Acta Chir Belg
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Comparative Study
Morbidity and mortality after induction chemotherapy followed by surgery in IIIa-N2 non small cell lung cancer.
To evaluate the frequency and risk of postoperative complications and mortality in patients with IIIa-N2 non small cell lung cancer after induction chemotherapy and surgery. ⋯ Although surgery after induction therapy for IIIa-N2 NSCLC can be done with a morbidity and mortality comparable to surgery alone, it remains a high risk operation. It should therefore be performed in a center with experience. Bronchial stump protection should be used whenever there is an increased risk for developing a bronchopleural fistula. In deciding whether to do surgery or radiotherapy one should keep in mind the feasibility of performing a complete resection together with a preoperative assessment to predict complications and mortality. For the preoperative assessment several scoring systems can be used from which we find the simplified comorbidity score most useful.
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Comparative Study
Major liver resections for primary liver malignancies in the elderly.
The aim of our prospective study was to assess the results of major hepatic resections for primary liver tumours in patients 75 years of age or older. ⋯ Advanced age does not seem to negatively affect the outcome of liver resections for malignancies. Hepatic resections in patients 75 years of age or older may be carried out with relative safety as long as patients are appropriately selected.
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Comparative Study
Role of the robot in totally laparoscopic aortic repair for occlusive and aneurysmal disease.
The feasibility of robotically-assisted laparoscopic aortic surgery has been adequately demonstrated. The authors report on their clinical experience with robot-assisted aortoiliac reconstruction for aorto-iliacocclusive disease, aortic aneurysm and two hybrid procedures performed using the da Vinci system. ⋯ Our clinical experience with robot-assisted laparoscopic surgery shows that it is a feasible technique for aortoiliac vascular and hybrid procedures. The da Vinci robotic system facilitated the creation of the aortic anastomosis and shortened aortic clamping time compared to purely laparoscopic techniques. Robotic maneuvers offer an unique ability to combine conventional laparoscopic surgery with stereoscopic 3D magnification and ultra-precise suturing techniques. However, previous laparoscopic aortoiliac experience is necessary before performing robot-assisted procedures in vascular surgery.
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Diaphragmatic rupture after blunt trauma is rare, but indicates a powerful external impact. Associated lesions are often life-threatening and require a rapid diagnosis and management. We report a case of a 24-year-old man, admitted to the emergency department after a serious car accident. ⋯ Closure of a small bowel perforation found during the laparoscopic exploration was also performed. We consider this therapeutic modality to be an excellent approach in the management of acute left side diaphragmatic rupture in haemodynamically stable patients. Firstly, it permits an inspection of the thoracic cavity through the diaphragmatic tear and secondly, an easy repair of damaged structures in the abdominal cavity.