Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Nov 2010
Laparoscopic Collis-Nissen for recurrent severe reflux in pediatric patients with esophageal atresia and recurrent hiatal hernia.
Patients following esophageal atresia repair may often have a congenitally short esophagus, leading to severe reflux and failed fundoplications. This report evaluates the efficacy of a laparoscopic Collis-Nissen fundoplication in this group of patients who have failed a previous fundoplication. ⋯ A laparoscopic Collis-Nissen in a child with previous failed fundoplication is a complex, but efficacious, procedure. Elongating the esophagus in patients with esophageal atresia may decrease the high recurrence rate of hiatal hernia in these patients and should be considered if the patient fails their primary repair.
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J Laparoendosc Adv Surg Tech A · Sep 2010
Comparative StudyInpatient mortality and length of stay comparison of percutaneous endoscopic gastrostomy and percutaneous endoscopic gastrojejunostomy.
Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic gastrojejunostomy (PEGJ) are endoscopic procedures often performed by surgeons. No recent population-based study has compared inpatient mortality or length of stay between patients who undergo PEG or PEGJ placement during their hospitalization. ⋯ Comparative analyses of patients undergoing PEG versus PEGJ revealed no detectable difference between inpatient mortality and hospital length of stay in this large observational study. Both procedures can be performed safely in high-risk populations, with no increased mortality or length of stay incurred by jejunal feeding access. However, further analysis is required to compare more specific short-term outcomes between these populations as well as their respective cost-effectiveness.
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J Laparoendosc Adv Surg Tech A · May 2010
Laparoscopic Ladd's procedure: treatment of choice for midgut malrotation in infants and children.
Rotational anomalies of the midgut encompass a broad spectrum of incomplete rotational events with malfixation of the intestines during fetal development. Ladd's procedure, as a correction of these anomalies, has traditionally been performed by laparotomy. In our institution, the laparoscopic Ladd's (LL) procedure was introduced in May 2004 and soon became the standard approach. ⋯ LL can be performed safely in selected patients with no increase in complications. Short-term results are superior to OL and can be achieved without any increase in operative duration.
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J Laparoendosc Adv Surg Tech A · Apr 2010
Randomized Controlled Trial Comparative StudyEffects of epidural-and-general anesthesia combined versus general anesthesia alone on femoral venous flow during laparoscopic cholecystectomy.
The pneumoperitoneum has been shown to decrease femoral blood flow, resulting in venous stasis. We analyzed the effects of the pneumoperitoneum and epidural analgesia on femoral vein diameter and the peak flow rate of femoral vein during laparoscopic cholecystectomy. ⋯ Abdominal insufflation during laparoscopic cholecystectomy results in dilation and decreased flow in the common femoral vein. Epidural analgesia added to the GA partially compensated for the reduction in femoral PFR.
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J Laparoendosc Adv Surg Tech A · Mar 2010
ReviewLaparoscopic repair of spigelian hernia: our experience.
Spigelian hernias are rare abdominal wall hernias occurring through a defect in the spigelian fascia lateral to the semilunar lines and pose great difficulty in diagnosis due to their location and varied presentations. The treatment of spigelian hernia has evolved from open surgical repair to laparoscopic hernioplasty. In this article, we share our experience of 6 patients with spigelian hernia managed by laparoscopic mesh repair and review the related literature on the topic. ⋯ Laparoscopic TAPP is an acceptable method of spigelian hernia repair with good results and low recurrence rates. However, long-term follow-up studies are required to assess the late recurrence rate.