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- Backman, Torbjörn, et al.
(författare)
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Omentum Herniation at a 2-mm Trocar Site.
- 2005
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Ingår i: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. - : Mary Ann Liebert Inc. - 1557-9034 .- 1092-6429. ; 15:1, s. 87-88
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Tidskriftsartikel (refereegranskat)
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- Brokelman, Walter, et al.
(författare)
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The peritoneal fibrinolytic response to conventional and laparoscopic colonic surgery.
- 2009
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Ingår i: Journal of laparoendoscopic & advanced surgical techniques. Part A. - : Mary Ann Liebert Inc. - 1092-6429 .- 1557-9034. ; 19:4, s. 489-93
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic surgery is considered to induce less peritoneal trauma than conventional surgery. The peritoneal plasmin system is important in the processes of peritoneal healing and adhesion formation. The present study assessed the peritoneal fibrinolytic response to laparoscopic and conventional colonic surgery. METHODS: Twenty-four patients scheduled for a right colonic resection were enrolled in the trial. Twelve underwent conventional surgery and 12 were operated laparoscopically. Biopsies of the parietal peritoneum were taken at standardized moments during the procedure. Tissue concentrations of tissue-type plasminogen activator (tPA) and its specific activity (tPA-activity), urokinase-type plasminogen activator (uPA), and plasminogen activator inhibitor type 1 (PAI-1) were measured, using commercial assays. RESULTS: After mobilization of the colon, peritoneal levels of tPA antigen and activity were significantly higher in the laparoscopic group (p < 0.005) due to a decrease in the conventional group (p < 0.05). At the end of the procedure, the concentrations of tPA antigen and activity significantly (p < 0.05) decreased in the laparoscopic group to levels comparable with the conventional group. Neither uPA antigen nor PAI-1 antigen changed throughout the procedures. CONCLUSIONS: Both conventional and laparoscopic surgery inflict a decrease in tPA antigen and its specific activity. Peritoneal hypofibrinolysis initiates more rapidly during conventional, compared to laparoscopic, surgery, but at the conclusion of the surgery, the effect was the same.
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4. |
- Gunnarsdottir, Anna, et al.
(författare)
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Wireless Esophageal pH Monitoring in Children.
- 2008
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Ingår i: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. - : Mary Ann Liebert Inc. - 1557-9034 .- 1092-6429. ; 18:3, s. 443-447
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT Introduction: A wireless BRAVO() (Medtronic, Shoreview, MN) capsule for pH measurement in the diagnosis of gastroesophageal reflux disease (GERD) is intended to be less uncomfortable, and facilitates activity during the measuring period, compared to the usual method with a naso-esophageal catheter. The aim of this study was to report on our experience with the wireless system in children. A secondary aim was to see if there was any cut-off level for esophageal acid exposure causing esophagitis as verified by pathologic examination. Materials and Methods: A total of 62 wireless 24-hour pH measurements with the BRAVO capsule were carried out over a period of 2 years in 58 children with symptoms of GERD. The median age of the children was 8 +/- 4 years (range, 1-15). They underwent upper endoscopies and the placement of the capsule under general anesthesia. Correlations between endoscope findings and pathologic diagnosis were done. Results: In 10 children, the endoscopies showed esophagitis. The median percent time of pH <4 was 7.0 +/- 9.6% (range, 0-61). The DeMeester score was abnormally high in 33 children. Three children described dysphagia during the measuring time. In 3 patients, we experienced technical problems with the wireless system. Biopsies were taken in 49 children, of which 18 showed esophagitis, with no correlation to the 24-hour pH-measurement findings. Conclusions: Ambulatory pH monitoring, using the wireless pH system, is feasible and was well tolerated by the children. No cut-off level for the acid exposure in correlation to pathologic diagnosis of esophagitis could be found. We recommend the use of the wireless pH-measurement system in children.
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7. |
- Krishnan, Nellai, et al.
(författare)
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Role of Magnetic Compression Anastomosis in Long-Gap Esophageal Atresia : A Systematic Review
- 2023
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Ingår i: Journal of Laparoendoscopic and Advanced Surgical Techniques. - : Mary Ann Liebert. - 1092-6429 .- 1557-9034. ; 33:12, s. 1223-1230
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Forskningsöversikt (refereegranskat)abstract
- Background: Magnetic compression anastomosis (MCA) is an alternative technique for patients with long-gap esophageal atresia (EA). It allows for preservation of the native esophagus. We aimed to systematically summarize the current literature on MCA in EA.Methods: Studies where neonates with EA were treated with MCA devices were included, while studies on esophageal stenosis were excluded. All clinical studies, including comparative studies, case series, and case reports, were eligible for inclusion. Methodological quality assessment was performed using a validated tool.Results: Twelve studies with a total of 42 patients were included in this review. There was a wide variation among these studies with regard to the time of initiation of MCA (1 day to 7 months), procedure time (13–320 minutes), and magnet characteristics (strength, size, and shape of the magnets used). The time to achieve anastomosis ranged from 1 to 12 days. Stricture at the anastomotic site was reported in almost all the patients, which required multiple endoscopic dilatations (median no. of dilatations/patient = 9.8). Stent placement for refractory stricture was required in 9 (21%) patients, and surgery for stricture was required in 6 (14%) patients. Long-term outcomes included esophageal dysmotility (n = 3) and recurrent pulmonary infections (n = 3) were reported in only four studies.Conclusion: As per the findings of this review, neonates with long-gap EA undergoing MCA would invariably require multiple sittings of endoscopic dilatations (median no. of dilatations/patient = 9.8). Also, there is a wide variation among the included studies in terms of the procedure of MCA. Future studies with a standardized procedure for achieving MCA are needed to determine additional outcomes in this fragile patient population.
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8. |
- Lensvelt, Mare M A, et al.
(författare)
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Peritoneal transforming growth factor beta-1 expression during prolonged laparoscopic procedures.
- 2010
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Ingår i: Journal of laparoendoscopic & advanced surgical techniques. Part A. - : Mary Ann Liebert Inc. - 1557-9034 .- 1092-6429. ; 20:6, s. 545-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic surgery may affect peritoneal physiology. Short-term laparoscopic surgery does not affect peritoneal transforming growth factor beta (TGF-b1) expression. The current study was conducted to evaluate the hypothesis that prolonged laparoscopic surgery may affect peritoneal TGF-b1 expression. STUDY DESIGN: In the first study, 24 patients scheduled for a right colonic resection were enrolled in the trial. Twelve underwent conventional surgery (CCR) and 12 were operated on laparoscopically (LCR). In the second study, 12 patients undergoing laparoscopic gastric bypass (LGB) surgery for morbid obesity were included. Biopsies of the parietal peritoneum were taken at standardized moments during the procedures. Tissue concentrations of active and total TGF-b1 were measured by using enzyme-linked immunosorbent assays. RESULTS: During the LCR, there was a significant increase in peritoneal active TGF-b1 levels (P < 0.05). A similar, but not significant, trend was observed during the CCR. A similar pattern was seen in the total TGF-b1 concentrations during both procedures. The LGB procedure did not affect peritoneal active or total TGF-b1 concentrations. During the procedure, both the active and total TGF-b1 levels were significantly higher in the LCR, when compared to the LGB, group (P < 0.05). CONCLUSIONS: Prolonged laparoscopic surgery may affect peritoneal TGF-b1 expression, depending on the procedure performed. Considering the role of TGF-b1 in various biologic processes, including adhesiogenesis and oncology, these results may have clinical consequences.
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- Ljungqvist, Olle, 1954-, et al.
(författare)
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The History of Enhanced Recovery After Surgery and the ERAS Society
- 2017
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Ingår i: Journal of Laparoendoscopic and Advanced Surgical Techniques. - : Mary Ann Liebert. - 1092-6429 .- 1557-9034. ; 27:9, s. 860-862
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Tidskriftsartikel (refereegranskat)abstract
- This short historical overview explains the development of enhanced recovery from a small group of surgeons in European academic centers to the establishment of ERAS (R) Society, a not-for-profit multiprofessional multidisciplinary medical-academic society, reaching all major continents and involving a wide range of surgical and anesthesia disciplines.
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- Noren, Erik, et al.
(författare)
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Laparoscopic gastrostomy in children with congenital heart disease
- 2007
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Ingår i: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. - : Mary Ann Liebert Inc. - 1557-9034 .- 1092-6429. ; 17:4, s. 483-489
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to study the type and frequency of complications and change in weight after a laparoscopic gastrostomy procedure in 31 children with congenital heart disease, comparing patient groups of children with univentricular and biventricular circulation, and with completed and uncompleted cardiac surgery. Methods: The method used was that of a retrospective study of all 31 children with congenital heart disease who underwent a laparoscopic gastrostomy at our center from 1995 to 2004. Main Outcome Measures: Postoperative complications and body weight changes during follow-up were the main outcome measures used in this study. Results: Minor stoma-related problems were common in both groups. Two severe complications requiring an operative intervention occurred in the univentricular circulation group. Weight was normal at birth, low at the time of the gastrostomy procedure, and did not catch up completely during the follow-up period of a mean of 20 months. There were no significant differences regarding mean weight gain between the groups. Conclusions: The complication rate after the laparoscopic gastrostomy procedure was higher in our patient group, compared to previously studied children with various diseases. Comparisons regarding mean weight gain between the groups showed no significant differences. The mean weight gain was low, suggesting that the energy expenditure in this patient group of children with severe congenital heart disease may be even higher than previously assumed.
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