Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2004
Late laparoscopic reoperation of failed antireflux procedures.
Failures of antireflux procedures occur in 5% to 10% of the patients. Our objective is to report our experience with laparoscopic management of failed antireflux operations. Of 1698 patients who underwent laparoscopic treatment of gastroesophageal reflux disease (GERD), 53 were reoperations following either a previous open or laparoscopic antireflux procedure. ⋯ Intra (n=5) and postoperative (n=16) complications were frequent, but they were usually minor. There was no mortality. The present study demonstrated that laparoscopic reoperation for failed antireflux procedures may be performed safely in most patients with excellent result, low severe morbidity, and no mortality.
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Surg Laparosc Endosc Percutan Tech · Apr 2004
Comparative StudyChemical pleurodesis to improve patients' quality of life in the management of malignant pleural effusions: the 15 year experience of the National Cancer Institute of Milan.
We analyzed chemical pleurodesis role in recurrent neoplastic pleural effusions management, performed by two different techniques: VATS and minimal lateral thoracotomy. We compared the results obtained using the two different procedures, and we also evaluated the two sclerosing agents used (talc and alcohol). From January 1987 to March 2002, we treated 565 patients with malignant pleural effusion: 355 (63%) by VATS and 210 (37%) through mini-thoracotomy all of them underwent chemical pleurodesis: 442 (78%) by means of talc and 123 (22%) by alcohol. ⋯ Talc was superior to alcohol as sclerosant agent regardless of the surgical procedure. Comparing the two techniques, VATS should be preferred to minimal thoracotomy. We can suggest talc pleurodesis by VATS as the choice treatment in case of recurrent pleural effusions.
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Surg Laparosc Endosc Percutan Tech · Dec 2003
Case ReportsDispersive pad site burns with modern radiofrequency ablation equipment.
Pad burns during or after radiofrequency ablation (RFA) are a skin complication probably underreported in the literature. We report on 4 severe pad burns, deep second and third degree, in 3 patients undergoing radiofrequency ablation of liver malignancies, 1 percutaneously and the other 2 after laparotomy. ⋯ Current dispersive pad designs do not prevent the leading edge phenomenon and subsequent burns. Further developmental work in the pad design with the possibility of skin temperature monitoring via temperature sensors under the leading pad edge is needed.
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Surg Laparosc Endosc Percutan Tech · Oct 2003
Review Case ReportsLaparoscopic treatment of a bilobed gallbladder: a case report and review of the literature.
A double or bilobed gallbladder is a rare congenital anomaly. Because other congenital vascular and biliary duct anomalies may accompany this pathology, open cholecystectomy was thought to be the best treatment of symptomatic patients. In this paper, we report a patient with a bilobed gallbladder whose symptoms were successfully treated with laparoscopic cholecystectomy. We also discuss the characteristics and the embryology of this rare anomaly.
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Surg Laparosc Endosc Percutan Tech · Oct 2003
Case ReportsHepatic duct confluence injury in blunt abdominal trauma: case report and synopsis on management.
Injuries of the extra hepatic biliary tree following blunt trauma to the abdomen are rare. We present here a case of injury to the confluence of the hepatic ducts and a brief synopsis on diagnosis and management of blunt injury to the extrahepatic biliary system.