ERAS pathway in colorectal surgery: structured implementation program and high adherence for improved outcomes
AbstractAlthough there is clear evidence that an Enhanced Recovery After Surgery (ERAS) program in colorectal surgery leads to significantly reduced morbidity rates and length of hospital stay (LOS), it is still unclear what modalities and levels of implementation of the program are necessary to achieve these results. The purpose of this study is to analyze the methods and results of the first year of structured implementation of a colorectal ERAS program in two surgical units of the Azienda Sanitaria Unica Regionale (ASUR) Marche in Italy. A two-center observational study on a prospectively maintained database was perform...
Source: Updates in Surgery - October 22, 2020 Category: Surgery Source Type: research

Surgical technique for mesorectal division during robot-assisted laparoscopic tumor-specific mesorectal excision (TSME) for rectal cancer using da Vinci Si surgical system: the simple switching technique (SST)
AbstractIn a narrow pelvic cavity, performing sufficient tumor-specific mesorectal excision (TSME) is difficult. Even in robot-assisted laparoscopic surgery (RALS), mesorectal division is difficult in a narrow pelvic cavity. To overcome this difficulty, we invented a novel method of mesorectal division. In this new approach, we switched the fenestrated bipolar forceps and the double-fenestrated forceps with each other so that both instruments were placed on the same (right) side of the patient. After the mesorectal fat and vessels were coagulated using the fenestrated bipolar forceps, coagulated tissues were divided using ...
Source: Updates in Surgery - October 20, 2020 Category: Surgery Source Type: research

Robotic and open pancreaticoduodenectomy: results from Taipei Veterans General Hospital in Taiwan
This study is to clarify the feasibility and justification of robotic pancreaticoduodenectomy (RPD) by comparing the outcomes between RPD and open pancreaticoduodenectomy (OPD) groups. All perioperative data and outcomes were prospectively collected. There were 304 (63.9%) RPD and 172 (36.1%) OPD. The median operation time was longer in RPD group than OPD (7.5 vs 7.0  h). The blood loss was much lower in RPD group, with a median of 130 vs. 400 c.c. in OPD group. Based on Clavien–Dindo classification, grade 0 (no complication) was 51.8% in RPD group, higher than 43.2% in OPD. Delayed gastric emptying was only 3.5...
Source: Updates in Surgery - October 17, 2020 Category: Surgery Source Type: research

Robotic-assisted resection for beyond TME rectal cancer: a novel classification and analysis from a specialized center
AbstractLocally advanced rectal cancer often requires an extended resection beyond the total mesorectal excision plane (bTME) to obtain clear resection margins. We classified three types of bTME rectal cancer following local disease diffusion: radial (adjacent pelvic organs), lateral (pelvic lateral lymph nodes) and longitudinal (below 3.5  cm from the anal verge, submitted to intersphincteric resection). The primary aim of this study was to evaluate the application of robotic surgery to the three types of bTME regarding the short and long-term oncological outcomes. Secondary aim was to identify survival prognostic fa...
Source: Updates in Surgery - October 17, 2020 Category: Surgery Source Type: research

Changes in gut microbial flora after Roux-en-Y gastric bypass and sleeve gastrectomy and their effects on post-operative weight loss
This study was designed to compare the effects of Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) on two main phyla of the gut microbiota in humans and evaluate their potential effect on weight changes. Thirty morbidly obese patients were divided into two groups and underwent laparoscopic SG or laparoscopic RYGB. The patients ’ weight changes and fecal samples were evaluated at baseline and 6 months after the surgery. A microbial flora count was carried out of the phylaBacteroidetes andFirmicutes andBacteroides Fragilis. Changes in the abundance of the flora and their correlation with weight loss were ana...
Source: Updates in Surgery - October 16, 2020 Category: Surgery Source Type: research

Role of percutaneous cholecystostomy in all-comers with acute cholecystitis according to current guidelines in a general surgical unit
AbstractAcute calculous cholecystitis (ACC) is a very common complication of gallstone-related disease. Its currently recommended management changes according to severity of disease and fitness for surgery. The aim of this observational study is to assess the short- and long-term outcomes in all-comers admitted with diagnosis of ACC, treated according to 2013 Tokyo Guidelines (TG13). A retrospective analysis was conducted on  a prospectively maintained database of 125 patients with diagnosis of ACC consecutively admitted between January 2017 and September 2019, subdivided in three groups according to TG13: percut...
Source: Updates in Surgery - October 15, 2020 Category: Surgery Source Type: research

Robotic-assisted gastrectomy for gastric cancer: single Western center results
This study demonstrated that robotic gastrectomy is feasible a nd can be safely performed. However, further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery. (Source: Updates in Surgery)
Source: Updates in Surgery - October 14, 2020 Category: Surgery Source Type: research

Comparison of emergency cholecystectomy and delayed cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with acute cholecystitis: a systematic review and meta-analysis
AbstractLaparoscopic cholecystectomy and percutaneous transhepatic gallbladder drainage (PTGBD) are common treatments for patients with acute cholecystitis. However, the safety and efficacy of emergency laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) after PTGBD in patients with acute cholecystitis remain unclear. The PubMed, EMBASE, and Cochrane Library databases were searched through October 2019. The quality of the included nonrandomized studies was assessed using the Methodological Index for Nonrandomized Studies (MINORS). The meta-analysis was performed using STATA version 14.2. A ran...
Source: Updates in Surgery - October 13, 2020 Category: Surgery Source Type: research

Robotic hepatic resection in postero-superior region of liver
ConclusionThe results indicated the safety and feasibility of robotic anatomical and non-anatomical liver resections in the posterosuperior hepatic region. The robotic transabdominal approach is an option for hepatectomy in the posterosuperior hepatic region. (Source: Updates in Surgery)
Source: Updates in Surgery - October 8, 2020 Category: Surgery Source Type: research

Current management of acute left colon diverticulitis: What have Italian surgeons learned after the IPOD study?
AbstractThe acute left diverticulitis is a common problem encountered by surgeons in the acute setting. Some years ago, the Italian Prospective Observational Diverticulitis (IPOD) study showed several disputes in managing acute left colon diverticulitis in Italian surgical department. The aim of this study is to check the compliance of Italian surgeons with clinical evidence-based guidelines in non-university hospitals. A 21 multiple-choice questions survey was sent to the Italian Society of Hospital Surgeons (ACOI) mailing list members, from the 1st April 2019 to 6th June 2019. One hundred and seventy-four Italian general...
Source: Updates in Surgery - October 2, 2020 Category: Surgery Source Type: research

Predicting primary postoperative pulmonary complications in patients undergoing minimally invasive surgery for colorectal cancer
ConclusionPrimary postoperative pulmonary complications affected 1.3% of patients undergoing MIS for colon or rectal cancer. The novel predictive risk score showed good discrimination and may help to identify patients who may benefit from perioperative optimization. (Source: Updates in Surgery)
Source: Updates in Surgery - September 30, 2020 Category: Surgery Source Type: research

Percutaneous-assisted vs mini-laparoscopic hysterectomy: comparison of ultra-minimally invasive approaches
AbstractTo assess the feasibility and the safety of the ultra-minimally invasive (U-MIS) approaches in gynecology, we compared our experience in percutaneous assisted hysterectomy (PSS-H) with a series of 3  mm mini-laparoscopy hysterectomy (m-LPS-H). 126 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive hysterectomy: 80 patients received PSS approach and 46  m-LPS approach. For both groups, we evaluated intra and perioperative outcomes, post-operative pain and cosmetic outcomes. The baseline characteristics were comparable between the two study gro...
Source: Updates in Surgery - September 28, 2020 Category: Surgery Source Type: research

Satisfactory short-term outcome of total laparoscopic loop ileostomy reversal in obese patients: a comparative study with open techniques
This study aims to compare short-term outcomes of TLAP and open approaches in obese patients undergoing loop ileostomy reversal after laparoscopic-assisted colorectal surgery. A retrospective review was performed for consecutive patients who underwent laparoscopic-assisted colorectal surgery previously and underwent loop ileostomy reversal between January 2017 and April 2020. TLAP and open cases performed in obese patients were identified and compared for the following outcomes: baseline characteristics, operative outcomes, postoperative recovery, and postoperative complications. TLAP or open-loop ileostomy reversal was pe...
Source: Updates in Surgery - September 25, 2020 Category: Surgery Source Type: research

Factors predicting survival in patients with locally advanced pancreatic cancer undergoing pancreatectomy with arterial resection
This study aimed to identify factors predicting cancer-specific survival in this patient population. A single-Institution prospective database was used. Pre-operative prognostic factors were identified and used to develop a prognostic score. Matching with pathologic parameters was used for internal validation. In a patient population with a median Ca 19.9 level of 19.8  U/mL(IQR: 7.1–77), cancer-specific survival was predicted by: metabolic deterioration of diabetes (OR = 0.22,p = 0.0012), platelet count (OR = 1.00;p = 0.0013), serum level of Ca 15.3 (OR&th...
Source: Updates in Surgery - September 24, 2020 Category: Surgery Source Type: research

Graft factors as determinants of postoperative delirium after liver transplantation
AbstractPost-operative delirium (POD) is a frequent complication after surgery, occurring in 15 –20% of patients. POD is associated with a higher complications rate and mortality. Literature on POD after liver transplantation (LT) is limited, with the few available studies reporting an incidence of 10–47%. The aim of this study was analyzing pattern, risk factors and clinical impact of POD after LT. Data on donor and recipient characteristics, postoperative course and POD of consecutive adult LT recipients from March 2016 to May 2018 were prospectively collected and retrospectively analyzed. Risk factors for PO...
Source: Updates in Surgery - September 23, 2020 Category: Surgery Source Type: research

Surgical strategy for recurrent common bile duct stones: a 10-year experience of a single center
This study aimed to report the experience of treating recurrent CBDS. A total of 106 consecutive cases of recurrent CBDS treated from January 2006 to December 2015 were included. During surgery, the choledochoscopic pass-through test was performed to assess the structure and function of the duodenal papilla. The choledochoscopic pass-through test revealed 62 patients (58.49%) with incomplete closure of the lower end of the common bile duct, and 28 (26.42%) with stenosis at the lower common bile duct. Intra-operative bile bacterial culture was positive in 98 (92.45%) patients. The rate of complete stone clearance was 99.1%....
Source: Updates in Surgery - September 23, 2020 Category: Surgery Source Type: research

Domino-liver transplantation: toward a safer and simpler technique in both donor and recipient
AbstractDomino-liver transplantation represents a rare chance to expand the donor liver pool. Fear of putting both donor and recipient at disadvantage has meant that the procedure has not been applied universally. A modification of the original technique which allows both safe procurement of the graft as well as safe implantation of the reconstructed graft in the domino-graft recipient using a 180 ° rotated, adequately trimmed, free iliaco-caval venous graft is described in detail. (Source: Updates in Surgery)
Source: Updates in Surgery - September 22, 2020 Category: Surgery Source Type: research

Complications in pediatric laparoscopic cholecystectomy: systematic review
This study reviewed the complications of LC in children. MEDLINE/PubMed, CENTRAL and Lilacs were reviewed for LC. Studies in patients  ≤ 18 years of age published in English, Portuguese or Spanish were selected by two independent reviewers. Data were collected for patients’ characteristics, surgical information, complications, mortality and follow-up. Twenty-four papers were identified and offered 2783 patients. Mean age was 11 years (3 months–18 years). In the 93/2783 (3.3%) complications, single-port procedures were associated with seven (7.5%), 3/4-port with 81 (87.1%) an...
Source: Updates in Surgery - September 16, 2020 Category: Surgery Source Type: research

Factors associated with prolonged hospital stay after laparoscopic adrenalectomy
AbstractLaparoscopy is the standard technique for resecting adrenal tumors, but short-term outcomes such as length of stay (LOS) vary widely between centers. We aimed to identify factors associated with LOS after lateral transperitoneal laparoscopic adrenalectomy (LTLA). We analyzed consecutive patients undergoing unilateral LTLA between April 2003 and April 2020. Prolonged LOS was defined as a stay longer than the 75th percentile of the overall cohort. To identify potential factors associated with prolonged LOS, we compared collected data from patients with LOS  ≤ 2 days versus LOS > &thins...
Source: Updates in Surgery - September 16, 2020 Category: Surgery Source Type: research

Cholecystectomy using the Revo-i robotic surgical system from Korea: the first clinical study
This study evaluated the safety and efficacy of the newly developed Revo-i (Meerecompany, Yongin, Republic of Korea) robotic surgical system during robot-assisted cholecystectomy. This prospective, phase I clinical study involved 15 patients with gallbladder-related disease. The primary outcome evaluated was the intraoperative safety of the Revo-i; the secondary outcomes measured were the 30-day postoperative complications and patient satisfaction with the Revo-i ’s performance. Between August 17 and December 23, 2016, we performed 15 robot-assisted cholecystectomies. The operations were successfully completed, witho...
Source: Updates in Surgery - September 15, 2020 Category: Surgery Source Type: research

Full robotic Roux-en-Y reconstruction after gastrectomy for gastric cancer: a loop reconstruction technique
This article including video shows our loop reconstruction technique with an intracorporeal robot-sewn anastomosis after robotic gastrectomy. (Source: Updates in Surgery)
Source: Updates in Surgery - September 14, 2020 Category: Surgery Source Type: research

Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study
In this study, we provided important insights into the superficial and deep SSIs risk assessment for patients who underwent surgery. Simple and easily viable precautions such as wearing surgical masks and the restriction of visitors emerged as promising tools for the reduction of SSIs risk. (Source: Updates in Surgery)
Source: Updates in Surgery - September 13, 2020 Category: Surgery Source Type: research

A comparative cost analysis of transanal and laparoscopic total mesorectal excision for rectal cancer
AbstractDespite proven clinical benefits in the short term, technical difficulties limit utilization of laparoscopy in rectal cancer surgery (RCS). Transanal Total Mesorectal Excision (taTME) overcomes many technical limitations of laparoscopic RCS. However, the costs of this procedure have not been addressed yet. Our goal was to perform a comparative cost analysis of taTME and laparoscopic TME (lapTME). Consecutive patients undergoing curative TME between 1 February 2014 and 31 October 2018 were selected from a prospectively maintained database and stratified, according to the type of procedure, into taTME and lapTME grou...
Source: Updates in Surgery - September 13, 2020 Category: Surgery Source Type: research

Mild impact of SARS-CoV-2 infection on the entire population of liver transplant recipients: the experience of an Italian Centre based in a high-risk area
(Source: Updates in Surgery)
Source: Updates in Surgery - September 9, 2020 Category: Surgery Source Type: research

Are there any limits for laparoscopy in splenomegaly? Our experience
AbstractLaparoscopic splenectomy in the case of massive or supermassive splenomegaly has been associated with higher conversion rates and morbidity. The purpose of our study is to evaluate the feasibility and safety of laparoscopic splenectomy for massive spleens and to identify if there are limits beyond which the laparoscopic approach is not recommended in massive and supermassive spleens. This is a retrospective study of 93 consecutive laparoscopic splenectomies in adult patients performed by a single surgeon, from January 2008 to December 2017. The data collected included the patient ’s age, sex, ASA, spleen weig...
Source: Updates in Surgery - September 6, 2020 Category: Surgery Source Type: research

The role of the comprehensive complication index for the prediction of survival after liver transplantation
This study aims to evaluate the role of the comprehensive complication index (CCI) as a useful scoring system for accurately predicting 90-day and 1-year graft loss after liver transplantation. A training set (n = 1262) and a validation set (n = 520) were obtained. The study was registered athttps://www.ClinicalTrials.gov (ID: NCT03723317). CCI exhibited the best diagnostic performance for 90  days in the training (AUC = 0.94;p 
Source: Updates in Surgery - September 5, 2020 Category: Surgery Source Type: research

Low-molecular weight vs. unfractionated heparin for prevention of venous thromboembolism in general surgery: a meta-analysis
AbstractTo assess the association between low-molecular weight heparin (LMWH) and unfractionated heparin (UFH) in the prevention of venous thromboembolism (VTE) among participants undergoing general surgery. LMWH and UFH are the standard of practice in the prevention of VTE in surgery. However, in the context of general surgery, studies comparing the effectiveness of these treatments are limited. A systematic search was conducted to find studies which examined the comparative effectiveness between LMWH and UFH in the prophylaxis of VTE in the context of general surgery. The number of events of VTE in groups receiving LMWH ...
Source: Updates in Surgery - September 2, 2020 Category: Surgery Source Type: research

Lessons from the past
(Source: Updates in Surgery)
Source: Updates in Surgery - September 2, 2020 Category: Surgery Source Type: research

SimLife model: introducing a new teaching device in endocrine surgery simulation
AbstractTo evaluate the validity and reliability of an innovative training model for endocrine surgical procedures. A simulator training model for endocrine procedures (SimLife) was developed at an academic center. The model consisted of a realistic operating environment with a coherent simulated patient dynamized by pulsatile vascularization with simulated blood warmed to 37  °C, and ventilation. Training sessions were designed for adrenal and thyroid surgery, as well as neck dissection. The primary outcome of interest was to evaluate learners’ performance and satisfaction. Learners’ performance was e...
Source: Updates in Surgery - September 1, 2020 Category: Surgery Source Type: research

The Italian mobile surgical units in the Great War: the modernity of the past
AbstractMedical services in WWI had to face enormous new problems: masses of wounded, most with devastating wounds from artillery splinters, often involving body cavities, and always contaminated. Tetanus, gas gangrene, wound infections were common and often fatal. Abdominal wounds were especially a problem: upon entering the war the commanders of all medical services ordered to avoid surgery, based on dismal experiences of previous wars. Surgical community divided into non-operative and operative treatment supporters. The problem seemed mainly organizational, as the wounded were rescued after many hours and treated by non...
Source: Updates in Surgery - September 1, 2020 Category: Surgery Source Type: research

Safety and effectiveness of minimal sphincterotomy in the treatment of female patients with chronic anal fissure
AbstractTo evaluate the outcome of a left lateral internal sphincterotomy extended for 20% of total sphincter length in female patients with chronic anal fissure, high anal resting pressure and normal preoperative anal continence. Between January 2014 and January 2018 all the female patients with chronic anal fissure showing failure of medical therapy, perfect anal continence (Cleveland Clinic Florida incontinence score  = 0) and high anal resting pressure underwent a lateral internal sphincterotomy extended for 1/5 of total lateral sphincter length, basing on the preoperative measurements by three-dimensiona...
Source: Updates in Surgery - September 1, 2020 Category: Surgery Source Type: research

Synchronous robotic right hemicolectomy and subtotal gastrectomy
AbstractAbout 4% of patients with stomach cancer diagnosis have synchronous colorectal cancer and some of these patients may require a synchronous surgical resection. So far, only few minimally invasive series of synchronous resections have been described. We investigated the feasibility and safety of the synchronous robotic resection of the right colon and stomach malignancies, trying to identify a standardised and reproducible technique. It is essential to carefully plan the operation and the trocars positioning to minimise the number of robotic dockings and be able to operate comfortably. Herein, we describe our approac...
Source: Updates in Surgery - August 26, 2020 Category: Surgery Source Type: research

Letter to the Editor
(Source: Updates in Surgery)
Source: Updates in Surgery - August 26, 2020 Category: Surgery Source Type: research

Blunt liver trauma: effectiveness and evolution of non-operative management (NOM) in 145 consecutive cases
AbstractIn recent decades, haemodynamically stable patients with traumatic liver injuries have been managed conservatively. The primary aim of this study is to retrospectively analyse the outcomes of the authors ’ approach to blunt hepatic trauma according to the degree of injury. The secondary aim is to analyse the changes in the decision-making process for blunt liver trauma management over the last 10 years. A total of 145 patients with blunt liver trauma managed by one trauma team were included in th e study. Causes, sites and grades of injury, clinical conditions, ultrasonography and CT results, associated ...
Source: Updates in Surgery - August 25, 2020 Category: Surgery Source Type: research

Seasonal variations in pancreatic surgery outcome A retrospective time-trend analysis of 2748 Whipple procedures
ConclusionBeing operated when more staff is on vacation significantly affects severe morbidity rate. Future healthcare system policies should prevent the relative shortage of resources during these periods. (Source: Updates in Surgery)
Source: Updates in Surgery - August 19, 2020 Category: Surgery Source Type: research

Response to: “Multidisciplinary treatment of cancer”
(Source: Updates in Surgery)
Source: Updates in Surgery - August 16, 2020 Category: Surgery Source Type: research

Another retrospective, stratified analysis of laparoscopic vs. open approach to colorectal emergency surgery: Are we continuing to compare apples and oranges?
(Source: Updates in Surgery)
Source: Updates in Surgery - August 12, 2020 Category: Surgery Source Type: research

Use of fibrin glue in bariatric surgery: analysis of complications after laparoscopic sleeve gastrectomy on 450 consecutive patients
In this study, we retrospectively compared the efficacy of Fibrin Glue in preventing staple line leak and bleeding. From September 2019 to January 2020, 450 obese patients underwent elective LSG and were placed into groups with Fibrin Glue reinforcement (Group A) or without Fibrin Glue reinforcement (Group B). Primary endpoints were postoperative staple line leak and bleeding; while, secondary endpoints were reintervention rate, total operative time and mortality. Mean Body Mass Index (BMI) was 45.4  ± 7.9 kg/m2 (range: 35.1 –81.8). Mean age was 43.3 ± 11.8 years (r...
Source: Updates in Surgery - August 11, 2020 Category: Surgery Source Type: research

Infectious complications of extra-peritoneal pelvic packing in emergency room
ConclusionsThe EPP is a safe procedure, even when performed out of OR. The EPP in ER allows an earlier control of bleeding in patients in extremis. To minimize the risk of infection, EPP should be removed early, as soon as hemodynamics have been stabilized. (Source: Updates in Surgery)
Source: Updates in Surgery - August 9, 2020 Category: Surgery Source Type: research

Trends of complications and innovative techniques ’ utilization for colectomies in the United States
AbstractDespite an increasing trend towards utilization of minimally invasive approaches (MIS), results regarding their safety profile are contradictory. All patients who underwent elective colectomy for any underlying disease with an identifiable operative approach available from the targeted colectomy files of the ACS-NSQIP PUFs 2013 to 2018 were included. The trend of utilization and complication rates of the different operative approaches (open, laparoscopic, robotic) were assessed during the inclusion period. Furthermore, overall, surgical, and medical complications were compared between the three approaches. The stud...
Source: Updates in Surgery - August 8, 2020 Category: Surgery Source Type: research

Deadlock of proctologic practice in Italy during COVID-19 pandemic: a national report from ProctoLock2020
AbstractProctology is one of the surgical specialties that suffered the most during COVID-19 pandemic. Using data from a cross-sectional worldwide web survey, we aimed to snapshot the current status of proctologic practice in Italy with differences between three macro areas (North, Centre, South).  Specialists affiliated to renowned scientific societies with an interest in coloproctology were invited to join a 27-item survey. Predictive power of respondents’ and hospitals’ demographics on the change of status of surgical activities was calculated. The study was registered at ClinicalTria ls.gov (NCT 043922...
Source: Updates in Surgery - August 7, 2020 Category: Surgery Source Type: research

Correction to: Predictors of bowel necrosis in patients with acute mesenteric ischemia: systematic review and meta-analysis
Table 4: The Column “Biochemical” the entire row “Hyperamylasemia” is missing the updated Table 4 has been copied below (Source: Updates in Surgery)
Source: Updates in Surgery - August 5, 2020 Category: Surgery Source Type: research

Hepatic function assessment to predict post-hepatectomy liver failure: what can we trust? A systematic review
AbstractPost hepatectomy liver failure (PHLF) could occur even though an adequate liver volume is preserved. Liver function is not strictly related to the volume and the necessity to pre-operatively predict the future liver remnant (FLR) function is emerging, together with the wide spreading of techniques, aiming to optimize the FLR. The aim of this study was to systematically review all the available tests, to pre-operatively assess the liver function and to estimate the risk of PHLF. A systematic literature research of Medline, Embase, Scopus was performed in accordance to the  preferred reporting items for systemat...
Source: Updates in Surgery - August 3, 2020 Category: Surgery Source Type: research

Correction to: Ileocecal valve syndrome and vitamin b12 deficiency after surgery: a multicentric prospective study
One of the co-author Eliana Cagnazzo has been incorrectly published. The correct co-author name has been copied below. (Source: Updates in Surgery)
Source: Updates in Surgery - July 31, 2020 Category: Surgery Source Type: research

Is there an indication left for gastric band? A single center experience on 178 patients with a follow-up of 10  years
AbstractBackgroundLaparoscopic Adjustable Gastric Banding (LAGB) has been widely performed in the past at our university bariatric center. Aim of this study was to retrospectively assess long term outcomes of LAGB at our university hospital, with special regard to non-response (EWL    50), while 38 (21.3%) were non-responders (%EWL 
Source: Updates in Surgery - July 30, 2020 Category: Surgery Source Type: research

Laparoscopic versus open hemihepatectomy: comprehensive comparison of complications and costs at 90  days using a propensity method
AbstractLaparoscopic hemihepatectomy (LHH) may offer advantages over open hemihepatectomy (OHH) in blood loss, recovery, and hospital stay. The aim of this study is to evaluate our recent experience performing hemihepatectomy and compare complications and costs up to 90  days following laparoscopic versus open procedures. Retrospective evaluation of patients undergoing hemihepatectomy at our center 01/2010–12/2018 was performed. Patient, tumor, and surgical characteristics; 90-day complications; and costs were analyzed. Inverse probability of treatment weighting (IPTW) was used to balance covariates. A total of ...
Source: Updates in Surgery - July 29, 2020 Category: Surgery Source Type: research

Development of the ‘PREDICT’ score through a systematic review and meta-analysis of the predictive parameters for locoregional recurrence after total mesorectal excision
AbstractBackgroundDespite robust management techniques, locoregional recurrence rates of rectal cancer are still significant. Although offering intensive follow-up has been shown to be beneficial in the early detection, it can be resource consuming. Having a robust knowledge of risk factors of locoregional recurrence will help in identification of patients who actually need intensive follow-up programs. This review aimed to identify the factors that can predict locoregional recurrence after Total mesorectal excision (TME).MethodsWe systematically reviewed PubMed, Scopus and Cochrane for relevant articles with no date restr...
Source: Updates in Surgery - July 29, 2020 Category: Surgery Source Type: research

Predictors of bowel necrosis in patients with acute mesenteric ischemia: systematic review and meta-analysis
AbstractAcute mesenteric ischemia (AMI) is a serious medical condition that can progress to transmural bowel necrosis. Prediction of the onset of bowel necrosis in AMI is crucial to justify surgical intervention before more severe consequences supervene. This systematic review aimed to identify the significant predictors of bowel necrosis in AMI in the current literature. In adherence to the PRISMA guidelines, electronic databases were searched for studies that reported significant independent predictors of bowel necrosis in AMI. The quality of the studies was assessed with MINORS score. The main outcomes of the review wer...
Source: Updates in Surgery - July 28, 2020 Category: Surgery Source Type: research

The modern trauma pancreaticoduodenectomy for penetrating trauma: a propensity-matched analysis
AbstractTrauma pancreaticoduodenectomy (TP) remains a challenging operation with morbidity and mortality rates as high as 80% and 50%. Many trauma surgeons consider it surgical dogma to avoid performing a TP during the index operation for patients with severe pancreatic or duodenal injuries. However, there is no modern analysis evaluating this belief. Therefore, we hypothesized no difference in risk of mortality between patients with severe pancreatic or duodenal injury undergoing a TP for penetrating trauma to propensity-matched controls undergoing laparotomy without TP. The Trauma Quality Improvement Program (2010 &ndash...
Source: Updates in Surgery - July 25, 2020 Category: Surgery Source Type: research

Risk factors and outcomes of conversion to open surgery in endoscopic thyroidectomy via bilateral areola approach: a retrospective Chinese population study
The objective of this study is to analyze the predictors for conversion to open procedure in patients who underwent ETBAA and its related outcomes.MethodsThe clinical data of patients who underwent ETBAA from May 2010 to May 2019 were analyzed retrospectively. The patients were divided into two groups according to operation notes: the conversion group and the non-conversion group. Univariate and multivariate logistic regression analyses were performed to investigate the risk factors for conversion to open surgery.ResultsAltogether, 140 patients were included in this study. Sixteen (11.4%) patients underwent conversion duri...
Source: Updates in Surgery - July 25, 2020 Category: Surgery Source Type: research