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Vlinimally invasive simple prostatectomy for a case ）f giant benign prostatic hyperplasia

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Asian Journal of Andrology 2017年第6期19卷 717-718页

作者： Qin-Song Zeng Yong-Bin Zhao Bang-Qi Wang Min Ying Wei-Lie Hu Department of Urology General Hospital of Guangzhou Military Command of CPLA Guangzhou China Guangzhou Huabo Biopharmaceutical Research Institute Guangzhou China Southern Medical University Guangzhou China

Dear Editor, We would like to present a rare case of giant prostatic hyperplasia （GPH）, which is defined as a prostate weight over 200g for Easterners or 500 g for Westerns.： Only 14 cases of GPH exceeding 500 g had been reported in the English literature by 2015 （Supplementary Table 1）. To the best of our knowledge, this is the first report of removing a GPH exceeding 500 g by using minimally invasive laparoscopic technique.

关键词： minimally prostatectomy hyperplasia

minimally invasive surgery for upper gastrointestinal cancer: Our experience and review of the literature

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World Journal of Gastroenterology 2016年第19期22卷 4626-4637页

作者： Koichi Suda Masaya Nakauchi Kazuki Inaba Yoshinori Ishida Ichiro Uyama Division of Upper GI Department of Surgery Fujita Health University

minimally invasive surgery(MIS) for upper gastro-intestinal(GI) cancer, characterized by minimal access, has been increasingly performed worldwide. It not only results in better cosmetic outcomes, but also reduces intraoperative blood loss and postoperative pain, leading to faster recovery; however, endoscopically enhanced anatomy and improved hemostasis via positive intracorporeal pressure generated by CO2 insufflation have not contributed to reduction in early postoperative complications or improvement in long-term outcomes. Since 1995, we have been actively using MIS for operable patients with resectable upper GI cancer and have developed stable and robust methodology in conducting totally laparoscopic gastrectomy for advanced gastric cancer and prone thoracoscopic esophagectomy for esophageal cancer using novel technology including da Vinci Surgical System(DVSS). We have recently demonstrated that use of DVSS might reduce postoperative local complications including pancreatic fistula after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy. In this article, we present the current status and future perspectives on MIS for gastric and esophageal cancer based on our experience and a review of the literature.

关键词： Stomach neoplasms Esophageal neoplasms minimally invasive surgical procedures Postoperative complica

Non-robotic minimally invasive gastrectomy as an independent risk factor for postoperative intra-abdominal infectious complications: A single-center, retrospective and propensity score-matched analysis

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World Journal of Gastroenterology 2020年第11期26卷 1172-1184页

作者： Susumu Shibasaki Koichi Suda Masaya Nakauchi Kenichi Nakamura Kenji Kikuchi Kazuki Inaba Ichiro Uyama Department of Surgery Fujita Health UniversityToyoake 470-1192AichiJapan Collaborative Laboratory for Research and Development in Advanced Surgical Technology Fujita Health University School of MedicineToyoake 470-1192AichiJapan

BACKGROUND minimally invasive surgery for gastric cancer(GC) has gained widespread use as a safe curative procedure especially for early GC.AIM To determine risk factors for postoperative complications after minimally invasive gastrectomy for GC.METHODS Between January 2009 and June 2019, 1716 consecutive patients were referred to our division for primary GC. Among them, 1401 patients who were diagnosed with both clinical and pathological Stage Ⅲ or lower GC and underwent robotic gastrectomy(RG) or laparoscopic gastrectomy(LG) were enrolled. Retrospective chart review and multivariate analysis were performed for identifying risk factors for postoperative morbidity.RESULTS Morbidity following minimally invasive gastrectomy was observed in 7.5% of the patients. Multivariate analyses demonstrated that non-robotic minimally invasive surgery, male gender, and an operative time of ≥ 360 min were significant independent risk factors for morbidity. Therefore, morbidity was compared between RG and LG. Accordingly, propensity-matched cohort analysis revealed that the RG group had significantly fewer intra-abdominal infectious complications than the LG group(2.5% vs 5.9%, respectively;P = 0.038), while no significant differences were noted for other local or systemic complications.Multivariate analyses of the propensity-matched cohort revealed that non-robotic minimally invasive surgery [odds ratio = 2.463(1.070–5.682);P = 0.034] was a significant independent risk factor for intra-abdominal infectious complications.CONCLUSION The findings showed that robotic surgery might improve short-term outcomes following minimally invasive radical gastrectomy by reducing intra-abdominal infectious complications.

关键词： Stomach neoplasms Gastrectomy Robotic surgical procedure minimally invasive procedures Morbidity Pancreatic fistula

Novel technique for anastomotic salvage using transanal minimally invasive surgery:A case report

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 271-278页

作者： Oscar A Olavarria Robert L Kress Shinil K Shah Amit K Agarwal Center for Surgical Trials and Evidence-Based Practice McGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTX 77033United States Department of Surgery McGovern Medical School at the University of Texas Health Science Center HoustonHoustonTX 77033United States

Anastomotic leak(AL)after low anterior resection(LAR)can be a highly morbid complication.The incidence of AL ranges from 5%to 20%depending on patient characteristics and the distance of the anastomosis from the anal verge.Low anastomoses and leaks pose technical challenges for endoscopic treatment.The aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery(TAMIS)port for the management of a symptomatic leak not requiring relaparotomy(grade B)after a LAR with diverting loop ileostomy.CASE SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal rectum.Pneumorectum was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar.A LigaSureTM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the coloproctostomy.The procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak cavity.Several months after serial TAMIS septotomies,barium enema demonstrated a patent anastomosis with no evidence of persistent leak or stricture.The patient subsequently underwent ileostomy reversal and has had no significant postoperative issues.CONCLUSION TAMIS septotomy with the LigaSureTM Retractable L-Hook is a feasible and effective,minimally invasive salvage technique for the treatment of grade B ALs.Larger studies are needed to assess the generalizability and long-term results of this technique.

关键词： Transanal minimally invasive surgery Ligasure hook Anastomotic leak Low anterior resection Septotomy Case report

Influencing factors of postoperative early delayed gastric emptying after minimally invasive Ivor-Lewis esophagectomy

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World Journal of Clinical Cases 2019年第3期7卷 291-299页

作者： Lei Huang Jian-Qiang Wu Bing Han Zhi Wen Pei-Rui Chen Xiao-Kang Sun Xiang-Dong Guo Chang-Ming Zhao Department of Cardiothoracic Surgery Deyang People's Hospital

BACKGROUND The main clinical treatment for esophageal cancer is surgery. Since traditional open esophageal cancer resection has the disadvantages of large trauma, long recovery period, and high postoperative complication rate, its clinical application is gradually reduced. The current report of minimally invasive Ivor-Lewis esophagectomy(MIILE) is increasing. However, researchers found that patients with MIILE had a higher incidence of early delayed gastric emptying(DGE).AIM To investigate the influencing factors of postoperative early DGE after MIILE.METHODS A total of 156 patients diagnosed with esophageal cancer at Deyang People's Hospital were enrolled. According to the criteria of DGE, patients were assigned to a DGE group(n = 49) and a control group(n = 107). The differences between the DGE group and the control group were compared. Multivariate logistic regression analysis was used to further determine the influencing factors of postoperative early DGE. The receiver operating characteristic(ROC) curve was used to assess potential factors in predicting postoperative early DGE.RESULTS Age, intraoperative blood loss, chest drainage time, portion of anxiety score ≥ 45 points, analgesia pump use, postoperative to enteral nutrition interval, and postoperative fluid volume in the DGE group were higher than those in the control group. Perioperative albumin level in the DGE group was lower than that in the control group(P < 0.05). Age, anxiety score, perioperative albumin level,and postoperative fluid volume were independent factors influencing postoperative early DGE, and the differences were statistically significant(P <0.05). The ROC curve analysis revealed that the area under the curve(AUC) foranxiety score was 0.720. The optimum cut-off value was 39, and the sensitivity and specificity were 80.37% and 65.31%, respectively. The AUC for postoperative fluid volume were 0.774. The optimal cut-off value was 1191.86 mL, and the sensitivity and specificity were 65.3% and 77.6%, respectively. The AUC for perioperative

关键词： Esophageal cancer Delayed gastric emptying minimally invasive Ivor-Lewis esophagectomy Influencing factors

Efficacy of hybrid minimally invasive esophagectomy vs open esophagectomy for esophageal cancer: A meta-analysis

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World Journal of Gastrointestinal Oncology 2019年第11期11卷 1081-1091页

作者： Jiao Yang Ling Chen Ke Ge Jian-Le Yang Department of Infectious Diseases Zhejiang Hospital

BACKGROUND The first line treatment regimen for esophageal cancer is still surgical resection and the choice of surgical scheme depends on surgeon.Now the efficacy comparison of hybrid minimally invasive esophagectomy(HMIE)and open esophagectomy(OE)is still controversial.AIM To compare the perioperative and postoperative outcomes of HMIE and OE in patients with esophageal cancer.METHODS PubMed,EMBASE,and Cochrane Library databases were searched for related articles.The odds ratio(OR)or standard mean difference(SMD)with a 95%confidence interval(CI)was used to evaluate the effectiveness of HMIE and OE.RESULTS Seventeen studies including a total of 2397 patients were selected.HMIE was significantly associated with less blood loss(SMD=-0.43,95%CI:-0.66,-0.20;P=0.0002)and lower incidence of pulmonary complications(OR=0.72,95%CI:0.57,0.90;P=0.004).No significant differences were seen in the lymph node yield(SMD=0.11,95%CI:-0.08,0.30;P=0.26),operation time(SMD=0.24,95%CI:-0.14,0.61;P=0.22),total complications rate(OR=0.68,95%CI:0.46,0.99;P=0.05),cardiac complication rate(OR=0.91,95%CI:0.62,1.34;P=0.64),anastomotic leak rate(OR=0.95,95%CI:0.67,1.35;P=0.78),duration of intensive care unit stay(SMD=-0.01,95%CI:-0.21,0.19;P=0.93),duration of hospital stay(SMD=-0.13,95%CI:-0.28,0.01;P=0.08),and total mortality rates(OR=0.70,95%CI:0.47,1.06;P=0.09)between the two treatment groups.CONCLUSION Compared with the OE,HMIE shows less blood loss and pulmonary complications.However,further studies are necessary to evaluate the long-term oncologic outcomes of HMIE.

关键词： Hybrid minimally invasive esophagectomy Open esophagectomy Esophageal cancer

A minimally invasive alternative for the treatment of nutcracker syndrome using individualized three-dimensional printed extravascular titanium stents

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Chinese Medical Journal 2019年第12期132卷 1454-1460页

作者： He Wang Yi-Tong Guo Yong Jiao Da-Li He Bin Wu Li-Jun Yuan Yan-Yan Li Yong Yang Tie-Sheng Cao Bo Zhang Department of Urology Tangdu HospitalThe Fourth Military Medical UniversityXi'anShaanxi 710038China Department of Ultrasound Diagnosis Tangdu HospitalThe Fourth Military Medical UniversityXi'anShaanxi 710038 China 3D Printing Research Center of The Fourth Military Medical University Xi'anShaanxi 710038China Department of Radiology Tangdu HospitalThe Fourth Military Medical UniversityXi'anShaanxi 710038China

Background: This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications. Method: The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV’s primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed. Results: The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7°± 4.3° to 48.0°± 8.8°(P minimally invasive alternative for the treatment of NCS.

关键词： Nutcracker syndrome Extravascular stent Three-dimensional printing Titanium minimally invasive Laparoscopy

Trans-anal minimally invasive surgery for rectal neoplasia:Experience from single tertiary institution in China

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World Journal of Gastrointestinal Oncology 2018年第6期10卷 137-144页

作者： Nan Chen Yi-Fan Peng Yun-Feng Yao Jin Gu Department of Gastrointestinal Center Unit Ⅲ Peking University Hospital and InstituteBeijing 100142China

AIM To evaluate the feasibility and safety of trans-anal minimally invasive surgery(TAMIS) from single institute in China. METHODS A retrospective review was conducted for patients with rectal neoplasia, who underwent TAMIS using single incision laparoscopic surgery-Port from January 2013 till January 2016 by a group of colorectal surgeons from Gastrointestinal Center Unit Ⅲ, Peking University Cancer Hospital. Patients' demographic data, surgical related information, post-operational pathology, as well as perioperative follow-up were all collected. RESULTS Twenty-five patients with rectal neoplasia were identified consequently. Complete full-thickness excision was achieved in all cases without conversion. 22(88%) cases had rectal malignancies [6 were adenocarcinomas and 16 were neuroendocrine tumors(NET)], while 3 patients had adenomas. Mean surgical duration was 61.3 min, and mean post-operative stay were 2.7 d. Post-operational examination demonstrated 5 cases had positive resection margin: 2 adenocarcinoma cases and 1 NET case with positive lateral margin, and the other 2 NET cases with positive basal margin. The curve of operation time for TAMIS cases suggested a minimum of 10 cases for a laparoscopic surgeon proficient withthis technique. CONCLUSION TAMIS was demonstrated to be reproducible and safe,with a relatively short learning process for laparoscopic surgeons in selected cases for rectal neoplasia. Longterm oncological outcome needs to be determined by further investigation.

关键词： Rectal neoplasia Resection margin Transanal minimally invasive surgery

Three-dimensional(3D) Printing Technology Assisted by minimally Invasive Surgery for Pubic Rami Fractures

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Current Medical Science 2018年第5期38卷 827-833页

作者： Wen-bo NIE Fa-gang YE Jian-lin MA Jiang-ping YU Ming-xing WANG Zhen-hua ZHANG Fu-jie SUN Department of Orthopedics Affiliated Hospital of Qingdao UniversityQingdao 266000China Department of Orthopedics Huxi Hospital Affiliated to Jining Medical College (Shanxian Central Hospital)Heze 274300China Department of Orthopedics Qingdao Chengyang District People's HospitalQingdao 266100China

The feasibility of three-dimensional (3D) printing technology cgmbined with minimally invasive surgery in the treatment of pubic rami fractures was explored.From August 2015 to October 2017,a series of 30 patients who underwent surgical stabilization of their anterior pelvic ring (all utilizing the 3D printing technology)by one surgeon at a single hospital were studied.The minimally invasive incisions were made through anterior inferior cilia spine and pubic nodule.Data collected included the operative duration,the blood loss,the damage of the important tissue,the biographic union and therecovery of the function after the operation.Measurements on inlet and outlet pelvic cardiograph were made immediately post-operation and at all follow-up clinic visits.The scores of reduction and function were measured during follow-up.Results showed that the wounds of 30 patients were healed in the first stage,and there was no injury of important structures such as blood vessels and nerves.According to the Matta criteria,excellent effectiveness was obtained in 22 cases and good in 8 cases.According to the functional evaluation criteria of Majeed,excellent effectiveness was obtained in 21 cases and good in 9 cases.It was suggested that the 3D printing technology assisted by minimally invasive surgery can better evaluate the pelvic fracture before operation,which was helpful in plate modeling, and can shorten surgery duration and reduce intraoperative blood loss and complications. The positioning accuracy was improved,and better surgical result was finally achieved.

关键词： digital design three-dimensional printing anterior ring pelvic fractures minimally invasive surgery