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Laparoscopic aortic surgery

Anne H Krog, Mehdi Sahba, Erik M Pettersen, Irene Sandven, Per M Thorsby, Jørgen J Jørgensen, Jon O Sundhagen, Syed Ss Kazmi
PURPOSE: Minimally invasive surgical techniques have been shown to reduce the inflammatory response related to a surgical procedure. The main objective of our study was to measure the inflammatory response in patients undergoing a totally laparoscopic versus open aortobifemoral bypass surgery. This is the first randomized trial on subjects in this population. PATIENTS AND METHODS: This is a substudy of a larger randomized controlled multicenter trial (Norwegian Laparoscopic Aortic Surgery Trial)...
2016: Vascular Health and Risk Management
Victor E Corona Montes, Antonio L Pastore, Louis Gausa, Oscar Rodríguez-Faba, Alberto Breda, Joan Palou
BACKGROUND: Today, access to technology through robotic surgery has allowed urologists to have a valuable tool in order to perform various robot - assisted laparoscopic procedures. Robotic surgery allows reproducing complex techniques such as retroperitoneal or extended pelvic lymphadenectomy. The aim of the study was to report our series of robot assisted retroperitoneal lymphadenectomy and to demonstrate its technical and oncological feasibility. METHODS: A retrospective analysis on 7 patients (four cases of testicular tumors, one prostate adenocarcinoma, and two bladder urothelial carcinomas), who underwent retroperitoneal para-aortic, interaorto-cava and extended pelvic lymphadenectomy by robot assisted laparoscopic surgery, was conducted...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Yudai Fukui, Junichi Shindoh, Shuichiro Matoba, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Jin Moriyama, Hiroya Kuroyanagi
A 53-year-old man was readmitted with abdominal distention 2 weeks after undergoing laparoscopic low anterior resection with para-aortic lymphadenectomy for advanced rectal cancer (T4aN1M0, Stage IIIb). Ultrasound revealed massive ascites, and paracentesis revealed chylous fluid with a markedly elevated triglyceride level (1762 mg/dL). Despite conservative management, the fistula remained on postoperative day 120. On percutaneous lymphangiography, the chylous leakage point was clearly visualized at the para-aortic site, and surgical intervention was planned...
September 26, 2016: Asian Journal of Endoscopic Surgery
Sara Nasser, Jumana Almuheimid, Helmut Plett, Jalid Sehouli, Mustafa Zelal Muallem
AIM: In this study we aimed to analyze the safety and feasibility of total mesometrial resection (TMMR) using the laparoscopic approach. PATIENTS AND METHODS: Laparoscopic TMMR and pelvic lymphadenectomy (LNE) was carried out in 34 patients with cervical cancer FIGO IA-IIB from April 2012-April 2016 at our tertiary center. Para-aortic LNE was performed when indicated. The main outcomes included surgical margins, a number of retrieved lymph node, intra- and post-operative complications, and recurrence rates...
September 2016: Anticancer Research
Allison Barrie, Alexandra H Freeman, Liisa Lyon, Christine Garcia, Carol Conell, Laura H Abbott, Ramey D Littell, C Bethan Powell
STUDY OBJECTIVE: To compare intraoperative and postoperative surgical complications and outcomes between robotic-assisted and laparoscopic surgical management of endometrial cancer using a standardized classification system. DESIGN: Retrospective Cohort Study DESIGN CLASSIFICATION: II-2 SETTING: Integrated health care system in Northern California PATIENTS: 1433 women with a diagnosis of complex atypical hyperplasia and endometrial cancer managed by minimally invasive hysterectomy and surgical staging from January 2009 to January 2014...
September 9, 2016: Journal of Minimally Invasive Gynecology
María Martín-Cameán, Elsa Delgado-Sánchez, Antonio Piñera, Maria Dolores Diestro, Javier De Santiago, Ignacio Zapardiel
Nowadays, the standard management of advanced epithelial ovarian cancer is correct surgical staging and optimal tumour cytoreduction followed by platinum and taxane-based chemotherapy. Standard surgical staging consists of peritoneal washings, total hysterectomy, and bilateral salpingo-oophorectomy, inspection of all abdominal organs and the peritoneal surface, biopsies of suspicious areas or randomised biopsies if they are not present, omentectomy and para-aortic lymphadenectomy. After this complete surgical staging, the International Federation of Gynaecology and Obstetrics (FIGO) staging system for ovarian cancer is applied to determine the management and prognosis of the patient...
2016: Ecancermedicalscience
Chyi-Long Lee, Soshi Kusunoki, Kuan-Gen Huang, Kai-Yun Wu, Chen-Yin Huang, Chih-Feng Yen
OBJECTIVE: To assess the long-term outcomes of laparoscopic staging surgery (LSS) in treating patients with endometrial carcinoma. MATERIALS AND METHODS: Patients with endometrial cancer who underwent LSS between June 1995 and June 2014 were prospectively registered. Perioperative data, complications, disease recurrence, and long-term survival were measured. RESULTS: The study included 287 consecutive patients [mean age (± standard deviation), 53±10...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Giovanni Favero, Cristina Anton, Xin Le, Alexandre Silva E Silva, Nasuh Utku Dogan, Tatiana Pfiffer, Christhardt Köhler, Edmund Chada Baracat, Jesus Paula Carvalho
BACKGROUND: Laparoscopy is considered the method of choice in the operative treatment of type I endometrial carcinoma (EC). However, there is a paucity of data regarding the safety of endoscopy for type II EC because these malignancies have several biological similarities with ovarian cancer. OBJECTIVES: This study aimed to evaluate the feasibility, operative outcomes, and oncologic safety of laparoscopic surgery in patients with type II EC. METHODS: A retrospective study with histologically confirmed serous or clear-cell EC without peritoneal carcinomatosis treated by laparoscopy (G1) or laparotomy (G2) was conducted...
August 22, 2016: International Journal of Gynecological Cancer
Lorna A Brudie, Faizan Khan, Michael J Radi, Sarfraz Ahmad
Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths and recurrences associated with endometrial cancer. Small-cell carcinoma of the endometrium is relatively rare but aggressive, and often presents a component of endometrioid carcinoma, and is not generally associated with serous carcinoma. Herein, we report a case of 74-year-old African-American female, who presented with intermittent post-menopausal bleeding for > 1-month. She underwent robotic-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node mapping, and pelvic-and-aortic lymphadenectomy...
August 2016: Gynecologic Oncology Reports
Hironori Shiozaki, Yusuke Shimodaira, Elena Elimova, Roopma Wadhwa, Kazuki Sudo, Kazuto Harada, Jeannelyn S Estrella, Prajnan Das, Brian Badgwell, Jaffer A Ajani
Surgical management of gastric cancer improves survival. However, for some time, surgeons have had diverse opinions about the extent of gastrectomy. Researchers have conducted many clinical studies, making slow but steady progress in determining the optimal surgical approach. The extent of lymph node dissection has been one of the major issues in surgery for gastric cancer. Many trials demonstrated that D2 dissection resulted in greater morbidity and mortality than D1 dissection. However, long-term outcomes demonstrated that D2 dissection resulted in longer survival than D1 dissection...
2016: Chinese Journal of Cancer
Falk C Thiel, Parnian Parvanta, Alexander Hein, Grit Mehlhorn, Michael P Lux, Stefan P Renner, Achim Preisner, Matthias W Beckmann, Michael G Schrauder
BACKGROUND AND OBJECTIVES: Chylous ascites, an accumulation of milky-white lymph fluid in the peritoneal cavity, is a rare complication following retroperitoneal lymphadenectomy. This study evaluated the appearance and management of chylous ascites following lymphadenectomy for gynecological malignancies. METHODS: A total of 931 patients who underwent lymphadenectomy for gynecological malignancies at Erlangen University Hospital between 2002 and 2013 were reviewed retrospectively...
July 4, 2016: Journal of Surgical Oncology
Mehmet Ali Erdoğan, Muharrem Uçar, Ahmet Selim Özkan, Ülkü Özgül, Mahmut Durmuş
Phaeochromocytoma is a catecholamine-secreting vascular tumour that is derived from chromaffin cell. Lethal cardiovascular complications, such as serious hypertension, myocardial infarction and aortic dissection, may occur because of uncontrolled catecholamine release. Each stage of anaesthesia management has vital importance because of this destructive catecholamine secretion that may occur during induction, perioperative stage and surgical manipulation. In this study, we report regarding the preoperative preparation and severe, persistent hypertension attack management with a combination of α-adrenergic blockade, β-adrenergic blockade, sodium nitroprusside and remifentanil in a patient who underwent laparoscopic surgery for phaeochromocytoma...
February 2016: Turk J Anaesthesiol Reanim
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Brazilian Journal of Anesthesiology
Shinichi Komiyama, Chiaki Takeya, Rena Takahashi, Sumito Nagasaki, Kaneyuki Kubushiro
[Objective] To achieve less invasive lymphadenectomy in endometrial cancer patients, we performed extraperitoneal pelvic and para-aortic lymphadenectomy via a small midline abdominal incision with retroperitoneal approach. The feasibility and safety of this method were investigated. [Methods] Inclusion criteria were 1) endometrioid adenocarcinoma diagnosed by preoperative biopsy, 2) myometrial invasion by magnetic resonance imaging, and 3) no peritoneal dissemination or distant metastasis by computed tomography...
2016: Journal of Cancer
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Revista Brasileira de Anestesiologia
Christer Borgfeldt, Grigorios Kalapotharakos, Katrin C Asciutto, Mats Löfgren, Thomas Högberg
INTRODUCTION: The aim was to evaluate surgical treatment of newly diagnosed uterine cancer in a Swedish population. MATERIAL AND METHODS: Data in the GynOp registry from 2008 to 2014 were analyzed. RESULTS: In total, 3443 cases were included: 430 (12%) were robotic-assisted laparoscopic, 272 (8%) laparoscopic, and 2741 (80%) abdominal operations. There was an increasing trend in minimally invasive surgery from 2008 to 2014 (41%). Women with lymph nodes removed in the robotic-assisted laparoscopic group experienced less blood loss (mean 105 vs...
August 2016: Acta Obstetricia et Gynecologica Scandinavica
Yoshihiro Shioi, Akira Sasaki, Hiroyuki Nitta, Akira Umemura, Shigeaki Baba, Takeshi Iwaya, Yusuke Kimura, Koki Otsuka, Keisuke Koeda, Masaru Mizuno, Kazuya Kumagai, Takeshi Kamada, Masayuki Mukaida, Hitoshi Okabayashi
With the increasing prevalence of severe obesity worldwide, surgical treatment for severely obese patients is becoming more popular. Bariatric surgery has occasionally been performed as a precursor to major operations for serious diseases to make these difficult surgeries safer for severely obese patients. We present the case of a severely obese patient with a dissected abdominal aortic aneurysm and left iliac artery aneurysm. Initially, we performed bariatric surgery on this patient to reduce perioperative risk and then subsequently performed bifurcated graft replacement...
May 2016: Asian Journal of Endoscopic Surgery
Yasuhiko Ebina, Hidetaka Katabuchi, Mikio Mikami, Satoru Nagase, Nobuo Yaegashi, Yasuhiro Udagawa, Hidenori Kato, Kaneyuki Kubushiro, Kiyoshi Takamatsu, Kazuhiko Ino, Hiroyuki Yoshikawa
The third version of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine body neoplasms was published in 2013. The guidelines comprise nine chapters and nine algorithms. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. This revision was intended to collect up-to-date international evidence. The highlights of this revision are to (1) newly specify costs and conflicts of interest; (2) describe the clinical significance of pelvic lymph node dissection and para-aortic lymphadenectomy, including variant histologic types; (3) describe more clearly the indications for laparoscopic surgery as the standard treatment; (4) provide guidelines for post-treatment hormone replacement therapy; (5) clearly differentiate treatment of advanced or recurrent cancer between the initial treatment and the treatment carried out after the primary operation; (6) collectively describe fertility-sparing therapy for both atypical endometrial hyperplasia and endometrioid adenocarcinoma (corresponding to G1) and newly describe relapse therapy after fertility-preserving treatment; and (7) newly describe the treatment of trophoblastic disease...
June 2016: International Journal of Clinical Oncology
Zhengxian Cheng, Xiaoqing He, Aihua Zhao, Qiaoyu Zhang, Yali Li
OBJECT: The present study sought to explore the therapeutic outcome of laparoscopic surgery for the endometrial cancer patients with morbidly obese in china. METHODS: The morbidly obese patients with clinical stage I or II endometrial cancer received laparoscopic surgery (LS) at the Obstetrics and Gynecology centers of PLA general hospital between November 2012 and November 2014. The clinical outcomes of these surgeries were compared with a historical cohort of similar morbidly obese patients who had received the open surgery (OS)...
June 2016: International Journal of Surgery
J-B Ricco, J Cau, F Biancari, M Desvergnes, N Lefort, R Belmonte, F Schneider
OBJECTIVE/BACKGROUND: To compare the post-operative and mid-term outcomes of laparoscopic aortic surgery with those of conventional aortic surgery performed by a surgical team trained in laparoscopic aortic surgery. METHODS: A prospective study was conducted between January 2006 and December 2011 with 228 consecutive patients having undergone aortic bypass surgery for either an abdominal aortic aneurysm (n = 139) or occlusive aorto-iliac disease (n = 89). Conventional open aortic surgery was carried out in 145 patients, and total laparoscopic repair in 83 patients...
August 2016: European Journal of Vascular and Endovascular Surgery
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