Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil
ConclusionBoth postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. (Source: Updates in Surgery)
Source: Updates in Surgery - February 24, 2021 Category: Surgery Source Type: research

Total upper transversal hepatectomy with outflow reconstruction for advanced mass-forming cholangiocarcinoma
We describe a complex case of extended hepatectomy with venous outflow reconstruction for the treatment of advanced mass-forming cholangiocarcinoma (MFCCC) invading the three main hepatic veins (HVs). A 50-year-old woman who received a diagnosis of MFCCC and judged unresectable, was referred to our hospital. After multidisciplinary team evaluation, the patient underwent abdominal computed tomography, gadoxetic acid-enhanced magnetic resonance imaging, and fluorodeoxyglucose positron emission tomography. The radiological examinations showed a large mass located in S4s-8 and S1, in contact with the right hepatic vein (RHV), ...
Source: Updates in Surgery - February 24, 2021 Category: Surgery Source Type: research

External validation of nomogram for predicting malignant intraductal papillary mucinous neoplasm (IPMN): from the theory to the clinical practice using the decision curve analysis model
AbstractThe management of IPMNs is a challenging and controversial issue because the risk of malignancy is difficult to predict. The present study aimed to assess the clinical usefulness of two preoperative nomograms for predicting malignancy of IPMNs allowing their proper management. Retrospective study of patients affected by IPMNs. Two nomograms, regarding main (MD) and branch duct (BD) IPMN, respectively, were evaluated. Only patients who underwent pancreatic resection were collected to test the nomograms because a pathological diagnosis was available. The analysis included: 1-logistic regression analysis to calibrate ...
Source: Updates in Surgery - February 23, 2021 Category: Surgery Source Type: research

Correction to: Platelet indices in patients with acute appendicitis: a systematic review with meta ‑analysis
The original article can be found online. (Source: Updates in Surgery)
Source: Updates in Surgery - February 22, 2021 Category: Surgery Source Type: research

Systematic review of perioperative and oncologic outcomes of minimally-invasive surgery for hilar cholangiocarcinoma
This study aimed to perform a systematic literature review on perioperative and oncologic results of pure laparoscopic and robotic curative-intent surgery for hilar cholangiocarcinoma. According to the PRISMA statement, a systematic review was conducted into Pubmed, EMBASE and Cochrane. A critical appraisal of study was performed according to the Joanna Briggs Institute tools. Nineteen studies (12 on pure laparoscopy and 7 on robotics) were included: 7 case reports, 9 case series, 3 case –control (193 patients). The pooled conversion, morbidity, biliary leak and mortality rates were 5.5%, 43%, 16.4% and 4%. The weigh...
Source: Updates in Surgery - February 22, 2021 Category: Surgery Source Type: research

Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis
ConclusionsOur meta-analysis has shown OAGB-MGB, used as revisional intervention after failed restrictive surgery, achieves outcomes comparable to RYGB in terms of perioperative complications providing a simpler and more effective technique. (Source: Updates in Surgery)
Source: Updates in Surgery - February 19, 2021 Category: Surgery Source Type: research

Implementation of enhanced recovery after surgery and its increasing compliance improved 5-year overall survival in resectable stage III colorectal cancer
ConclusionERAS was associated with improved 5-year OS following non-metastatic CRC surgery (especially stage III disease) than CC. High ERAS compliance had better OS than its counterpart. (Source: Updates in Surgery)
Source: Updates in Surgery - February 18, 2021 Category: Surgery Source Type: research

The comparation of short-term outcome between laparoscopic and open pancreaticoduodenectomy: a propensity score matching analysis
AbstractPancreaticoduodenectomy (PD) is one of the most complex and delicate operations in abdominal surgery. With the development of laparoscopic techniques, more and more pancreatic experts have become skilled in laparoscopic pancreaticoduodenectomy (LPD). However, the short-term efficacy of LPD compared to open pancreaticoduodenectomy (OPD) remains unclear. Here, we performed a propensity score matching study aiming to compare the short outcomes of patients who underwent LPD or OPD after the learning curve and established a risk model of pancreatic fistula. The data of 346 patients who had OPD or LPD from July 2015 to J...
Source: Updates in Surgery - February 15, 2021 Category: Surgery Source Type: research

The impact of intracorporeal anastomosis in right laparoscopic colectomy in the surgical site infections and the hospital stay: a cohort study
AbstractIleocolic anastomosis in laparoscopic-assisted right colectomy is frequently performed extracorporeally. Intracorporeal anastomosis could be associated with several short-term benefits. However, it is a more technically demanding procedure. The primary endpoint of the study aimed to evaluate the postoperative surgical-site infection rate and its impact on the length of hospital stay after laparoscopic right colectomy with intracorporeal anastomosis compared to extracorporeal anastomoses. Between 2010 and 2019, 108 unselected consecutive patients underwent right colectomy. An observational comparative cohort study o...
Source: Updates in Surgery - February 15, 2021 Category: Surgery Source Type: research

Meta-analysis and trial sequential analysis of three-port vs four-port laparoscopic cholecystectomy (level 1 evidence)
AbstractTo compare the outcomes of three-port and four-port laparoscopic cholecystectomy. In compliance with PRISMA statement standards, electronic databases were searched to identify all comparative studies investigating outcomes of three-port vs four-port laparoscopic cholecystectomy. Two techniques were compared using direct comparison meta-analysis model. The risks of type 1 or type 2 error in the meta-analysis model were assessed using trial sequential analysis model. The certainty  of evidence was assessed using GRADE system. Random effects modelling was applied to calculate pooled outcome data. Analysis of 2524...
Source: Updates in Surgery - February 15, 2021 Category: Surgery Source Type: research

Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients
AbstractPostoperative complications and mortality rates after rectal cancer surgery are higher in elderly than in non-elderly patients. The aim of this study is to evaluate whether, like in open surgery, age and comorbidities affect postoperative outcomes limiting the benefits of a laparoscopic approach. Between April 2011 and July 2020, data of 287 patients with rectal cancer submitted to laparoscopic rectal resection from different institutions were collected in an electronic database and were categorized into two groups:  
Source: Updates in Surgery - February 14, 2021 Category: Surgery Source Type: research

Effect of antithrombotic therapy on postoperative outcome of 538 consecutive emergency laparoscopic cholecystectomies for acute cholecystitis: two Italian center ’s study
AbstractThe risk of developing hemorrhagic complications during or after emergency cholecystectomy (EC) for acute cholecystitis (AC) in patients with antithrombotic therapy (ATT) remains uncertain. In this double-center study, we evaluated post-operative outcomes in patients with ATT undergoing EC. We retrospectively evaluated 538 patients who underwent laparoscopic EC for AC between May 2015 and December 2019 at two referral centers. 89 of them (17%) were on ATT. We defined postoperative complication rates, including bleeding, as our primary outcome. Mortality was higher in the ATT group. Morbidity was higher in the ATT g...
Source: Updates in Surgery - February 13, 2021 Category: Surgery Source Type: research

Pancreatoduodenectomy associated with colonic resections: indications, pitfalls, and outcomes
AbstractPancreatoduodenectomy (PD) associated with colonic resections (CR) (PD-CR) might be a viable option in case of locally advanced periampullary tumors or right colon cancer. The aim of this review was to reappraise the indications and outcomes of PD-CR focusing on the occurrence of postoperative pancreatic fistula (POPF) and colonic anastomotic leak (CAL). A systematic literature search was performed in Medline and Cochrane Central Register of Controlled Trials (CENTRAL) for studies published between 2000 and 2020 concerning PD-CR for periampullary or colonic neoplasms. Twenty-seven studies were selected. Morbidity a...
Source: Updates in Surgery - February 13, 2021 Category: Surgery Source Type: research

A novel method for π-shaped esophagojejunostomy and double-tract reconstruction (DTR) as an alternative in totally laparoscopic or robotic proximal gastrectomy for treating upper third proximal early gastric cancer
This study evaluated the impact of a new intracorporeal π-shaped esophagojejunostomy (EJS) and double-tract reconstruction (DTR) in totally laparoscopic and totally robotic proximal gastrectomy (TLPG or TRPG) for treating upper third early gastric cancer (U-EGC) in terms of intraoperative and short-term postoperative outcomes. Early proximal gastric can cer patients were identified based on a prospectively established database. From January 2017 to December 2018, these patients underwent intracorporeal π-shaped EJS and DTR after totally laparoscopic (n = 8) or robotic (n = 4) proximal gast...
Source: Updates in Surgery - February 12, 2021 Category: Surgery Source Type: research

Full robotic multivisceral resections: the Modena experience and literature review
AbstractThe robotic platform is becoming a multidisciplinary tool, versatile, and suitable for multiple procedures. Combined multivisceral resections may represent an alternative to sequential procedures with a potential favorable impact on postoperative morbidity, and on the timing of administration of adjuvant chemotherapy. We herein present our initial experience with full robotic multivisceral resections, and a review of the literature available. Between January 2018 and April 2020, 11 patients underwent multivisceral full robotic abdominal surgery: 4 patients presented with two synchronous tumors, 4 with primary cance...
Source: Updates in Surgery - February 11, 2021 Category: Surgery Source Type: research

Prediction of R0/R+ surgery by different classifications for locally recurrent rectal cancer
AbstractA widely adopted classification system for locally recurrent rectal cancer (LRRC) is currently missing, and the indication for surgery is not standardized. To evaluate all the published classification systems in a large monocentric cohort of LRRC patients, assessing their capability to predict a radical (R0) resection. A total of 152 consecutive LRRC patients treated at the National Cancer Institute of Milan (NCIM) from 2009 to 2017 were classified according to Pilipshen, Mayo Clinic, Memorial Sloan-Kettering Cancer Center (MSKCC), Wanebo, Yamada, Boyle, Dutch TME Trial, Royal Marsden and National Cancer Institute ...
Source: Updates in Surgery - February 8, 2021 Category: Surgery Source Type: research

Incidence of adhesive small bowel obstruction after gastrectomy for gastric cancer and its risk factors: a long-term retrospective cohort study from a high-volume institution in China
AbstractAdhesive small bowel obstruction (ASBO) has a significant impact on quality of life and medical costs. However, data about ASBO after gastrectomy remain sparse. From January 2009 to December 2017, 3025 patients who underwent gastrectomy for gastric cancer were retrospectively collected and analyzed. Clinicopathological materials were obtained retrospectively, and univariate and multivariate regression analyses were performed to determine risk factors for ASBO. A nomogram for the prediction of ASBO was generated using the results of multivariable analyses. Bootstraps with 1000 resamples were performed for internal v...
Source: Updates in Surgery - February 6, 2021 Category: Surgery Source Type: research

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for resectable peritoneal metastases is feasible in elderly patients
AbstractThe aim is to evaluate the feasibility and the prognosis of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for resectable peritoneal metastases (RPM) in elderly patients. Patients who underwent CRS with HIPEC for RPM between 2012 and 2018 in one tertiary reference center were retrospectively included and divided according to the age: Group A (
Source: Updates in Surgery - February 6, 2021 Category: Surgery Source Type: research

Comparative short-term outcomes of robotic-assisted surgery for older patients with non-small cell lung cancer: a propensity matched study
AbstractTo investigate comparative short-term outcomes of robotic-assisted surgery (RAS) versus video-assisted thoracoscopic surgery (VATS) for older non-small cell lung cancer (NSCLC) patients. Patients ≥ 65 years old with stage I–III NSCLC operated with RAS or VATS from 2016 to 2018 were consecutively included. Propensity score-matched (PSM) method was implemented to balance inter-group biases. Totally 376 participants (224 with VATS and 152 with RAS) were included. After PSM, a cohort (144 with VATS and 107 with RAS) was generated with balanced baseline characteristics. RAS was significantly superio...
Source: Updates in Surgery - February 4, 2021 Category: Surgery Source Type: research

Re-exploring the pelvic neuroanatomy from a new perspective and a potential guidance for TaTME: a “bottom-up” approach
We report anatomical observations deriving from a relevant experience in the colorectal surgery field. The collective multicenter experience of the present study is clinically relevant and based on the rectal and transanal resections performed in colorectal centers of excellence from Greece, UK, and Italy over the last 10  years (2011–2020). From the original anatomical and intraoperative observations derived from collective cases operated by this multicenter group of colorectal surgical centers in three European countries, data were retrieved and analyzed in collaboration with specialist researchers of hum...
Source: Updates in Surgery - February 3, 2021 Category: Surgery Source Type: research

Meta-analysis of randomised controlled trials comparing intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: upgrading the level of evidence
AbstractThe need for escalation of level of evidence regarding the comparative outcomes of intracorporeal (ICA) and extracorporeal (ECA) anastomosis in laparoscopic right hemicolectomy has been persistently highlighted by previous meta-analyses of level 2 and 3 evidence. A systematic search of electronic databases and bibliographic reference lists were conducted. Overall perioperative morbidity, anastomotic leak, surgical site infection (SSI), paralytic ileus, bleeding, postoperative pain within 5  days, length of incision, conversion to an open procedure, harvested lymph nodes, procedure time, and length of hospital ...
Source: Updates in Surgery - February 3, 2021 Category: Surgery Source Type: research

Mean platelet volume may not decrease in patients with acute appendicitis
(Source: Updates in Surgery)
Source: Updates in Surgery - February 2, 2021 Category: Surgery Source Type: research

Foreword
(Source: Updates in Surgery)
Source: Updates in Surgery - February 1, 2021 Category: Surgery Source Type: research

Prognosis and factors affecting colorectal cancer with ovarian metastasis
AbstractColorectal cancer is one of the most common malignant tumors. Its incidence has been increasing in recent years, as has the number of cases of ovarian metastasis of colorectal cancer. The prognosis of colorectal cancer with ovarian metastasis is poor, and it is an important cause of death in female patients. A variety of clinicopathological factors were found to be related to the prognosis of patients with colorectal cancer with ovarian metastasis, such as menopausal status, metastasis limited to the pelvis, and tumor differentiation. Tumor genetic characteristics also provide a new perspective for the prognostic e...
Source: Updates in Surgery - February 1, 2021 Category: Surgery Source Type: research

Congenital diaphragmatic hernia repair analysis in relation to postoperative abdominal compartment syndrome and delayed abdominal closure
ConclusionsACS/DAC after CDH repair are reported more frequently in neonates (112/118; 94.9%). There is no clear rationale stated behind the decision to perform DAC, with the silo being the preferred approach. Criteria need to be worked for DAC in CDH with large herniated content and small volume abdomen to prevent ACS. (Source: Updates in Surgery)
Source: Updates in Surgery - January 28, 2021 Category: Surgery Source Type: research

Stapler-less burst pressure in an ex vivo human gastric tissue: a randomized controlled trial
AbstractStapler-less laparoscopic sleeve gastrectomy (LSG) is emerging as a new potential affordable cost-effective alternative procedure. However, no pre-clinical data are currently available on human tissue. We aimed to evaluate whether traditionally suturing without the use of surgical stapling may produce a comparable bursting pressure on human gastric tissue. A prospective cohort of consecutive patients undergoing LSG was divided in two groups to compare a barbed extra-mucosal running suture (stapler-less) versus a standard stapler line. A burst pressure test was applied to the gastric specimen employing high-resoluti...
Source: Updates in Surgery - January 26, 2021 Category: Surgery Source Type: research

Mesenteric lengthening during pouch surgery: technique and outcomes in a tertiary centre
AbstractAnastomotic complications after ileal pouch-anal anastomosis (IPAA) are often associated with excessive tension and poor blood supply. Carrying out a tension-free IPAA might prove difficult in a proportion of cases, especially if mucosectomy and hand-sewn anastomosis are necessary. The aim of the study was to analyse the outcomes of mesenteric lengthening in patients undergoing IPAA in a tertiary centre. Consecutive patients who required mesenteric lengthening during IPAA surgery between 2000 and 2019 were retrospectively included. Short and long-term outcomes were analyzed. Chi square, Fisher ’s exact test a...
Source: Updates in Surgery - January 25, 2021 Category: Surgery Source Type: research

Laparoscopic resection and primary anastomosis for perforated diverticulitis: with or without loop ileostomy?
ConclusionLaparoscopic RPA had favorable outcomes in selected patients with Hinchey III diverticulitis. The addition of a proximal ileostomy resulted in increased morbidity, readmissions, and length of stay. Further investigation is needed to establish which patients might benefit from proximal diversion. (Source: Updates in Surgery)
Source: Updates in Surgery - January 24, 2021 Category: Surgery Source Type: research

Intra-pancreatic distal cholangiocarcinoma and pancreatic ductal adenocarcinoma: a common short and long-term prognosis?
AbstractThe aim of the study was to compare histological features, postoperative outcomes, and long-term prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma. From 2005 to 2017, 188 pancreaticoduodenectomies (pancreatic ductal adenocarcinoman = 151, distal cholangiocarcinoman = 37) were included. Postoperative outcomes were compared after matching on pancreatic gland texture and main pancreatic duct size. Matching according to tumor size, lymph node invasion and resection margin was used to compare overall and disease-free survival. ...
Source: Updates in Surgery - January 24, 2021 Category: Surgery Source Type: research

Robotic gastrointestinal surgery: learning curve, educational programs and outcomes
This article will focus on the implementation of the robotic platform for surgery of the pancreas, stomach, liver, colon and rectum with an emphasis on the associated learning curve, educational platforms to develop proficiency and perioperative outcomes. (Source: Updates in Surgery)
Source: Updates in Surgery - January 23, 2021 Category: Surgery Source Type: research

The art of robotic colonic resection: a review of progress in the past 5  years
AbstractSurgery is developing in the direction of minimal invasiveness, and robotic surgery is becoming increasingly adopted in colonic resection procedures. The ergonomic improvements of robot promote surgical performance, reduce workload for surgeons and benefit patients. Compared with laparoscopy-assisted colon surgery, the robotic approach has the advantages of shorter length of hospital stay, lower rate of conversion to open surgery, and lower rate of intraoperative complications for short-term outcomes. Synchronous robotic liver resection with colon cancer is feasible. The introduction of the da Vinci Xi System (Intu...
Source: Updates in Surgery - January 22, 2021 Category: Surgery Source Type: research

Timing of cholecystectomy for acute cholecystitis impacts surgical morbidity and mortality: an NSQIP database analysis
AbstractThe aim of this study is to identify the optimal timing for cholecystectomy for acute cholecystitis. Patients undergoing cholecystectomy for acute cholecystitis from the National Surgery Quality Improvement Program database between 2014 and 2016 were included. The patients were divided into 4 groups, those who underwent surgery at days 0, 1, 2, or 3+  days. The primary outcome was short-term surgical morbidity and mortality. A total of 21,392 patients were included. After adjusting for confounders, compared to day 0 patients, those who underwent surgery at day 1 and day 2 had lower composite morbidity rate, ...
Source: Updates in Surgery - January 21, 2021 Category: Surgery Source Type: research

Viability testing during normothermic machine perfusion requires both hepatocellular and cholangiocellular criteria
(Source: Updates in Surgery)
Source: Updates in Surgery - January 21, 2021 Category: Surgery Source Type: research

Outcome of bile leakage following liver resection with hepaticojejunostomy for liver cancer
AbstractWe aimed to investigate contemporary management and outcomes of bile leakage in patients who underwent hepatectomy with hepaticojejunostomy for liver malignancy. The NSQIP database was used to study clinical data of patients who underwent a hepatectomy with hepaticojejunostomy for a primary hepatobiliary cancer and developed bile leakage between 1/2014 and 12/2017. Multivariate regression analysis was performed to investigate outcomes. Five hundred patients underwent a hepatectomy with hepaticojejunostomy for a malignant primary hepatobiliary cancer (41% intrahepatic cholangiocarcinoma, 38.2% hilar cholangiocarcino...
Source: Updates in Surgery - January 20, 2021 Category: Surgery Source Type: research

Gender disparities in Ecuador: a survey study of the under-representation of women in surgery
AbstractThe aim of this study is to describe the state of gender representation in surgery across Ecuador.  A survey of female surgeons in Ecuador was conducted, collecting information regarding demographics, academics, family and relationships, sexual harassment, discrimination and gender preference of one’s own surgeon. All statistical analysis was conducted with IBM-SPSS version 25. The platform,Worlde, was used for discourse analysis. Of the 144 female surgeons who received the survey, 105 responded.  Almost half of respondents had a higher degree in addition to their surgical training. Leadership posit...
Source: Updates in Surgery - January 19, 2021 Category: Surgery Source Type: research

Application of ERAS protocol in esophagectomy: a national survey among Italian centers performing esophageal surgery
AbstractThe application of enhanced recovery after surgery guidelines for esophageal surgery in different units remains unclear. This survey intended to investigate how such protocol is applied among Italian esophageal surgery units. A survey with 40 questions was mailed to Italian centers that performed at least 10 esophagectomies per year. It included questions about the type of hospital and unit and pre-, intra- and post-operative items. Difficulties encountered were investigated. Thirteen (65%) centers answered the survey, and all met the minimal safety requirements, e.g., the presence of intensive care units and 24-h ...
Source: Updates in Surgery - January 13, 2021 Category: Surgery Source Type: research

Platelet indices in patients with acute appendicitis: a systematic review with meta-analysis
AbstractCorrelation between blood inflammatory parameters and acute appendicitis (AA) remains controversial. This meta-analysis aims to evaluate whether platelet (PLT) indices including mean platelet volume (MPV), PLT count, and platelet distribution width (PDW) are associated with AA. Pubmed, Embase, and Cochrane Library databases were searched for observational studies published from inception through April 2020 by two independent investigators. Studies reporting associations between platelet indices and AA were selected for inclusion. Standardized mean difference (SMD) and 95% confidence interval (CI) were estimated for...
Source: Updates in Surgery - January 13, 2021 Category: Surgery Source Type: research

Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis
AbstractMorbid obesity is a global chronic disease, and bariatric procedures have been approved as the best method to control obesity. Roux-en-Y gastric bypass is one of the most common bariatric surgeries in the world and has become the gold standard procedure for many years. However, some patients experience weight regain or weight loss failure after the initial bypass surgery and require revisional or conversional interventions. International databases including PubMed, International Scientific Indexing (ISI), and Scopus were considered for a systematic search of articles that were published by 5th of May 2020. Forty-on...
Source: Updates in Surgery - January 11, 2021 Category: Surgery Source Type: research

Letter to the editor
(Source: Updates in Surgery)
Source: Updates in Surgery - January 11, 2021 Category: Surgery Source Type: research

Upper GI training of young surgeons: a reality full of hurdles. An international survey
ConclusionsThe present survey reveals that the young surgeons of the twenty-first century face many hurdles during their surgical training. Overall, the surgical education settings are limited for both practical and scientific training for upper GI trainees. As a result, it is not possible to train in upper GI surgery to a level of competent independent practice. (Source: Updates in Surgery)
Source: Updates in Surgery - January 8, 2021 Category: Surgery Source Type: research

Intraoperative neuromonitoring during prone thoracoscopic esophagectomy for esophageal cancer reduces the incidence of recurrent laryngeal nerve palsy: a single-center study
AbstractThe incidence of recurrent laryngeal nerve palsy (RLNP) following minimally invasive esophagectomy has yet to be satisfactorily reduced. Use of intraoperative neuromonitoring (IONM), specifically of the RLN, during thyroidectomy has been reported to reduce the incidence of RLN injury. We now apply IONM during curative prone thoracoscopic esophagectomy, and we conducted a retrospective study to evaluate the feasibility and efficacy of intermittent monitoring of the RLN during the surgery. The study involved 32 consecutive patients who underwent esophagectomy with radical lymph node dissection for esophageal cancer. ...
Source: Updates in Surgery - January 7, 2021 Category: Surgery Source Type: research

Robotic approach for partial adrenalectomy
AbstractAlthough safe and feasible, partial adrenalectomy is not a widespread procedure. Endorsement of robotic technologies and fluorescence techniques in adrenal surgery might help develop partial adrenalectomy and could avoid unnecessary total adrenalectomies. When performed in selected cases, partial adrenalectomy is associated with good postoperative outcomes comparable with those reported after total adrenalectomy. It has been hypothesized that one of the advantages of the robotic approach in adrenal-sparing surgery is to reduce manipulation of the gland allowing preservation of the vascularization of the residual ad...
Source: Updates in Surgery - January 7, 2021 Category: Surgery Source Type: research

Major robotic hepatectomies: technical considerations
AbstractRobotic approach to the liver may allow to perform difficult resections with a minimally invasive strategy in an easier way as compared to standard laparoscopy. The aim of this study is to review our experience with robotic major hepatectomies, reporting technical considerations, and describing the outcomes of patients that underwent either left (LRH) or right robotic hepatectomy (RRH). Our prospectively maintained database was screened to identify all patients that received a major liver resection for benign or malignant disease. Preoperative data and postoperative short-term and long-term outcomes were reported. ...
Source: Updates in Surgery - January 7, 2021 Category: Surgery Source Type: research

Anastomosis configuration and technique following ileocaecal resection for Crohn ’s disease: a multicentre study
AbstractA limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30  d...
Source: Updates in Surgery - January 6, 2021 Category: Surgery Source Type: research

Does preoperative stent positioning in obstructive left sided colon cancer increase the risk of perineural invasion?
AbstractColonic stenting as a bridge to surgery has been shown to be a safe and effective treatment for left-sided malignant colonic obstruction depending on local expertise. However, concerns still exist regarding its oncological safety. In particular, several reports showed an increased prevalence of perineural tumor invasion following stent placement. Since perineural invasion negatively affects oncological outcomes, the present study sought to evaluate this controversial association. We retrospectively reviewed 114 patients presenting with left-side obstructing colon cancer over a 10-year period. The relationship betwe...
Source: Updates in Surgery - January 6, 2021 Category: Surgery Source Type: research

How, Why, and When to administer transversus abdominis plane block in laparoscopic surgery?
(Source: Updates in Surgery)
Source: Updates in Surgery - January 6, 2021 Category: Surgery Source Type: research

The use of an implemented infection prevention bundle reduces the incidence of surgical site infections after colorectal surgery: a retrospective single center analysis
AbstractBackgroundSurgical-site infections (SSIs) represent the most common complications after colorectal surgery (CS). Role of preoperative administration of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP), alone or in combination, in the prevention of SSIs after CS is debated. Aim of this study was to assess the effect of the introduction of an Implemented Infection Prevention Bundle (IIPB) in preventing SSIs in CS.MethodsA group of 251 patients (Group 1) who underwent CS receiving only preoperative intravenous antibiotic prophylaxis (IAP) was compared to a Group of 107 patients (Group 2) who al...
Source: Updates in Surgery - January 5, 2021 Category: Surgery Source Type: research

Robotic assistance for quick and accurate image-guided needle placement
AbstractComputed tomography (CT) image-guided procedures including biopsy, drug delivery, and ablation are gaining increasing application in medicine. Robotic technology holds the promise for allowing surgeons, and other proceduralists, access to such CT-guided procedures by potentially shortening training, improving accuracy, decreasing needle passes, and reducing radiation exposure. We evaluated surgeon learning and proficiency for image-guided needle placement with an FDA-cleared robotic arm. Five out of six surgeons had no prior CT-guided procedural experience, while one had prior experience with freehand CT-guided nee...
Source: Updates in Surgery - January 4, 2021 Category: Surgery Source Type: research

Development and validation of risk prediction score for incisional surgical site infection after appendectomy
AbstractSurgical site infection (SSI) is a challenging and resource-consuming healthcare problem. Predicting the onset of SSI beforehand can help prevent or minimize its incidence. The present study aimed to determine the independent predictors of incisional SSI after open appendectomy using a multivariate analysis and to establish a predictive risk score of SSI after appendectomy. Records of eligible patients who underwent open appendectomy were reviewed. The characteristics and treatment outcomes of patients were collected and analyzed. Significant association between different variables and SSI after appendectomy was ex...
Source: Updates in Surgery - January 4, 2021 Category: Surgery Source Type: research

Current status of robotic gastrectomy for gastric cancer: comparison with laparoscopic gastrectomy
AbstractRobotic systems were developed to overcome limitations of laparoscopic surgery with its mechanical advantages. Along with the technical advances, robotic gastrectomy for gastric cancer is increasing. However, the evidence regarding safety and efficacy for robotic gastrectomy for gastric cancer is not mature yet. Although studies are limited, it is evident that robotic gastrectomy has a longer operation and less blood loss compared with laparoscopic gastrectomy. Studies revealed long-term oncological outcomes after robotic gastrectomy was comparable to those after laparoscopic gastrectomy. Taken together, robotic ga...
Source: Updates in Surgery - January 4, 2021 Category: Surgery Source Type: research