Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Langenbecks Arch Surg ; 408(1): 317, 2023 Aug 17.
Article in English | MEDLINE | ID: mdl-37587225

ABSTRACT

BACKGROUND: Reducing clinically relevant post-operative pancreatic fistula (CR-POPF) incidence after pancreatic resections has been a topic of great academic interest. Optimizing post-operative drain management is a potential strategy in reducing this major complication. METHODS: Studies involving pancreatic resections, including both pancreaticoduodenectomy (PD) and distal pancreatic resections (DP), with intra-operative drain placement were screened. Early drain removal was defined as removal before or on the 3rd post-operative day (POD) while late drain removal was defined as after the 3rd POD. The primary outcome was CR-POPF, International Study Group of Pancreatic Surgery (ISGPS) Grade B and above. Secondary outcomes were all complications, severe complications, post-operative haemorrhage, intra-abdominal infections, delayed gastric emptying, reoperation, length of stay, readmission, and mortality. RESULTS: Nine studies met the inclusion criteria and were included for analysis. The studies had a total of 8574 patients, comprising 1946 in the early removal group and 6628 in the late removal group. Early drain removal was associated with a significantly lower risk of CR-POPF (OR: 0.24, p < 0.01). Significant reduction in risk of post-operative haemorrhage (OR: 0.55, p < 0.01), intra-abdominal infection (OR: 0.35, p < 0.01), re-admission (OR: 0.63, p < 0.01), re-operation (OR: 0.70, p = 0.03), presence of any complications (OR: 0.46, p < 0.01), and reduced length of stay (SMD: -0.75, p < 0.01) in the early removal group was also observed. CONCLUSION: Early drain removal is associated with significant reductions in incidence of CR-POPF and other post-operative complications. Further prospective randomised trials in this area are recommended to validate these findings.


Subject(s)
Intraabdominal Infections , Pancreatectomy , Humans , Pancreatectomy/adverse effects , Device Removal , Pancreas , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Postoperative Hemorrhage/epidemiology , Postoperative Hemorrhage/etiology
2.
Surg Oncol ; 35: 382-387, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33035786

ABSTRACT

BACKGROUND: We report a single surgeon experience with laparoscopic repeat liver resection (LRLR), and analyse short-term outcomes relative to laparoscopic primary liver resection (LPLR). METHODS: Two-hundred and twenty-two laparoscopic liver resections were performed from 2012 to 2019 of which 33 were LRLR. 1:2 propensity-score matching was done to compare 32 LRLR with 64 LPLR cohort. We further analyzed the first 16 LRLR cases compared to the subsequent 17 cases. RESULTS: 32 LRLR cases were matched to 64 LPLR cases. Apart from a higher frequency of Pringle maneuver in the LPLR cohort (p = 0.006), there were no differences in other perioperative outcomes. There were more posterosuperior located tumours (75.0% vs 17.6%, p = 0.003) and higher median difficulty score (8.50 vs 5.00, p = 0.025) in the initial 16 LRLR cases compared to the next 17. The earlier group had higher median blood loss (250.00 ml vs 50.00 ml, p = 0.012), but other outcomes were similar. CONCLUSION: LRLR may be safely performed in selected patients with no difference in key perioperative outcomes compared to LPLR.


Subject(s)
Hepatectomy/methods , Laparoscopy/statistics & numerical data , Liver Neoplasms/surgery , Aged , Aged, 80 and over , Female , Humans , Laparoscopy/methods , Male , Middle Aged , Neoplasm Recurrence, Local/surgery , Perioperative Period , Propensity Score , Surgeons , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...