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  • 1
    Language: English
    In: Journal of Gastrointestinal Surgery, Feb, 2010, Vol.14(1), p.46(12)
    Description: Byline: Ines Gockel (1), Stephan Timm (1), George G. Sgourakis (1), Thomas J. Musholt (1), Andreas D. Rink (1), Hauke Lang (1) Keywords: Myotomy; Achalasia; LES; Laparoscopic myotomy; Heller myotomy Abstract: Introduction Heller myotomy leads to good--excellent long-term results in 90% of patients with achalasia and thereby has evolved to the "first-line" therapy. Failure of surgical treatment, however, remains an urgent problem which has been discussed controversially recently. Materials and Methods A systematic review of the literature was performed to analyze the long-term results of failures after Heller's operation with emphasis on treatment by remedial myotomy. Discussion Other reinterventions and their causes after failure of surgical treatment in patients with achalasia are discussed. Author Affiliation: (1) Department of General and Abdominal Surgery, Johannes Gutenberg-University of Mainz, Langenbeckstr. 1, 55131, Mainz, Germany Article History: Registration Date: 25/08/2009 Received Date: 29/04/2009 Accepted Date: 25/08/2009 Online Date: 24/10/2009
    Keywords: Surgery -- Analysis
    ISSN: 1091-255X
    E-ISSN: 18734626
    Source: Cengage Learning, Inc.
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  • 2
    Language: English
    In: Journal of Gastrointestinal Surgery, Oct, 2009, Vol.13(10), p.1869(1)
    Description: Byline: Constantine Karaliotas (1), George Sgourakis (1) Keywords: Pancreatic insulinoma; Laparoscopic enucleation; Intraoperative ultrasound Abstract: Background Insulinomas, benign in the vast majority, are the prevailing pancreatic endocrine tumors amenable to surgical resection which is beneficial in most instances. This study aimed to compare the results of laparoscopic vs. open surgery enucleation of insulinomas. Methods From October 1999 to June 2008, 12 case series of enucleation for benign insulinoma in the body and tail of the pancreas were identified through retrospective review of medical records. Main outcome measures were recurrent hypoglycemia, conversion to open procedure, complications, and length of hospital stay. Results Seven patients were addressed with open and five with laparoscopic procedure. Mean age was 55 years (36--69). Lesions were identified preoperatively (via computed tomography and endoscopic ultrasonography) in 5/7 in the open and 4/5 in the laparoscopic group. Intraoperative ultrasound identified the rest of insulinomas. One conversion to the open approach was mandatory because the insulinoma was resting on the portal vein. The mean operative time and hospital stay was 92 min (66--126)/14 days (11--22) for the open and 121 min (89--187)/11 days (5--18) for the laparoscopic procedure (including conversion) (p〈0.5 in both comparisons). Pancreatic fistula rate was respectively 28.57% (2/7) and 20% (1/5) (p=0.65). Mortality was nil. Mean follow-up was 54 months (3--109). Recurrent hypoglycemia was documented in one patient of the laparoscopic group (p=0.46) but blood glucose concentrations remained stable with diazoxide. Conclusion Laparoscopic insulinoma enucleation seems to be a feasible and safe approach associated with reduction in hospital stay and comparable rates of pancreatic fistula in relation to open surgery. Author Affiliation: (1) 2nd Surgical Department and Surgical Oncology Unit of "Korgialenio--Benakio", Red Cross Hospital, 11 Mantzarou str., Neo Psychiko, 15451, Athens, Greece Article History: Registration Date: 12/06/2009 Received Date: 04/01/2009 Accepted Date: 12/06/2009 Online Date: 18/07/2009 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s11605-009-0954-z) contains supplementary material, which is available to authorized users.
    Keywords: Surgery
    ISSN: 1091-255X
    Source: Cengage Learning, Inc.
    Library Location Call Number Volume/Issue/Year Availability
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  • 3
    Language: English
    In: Journal of Gastrointestinal Surgery, 2010, Vol.14(Supplement 1), pp.46-57
    Description: Issue Title: Festschrift: Tom R. DeMeester Heller myotomy leads to good-excellent long-term results in 90% of patients with achalasia and thereby has evolved to the "first-line" therapy. Failure of surgical treatment, however, remains an urgent problem which has been discussed controversially recently. A systematic review of the literature was performed to analyze the long-term results of failures after Heller's operation with emphasis on treatment by remedial myotomy. Other reinterventions and their causes after failure of surgical treatment in patients with achalasia are discussed.[PUBLICATION ]
    Keywords: Myotomy ; Achalasia ; LES ; Laparoscopic myotomy ; Heller myotomy
    ISSN: 1091-255X
    E-ISSN: 1873-4626
    Library Location Call Number Volume/Issue/Year Availability
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  • 4
    Language: English
    In: Journal of Gastrointestinal Surgery, 2009, Vol.13(10), pp.1869-1869
    Description: BACKGROUND: Insulinomas, benign in the vast majority, are the prevailing pancreatic endocrine tumors amenable to surgical resection which is beneficial in most instances. This study aimed to compare the results of laparoscopic vs. open surgery enucleation of insulinomas.METHODS: From October 1999 to June 2008, 12 case series of enucleation for benign insulinoma in the body and tail of the pancreas were identified through retrospective review of medical records. Main outcome measures were recurrent hypoglycemia, conversion to open procedure, complications, and length of hospital stay.RESULTS: Seven patients were addressed with open and five with laparoscopic procedure. Mean age was 55 years (36-69). Lesions were identified preoperatively (via computed tomography and endoscopic ultrasonography) in 5/7 in the open and 4/5 in the laparoscopic group. Intraoperative ultrasound identified the rest of insulinomas. One conversion to the open approach was mandatory because the insulinoma was resting on the portal vein. The mean operative time and hospital stay was 92 min (66-126)/14 days (11-22) for the open and 121 min (89-187)/11 days (5-18) for the laparoscopic procedure (including conversion) (p 〈 0.5 in both comparisons). Pancreatic fistula rate was respectively 28.57% (2/7) and 20% (1/5) (p = 0.65). Mortality was nil. Mean follow-up was 54 months (3-109). Recurrent hypoglycemia was documented in one patient of the laparoscopic group (p = 0.46) but blood glucose concentrations remained stable with diazoxide.CONCLUSION: Laparoscopic insulinoma enucleation seems to be a feasible and safe approach associated with reduction in hospital stay and comparable rates of pancreatic fistula in relation to open surgery.
    Keywords: Pancreatic insulinoma ; Laparoscopic enucleation ; Intraoperative ultrasound
    ISSN: 1091-255X
    E-ISSN: 1873-4626
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
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