Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jul 2012
Comparative StudyPancreatic enucleation: improved outcomes compared to resection.
Pancreatic enucleation is associated with a low operative mortality and preserved pancreatic parenchyma. However, enucleation is an uncommon operation, and good comparative data with resection are lacking. Therefore, the aim of this analysis was to compare the outcomes of pancreatic enucleation and resection. ⋯ Compared to resection, pancreatic enucleation is associated with improved operative as well as short- and long-term postoperative outcomes. For small benign and premalignant pancreatic lesions, enucleation should be considered the procedure of choice when technically appropriate.
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J. Gastrointest. Surg. · Jul 2012
Case ReportsLaparoscopic transabdominal preperitoneal hernioplasty for reduction en masse of an incarcerated inguinal hernia: a case report.
Reduction en masse is a rare complication of an incarcerated inguinal hernia. Its occurrence should be suspected when intestinal obstruction persists despite a seemingly successful manual reduction or hernioplasty. ⋯ The safety, effectiveness, and minimal invasiveness conferred by the laparoscopic approach justified its application under such conditions.
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J. Gastrointest. Surg. · Jul 2012
Review Meta AnalysisPancreatic lesions in von Hippel-Lindau disease? A systematic review and meta-synthesis of the literature.
von Hippel-Lindau (vHL) disease is a rare condition that leads to characteristic lesions within many different body systems. Pancreatic manifestations of vHL cover a wide spectrum of pathologies, and thus, accurate characterization and management is critical. ⋯ This review highlights the wide spectrum and high prevalence of pancreatic lesions in vHL. Simple cysts and SCAs are benign, but NETs require careful observation due to their malignant potential.
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J. Gastrointest. Surg. · Jul 2012
Randomized Controlled Trial Comparative StudyRandomized trial comparing side-to-side stapled and hand-sewn esophagogastric anastomosis in neck.
Leak from cervical esophagogastric anastomosis (CEGA) following esophagectomy is associated with morbidity and poor functional outcome. To address this issue, we conducted a randomized trial comparing "hand-sewn" with "stapled side-to-side" CEGA. ⋯ There were no differences in the leak rates and postoperative outcome between the two CEGA techniques. At follow up, anastomotic strictures occurred less frequently following stapled CEGA. The ideal CEGA technique remains elusive.
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J. Gastrointest. Surg. · Jul 2012
Randomized Controlled TrialImmunologic response after laparoscopic colon cancer operation within an enhanced recovery program.
It has been demonstrated that colon operation combined with fast-track (FT) surgery and laparoscopic technique can shorten the length of hospital stay, accelerate recovery of intestinal function, and reduce the occurrence of post-operative complications. However, there are no reports regarding the combined effects of FT colon operation and laparoscopic technique on humoral inflammatory cellular immunity. ⋯ The laparoscopic technique and FT surgery rehabilitation program effectively inhibited release of post-operative inflammatory factors with a reduction in peri-operative trauma and stress, which together played a protective role on the post-operative immune system. Combining two treatment measures during colon operation produced better protective effects via the immune system. The beneficial clinical effects support that the better-preserved post-operative immune system may also contribute to the improvement of post-operative results in FT laparoscopic patients.