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  • Review ArticleMarch 15, 2022

    5 345 591

    Surgical outcomes of various surgical approaches for transverse colon cancer

    Hyo Jun Kim , Ji Won Park

    Journal of Minimally Invasive Surgery 2022; 25(1): 1-6 https://doi.org/10.7602/jmis.2022.25.1.1
    Abstract

    The transverse colon has anatomical peculiarities in the middle position between the foregut and the midgut. Because the transverse colon harbors a flexure at both ends, mobilization of the transverse colon can be especially challenging compared with other colons. Although transverse colon cancer is relatively uncommon, an optimal surgical management for transverse colon cancer must be established. In transverse colon cancer, proximity to the pancreas and variation in arterial and venous anatomy make radical resection more difficult. Dissection of lymph nodes around the middle colic vessels is a critical step in transverse colon cancer resection. The proximity of the middle colic vessels to the superior mesenteric vessels contributes to the complexity of this step, making it challenging for less-trained surgeons. For these reasons, patients with transverse colon cancer were not included in most landmark studies that compared laparoscopic surgery with open surgery. More radical operations, such as subtotal colectomy or extended right or left hemicolectomy, can be performed for transverse colon cancer to secure an adequate lymphadenectomy. Such cancers have also been treated with limited segmental colectomies, such as right, transverse, or left colectomy. Currently, there is still a lack of standardized definitions and procedures. Therefore, it is time to discuss and establish optimal surgical treatments for transverse colon cancer.

  • EditorialMarch 15, 2022

    0 142 249

    At present, the optimal treatment for common bile duct (CBD) stones combined with gallstones is still controversial. The two most widely accepted techniques are one-stage laparoscopic CBD exploration plus laparoscopic cholecystectomy (LC) and two-stage preoperative endoscopic sphincterotomy plus LC. Considering that all current evidence comes from nonrandomized controlled trials, multicenter randomized controlled trials are needed to further establish the treatment strategy for elderly patients with CBD stones combined with gallstones.

  • EditorialMarch 15, 2022

    0 168 249

    The incidence and risk factors of incisional hernia after laparoscopic surgery for colorectal disease have not yet been fully investigated. The surgeon should always consider several potential risk factors of incisional hernia when closing the abdominal wall in laparoscopic colorectal surgery.

  • Original ArticleMarch 15, 2022

    6 352 331
    Abstract

    Purpose: This study was performed to compare the safety and efficacy of one-stage laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC) with those of endoscopic sphincterotomy (EST) plus LC for concomitant gallbladder (GB) and common bile duct (CBD) stones in elderly patients.
    Methods: This single-center retrospective study reviewed the medical records of patients aged >80 years who were diagnosed with concomitant GB and CBD stones between January 2010 and December 2020.
    Results: Of the 137 patients included in this study, 46 underwent one-stage LCBDE + LC and 91 underwent two-stage EST + LC. The frequency of previous gastrectomy (23.9% vs. 5.5%, p = 0.002) and multiple stones (76.1% vs. 49.5%, p = 0.003) was higher in the LCBDE + LC group than in the EST + LC group. Further, patients in LCBDE + LC group had larger CBD stones (11.9 mm vs. 6.0 mm, p < 0.001). There were no significant differences in the clearance (91.3% vs. 95.6%, p = 0.311) and recurrence (4.3% vs. 8.8%, p = 0.345) rates between the groups. The incidence of posttreatment overall complications (17.4% vs. 22.0%, p = 0.530) and total hospital stay (12.7 days vs. 11.7 days, p = 0.339) were similar in the two groups.
    Conclusion: One-stage LCBDE + LC is a safe and effective treatment for concomitant GB and CBD stones, even in elderly patients, and may be considered as the first treatment option in elderly patients with previous gastrectomy, multiple large (≥ 15 mm) CBD stones, or inability to cooperate with endoscopic procedures.

  • Original ArticleMarch 15, 2022

    5 389 422
    Abstract

    Purpose: Totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are laparoscopic techniques frequently used in inguinal hernia surgeries. There are very few studies directly comparing the outcomes of TEP and TAPP. The present study compared both techniques’ technical aspects, intraoperative and postoperative early complications.
    Methods: In this study, 108 patients diagnosed with inguinal hernia underwent laparoscopic surgery between May 2016 and December 2020. Seventy six of these patients (70.4%) underwent TEP, and 32 (29.6%) underwent TAPP. This study was retrospective. However, the data were registered prospectively (including video recordings).
    Results: No significant difference was found between the groups regarding age, sex, body mass index, American Society of Anesthesiologist physical status classification, and duration of hospitalization. Although the TEP group had a higher overall complication rate than TAPP, the difference between the two groups was not significant (TEP, 9.2% vs. TAPP, 3.1%, p = 0.979). Two conversions and two recurrences (2.6% each) were observed in TEP. The hematoma was seen in one case in both techniques (3.1% vs. 1.3%, p = 0.665), respectively. A patient in the TEP group developed a pseudoaneurysm and was treated with endovascular embolization.
    Conclusion: In our study, conversion and intraoperative early postoperative complications were more prevalent in TEP than TAPP. On the other hand, no significant difference was determined between the results of the two techniques. It has been found that TAPP is as safe as TEP in inguinal hernia surgery; however, the superiority of one method over the other was not observed in this study.

  • Original ArticleMarch 15, 2022

    3 287 295

    Risk factors of incisional hernia after laparoscopic colorectal surgery with periumbilical minilaparotomy incision: a propensity score matching analysis

    Yoonhong Kim , Ki Hyun Kim , Kyung Won Seo , Seung Hun Lee , Gyung Mo Son

    Journal of Minimally Invasive Surgery 2022; 25(1): 24-31 https://doi.org/10.7602/jmis.2022.25.1.24
    Abstract

    Purpose: Incisional hernia is one of the most common complications after abdominal surgery conducted through a midline incision. Considerable debate remains regarding the design, comorbidity, suture material, and method. We investigated the risk factors for incisional hernia after laparoscopic colorectal surgery in the presence of limited surgery-related factors.
    Methods: A retrospective study was designed with 541 patients who underwent laparoscopic colorectal surgery performed by a single operator from January 2015 to December 2017. Due to open conversions, other abdominal operations, or follow-up loss, only 445 patients were included in the study. After propensity score matching, 266 patients were included. The study was based on diagnosis of incisional hernia on computed tomography at 6 and 12 months postoperatively.
    Results: Of the 266 total patients, 133 underwent abdominal closure using PDS (Ethicon), while the remaining 133 underwent closure with Vicryl (Ethicon). Of these patients, nine were diagnosed with incisional hernia at the 12-month follow-up: six (4.5%) in the Vicryl group and three (2.3%) in the PDS group (p = 0.309). The incidence of incisional hernia was significantly increased in females (odds ratio [OR], 15.233; 95% confidence interval [CI], 1.905–121.799; p = 0.010), in patients with body mass index (BMI) of >25 kg/m2 (OR, 4.740; 95% CI, 1.424–15.546; p = 0.011), and in patients with liver disease (OR, 19.899; 95% CI, 1.614–245.376; p = 0.020).
    Conclusion: BMI of >25 kg/m2, female, and liver disease were significant risk factors for incisional hernia after elective laparoscopic colorectal surgery performed through a transumbilical minilaparotomy incision.

  • Case ReportMarch 15, 2022

    1 238 354

    Dome-type carcinoma of the rectum mimicking a submucosal tumor: a case report and literature review

    Byeong-Joo Noh , Sun Jin Park , Jae-Young Jang , Youn Wha Kim

    Journal of Minimally Invasive Surgery 2022; 25(1): 32-35 https://doi.org/10.7602/jmis.2022.25.1.32
    Abstract

    Dome-type carcinoma (DC) has been recognized as a rare variant of adenocarcinoma, which arises in gut-associated lymphoid tissue. It has a specific morphologic feature of a dome-like protrusion associated with lymphoid tissue. We report a case of a DC of the rectum in an asymptomatic 58-year-old male. A 2-cm sized, well-demarcated, round mass masquerading as a submucosal tumor (SMT) was identified in the rectum and was resected by endoscopic submucosal dissection. The tumor was revealed as an adenocarcinoma with submucosal invasion of 3,700 μm, which consisted of dilated cystic glands and the lymphoid stroma with reactive germinal centers. On immunohistochemistry, the tumor cells revealed retained expression for mismatch repair proteins. Laparoscopic surgical resection was subsequently performed. DC is considered a distinctive subtype of colorectal adenocarcinoma with characteristic morphology and lowgrade malignant potential. Careful detection of the overlying mucosal lesion is crucial to differentially diagnose DC from SMT.

  • Video/Multimedia ArticleMarch 15, 2022

    1 466 315

    Prevention and management of intraoperative complication during single incision laparoscopic totally extraperitoneal repair

    Sungwoo Jung , Jin Ho Lee , Jae Uk Chong , Hyung Soon Lee

    Journal of Minimally Invasive Surgery 2022; 25(1): 36-39 https://doi.org/10.7602/jmis.2022.25.1.36
    Abstract

    Serious complications related to hernia surgeries have rarely been reported. One meta-analysis comparing laparoscopic and open mesh repair reported that 0.4% of potentially serious operative complications were reported. Previous studies have reported that uncommon serious intraoperative complications more frequently occur during laparoscopic inguinal hernia repairs. One study has shown that patients with history of lower abdominal surgery are at an increased risk of visceral injury during laparoscopic hernia repair. Vascular injuries at dissection and mesh fixation or suturing in the preperitoneal space typically involve the epigastric or aberrant obturator vessels crossing the Cooper’s ligament. However, complications can occur at every step of the operation, although only few are reported. Therefore, we report our experiences of intraoperative complications during single-incision laparoscopic totally extraperitoneal hernia repair and how to prevent and manage intraoperative complications.

JMIS
Mar 15, 2024 Vol.27 No.1
pp. 1~54

Archives

Journal of Minimally Invasive Surgery

pISSN 2234-778X
eISSN 2234-5248