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Langenbeck's Archives of Surgery

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https://www.readbyqxmd.com/read/30219924/intensive-perioperative-rehabilitation-improves-surgical-outcomes-after-pancreaticoduodenectomy
#1
Yuji Kitahata, Seiko Hirono, Manabu Kawai, Ken-Ichi Okada, Motoki Miyazawa, Atsushi Shimizu, Ryouhei Kobayashi, Masaki Ueno, Shinya Hayami, Toshio Shimokawa, Ken Kouda, Fumihiro Tajima, Hiroki Yamaue
PURPOSE: Although the mortality rate for pancreaticoduodenectomy (PD) has decreased to around 2.8-5% in high-volume centers, postoperative complications are still common in 30-50% of cases. Preoperative exercise, called "prehabilitation," has been recently reported to reduce the frequency of complications after surgery. This study aims to evaluate the impact of the intensive perioperative rehabilitation on improvement of surgical outcomes for patients undergoing PD. METHODS: Between 2003 and 2014, 576 consecutive patients underwent PD in Wakayama Medical University Hospital...
September 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30218193/prognostic-factors-for-actual-long-term-survival-in-the-era-of-multidisciplinary-treatment-for-pancreatic-ductal-adenocarcinoma
#2
Kenji Nakagawa, Takahiro Akahori, Satoshi Nishiwada, Minako Nagai, Kota Nakamura, Toshihiro Tanaka, Tetsuro Tamamoto, Chiho Ohbayashi, Masatoshi Hasegawa, Kimihiko Kichikawa, Naoya Ikeda, Masayuki Sho
PURPOSE: Recent advances in multidisciplinary treatments are improving the postoperative prognosis of pancreatic ductal adenocarcinoma (PDAC). However, the prognosis even after potentially curative resection remains poor. The aim of this study was to identify the clinical and pathological features of actual 5-year survivors under current circumstances. METHODS: A total of 128 patients who underwent pancreatectomy for PDAC at our institution between January 2006 and December 2011 were retrospectively analyzed...
September 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30218192/small-incision-cholecystectomy-through-a-cylinder-retractor-under-local-anaesthesia-and-sedation-a-prospective-observational-study-of-five-hundred-consecutive-cases
#3
Enrique J Grau-Talens, José Jacob Motos-Micó, Rafael Giraldo-Rubio, José M Aparicio-Gallego, José F Salgado, Carlos D Ibáñez, Pablo G Mangione-Castro, Martina Arribas-Jurado, Carlos Jordán-Chaves, Javier Arias-Díaz
BACKGROUND: Transcylindrical cholecystectomy (TC) can be performed under local anaesthesia and sedation (LAS) in ambulatory surgery (AS). The aim of this study was to assess the feasibility and results of TC under LAS. METHODS: TC under LAS was proposed to 583 consecutive patients with cholelithiasis in an AS unit. For the TC procedure, a cylindrical retractor with a transparent plunger was inserted into the hepatocystic triangle, and cholecystectomy was performed through the retractor with reusable open instruments...
September 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30215157/feasibility-of-a-unidirectionally-progressive-pancreas-oriented-procedure-for-laparoscopic-d3-right-hemicolectomy
#4
Xiangbing Deng, Tao Hu, Mingtian Wei, Qingbin Wu, Tinghan Yang, Wenjian Meng, Ziqiang Wang
BACKGROUND: Complete mesocolic excision (CME) with central ligation or D3 lymphadenectomy has been reported to provide increased lymph node retrieval with the prospect of superior oncological results in colon cancer. However, right hemicolectomy with CME or D3 lymphadenectomy by laparoscopy is considered to be a technically challenging and time-consuming procedure with a higher risk of causing intraoperative injuries. Here, we introduce a novel laparoscopic approach for the D3 right hemicolectomy and report its feasibility, safety, and efficacy in cancer clearance...
September 13, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30206683/malignant-colorectal-polyps-endoscopic-polypectomy-and-watchful-waiting-is-not-inferior-to-subsequent-bowel-resection-a-nationwide-propensity-score-based-analysis
#5
Katarina Levic, Orhan Bulut, Tine Plato Hansen, Ismail Gögenur, Thue Bisgaard
BACKGROUND AND AIMS: The optimal treatment of patients with malignant colorectal polyps is unsettled. The surgical dilemma following polypectomy is selecting between watchful waiting (WW) and subsequent bowel resection (SBR), but the long-term survival outcomes have not been established yet. This nationwide study compared survival of patients after WW or SBR. METHODS: Danish nationwide study with 100% follow-up of all patients with malignant colorectal polyps (the Danish Colorectal Cancer Group database) in a 10-year period from 2001 to 2011...
September 11, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30132134/minimally-invasive-donor-nephrectomy-current-state-of-the-art
#6
REVIEW
Nicole M Shockcor, Sam Sultan, Josue Alvarez-Casas, Philip S Brazio, Michael Phelan, John C LaMattina, Rolf N Barth
BACKGROUND: The concept of a minimally invasive live donor nephrectomy developed over 20 years ago. Surgeons gained expertise with the laparoscopic technique and utilized multiple variations that are now utilized in transplant centers throughout the world. Recent modifications include laparoendoscopic single-site and robotic approaches that have been adopted by an additional smaller set of programs. PURPOSE: Review was performed of the following eight different surgical approaches to a "minimally invasive" live donor nephrectomy: laparoscopic (LDN), hand-assisted laparoscopic (HALDN), retroperitoneoscopic (RLDN), hand-assisted retroperitoneoscopic (HARS), single-port laparoscopic (LESS), robotic-assisted laparoscopic (RALDN), mini open, and natural orifice transluminal endoscopic (NOTES)...
August 21, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30112639/the-impact-of-major-extended-donor-criteria-on-graft-failure-and-patient-mortality-after-liver-transplantation
#7
Vladimir J Lozanovski, Elias Khajeh, Hamidreza Fonouni, Jan Pfeiffenberger, Rebecca von Haken, Thorsten Brenner, Markus Mieth, Peter Schirmacher, Christoph W Michalski, Karl Heinz Weiss, Markus W Büchler, Arianeb Mehrabi
INTRODUCTION: Numerous extended donor criteria (EDC) have been identified in liver transplantation (LT), but different EDC have different impacts on graft and patient survival. This study aimed to identify major EDC (maEDC) that were best able to predict the outcome after LT and to examine the plausibility of an allocation algorithm based on these criteria. METHODS: All consecutive LTs between 12/2006 and 03/2014 were included (n = 611). We analyzed the following EDC: donor age > 65 years, body mass index > 30, malignancy and drug abuse history, intensive care unit stay/ventilation > 7 days, aminotransferases > 3 times normal, serum bilirubin > 3 mg/dL, serum Na+ > 165 mmol/L, positive hepatitis serology, biopsy-proven macrovesicular steatosis (BPS) > 40%, and cold ischemia time (CIT) > 14 h...
August 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30112638/impact-of-adjuvant-chemotherapy-after-pancreaticoduodenectomy-for-distal-cholangiocarcinoma-a-propensity-score-analysis-from-a-french-multicentric-cohort
#8
Damien Bergeat, Olivier Turrini, Laetitia Courtin-Tanguy, Stéphanie Truant, Benjamin Darnis, Jean Robert Delpero, Jean-Yves Mabrut, Nicolas Regenet, Laurent Sulpice
BACKGROUND: The benefit of adjuvant chemotherapy (AC) after pancreaticoduodenectomy (PD) for distal cholangiocarcinoma (DCC) remains controversial. The study aimed to evaluate the impact of AC after PD for DCC in a large multicentric cohort. METHODS: Patients from five French centers who underwent from PD for DCC between 2000 and 2015 and received AC (AC+ group) or surgery only (AC- group) were included in the analysis. Variables associated with AC administration were analyzed by univariate analysis...
August 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30094627/development-and-validation-of-a-new-score-for-measuring-post-operative-complications
#9
Rajesh Panwar, Vedavyas Mohapatra, Karthik Raichurkar, Peush Sahni
PURPOSE: Assigning a numerical value to post-operative morbidity may improve its usefulness as an outcome measure. The recently developed Comprehensive Complication Index (CCI) is a step forward in this process but assigns an inappropriately high score to a combination of complications. METHODS: We developed a new score called the complication severity score (CSS) using a mathematical process and compared it with the CCI using a questionnaire-based survey of 49 experienced gastrointestinal and hepato-pancreatico-biliary surgeons...
August 9, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30083837/how-we-do-it-totally-laparoscopic-complete-mesocolon-excision-for-splenic-flexure-cancer
#10
Paolo Panaccio, Tommaso Grottola, Marco Ricciardiello, Pierluigi di Sebastiano, F Francesco di Mola
BACKGROUND: Splenic flexure (SF) cancer is not a common condition and its treatment is still under discussion. Although laparoscopic surgery is well accepted for the treatment of colon cancer at any stage, complete mesocolon excision (CME) with selective vascular ligation using the laparoscopic approach for SF cancer remains technically demanding and represents a real challenge for surgeons. METHODS: We present a single-institution experience of laparoscopic CME for SF cancer...
August 7, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30058037/trans-infundibular-choledochoscopy-a-method-for-accessing-the-common-bile-duct-in-complex-cases
#11
Lalin Navaratne, Jasim Al-Musawi, Asuncion Acosta Mérida, Jaime Vilaça, Alberto Martinez Isla
PURPOSE: During laparoscopic common bile duct exploration (LCBDE) where Calot's triangle cannot be safely dissected due to a 'frozen' hepatic hilum secondary to severe inflammation or fibrosis, the preferred transcystic approach to the common bile duct (CBD) is precluded. The aim of this paper is to describe a safe method of accessing the CBD via a trans-infundibular approach (TIA) in complex cases where conventional access to the cystic duct or CBD is denied. METHODS: A retrospective review of 154 consecutive patients who underwent LCBDE at a single centre between 2014 and 2018 was performed...
July 29, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30003323/renal-cell-cancer-after-kidney-transplantation
#12
Dennis Kleine-Döpke, Matthias Oelke, Anke Schwarz, Ysabell Schwager, Frank Lehner, Jürgen Klempnauer, Harald Schrem
PURPOSE: This study aims to identify modifiable risk factors for de novo renal cell carcinoma (RCC) after kidney transplantation in a matched-pair approach matching for unmodifiable factors. PATIENTS AND METHODS: One thousand six hundred fifty-five adults who underwent kidney transplantation in the period 1 January 2000 to 31 December 2012 were analyzed. Patients with RCC after kidney transplantation were matched in a 1:2 ratio with those without RCC using the indication for transplantation, age at transplantation (± 10 years), recipient sex (male/female), number of received transplants, living organ donor transplantation (yes/no), and time of follow-up in days as matching criteria...
July 12, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30120543/hangzhou-criteria-are-more-accurate-than-milan-criteria-in-predicting-long-term-survival-after-liver-transplantation-for-hcc-in-germany
#13
Zhi Qu, Qi Ling, Jill Gwiasda, Xiao Xu, Harald Schrem, Jan Beneke, Alexander Kaltenborn, Christian Krauth, Heiko Mix, Jürgen Klempnauer, Nikos Emmanouilidis
BACKGROUND: Milan criteria are used for patient selection in liver transplantation for hepatocellular carcinoma (HCC). Hangzhou criteria have been shown in China to enable access to liver transplantation for more patients when compared to Milan criteria without negative effects on long-term survival. The purpose of this study was to evaluate the Hangzhou criteria in a German cohort. METHODS: One hundred fifty-nine patients transplanted for HCC between 1975 and 2010 were investigated...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30066108/karydakis-flap-reconstruction-versus-limberg-flap-transposition-for-pilonidal-sinus-disease-a-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Dimitrios Prassas, Thomas-Marten Rolfs, Franz-Josef Schumacher, Andreas Krieg
INTRODUCTION: The definitive treatment of pilonidal sinus disease (PSD) is surgical. There is still no consensus as to the most appropriate off-midline primary closure technique. The aim of this meta-analysis has been to compare Karydakis flap reconstruction (KF) to Limberg flap transposition (LF) with regard to short- and long-term postoperative outcomes. METHODS: A systematic literature search for randomized controlled trials (RCTs) comparing KF to LF was performed...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/30043166/ampullary-neuroendocrine-neoplasms-surgical-experience-of-a-rare-and-challenging-entity
#15
A C Milanetto, C Pasquali, M Da Broi, T Brambilla, G Capretti, A Zerbi
PURPOSE: Ampullary neuroendocrine neoplasms (NENs) account for < 0.3% of gastrointestinal NENs. Surgical options include transduodenal ampullectomy/tumour excision or pancreaticoduodenectomy (PD). We report the experience of two high-volume pancreatic surgical centres of ampullary NENs. METHODS: Clinical records of patients who underwent surgery for ampullary NENs (January 2007-November 2017) in the study centres were retrieved retrospectively. We evaluated clinical-pathological features, post-operative outcome and follow-up (FU)...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29971614/patients-views-about-parathyroid-transplantation-for-post-thyroidectomy-hypoparathyroidism
#16
Alexander Stevenson, Radu Mihai
BACKGROUND: Permanent hypoparathyroidism (hypoPT) represents the most common postoperative complication associated with total thyroidectomy. Current treatment relies on high-dose calcium and/or vitamin D supplementation, but often this is insufficient and some patients remain symptomatic. Parathyroid allotransplantation is a new therapeutic option described recently in the literature. This study aims to investigate the patients' acceptability of parathyroid transplantation as a potential new treatment for hypoPT...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29956032/segment-5-parenchymal-sparing-in-extended-left-hepatectomy-with-respect-to-venous-outflow-is-it-a-feasible-procedure
#17
Jun Li, Moustafa Mohamed, Lutz Fischer, Björn Nashan
BACKGROUND: Segment 5 (S5) sparing liver resection for cases that require an anatomic left trisectionectomy has not been reported yet. The authors intended to verify the outcome of S5-sparing extended left hepatectomy (ELH) in respect to venous outflow. METHODS: All adult patients who underwent S5-sparing ELH between 2012 and 2017 in authors' institute have been enrolled in this study. S5-sparring ELH was defined as resection of S2, S3, S4, and S8 with or without S1...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29956031/ischemic-gastropathy-after-distal-pancreatectomy-with-en-bloc-celiac-axis-resection-for-pancreatic-body-cancer
#18
Ken-Ichi Okada, Manabu Kawai, Seiko Hirono, Motoki Miyazawa, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Toshio Shimokawa, Hiroki Yamaue
PURPOSE: Risk factors of ischemic gastropathy (IG) following distal pancreatectomy with en bloc celiac axis resection (DP-CAR) remain unclear. METHODS: Fifty consecutive patients with pancreatic cancer who underwent DP-CAR were retrospectively reviewed for possible risk factors for IG. This study was registered on the UMIN Clinical Trials Registry (UMIN 000028732). RESULTS: Complications higher than grade 3 were observed in 21 patients (42%) and mortality in 4 (8%)...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29956030/perioperative-outcomes-of-laparoscopic-pancreaticoduodenectomy-for-benign-and-borderline-malignant-periampullary-disease-compared-to-open-pancreaticoduodenectomy
#19
Chul Seung Lee, Eun Young Kim, Young Kyoung You, Tae Ho Hong
PURPOSE: The objective of this study was to compare perioperative outcomes between laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for benign and borderline malignant periampullary diseases. METHODS: Of 107 pancreaticoduodenectomy cases for non-malignant diseases from March 1993 to July 2017, 76 patients underwent OPD and 31 patients received LPD. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM)...
August 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29943225/is-systematic-nasogastric-decompression-after-pancreaticoduodenectomy-really-necessary
#20
Elodie Gaignard, Damien Bergeat, Laetitia Courtin-Tanguy, Michel Rayar, Aude Merdrignac, Fabien Robin, Karim Boudjema, Helene Beloeil, Bernard Meunier, Laurent Sulpice
BACKGROUND: Since the spread of enhanced recovery programs, early withdrawal of the nasogastric tube (NGT) is recommended after pancreaticoduodenectomy (PD), although few data on the safety of this practice are available. The aim of the present study was to evaluate the absence of nasogastric decompression after PD on postoperative outcome. STUDY DESIGN: All consecutive patients undergoing PD between January 2014 and December 2015 at a single center were retrospectively analyzed...
August 2018: Langenbeck's Archives of Surgery
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