with Pancreato-Gastrostomy (PG), versus Isolated Jejunal Loop Pancreato-Jejunostomy (IJL-PJ). 193 patients with a Callery Fistula Risk Score (C-FRS)  ≥ 3 operated at 3 HPB Units, two performing PG and one IJL-PJ as their preferred anastomotic technique following PD (2009–2019) were included in this study (PG =...
Source: Updates in Surgery - November 11, 2021 Category: Surgery Source Type: research

The role of endocervicoscopy in women with cervical intraepithelial neoplasia: a systematic review of the literature
AbstractEndocervicoscopy is an alternative diagnostic tool to endocervical curettage for the diagnostic workup of repeatedly positive cervicovaginal cytology suggestive of a high-grade squamous intraepithelial lesion (HSIL) and negative or unsatisfactory colposcopy. The aim of this review is to summarize the current evidence on the diagnostic accuracy of endocervicoscopy in women with cervical intraepithelial neoplasia in the presence of nonvisible squamocolumnar junction with unsatisfactory colposcopy. A systematic review of literature was performed by searching in the main electronic databases (MEDLINE, EMBASE, Web of Sc...
Source: Updates in Surgery - November 5, 2021 Category: Surgery Source Type: research

The utility of indocyanine green (ICG) for the identification and assessment of viability of the parathyroid glands during thyroidectomy
In this study, there was no additional benefit of ICG and NIRF camera in the identification of parathyroid glands. However, ICG angiogram s eems to be a good adjunct for the intraoperative assessment of the viability of the parathyroid glands and accurately predicts the development of postoperative hypoparathyroidism. (Source: Updates in Surgery)
Source: Updates in Surgery - November 2, 2021 Category: Surgery Source Type: research

Repeated surgery for recurrent Crohn ’s disease: does the outcome keep worsening operation after operation? A comparative study of 1224 consecutive procedures
AbstractComplicated Crohn ’s disease (CD) will require surgical treatment during patients’ lifetime, with a considerable recurrence rate requiring additional surgery. The present study is a retrospective analysis of a prospectively maintained database in an IBD Tertiary Centre that included all the consecutive, unselecte d patients undergoing surgery for CD between 1993 and 2019. Patients treated with small bowel resections, colonic resections, conventional and non-conventional strictureplasties were considered. The aim was to evaluate morbidity and long-term recurrence of repeated surgery. Among the population...
Source: Updates in Surgery - November 1, 2021 Category: Surgery Source Type: research

Performance of EUS-FNB in solid pancreatic masses: a lesson from 463 consecutive procedures and a practical nomogram
AbstractThe study ’s main goal was the diagnostic adequacy of pancreatic endoscopic ultrasonographic (EUS) fine-needle biopsy (FNB) and associated predictive factors. The secondary objective was to define the diagnostic accuracy of EUS-FNB in the diagnosis of pancreatic masses and pancreatic malignancies. None of t he studies reported the diagnostic adequacy and accuracy of EUS. We retrospectively identified patients with solid pancreatic lesions that underwent EUS-FNB between 2013, and 2018. We calculated diagnostic adequacy and related factors. Using definitive histology on the surgically resected specimen a s the ...
Source: Updates in Surgery - October 29, 2021 Category: Surgery Source Type: research

Correction to: Is minimally invasive liver surgery a reasonable option in recurrent HCC? A snapshot from the I Go MILS registry
(Source: Updates in Surgery)
Source: Updates in Surgery - October 29, 2021 Category: Surgery Source Type: research

Comparison of 2D 4K vs. 3D HD laparoscopic imaging systems using a pelvitrainer model: a randomized controlled study
AbstractLaparoscopic surgery provides well-known benefits, but it has technological limitations. Depth perception is particularly crucial, with three-dimensional (3D) imaging being superior to two-dimensional (2D) HD imaging. However, with the introduction of 4K resolution monitors, 2D rendering is capable of providing higher-quality visuals. Therefore, this study aimed to compare 3D HD and 2D 4K imaging using a pelvitrainer model. Eight experts and 32 medical students were performing the same four standardized tasks using 2D 4K and 3D HD imaging systems. Task completion time and the number of errors made were recorded. Th...
Source: Updates in Surgery - October 26, 2021 Category: Surgery Source Type: research

Strong impact of sarcopenia as a risk factor of survival in resected gastric cancer patients: first Italian report of a Bicentric  study
AbstractGastric cancer (GC) accounts for 4% of all cancers in Europe. Sarcopenia is a complex syndrome characterized by a loss of muscle mass and function associated with age, often present in neoplastic patients. Recently, several studies have shown a significant association between sarcopenia and poor prognosis in various pathological conditions. The current observational retrospective study investigates the association between sarcopenia and overall survival (OS) and recurrence-free survival (RFS) in patients with GC undergoing up-front surgery with curative intent. Resected GC patients' clinical records and CT images w...
Source: Updates in Surgery - October 26, 2021 Category: Surgery Source Type: research

C-reactive protein but not procalcitonin may predict antibiotic response and outcome in infections following major abdominal surgery
AbstractWe aimed to evaluate the usefulness of C-reactive protein (CRP) and procalcitonin (PCT) as markers of infection, sepsis and as predictors of antibiotic response after non-emergency major abdominal surgery. We enrolled, from June 2015 to June 2019, all patients who underwent surgery due to abdominal infection (peritoneal abscess, peritonitis) or having sepsis episode after surgical procedures (i.e. hepatectomy, bowel perforation, pancreaticoduodenectomy (PD), segmental resection of the duodenum (SRD) or biliary reconstruction in a Tertiary Care Hospital. Serum CRP (cut-off value  
Source: Updates in Surgery - October 26, 2021 Category: Surgery Source Type: research

Development and validation of a novel nomogram for postoperative pulmonary complications following minimally invasive esophageal cancer surgery
This study aims to construct a nomogram based on clinical factors to predict PPCs and investigate related early outcomes. Clinical data of 969 consecutive patients receiving MIE were retrospectively collected. Univariate and multivariate analysis were performed to select independent predictors. Using independent predictors to develop a nomogram and using a bootstrap-resampling approach to conduct internal verification. Early outcomes of PPCs were analyzed. The incidence of PPCs following MIE was 39.6% (384 out of 969). In multivariate analysis, older age (Odds ratio (OR) 1.034,P 
Source: Updates in Surgery - October 24, 2021 Category: Surgery Source Type: research

Pancreatic surgery during COVID-19 pandemic: major activity disruption of a third-level referral center during 2020
ConclusionThe COVID-19 pandemic has severely disrupted the activity of a third-level referral center for pancreatic surgery, affecting the access to cancer surgical procedures and raising concerns regarding the solidity of the current centralization model. (Source: Updates in Surgery)
Source: Updates in Surgery - October 23, 2021 Category: Surgery Source Type: research

Evaluation of factors predicting loss of benefit provided by laparoscopic distal pancreatectomy compared to open approach
In conclusion, LDP seems comparable to ODP in terms of TFR in patients aged >  70 years. This finding could be helpful in the choice of the best surgical approach in elderly patients undergoing potentially challenging DPs. (Source: Updates in Surgery)
Source: Updates in Surgery - October 23, 2021 Category: Surgery Source Type: research

Usefulness of damage control approach in patients with limited acute mesenteric ischemia: a prospective study of 85 patients
AbstractTo evaluate the efficacy of the damage control approach by two-step surgical procedure in not critical patients (without sepsis or septic shock) with peritonitis from limited acute mesenteric ischemia. From April 2013 to April 2020, 85 patients [49 (57.7%) women and 36 (42.3%) men, median age 69.5 (range 38 –92)] were enrolled in this study and underwent emergency surgery. After resection of ischemic bowel, basing on the individual decision of the single surgeon, the patients underwent primary end-to-end anastomosis (Group 1) or damage control approach (Group 2) including primary laparotomy with rese ction of...
Source: Updates in Surgery - October 22, 2021 Category: Surgery Source Type: research

Quality of life and patient satisfaction in outpatient thyroid surgery
AbstractIn the last three decades surgeons have begun to perform outpatient thyroid surgery (OTS). Important outcome measures of a day-hospital procedure are the patient ’s quality of life (QoL) and satisfaction, but information on these issues in the OTS setting is scanty. The aim of this pilot study was to explore how early discharge after thyroidectomy affects patients’ QoL and satisfaction. Postoperative QoL and satisfaction were assessed retrospectively by giving each patient a self-report questionnaire specifically created in our center for OTS and derived from the post-discharge surgical recovery (PSR) s...
Source: Updates in Surgery - October 22, 2021 Category: Surgery Source Type: research

Concomitance of intraductal papillary mucinous neoplasm with pancreatic stones: indication for immediate surgery
(Source: Updates in Surgery)
Source: Updates in Surgery - October 21, 2021 Category: Surgery Source Type: research

Transoral thyroid surgery vestibular approach: is there an increased risk of surgical site infections?
AbstractTransoral endoscopic thyroidectomy vestibular approach (TOETVA) is an upcoming surgical technique with the aim to optimize cosmetic outcome avoiding visible scars in the neck. However, the transoral access bears the risk of contamination and microbial allocation from the mouth into the thyroid region. Therefore, some authors recommend extended antibiotic therapy up to 7  days after surgery. Our aim was to evaluate infection rates and parameters before and after transoral surgery and to suggest a viable and safe routine in transoral surgery. Prospectively collected data of patients who were eligible for transor...
Source: Updates in Surgery - October 20, 2021 Category: Surgery Source Type: research

Ventral Prosthesis Rectopexy for obstructed defaecation syndrome: a systematic review and meta-analysis
This study assesses new evidence on the efficacy of VPR for the treatment of ODS, specifically focusing on inclusion criteria for surgery and the long-term outcomes. A search was performed of MEDLINE, EMBASE, Ovid and Cochrane databases on all studies reporting on VPR for ODS from 2000 to March 2020. No language restrictions were made. All studies on VPR were reviewed systematically. The main outcomes were intra-operative complications, conversion, procedure duration, short-term mortality and morbidity, length of stay, faecal incontinence and constipation, quality of life (QoL) score and patient satisfaction. Quality asses...
Source: Updates in Surgery - October 19, 2021 Category: Surgery Source Type: research

Effect of delaying surgery by more than 10  weeks after neoadjuvant therapy in rectal cancer: a single institution experience
AbstractThe optimal timing of surgery after neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer is still controversial. Aim of this study was to evaluate the effect of increasing time interval between the end of CRT and surgery on pathological outcomes. This is a retrospective analysis on 114 patients treated with long-course neoadjuvant RT with or without chemotherapy between January 2005 and September 2020. 43 patients underwent surgery within 10  weeks from the end of CRT (1st group), whereas 71 patients underwent total mesorectal excision with a time interval equal or greater than 10 weeks (...
Source: Updates in Surgery - October 18, 2021 Category: Surgery Source Type: research

Effectiveness and safety of robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta-analysis of 12,401 gastric cancer patients
AbstractAdvanced minimally invasive techniques, such as robotic surgeries, are applied increasingly frequently around the world and are primarily used to improve the surgical outcomes of laparoscopic gastrectomy (LG). Against that background, we conducted a meta-analysis to evaluate the feasibility, safety, and effectiveness of robotic gastrectomy (RG). Studies comparing surgical outcomes between LG and RG patients were retrieved from medical databases, including RCTs and non-RCTs. The primary outcome of this study was overall survival, which was obtained by evaluating the 3-year survival rate and the 5-year survival rate....
Source: Updates in Surgery - October 16, 2021 Category: Surgery Source Type: research

A combination of laparoscopic approach and ERAS pathway optimizes outcomes and cost for adrenalectomy
AbstractEnhanced recovery after surgery (ERAS) pathway comprises a set of comprehensive elements which have been reported to enhance patient postoperative prognosis. In the current study, we aimed to evaluate the effectiveness of the ERAS in patients undergoing laparoscopic adrenal resection. A retrospective review was performed to compare the outcomes of patients undergoing adrenalectomy for primary aldosteronism between the pre-ERAS period and the ERAS era. Data was generated from the traditional surgical period (September 1, 2019, to December 31, 2019) and the ERAS period (September 1, 2020, to December 31, 2020), respe...
Source: Updates in Surgery - October 11, 2021 Category: Surgery Source Type: research

Neoadjuvant therapy for pancreatic cancer
AbstractMultimodal treatment including surgery and chemotherapy is considered the gold standard treatment of pancreatic cancer by most guidelines. Neoadjuvant therapy (NAT) has been seen as a possible treatment option for resectable, borderline resectable and locally advanced PaC. The aim of this paper is to offer a state-of-the-art review on neoadjuvant treatments in the setting of pancreatic ductal adenocarcinoma. A systematic literature search was performed using PubMed, Cochrane, Web of Science and Embase databases, in order to identify relevant studies published up to and including July 2021 that reported and analyzed...
Source: Updates in Surgery - October 9, 2021 Category: Surgery Source Type: research

Preoperative Localization in Colonic Surgery (PLoCoS Study): a multicentric experience on behalf of the Italian Society of Colorectal Surgery (SICCR)
AbstractThe aim of this prospective multicentric study was to compare the accurate colonic lesion localization ratio between CT and colonoscopy in comparison with surgery. All consecutive patients from 1st January to 31st December 2019 with a histologically confirmed diagnosis of dysplastic adenoma or adenocarcinoma with planned elective, curative colonic resection who underwent both colonoscopy and CT scans were included. Each patient underwent conventional colonoscopy and CT to stage the tumour, and the localization results of each procedure were registered. CT and colonoscopic localization were compared with surgical lo...
Source: Updates in Surgery - October 5, 2021 Category: Surgery Source Type: research

Laparoscopic resection and primary anastomosis for perforated diverticulitis: with or without loop ileostomy? The response is the colon leakage risk score!
(Source: Updates in Surgery)
Source: Updates in Surgery - October 5, 2021 Category: Surgery Source Type: research

Is minimally invasive liver surgery a reasonable option in recurrent HCC? A snapshot from the I Go MILS registry
AbstractLaparoscopic liver resection (LLR) for Hepatocellular carcinoma (HCC) is a safe procedure. Repeat surgery is more often required, and the role of minimally invasive liver surgery (MILS) is not yet clearly defined. The present study analyzes data compiled by the Italian Group of Minimally Invasive Liver Surgery (IGoMILS) on LLR. To compare repeated LLR with the first LLR for HCC is the primary endpoint. The secondary endpoint was to evaluate the outcome of repeat LLR in the case of primary open versus primary MILS surgery. The data cohort is divided into two groups. Group 1: first liver resection and Group 2: Repeat...
Source: Updates in Surgery - October 3, 2021 Category: Surgery Source Type: research

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study
AbstractLaparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3  years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 5...
Source: Updates in Surgery - October 3, 2021 Category: Surgery Source Type: research

Clinical epigenetics and restoring of metabolic health in severely obese patients undergoing batriatric and metabolic surgery
AbstractEpigenetic-sensitive mechanisms, mainly DNA methylation, mirror the relationship between environmental and genetic risk factors able to affect the sensitiveness to development of obesity and its comorbidities. Bariatric and metabolic surgery may reduce obesity-related cardiovascular risk through tissue-specific DNA methylation changes. Among the most robust results, differential promoter methylation ofACACA,CETP,CTGF,S100A8, andS100A9 genes correlated significantly with the levels of mRNA before and after gastric bypass surgery (RYGB) in obese women. Additionally, promoter hypermethylation ofNFKB1 gene was signific...
Source: Updates in Surgery - October 2, 2021 Category: Surgery Source Type: research

A machine learning risk model based on preoperative computed tomography scan to predict postoperative outcomes after pancreatoduodenectomy
AbstractClinically relevant postoperative pancreatic fistula (CR-POPF) is a life-threatening complication following pancreaticoduodenectomy (PD). Individualized preoperative risk assessment could improve clinical management and prevent or mitigate adverse outcomes. The aim of this study is to develop a machine learning risk model to predict occurrence of CR-POPF after PD from preoperative computed tomography (CT) scans. A total of 100 preoperative high-quality CT scans of consecutive patients who underwent pancreaticoduodenectomy in our institution between 2011 and 2019 were analyzed. Radiomic and morphological features ex...
Source: Updates in Surgery - October 1, 2021 Category: Surgery Source Type: research

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key
AbstractAfter the initial widespread diffusion, laparoscopic adjustable gastric banding (LAGB) has been progressively abandoned and laparoscopic sleeve gastrectomy (LSG) has become the worldwide most adopted procedure. Nevertheless, recent reports raised concerns about the long-term weight regain after different bariatric techniques. Considering the large LAGB series recorded in our multicentric bariatric database, we analysed the anthropometric and surgical outcomes of obese patients underwent LAGB at a long-term follow-up, focusing on LAGB management. Between January 2008 to January 2018, demographics, anthropometric and...
Source: Updates in Surgery - October 1, 2021 Category: Surgery Source Type: research

Letter to Baeza-Murcia M et al. ‘Early diagnosis of anastomotic leakage in colorectal surgery: prospective observational study of the utility of inflammatory markers and determination of pathological levels”
(Source: Updates in Surgery)
Source: Updates in Surgery - October 1, 2021 Category: Surgery Source Type: research

Laparoscopic liver resection for primary liver cancers originating in the paracaval portion of the caudate lobe: a preliminary retrospective analysis with 31 patients
This study aimed to explore the safety and feasibility of LLR in the treatment of paracaval-originating cancers. This study included 11 patients who underwent LLR and 20 who underwent open liver resection (OLR) for paracaval-originating cancers between May 2010 and November 2020. The outcomes of the procedures were retrospectively analyzed. There were no cases of perioperative death or conversion to laparotomy. The LLR group had an earlier postoperative feeding time, shorter postoperative hospital stay, and lower total bilirubin levels on the first day after surgery. No significant differences in the incidence of overall p...
Source: Updates in Surgery - September 29, 2021 Category: Surgery Source Type: research

Management of gastric intestinal metaplasia in patients undergoing routine endoscopy before bariatric surgery
AbstractRoutine preoperative endoscopic evaluation for bariatric surgery is controversial; however, for patients undergoing endoscopy, some findings may alter surgical management. Gastric intestinal metaplasia (GIM) is found in up to 11.7% of the general population. When associated with determined risk factors, GIM has a risk of progressing to gastric cancer. The aim of our study was to assess the prevalence of GIM and possible associated factors in those undergoing bariatric surgery. We performed a retrospective chart review of patients who underwent primary sleeve gastrectomy or Roux-en-Y gastric bypass at our institutio...
Source: Updates in Surgery - September 29, 2021 Category: Surgery Source Type: research

Can preoperative 25-hydroxyvitamin D levels predict transient hypocalcemia after total thyroidectomy?
We reported gender, age, estimated glomerular filtration rate, creatinine, preoperative 25-hydroxyvitaminD, serum pre- and postoperative calcium, pre- and postoperative PTH levels and transient postoperative hypocalcemia occurrences. We co mpared variables both among patients with and without transient postoperative hypocalcemia and between patients with different 25-hydroxyvitaminD levels (  30 ng/ml, normal). A binomial logistic regression model evaluating the risk for transient postoperative hypocalcemia was elaborated. Patients with transient postoperative hypocalcemia had lower levels of postoperative PTH (p 
Source: Updates in Surgery - September 26, 2021 Category: Surgery Source Type: research

The innate aptitude ’s effect on the surgical task performance: a systematic review
AbstractSurgery is known to be a craft profession requiring individuals with specific innate aptitude for manipulative skills, and visuospatial and psychomotor abilities. The present-day selection process of surgical trainees does not include aptitude testing for the psychomotor and manual manipulative skills of candidates for required abilities. We aimed to scrutinize the significance of innate aptitudes in surgical practice and impact of training on skills by systematically reviewing their significance on the surgical task performance. A systematic review was performed in compliance with PRISMA guidelines. An initial sea...
Source: Updates in Surgery - September 25, 2021 Category: Surgery Source Type: research

Neoadjuvant chemotherapy with S-1 plus cisplatin for esophageal squamous cell carcinoma
In this study, patients with clinical stage II/III/IV ESCC received NAC with SP regimen from June 2016 to July 2020 in Ogaki Municipal Hospital were retrospectively evaluated. In the SP regimen, S-1 80  mg/m2 was administered on days 1 –14, and cisplatin was administered 70 mg/m2 on day 1, repeated every 4  weeks, for two cycles. The completion rate, clinical and pathological response rate, adverse events, and long-term outcomes were analyzed. 43 ESCC patients were diagnosed clinical stage II/III/IV ESCC. Among the 43 patients, 31 patients underwent NAC with SP regimen. The completion rate was 93.5%. T...
Source: Updates in Surgery - September 24, 2021 Category: Surgery Source Type: research

Correction to: E ‑consensus on telemedicine in colorectal surgery: a RAND/UCLA‑modified study
(Source: Updates in Surgery)
Source: Updates in Surgery - September 21, 2021 Category: Surgery Source Type: research

The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors
AbstractThe use of expanded criteria donors is one of the strategies used to overcome the gap between the demand for organs and the number of donors. Physicians debate the extent to which marginal grafts can be used. In recent years, normothermic machine perfusion (NMP) has been used to test liver viability before transplantation. Grafts underwent NMP whenever histological steatosis was  >  40% or there were at least three Eurotransplant criteria for expanded criteria donor (ECD). We used NMP to test 19 grafts, 3 from donation after type 3 controlled cardiac death (DCD), and 16 from donation after brain de...
Source: Updates in Surgery - September 20, 2021 Category: Surgery Source Type: research

Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study
AbstractThe role of minimally invasive surgery in the treatment of transverse colon cancer is still controversial. The aim of this study is to investigate the advantages of a totally laparoscopic technique comparing open versus laparoscopic/robotic approach. Three hundred and eighty-eight patients with transverse colon cancer, treated with a segmental colon resection, were retrospectively analyzed. Demographic data, tumor stage, operative time, intraoperative complications, number of harvested lymph nodes and recovery outcomes were recorded. Recurrences and death were also evaluated during the follow-up. No differences wer...
Source: Updates in Surgery - September 14, 2021 Category: Surgery Source Type: research

Can you trust clinical practice guidelines for laparoscopic surgery? A systematic review of clinical practice guidelines for laparoscopic surgery
AbstractBackgroundClinical practice guidelines aim to support clinicians in providing clinical care and should be supported by evidence. There is currently no information on whether clinical practice guidelines in laparoscopic surgery are supported by evidence.MethodsWe performed a systematic review and identified clinical practice guidelines of laparoscopic surgery published in PubMed and Embase between March 2016 and February 2019. We performed an independent assessment of the strength of recommendation based on the evidence provided by the guideline authors. We used the ‘Appraisal of Guidelines for Research& E...
Source: Updates in Surgery - September 14, 2021 Category: Surgery Source Type: research

Trauma, alcohol and drugs misuse in car and motorcycle drivers: a prevalence study in a level one trauma center
AbstractAlcohol and drugs misuse represents an important social problem. There is no agreement about influence of ethanol and drugs on trauma severity and clinical course. The aim of this study was to investigate the impact of alcohol and drugs abuse on road related trauma managed to our Level I Trauma Center. Data of 1067 car or motorcycle drivers consecutively admitted in a 5  years period were retrospectively analyzed. The sample was divided into two groups: patients with alcohol and/or drugs misuse and patients without detectable plasmatic levels or not screened because no clinical suspicion of these substance. De...
Source: Updates in Surgery - September 13, 2021 Category: Surgery Source Type: research

Double layer stent for the treatment of leaks and fistula after upper gastrointestinal oncologic surgery: a retrospective study
AbstractAnastomotic dehiscence is one of the most morbidity related and deadly complication after foregut oncologic surgery. The aim of the study is to evaluate the effectiveness of double layer stents (Niti-S ™ Beta™ Esophageal Stent) in the management of dehiscences after upper gastrointestinal oncologic surgery. We retrospectively studied consecutive patients who underwent Niti-S™ Beta™ esophageal stent placement from June 2014 to September 2019 for the treatment of anastomotic leaks/fistula fo llowing esophagectomy or gastrectomy for cancer. Univariate two-sided logistic regression analysis was ...
Source: Updates in Surgery - September 12, 2021 Category: Surgery Source Type: research

Colectomy risk score predicts pouchitis in patients with ulcerative colitis
AbstractRisk stratification is required to improve the management of pouchitis with ulcerative colitis (UC) patients who undergo ileal pouch-anal anastomosis (IPAA). Recently, the colectomy risk score (CRS) has been used to assess UC severity and predict the need for surgery. We explored whether the CRS predicted pouchitis in patients with UC who underwent IPAA. This retrospective study included 168 UC patients who underwent IPAA. Pouchitis was diagnosed according to the pouchitis disease activity index. The primary endpoint was the cumulative incidence of pouchitis. The risk factors for pouchitis using preoperatively obta...
Source: Updates in Surgery - September 7, 2021 Category: Surgery Source Type: research

Correction to: Inflammatory bowel disease patients requiring surgery can be treated in referral centres regardless of the COVID-19 status of the hospital: results of a multicentric European study during the first COVID-19 outbreak (COVIBD-Surg)
(Source: Updates in Surgery)
Source: Updates in Surgery - September 7, 2021 Category: Surgery Source Type: research

The impact of mini-invasive right hepatectomy in the setting of living donation: a meta-analysis
AbstractAdult-to-adult living-donor liver transplantation (A2ALDLT) represents a challenging procedure, mainly when the right hepatic lobe is donated. Therefore, especially in Western countries, the medical community still considers it a “risky procedure”. The present meta-analysis investigated the postoperative results reported in donors undergoing right hepatectomy for A2ALDLT through a minimally invasive liver resection (MILR) vs. open liver resection (OLR) approach, with the intent to clarify the hypothesis that the MILR app roach should minimize the risks for the donor. A systematic literature search was p...
Source: Updates in Surgery - September 6, 2021 Category: Surgery Source Type: research

Comparing and contrasting clinical consensus and guidelines for anal intraepithelial neoplasia in different geographical regions
AbstractAnal Squamous Cell Carcinoma (ASCC) is an uncommon cancer with a recognised precursor Anal Intraepithelial Neoplasia (AIN). Although there are consistent evidence-based guidelines for the management of ASCC, historically this has not been the case for AIN and as a result there have been geographical variations in the recommendations for the treatment of AIN. More recently there have been updates in the literature to the recommendations for the management of AIN. To assess whether we are now closer to achieving an international consensus, we have completed a systematic scoping review of available guidelines for the ...
Source: Updates in Surgery - September 4, 2021 Category: Surgery Source Type: research

Prevention of incisional hernia after midline laparotomy for abdominal aortic aneurysm repair
(Source: Updates in Surgery)
Source: Updates in Surgery - September 4, 2021 Category: Surgery Source Type: research

Longitudinal analysis of retroperitoneoscopic adrenalectomy regarding cosmesis outcomes: comparison of lateral transperitoneal and reduced port laparoscopic adrenalectomy
This study is the first comprehensive longitudinal analysis of patient-reported cosmesis outcomes between LRA, LESS/RP-A and LTA. LRA was the surgical procedure that resulted in lower cosmesis scores when compared with those following the LESS/RP-A and LTA procedures. (Source: Updates in Surgery)
Source: Updates in Surgery - September 3, 2021 Category: Surgery Source Type: research

Comparison of a new gasless method and the conventional CO2 pneumoperitoneum method in laparoendoscopic single-site cholecystectomy: a prospective randomized clinical trial
AbstractTo avoid CO2 pneumoperitoneum-associated cardiopulmonary side-effects during conventional laparoscopic surgeries, we have developed a gasless laparoscopic operation field formation (LOFF) device for laparoendoscopic single-site surgery. The aim of this study is to analyze the safety and efficacy of the LOFF device for laparoendoscopic single-site cholecystectomy and to verify its advantage of avoiding CO2 pneumoperitoneum-associated complications. In this prospective, randomized, observer-blinded clinical trial, eligible participants were randomized in a 1:1 ratio to undergo either conventional CO2 pneumoperitoneum...
Source: Updates in Surgery - August 31, 2021 Category: Surgery Source Type: research

Hemithyroidectomy versus total thyroidectomy in the intermediate-risk differentiated thyroid cancer: the Italian Societies of Endocrine Surgeons and Surgical Oncology Multicentric Study
AbstractThe surgical treatment of the intermediate-risk DTC (1 –4 cm) remains still controversial. We analyzed the current practice in Italy regarding the surgical management of intermediate-risk unilateral DTC to evaluate risk factors for recurrence and to identify a group of patients to whom propose a total thyroidectomy (TT) vs. hemithyroidectomy (HT). Am ong 1896 patients operated for thyroid cancer between January 2017 and December 2019, we evaluated 564 (29.7%) patients with unilateral intermediate-risk DTC (1–4 cm) without contralateral nodular lesions on the preoperative exams, chronic autoimm...
Source: Updates in Surgery - August 25, 2021 Category: Surgery Source Type: research