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Updates in Surgery

Hui Sun, Che-Wei Wu, Antonina Catalfamo, Valerio Fabiano, Gianlorenzo Dionigi
No abstract text is available yet for this article.
September 11, 2018: Updates in Surgery
Matteo Rottoli, Benedetta Casadei, Carlo Vallicelli, Giulia Vitali, Federico Ghignone, Marica Melina, Marta Tanzanu, Gilberto Poggioli
The aim of the study was to compare the perioperative outcomes of patients undergoing ileostomy closure after a three-stage ileal pouch-anal anastomosis to a control group of patients who had elective colorectal resections and stoma, and to analyse the differences based on the technique of closure. The cases were retrospectively compared for demographic characteristics and postoperative outcomes. Chi-square, Fisher's exact and Wilcoxon rank sum tests were used as appropriate. Between 2011 and 2016, 338 patients having their stoma reversed after three-stage IPAA were compared to 158 patients in the control group...
September 8, 2018: Updates in Surgery
Francesco Pennestrì, Pierpaolo Gallucci, Francesca Prioli, Piero Giustacchini, Luigi Ciccoritti, Luca Sessa, Rocco Bellantone, Marco Raffaelli
The use of barbed sutures for constructing an anastomosis is favoured by a few bariatric surgeons as compared to conventional sutures. The aim of this study is to assess safety and efficacy of barbed sutures to close the gastric pouch-jejunal anastomosis (GPJA) in laparoscopic gastric bypass (Roux-en-Y gastric bypass-RYGB, and One-Anastomosis gastric bypass-OAGB) using propensity score-matching (PSM) analysis. A retrospective analysis of patients who underwent primary laparoscopic gastric bypasses between January 2012 and December 2017 was performed...
September 6, 2018: Updates in Surgery
Stefano Guadagni, Marco Clementi, Maria Bencivenga, Shigeki Kusamura, Caterina Fiorentini, Francesco Masedu
Patients with unresectable recurrent rectal cancer that progresses after systemic chemotherapy and radiotherapy are candidates for palliation with hypoxic pelvic perfusion (HPP). The aim of this observational retrospective study was to evaluate if a multimodality treatment including HPP and targeted-therapy may be useful to prolong clinical responses and survival of these patients. From a cohort of 77 patients with unresectable recurrent rectal cancer in progression after standard treatments and submitted to HPP, 21 patients underwent repeat HPP using mitomycin C (MMC) at the dose of 25 mg/m2 ...
September 6, 2018: Updates in Surgery
Antonio Brescia, Massimo Pezzatini, Gherardo Romeo, Matteo Cinquepalmi, Fioralba Pindozzi, Anna Dall'Oglio, Marcello Gasparrini, Fulger Lazar
ERAS protocol and indocyanine green fluorescence angiography (ICG-FA) represent the new surgical revolution minimizing complications and shortening recovery time in colorectal surgery. As of today, no studies have been published in the literature evaluating the impact of the ICG-FA in the ERAS protocol for the patients suitable for colorectal surgery. The aim of our study was to assess whether the systematic evaluation of intestinal perfusion by ICG-FA could improve patients outcomes when managed with ERAS perioperative protocol, thus reducing surgical complication rate...
September 1, 2018: Updates in Surgery
Luigi Pugliese, Stefania Marconi, Erika Negrello, Valeria Mauri, Andrea Peri, Virginia Gallo, Ferdinando Auricchio, Andrea Pietrabissa
The use of 3D printing is gaining considerable success in many medical fields including surgery. Here, the technology was introduced for increasing the level of anatomical understanding thanks to the inherent characteristics of 3D printed models: these are highly accurate and customized reproductions, being obtained from own radiological imaging of patients, and are solid graspable objects allowing for free manipulation on part of the user. The resulting tactile feedbacks significantly help the comprehension of anatomical details, especially the spatial relations between structures...
August 30, 2018: Updates in Surgery
Nicola de'Angelis, Niccoló Petrucciani, Giusy Giannandrea, Francesco Brunetti
Low-impact laparoscopic (LIL) cholecystectomy is an innovative surgical protocol that combines the use of mini-laparoscopic instruments (3-mm ports) under a low- and stable-pressure pneumoperitoneum (8 mmHg), with the aim of minimizing the surgical invasiveness and the risks related to CO2 insufflation on the peritoneal environment. In day-surgery settings, LIL may contribute to increase the surgical success due to several potential benefits in terms of postoperative pain intensity and time to full recovery...
August 29, 2018: Updates in Surgery
Giuseppe Spinoglio, Emilio Bertani, Simona Borin, Alessandra Piccioli, Wanda Petz
Fluorescent imaging with indocyanine green (ICG) is an emerging technology that is gaining acceptance for being a valid tool in surgeons' decision making. ICG binds to plasma lipoproteins if injected intravenously and, when excited by near-infrared light, provides anatomic information about organs vascularization and tissues perfusion. If injected in tissues, it migrates in the lymphatic system, therefore enabling the identification of lymphatic draining pathways of different organs. In this paper we address specific applications of ICG fluorescence in robotic general surgery...
August 29, 2018: Updates in Surgery
Areg Grigorian, Alessio Pigazzi, Ninh T Nguyen, Sebastian D Schubl, Victor Joe, Matthew Dolich, Michael Lekawa, Jeffry Nahmias
Laparoscopy accounts for > 70% of general surgical cases. Given the increased use of laparoscopy in emergent colorectal disease, we hypothesized that there would be an increased use of laparoscopic colectomy (LC) in trauma patients. In addition, we hypothesized increased length of stay (LOS) and mortality in trauma patients undergoing open colectomy (OC) vs. LC. This was a retrospective analysis using the National Trauma Data Bank (2008-2015). We included adult patients undergoing LC or OC. A multivariable logistic regression model was used for determining risk of LOS and mortality...
August 24, 2018: Updates in Surgery
Marco Patti, Francisco Schlottmann
No abstract text is available yet for this article.
August 24, 2018: Updates in Surgery
Paolo Magistri, Tiziana Olivieri, Valentina Serra, Giuseppe Tarantino, Giacomo Assirati, Annarita Pecchi, Roberto Ballarin, Fabrizio Di Benedetto
Immune compromised as well as critically ill patients are at higher risk of surgical wound infection and dehiscence. Wound infections critically influence the outcomes after liver transplantation. In particular, it was shown that they significantly reduce the overall survival rate when compared to patients with uneventful wound healing, and their occurrence is associated with death or graft loss within 1-year post-transplantation. From January 2001 through December 2017, 763 patients underwent liver transplantation in our Institution, the Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, "Policlinico" University Hospital, University of Modena and Reggio Emilia, Modena, Italy...
August 24, 2018: Updates in Surgery
Verónica Gorodner, Germán Viscido, Franco Signorini, Lucio Obeide, Federico Moser
Gastroesophageal reflux disease (GERD) is markedly increased among the obese population being recognized as one of the many obesity-related comorbidities. This concept should raise awareness, making physicians investigate more profoundly about this disease in this kind of patients. Currently, bariatric surgery is considered the gold standard treatment for morbid obesity. However, not all the operations are appropriate for the treatment of GERD and not all the patients are willing to receive bariatric surgery for the treatment of GERD...
August 24, 2018: Updates in Surgery
Marina Carbone, Vincenzo Ferrari, Michele Marconi, Roberta Piazza, Andrea Del Corso, Daniele Adami, Quintilia Lucchesi, Valeria Pagni, Raffaella Berchiolli
In non-urban scenarios: rural areas or small cities, there is often a limited access to specialistic healthcare due to the inherent challenges associated with recruitment, retention, and access to healthcare professionals. Telemedicine is an economical and effective way to address this problem. In this research, we developed a framework for real-time communication during ultrasound examination that combines interaction via standard video conference protocols and basic AR functionalities (commercial) and a custom-developed application...
August 18, 2018: Updates in Surgery
Luca Morelli, Raffaella Berchiolli, Gregorio Di Franco, Mauro Ferrari, Franco Mosca
No abstract text is available yet for this article.
August 17, 2018: Updates in Surgery
Fabrizio Luca, Danielle K Craigg, Maheswari Senthil, Matthew J Selleck, Blake D Babcock, Mark E Reeves, Carlos A Garberoglio
Several studies have reported high rates of urogenital dysfunction after open and laparoscopic surgery for rectal cancer. Robotic surgery has several features that could facilitate identification and preservation of autonomic nerves. This manuscript aims to summarize the literature regarding urogenital function after robotic rectal cancer surgery and focus on technical aspects of nerve-sparing total mesorectal excision. Comprehensive searches were conducted through online databases. Selection criteria included: original articles assessing urinary and sexual function after robotic surgery of males and/or females with standardized questionnaires...
August 17, 2018: Updates in Surgery
Melissa G Medina, Steven S Tsoraides, Anthony M Dwyer
As the field of surgery advances, new approaches have allowed surgeons additional flexibility to perform further interventions with minimal or no external incisions. For many years, single site access (SSA) has been used for transanal procedures, and platforms allowing modified endoscopic approaches have been available. These platforms have limitations related to access, visualization, dexterity, camera control, and instrumentation. Recently, surgical robotics companies have developed and introduced new technologies and platforms, which may help address some of these limitations...
August 17, 2018: Updates in Surgery
Matteo Gregori, Diletta Cassini, Norma Depalma, Michelangelo Miccini, Farshad Manoochehri, Gianandrea A Baldazzi
The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there is no uniformity in terms of surgical technique adopted and data show significant differences in postoperative outcomes...
August 10, 2018: Updates in Surgery
Stefano Cianci, Carlo Abatini, Anna Fagotti, Benito Chiofalo, Alessandro Tropea, Antonio Biondi, Giovanni Scambia, Fabio Pacelli
The most frequent peritoneal surface malignancies originate principally by gastric cancer, colorectal cancer and ovarian cancer. Apart from the origin, peritoneal carcinosis (PC) is considered a negative prognostic factor. The hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal malignancies is considered an attractive method to deliver chemotherapy with enhanced effect directly at the tumor site. The use of such loco-regional approach has proved to improve prognosis of peritoneal carcinomatosis from different origins...
August 9, 2018: Updates in Surgery
Alberto Sartori, Maurizio De Luca, Valentino Fiscon, Mauro Frego, Giuseppe Portale
Anastomotic stenosis after colorectal surgery is usually considered low-rate complication and often is under-reported in most studies. Few data are available on management strategies. The aim of the study was to assess the prevalence of stenosis after stapled colorectal anastomosis, performed either in elective or emergent setting, for benign or malignant disease, and to evaluate treatment profiles. This retrospective study was a survey conducted in a large Italian North-Eastern area including three regions (Triveneto), over a 12-month period (January-December 2015)...
August 2, 2018: Updates in Surgery
Chadrick R Evans, Melissa G Medina, Anthony Michael Dwyer
Advances in communication technologies have paved the way for telemedicine to transform the delivery of medical care throughout the world. Coinciding developments in minimally invasive surgery and in particular teleoperated robotic surgical systems will allow the surgeon to deliver expert care in remote locations. This study presents a systematic review of telemedicine, focusing on telerobotic surgical systems. A brief historical review of telemedicine and telerobotics is provided, including a description of the various subtypes of telemedicine...
July 28, 2018: Updates in Surgery
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