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Surgical Endoscopy (Online First™)
Efficacy of the over-the-scope clip (OTSC) for treatment of colorectal postsurgical leaks and fistulas
Sat, 12 May 2012 06:19:03 -0000
Abstract Background Colorectal postsurgical leaks and fistulas are severe complications that dramatically increase morbidity and mortality. The aim of this study was to evaluate the clinical impact of over-the-scope clip (OTSC) closure to seal the visceral wall in the management of acute and chronic colorectal postsurgical leaks and fistulas. Methods We reviewed our prospective series of acute and chronic colorectal postsurgical leaks and fistulas observed between April 2008 and September 2011 and treated by OTSC. Indications were all cases with an orifice <15 mm in maximum diameter with no extraluminal abscess and luminal stenosis. Results Endoscopic OTSC closure was performed in 14 consecutive patients (mean defect = 9.1 mm in diameter) by means of 10.5- or 12-mm clips, depending on the wall defect diameter. In eight cases, the indication was an acute leak and in six cases a chronic leak, mainly after anterior rectal resection; two cases were complicated by a rectovaginal fistula and in two other cases by a colocutaneous fistula. OTSC treatment was used to complete endoscopic vacuum-assisted closure of a large defect in three cases. The overall success rate was 86 % (12/14): 87 % (7/8) in acute and 83 % (5/6) in chronic cases. No OTSC-related complications occurred. Further surgery was required in one case. Conclusion Endoscopic OTSC closure of colorectal postsurgical leaks and fistulas is a safe technique, with a high success rate in both acute and chronic cases, including rectovaginal and colocutaneous fistulas. Content Type Journal ArticleCategory New TechnologyPages 1-4DOI 10.1007/s00464-012-2340-2Authors Alberto Arezzo, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMauro Verra, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyRossella Reddavid, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyFrancesca Cravero, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMarco Augusto Bonino, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMario Morino, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Intrahepatic choledochoscopy during trans-cystic common bile duct exploration; technique, feasibility and value
Sat, 12 May 2012 06:19:02 -0000
Abstract Background Transcystic laparoscopic common bile duct exploration (TC-LCBDE) is advantageous for exploring the bile duct. Choledochoscopy, however, may be quite challenging to perform transcystically because the cystic duct is usually narrow, duct anatomy may be unfavorable, and not all stones are amenable to transcystic extraction. Convention suggests that it is technically very difficult to visualize the intrahepatic bile ducts with transcystic choledochoscopy, due to the angle of insertion of the cystic into the common bile duct (CBD). However, we have performed intrahepatic choledochoscopy successfully, moving the choledochoscope from the CBD into the common hepatic duct by using what we have termed a “wiper blade maneuver”. The purpose of this study was to confirm how often this was possible. Methods A search of a prospectively collected database of patients undergoing routine intraoperative cholangiography (IOC) and laparoscopic CBD exploration under the care of a single consultant surgeon was performed. Results A total of 592 LCBDEs were performed between September 1992 and January 2011; 325 were transcystic explorations. Of these, 72.5 % were female and 56 % were admitted acutely. Exploration and duct clearance was performed by blind Dormia basket trawling in 63 %. The choledochoscope was utilized in 120 cases (37 %). The 3-mm choledochoscope was used in 66 (55 %) and the 5-mm scope in 54 (45 %). Intrahepatic choledochoscopy was performed in 49 patients (40.8 %). Length of surgery was 40–350 min (median 90 min; standard deviation 49 min). Conclusions It is technically challenging to perform intrahepatic choledochoscopy with a 3-mm choledochoscope due to its narrow gauge. The more rigid 5-mm scope is thus preferred, but is limited in TCE because its effective use depends on the presence of a dilated cystic duct. Despite the technical limitations of both caliber scopes, we have demonstrated that intrahepatic choledochoscopy during TCE is possible, with each, in 40 % of cases. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-012-2315-3Authors Vivienne Gough, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKNathan Stephens, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKZubir Ahmed, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKAhmad H. M. Nassar, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy: experience of a single center in a series of 300 cases
Sat, 12 May 2012 06:19:02 -0000
Abstract Background Laparoscopic splenectomy (LS) has gradually become the technique of choice for surgical removal of the spleen. The aim of this study was to evaluate the efficacy of LS in a large cohort of patients from a single center. Methods From March 1992 to June 2010, 300 patients underwent LS at our hospital for predominantly hematologic disorders. The first 92 cases were performed using an anterior approach, whereas in the remaining 208 cases a lateral approach with a four-trocar technique was used. Patient demographics, diagnosis, and outcomes were reviewed. Results Spleen volume was similar between the anterior (350 ml) and the lateral (370 ml) approaches. The lateral approach was associated with shorter operative time (60 vs. 80 min), less blood loss (30 vs. 110 ml), and no conversion (0 vs. 2.2 %) compared to the anterior approach. Reoperations were required in three patients (1.0 %) because of bleeding, subphrenic abscess, and intestinal ischemia. Postoperative complications were significantly fewer for the lateral (4.8 %) than for the anterior (31.5 %) approach and the hospital stay was shorter (3.1 vs. 5.2 days) and there was less postoperative pain. Splenectomy for hematologic malignancies resulted in a higher morbidity rate, more postoperative pain, and longer hospital stay. Overall mortality rate was 0.3 %. No late complications were observed during the 1–5-year follow-up. Conclusions LS using the lateral approach with the placement of four trocars can be considered the procedure of choice for both benign and malignant diseases affecting the spleen. Extensive experience and technical standardization help to avoid surgical pitfalls, providing an adequate control of hemostasis, the excision of accessory spleens (AS), and the avoidance of parenchymal rupture. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2272-xAuthors Francesco Corcione, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyFelice Pirozzi, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyGiuseppe Aragiusto, Department of Hepatobiliary Surgery and Liver Transplantation, “A. Cardarelli” Hospital, Naples, NA, ItalyFrancesco Galante, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyAntonio Sciuto, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Description of a novel approach for intraperitoneal drug delivery and the related device
Sat, 12 May 2012 06:19:01 -0000
Abstract Background Two significant limitations of intraperitoneal drug therapy are limited drug distribution and poor penetration into peritoneal nodules. A possible solution is the application of the so-called “therapeutic pneumoperitoneum,” taking advantage of the gaseous nature and the pressure of capnoperitoneum during laparoscopy. Our objective was to develop a device able to apply such therapeutic pneumoperitoneum. Methods The technology presented here is a spraying device and can be introduced through a trocar. It is driven by mechanical pressure and consists of an injector, a line, and a nozzle. An in vivo experimental study was performed in five pigs. A transvaginal cholecystectomy was performed. At the end of the procedure, a standard dose of methylene blue was sprayed/infused into the abdominal cavity for 30 min (4 test animals w/therapeutic pneumoperitoneum (12 mmHg CO2) and 1 control animal w/conventional lavage (2 l intra-abdominal volume with extracorporeal circulation)). At the end of the procedure, all animals were autopsied and the peritoneum was analyzed. Outcome criteria were: (1) drug distribution (as assessed by the stained peritoneal surface at autopsy), and (2) diffusion into the peritoneum (presence or not of macroscopic staining of the outer aspect of the peritoneum immediately after surgery). Results Stained peritoneal surface was larger after aerosol application compared with peritoneal lavage, and staining more intense. Hidden peritoneal surfaces and the anterior abdominal wall were stained only in the aerosol group. In contrast to peritoneal lavage, the outer aspect of peritoneal membrane was immediately stained after pressurized spraying. Conclusions This device and the related approach significantly improve both distribution and penetration of a test substance into the peritoneal cavity in a large animal model. This might be a significant progress in treating intraperitoneal disease, in particular peritoneal carcinomatosis. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2148-0Authors Wiebke Solaß, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyAlexander Hetzel, Reger Medizintechnik, Rottweil, GermanyGiorgi Nadiradze, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyEmil Sagynaliev, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyMarc A. Reymond, Department of Surgery, Otto-von-Guericke University, Magdeburg, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Retraction Note: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy
Sat, 12 May 2012 06:19:00 -0000
Retraction Note: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy Content Type Journal ArticleCategory Retraction NotePages 1-1DOI 10.1007/s00464-012-2321-5Authors Y. Fujii, Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, JapanM. Itakura, Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, Japan Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis
Sat, 12 May 2012 06:19:00 -0000
Abstract Background Despite the emphasis on its role, the spleen has commonly been removed in distal pancreatectomy. We designed this study to evaluate the efficacy of spleen salvage during laparoscopic distal pancreatectomy for patients with benign and borderline malignant tumors. Materials and methods From February 2005 to December 2010, 40 patients underwent spleen-preserving laparoscopic distal pancreatectomy (Sp-Lap DP) and 32 patients underwent laparoscopic distal pancreatosplenectomy (Lap DPS). Medical records were retrospectively reviewed, and a specially designed questionnaire was administered to the patients for the follow-up study. Results The demographics and final diagnoses were similar between the two groups. The operative time was significantly longer in the Sp-Lap DP group (303.9 ± 136.0 versus 239.0 ± 94.9 min, p = 0.024). Patients in the Lap DPS group had more postoperative pancreatic fistulas of higher grade (p = 0.026). A higher grade of postoperative complications occurred more frequently in the Lap DPS group (p = 0.003). Consequently, postoperative hospital stay was significantly shorter for Sp-Lap DP than for Lap DPS patients (7.1 ± 2.3 versus 12.5 ± 10.8 days, p = 0.004). On the follow-up survey, episodes of common cold or flu were apparently more frequent in the Lap DPS group (p = 0.026). Despite the similar recovery period between the two groups, significantly more patients who underwent Lap DPS felt fatigue (p = 0.014) and poorer health condition (p = 0.042). Conclusions In addition to frequent higher-grade complications and prolonged hospital stays, Lap DPS appeared to impair patient quality of life based on follow-up survey. Even an effort to preserve adult spleen in distal pancreatectomy is worthwhile. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2306-4Authors Sung Hoon Choi, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaMi Ae Seo, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaHo Kyoung Hwang, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaChang Moo Kang, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaWoo Jung Lee, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
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Efficacy of the over-the-scope clip (OTSC) for treatment of colorectal postsurgical leaks and fistulas
Sat, 12 May 2012 06:19:03 -0000
Abstract Background Colorectal postsurgical leaks and fistulas are severe complications that dramatically increase morbidity and mortality. The aim of this study was to evaluate the clinical impact of over-the-scope clip (OTSC) closure to seal the visceral wall in the management of acute and chronic colorectal postsurgical leaks and fistulas. Methods We reviewed our prospective series of acute and chronic colorectal postsurgical leaks and fistulas observed between April 2008 and September 2011 and treated by OTSC. Indications were all cases with an orifice <15 mm in maximum diameter with no extraluminal abscess and luminal stenosis. Results Endoscopic OTSC closure was performed in 14 consecutive patients (mean defect = 9.1 mm in diameter) by means of 10.5- or 12-mm clips, depending on the wall defect diameter. In eight cases, the indication was an acute leak and in six cases a chronic leak, mainly after anterior rectal resection; two cases were complicated by a rectovaginal fistula and in two other cases by a colocutaneous fistula. OTSC treatment was used to complete endoscopic vacuum-assisted closure of a large defect in three cases. The overall success rate was 86 % (12/14): 87 % (7/8) in acute and 83 % (5/6) in chronic cases. No OTSC-related complications occurred. Further surgery was required in one case. Conclusion Endoscopic OTSC closure of colorectal postsurgical leaks and fistulas is a safe technique, with a high success rate in both acute and chronic cases, including rectovaginal and colocutaneous fistulas. Content Type Journal ArticleCategory New TechnologyPages 1-4DOI 10.1007/s00464-012-2340-2Authors Alberto Arezzo, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMauro Verra, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyRossella Reddavid, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyFrancesca Cravero, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMarco Augusto Bonino, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, ItalyMario Morino, Digestive, Colorectal and Minimal Invasive Surgery, University of Turin, corso Dogliotti 14, 10126 Torino, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Intrahepatic choledochoscopy during trans-cystic common bile duct exploration; technique, feasibility and value
Sat, 12 May 2012 06:19:02 -0000
Abstract Background Transcystic laparoscopic common bile duct exploration (TC-LCBDE) is advantageous for exploring the bile duct. Choledochoscopy, however, may be quite challenging to perform transcystically because the cystic duct is usually narrow, duct anatomy may be unfavorable, and not all stones are amenable to transcystic extraction. Convention suggests that it is technically very difficult to visualize the intrahepatic bile ducts with transcystic choledochoscopy, due to the angle of insertion of the cystic into the common bile duct (CBD). However, we have performed intrahepatic choledochoscopy successfully, moving the choledochoscope from the CBD into the common hepatic duct by using what we have termed a “wiper blade maneuver”. The purpose of this study was to confirm how often this was possible. Methods A search of a prospectively collected database of patients undergoing routine intraoperative cholangiography (IOC) and laparoscopic CBD exploration under the care of a single consultant surgeon was performed. Results A total of 592 LCBDEs were performed between September 1992 and January 2011; 325 were transcystic explorations. Of these, 72.5 % were female and 56 % were admitted acutely. Exploration and duct clearance was performed by blind Dormia basket trawling in 63 %. The choledochoscope was utilized in 120 cases (37 %). The 3-mm choledochoscope was used in 66 (55 %) and the 5-mm scope in 54 (45 %). Intrahepatic choledochoscopy was performed in 49 patients (40.8 %). Length of surgery was 40–350 min (median 90 min; standard deviation 49 min). Conclusions It is technically challenging to perform intrahepatic choledochoscopy with a 3-mm choledochoscope due to its narrow gauge. The more rigid 5-mm scope is thus preferred, but is limited in TCE because its effective use depends on the presence of a dilated cystic duct. Despite the technical limitations of both caliber scopes, we have demonstrated that intrahepatic choledochoscopy during TCE is possible, with each, in 40 % of cases. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-012-2315-3Authors Vivienne Gough, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKNathan Stephens, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKZubir Ahmed, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UKAhmad H. M. Nassar, Department of Surgery, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, Scotland, UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy: experience of a single center in a series of 300 cases
Sat, 12 May 2012 06:19:02 -0000
Abstract Background Laparoscopic splenectomy (LS) has gradually become the technique of choice for surgical removal of the spleen. The aim of this study was to evaluate the efficacy of LS in a large cohort of patients from a single center. Methods From March 1992 to June 2010, 300 patients underwent LS at our hospital for predominantly hematologic disorders. The first 92 cases were performed using an anterior approach, whereas in the remaining 208 cases a lateral approach with a four-trocar technique was used. Patient demographics, diagnosis, and outcomes were reviewed. Results Spleen volume was similar between the anterior (350 ml) and the lateral (370 ml) approaches. The lateral approach was associated with shorter operative time (60 vs. 80 min), less blood loss (30 vs. 110 ml), and no conversion (0 vs. 2.2 %) compared to the anterior approach. Reoperations were required in three patients (1.0 %) because of bleeding, subphrenic abscess, and intestinal ischemia. Postoperative complications were significantly fewer for the lateral (4.8 %) than for the anterior (31.5 %) approach and the hospital stay was shorter (3.1 vs. 5.2 days) and there was less postoperative pain. Splenectomy for hematologic malignancies resulted in a higher morbidity rate, more postoperative pain, and longer hospital stay. Overall mortality rate was 0.3 %. No late complications were observed during the 1–5-year follow-up. Conclusions LS using the lateral approach with the placement of four trocars can be considered the procedure of choice for both benign and malignant diseases affecting the spleen. Extensive experience and technical standardization help to avoid surgical pitfalls, providing an adequate control of hemostasis, the excision of accessory spleens (AS), and the avoidance of parenchymal rupture. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2272-xAuthors Francesco Corcione, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyFelice Pirozzi, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyGiuseppe Aragiusto, Department of Hepatobiliary Surgery and Liver Transplantation, “A. Cardarelli” Hospital, Naples, NA, ItalyFrancesco Galante, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, ItalyAntonio Sciuto, Department of Laparoscopic and Robotic Surgery, “Azienda Ospedaliera dei Colli”—Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, NA, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Description of a novel approach for intraperitoneal drug delivery and the related device
Sat, 12 May 2012 06:19:01 -0000
Abstract Background Two significant limitations of intraperitoneal drug therapy are limited drug distribution and poor penetration into peritoneal nodules. A possible solution is the application of the so-called “therapeutic pneumoperitoneum,” taking advantage of the gaseous nature and the pressure of capnoperitoneum during laparoscopy. Our objective was to develop a device able to apply such therapeutic pneumoperitoneum. Methods The technology presented here is a spraying device and can be introduced through a trocar. It is driven by mechanical pressure and consists of an injector, a line, and a nozzle. An in vivo experimental study was performed in five pigs. A transvaginal cholecystectomy was performed. At the end of the procedure, a standard dose of methylene blue was sprayed/infused into the abdominal cavity for 30 min (4 test animals w/therapeutic pneumoperitoneum (12 mmHg CO2) and 1 control animal w/conventional lavage (2 l intra-abdominal volume with extracorporeal circulation)). At the end of the procedure, all animals were autopsied and the peritoneum was analyzed. Outcome criteria were: (1) drug distribution (as assessed by the stained peritoneal surface at autopsy), and (2) diffusion into the peritoneum (presence or not of macroscopic staining of the outer aspect of the peritoneum immediately after surgery). Results Stained peritoneal surface was larger after aerosol application compared with peritoneal lavage, and staining more intense. Hidden peritoneal surfaces and the anterior abdominal wall were stained only in the aerosol group. In contrast to peritoneal lavage, the outer aspect of peritoneal membrane was immediately stained after pressurized spraying. Conclusions This device and the related approach significantly improve both distribution and penetration of a test substance into the peritoneal cavity in a large animal model. This might be a significant progress in treating intraperitoneal disease, in particular peritoneal carcinomatosis. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2148-0Authors Wiebke Solaß, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyAlexander Hetzel, Reger Medizintechnik, Rottweil, GermanyGiorgi Nadiradze, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyEmil Sagynaliev, Department of Surgery, Otto-von-Guericke University, Magdeburg, GermanyMarc A. Reymond, Department of Surgery, Otto-von-Guericke University, Magdeburg, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Retraction Note: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy
Sat, 12 May 2012 06:19:00 -0000
Retraction Note: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy Content Type Journal ArticleCategory Retraction NotePages 1-1DOI 10.1007/s00464-012-2321-5Authors Y. Fujii, Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, JapanM. Itakura, Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, Japan Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis
Sat, 12 May 2012 06:19:00 -0000
Abstract Background Despite the emphasis on its role, the spleen has commonly been removed in distal pancreatectomy. We designed this study to evaluate the efficacy of spleen salvage during laparoscopic distal pancreatectomy for patients with benign and borderline malignant tumors. Materials and methods From February 2005 to December 2010, 40 patients underwent spleen-preserving laparoscopic distal pancreatectomy (Sp-Lap DP) and 32 patients underwent laparoscopic distal pancreatosplenectomy (Lap DPS). Medical records were retrospectively reviewed, and a specially designed questionnaire was administered to the patients for the follow-up study. Results The demographics and final diagnoses were similar between the two groups. The operative time was significantly longer in the Sp-Lap DP group (303.9 ± 136.0 versus 239.0 ± 94.9 min, p = 0.024). Patients in the Lap DPS group had more postoperative pancreatic fistulas of higher grade (p = 0.026). A higher grade of postoperative complications occurred more frequently in the Lap DPS group (p = 0.003). Consequently, postoperative hospital stay was significantly shorter for Sp-Lap DP than for Lap DPS patients (7.1 ± 2.3 versus 12.5 ± 10.8 days, p = 0.004). On the follow-up survey, episodes of common cold or flu were apparently more frequent in the Lap DPS group (p = 0.026). Despite the similar recovery period between the two groups, significantly more patients who underwent Lap DPS felt fatigue (p = 0.014) and poorer health condition (p = 0.042). Conclusions In addition to frequent higher-grade complications and prolonged hospital stays, Lap DPS appeared to impair patient quality of life based on follow-up survey. Even an effort to preserve adult spleen in distal pancreatectomy is worthwhile. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2306-4Authors Sung Hoon Choi, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaMi Ae Seo, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaHo Kyoung Hwang, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaChang Moo Kang, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 KoreaWoo Jung Lee, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Sites:
Carpal Tunnel Syndrome: The Southern California Orthopedic Institute (SCOI) - serving the Los Angeles and San Fernando Valley California in orthopedic surgery, sports medicine, knee and shoulder surgery, joint replacement, MRI, and physical rehabilitation.Duke US Surgical Endosurgery Center: The Center was established for the purpose of improving endosurgical education, advancing endosurgery through research and technical developments, and assessing the appropriate applications of endosurgical techniques.
Endius: endoscopic spinal surgery - Endius Incorporated
Gastrointestinal Endoscopy: Explains how the stomach and intestines can be examined using endoscopes, without surgery.
Laparoscopic Surgery: RSAPC1.com provides information about a broad spectrum of procedures including minimally invasive surgery, colo-rectal , breast and hernia surgery with special interest in advanced laparoscopic procedures including surgical weight loss, esophagus, stomach, liver, gallbladder, colon small intestin...
Laparoscopy Hospital: Laparoscopy Hospital is super specialized institute for laparoscopic treatment training and research
MicroSpine - Minimally Invasive Spinal Surgery Specialists: Endoscopic Laser Spine Surgery
Neurosurgeon and Pain Management Specialist: Dr. Ramsis F. Ghaly is a Neurosurgeon who is uniquely specialized in the latest endoscopic surgical techniques. Dr. Ghaly also specializes in Pain Management by using techniques that alleviate refractory pain sufferers. He also specializes in Anesthesiology and Intensive Care Management.
Plastic Surgery Performed Using Endoscopes: Provides explanations of various procedures (browlifts, facelifts) that can be performed endoscopically. Compares conventional and endoscopic procedures.
San Diego Shoulder Arthroscopy: An on-line library of tips, techniques, and procedures.
Society of American Gastrointestinal Endoscopic Surgeons: The leading professional society and CME meeting, representing more than 5000 board certified surgeons who use endoscopy and laparoscopy as an integral part of their treatment of patients
The Belgian Group for Endoscopic Surgery: An association of endoscopic surgeons in Belgium.
TMJ (Temporomandibular Joint) Disorders: The temporomandibular joint, anatomy, disorders, surgery. Includes a brief discussion of TMJ arthroscopy.
University of Massachusetts EndoSurgery Center: Laparoscopic surgical techniques, online courses and educational resources for minimally invasive and hand-assisted laparoscopic surgery. Watch videos and learn the essentials of laparoscopy, including cholecystectomy, hernia repair, Nissen and Toupet fundoplication for GERD.
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