The “Basket-in-Catheter” technique: facilitating transcystic bile duct exploration and optimising the management of suspected ductal stones
This study evaluates its benefits in confirmed and suspe cted ductal stones. Retrospective analysis of prospectively collected data on patients with pre-operative or operative suspicion of bile duct stones or with positive and equivocal intraoperative cholangiographies (IOC) who had LTCE attempted using blind basket trawling, without choledochoscopy, were reviewed. The incidence and outcomes of blind basket LTCEs attempted before and after introducing the BIC technique, whether or not stones were retrieved, were analysed. Blind basket LTCE was attempted in 732 patients. Of 377 (51.5%) patients undergoing successful stone r...
Source: Updates in Surgery - August 4, 2023 Category: Surgery Source Type: research
Predictors of Clostridium difficile infection after stoma reversal following TaTME surgery
Conclusions: Stoma reversal surgery can result in moderate rate of in-hospital CDI. Time-to stoma reversal is a crucial variable significantly related with this adverse outcome. (Source: Updates in Surgery)
Source: Updates in Surgery - August 4, 2023 Category: Surgery Source Type: research
Association of mechanical power during one-lung ventilation and post-operative pulmonary complications among patients undergoing lobectomy: a protocol for a prospective cohort study
AbstractThe association of intra-operative mechanical power (MP) with post-operative pulmonary complications (PPCs) has been described before, but it is uncertain whether the potential inherent bias can limit the use of this parameter, particularly in the context of one-lung ventilation. This single-center study aims to investigate the effect of MP during one-lung ventilation (OLV), and the risks of PPCs in patients undergoing thoracoscopic lobectomy. This prospective observational study is being conducted in an academic tertiary hospital in mainland China. Participants diagnosed with lung cancer, and aged 50 to 80 years...
Source: Updates in Surgery - August 4, 2023 Category: Surgery Source Type: research
Ca 125 is an independent prognostic marker in resected pancreatic cancer of the head of the pancreas
This study confirmed the prognostic value of Ca125 in resected pancreatic cancer and, therefore, the importance of biologic over anatomic resectability. Ca 125 should be routinely assayed in surgical candidates with PDAC. (Source: Updates in Surgery)
Source: Updates in Surgery - August 3, 2023 Category: Surgery Source Type: research
Long-term outcomes and health-related quality of life 20 years after pediatric liver transplantation
AbstractPediatric liver transplantation is a challenging surgical procedure requiring complex post-transplant patient management. Liver transplantation in children should ensure long-term survival and good health-related quality of life (HR-QOL), but data in the literature are conflicting. With the aim of investigating survival and psychosocial outcomes of patients transplanted during childhood, we identified 40 patients with ≥ 20-year follow-up after liver transplantation regularly followed up at our Institution. Clinical charts were reviewed to retrieve patients’ data. Psychosocial aspects and HR-QOL were invest...
Source: Updates in Surgery - August 3, 2023 Category: Surgery Source Type: research
Prognostic factors, treatment decisions, and nomograms for patients with second primary lung cancer following colorectal cancer: a population-based study
In this study, we explored the prognostic factors and clinical management decisions of patients with second primary lung cancer after colorectal cancer (SPLC-CRC). We identified the data of 1637 patients with SPLC-CRC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Cox regression modeling was used to construct a nomogram for predicting the prognosis of SPLC-CRC patients. The Fine –Gray competing risk model was used to determine the association between factors and cancer-specific mortality. After this, survival analyses were performed to assess the benefit of each treatment meth...
Source: Updates in Surgery - August 3, 2023 Category: Surgery Source Type: research
A pilot study on staged surgery by delta video-assisted anal fistula treatment (dVAAFT) for complex anal fistula
This study aims to introduce a novel staged approach for CAF treatment, combining video-assisted anal fistula treatment (VAAFT), seton placement, and other staged approaches. Consecutive patients with CAF underwent the staged approach involving VAAFT and seton placement. Data on patient demographics, fistula characteristics, and operative findings were collected. Pre-operative work-up included clinical evaluation, endoanal ultrasonography (EAUS), and magnetic resonance imaging (MRI). Surgical techniques and outcomes were evaluated. Eighteen patients (median age 38 years) were included. Misplacement of a previously placed...
Source: Updates in Surgery - August 3, 2023 Category: Surgery Source Type: research
Scientific requisites for academic advancements in Italy: time to change the rules
(Source: Updates in Surgery)
Source: Updates in Surgery - August 3, 2023 Category: Surgery Source Type: research
The learning curve on robot-assisted transaxillary thyroidectomy performed by a single endocrine surgeon in a third-level institution in Europe: a cumulative sum (CUSUM) analysis
AbstractRobot-assisted transaxillary thyroidectomy is widely performed in Asian countries, although it is still under discussion in the Western World. However, there have been few studies reporting on the learning curve of robot-assisted transaxillary thyroidectomy. We used the cumulative sum (CUSUM) analysis to assess the learning curve of gasless robot-assisted transaxillary thyroidectomy at a third-level institution in Europe. We included all consecutive patients operated by a single surgeon without previous experience of robotic surgery from February 2012 to January 2023. The primary endpoint of the study was the learn...
Source: Updates in Surgery - August 2, 2023 Category: Surgery Source Type: research
Effects of mobilization within the first 4 h following anatomical lung resection with thoracotomy
In this study, 18% of patients received narcotic analgesics. Thromboembolic event and arrhythmia did not develop in any patient. The most common complication was prolonged air leaks (18.8%). Mobilization within the first 4 h following anatomical lung resection is feasible and safe. Early mobilization provided pain relief after lung surgery and reduced the use of narcotic analgesics and cardiovascular complications. The article is the first study about walking in first hours after pulmonary lobectomy with thoracotomy in the thoracic surgery literature. (Source: Updates in Surgery)
Source: Updates in Surgery - August 1, 2023 Category: Surgery Source Type: research
Inframesocolic main pancreatic vessels-first approach for minimally invasive radical antegrade modular pancreaticosplenectomy (RAMPS): technical description and first experience
We present for the first time a minimally invasive RAMPS technique with an innovative approach providing early dissection and control of the main peripancreatic vessels from an inframesocolic embryonal window, suitable for laparoscopy and robotics. Minimally invasive RAMPS with inframesocolic main pancreatic vessels-first approach was performed at the Tricase Hospital (Italy) from May 2017 to April 2022 in 11 consecutive patients with neoplastic lesions of the pancreas (8 laparoscopic RAMPS and 3 robotic RAMPS). Among the laparoscopic cases, 1 included a portal vein tangential resection and 1 a celiac artery resection (mod...
Source: Updates in Surgery - July 19, 2023 Category: Surgery Source Type: research
Correction to: Sequential transcatheter arterial chemoembolization and portal vein embolization before hepatectomy for the management of patients with hepatocellular carcinoma: a systematic review and meta-analysis
(Source: Updates in Surgery)
Source: Updates in Surgery - July 19, 2023 Category: Surgery Source Type: research
Practical implications of tumor proximity to landmark vessels in minimally invasive radical antegrade modular pancreatosplenectomy
AbstractCareful preoperative planning is key in minimally invasive radical antegrade modular pancreatosplenectomy (MI-RAMPS). This retrospective study aims to show the practical implications of computed tomography distance between the right margin of the tumor and either the left margin of the spleno-mesenteric confluence (d-SMC) or the gastroduodenal artery (d-GDA). Between January 2011 and June 2022, 48 minimally invasive RAMPS were performed for either pancreatic cancer or malignant intraductal mucinous papillary neoplasms. Two procedures were converted to open surgery (4.3%). Mean tumor size was 31.1 ± 14.7 mm. ...
Source: Updates in Surgery - July 17, 2023 Category: Surgery Source Type: research
Surgical treatment of tracheal stenosis during Covid-19 era: a single-center experience and lessons learnt on the field
AbstractSARS-CoV2 outbreak led to several healthcare system challenges, especially concerning respiratory support to Covid-19 patients. In the first 2 years of pandemic (2020–2021), we assisted to a marked increase of post-invasive mechanical ventilation (IMV) tracheal stenosis incidence, many of them requiring surgical treatment, namely resection and primary end-to-end anastomosis. Our aim is to describe our experience during the abovemention ed biennium, focusing on postoperative outcomes of patients who have had Covid-19 (“post-Covid”). We retrospectively collected pre-, intra- and postoperative data on all pati...
Source: Updates in Surgery - July 17, 2023 Category: Surgery Source Type: research
How to reduce the colorectal anastomotic leakage? The MIRACLe protocol experience in a cohort in a single high-volume centre
This article reports the results of a novel perioperative treatment implementing the gut microbiota to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer and represents the continuation of our pilot study on 60 cases. A series of 131 patients underwent elective colorectal surgery at the S. Eugenio Hospital (Rome —Italy) between December 1, 2020, and November 30, 2022, and received a perioperative preparation following theMicrobiota Implementation to Reduce Anastomotic Colorectal Leaks (MIRACLe) protocol comprising oral antibiotics, mechanical bowel preparatio...
Source: Updates in Surgery - July 15, 2023 Category: Surgery Source Type: research
