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Staple-line leak after sleve gastrectomy in obese patients: A hot topic in bariatric surgery

World Journal of Gastrointestinal Endoscopy 2015年第9期7卷 843-846页

作者： giuseppe Galloro Simona Ruggiero Teresa Russo donato Alessandro Telesca Mario Musella Marco Milone Raffaele Manta department of Clinical Medicine and Surgery Surgical Digestive Endoscopy UnitUniversity Federico Ⅱ-School of Medicine department of Advanced Biomedical Sciences General Surgery UnitUniversity Federico Ⅱ-School of Medicine Digestive Endoscopy Unit Niguarda Hospital

Laparoscopic sleeve gastrectomy is a surgical procedure that is being increasingly performed on obese patients. Among its complications, leaks are the most serious and life threatening. The placement of esophageal, covered, self-expandable metal stents in these cases has been performed by many authors but reports on the outcome of this procedure are limited and the technical aspects are not well defined. Stent migration is the main complication of the procedure and poses a challenge to the surgeon, with a limited number of options. Here we evaluate the technical and clinical outcome of a new, dedicated, self-expanding metal stent, comparing the advantages of this stent to those traditionally used to treat staple-line leak after sleeve gastrectomy. While published data are limited, they seem support the use of this kind of new stent as the best option for the stenting treatment of a staple-line leak after sleeve gastrectomy, over other kinds of stents. Further studies based on larger series are needed to better evaluate patient outcome.

关键词： Bariatric surgery Leak Obesity Sleevegastrectomy Endoscopic stent Therapy

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Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience?

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Asian Journal of Urology 2019年第4期6卷 339-345页

作者： Giovanni Saredi Giacomo Maria Pirola Francesca Ambrosini Simone Barbieri Lorenzo Berti Andrea Pacchetti Domenico Iovino giuseppe Ietto Letizia Libassi Giulio Carcano department of Urology Ospedale di Circolo e Fondazione MacchiVareseItaly department of Urology Usl Toscana Sud EstSan Donato HospitalArezzoItaly Centro Cardiologico Monzino IRCCSMilanItaly department of Urology University of GenovaGenovaItaly department of Surgery University of InsubriaVareseItaly

Objective:To provide the first large single-operator case series of patients who undergo“en bloc”thulium laser enucleation of the prostate(ThuLEP)and to demonstrate an improvement in enucleation efficacy with ***:We prospectively evaluated a cohort of patients with symptomatic benign prostatic hyperplasia(BPH)who underwent“en bloc”ThuLEP between May 2015 and November *** between dependent variables(delivered energy and operating time)and independent variables(adenoma volume and experience)were estimated with regression *** experience was calculated as the time interval between the date of the first operation of the series and the date of the operation being ***:A total of 100 patients were registered for the *** operative time was 56.5 min(interquartile range[IQR]:40-85 min).Median enucleation time was 17.4 min(IQR:15-21.5 min).Median enucleation index(enucleation time per adenoma gram)was 0.3 min/g(0.2-0.3 min/g).The overall operative time is not influenced by experience,but we registered a significant trend towards a reduction in the total amount of energy delivered energy normalized per adenoma gram(p=0.0148).Conclusion:We believe that further attention is needed for these new“en bloc”prostatic enucleation techniques,which can facilitate some surgical steps,leading to a widespread use of laser technology for BPH surgical treatment.

关键词： Benign prostatic hyperplasia Endoscopic enucleation of the prostate Laser surgery Thulium laser enucleation of the prostate

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Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

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Asian Journal of Urology 2019年第3期6卷 270-274页

作者： Luca Carmignani Maria Chiara Clementi Claudia Signorini Gloria Motta Sebastiano Nazzani Franco Palmisano Elisa de Lorenzis Michele Catellani Alessandro Francesco Mistretta Andrea Conti Valeria Tringali Maria Beatrice Costa Damiano Vizziello Policlinico San donato UrologySan DonatoMilaneseItaly Ospedale Maggiore Policlinico UrologyMilanItaly Istituto Europeo di Oncologia UrologyMilanItaly Ospedale San giuseppe UrologyMilanItaly

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single *** were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.

关键词： Laser Thulium Prostate Overweight

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