The resection in partial pancreatico-duodenectomy as the standard treatment for malignancies of the pancreatic head is commonly performed starting from the hepatoduodenal ligament after division of the bile duct, stomach, or proximal duodenum and pancreatic body. The "Uncinate First" approach is a technical modification with a retrograde dissection of the ...

Although laparoscopic pancreatic resections have become more common, laparoscopic minimally invasive and function-preserving pancreatic resections have not been widely accepted. Branch-type intraductal papillary mucinous neoplasm (IPMN) has a low-grade malignant potential and shows a favorable prognosis. In branch-type IPMN, minimal resection techniques with preservation of the pancreatic functional reserve have ...

Background  Verrucous carcinoma (VC) of the anogenital area is an uncommon variant of squamous cell carcinoma (SCC). Its treatment is not standardized, but surgical excision must be performed if possible. The traditional approach does not distinguish between conventional SCC and VC, despite the extremely low metastatic potential of VC. Accordingly, ...

Background/Aims: Although laparoscopic hepatectomy is increasingly performed for hepatocellular carcinoma, few studies have investigated the efficacy of laparoscopic surgery, including hepatectomy for the treatment of recurrent hepatocellular carcinoma. We report the results of our study on the efficacy of laparoscopic surgery. Methodology: Forty-three of 123 hepatocellular carcinoma patients underwent laparoscopic ...

Abstract Purpose: Laparoscopic colorectal surgery creates fewer adhesions compared with open colorectal resection. Small bowel obstruction after laparoscopic colorectal resection may be caused by internal herniation of the small bowel through a colomesenteric defect, probably related to a lack of adhesion formation. This is seen especially after left colonic resections. ...

OBJECTIVE: Thoracoscopic dissection of the esophagus and laparoscopic dissection of the stomach with cervical esophagogastric anastomosis is a safe method for resection of esophageal and gastroesophageal junction malignancy. SETTING: The setting was at University Tertiary Care Center. PATIENTS: Subjects are patients with esophageal or gastroesophageal junction malignancy undergoing minimally invasive ...

Background/Aims: To determine the safety and the efficacy of total pancreatectomy for the curative treatment of pancreatic carcinoma. Methodology: Retrospective analysis was performed using 10 patients receiving total pancreatectomy. Results: The median duration of the operative procedure was 8.7 hours and the median estimated blood loss was 2,700mL. Seven patients ...

The colorectum is known to be the most difficult organ to perform endoscopic submucosal dissection (ESD), however, the training has not been sufficiently established. In our hospital, the essential condition to start colorectal ESD was to experience at least 30 gastric ESD and to have sufficient knowledge and techniques beforehand. ...

We evaluated risk factors for residual neoplasia on first follow-up endoscopy after colonic endoscopic mucosal resections (EMRs). This retrospective study in a high-volume EMR tertiary-referral center examined EMRs on 423 colonic lesions in 313 patients. Residual neoplasia at first follow-up endoscopy was present following 12% of colonic EMRs. Single-variable analysis ...

Colonoscopy is the best method for the diagnosis, treatment, and follow-up of colorectal cancer. Although it is generally considered a safe procedure, complications during colonoscopy may occur. The most serious complication is iatrogenic perforation of the colon. Although rare, it can be potentially lethal, especially when it is not recognized ...

BACKGROUND: Radical rectal resection with total mesorectal excision is the current standard of care for the operative treatment of rectal cancer. Local excision is an acceptable alternative in selected patients with early disease (T(is)0-T(1)) and low-risk features, in whom radical resection may be associated with unacceptably high morbidity. With recent ...

ABSTRACT: BACKGROUND: Single-port laparoscopic surgery is a new technique that leaves no visible scar. This new technique has generated strong interest among surgeons worldwide. However, single-port laparoscopic colon surgery has not yet been standardized. Our aim in this study was to evaluate the feasibility of single-port laparoscopic colectomy compared with ...

Background and study aims: Endoscopic submucosal dissection (ESD) in the colorectum is not currently a standard procedure. Few data are available from the Western world. The aim of the present study was to report on the first experiences and the learning curve of colorectal ESD in a European center.Patients and ...

Background/Aims: To summarize the experience of diagnosis and surgical treatment of mucin-producing bile duct tumors (MPBTs). Methodology: A retrospective analysis was undertaken to determine the radiography characteristics and results of surgical treatment of MPBTs over the past 9 years. Only eight patients underwent such treatment. The detailed data of diagnosis, ...

In locally advanced pancreatic body cancers, cancer infiltrates major vessels such as the celiac axis, common hepatic artery and superior mesenteric artery or vein, which is the borderline of resectability. Patients also suffer severe abdominal pain. Kondo and Hirano et al. developed a radical operation called "distal pancreatectomy with en ...

PURPOSE: Outcomes of complex surgical procedures tend to be better for high volume providers, although this has not been clearly established for renal cell carcinoma. We determined the relationship of provider volume with partial nephrectomy and morbidity for renal cell carcinoma treatment. MATERIALS AND METHODS: We performed a population based, ...

Aim:  We surveyed multiple centers to identify types and frequency of complications and mortality rate associated with radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Methods:  We distributed a questionnaire developed by members of the Chugoku-Shikoku Society for the Local Ablation Therapy of Hepatocellular Carcinoma to 20 centers and analyzed types ...

Pancreatic and esophageal cancers are both gastrointestinal malignancies with relatively low long term survival. In part, the aggressiveness of these tumors is related to local and distant metastatic potential, subsequently affecting prognosis and treatment modalities. Currently, the mainstay of staging involves in-depth radiographic imaging with surgery offered for potentially curative ...

: Laparoscopic surgery has extended its applications to resection of malignancies with favorable results. We report the first successful simultaneous laparoscopic subtotal colectomy and pancreaticoduodenectomy (PD) in a patient with familial adenomatous polyposis (FAP). : A 37-year-old man presented with obstructive jaundice. Gastroscopy and biopsies revealed a large ampullary tubulovillous ...

Currently, no recommendations exist for the endoscopic screening of patients in adulthood, with surgically corrected esophageal atresia (EA), for the development of esophageal cancer. A small number of individual case reports in the literature have raised concern that these cancers pose an increased risk (2 adenocarcinoma and 3 squamous cell ...

Spontaneous perforation of the colon is a rare complication in neonates with anorectal malformations (ARMs). There are no detailed studies concerning this complication. A retrospective review of hospital records between 1994 and 2010 revealed 8 cases of bowel perforation among 136 cases of ARM. Eighteen additional cases were culled from ...

Most gallbladder carcinoma cases are suspected pre-operatively or intra-operatively. In Malaysia histopathological examination of cholecystectomy specimens has become routine practice. The aim of this study was to assess the impact of routine histological examinations on cholecystectomy specimens from an Asian demographic, which may differ from a Caucasian demographic. A retrospective ...

Background and Aim:  Endoscopic definitions of Barrett's esophagus (BE) vary among countries, mainly because of the difficulty in diagnosing short-segment BE (SSBE) endoscopically. The aim of this study was to investigate whether the endoscopic identification of squamous islands and the specific position of columnar epithelium helps improve the diagnosis of ...

OBJECTIVE: To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. STUDY DESIGN: Retrospective case series. ANIMALS OR SAMPLE POPULATION: Geldings (8) with cystic calculi. METHODS: After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was ...

Aims: To assess the feasibility of a flexible thulium laser coupled with a novel robotic introducer for head and neck cancers. Methods: In a prospective nonrandomized clinical trial, 58 patients were evaluated. When indicated, transoral robotic surgery (TORS) with laser was performed using an Intuitive da Vinci S System with ...

The standardisation of the surgical management of rectal cancer has been facilitated by adoption of an anatomic surgical nomenclature. Thus, "total mesorectal excision" substituted "anterior resection" or "proctosigmoidectomy" and implies resection of both rectum and mesorectum. Similar trends towards standardisation of colonic surgery are ongoing, yet there remains a heterogeneity ...

Aim:  The aim of this study is to audit our outcomes and experience of colonic stent insertion for malignant bowel obstruction. Method:  Retrospective audit of all stent insertions in a single district general hospital between August 2003 and December 2009. All patients had presented with acute bowel obstruction caused by ...

INTRODUCTION: Laparoscopy is an accepted treatment for colorectal cancer and liver metastases, but there is no consensus for its use in the management of synchronous liver metastases (SCRLM). The purpose of this study was to evaluate totally laparoscopic strategies in the management of colorectal cancer with synchronous liver metastases. METHODS: ...

Background and Aim:  A single operator cholangiopancreatoscopy was developed to overcome a problem in conventional peroral cholangiopancreatoscopy. The aim of this pilot study was to clarify the clinical utility of single operator cholangiopancreatoscopy using a SpyGlass probe through an endoscopic retrograde cholangiopancreatography catheter. Methods:  Patients undergoing ERCP with a SpyGlass ...

BACKGROUND: Free tissue reconstruction after ablation of head and neck malignancy often requires extensive cervical manipulation, which may exacerbate preexisting cervical spondylosis and result in progression to cervical myelopathy. We present a rare case of postoperative quadriplegia caused by cervical spondylotic myelopathy after head and neck reconstruction. METHODS AND RESULTS: ...

INTRODUCTION: Achieving hemostasis in laparoscopic nephron sparing surgery (LNSS), a technically demanding procedure, is challenging. Absorbable hemostatic agents, such as oxidized regenerated cellulose (ORC) are frequently used for hemostasis in laparoscopic nephron sparing surgery. Retention of this material is a very rare situation. PRESENTATION OF THE CASE: We are presenting ...

In advanced cancers of hepatobiliary and pancreatic lesions, major vascular resection and reconstruction are necessary to accomplish curative resection. Stenosis of vascular anastomosis is a concern in case of portal or superior mesenteric venous anastomosis with different vascular calibers. We attempted to apply parachute anastomosis in such a situation, which ...

BACKGROUND: When endometriosis infiltrates more than 5 mm beneath the peritoneum it is called deeply infiltrating endometriosis and may involve the bladder. Only 1-2% of women with endometriosis have urinary involvement, mainly in the bladder. Resectoscopic transurethral resection alone is no longer recommended because of the surgical risks and recurrence. Usually ...

Retroileal colorectal anastomosis is an infrequently used technique providing tension-free anastomosis after extended left-sided colonic resection, which was first described by Turnbull in 1972. The authors describe the use of a retroileal colorectal anastomosis in a patient with chronic Candida albicans and Enterococcal retroperitoneal abscess. The patient's condition was most ...

Objective: To report an uncommon method of managing pancreatic fistulas and retroperitoneal abscess. Clinical Presentation and Intervention: A 50-year-old man was admitted with fever, abdominal pain, periumbilical fistula and pus in stool. Five months before admission, he underwent urgent necrosectomy (7 days after onset of pain) and subsequently two more ...

BACKGROUND: Meticulous mediastinal lymphadenectomy frequently induces recurrent laryngeal nerve palsy (RLNP). Surgical robots with impressive dexterity and precise dissection skills have been developed to help surgeons perform operations. The objective of this study was to determine the impact on short-term outcomes of robot-assisted thoracoscopic radical esophagectomy performed on patients in ...

Vaginal reconstructive options commonly include the use of split-thickness skin grafts or intestinal conduits. When a colonic segment is chosen, the sigmoid colon is favored because of its location, size, and durability. When circumstances preclude the use of sigmoid colon and a colonic conduit is preferred, creative means of mobilization ...

Abstract Background: Morbidity and mortality remain relatively high for transthoracic esophagectomy with open thoracotomy. The literature is limited in describing the total combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy. The aim of this study is to evaluate the outcomes of combined thoracoscopic and laparoscopic Ivor Lewis esophagectomy for the treatment ...

Replacing the thoracic esophagus with the colon is one mode of reconstruction after esophagectomy for esophageal cancer. There is, however, a high incidence of postoperative necrosis of the transposed colon. This study evaluated the outcomes of colon interposition with the routine use of superdrainage by microvascular surgery. Twenty-one patients underwent ...

Background/Aims: Transanal endoscopic microsurgery is a minimally invasive approach for rectal lesions. Superior exposure and access to the entire rectum result in lesser risk of compromised margin and lower recurrence rates compared to conventional transanal excision. It was aimed at describing a single institution's initial experience with transanal endoscopic microsurgery. ...

Background  The choice between pneumatic dilation and surgical myotomy is mainly determined by the preference and expertise of the treating physician. Ideally, however, treatment should be personalized to provide the optimal clinical outcome. The introduction of high resolution manometry has not only improved the specificity to diagnose achalasia, but also ...

Background  Symptom based diagnosis is not reliable in patients with swallowing problems, heartburn, and other dyspeptic complaints. The aim of investigation is to provide clinically relevant measurements of gastrointestinal structure and function that explain the cause of symptoms, identify pathology, and guide effective management. Current practice rarely meets these ideals. ...

BACKGROUND: The aim of this meta-analysis is to evaluate the effect of stenting the pancreatic duct during pancreaticojejunostomy formation on perioperative outcomes. METHODS: Primary outcome measures were operative mortality and pancreatic fistula. Secondary outcomes were length of hospital stay, reoperation, delayed gastric emptying, estimated blood loss, and length of operation. ...

Objective: To evaluate the usefulness of fistulography as a diagnostic and management tool for clinically suspected pancreatic fistulas (PF) after pancreaticoduodenectomy (PD). Methods: 84 consecutive fistulographies were performed for clinical suspicion of PF and retrospectively analysed. We radiologically defined two types of PF by means of fistulography, PF1 in the ...

The widespread adoption of laparoscopic colorectal surgery has rekindled the debate on the optimal postoperative methods for analgesia after major bowel resection.

: Process and outcome measures for quality assessment of colorectal surgical care are poorly defined. : The aim of this study was to develop candidate end points for use in surgeon-specific registries designed for case reporting and quality improvement program development. : The study design was based on modified Delphi-based ...

Rhinophyma is a subtype of rosacea which develops at the advanced stage of rosacea and is characterized by an excessive enlargement of the sebaceous glands. Its etiology is not well-defined beyond the following usual suspects: vitamin deficiencies, stress, hormonal factors and the Demodex folliculorum mite. Carcinoma may develop in rhinophyma ...

Chemoradiation is increasingly being used to treat locally advanced head and neck carcinomas. Possible rare complications of this treatment modality have begun to appear, as the number of treated patients increase. In this report, we present a case who underwent chemoradiation due to T3N3M0 tonsil cancer and developed necrotizing fasciitis ...

Pancreatic-pleural fistula is a rare condition and few data related to its diagnosis and treatment are available. A fistulous connection linking the pancreas with the pleura via the diaphragm or mediastinum through the retroperitoneal area is formed. We report on a case with pancreatic-pleural fistula at its early stages in ...

BACKGROUND: Despite the advantages of laparoscopic colon surgery, the need for an incision in the abdominal wall to remove the surgical specimen is a morbidity factor. The objective of this article is to introduce transvaginal specimen extraction after laparoscopic colectomy, in order to avoid an abdominal incision. METHODS: Between 2008 ...