Long-term and short-term surgical outcomes of single-incision laparoscopic hepatectomy on anterolateral liver segments

2019 ◽  
Vol 34 (7) ◽  
pp. 2969-2979 ◽  
Author(s):  
Kuei-Yen Tsai ◽  
Hsin-An Chen ◽  
Wan-Yu Wang ◽  
Ming-Te Huang
2018 ◽  
Vol 128 (2) ◽  
pp. 541-552 ◽  
Author(s):  
Yuanxiang Lin ◽  
Fuxin Lin ◽  
Dezhi Kang ◽  
Yuming Jiao ◽  
Yong Cao ◽  
...  

OBJECTIVEDiffusion tensor imaging (DTI) findings may facilitate clinical decision making in patients with supratentorial cavernous malformations adjacent to the corticospinal tract (CST-CMs). The objective of this study was to determine the predictive value of preoperative DTI findings for surgical outcomes in patients with CST-CMs.METHODSA prospectively maintained database of patients with CM referred to the authors' hospital between September 2012 and October 2015 was reviewed to identify all consecutive surgically treated patients with CST-CM. All patients had undergone sagittal T1-weighted anatomical imaging and DTI before surgery. Both DTI findings and clinical characteristics of the patients and lesions were analyzed with respect to surgery-related motor deficits. DTI findings included lesion-to-CST distance (LCD) and the alteration (i.e., deviation, interruption, or degeneration due to the CM) of CST on preoperative DTI images. Surgery-related motor deficits at 1 week and the last clinic visit (≥ 3 months) after surgery were defined as short-term and long-term deficits, respectively. Preoperative and final modified Rankin Scale scores were also analyzed to identify the surgical outcomes in these patients.RESULTSA total of 56 patients with 56 CST-CMs were included in this study. The mean LCD was 3.9 ± 3.2 mm, and alterations of the CST were detected in 20 (36.7%) patients. One week after surgery, 21 (37.5%) patients had short-term surgery-related motor deficits, but only 14 (25.0%) patients had long term deficits at the last clinical visit. The mean patient follow-up was 14.7 ± 10.1 months. The difference between preoperative and final modified Rankin Scale scores was not statistically significant (p = 0.490). Multivariate analysis showed that both short-term (p < 0.001) and long-term (p = 0.002) surgery-related motor deficits were significantly associated with LCD. Receiver operating characteristic (ROC) curve results were as follows: for short-term surgery-related motor deficits, the area under the ROC curve (AUC) was 0.860, and the cutoff point was LCD = 2.55 mm; for long-term deficits, the AUC was 0.894, and the cutoff point was LCD = 2.30 mm. Both univariate (p = 0.012) and multivariate (p = 0.049) analyses revealed that CST alteration on preoperative DTI was significantly correlated with short-term surgery-related motor deficits. On univariate analysis, deep location of the CST-CMs was significantly correlated with long-term motor deficits (p = 0.016). Deep location of the CST-CMs had a trend toward significance with long-term motor deficits on the multivariate analysis (p = 0.060).CONCLUSIONSTo facilitate clinical practice, the authors propose that 3.00 mm (2.55 to ∼3.00 mm) may be the safe LCD for surgery in patients with CST-CMs. A CST alteration on preoperative DTI and a deep location of the CST-CM may be risk factors for short- and long-term surgery-related motor deficits, respectively. A randomized controlled trial is needed to demonstrate the predictive value of preoperative DTI findings on surgical outcomes in patients with CST-CMs in future studies.


2019 ◽  
Author(s):  
Zhao Lei ◽  
Wang Jian Gang ◽  
Zheng Xing ◽  
Yu Xin

Abstract Background : To investigate the influence of body mass index (BMI) on the short-term and long-term outcome s including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m 2 , Group1), normal (18.5≤BMI< 23kg/m 2, Group2), overweight (BMI≥ 23kg/m 2, Group3) respectively. Short-term and long-term outcome s including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months , 30 months , and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56 , and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications ( Clavien-Dindo classification ) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions : Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH. Key Word s: body mass index, liver carcinoma, Prognosis, laparoscopic hepatectomy


2012 ◽  
Vol 29 (6) ◽  
pp. 477-483 ◽  
Author(s):  
Simone Velthuis ◽  
Peter B. van den Boezem ◽  
Daan J. Lips ◽  
Hubert A. Prins ◽  
Miguel A. Cuesta ◽  
...  

2020 ◽  
Vol 9 (2) ◽  
pp. 416
Author(s):  
Jiyun Lee ◽  
Chan Kee Park ◽  
Kyoung In Jung

Background: To compare the effects of aqueous suppressants (AS) and prostaglandin (PG) analogs during the hypertensive phase on intraocular pressure (IOP) and surgical outcomes. Methods: In this retrospective, observational study, 66 eyes (66 patients) with Ahmed glaucoma valve (AGV) implantation were included. As evaluation items, IOP changes, number of postoperative medications, the surgical success rate, and postoperative complications were examined. Complete success was defined as IOP between 6 and 21 mmHg without medications, while qualified success was with a maximum of four medications. Results: The short-term IOP reduction following initial medication was 9.3 mmHg for AS and 4.4 mmHg for PG analogs (p = 0.016). More postoperative medications were used in PG than in AS from postoperative 3 months to 3 years (all p < 0.05). The qualified success rate with the initial medication was higher in AS than in PG (67.5% vs. 42.3% at 1 year, 80.6% vs. 37.5% at 2 years, 80.0% vs. 35.0% at 3 years, all p < 0.05). Conclusions: Association between AS used as the first medications during the hypertensive phase and better IOP control and a higher success rate was observed. The type of the initial glaucoma medication after AGV implantation could affect short- and long-term surgical outcomes.


2020 ◽  
Author(s):  
Lei Zhao ◽  
JianGang Wang ◽  
JingXia Kong ◽  
Xing Zheng ◽  
Xin Yu

Abstract Background To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment. Methods Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI < 18.5 kg/ m2, Group1), normal (18.5 ≤ BMI < 23 kg/m2, Group2), overweight (BMI ≥ 23 kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories. Results Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44%. Conversion rate in the three groups was 14.29%, 21.54% and 20.69% (P = 0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85 ± 4.04, 11.57 ± 5.56, and 10.88 ± 5.70, P = 0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P = 0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P = 0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P = 0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P = 0.043). Conclusions Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.


2020 ◽  
Author(s):  
Lei Zhao ◽  
Gang Jian Wang ◽  
Jingxia Kong ◽  
Xing Zhen ◽  
Xin Yu

Abstract Background: To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m2, Group1), normal (18.5≤BMI< 23kg/m2, Group2), overweight (BMI≥ 23kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56, and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions: Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.


Sign in / Sign up

Export Citation Format

Share Document