World journal of surgery
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World journal of surgery · May 2015
ReviewNear-infrared fluorescence imaging for real-time intraoperative anatomical guidance in minimally invasive surgery: a systematic review of the literature.
Near-infrared fluorescence (NIRF) imaging, using contrast agents with fluorescent characteristics in the near-infrared (NIR: 700-900 nm) window, is considered to possess great potential for clinical practice in the future of minimally invasive surgery (MIS), given its capacity for intraoperative, real-time anatomical navigation, and identification. The aim of this review is to provide an overview of the literature concerning the current and potential future applications of fluorescence imaging in supporting anatomical guidance during MIS, and thereby guiding future research. ⋯ Future implementation of new intraoperative optical methods, such as NIRF, could significantly contribute to intraoperative anatomy navigation and facilitate critical decision-making in MIS. Further research (i.e., large multi-center randomized controlled trials) is needed to establish the true value of this innovative optical imaging technique in standard clinical practice.
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World journal of surgery · May 2015
Comparative StudyLaparoscopic liver resection in obese patients.
Obesity has been associated with worse postoperative outcomes than those for normal weight. Data on the short-term results of laparoscopic liver resection (LLR) in patients with obesity are scarce. Furthermore, the long-term outcomes of LLR versus open liver resection (OLR) have not been adequately assessed. The aims of this study were to analyze the outcomes of obese patients undergoing LLR and to compare these to the outcomes of obese patients undergoing OLR. ⋯ LLR in obese patients results in decreased intraoperative blood loss and shorter postoperative hospital stays compared with OLR. When performed in selected patients, LLR may be a safe and feasible option for obese patients.
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World journal of surgery · May 2015
Tracheobronchial fistula during the perioperative period of esophagectomy for esophageal cancer.
Tracheobronchial (TB) injury and fistula formation during the perioperative period of esophagectomy is a rare but life-threatening complication. ⋯ Careful dissection with direct vision of the esophagus, as well as oversewing of the staplers on the gastric tube, is mandatory for preventing TB injury and fistula formation. Appropriate drainage is effective in cases with peri-tracheal abscesses. If the TB fistula fails to heal within a 4- to 6-week period, conservative management should be abandoned. Direct surgical intervention with coverage by a muscle flap is important for TB fistulas.
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World journal of surgery · May 2015
B-type natriuretic peptide-guided risk assessment for postoperative complications in lung cancer surgery.
Since lung cancer surgery is still associated with a high complication rate, it is important to efficiently identify patients at high risk for postoperative complications following lung cancer surgery. We previously reported that elderly patients with elevated preoperative B-type natriuretic peptide (BNP) levels (>30 pg/mL) have an increased risk for postoperative atrial fibrillation and cardiopulmonary complications following lung cancer surgery. The objective of this study was to evaluate the clinical utility of BNP-guided risk classification for postoperative complications after lung cancer surgery. ⋯ Risk assessment using preoperative BNP levels was clinically useful for the identification of patients at high risk for postoperative complications.
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World journal of surgery · May 2015
Risk factors for incisional and organ space surgical site infections after liver resection are different.
Surgical site infection (SSI) is a common cause of major morbidity after liver resection. This study aimed to identify the risk factors for incisional and organ/space SSIs after liver resection. ⋯ High ASA scores, anemia, chronic hepatitis or liver cirrhosis, and prolonged operations increased the risk of incisional SSIs; concomitant bowel surgery increased the risk of organ/space SSI. Specific precautions to prevent organ/space and incisional SSIs may shorten hospital stays.