AnatomyDiseasesAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesDisciplines and OccupationsAnthropology, Education, Sociology and Social PhenomenaTechnology, Industry, AgricultureHumanitiesInformation ScienceHealth CareGeographicals
LaparoscopyConversion to Open SurgeryTreatment OutcomeSurgical Procedures, Minimally InvasivePostoperative ComplicationsGene ConversionBlood Vessel Prosthesis ImplantationAortic Aneurysm, AbdominalRetrospective StudiesVascular Surgical ProceduresAortic RuptureReoperationTime FactorsColectomyEndovascular ProceduresLength of StayOperative TimeColorectal SurgeryLaparotomyFollow-Up StudiesBlood Vessel ProsthesisTrigger Finger DisorderIntraoperative ComplicationsThoracic Surgery, Video-AssistedProspective StudiesCholecystectomy, LaparoscopicRoboticsBariatric SurgeryStentsVideo-Assisted SurgeryBlood Loss, SurgicalSurgical Procedures, ElectiveDigestive System Surgical ProceduresAortic Aneurysm, ThoracicUrologic Surgical ProceduresAortographyGeneral SurgerySurgery, Computer-AssistedOpen Reading FramesPostoperative PeriodOrthopedic ProceduresLaparoscopesTomography, X-Ray ComputedAngioplastyThoracic SurgeryPatient SelectionUreteral CalculiNephrectomyRetroperitoneal SpaceRisk AssessmentCardiac Surgical ProceduresUreteral DiseasesSurgical InstrumentsFeasibility StudiesPain, PostoperativeEndoscopyEsophagostomyConversion DisorderGynecologic Surgical ProceduresUrinary Bladder CalculiAnastomosis, SurgicalHand-Assisted LaparoscopyChi-Square DistributionSuture TechniquesRisk FactorsAortic DiseasesPneumoperitoneum, ArtificialArthroscopyTissue AdhesionsSurgical EquipmentSurgery, PlasticLearning CurveUreterHerniorrhaphyDiskectomy, PercutaneousCholecystectomyIntraoperative PeriodUreteroscopyProsthesis DesignParaparesisProsthesis FailureMolecular Sequence DataAneurysm, DissectingHernia, InguinalObesity, MorbidPreoperative CareRecurrenceCholecystitis, AcuteThoracotomyParaplegiaCataract ExtractionSurgical Procedures, OperativeAppendectomyPostoperative CareSurgical MeshGastrectomyThoracoscopyLithotripsyAorta, AbdominalAneurysm, Ruptured

Advantages of early cholecystectomy in clinical practice of a terciary care center. (9/26)

BACKGROUND: Despite a number of studies show the superiority of early over delayed cholecystectomy in the treatment of acute cholecystitis, there is still controversy over the time for intervention. This study aimed to assess the use of early versus delayed cholecystectomy for the treatment of acute cholecystitis in terms of complications, conversion to open surgery and mean hospital stay. METHOD: We collected patients with acute cholecystitis treated at a referral center for a year, and retrospectively analyzed the chosen therapeutic approach, the percentage of conversion of early cholecystectomy to open surgery, appearance of surgical complications, and mean hospital stay. RESULTS: The study included 117 patients, 44 women and 73 men, who had a mean age of 67.36+/-15.74 years. Early cholecystectomy was chosen in 31 (26.5%) and delayed cholecystectomy in 74 patients (63.2%). Of the 74 patients, 28 (37.8%) required emergency performance of delayed cholecystectomy, and 19 (25.7%) had not undergone surgery by the end of the study. While no differences were observed between early and delayed cholecystectomy in terms of surgical complications and conversion to open surgery, mean hospital stay was nevertheless significantly shorter in the early versus the delayed cholecystectomy group (8.32+/-4.98 vs 15.96+/-8.89 days). CONCLUSION: Under the routine working conditions of a hospital that is neither specially dedicated to the surgical treatment of acute cholecystitis nor provided with specific management guidelines, early cholecystectomy can reduce the hospital stay without increase of the conversion rate or complications.  (+info)

Delayed open conversion after endovascular abdominal aortic aneurysm: device-specific surgical approach. (10/26)

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Laparoscopic cholecystectomy for treating acute cholecystitis -- possibilities and limitations. (11/26)

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Treatment of bilateral inguinal hernia -- minimally invasive versus open surgery procedure. (12/26)

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Endovascular stenting of the ascending aorta for type A aortic dissections in patients at high risk for open surgery. (13/26)

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Oncologic outcomes of laparoscopic gastrectomy: a single-center safety and feasibility study. (14/26)

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Conversion to Stoppa procedure in laparoscopic totally extraperitoneal inguinal hernia repair. (15/26)

BACKGROUND AND OBJECTIVES: Conversion to open surgery is an important problem, especially during the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. METHODS: Here, we discuss conversion to the Stoppa procedure during laparoscopic TEP inguinal hernia repair. Outcomes of patients who underwent conversion to an open approach during laparoscopic TEP inguinal hernia repair between September 2004 and May 2010 were evaluated. RESULTS: In total, 259 consecutive patients with 281 inguinal hernias underwent laparoscopic TEP inguinal hernia repair. Thirty-one hernia repairs (11%) were converted to open conventional surgical procedures. Twenty-eight of 31 laparoscopic TEP hernia repairs were converted to modified Stoppa procedures, because of technical difficulties. Three of these patients underwent Lichtenstein hernia repairs, because they had undergone previous surgeries. CONCLUSION: Stoppa is an easy and successful procedure used to solve problems during TEP hernia repair. The Lichtenstein procedure may be a suitable option in patients who have undergone previous operations, such as a radical prostatectomy.  (+info)

The implementation of a standardized approach to laparoscopic rectal surgery. (16/26)

BACKGROUND AND OBJECTIVES: The purpose of this study was to audit our results after implementation of a standardized operative approach to laparoscopic surgery for rectal cancer within a fast-track recovery program. METHODS: From January 2009 to February 2011, 100 consecutive patients underwent laparoscopic surgery on an intention-to-treat basis for rectal cancer. The results were retrospectively reviewed from a prospectively collected database. Operative steps and instrumentation for the procedure were standardized. A standard perioperative care plan was used. RESULTS: The following procedures were performed: low anterior resection (n = 26), low anterior resection with loop-ileostomy (n = 39), Hartmann's operation (n = 14), and abdominoperineal resection (n = 21). The median length of hospital stay was 7 days; 9 patients were readmitted There were 9 cases of conversion to open surgery. The overall complication rate was 35%, including 6 cases (90/%) of anastomotic leakages requiring reoperation. The 30-day mortality was 5%. The median number of harvested lymph nodes was 15 (range, 2 to 48). There were 6 cases of positive circumferential resection margins. The median follow-up was 9 (range, 1 to 27) months. One patient with disseminated cancer developed port-site metastasis. CONCLUSIONS: The results confirm the safety of a standardized approach, and the oncological outcomes are comparable to those of similar studies.  (+info)