Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 5 Articles
Laparoscopic approach is now a widespread technique used worldwide, but there are few recent\nstudies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of\nparastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be\ntemporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia\nand other stoma-related complications were also analyzed.\nMethods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients\nwho underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at\nour hospital from January to December 2016.\nResults: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination\nand 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the\nrectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p = 0.005) during\nthe median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing\nthrough the middle of the rectus abdominis muscle, the only independent factor associated with this\nmisplacement of the stoma was a laparoscopic approach (p = 0.012). An analysis of stoma-related complications\nshowed that peristomal skin disorders were significantly associated with parastomal hernia (p = 0.049).\nConclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis\nmuscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk\nfactor. Moreover, parastomal hernia is significantly associated with peristomal skin disorders....
The concept of single-port laparoscopic percutaneous extraperitoneal closure for the treatment of\ninguinal hernias repair in children has been practising recent years. The applicable instruments and skills are still\nevolving. In this study, we used an epidural needle assisted by a towel forceps to practise this minimal invasive\nmethod for inguinal hernias repair in girls. Its safety and effectiveness were studied.\nMethods: From July 2008 to January 2020, thirty-five girls diagnosed of indirect inguinal hernias were studied\nretrospectively. From April 2017 to January 2020, the author was free to propose open or laparoscopic repair for the\npatients. The open group included twenty-four girls and the laparoscopic group included eleven. The data of the\npatients age, constituent ratios of sliding and bilateral hernias, operating time, postoperative time in hospital,\nfollow-up time, conversion, postoperative complications were assessed.\nResults: There were no statistically significant difference between the laparoscopic group and open group for the\nfollowing items: age, operating time, postoperative time in hospital, the constituent ratios of sliding hernia and\nbilateral hernias....................
The mortality following pancreaticoduodenectomy has markedly decreased but remains an important\nchallenge for the complexity of operation and technical skills involved. The present study aimed to clarify the\nimpact of individualized pancreaticoenteric anastomosis and management to postoperative pancreatic fistula.\nMethods: Data from 529 consecutive pancreaticoduodenectomies were retrospectively analysed from the\nHepatobiliary and Pancreatic Surgery Unit I, Peking Cancer Hospital. The pancreaticoenteric anastomosis was\ndetermined based on the pancreatic texture and diameter of the main pancreatic duct. The amylase value of the\ndrainage fluid was dynamically monitored postoperatively on days 3, 5 and 7. A low speed intermittent irrigation\nwas performed in selected patients. Intraoperative and postoperative results were collected and compared between\nthe pancreaticogastrostomy (PG) group and pancreaticojejunostomy (PJ) group.\nResults: From 2010 to 2019, 529 consecutive patients underwent pancreaticoduodenectomy.\nPancreaticogastrostomy was performed in 364 patients; pancreaticojejunostomy was performed in 150 patients\nrespectively. The clinically relevant pancreatic fistula (CR-POPF) was 9.8% and mortality was zero. The soft pancreas,\ndiameter of main pancreatic............................
Transanal Minimally Invasive Surgery (TAMIS) has revolutionized local excision of mid and high rectal\nlesions; benign or malignant. It is a technique that is developed as a hybrid between Transanal Endoscopic\nMicrosurgery (TEM) and laparoscopic surgery for resection of rectal lesions.\nMethods: We retrospectively reviewed prospectively collected data on patients who underwent TAMIS for benign\nand early malignant rectal lesions between Jan 2015 and Sept 2019, at Hamad General Hospital, Doha, Qatar.\nWe assessed the following outcomes: feasibility, fragmentation of specimen, operative time, length of stay (LOS)\npost-operative complications, and margin negativity.\nResults: Seventeen consecutive patients underwent TAMIS for benign and malignant rectal lesions. The average\nlength of stay (LOS) is 1.5 days (1-6 days). Seven patients had different types of benign adenomas, five patients had\nproven adenocarcinoma, three patients had well-differentiated neuroendocrine tumors, one patient with\nhyperplastic polyp, and one patient had inflammatory polyp. No fragmentation occurred or detected by\nhistopathologic examination, except in a patient who had inflammatory polyp, where the lesion removed in two\nfragments.\nConclusion: TAMIS procedure is feasible and safe even in a relatively low-volume colorectal unit. Using this tool,\nmany patients can avoid unnecessary radical surgery. Therefore, we believe that TAMIS should form part of every\nspecialized colorectal service repertoire. To our knowledge, this is the largest series in the gulf region....
Castlemanâ??s disease (CD) is a rare non-clonal lymphadenopathy. Application of video-assisted\nthoracoscopic surgery (VATs) in intrathoracic unicentric Castlemanâ??s disease (UCD) is rarely reported. This study is\naimed to clarify the role of VATs for diagnosis and treatment in intrathoracic UCD.\nMethods: The authors reviewed and identified patients who had received a histologic diagnosis of CD through\nVATs at our hospital from January2010 to June 2018. Clinical and radiologic variables, histopathology, type of\napproach, complications, and long-term effect were analyzed to evaluate the safety and efficacy of VATs.\nResults: A total of 10 patients were included in this study, with 8 hyaline vascular type and 2 plasma cell type. The\nmean maximum diameter of the lesions was 4.66 cm. Nine cases underwent complete surgical excision by VATs,\nand 1 case was converted to thoracotomy. All patients had no postoperative complications. With a median followup\nof 5 years (range: 1-9 years), no tumor recurrence was found in 9 patients receiving complete tumor resection,\nand 1 patient with incomplete tumor resection remained symptom free without clinical or radiographic progression.\nConclusions: VATs is an alternative, minimally invasive technique for the diagnosis and treatment in patients with\nintrathoracic UCD....
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