Langenbeck's archives of surgery
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Langenbecks Arch Surg · Dec 2020
Irrigation and passive drainage of pancreatic stump after distal pancreatectomy in high-risk patients: an innovative approach to reduce pancreatic fistula.
Postoperative pancreatic fistula (POPF) represents the most common form of morbidity after distal pancreatectomy (DP). The aim of this study was to illustrate an innovative technique of irrigation and passive drainage to reduce clinically relevant POPF (CR-POPF) incidence in high-risk patients undergoing DP. ⋯ Irrigation with passive drainage of the pancreatic stump after DP is an interesting approach for CR-POPF prevention in high-risk patients.
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Langenbecks Arch Surg · Sep 2020
Meta AnalysisA systematic review and meta-analysis of diverting loop ileostomy versus total abdominal colectomy for the treatment of Clostridium difficile colitis.
Clostridium difficile is an increasingly common source of in-patient morbidity and mortality. We aim to assess the effects of diverting loop ileostomy (DLI) versus total abdominal colectomy (TAC) for Clostridium difficile colitis (CDC), in terms of mortality and morbidity. ⋯ The overall morbidity and mortality rates between DLI and TAC for the treatment of CDC seemed to be equivalent. Evidence from a randomized controlled trial is needed to clarify the timing and understand the impact of DLI for CDC.
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Langenbecks Arch Surg · Jun 2020
Meta Analysis Comparative StudyFixation versus no fixation in laparoscopic totally extraperitoneal repair of primary inguinal hernia-a systematic review and meta-analysis of randomized controlled trials.
The necessity of mesh fixation in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair remains controversial. We performed a systematic review and meta-analysis to compare the effectiveness of mesh fixation versus no fixation in laparoscopic TEP repair for primary inguinal hernia. ⋯ Mesh fixation in laparoscopic TEP repair for primary inguinal herniae is associated with increased postoperative pain at 24 h but similar recurrence, seroma, and urinary retention. Therefore, it may be omitted.
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Langenbecks Arch Surg · Jun 2020
Non-flap hand-sewn esophagogastrostomy as a simple anti-reflux procedure in laparoscopic proximal gastrectomy for gastric cancer.
No ideal and generally accepted method of reconstruction for laparoscopic proximal gastrectomy (LPG) has been established because of a high incidence of postoperative reflux and anastomotic stenosis. The aim of this study was to evaluate the short-term outcomes of LPG with a non-flap hand-sewn technique as a simple anti-reflux procedure for the upper part of clinical Stage I gastric cancer. ⋯ Our non-flap hand-sewn technique for esophagogastrostomy had favorable outcomes and might be one of reliable techniques as an anti-reflux procedure in LPG for gastric cancer.
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Langenbecks Arch Surg · May 2020
Meta Analysis Comparative StudyLaparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: the first meta-analysis.
Laparoscopic liver resection (LLR) has gained increasing acceptance for surgical treatment of malignant and benign liver tumors. LLR for intrahepatic cholangiocarcinoma (ICC) is not commonly performed because of the concern for the frequent need for major hepatectomy, vascular-biliary reconstructions, and lymph node dissection (LND). The aim of this present meta-analysis is to compare surgical and oncological outcomes of laparoscopic (LLR) versus open liver resection (OLR) for ICC. ⋯ Laparoscopic liver resection for ICC seems to achieve better surgical outcomes, providing short-term benefits without negatively affecting oncologic adequacy in terms of R0 resections and disease recurrence. However, a higher LND rate was observed in the open group. Due to the risk of bias and the statistical heterogeneity between the studies included in this review, further RCTs are needed to reach stronger scientific conclusions.