Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Oct 2018
Meta Analysis Comparative StudyLaparoscopic Versus Open Major Hepatectomy for Hepatocellular Carcinoma: A Meta-Analysis.
Although large series of laparoscopic resections for hepatocellular carcinoma (HCC) were published, reports of laparoscopic major hepatectomy (LMH) are still limited in expert centers because LMH for HCC remains a challenging procedure requiring extensive experience in both laparoscopic and hepatic surgery. We performed a meta-analysis to assess the safety and efficacy of LMH and open major hepatectomy (OMH) for HCC. ⋯ LMH can be performed as safely and efficiently as OMH for HCC regarding both surgical and oncological outcomes. LMH is associated with less intraoperative blood loss and postoperative morbidity and may serve as a promising alternative to OMH for HCC patients.
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Surg Laparosc Endosc Percutan Tech · Oct 2018
Laparoscopic Ileocolic Pexy as Preventive Treatment Alternative for Ileocolic Intussusception With Multiple Recurrences in Children.
Idiopathic intussusception is one of the most common causes of small bowel obstruction in children. To decrease subsequent recurrence and to detect a lead point, an early laparoscopy was performed for children with multiple recurrent ileocolic intussusception. ⋯ Early preventive laparoscopic ileocolic pexy should be undertaken for the patients with multiple recurrences after the last nonsurgical reduction had been attempted successfully.
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Surg Laparosc Endosc Percutan Tech · Jun 2018
Review Meta Analysis Comparative StudyPancreaticojejunostomy Versus Pancreaticogastrostomy After Pancreaticoduodenectomy: An Up-to-date Meta-analysis of RCTs Applying the ISGPS (2016) Criteria.
The goal of our study was to compare the impact of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) on the incidence of complications after pancreaticoduodenectomy. A systematic search was performed using RevMan 5.3 software. A meta-analysis showed that PG was not superior to PJ in terms of postoperative pancreatic fistula (POPF). ⋯ PG and PJ have similar incidences of POPF, but PG could be slightly superior to PJ in multicenter trials. However, this analysis verifies that PG has a higher rate of postpancreatectomy hemorrhage. Of note, a 2-layer anastomosis could reduce the occurrence of postpancreatectomy hemorrhage.
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Surg Laparosc Endosc Percutan Tech · Jun 2018
Review Meta Analysis Comparative StudyThe Comparison of Midazolam and Propofol in Gastrointestinal Endoscopy: A Systematic Review and Meta-analysis.
Midazolam and propofol are both used for sedation in gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare the efficacy and safety of midazolam and propofol in gastrointestinal endoscopy. ⋯ When compared with midazolam sedation for gastrointestinal endoscopy, propofol sedation results in higher endoscopist satisfaction scores, but may increase the incidence of hypotension.
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Surg Laparosc Endosc Percutan Tech · Feb 2018
Comparative StudyAdvantages of Robotic Right Colectomy With Intracorporeal Anastomosis.
Through retrospective review of consecutive charts, we compare the short-term and long-term clinical outcomes after robotic-assisted right colectomy with intracorporeal anastomosis (RIA) (n=89) and laparoscopic right colectomy with extracorporeal anastomosis (LEA) (n=135). Cohorts were similar in demographic characteristics, comorbidities, pathology, and perioperative outcomes (conversion, days to flatus and bowel movement, and length of hospitalization). The RIA cohort experienced statistically significant: less blood loss, shorter incision lengths, and longer specimen lengths than the LEA cohort. ⋯ No incisional hernias occurred in the RIA group, whereas the LEA group had 5 incisional hernias; mean follow-up was 33 and 30 months, respectively. RIA is effective and safe and provides some clinical advantages. Future studies may show that, in obese and other technically challenging patients, RIA facilitates resection of a longer, consistent specimen with less mesentery trauma that can be extracted through smaller incisions.