ABSTRACT
OBJECTIVE: This study aimed to evaluate how cold ischemia time (CIT) interferes with liver graft function in the first 7 days after surgery for Custodiol (HTK) preserved organs. METHODS: This retrospective observational study analyzed the medical records of 38 transplantation patients at Hospital Leforte Liberdade, São Paulo, in 2018. The study population was divided into 2 groups (group A, CIT < 8 hours; group B, CIT > 8 hours). Postoperative parameters-such as international normalized ratio, total bilirubin, aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, gamma glutamyl transferase (GGT), lactate dehydrogenase, lactate, creatinine, red blood cell transfusion, need for hemodialysis, use of vasoactive drugs, endotracheal intubation time, length of stay in the intensive care unit (ICU), and length of hospital stay-were compared. RESULTS: Group A (CIT < 8 hours) presented less need for red blood cell transfusions (odds ratio 0.29; confidence interval 0.06-0.98; P = .04), had a shorter hospital stay (P = .024), and had lower levels of total bilirubin (P = .05) and GGT (P = .05) in the first 7 postoperative days. The other variables showed no statistically significant difference. CONCLUSION: In livers preserved with Custodiol, CIT > 8 hours generated higher levels of total bilirubin and GGT in the postoperative period, in addition to higher hospital costs; greater need for red blood cell transfusions; and longer hospitalization, including longer stays in the ICU.
Subject(s)
Cold Ischemia/methods , Liver Transplantation/methods , Organ Preservation Solutions/pharmacology , Organ Preservation/methods , Female , Glucose/pharmacology , Humans , Male , Mannitol/pharmacology , Middle Aged , Organ Preservation/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Potassium Chloride/pharmacology , Procaine/pharmacology , Reperfusion Injury/etiology , Retrospective StudiesABSTRACT
INTRODUCTION: Inguinal hernia is one of the most frequent surgical diseases. Currently, with the advantages of minimally invasive surgery, new questions arise: what will be the best approach for correction of inguinal hernia? Is there real benefit to the robotic approach? OBJECTIVE: To compile results of the published studies that used the robot-assisted technique in the repair of inguinal hernia, analyzing its limitations, complications and comparing it with those of the pre-existing techniques. METHOD: The review was performed from the Medline database with the following descriptors: (inguinal hernia repair OR hernioplasty OR hernia) AND (robot OR robotic OR robotic assisted) being retrieved 391 articles. After verification of the titles and abstracts, we identified eight series of cases congruent with the objectives of this review. Three reviewers participated in the extraction and selection of results. RESULTS: Comparative studies showed an increase in surgical time in relation to the open and videolaparoscopic approach. The complications present similar rates with the other repair routes. CONCLUSION: This technique has been shown to be effective for the correction of inguinal hernia, but the benefits of using robotic surgery are unclear. So, there is a need for randomized studies comparing laparoscopic to robotic repair.
Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/methods , Robotic Surgical Procedures/methods , Herniorrhaphy/adverse effects , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Operative Time , Postoperative Complications , Robotic Surgical Procedures/adverse effects , Treatment OutcomeABSTRACT
ABSTRACT Introduction: Inguinal hernia is one of the most frequent surgical diseases. Currently, with the advantages of minimally invasive surgery, new questions arise: what will be the best approach for correction of inguinal hernia? Is there real benefit to the robotic approach? Objective: To compile results of the published studies that used the robot-assisted technique in the repair of inguinal hernia, analyzing its limitations, complications and comparing it with those of the pre-existing techniques. Method: The review was performed from the Medline database with the following descriptors: (inguinal hernia repair OR hernioplasty OR hernia) AND (robot OR robotic OR robotic assisted) being retrieved 391 articles. After verification of the titles and abstracts, we identified eight series of cases congruent with the objectives of this review. Three reviewers participated in the extraction and selection of results. Results: Comparative studies showed an increase in surgical time in relation to the open and videolaparoscopic approach. The complications present similar rates with the other repair routes. Conclusion: This technique has been shown to be effective for the correction of inguinal hernia, but the benefits of using robotic surgery are unclear. So, there is a need for randomized studies comparing laparoscopic to robotic repair
RESUMO Introdução: A hérnia inguinal é uma das doenças cirúrgicas mais frequentes. Atualmente, com as vantagens da cirurgia minimamente invasiva, novas questões surgem: qual será a melhor abordagem para correção de hérnia inguinal? Existe benefício real com a abordagem robótica? Objetivo: Compilar resultados dos estudos publicados que utilizaram a técnica robô-assistida no reparo da hérnia inguinal analisando suas limitações, complicações e comparando-a com as das técnicas pré-existentes. Método: A revisão foi realizada a partir da base de dados do Medline com os seguintes descritores: (inguinal hernia repair OR hernioplasty OR hernia) AND (robot OR robotic OR robotic assisted) sendo recuperados 391 artigos. Após verificação dos títulos e resumos, identificou-se oito séries de casos congruentes com os objetivos desta revisão. Três revisores participaram do processo de extração e seleção de resultados. Resultados: Nos estudos comparativos demonstrou-se aumento no tempo cirúrgico em relação à via aberta e videolaparoscópica. As complicações apresentam taxas similares com as outras vias de reparo. Conclusão: Esta técnica demonstrou-se efetiva para correção da hérnia inguinal, mas os benefícios da utilização da cirurgia robótica não estão claros. Para isso, há a necessidade de trabalhos randomizados que comparem o reparo laparoscópico ao robotizado.
