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Updates in Surgery

J Weindelmayer, S Laiti, R La Mendola, M Bencivenga, L Scorsone, V Mengardo, S Giacopuzzi
Anastomotic intraluminal bleeding is a well-known complication after total gastrectomy. Nevertheless, few data are published on acute bleeding obstruction pancreatitis (BOP) due to a bleeding from the jejunojejunostomy (JJ). In this paper we describe our experience. A total of 140 gastrectomies for EGJ cancer were performed in our Institute from January 2012 to January 2017. All reconstructions were performed with a Roux-en-Y anastomosis: a mechanical end-to-side esophago-jejunostomy and a mechanical end-to-side JJ...
May 22, 2018: Updates in Surgery
Giovanni Capretti, Ugo Boggi, Roberto Salvia, Giulio Belli, Roberto Coppola, Massimo Falconi, Andrea Valeri, Alessandro Zerbi
The value of minimally invasive pancreatic surgery (MIPS) is still debated. To assess the diffusion of MIPS in Italy and identify the barriers preventing wider implementation, a questionnaire was developed under the auspices of three Scientific Societies (AISP, It-IHPBA, SICE) and was sent to the largest possible number of Italian surgeons also using the mailing list of the two main Italian Surgical Societies (SIC and ACOI). The questionnaire consisted of 25 questions assessing: centre characteristics, facilities and technologies, type of MIPS performed, surgical techniques employed and opinions on the present and future value of MIPS...
May 16, 2018: Updates in Surgery
Salomone Di Saverio, Arianna Birindelli, Richard Ten Broek, Justin R Davies, Matteo Mandrioli, Ville Sallinen
ASBO is a common cause of emergency surgery and the use of laparoscopy for the treatment of these patients is still under debate and conflicting results have been published, in particular regarding the high risk of iatrogenic bowel injury. In fact, although over the last few years there has been an increasing enthusiasm in the surgical community about the advantages and potential better outcomes of laparoscopic management of adhesive small bowel obstruction (ASBO), recently published studies have introduced a significant word of caution...
May 16, 2018: Updates in Surgery
Riccardo Caruso, Emilio Vicente, Yolanda Quijano, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Valentina Ferri
In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic gastrectomy, however, is adopted in only a few selected centers. The goals of this study were to examine the adoption of robotic gastrectomy and to compare outcomes between open and robotic gastric resections. This is a case-matched analysis of patients who underwent robotic and open gastric resection performed at Sanchinarro University Hospital, Madrid from November 2011 to February 2017. Patient data were obtained retrospectively...
May 4, 2018: Updates in Surgery
Théophile Guilbaud, François Portier, Antoine Camerlo
No abstract text is available yet for this article.
April 26, 2018: Updates in Surgery
Pankti Kothari, Dominick V Congiusta, Aziz M Merchant
Frailty in the elderly population is an important predictor of surgical outcomes. It has been quantified by several models, including the modified frailty index, which has demonstrated applicability in many surgical subspecialties. We aim to conduct the first decade-long retrospective analysis of frailty and complications between open and laparoscopic colectomy. We used the American College of Surgeons National Surgical Quality Improvement Program database to identify colectomies performed between 2005 and 2014...
April 16, 2018: Updates in Surgery
Uberto Fumagalli Romario, Jacopo Weindelmayer, Andrea Coratti, Andrea Cossu, Luca Gianotti, Stefano Rausei, Andrea Sansonetti, Stefano De Pascale
In the last years, the concept of 'enhanced recovery after surgery' (ERAS) has become a routine in the perioperative care of patients undergoing colorectal resection. The application of ERAS programs in gastric surgery had a more difficult penetration into clinical practice, mainly for the introduction of radical changes in the traditional postoperative management. The aim of the study was to analyze the rate of compliance to a standardized ERAS protocol in different Italian centers and evaluate the results in terms of postoperative outcomes...
April 9, 2018: Updates in Surgery
Chandramohan Servarayan Murugesan, Kanagavel Manickavasagam, Apsara Chandramohan, Abishai Jebaraj, Abdul Rehman Abdul Jameel, Mayank Shikar Jain, Jayanthi Venkataraman
India has a low incidence of gastric cancer. It ranks among the top five most common cancers. Regional diversity of incidence is of importance. It is the second most common cause of cancer related deaths among Indian men and women in the age between 15 and 44. Helicobacter pylori carcinogenesis is low in India. Advanced stage at presentation is a cause of concern. Basic and clinical research in India reveals a globally comparable standard of care and outcome. The large population, sociodemographic profile and challenges in health expenditure, however, remain a major challenge for health care policy managers...
April 2, 2018: Updates in Surgery
Gian Luca Baiocchi, Simone Giacopuzzi, Daniele Marrelli
Gastric cancer is one of the most frequent cancers worldwide, and surgical resection remains the mainstay of the therapeutic pathway. Gastrectomy for cancer is still performed in many hospitals, and centralization remains limited to a small number of health systems. Morbidity and mortality after surgery for gastric cancer are surprisingly high. However, while mortality is obviously defined, major morbidity definitions still present some critical points. The aim of this study is to underline the need for universally accepted definitions of major complications and to describe the research agenda of a multicenter, European-based, prospective project launched by the European Chapter of the International Gastric Cancer Association (IGCA), with the goal of providing a list of complications related to gastrectomy for cancer with their definitions...
March 31, 2018: Updates in Surgery
Marco Ceresoli, Fausto Catena, Luca Ansaloni
No abstract text is available yet for this article.
March 27, 2018: Updates in Surgery
Benedetto Ielpo, Riccardo Caruso, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malavé, Yolanda Quijano, Emilio Vicente
Interest in robotic pancreatectomy has been greatly increasing over the last decade. However, evidence supporting the benefits of robotic over open pancreatectomy is still outstanding. This study aims to assess the safety and efficacy of robotic pancreatectomy compared with the conventional open surgical approach. Propensity score-matched (1:1) was used to balance age, sex, BMI, ASA, tumor size, and malignancy of 17 robotic pancreaticoduodenectomies (PD), 12 pancreatic enucleations (PE), and 28 distal pancreatectomies (DP); and was compared with the open standard approach...
March 26, 2018: Updates in Surgery
Daniela Zanotti, Gian Luca Baiocchi, Arianna Coniglio, Borzoueh Mohammadi, Silvia Ministrini, Muntzer Mughal, Guido A M Tiberio, Khaled Dawas
There is no consensus on follow-up after gastric surgery for cancer, nor evidence that it improves outcomes. We investigated the impact of intensity of follow-up, comparing the regimens adopted by two centres, in Italy and in the UK. Patients who underwent surgery for gastric and junctional type-3 adenocarcinoma, between September 2009 and April 2013, at the Surgical Clinic, University of Brescia (Italy), and at the Department of Upper Gastrointestinal Surgery, University College London Hospital (UK), were identified...
March 26, 2018: Updates in Surgery
Jobbe P L Leenen, Judith E K R Hentzen, Henrietta D L Ockhuijsen
It has been a standard practice to perform mechanical bowel preparation (MBP) prior to colorectal surgery to reduce the risk of colorectal anastomotic leakages (CAL). The latest Cochrane systematic review suggests there is no benefit for MBP in terms of decreasing CAL, but new studies have been published. The aim of this systematic review and meta-analysis is to update current evidence for the effectiveness of preoperative MBP on CAL in patients undergoing colorectal surgery. Consequently, PubMed, MEDLINE, Embase, CENTRAL and CINAHL were searched from 2010 to March 2017 for randomised controlled trials (RCT) that compared the effects of MBP in colorectal surgery on anastomotic leakages...
March 21, 2018: Updates in Surgery
Damiano Patrono, Gianluca Paraluppi, Renato Romagnoli
No abstract text is available yet for this article.
March 20, 2018: Updates in Surgery
Luca Cozzaglio, Federica Marazzi, Vittorio Quagliuolo
No abstract text is available yet for this article.
March 8, 2018: Updates in Surgery
Andrea Scarinci, Tatiana Di Cesare, Daniele Cavaniglia, Tiziano Neri, Michelle Colletti, Giulia Cosenza, Andrea Liverani
Log odds of positive nodes (LODDS), defined as the log of the ratio between the number of positive nodes and the number of negative nodes, has been recently introduced as a tool in predicting prognosis. This study aims to establish the effective and prognostic value of LODDS in predicting the survival outcome of CRC patients undergoing surgical resection. The study population is represented by 323 consecutive patients with primary colon or rectal adenocarcinoma thatunderwent curative resection. LODDS values were calculated by empirical logistic formula, log(pnod + 0...
March 2018: Updates in Surgery
Gian Luca Baiocchi, Edoardo Rosso, Andrea Celotti, Giuseppe Zimmiti, Alberto Manzoni, Marco Garatti, Guido Tiberio, Nazario Portolani
To analyze the clinical outcomes of patients undergoing minimally invasive surgery for pancreatic neoplasms, in two medium-volume centers in Northern Italy, a retrospective chart review was performed in the operative registries, searching for patients who had undergone pancreatic surgery via laparoscopy, irrespective of the final pathological nature of the resected neoplasm. For each case, a standard data extraction form was completed and the following data was extracted: age and sex, type of resection, estimated blood loss, length of the operation, number of harvested nodes, post-operative pancreatic fistula, major post-operative complications, mortality and final pathological diagnosis...
March 2018: Updates in Surgery
Eduardo Smith-Singares
The rise in gun violence and other penetrating trauma constitutes one of the main challenges in the modern practice of Acute Care Surgery. Expertise in the emergency management of this type of injuries is needed if one is to avoid preventable complications, such as short bowel syndrome. Revisiting and sometimes repurposing old surgical techniques may facilitate this task. The use of a modified Finney enteroplasty as a bowel sparing damage control technique for penetrating jejunal and ileal injuries was studied on 87 gunshot wound victims...
March 2018: Updates in Surgery
Andrea Moglia
No abstract text is available yet for this article.
March 2018: Updates in Surgery
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