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From conventional two-stage hepatectomy to ALPPS:Fifteen years of experience in a hepatobiliary surgery unit

Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 542-550页

作者： Javier Maupoey Ibáñez Eva María MontalváOrón Andrea BoscàRobledo Alonso Camacho Ramírez Ana Hernando Sanz Pablo Granero Castro Alberto Alegre Delgado Rafael López-Andújar Hepatobiliary surgery and Transplant unit La Fe University and Polytechnic HospitalValenciaSpain Department of Radiology La Fe University and Polytechnic HospitalValenciaSpain

Background:Hepatectomy in patients with large tumor load may result in postoperative liver failure and associated complications due to excessive liver parenchyma *** two-stage hepatectomy(TSH)and associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)technique are possible solutions to this *** liver metastases(CRLM)is the most frequent indication,and there is a need to assess outcomes for both techniques to improve surgical and long-term oncological outcomes in these ***:A single-center retrospective study was designed to compare TSH with ALPPS in patients with initially unresectable bilateral liver tumors between January 2005 and January *** was performed from January 2012 onwards as the technique of ***-term overall survival(OS)and disease-free survival(DFS)were evaluated as primary outcome in CRLM *** morbidity,mortality and liver growth in all patients were also ***:A total of 38 staged hepatectomies were performed:17 TSH and 21 *** resection rate was 76.5%(n=13)in the TSH group and 85.7%(n=18)in the ALPPS group(P=0.426).Overall major morbidity(Clavien-Dindo≥3 a)(stage 1+stage 2)was 41.2%(n=7)in TSH and 33.3%(n=7)in ALPPS patients(P=0.389),and perioperative 90-day mortalities were 11.8%(n=2)vs.19.0%(n=4)in each group,respectively(P=0.654).Intention-to-treat OS rates at 1 and 5 years in CRLM patients for TSH(n=15)were 80%and 33%,and for ALPPS(n=17)76%and 35%,*** rates at 1 and 5 years were 36%and 27%in the TSH group vs.33%and 27%in the ALPPS group,***:ALPPS is an effective alternative to TSH in bilateral affecting liver tumors,allowing higher resection rate,but patients must be carefully *** CRLM patients similar long-term OS and DFS can be achieved with both techniques.

关键词： ALPPS Two-stage hepatectomy Colorectal liver metastases Posthepatectomy liver failure

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A Short Term Review of Operated Cases in the Plastic surgery unit at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

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Modern Plastic surgery 2013年第3期3卷 100-103页

作者： Pius Agbenorku Paa Ekow Hoyte-Williams Isaac Kofi Omari Reconstructive Plastic surgery & Burns unit Department of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana

Introduction: Surgical problems are of much disturbance to the world and should therefore be given serious attention. The prevalence of these surgical problems, has made plastic surgery become a broadly relevant and acceptable way for addressing problems like injuries, congenital anomalies, surgical infections and malignancies among others. Aim: This study is to quantify and characterize surgical procedures done in the plastic surgery theatre located in the new Accident and Emergency (A & E) Building of KATH. Materials and Methods: Data were obtained from the Operation Register/Theatre Books in the plastic surgery theatre at the A & E Centre on cases operated on from October 1, 2009 to September 30, 2012. Data entry, presentation and analysis were done using Statistical Package for the Social Sciences (SPSS) 20.0 version. Results: Adults formed the majority of patients who sought for plastic surgery with a percentage of 70.3%. The male patients also outnumbered the females recording (61.5%) out of the total number of patients. Most of the cases recorded were acquired cases (93.2%). Reconstructive surgery was the commonest operation performed (30%);in 53.8% cases general anaesthesia was used. Conclusion: Among all the procedures used reconstructive surgery was the commonest surgery performed in the unit and general anaesthesia was the most type of anaesthesia used for the operations.

关键词： Reconstructive Plastic surgery Congenital Anomalies Injuries Surgical Operations Short-Term Review

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Tumours of salivary glands in the stomatology and maxillo-facial surgery unit at the university hospital centre —Yalgado Ouédraogo

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Open Journal of Stomatology 2013年第9期3卷 465-470页

作者： Mathieu Millogo Tarcissus Konsem Haréfétéguén Bissa Rasmané Béogo Dieudonné Ouédraogo Service of Stomatology and Maxillo-Facial surgery of the University Hospital of Tokoin Lomé Togo Service of Stomatology and Maxillo-Facial surgery of the University Hospital Souro SANOU Bobo-Dioulasso Burkina Faso Service of Stomatology and Maxillo-Facial surgery of the University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso

The aim of this study was to contribute to strengthening the efficiency in the treatment of the salivary gland tumours in the Stomatology and Maxillo-facial surgery service at the University Hospital Centre/Yalgado OUEDRAOGO of Ouagadougou. It has been a retrospective and descriptive study covering seven (7) years [January 2006-December 2012] on epidemiology and the treatment of 54 cases of the salivary glands tumours histologically confirmed. Benign tumours (non-malignant tumours were prevalent (61.11% of cases). The annual incidences were 4.71 cases for non malignant tumours and 3 cases for malignant tumours. The average age was 34-45 years for non malignant tumours and 44-33 years for malignant ones. In both groups, the tumour was discovered lately with an average 32-48 months before consulting in case of non malignant tumours and 18-29 months for malignant tumours. The location of non malignant tumours was very often the parotid (42.42%), under mandible gland (27.28%). Malignant tumours very often concerned the parotid (76.18%) and the under mandible gland (14.29%). The histology has revealed that pleomorphic adenoma was the leading type of non-malignant tumours (93.94% of cases) whereas carcinoma was predominant in malignant tumours (80.95% of cases). Long term track keeping was difficult and it has been complicated by the loss of contact with some patients. The low living standard, the time wasted before consulting, limited human resources and therapeutic means constitute handicaps to the treatment in our African context.

关键词： Tumours Salivary Glands Epidemiology Histology Treatment

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A novel use of the comprehensive complication index in perihilar cholangiocarcinoma surgery

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Hepatobiliary surgery and Nutrition 2024年第1期13卷 139-142页

作者： Edoardo Poletto Simone Conci Tommaso Campagnaro Mario De Bellis Laura Alaimo Andrea Ruzzenente Department of surgery DentistryPediatrics and GynecologyHepatobiliary Surgery UnitUniversity Hospital Integrated Trust of VeronaUniversity of VeronaVeronaItaly HPB surgery and Transplantation unit Erasmus MCRotterdamThe Netherlands

It is well known that radical intent surgery is,as of today,the only curative treatment available for perihilar cholangiocarcinoma(pCCA);the standard surgical procedure includes major hepatectomy with caudate lobe resection and extrahepatic bile duct resection(1).A recent paper set the benchmark values for pCCA surgery:in this paper,acceptable benchmark values for morbidity.

关键词： Comprehensive complication index(CCI) perihilar cholangiocarcinoma(pCCA) postoperative complication trajectory

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Quality of life and functional capacity in patients after cardiac surgery intensive care unit

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World Journal of Cardiology 2024年第8期16卷 436-447页

作者： Vasiliki Raidou Katerina Mitete Christos Kourek Michael Antonopoulos Theodora Soulele Kyriaki Kolovou Ioannis Vlahodimitris Ioannis Vasileiadis Stavros Dimopoulos Clinical Ergospirometry Exerciseand Rehabilitation LaboratoryDepartment of First Critical Care MedicineEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Cardiac surgery Intensive Care unit Onassis Cardiac Surgery CenterAthens 17674Greece

Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide,leading to morbidity and *** artery bypass grafting(CABG)and surgical aortic valve replacement(SAVR)have therapeutic benefits,including improved postoperative quality of life(QoL)and enhanced patient functional capacity which are key indicators of cardiac surgery *** this article,we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac *** standardized instruments are used to evaluate QoL and functional *** health status,age,length of intensive care unit stay,operative risk,type of procedure,and other pre-,intra-,and postoperative factors affect postoperative *** patients experience impaired physical status soon after cardiac surgery,but it improves in the following *** and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long *** rehabilitation improves patient functional capacity,QoL,and frailty following cardiac surgery.

关键词： Quality of life Health-related quality of life Functional capacity Cardiac rehabilitation Cardiac surgery Coronary artery bypass grafting Heart valve surgery Heart valve replacement

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Parallel pathways:A chronicle of evolution in rectal and breast cancer surgery

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1091-1096页

作者： Antonio Pesce NicolòFabbri Diletta Iovino Carlo Vittorio Feo unit of General surgery University of FerraraAzienda USL of FerraraFerrara 44023LagosantoItaly

In this editorial,we have analyzed the historical evolution of rectal and breast cancer surgery,focusing on the progressive reduction of demolitive approaches and the increasing use of more conservative strategies,accompanied by a growing emphasis on perioperative treatments aimed at enhancing surgical *** of these changes have been made possible due to an increased awareness and understanding of oncological diseases and improved perioperative treatments.

关键词： Rectal cancer History Breast surgery Demolitive treatment Conservative surgery

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Effect of programmed comprehensive nursing on delirium incidence in intensive care unit children following severe cardiac surgery

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World Journal of Psychiatry 2024年第9期14卷 1301-1307页

作者： Qiu-Yue Wang Xiang Wang Ming-Xiong Li Department of Cardiothoracic surgery Children’s Hospital of Nanjing Medical UniversityNanjing 210000Jiangsu ProvinceChina

BACKGROUND Programmed comprehensive nursing was adopted for intensive care unit(ICU)children following severe cardiac surgery to improve respiratory function and delirium *** To explore how programmed comprehensive nursing impacts respiratory func-tion and delirium incidence in ICU children post cardiac *** Between January 2022 and January 2024,180 pediatric patients from the Chil-dren’s Hospital of Nanjing were admitted to the ICU after cardiac surgery and randomly *** control group comprised 90 patients and received routine nursing *** observation group comprised 90 patients and received program-med comprehensive *** groups received continuous nursing care until *** respiratory function,incidence of delirium,and clinical outcomes were *** memory state and sleep quality of both groups were *** The incidence of delirium was 5.56%in the observation group when admitted to ICU,which was lower than that in the control group(20.00%;Psurgery can reduce the impact on respiratory function,improve sleep quality,and alleviate postoperative delirium,showing significant promise for clinical application.

关键词： Programmed comprehensive nursing Intensive care unit Cardiac surgery Respiratory function Delirium

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Can we talk about “futile surgery” for the upfront treatment of the perihilar cholangiocarcinoma?

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 672-674页

作者： Maria Conticchio David Fuks Stylianos Tzedakis unit of Hepatobiliairy and Pancreatic surgery Ente Ecclesiastico F.MiulliAcquaviva delle FontiBariItaly unit of Hepatobiliary Digestive and Endocrine SurgeryCochin HospitalUniversitéParis CitéParisFrance

In this work(1),Ratti et *** to identify a subgroup of patients with perihilar cholangiocarcinoma(PHC)for whom the benefit of surgery could be compromised by morbidity,mortality and the risk of early tumor *** for this study come from a multi-institutional database that includes consecutive patients undergoing elective surgery for PHC in 27 Western centers(with experience of more than 15 major liver resections per year)starting in January *** from 2,271 patients were analyzed *** there is neither international consensus on preoperative management nor standardization of surgical technique,the indications for resection were validated at a local multidisciplinary consultation *** optimization was standardized with endoscopic or percutaneous biliary drainage to treat jaundice and the performance of portal embolization was proposed in the event of insufficient volume of the future remaining liver.

关键词： Perihilar cholangiocarcinoma(PHC) upfront surgery predictive risk score

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Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions

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World Journal of Gastrointestinal surgery 2024年第2期16卷 270-275页

作者： Davina Perini Jacopo Martellucci Department of Emergency Emergency and Minimally Invasive Surgery UnitCareggi University HospitalFirenze 50041Italy

Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency *** trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective *** is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been *** present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal ***,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute *** the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute *** then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two *** emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality *** need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures.

关键词： Indocyanine green Fluorescence Navigation surgery Angiography Emergency surgery Decision-making

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Beyond total mesorectal excision: The emerging role of minimally invasive surgery for locally advanced rectal cancer

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2382-2385页

作者： Davina Perini Francesca Cammelli Maximilian Scheiterle Jacopo Martellucci Annamaria Di Bella Carlo Bergamini Paolo Prosperi Alessio Giordano Department of Emergency and Acceptance Emergency Surgery UnitCareggi University HospitalFirenze 50137Italy

Multivisceral resection and/or pelvic exenteration represents the only potential curative treatment for locally advanced rectal cancer(LARC);however,it poses significant technical challenges,which account for the high risk of morbidity and mortality associated with the *** complete histopathologic resection is the most important determinant of patient outcomes,LARC often requires an extended resection beyond the total mesorectal excision plane to obtain clear re-section *** an era when laparoscopic surgery and robot-assisted surgery are becoming commonplace,the optimal approach to extensive pelvic inter-ventions remains ***,acceptance of the suitability of mini-mally invasive surgery is slowly gaining ***,there is still a lack of evidence in the literature about minimally invasive approaches in multiple and extensive surgical resections,highlighting the need for research studies to explore,validate,and develop this *** editorial aims to provide a critical overview of the currently available applications and challenges of minimally invasive abdo-minopelvic surgery for ***,we discuss recent developments in the field of robotic surgery for LARC,with a specific focus on new innovations and emerging frontiers.

关键词： Robotic surgery Pelvic exenteration Multivisceral resection Rectal cancer Total mesorectal excision

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