Surgical endoscopy
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Observational Study
Decision-making in Colorectal Cancer Tumor Board meetings: results of a prospective observational assessment.
The management of colorectal cancer increasingly involves multidisciplinary tumor boards. In cases where these occur, the quality can be variable. Despite this, there are no uniform measures to evaluate them. The aim of this study was to evaluate the performance of colorectal cancer tumor boards, via real-time prospective observation. ⋯ The cMDT-MODe instrument can be reliably used to prospectively assess decision making in the multidisciplinary management of colorectal patients. By systematically quantifying the quality of a colorectal cancer tumor board, we can identify areas for improving practice so as to optimize decision making for cancer care.
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Early detection of infectious complications is urgently needed in the era of DRG-based compensation. This work assessed the diagnostic accuracy of c-reactive protein (CRP) level in the detection of infectious complications after laparoscopic colorectal resection. ⋯ Monitoring CRP level in laparoscopic colorectal surgery demonstrated a high diagnostic accuracy for infectious complications, thus allowing for safe and early discharge.
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Review Meta Analysis
A meta-analysis of robotic versus laparoscopic gastrectomy for gastric cancer.
Robot-assisted gastrectomy (RAG) for gastric cancer is still a controversial surgical technique for adequate tumor resection, lymphadenectomy, and postoperative outcome. ⋯ RAG is as acceptable as LAG for obtaining safe complications and for performing radical gastrectomy.
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Multicenter Study Comparative Study
Perioperative outcomes of laparoscopic and robot-assisted major hepatectomies: an Italian multi-institutional comparative study.
Laparoscopic major hepatectomy (LMH), although safely feasible in experienced hands and in selected patients, is a formidable challenge because of the technical demands of controlling hemorrhage, sealing bile ducts, avoiding gas embolism, and maintaining oncologic surgical principles. The enhanced surgical dexterity offered by robotic assistance could improve feasibility and/or safety of minimally invasive major hepatectomy. The aim of this study was to compare perioperative outcomes of LMH and robotic-assisted major hepatectomy (RMH). ⋯ This retrospective multi-institution study confirms that selected patients can safely undergo minimally invasive major hepatectomy, either LMH or RMH. The fact that intermittent pedicle occlusion could be avoided in RMH suggests improved surgical ability to deal with bleeding during liver transection, but further studies are needed before any final conclusion can be drawn.