Minerva chirurgica
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Percutaneous cholecystostomy (PC) is an effective procedure to treat moderate or severe acute cholecystitis (AC) in high-risk patients. The ideal timing of the drainage removal is argued. The aim of this study is to analyze our experience and perform a systematic review about the ideal timing of a percutaneous cholecystostomy (PC) tube removal. ⋯ PC is an effective procedure in high-risk patients with moderate or severe AC. At the moment there is no evidence whether the duration of PC tube may affect outcome.
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Comparative Study
Robotic versus laparoscopic right colectomy for cancer: short-term outcomes and influence of Body Mass Index on conversion rate.
It is still controversial if the robotic colorectal surgery provides any advantage compared to conventional laparoscopy. We compared the short-term outcomes of robotic right colectomy (RRC) and laparoscopic right colectomy (LRC) and the influence of Body Mass Index (BMI) on each one. ⋯ RRC offers slightly advantages to the LRC with extracorporeal anastomosis, even if it still requests increased time and costs. This study suggested that this difference increases when BMI rises.
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Multicenter Study Observational Study
Repeat sentinel lymph node biopsy in patients with ipsilateral recurrent breast cancer after breast-conserving therapy and negative sentinel lymph node biopsy: a prospective study.
Patients with ipsilateral breast tumor recurrence or new ipsilateral primary tumor after previous breast conservative surgery with negative sentinel lymph node biopsy need a new axillary staging procedure. However, the best surgical option, i.e. repeat sentinel lymph node biopsy or axillary lymph node dissection, is still debated. Purpose of the study is to assess the performance of repeat sentinel lymph node biopsy. ⋯ Repeat sentinel lymph node biopsy is feasible and accurate, with a high negative predictive value. Patients with ipsilateral breast tumor recurrence or new ipsilateral primary tumor after previous breast conservative surgery and negative sentinel lymph node biopsy can be treated with repeat sentinel lymph node biopsy for the axillary staging and can be spared axillary dissection in case of absence of metastases. However, repeat sentinel lymph node biopsy may prove technically impracticable in about one quarter of cases and thus axillary lymph node dissection remains the only viable option in such instance.
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Uniportal Video-Assisted Thoracic Surgery (uniportal VATS) lobectomy represents the last evolution of minimally invasive techniques for the surgical treatment of lung cancer. Uniportal VATS was developed from two-ports approach, with two main advantages: only one intercostal space is damaged and the direct view to the target tissue. Improvements in camera systems, instruments and stapler technology have facilitated this development. ⋯ In our center, as we gain experience with the approach, we performed advanced cases with similar results to the initial stages. Segmentectomies, bronchovascular reconstructions and selected cases that need chest wall resection were also carried out by uniportal VATS. The last advance is the uniportal VATS lobectomy in non-intubated patients with spontaneous breathing, the less invasive surgical approach in combination with a less invasive anesthetic management.