Int Surg
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Laparoscopic surgery is estimated to produce a minor surgical injury in comparison with open and laparoscopic cholecystectomies. Studies in the past compare almost data of the first hours until day two. However, the surgical injury and the wound healing metabolism has to be detected. ⋯ Cytokine response after cholecystectomy demonstrates the lesser degree of surgical injury in the laparoscopic group, however, TNF-alpha demonstrates on day 4 a similar increase in both groups. This is a new result of studies working in this field. In conclusion, the benefit of laparoscopic surgery results only in the minimal access to the abdominal cavity, the wound healing metabolism is at last the same in both groups.
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Blunt transhiatal esophagectomy is largely performed in selected cases of esophageal cancer according to the experience of Mark Orringer. We have recently performed eleven consecutive videolaparoscopy assisted transhiatal esophagectomies in order to help esophageal dissection and to avoid injuries to mediastinal structures. In our experience the routine use of laparoscopic assistance during transhiatal esophageal dissection improves the safety of this technique and lowers postoperative complications. The results of neoadjuvant treatments (radio-chemotherapy) recently reported emphasize the role of transhiatal esophagectomy for cancer.
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Over 8 years, 1700 patients were referred from the Mohs' Surgery and Cutaneous Laser Unit after Mohs micrographic skin tumor excision to the Division of Plastic and Reconstructive Surgery. Preoperative coordination between the two divisions was emphasised in wound preparation and timing of reconstruction for maximized patient convenience and outcome. ⋯ Direct closure, skin grafts and flaps were used. Preference for aesthetic subunit reconstruction of the face and the use of particular flap techniques including the O-to-S, O-to-T, V-to-Y island advancement, islandized nasolabial flap for alar reconstruction and the forehead flap for nasal dorsum and tip repair are illustrated.