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Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review

World Journal of Gastrointestinal Surgery 2024年第3期16卷 777-789页

作者： Kai Siang Chan Biquan Liu Ming Ngan Aloysius Tan Kwang Yeong How Kar Yong Wong Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality *** 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on *** LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical *** and/or PE is a major and complex surgery with high post-operative *** invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic *** is a single-center retrospective cohort study from 1st January 2015 to 31st March *** criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic ***-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also *** criteria were patients with systemic metastases with non-resectable *** patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal *** sur-gery was defined based on technical difficulty of surgery(*** PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication ***-gorical values were described as percentages and analysed by the chi-square *** variables were expressed as median(range)and analysed by Mann-Whitney U *** overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table ***-rank test was performed to determine statistical significance between cumulative *** significance was defined as P<*** estimates with li

关键词： Laparoscopy minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms Robotic surgical procedures

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In-Hospital Outcomes in minimally invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

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Open Journal of Thoracic Surgery 2024年第1期14卷 17-28页

作者： Daniel de Magalhães Freitas João Alberto Pansani Max Weyler Nery Stanlley de Oliveira Loyola Maurício Lopes Prudente Giulliano Gardenghi Artur Henrique de Souza Department of Cardiovascular Surgery Encore Hospital Aparecida de Goiania Brazil Anesthesia Clinic (Clianest) Goiania Brazil

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

关键词： minimally invasive surgical procedures Mitral Valve Outcome Assessment Health Care

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minimally invasive pelvic exenteration for primary or recurrent locally advanced rectal cancer:A glimpse into the future

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1960-1964页

作者： Dimitrios Kehagias Charalampos Lampropoulos Ioannis Kehagias Department of General Surgery General University Hospital of PatrasPatras 26504Greece Intensive Care Unit Saint Andrew’s General HospitalPatras 26335Greece Division of Bariatric and Metabolic Surgery Department of SurgeryUniversity of PatrasPatras 26504Greece

Surgeons have grappled with the treatment of recurrent and T4b locally advanced rectal cancer(LARC)for many *** main objectives are to increase the overall survival and quality of life of the patients and to mitigate postoperative ***,pelvic exenteration(PE)with or without neoadjuvant treatment is a curative treatment when negative resection margins are *** traditional open approach has been favored by many ***,the technological advancements in minimally invasive surgery have radically changed the surgical *** studies have demonstrated promising results in postoperative complications and oncological outcomes after robotic or laparoscopic PE.A recent retrospective study entitled“Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review”was published in the World Journal of Gastrointestinal *** we read this article with great interest,we decided to delve into the latest data regarding the benefits and risks of minimally invasive PE for ***,the small number of suitable patients,limited surgeon experience,and steep learning curve are hindering the establishment of minimally invasive PE.

关键词： Locally advanced rectal cancer Pelvic exenteration Multivisceral resection minimally invasive surgical procedures Robotic surgical procedures

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Simultaneous robot-assisted approach in a super-elderly patient with urothelial carcinoma and synchronous contralateral renal cell carcinoma:A case report

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World Journal of Clinical Cases 2022年第20期10卷 7153-7162页

作者： Ji Kang Yun Si Hyun Kim Woong Bin Kim Hee Kyung Kim Sang Wook Lee Department of Urology Soonchunhyang University Bucheon HospitalSoonchunhyang University College of MedicineBucheon 14584South Korea Department of Urology Soonchunhyang University Cheonan HospitalSoonchunhyang University College of MedicineCheonan 31151South Korea Department of Pathology Soonchunhyang University Bucheon HospitalSoonchunhyang University College of MedicineBucheon 14584South Korea

BACKGROUND It is rare for urothelial and renal cell carcinomas to coexist in the same patient,and even rarer for them to be detected *** of this rarity,a standard treatment has not been established and studies about overall survival are ***,physicians must modify treatments according to the individual’s situation and the stage of each *** recent years,with advances in the instruments and techniques,minimal invasive robotic surgeries have become available for advanced-stage or high-risk *** SUMMARY An 85-year-old woman with a medical history of hypertension and hyperlipidemia visited our *** had visited her local hospital complaining of intermittent,painless,gross hematuria that had started 3 mo *** computed tomography,a right renal mass and left proximal ureteral mass with hydronephrosis were found *** decided to perform robot-assisted surgery on both sides during one *** renal function and kidney loading,right partial nephrectomy was performed first,followed by left nephroureterectomy with bladder cuff *** the 6-mo follow-up,no specific symptoms were reported and dialysis was not *** were no unusual findings in the imaging study,and regular follow-up and imaging studies are *** This case report assessed the feasibility of simultaneous minimal invasive robotic surgery as an alternative to conventional open or laparoscopic surgery.

关键词： Robot surgical procedure Renal cell carcinoma Transitional cell carcinoma minimally invasive surgical procedures Case report

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Simultaneous endoscopic and video-assisted retroperitoneal debridement in walled-off pancreatic necrosis using a laparoscopic access platform:Two case reports

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World Journal of Gastroenterology 2022年第5期28卷 588-593页

作者： Lars Lindgaard Morten Laksáfoss Lauritsen Srdan Novovic Erik Feldager Hansen John Gásdal Karstensen Palle Nordblad Schmidt Pancreatitis Centre East(PACE) Gastro UnitCopenhagen University Hospital-Amager and HvidovreHvidovre 2650Capital RegionDenmark Department of Clinical Medicine University of CopenhagenCopenhagen 2100Capital RegionDenmark

BACKGROUND Infected walled-off necrosis is a potentially life-threatening complication of necrotizing *** some patients can be treated by drainage alone,many patients also need evacuation of the infected *** necroses in relation to the pancreatic bed are easily reached via an endoscopic transluminal approach,whereas necroses that involve the paracolic gutters and the pelvis are most efficiently treated via a percutaneous *** and complex necroses may need a combination of the two *** SUMMARY Transluminal and percutaneous drainage followed by simultaneous endoscopic and modified video-assisted retroperitoneal debridement was carried out in two patients with very large(32-38 cm),infected walled-off necroses using a laparoscopic access *** 34 d and 86 d and a total of 9 and 14 procedures,respectively,complete regression of the walled-off necroses was *** laparoscopic access platform improved both access to the cavities as well as the *** transluminal and percutaneous necrosectomy are feasible with the laparoscopic access platform serving as a useful *** This approach may be necessary to control infection and achieve regression in some patients with complex collections.

关键词： Acute necrotizing pancreatitis Walled-off necroses minimally invasive surgical procedures

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Carbon footprints in minimally invasive surgery:Good patient outcomes,but costly for the environment

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World Journal of Gastrointestinal Surgery 2023年第7期15卷 1277-1285页

作者： Kai Siang Chan Hong Yee Lo Vishal G Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore

Advancements in technology and surgical training programs have increased the adaptability of minimally invasive surgery(MIS).Gastrointestinal MIS is superior to its open counterparts regarding post-operative morbidity and *** has become the first-line surgical intervention for some types of gastrointestinal surgery,such as laparoscopic cholecystectomy and *** dioxide(CO_(2))is the main gas used for insufflation in ***_(2)contributes 9%-26%of the greenhouse effect,resulting in global *** rise in global CO_(2)concentration since 2000 is about 20 ppm per decade,up to 10 times faster than any sustained rise in CO_(2)during the past 800000 *** 1970,there has been a steady yet worrying increase in average global temperature by 1.7℃ per century.A recent systematic review of the carbon footprint in MIS showed a range of 6-814 kg of CO_(2)emission per surgery,with higher CO_(2)emission following robotic compared to laparoscopic ***,with superior benefits of MIS over open surgery,this poses an ethical dilemma to surgeons.A recent survey in the United Kingdom of 130 surgeons showed that the majority(94%)were concerned with climate change but felt that the lack of leadership was a barrier to improving environmental *** the deleterious environmental effects of MIS,this study aims to summarize the trends of MIS and its carbon footprint,awareness and attitudes towards this issue,and efforts and challenges to ensuring environmental sustainability.

关键词： Carbon footprint Environment Environmental pollution minimally invasive surgical procedures Sustainability

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Current diagnostic tools and treatment modalities for rectal prolapse

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World Journal of Clinical Cases 2023年第16期11卷 3680-3693页

作者： Mustafa Oruc Timucin Erol Department of General Surgery Hacettepe University School of MedicineAnkara 06100Turkey

Rectal prolapse is a circumferential,full-thickness protrusion of the rectum through the *** is a rare condition,and only affects 0.5%of the general *** treatment modalities have been described,which have changed significantly over *** in the last decade,laparoscopic and robotic surgical approaches with different mobilization techniques,combined with medical therapies,have been widely *** patients have presented with a wide range of complaints(ranging from abdominal discomfort to incomplete bowel evacuation,mucus discharge,constipation,diarrhea,and fecal incontinence),understanding the extent of complaints and ruling out differential diagnoses are essential for choosing a tailored surgical *** is crucial to assess these additional symptoms and their severities using preoperative scoring ***,radiological and physiological evaluations may explain some vague symptoms and reveal concomitant pelvic ***,there is no consensus on or standardization of the optimal extent of dissection,type of procedure,and materials used for rectal fixation;this makes providing maximum benefits to patients with minimal complications *** recent publications and systematic reviews have not recommended the most appropriate treatment *** review explains the appropriate diagnostic tools for different conditions and summarizes the current treatment approaches based on existing literature and expert opinions.

关键词： Rectal prolapse Constipation Fecal incontinence Diagnosis minimally invasive surgical procedures Colorectal surgery

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Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients： A Two-year, Retrospective, Multicentre Study

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Chinese Medical Journal 2018年第4期131卷 420-425页

作者： Ya-Long Dang Yu-Jie Cen Ying Hong Ping Huang Ning-Li Wang Chao Wang Chun Zhang Department of Ophthalmology Peking University Third Hospital Beijing 100191 China Department of Ophthalmology Beijing Tongren Hospital Capital Medical Univerty Beijing 100005 China Department of Ophthalmology University of Pittsburgh Pittsburgh Pennsylvania 15213 USA

Background： The aim of the study was to evaluate the long-term safety and efficacy of the Trabectome for Chinese glaucoma patients. Methods： This was a multicenter, retrospective, observational study. Glaucoma patients, except those with neovascular glaucoma, with/without a visually significant cataract were enrolled. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome evaluation was a reduction in intraocular pressure （IOP）, and the secondary outcomes were a reduction in glaucoma medication, the 2-year success percentages, and complications. Success was defined as an IOP 〈21 mmHg and at least a 20% IOP reduction from baseline after 3 months for any two consecutive visits, without additional glaucoma surgery. The data were processed using the R Stats Package version 3.0.0. The Wilcoxon test was used to compare the postoperative IOP and the number of glaucoma medications with baselines. The Kaplan–Meier test was used to calculate the 2-year success percentage. The risk factors related to Trabectome failure were determined by logistic regression. Results： A total of 120 glaucoma patients were enrolled. The Trabectome efficiently reduced the IOP from a baseline of 22.8 ± 1.34 mmHg to 17.6 ± 0.96 mmHg, and the use of glaucoma medications from 2.2 ± 0.17 mmHg to 1.4 ± 0.21 in a 2-year follow-up （both, P 〈 0.01）. The overall success percentage was 80%. No risk factor related to Trabectome failure was identified. No vision-threatening complication was observed. Ten patients, who required secondary glaucoma surgery, all reached the target IOP. Conclusions： In a 2-year follow-up, Trabectome was an efficient and safe procedure for Chinese glaucoma patients.

关键词： Glaucoma Intraocular Pressure minimally invasive surgical procedures Trabecular Meshwork

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minimally invasive Cochlear Implantation Assisted by Bi-planar Device： An Exploratory Feasibility Study in vitro

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Chinese Medical Journal 2016年第20期129卷 2476-2483页

作者： Jia Ke Shao-Xing Zhang Lei Hu Chang-Sheng Li Yun-Feng Zhu Shi-Long Sun Li-Feng Wang Fu-Rong Ma Department of Otorhinolarygology-Head and Neck Surgery Peking University Third HospitalBeijing 100191China Robotics Institute School of Mechanical Engineering and AutomationBeihang UniversityBeijing 100191China

Background：A single drilled tunnel from the lateral mastoid cortex to the cochlea via the facial recess is essential for minimally invasive cochlear implant *** study aimed to explore the safety profile of this kind of new image-guided and bi-planar device-assisted surgery procedure in ***：Image-guided minimally invasive cochlear implantations were performed on eight cadaveric temporal bone *** main procedures were：（1） temporal bone specimens were prepared for surgery and fiducial markers were registered.（2） computed tomography （CT） scans were performed for future reference.（3） CT scan images were processed and drill path was planned to minimize cochlear damage.（4） bi-planar device-assisted drilling was performed on the specimens using the registration.（5） surgical safety was evaluated by calculating the deviation between the drill and the planned paths,and by measuring the closest distance between the drilled path and critical anatomic ***：Eight cases were operated successfully to the basal turn of the cochlear with intact facial nerves （FNs）.The deviations from target points and entrance points were 0.86 mm （0.68-1.00 mm） and 0.44 mm （0.30-0.96 mm）,*** angular error between the planned and the drilled trajectory was 1.74° （1.26-2.41°）.The mean distance from the edge of the drilled path to the FN and to the external canal was 0.60 mm （0.35-0.83 mm） and 1.60 mm （1.30-2.05 mm）,*** five specimens,the chorda tympani nerves were well *** all cases,no injury happened to auditory ***：This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational ***,more in vitro experiments are needed to improve the system operation and its safety.

关键词： Cochlear Implantation minimally invasive surgical procedures Navigation

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Laparoscopic surgery for gastric cancer:Current status and future direction

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Chinese Journal of Cancer Research 2021年第2期33卷 133-141页

作者： So Hyun Kang Hyung-Ho Kim Department of Surgery Seoul National University Bundang HospitalSeongnam 13620Republic of Korea Department of Surgery Seoul National University College of MedicineSeoul 03080Republic of Korea

Gastric cancer is still a major cause of death *** laparoscopic gastrectomy(LG)has gained evidence as a standard treatment for early gastric cancer in the distal stomach,there are still concerns regarding its application for gastric cancer in the upper stomach and advanced gastric ***,LG has shown to have faster recovery,shorter hospital stay,less pain,and less blood loss in many retrospective and prospective *** application of LG has now extended from conventional radical gastrectomy to novel approaches such as function-preserving gastrectomy and sentinel-node navigated *** on the use of laparoscopy in treatment for stage IV gastric cancer are rare,but show that there may be some roles of LG in selected *** the development of new laparoscopic tools that augment human ability,the future of LG should move on from proving non-inferiority to demonstrating superiority compared to the traditional open gastrectomy.

关键词： Laparoscopy stomach neoplasm minimally invasive surgical procedures

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