The role of transanal compared to laparoscopic total mesorectal excision (taTME vs. lapTME) for the treatment of mid-low rectal cancer in obese patients: outcomes of a multicenter propensity-matched analysis
AbstractTo compare the rate of sphincter-saving interventions between transanal and laparoscopic Total Mesorectal Excision in this particular group of patients. A multicentre observational study was conducted using a prospective database, including patients diagnosed with rectal cancer below the peritoneal reflection and BMI ≥ 30 kg/m2, who underwent minimally invasive elective surgery over a 5-year period. Exclusion criteria were (1) sphincter and/or puborectalis invasion; (2) multi-visceral resections; (3) palliative surgeries. The study population was divided into two groups according to the intervention: transa...
Source: Updates in Surgery - October 31, 2023 Category: Surgery Source Type: research
Using the hazard function to evaluate hepatocellular carcinoma recurrence risk after curative resection
This study aimed to use the hazard function to investigate recurrence hazard and peak recurrence time transitions in patients with HCC undergoing liver resection (LR). We enrolled 1204 patients with HCC undergoing LR between 2007 and 2018 at our institution. Recurrence hazard, patterns, and peak rates were analyzed. The overall recurrence hazard peaked at 7.2 months (peak hazard rate [pHR]: 0.0197), but varied markedly. In subgroups analysis based on recurrence risk factors, patients with a high radiographic tumor burden score (pHR: 0.0521), alpha-fetoprotein level ≥ 400 ng/ml (pHR: 0.0427), and pT3–4 (pHR: 0.06...
Source: Updates in Surgery - October 30, 2023 Category: Surgery Source Type: research
Microwave ablation for large benign thyroid nodules: a proposal for a new approach: “the fluid-motion technique”
ConclusionOur study shows that ultrasound-guided MWA is an effective and safe minimally invasive treatment for benign thyroid nodules. The goal is to achieve a VRR that can reduce symptoms and improve cosmetic appearance. (Source: Updates in Surgery)
Source: Updates in Surgery - October 29, 2023 Category: Surgery Source Type: research
Uterine retroversion and gluteal transposition flap for postoperative perineal evisceration after extralevator abdominoperineal resection
AbstractAnal squamous cell carcinoma (ASCC) is the most common histological subtype of malignant tumor affecting the anal canal. Chemoradiotherapy (CRT) is the first-line treatment in nearly all cases, ensuring complete clinical response in up to 80% of patients. Abdominoperineal resection (APR) is typically reserved as salvage therapy in those patients with persistent or recurrent tumor after CRT. In locally advanced tumors, an extralevator abdominoperineal excision (ELAPE), which entails excision of the anal canal and levator muscles, might be indicated to obtain negative resection margins. In this setting, the combinati...
Source: Updates in Surgery - October 29, 2023 Category: Surgery Source Type: research
Comparison of clinical outcomes of anal fistula plug and endoanal advancement flap repair treating the complex anal fistula: a systematic review and meta-analysis
AbstractAnal fistula (AF) is a common disease with high prevalence and surgical operations are effective treatments in clinical work. There exist many well ‐known surgical techniques treating complex anal fistula (CAF), however, none is ideal. To compare the superiority of Anal fistula plug (AFP) and Endoanal advancement flap repair (EAFR) for complex anal fistula. We searched worldwide databases including Pubmed, Embase, Cochrane Library, Web of Sc ience, CNKI, WanFang, VIP, and SinoMed from their inception to March 2023. Studies comparing the outcomes of AFP and EAFR were included according to the PICO principles. The ...
Source: Updates in Surgery - October 26, 2023 Category: Surgery Source Type: research
Current status of liver surgery for non-colorectal non-neuroendocrine liver metastases: the NON.LI.MET. Italian Society for Endoscopic Surgery and New Technologies (SICE) and Association of Italian Surgeons in Europe (ACIE) collaborative international survey
AbstractDespite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and inconclusive, as in our case. The dissemination of this preliminary survey would allow us to understand if the creation of an International Registry is a viable option, while still offering a snapshot on this issue, investigating clinical practices worldwide. The steering comm...
Source: Updates in Surgery - October 24, 2023 Category: Surgery Source Type: research
Transition from laparoscopic to robotic approach in rectal cancer: a single-center short-term analysis based on the learning curve
AbstractAs a novel procedure becomes more and more used, knowledge about its learning curve and its impact on outcomes is useful for future implementations. Our aim is (i) to identify the phases of the robotic rectal surgery learning process and assess the safety and oncological outcomes during that period, (ii) to compare the robotic rectal surgery learning phases outcomes with laparoscopic rectal resections performed before the implementation of the robotic surgery program. We performed a retrospective study, based on a prospectively maintained database, with methodological quality assessment by STROBE checklist. All the...
Source: Updates in Surgery - October 24, 2023 Category: Surgery Source Type: research
Laparoscopic transabdominal anterior bilateral adrenalectomy (La-TABA): an alternative approach for severe Cushing ’s syndrome
We report our preliminary experience with an alternative approach in this selected patients’ category. Among 613 patients who underwent endoscopic adrenalectomy at our centre (34–5.6% BA) between January 1997 and October 2021, 3 patients were scheduled for laparoscopic transabdominal anterior bilateral adrenalectomy (La-TABA). Surgery was performed with patient in supine position, with fastened arms and legs to allow Trendelenburg and anti-Trendelenburg movements and lateral rotations. The procedure consisted in a synchronous bilateral adrenalectomy. A modern multi-articulated operative table provided rotations on the ...
Source: Updates in Surgery - October 21, 2023 Category: Surgery Source Type: research
Updated findings of skin flap thickness and residual breast tissue after mastectomy for breast cancer: a systematic review of the literature
ConclusionCamper's fascia can serve as an ideal demarcation between fat and breast tissue based on most current studies. 5 mm thickness of the flap retention in mastectomy is recommended if Camper's fascia is absent or obscure, through which better cosmetic outcomes and less RBT can be achieved. (Source: Updates in Surgery)
Source: Updates in Surgery - October 21, 2023 Category: Surgery Source Type: research
Robotic-assisted Roux-en-Y gastric bypass with the novel platform HugoTM RAS: preliminary experience in 15 patients
In this study, we present the first fifteen cases of Roux-en-Y Gastric Bypass (RYGB) operations performed with the new Hugo ™ RAS system (Medtronic, Minneapolis, MN, USA). From January to March 2023, consecutive patients scheduled for minimal invasive Roux-en-Y-Bypass were randomly selected and underwent the procedure robotic-assisted with the new platform. No exclusion criteria were applied. Seven female and eight mal e patients with a median BMI of 42 (range: 36–50) and obesity-related comorbidities in eight cases underwent RYGB. The median docking time was 7 min (range: 6–8.5) and the median console time was 100...
Source: Updates in Surgery - October 20, 2023 Category: Surgery Source Type: research
The effect of platelet-to-lymphocyte rat ıo (PLR) and glasgow prognostıc score (GPS) on recurrence, and survıval ın patıents undergoıng lobectomy for early-stage non-small cell lung cancer (NSCLC)
In this study, we investigated the prognostic impact of the platelet-to-lymphocyte ratio (PLR) and Glasgow Prognostic Score (GPS), known as inflammation markers in peripheral blood, in patients who underwent resection for early-stage non-small cell lung cancer (NSCLC). We retrospectively analyzed the medical records of a total of 3300 patients who underwent surgery for NSCLC between 2010 and 2020. Among these patients, 250 met the inclusion criteria of lobectomy, pT1-T2N0 stage, and histology of adenocarcinoma or squamous cell carcinoma. Preoperative albumin, C-reactive protein (CRP), preoperative PLR, and postoperative 5t...
Source: Updates in Surgery - October 18, 2023 Category: Surgery Source Type: research
Mechanical bowel preparation in elective colorectal surgery: a propensity score-matched analysis of the Italian colorectal anastomotic leakage (iCral) study group prospective cohorts
This study confirms that no MBP before elective colorectal surgery is significantly associated with a lower risk of AL, reoperation rate, and LOS < 6 days when compared with MBP. (Source: Updates in Surgery)
Source: Updates in Surgery - October 18, 2023 Category: Surgery Source Type: research
Laparoscopic approach in the management of diaphragmatic eventration in adults: gastrointestinal surgical perspective
AbstractThe current literature is poor with studies handling the role of laparoscopy in managing diaphragmatic eventration (DE). Herein, we describe our experience regarding the role of laparoscopy in managing DE patients presenting mainly with gastrointestinal symptoms. We retrospectively reviewed the data of 20 patients who underwent laparoscopic diaphragmatic plication between January 2010 and December 2018. Postoperative outcomes and quality of life were assessed. Most DEs were left sided (95%). Laparoscopic diaphragmatic plication was possible in all patients, along with correcting all associated gastrointestinal and ...
Source: Updates in Surgery - October 17, 2023 Category: Surgery Source Type: research
World ’s first report of sigmoidectomy for sigmoid cancer using the Saroa surgical system with tactile feedback
AbstractIncreasing evidence based on the safety and benefits of robot-assisted surgery indicates the disadvantage of the lack of tactile feedback. A lack of tactile feedback increases the risk of intraoperative complications, prolongs operative times, and delays the learning curve. A 40-year-old female patient presented to our hospital with a positive fecal occult blood test. A colonoscopy revealed type 2 advanced cancer of the sigmoid colon, and histological examination showed a well-differentiated adenocarcinoma. Furthermore, abdominal contrast-enhanced computed tomography revealed a tumor in the sigmoid colon and severa...
Source: Updates in Surgery - October 16, 2023 Category: Surgery Source Type: research
Robotic Hartmann ’s reversal—feasibility and technical aspects
AbstractHartmann ’s reversal as a staged procedure after emergency surgery is a major abdominal operation with undeniable skill-demanding steps. The robotic approach and its advantages seem to be a safe and feasible technique and could overcome necessary technical compromises of laparoscopy, ensuring a significant reduction in restoration failures or conversion. (Source: Updates in Surgery)
Source: Updates in Surgery - October 16, 2023 Category: Surgery Source Type: research
