Surgical endoscopy
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Multicenter Study
Laparoscopic right colon resection with intracorporeal anastomosis.
This study was performed to evaluate short-term clinical outcomes of laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon. ⋯ Laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon resulted in a favorable outcome in selected patients with Crohn's disease or tumors of the right colon.
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This study aimed to evaluate early outcomes after antireflux surgery for lung transplant (LTx) recipients in the United States. ⋯ To date, this is the largest study to examine outcomes of antireflux surgery for LTx recipients. Operative mortality and morbidity appear to be comparable with those of the general population, although resource utilization is greater. Based on these data, trials to evaluate the role of antireflux surgery in preserving allograft function after LTx should not be hindered by a perceived notion of prohibitive operative risk in this patient population.
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Clinical Trial
Evaluation of the appendix during diagnostic laparoscopy, the laparoscopic appendicitis score: a pilot study.
Diagnostic laparoscopy is the ultimate diagnostic tool to evaluate the appendix. Still, according to the literature, this strategy results in a negative appendectomy rate of approximately 12-18 % and associated morbidity. Laparoscopic criteria for determining appendicitis are lacking. The goal of this study is to define clear and reliable criteria for appendicitis during diagnostic laparoscopy that eventually may safely reduce the negative appendectomy rate. ⋯ This study presents the LAPP score. The LAPP score is an easily applicable score that can be used by surgeons to evaluate the appendix during diagnostic laparoscopy. The score has high positive and negative predictive value. The LAPP score needs to be validated in a multicentre validation study.
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Comparative Study
Risk of adhesive obstruction after colorectal surgery: the benefits of the minimally invasive approach may extend well beyond the perioperative period.
Risk of adhesive small-bowel obstruction (SBO) is high following open colorectal surgery. Laparoscopic surgery may induce fewer adhesions; however, the translation of this advantage to a reduced rate of bowel obstruction has not been well demonstrated. This study evaluates whether SBO is lower after laparoscopic compared with open colorectal surgery. ⋯ Although the rate of SBO was similar after laparoscopic and open colorectal surgery, the need for operative intervention for SBO was significantly lower after laparoscopic operations. These findings especially in the context of the longer follow-up for laparoscopic patients suggests that the lower incidence of adhesions expected after laparoscopic surgery likely translates into long-term benefits in terms of reduced SBO.
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During laparoscopic incisional hernia repair, conversion to open surgery is sometimes needed, especially in cases of large complicated incisional hernias. No guidelines exist for determining when conversions should be considered. This study aimed to investigate the safety of a combined technique as an alternative to conversion in the laparoscopic repair of large complicated incisional hernias and to evaluate the impact of early conversion to the combined technique on patient outcome. ⋯ The combined technique proved to be a safe and minimally invasive alternative to conversion in laparoscopic repair of large complicated incisional hernias. Early conversion to the combined technique was associated with less technical difficulty, deceased operative time, lower enterotomy rate, and shorter postoperative hospital stay.