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Rationale and surgical technique of laparoscopic left lateral sectionectomy using endoscopic staples.

Lee BH, Yun SS, Kim MK, Jung HK, Lee DS, Kim HJ - Ann Surg Treat Res (2014)

Bottom Line: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery.There was significantly shorter in the batch group, also (P = 0.006).There were no significant complications or mortality in both groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

ABSTRACT

Purpose: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery. Some surgeons prefer to isolate glissonian pedicles to segments II and III and to control individual pedicles with surgical clips, whereas opt like to control glissonian pedicles simultaneously using endoscopic stapling devices. The aim of this study was to find the rationale of LLLS using endoscopic staples.

Methods: We retrospectively analyzed and compared the clinical outcomes (operation time, drainage length, transfusion, hospital stay, and complication rate) of 35 patients that underwent LLLS between April 2004 and February 2012. Patients were dichotomized by surgical technique based on whether glissonian pedicles were isolated and controlled (the individual group, n = 21) or controlled using endoscopic staples at once (the batch group, n = 14).

Results: Mean operation time was 265.3 ± 21.3 minutes (mean ± standard deviation) in the individual group and 170 ± 22.9 minutes in the batch group. Operation time in the batch group was significantly shorter than the individual group (P = 0.007). Mean drainage length was 4.8 ± 1.6 and 2.6 ± 1.5 days in the individual and the batch group. There was significantly shorter in the batch group, also (P = 0.006). No transfusion was required in the batch group, but 4 patients in the individual group needed transfusion. Mean hospital stay was 10.7 ± 1.1 and 9.4 ± 0.8 days in the individual and the batch groups (P = 0.460). There were no significant complications or mortality in both groups.

Conclusion: LLLS using endoscopic staples (batch group) was found to be an easier and safer technique without morbidity or mortality.

No MeSH data available.


Related in: MedlinePlus

Postoperative laboratory finding in the individual group and batch group. There was no significant difference between the individual and the batch group (A, P = 0.584; B, P = 0.617; C, P = 0.107). POD, postoperative day.
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Figure 7: Postoperative laboratory finding in the individual group and batch group. There was no significant difference between the individual and the batch group (A, P = 0.584; B, P = 0.617; C, P = 0.107). POD, postoperative day.

Mentions: The surgical results are summarized in Table 3 and Fig. 7. The Individual method was conducted in 21 patients and the batch method was conducted in 14. Mean operation time was 265.3 ± 21.3 minutes (mean ± standard deviation) and 170.0 ± 22.9 minutes in the individual and the batch group and mean operation time was significantly shorter in the batch group (P = 0.007). Mean drainage length was 4.8 ± 1.6 and 2.6 ± 1.5 days in the individual and the batch group. There was significantly shorter in batch group, also (P = 0.006). Mean postoperative hospital stay was 10.7 ± 1.1 and 9.4 ± 0.8 days in the individual and the batch group. There was not significant differences between the individual and the batch group (P = 0.460). No transfusion was required in the batch group, but 4 of 21 patients in the individual group needed a blood transfusion during surgery. Postoperative laboratory findings between the individual and the batch group were not statistically significant. One open conversion due to tumor rupture occured in the individual group. Three cases of postoperative atelectasis were encountered in the individual group but only one in the batch group. We did not experience gas embolism, bile leakage, postoperative bleeding, bile duct injury, or vascular injury in either group. There was no postoperative death (defined as death during first 90 postoperative days). The average number of the Endo-GIA we used in the batch group was 2.92 ± 0.14.


Rationale and surgical technique of laparoscopic left lateral sectionectomy using endoscopic staples.

Lee BH, Yun SS, Kim MK, Jung HK, Lee DS, Kim HJ - Ann Surg Treat Res (2014)

Postoperative laboratory finding in the individual group and batch group. There was no significant difference between the individual and the batch group (A, P = 0.584; B, P = 0.617; C, P = 0.107). POD, postoperative day.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127897&req=5

Figure 7: Postoperative laboratory finding in the individual group and batch group. There was no significant difference between the individual and the batch group (A, P = 0.584; B, P = 0.617; C, P = 0.107). POD, postoperative day.
Mentions: The surgical results are summarized in Table 3 and Fig. 7. The Individual method was conducted in 21 patients and the batch method was conducted in 14. Mean operation time was 265.3 ± 21.3 minutes (mean ± standard deviation) and 170.0 ± 22.9 minutes in the individual and the batch group and mean operation time was significantly shorter in the batch group (P = 0.007). Mean drainage length was 4.8 ± 1.6 and 2.6 ± 1.5 days in the individual and the batch group. There was significantly shorter in batch group, also (P = 0.006). Mean postoperative hospital stay was 10.7 ± 1.1 and 9.4 ± 0.8 days in the individual and the batch group. There was not significant differences between the individual and the batch group (P = 0.460). No transfusion was required in the batch group, but 4 of 21 patients in the individual group needed a blood transfusion during surgery. Postoperative laboratory findings between the individual and the batch group were not statistically significant. One open conversion due to tumor rupture occured in the individual group. Three cases of postoperative atelectasis were encountered in the individual group but only one in the batch group. We did not experience gas embolism, bile leakage, postoperative bleeding, bile duct injury, or vascular injury in either group. There was no postoperative death (defined as death during first 90 postoperative days). The average number of the Endo-GIA we used in the batch group was 2.92 ± 0.14.

Bottom Line: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery.There was significantly shorter in the batch group, also (P = 0.006).There were no significant complications or mortality in both groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

ABSTRACT

Purpose: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery. Some surgeons prefer to isolate glissonian pedicles to segments II and III and to control individual pedicles with surgical clips, whereas opt like to control glissonian pedicles simultaneously using endoscopic stapling devices. The aim of this study was to find the rationale of LLLS using endoscopic staples.

Methods: We retrospectively analyzed and compared the clinical outcomes (operation time, drainage length, transfusion, hospital stay, and complication rate) of 35 patients that underwent LLLS between April 2004 and February 2012. Patients were dichotomized by surgical technique based on whether glissonian pedicles were isolated and controlled (the individual group, n = 21) or controlled using endoscopic staples at once (the batch group, n = 14).

Results: Mean operation time was 265.3 ± 21.3 minutes (mean ± standard deviation) in the individual group and 170 ± 22.9 minutes in the batch group. Operation time in the batch group was significantly shorter than the individual group (P = 0.007). Mean drainage length was 4.8 ± 1.6 and 2.6 ± 1.5 days in the individual and the batch group. There was significantly shorter in the batch group, also (P = 0.006). No transfusion was required in the batch group, but 4 patients in the individual group needed transfusion. Mean hospital stay was 10.7 ± 1.1 and 9.4 ± 0.8 days in the individual and the batch groups (P = 0.460). There were no significant complications or mortality in both groups.

Conclusion: LLLS using endoscopic staples (batch group) was found to be an easier and safer technique without morbidity or mortality.

No MeSH data available.


Related in: MedlinePlus