Surgical endoscopy
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Comparative Study
Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer.
Laparoscopically assisted gastric surgery has become an option for the treatment of early gastric cancer. However, the feasibility and safety of laparoscopically assisted gastrectomy for advanced gastric cancer has rarely been studied. This study evaluated the short- and long-term outcomes of laparoscopically assisted distal gastrectomy (LADG) for advanced gastric cancer. ⋯ Laparoscopically assisted gastrectomy for advanced gastric cancer is safe and effective. In this study, it did not differ significantly from open surgery in terms of survival rate or recurrence after surgery based on long-term follow-up evaluation. It can achieve the same beneficial effects as open surgery, and it has the advantages of a small operation wound, less bleeding, good safety, rapid postoperative recovery, and fewer complications.
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Laparoscopic appendectomy (LA) is not routinely performed for appendicitis because the costs associated with that procedure are higher than those for open appendectomy (OA). However, few studies have investigated the economic influence of LA and OA on specific subpopulations including the elderly, patients with comorbidities, and patients with complicated appendicitis. This population-based study was designed to investigate determinants of costs and hospital length of stay (LOS) for patients undergoing appendectomy. Furthermore, the differences in costs and LOS were compared between LA and OA for various subpopulations. ⋯ Considering costs and LOS, patients older than 65 years, patients with comorbidities, and patients with complicated appendicitis benefit more from the laparoscopic approach for the treatment of appendicitis.
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Comparative Study
Single-incision laparoscopic cholecystectomy: a comparison with the gold standard.
Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC. ⋯ Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.
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Comparative Study
Oncological outcomes of laparoscopic colon resection for cancer after implementation of a full-time preceptorship.
The learning curve for laparoscopic colectomy (LC) is considered long and difficult. The presence of a preceptor may shorten the learning curve of LC and ensure adequate oncologic and short-term results. City of Hope implemented a full-time LC preceptorship between September 2004 and March 2006 with one experienced surgeon assisting other surgeons. We review our outcomes with laparoscopic colon resection for colon adenocarcinoma after implementation of this preceptorship. ⋯ Implementation of a program with a full-time preceptorship can help institutions overcome the challenges of laparoscopic colectomy and achieve acceptable postoperative and oncologic outcomes.
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Whether laparoscopic colorectal resection improved recovery within an enhanced recovery program was investigated. ⋯ This study suggests that within an enhanced recovery program, laparoscopic resection may provide the best short-term clinical outcomes for patients with resectable colorectal cancer.