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Digestive Surgery

Marco Vito Marino, Galyna Shabat, Domenico Guarrasi, Gaspare Gulotta, Andrzej Lech Komorowski
BACKGROUND: Despite potential benefits of robotic liver surgery, it is still considered a "development in progress" technique. METHODS: The outcomes of 14 patients undergoing robotic right hepatectomy were analyzed and compared with the results of 20 laparoscopic right hepatectomies consecutively performed by the same young surgeon. RESULTS: The overall mean operative time was less in robotic arm (425 ± 139 vs. 565.18 ± 183.73, p = 0...
March 14, 2018: Digestive Surgery
Rana Madani, Nigel Day, Lalit Kumar, Henry S Tilney, Andrew Mark Gudgeon
BACKGROUND: Individual trials comparing hand-sewn with stapled closure of loop ileostomy show different outcomes due to lack of statistical power. A systematic review, with a pooled analysis of results, might provide a more definitive answer. This review aimed to compare hand-sewn with stapled anastomotic technique for closure of a loop ileostomy and looked at the effect of bowel resection on the complication rates. METHODOLOGY: Relevant studies were identified from MEDLINE, EMBASE and the Cochrane database...
March 7, 2018: Digestive Surgery
Tim van Tuil, Ali A Dhaif, Wouter W Te Riele, Bert van Ramshorst, Hjalmar C van Santvoort
BACKGROUND: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. METHODS: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. RESULTS: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included...
March 2, 2018: Digestive Surgery
Kadri Altundag
No abstract text is available yet for this article.
March 2, 2018: Digestive Surgery
Luis Ruso Martinez
Regarding the history of liver surgery, Latin American pioneers have only occasionally been mentioned in the Anglo-Saxon literature. One of such rare cases was Uruguayan surgeon Gerardo Caprio, who in 1931 published a report about a resection of the left lobe of the liver. This was done during an uneventful period in the development of ideas on this surgical technique, following the remarkable advances made in the last quarter of the 19th Century. The anatomic and liver manipulation concepts used by Caprio had been developed by Merola in reports dating back to 1916 and 1920, which revealed well-grounded disagreements with the most renowned anatomists of the time...
March 1, 2018: Digestive Surgery
Jeroen L A van Vugt, Marcia P Gaspersz, Jaynee Vugts, Stefan Buettner, Stef Levolger, Ron W F de Bruin, Wojciech G Polak, Jeroen de Jonge, François E J A Willemssen, Bas Groot Koerkamp, Jan N M IJzermans
BACKGROUND: Low skeletal muscle mass is associated with increased postoperative morbidity and worse survival following resection for perihilar cholangiocarcinoma (PHC). We investigated the predictive value of skeletal muscle mass and density for overall survival (OS) of all patients with suspected PHC, regardless of treatment. METHODS: Baseline characteristics and parameters regarding disease and treatment were collected from all patients with PHC from 2002 to 2014...
February 16, 2018: Digestive Surgery
Guido Torzilli, Luca Viganò, Matteo Cimino, Katsunori Imai, Eric Vibert, Matteo Donadon, Doaa Mansour, Denis Castaing, Ren Adam
BACKGROUND: Two-stage hepatectomy (TSH) is the present standard for multiple bilobar colorectal metastases (CLM). As alternative, ultrasound-guided one-stage hepatectomy (E-OSH) has been proposed even for deep-located nodules to compare TSH and E-OSH. METHODS: All consecutive TSH at the Paul Brousse Hospital and E-OSH at the Humanitas Research Hospital were considered. The inclusion criteria were ≥6 CLM, ≥3 CLM in the left liver, and ≥1 lesion with vascular contact...
February 13, 2018: Digestive Surgery
Sami Miilunpohja, Jussi Kärkkäinen, Juha Hartikainen, Johanna Jyrkkä, Tuomo Rantanen, Hannu Paajanen
BACKGROUND/AIMS: The role of emergency surgery is decreasing in the treatment of patients with upper gastrointestinal bleeding (UGIB). We investigated the need of urgent surgery and outcome of elderly UGIB patients who often have cardiovascular comorbidities with antithrombotic medication. METHODS: All consecutive adult patients who received emergency treatment for suspected gastrointestinal bleeding between January 2009 and December 2011 were registered in an electronic database (n = 1,643)...
February 13, 2018: Digestive Surgery
Max Ditzel, Sandra Vennix, Anand G Menon, Paul C M Verbeek, Willem A Bemelman, Johan F Lange
BACKGROUND: Diverticulitis can lead to localized or generalized peritonitis and consequently induce abdominal adhesion formation. If adhesions would lead to abdominal complaints, it might be expected that these would be more prominent after operation for perforated diverticulitis with peritonitis than after elective sigmoid resection. AIMS: The primary outcome of the study was the incidence of abdominal complaints in the long-term after acute and elective surgery for diverticulitis...
February 9, 2018: Digestive Surgery
Chiara Dal Borgo, Giampaolo Perri, Alex Borin, Giovanni Marchegiani, Roberto Salvia, Claudio Bassi
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas comprise a heterogeneous group of intraductal mucin-producing neoplasms representing a typical adenoma-to-carcinoma sequence. The involvement of the main pancreatic duct (MPD) is a feature of paramount importance, directly related to a more aggressive biology and a higher malignancy rate. METHOD: We review and discuss the clinical management of IPMNs with a MPD involvement, recalling the different consensus guidelines and addressing recent controversies in literature, presenting the current clinical practice in Verona Pancreas Institute...
February 8, 2018: Digestive Surgery
Takeshi Kawamura, Takehiro Noji, Keisuke Okamura, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Yuma Ebihara, Yo Kurashima, Toru Nakamura, Soichi Murakami, Takahiro Tsuchikawa, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: Post-hepatectomy liver failure (PHLF) is a serious complication after major hepatectomy with extrahepatic bile duct resection (Hx with EBDR) that may cause severe morbidity and even death. The purpose of this study was to compare several criteria systems as predictors of PHLF-related mortality following Hx with EBDR for perihilar cholangiocarcinoma (PHCC). METHODS: The study cohort consisted of 222 patients who underwent Hx with EBDR for PHCC. We compared several criteria systems, including previously established criteria (the International Study Group of Liver Surgery (ISGLS) criterion; and the "50-50" criterion), and our institution's novel systems "Max T-Bili" defined as total bilirubin (T-Bili) >7...
February 8, 2018: Digestive Surgery
Robbert J I Bosker, Esther Van't Riet, Mirre de Noo, Maarten Vermaas, Tom M Karsten, Jean-Pierre Pierie
BACKGROUND: There is ongoing debate whether laparoscopic right colectomy is superior to open surgery. The purpose of this study was to address this issue and arrive at a consensus using data from a national database. METHODS: Patients who underwent elective open or laparoscopic right colectomy for colorectal cancer during the period 2009-2013 were identified from the Dutch Surgical Colorectal Audit. Complications that occurred within 30 days after surgery and 30-day mortality rates were calculated and compared between open and laparoscopic resection...
February 7, 2018: Digestive Surgery
Hiroaki Saito, Yusuke Kono, Yuki Murakami, Yuji Shishido, Hirohiko Kuroda, Manabu Yamamoto, Yoji Fukumoto, Tomohiro Osaki, Keigo Ashida, Yoshiyuki Fujiwara
BACKGROUND: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. METHODS: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. RESULTS: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0...
February 7, 2018: Digestive Surgery
Takatsugu Matsumoto, Keiichi Kubota, Taku Aoki, Takayuki Shimizu, Shozo Mori, Masato Kato, Hirotaka Asato
BACKGROUND/AIMS: Because of the anatomical characteristics, pancreatic cancers (PC) can easily invade to visceral vessels such as celiac artery, superior mesenteric artery, common hepatic artery (CHA) and portal vein, which makes curative resection difficult. In this study, we report an R0 resection for locally advanced PC by total pancreatectomy, combined resection of CHA, and reconstruction of hepatic artery using autologous left inferior phrenic artery (IPA). METHODS: A 47-year-old woman with complaints of low back pain was referred to our department...
February 7, 2018: Digestive Surgery
Andres Mora, Yasuaki Nakajima, Takuya Okada, Yutaka Tokairin, Kenro Kawada, Tatsuyuki Kawano
BACKGROUND/AIM: Esophagectomy is still the best therapeutic option for curing resectable esophageal cancer (EC). Radical surgical resection with three-field lymphadenectomy (3FLD) is a potentially curative treatment option. We compared the predictive accuracy of 5 different scores in patients with EC who underwent 3FLD. METHODS: Five years' worth of medical records in a single institution were analyzed (January 2010 to January 2015) from 311 patients who underwent esophagectomy for EC...
January 30, 2018: Digestive Surgery
Akira Umemura, Takayuki Suto, Seika Nakamura, Hisataka Fujiwara, Fumitaka Endo, Hiroyuki Nitta, Takeshi Takahara, Akira Sasaki
BACKGROUND: Both single-incision laparoscopic cholecystectomy (SILC) and needlescopic cholecystectomy (NSC) are superior to conventional laparoscopic cholecystectomy in terms of cosmetic outcome and incisional pain. We conducted a prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures. METHODS: In this trial, 105 patients were enrolled (52 in the SILC group; 53 in the NSC group)...
January 24, 2018: Digestive Surgery
Giorgio Ercolani, Metteo Zanello, Matteo Serenari, Matteo Cescon, Alessandro Cucchetti, Matteo Ravaioli, Massimo Del Gaudio, Antonietta D'Errico, Giovanni Brandi, Antonio Daniele Pinna
BACKGROUND: The role of liver resection for metastatic breast carcinoma is still debated. METHODS: Fifty-one resected patients were reviewed. All patients received adjuvant chemotherapy after resection of the primary tumor. Clinicopathological characteristics and immunohistochemistry expression of estrogen (ER), progesterone (PR), human epidermal growth factor (HER2), or Ki67 were evaluated. RESULTS: The median number of metastases was 2; single metastases were present in 24 (47%) patients...
January 24, 2018: Digestive Surgery
Fabiola Aguilera, Levan Tsamalaidze, Massimo Raimondo, Ruchir Puri, Horacio J Asbun, John A Stauffer
BACKGROUND/AIMS: The operative management of groove pancreatitis (GP) is still a matter of controversy and pancreaticoduodenectomy (PD) can be a high-risk procedure for patients. The aim of this study was to report our 9-year experience of surgical resection for GP and to review relevant literature. METHODS: A retrospective review of patients undergoing pancreatectomy for GP from August 1, 2008, through May 31, 2017 was performed. Patients with clinical, radiologic, and final pathologic confirmation of GP were included...
January 18, 2018: Digestive Surgery
Fiona Hand, Rebeca Sanabria Mateos, Michael Durand, David Fennelly, Ray McDermott, Donal Maguire, Justin Geoghegan, Des Winter, Emir Hoti
Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of evidence comparing similar patient groups. We aimed to evaluate the outcomes of hepatectomy for CRLM when combined with other viscera and compare to a matched cohort of isolated hepatic resections...
January 18, 2018: Digestive Surgery
Feng Zhou, Han-Zhang Huang, Meng-Tao Zhou, Shao-Liang Han
BACKGROUND: The aim of this study is to improve the preoperative diagnostic accuracy and treatment results by investigating the clinical features and prognosis of primary liver sarcoma (PLS). METHODS: Clinical data, surgical treatments, adjuvant chemotherapy, and prognosis of 17 PLS patients whose diseases were pathologically confirmed were retrospectively analyzed. RESULTS: The main clinical symptoms included epigastric pain in 9 patients, epigastric distention in 7, and loss of appetite in 4; these symptoms were detected during the postoperative follow-up for gastric carcinoma in 1...
January 18, 2018: Digestive Surgery
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