Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy
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Minim Invasive Ther Allied Technol · Dec 2018
Multicenter Study Comparative StudyImplementation of the Spanish ERAS program in bariatric surgery.
Introduction: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish Fast Track Group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery, comparing it with a historical cohort receiving standard care. ⋯ The total compliance to protocol was 80%. Conclusion: The Spanish National ERAS protocol is a safe issue, obtaining similar results to standard care in terms of complications, reoperations, mortality and readmissions. It is associated with less postoperative pain and earlier hospital discharge.
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Minim Invasive Ther Allied Technol · Aug 2018
Minimally invasive surgical approach for radicalization of incidental post-cholecystectomy gallbladder carcinoma: safety, feasibility and outcomes.
Gallbladder carcinoma is a rare but aggressive malignant neoplasm. The incidence of intra- or post-operative incidental gallbladder carcinoma diagnosis following laparoscopic cholecystectomy is estimated to be 1-2%. Aggressive re-resection is warranted as the majority of patients have residual disease either in the liver or the lymph nodes. However the use of a minimally invasive surgical approach (MISA) to perform a radicalization in these patients has not been investigated yet. We retrospectively analyzed surgical and oncologic outcome of a small selected cohort of patients with incidental gallbladder carcinoma whom underwent redo radicalization surgery by MISA. ⋯ Our data suggest that radicalization of patients with stage I incidental postoperative gallbladder carcinoma can be done by a MISA without compromising the oncologic outcome. Larger studies are needed to validate these results.
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Minim Invasive Ther Allied Technol · Jun 2017
Randomized Controlled Trial Comparative StudyThree-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation.
The aim of this study is to assess the long-term clinical and radiological outcomes between minimally invasive (MIS) and conventional transforaminal lumbar interbody fusion (TLIF) in treating one-segment lumbar disc herniation (LDH). ⋯ Both MIS and conventional TLIF were beneficial for patients with LDH. However, MIS-TLIF manifests a great improvement in perioperative outcomes, low back pain, disability and preventing paraspinal muscle atrophy during the follow-up period observation.
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Minim Invasive Ther Allied Technol · Feb 2017
Case ReportsIntrahepatic portosystemic venous shunt via the right adrenal vein: treatment with vascular plug.
A 65-year-old man with hepatocellular carcinoma (HCC) due to alcohol-related liver cirrhosis had undergone transarterial chemoembolization 11 times. However, treatment for HCC was difficult to continue, due to episodic hepatic encephalopathy. He was referred to our hospital for treatment of hepatic encephalopathy, showing a Child-Pugh score of 8 despite medical therapy. ⋯ The larger tract was occluded using an Amplatzer Vascular Plug (AVP) II, and the smaller tract was occluded using an original AVP. The postembolization course was uneventful. Hepatic encephalopathy improved after shunt occlusion and no recurrence had occurred as of one year after the procedure.
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Minim Invasive Ther Allied Technol · Dec 2016
Case ReportsCombined application of laryngoscopy and flexible bronchoscopy in endobronchial foreign body extraction.
Foreign body aspiration is a life-threatening emergency in children. An 11-year-old girl presented at the emergency department with a case of accidental foreign body aspiration. ⋯ Under analgesic and amnestic anesthesia, we extracted the metal bead using alligator forceps, with a direct laryngoscope and a flexible bronchoscope. This method afforded an improved visual access to the operative field and allowed for intra-operative manipulation, thus obviating the need for thoracotomy.