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Langenbeck's Archives of Surgery

Emanuela Traini, Rocco Bellantone, Serena Elisa Tempera, Salvatore Russo, Carmela De Crea, Celestino Pio Lombardi, Marco Raffaelli
PURPOSE: Indications and advantages of parathyroidectomy in patients with normocalcemic primary hyperparathyroidism (NHPT) are still matter of debate. We aimed to compare clinical presentation and surgical outcome between normocalcemic and hypercalcemic forms in a consecutive series of patients who underwent parathyroidectomy for primary hyperparathyroidism. METHODS: Data of 731 consecutive patients were reviewed and retrospectively compared according to normocalcemic (group A) and hypercalcemic (group B) phenotypes...
March 14, 2018: Langenbeck's Archives of Surgery
P F Alesina, B Meier, J Hinrichs, W Mohmand, M K Walz
PURPOSE: Visualization and precise dissection of the parathyroid glands are a crucial step of thyroidectomy. Moreover, identification of parathyroid adenoma in patients with primary hyperparathyroidism can be challenging due to the possible abnormal location of the enlarged parathyroid. Near-infrared fluorescence (NIR) can be adopted during video-assisted neck surgery in addition to standard endoscopic magnification to enhance the visualization of the parathyroid tissue. METHODS: Between July and August 2017, five patients (one male, four females) underwent video-assisted neck surgery at our hospital...
March 13, 2018: Langenbeck's Archives of Surgery
Johannes Fritzmann, Pietro Contin, Christoph Reissfelder, Markus W Büchler, Jürgen Weitz, Nuh N Rahbari, Alexis B Ulrich
PURPOSE: The present study compared the prognostic value of the lymph node ratio (LNR) and the 6th and the 7th TNM edition as three different lymph node classifications for rectal cancer patients. METHODS: A total of 630 patients who underwent total mesorectal excision for primary rectal cancer between October 2001 and December 2007 were included. Prognostic factors of overall survival were analyzed using Cox proportional hazards models. RESULTS: The median follow-up was 36...
March 9, 2018: Langenbeck's Archives of Surgery
Emanuele Asti, Gianluca Bonitta, Matteo Melloni, Stefania Tornese, Pamela Milito, Andrea Sironi, Elena Costa, Luigi Bonavina
BACKGROUND: Early detection of anastomotic leakage after esophagectomy has the potential to reduce morbidity and mortality. Prompt suspicion of leak may help to exclude patients from fast-track protocols, thereby avoiding early oral feeding and early hospital discharge which could aggravate the prognosis of a clinically occult leak. PATIENTS AND METHODS: Observational retrospective cohort study. Patients with diagnosis of esophageal cancer who underwent elective minimally invasive esophagectomy were included...
March 7, 2018: Langenbeck's Archives of Surgery
Alvaro Robin-Lersundi, Luis Blazquez Hernando, Javier López-Monclús, Arturo Cruz Cidoncha, Carlos San Miguel Méndez, Elena Jimenez Cubedo, Miguel Angel García-Ureña
BACKGROUND: Posterior component separation with transversus abdominis release technique is increasingly being used for abdominal wall reconstruction in complex abdominal wall repair. The main purpose of this study is to present a modification of the surgical technique originally described that facilitates the surgical procedure and offers additional advantages. METHODS: Based on the knowledge of the anatomy of the retromuscular space and the preperitoneal aerolar tissue distribution, we start the incision on the posterior rectus sheath from the arcuate line in a down to up direction...
March 3, 2018: Langenbeck's Archives of Surgery
F Oldhafer, K I Ringe, K Timrott, M Kleine, O Beetz, W Ramackers, S Cammann, J Klempnauer, F W R Vondran, H Bektas
PURPOSE: Treatment of malignancies invading the hepatic veins/inferior vena cava is a surgical challenge. An ante situm technique allows luxation of the liver in front of the situs to perform tumor resection. Usually, cold perfusion and veno-venous bypass are applied. Our experience with modified ante situm resection relying only on total vascular occlusion is reported. METHODS: Retrospective analysis on an almost 15-year experience with ante situm resection without application of cold perfusion or veno-venous bypass RESULTS: The ante situm technique was applied on eight patients...
February 22, 2018: Langenbeck's Archives of Surgery
Nathalie Chereau, Etienne Dauzier, Gaëlle Godiris-Petit, Séverine Noullet, Isabelle Brocheriou, Laurence Leenhardt, Camille Buffet, Fabrice Menegaux
BACKGROUND: International guidelines for the management of differentiated thyroid cancers are based on the 7th TNM classification: pT3 tumors are defined as differentiated thyroid cancers (DTCs) measuring more than 4 cm in their greatest dimension that are limited to the thyroid or any tumor with minimal extrathyroidal extension (ETE; sternothyroid muscle or perithyroid soft tissues). Differences in clinicohistological features and prognosis among patients with pT3 tumors remain controversial, and studies regarding pT3 subgroups are lacking...
February 14, 2018: Langenbeck's Archives of Surgery
Antonio Sitges-Serra, Leyre Lorente-Poch, Juan Sancho
BACKGROUND: Careful parathyroid gland dissection and in situ preservation was the time-honored approach to prevent parathyroid failure after total thyroidectomy. The relative success of parathyroid autotransplantation of hyperplastic parathyroid tissue in patients with renal or hereditary hyperparathyroidism did popularize the use of normal parathyroid tissue autografts during thyroidectomy to prevent permanent hypoparathyroidism. Proof of autograft function in this setting, however, is controversial...
February 10, 2018: Langenbeck's Archives of Surgery
Sudharsan Madhavan, Vishal G Shelat, Su-Lin Soong, Winston W L Woon, Terence Huey, Yiong H Chan, Sameer P Junnarkar
PURPOSE: Multiple models have attempted to predict morbidity of liver resection (LR). This study aims to determine the efficacy of American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator and the Physiological and Operative Severity Score in the enUmeration of Mortality and Morbidity (POSSUM) in predicting post-operative morbidity in patients who underwent LR. METHODS: A retrospective analysis was conducted on patients who underwent elective LR...
February 7, 2018: Langenbeck's Archives of Surgery
Ji Hoon Kim, Byung Sun Cho, Je-Ho Jang
BACKGROUND: Pure laparoscopic anatomical segmental resection has rarely been reported because this technique frequently presents technical difficulties. We describe the laparoscopic resection of anatomical segment VI using the Glissonian approach and a modified liver hanging maneuver. METHODS: Rouviere's sulcus is identified after retracting superiorly the gallbladder. The Glissonian approach for anatomical resection of segment VI can be performed with minimal dissection of the liver parenchyma around the sulcus...
January 29, 2018: Langenbeck's Archives of Surgery
Adolfo Cuendis-Velázquez, Orlando Bada-Yllán, Mario Trejo-Ávila, Enrique Rosales-Castañeda, Andrés Rodríguez-Parra, Alberto Moreno-Ordaz, Eduardo Cárdenas-Lailson, Martin Rojano-Rodríguez, Carlos Sanjuan-Martínez, Mucio Moreno-Portillo
BACKGROUND: The Da Vinci Robotic Surgical System has positioned itself as a tool that improves the ergonomics of the surgeon, facilitating dissection in confined spaces and enhancing the surgeon's skills. The technical aspects for successful bile duct repair are well-vascularized ducts, tension-free anastomosis, and complete drainage of hepatic segments, and all are achievable with robotic-assisted approach. METHODS: This was a retrospective study of our prospectively collected database of patients with iatrogenic bile duct injury who underwent robotic-assisted Roux-en-Y hepaticojejunostomy...
January 26, 2018: Langenbeck's Archives of Surgery
Abhishek Mitra, Esha Pai, Rohit Dusane, Priya Ranganathan, Ashwin DeSouza, Mahesh Goel, Shailesh V Shrikhande
PURPOSE: Extended pancreatectomy aimed at R0 resection of pancreatic tumors with adjacent vessel and organ involvement may be the only option for cure. This study was done with an objective to analyze the short- and long-term outcomes of extended pancreatic resections. METHODS: All pancreatectomies performed between 2006 and 2015 were included. The pancreatectomies were classified as standard or extended, as per the International Study Group for Pancreatic Surgery...
January 23, 2018: Langenbeck's Archives of Surgery
Toshimichi Asano, Toru Nakamura, Takehiro Noji, Keisuke Okamura, Takahiro Tsuchikawa, Yoshitsugu Nakanishi, Kimitaka Tanaka, Soichi Murakami, Yuma Ebihara, Yo Kurashima, Toshiaki Shichinohe, Satoshi Hirano
PURPOSE: It has been reported that preoperative embolization or intraoperative reconstruction of the replaced right hepatic artery (rRHA) in order to secure the arterial blood flow to the liver and biliary tract are useful for patients who have undergone pancreaticoduodenectomy (PD) with concomitant rRHA resection. In this study, the feasibility of concomitant resection of rRHA in PD without preoperative embolization or intraoperative reconstruction were retrospectively evaluated with a particular focus on postoperative complications...
January 23, 2018: Langenbeck's Archives of Surgery
F Rassam, E Roos, K P van Lienden, J E van Hooft, H J Klümpen, G van Tienhoven, R J Bennink, M R Engelbrecht, A Schoorlemmer, U H W Beuers, J Verheij, M G Besselink, O R Busch, T M van Gulik
AIM: Perihilar cholangiocarcinoma (PHC) is a challenging disease and requires aggressive surgical treatment in order to achieve curation. The assessment and work-up of patients with presumed PHC is multidisciplinary, complex and requires extensive experience. The aim of this paper is to review current aspects of diagnosis, preoperative work-up and extended resection in patients with PHC from the perspective of our own institutional experience with this complex tumor. METHODS: We provided a review of applied modalities in the diagnosis and work-up of PHC according to current literature...
January 19, 2018: Langenbeck's Archives of Surgery
Mark Thier, Sébastien Daudi, Anders Bergenfelz, Martin Almquist
BACKGROUND: Primary hyperparathyroidism (pHPT) is caused by single- or multiglandular disease (MGD). Patients with MGD have an increased risk of complications at surgery and for persistence and recurrence after surgery. The study evaluated whether preoperative clinical and biochemical characteristics could predict MGD in patients with pHPT. METHODS: We retrospectively evaluated patients operated 1989-2013 for first-time, non-hereditary pHPT. MGD was defined in patients with more than one pathological gland excised at surgery or with persistent hypercalcemia after the excision of a single pathological parathyroid gland, confirmed by histopathology...
January 2, 2018: Langenbeck's Archives of Surgery
Rosa Klotz, Pascal Probst, Marlene Deininger, Ulla Klaiber, Kathrin Grummich, Markus K Diener, Markus A Weigand, Markus W Büchler, Phillip Knebel
PURPOSE: Tracheostomy is one of the most frequently performed procedures in intensive care medicine. The two main approaches are open surgical tracheostomy (ST) and percutaneous dilatational tracheostomy (PDT). This systematic review summarizes and analyzes the existing evidence regarding perioperative and postoperative parameters of safety. METHODS: A systematic literature search was conducted in the Cochrane Library, EMBASE, LILACS, and MEDLINE to identify all randomized controlled trials (RCTs) comparing complications of ST and PDT and to define the strategy with the lower risk of potentially life-threatening events...
December 27, 2017: Langenbeck's Archives of Surgery
Sarah L Hillary, Stephanie Guillermet, Nicola J Brown, Sabapathy P Balasubramanian
PURPOSE: Intraoperative localisation and preservation of parathyroid glands improves outcomes following thyroid and parathyroid surgery. This can be facilitated by fluorescent imaging and methylene blue; a fluorophore is thought to be taken up avidly by parathyroid glands. This preliminary study aims to identify the optimum dose of methylene blue (MB), fluorescent patterns of thyroid and parathyroid glands and develop a protocol for the use of intravenous MB emitted fluorescence to enable parathyroid identification...
February 2018: Langenbeck's Archives of Surgery
Käthe Goossen, Solveig Tenckhoff, Pascal Probst, Kathrin Grummich, André L Mihaljevic, Markus W Büchler, Markus K Diener
BACKGROUND: The aim of the present study was to determine empirically which electronic databases contribute best to a literature search in surgical systematic reviews. METHODS: For ten published systematic reviews, the systematic literature searches were repeated in the databases MEDLINE, Web of Science, CENTRAL, and EMBASE. On the basis of these reviews, a gold standard set of eligible articles was created. Recall (%), precision (%), unique contribution (%), and numbers needed to read (NNR) were calculated for each database, as well as for searches of citing references and of the reference lists of related systematic reviews (hand search)...
February 2018: Langenbeck's Archives of Surgery
Manish S Bhandare, Shraddha Patkar, Nitin Shetty, Ashwin Polnaya, Suyash Kulkarni, Rohit R Dusane, Shailesh V Shrikhande, Mahesh Goel
PURPOSE: Surgical resection still remains the mainstay of management of hepatocellular carcinoma (HCC). At present, Barcelona clinic liver cancer (BCLC) staging is the most widely used tool to guide treatment; however, criteria for offering surgery as curative treatment are restrictive. We aimed to evaluate short-term and long-term outcomes of HCC after resection, even for patients outside BCLC criteria for resection. METHODS: Data was collected from a prospective database from GI and HPB Department, Tata Memorial Hospital, Mumbai...
February 2018: Langenbeck's Archives of Surgery
Marco Milone, Ugo Elmore, Andrea Vignali, Nicola Gennarelli, Michele Manigrasso, Morena Burati, Francesco Milone, Giovanni Domenico De Palma, Paolo Delrio, Riccardo Rosati
PURPOSE: Although intracorporeal anastomosis (IA) appears to guarantee a faster recovery compared to extracorporeal anastomosis (EA), the data are still unclear. Thus, we performed a systematic review of the literature with meta-analysis to evaluate the recovery benefits of intracorporeal anastomosis. MATERIALS AND METHODS: A systematic search was performed in electronic databases (PubMed, Web of Science, Scopus, EMBASE) using the following search terms in all possible combinations: "laparoscopic," "right hemicolectomy," "right colectomy," "intracorporeal," "extracorporeal," and "anastomosis...
December 12, 2017: Langenbeck's Archives of Surgery
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