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Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status

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World Journal of Gastroenterology 2015年第43期21卷 12482-12497页

作者： Dimitrios Ntourakis Georgios Mavrogenis Third Department of Surgery University of Athens Faculty of MedicineAttikon University Hospital Service de Gastroentérologie Site Notre DameGrand H?pital de Charleroi Gastroenterology and Endoscopy Center of Mytilene

AIM: To investigate the cooperative laparoscopic and endoscopic techniques used for the resection of upper gastrointestinal ***: A systematic research of the literature was performed in Pub Med for English and French language articles about laparoscopic and endoscopic cooperative,combined,hybrid and rendezvous techniques. Only original studies using these techniques for the resection of early gastric cancer,benign tumors and gastrointestinal stromal tumors of the stomach and the duodenum were included. By excluding case series of less than 10 patients,25 studies were identified. The study design,number of cases,tumor pathology size and location,the operative technique name,the endoscopy team and surgical team role,operative time,type of closure of visceral wall defect,blood loss,complications and length of hospital stay of these studies were evaluated. Additionally all cooperative techniques found were classified and are presented in a systematic ***: The studies identified were case series and retrospective cohort studies. A total of 706 patients were operated on with a cooperative technique. The tumors resected were only gastrointestinal stromal tumors(GIST) in 4 studies,GIST and various benign submucosal tumors in 22 studies,early gastric cancer(p T1 a and p T1b) in 6 studies and early duodenal cancer in 1 study. There was important heterogeneity between the studies. The operative techniques identified were:laparoscopic assisted endoscopic resection,endoscopic assisted wedge resection,endoscopic assisted transgastric and intragastric surgery,laparoscopic endoscopic cooperative surgery(LECS),laparoscopic assisted endoscopic full thickness resection(LAEFR),clean non exposure technique and non-exposed endoscopic wallinversion surgery(NEWS). Each technique is illustrated with the roles of the endoscopic and laparoscopic teams; the indications,characteristics and short term results are ***: Along with the traditional cooperativ

关键词： Cooperative laparoscopic endoscopic Hybrid laparos

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New minimally invasive approaches for cholecystectomy: Review of literature

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World Journal of Gastrointestinal Surgery 2015年第10期7卷 243-248页

作者： Martin Gaillard Hadrien Tranchart Panagiotis Lainas Ibrahim Dagher Department of Digestive Minimally Invasive Surgery Antoine-Beclere Hospital Faculté de Médecine Paris-Sud University

laparoscopic cholecystectomy is the most commonlyperformed abdominal intervention in Western countries. In an attempt to reduce the invasiveness of the procedure, surgeons have developed single-incision laparoscopic cholecystectomy(SILC), minilaparoscopic cholecystectomy(MLC) and natural orifice transluminal endoscopic surgery(NOTES). The aim of this review was to determine the role of these new minimally invasive approaches for elective laparoscopic cholecystectomy in the treatment of gallstone related disease. Current literature remains insufficient for the correct assessment of emerging techniques for laparoscopic cholecystectomy. None of these procedures has demonstrated clear benefits over conventional laparoscopic cholecystectomy. SILC cannot be currently recommended as it can be associated with an increased risk of bile duct injury and incisional hernia incidence. NOTES cholecystectomy is still experimental, although hybrid transvaginal cholecystectomy is gaining popularity in clinical practice. As it is standardized and almost identical to the standard laparoscopic technique, MLC could lead to limited benefits without exposing patients to increased postoperative complications, being therefore adoptable for routine elective cholecystectomy. Technical challenges of SILC and NOTES cholecystectomy could be addressed with the evolution of new surgical tools that need to catch up with the innovative minds of surgeons. Regardless the place of these approaches in the future, robotization may be necessary to impose them as standard treatment.

关键词： Cholecystectomy laparoscopy Singleincision laparos

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