Can the depth of invasion of early esophageal cancer be predicted based on endoscopic appearances?
CONCLUSIONS: Endoscopic assessment allows a rather accurate estimation of invasion depth of early esophageal cancer. To determine the final treatment modality however the final histological staging obtained by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is crucial.
PMID: 29795069 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Endoscopic treatment of early esophageal adenocarcinoma.
Authors: Milano RV, Bergman JJ, Pouw RE
Abstract
The incidence of esophageal adenocarcinoma is on the rise. With advances in endoscopic techniques and imaging technology, early neoplastic lesions are being increasingly detected and treated. Managing early esophageal adenocarcinoma with endoscopic techniques is now considered the cornerstone of therapy, offering an alternative to surgery. The available endoscopic techniques can be broadly categorized into resection and ablation techniques that may be combined to increase the effectiveness of therapy. However, endoscopic treatments are highly specialized and...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Emergent treatment of carotid stenosis. A systematic review focused on evidence based medicine.
CONCLUSIONS: CEA is considered a less problematic method than CAS, specially for patients over the age of 75 ; CAS remains recommended in patients with a favorable anatomy or high surgical risks. Studies that showed more solid results seem to lead to the conclusion that optimal timing may be between 2 days and the end of the first week from the onset of symptoms in patients who are appropriate candidates for surgery.
PMID: 29806753 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Endovascular repair versus open repair in the treatment of ruptured aortic aneurysms. A systematic review.
CONCLUSIONS: The bulk of evidence regarding the comparison between endovascular and open surgery approach to RAAA points to: 1) non inferiority of rEVAR in terms of early (within 30 days) and late mortality as well as rate of complications and length of hospitalization, with trends of better outcomes associated to the endovascular approach; 2) significantly better outcomes in terms of intensive care unit transfer and blood loss with or without transfusion need in the rEVAR group. These conclusions reflect the results of the available RCTs included in the present review. Thus rEVAR can be considered a safe method in treatin...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Robotic surgery for rectal cancer: the future?
Authors: Sammour T, Chang GJ
Abstract
Robotic technology currently offers some technical advantages in pelvic dissection compared with competing minimally invasive techniques, and adoption for the surgical treatment of rectal cancer is rapidly increasing worldwide. While there is some early data demonstrating modest improvement in patient outcomes, benefits in terms of long term oncological outcomes, as well as potential improvements in surgeon-centered outcomes such as fatigue and repetitive stress injury are actively being investigated. Rapid innovation, and the impending release of several new robotic p...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
The evolution of pelvic dissection for rectal cancer from blunt dissection to total mesorectal excision.
This article reviews the individuals and their advancements in rectal cancer treatment. It describes the changes in the surgical approach for tumor resection, the study of the lymphatic spread of rectal cancer and the advances in sphincter preservation procedures from the era of blunt dissection until the paradigm changing revolution of total mesorectal excision (TME).
PMID: 29806756 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Radiofrequency ablation for Barrett's esophagus related neoplasia.
Authors: Krajciova J, Vackova Z, Spicak J, Martinek J
Abstract
Barrett's esophagus (BE) is a premalignant condition associated with increased risk of developing esophageal adenocarcinoma. In the past, BE patients with high-grade intraepithelial neoplasia (IEN) or early adenocarcinoma (EAC) were indicated for esophagectomy. With the recent advance in endoscopy, endoscopic techniques have surpassed esophagectomy in the treatment of Barrett's esophagus related neoplasia (BORN) and minimized the treatment-related morbidity. Patients with IEN are candidates for endoscopic treatment - endoscopic mucosal resectio...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Selective use of radiation for locally advanced rectal cancer: one size does not fit all.
CONCLUSIONS: LARC is a heterogeneous disease with varying risk of relapse. Studies are underway to attempt to individualise care to avoid overtreatment while maintaining excellent oncologic outcomes.
PMID: 29806758 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
The role of confocal laser endomicroscopy in patients with early esophageal neoplasia.
This article describes the principle and performance of pCLE and reviews its use in patients with BE and early esophageal neoplasia.
PMID: 29806759 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Oligometastatic prostate cancer and salvage lymph node dissection: systematic review.
CONCLUSIONS: sLND is not associated with a durable response over time but may postpone HT and its related complications, in selected patients. Although a limited morbidity was reported, sLND remains technically demanding and a careful selection of patients is advisable.
PMID: 29806760 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Iatrogenic spleen injury risk during robotic left colonic and rectal resections performed with routine left flexure mobilization technique. Retrospective original paper.
CONCLUSIONS: In our experience, and according to some of the literature data as well, during robotic left colonic/rectal resections the routine mobilization of the left flexure as a standard procedure is not a risk factor in terms of iatrogenic spleen injury rate. Conversely, this technique may be beneficial: a) it does not excessively extend the operative time; b) It increases the surgical skills acquirement; c) It reduces the tension-related anastomotic ischemia; d) It allows a better oncological dissection. Standard laparoscopic approach reduces the rate of spleen by almost 3,5 times in comparison to open surgery. The i...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Operative technique in robotic left colonic resection.
Authors: Mangano A, Valle V, Fernandes E, Bustos R, Gheza F, Giulianotti PC
Abstract
Minimally invasive techniques have changed the clinical practice in general surgery and provided an improvement of outcomes. Laparoscopic surgery has similar oncological outcomes vs open in the colorectal field. Those findings have been proven by prospective randomized multicenter trials and systematic reviews. However, part of the colorectal operations are still being performed by the open approach. This is partially related to the technical hurdles of the laparoscopic approach (particularly for more complex cases). Robot...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Operative technique in robotic rectal resection.
Authors: Mangano A, Valle V, Fernandes E, Bustos R, Gheza F, Giulianotti PC
Abstract
A still too high percentage of the colorectal resections are currently performed by open technique. This in part because laparoscopy has some technical hurdles: not ideal ergonomics, poor control on the traction exerted by the Assistant, long/steep learning curve, confined dexterity, low tactile feedback, hand-tremor and 2D vision with a not completely stable camera. The robotic approach, given the increased surgical dexterity and the better surgical view, may be used to solve the laparoscopic downsides (in particular in t...
Source: Minerva Chirurgica - May 30, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Resection of the caudate lobe for the treatment of hilar cholangiocarcinoma. Systematic review and meta-analysis.
CONCLUSIONS: Despite the paucity of data and the retrospective nature of the included studies, our results suggest that major hepatectomy plus caudate lobe resection may improve the likelihood of R0 resection and the overall survival in patients with hilar cholangiocarcinoma.
PMID: 29658674 [PubMed - as supplied by publisher] (Source: Minerva Chirurgica)
Source: Minerva Chirurgica - April 18, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
Local excision for rectal cancer. A minimally invasive option.
Authors: Allaix ME, Arezzo A, Nestorović M, Galosi B, Morino M
Abstract
Transanal excision (TAE) with conventional retractors and transanal endoscopic microsurgery (TEM) are two well established minimally invasive surgical options for the treatment of selected rectal cancers. TEM is nowadays considered the standard of care for the transanal excision of rectal tumors, since it is associated with significantly better quality of excision and lower rates of recurrence than TAE. When compared with rectal resection and total mesorectal excision, TEM has lower postoperative morbidity and better functional outcom...
Source: Minerva Chirurgica - April 18, 2018 Category: Surgery Tags: Minerva Chir Source Type: research
