|1.||A comparison of laparoscopic and conventional surgery for colorectal cancers: Evaluation of initial experience|
Süleyman Çetinkünar, Recep Aktimur, Faik Yaylak, Yılmaz Polat, Kadir Yıldırım
doi: 10.14744/less.2014.36855 Pages 25 - 29
INTRODUCTION: The aim of this study was to analyze initial experience with laparoscopic colorectal resection at 1 center and compare it with conventional open surgery.
METHODS: In this retrospective, case-controlled study, prospective data of colorectal cancer patients was analyzed retrospectively. Fifteen laparoscopic (3 right, 6 left, and 6 rectal) and 15 open (3 right, 6 left, and 6 rectal) colorectal resections were analyzed with respect to patient demographics, pathological characteristics, and early postoperative complications.
RESULTS: Mean operating time was longer in laparoscopic group (227±83.9 min vs. 174.6±54.7 min; p=0.077). Mean estimated blood loss was lower in laparoscopic group compared with open group (215.3±97 mL vs. 223.3±56 mL; p=0.500). In the laparoscopic group, number of lymph nodes and metastatic lymph nodes retrieved was higher than in open group (18±8.3 and 14.7±3.3, 1.1±2.1 and 0.8±1.3, respectively; p=0.243 and p=0.692). Overall early postoperative complication rate was 23.3%. Surgical site infection was seen in 6 patients (20%): 4 in the open surgery group, and 2 in the laparoscopic group. In 1 patient, after laparoscopic total mesorectal excision for rectal cancer, anastomotic leakage was seen and managed successfully with conservative methods.
DISCUSSION AND CONCLUSION: Early results in laparoscopic colorectal surgery were comparable to open approach. Laparoscopic surgery for colorectal cancer is a feasible option, even in the surgeons learning period.
|2.||Single stage treatment of cholelithiasis and choledocholithiasis: Report of first cases with combined endoscopic and laparoscopic technique|
Evren Dilektaşlı, Nizamettin Demirci, Mehmet Fatih Erol, Mehmet Emrah Bayam, Deniz Tihan, Hacı Murat Çaycı, Uğur Duman
doi: 10.14744/less.2014.43534 Pages 30 - 33
INTRODUCTION: There are still many controversies in the treatment of cholecysto-choledocholithiasis. When cholelithiasis is present with concomitant choledochus stone, both choledochus clearance and cholecystectomy have been advised in recent guidelines. However, the sequence and whether there should or should not be an interval between the 2 procedures is still debated.
METHODS: Data of 10 patients who underwent endoscopic retrograde cholangio pancreatography (ERCP) and laparoscopic cholecystectomy in same session between 2012 and 2013 were retrieved and analyzed.
RESULTS: Feasibility of combination of procedures, under the same general anesthesia was examined.
DISCUSSION AND CONCLUSION: Analysis of first 10 cases suggests that single session ERCP and laparoscopic cholecystectomy is safe and feasible means of managing cholecysto-choledocholithiasis. No increase in complication rate, operation time, or hospital stay was found.
|3.||Lumbar hernia repair: Myth or reality?|
Aziz Sümer, Ediz Altınlı, Ersan Eroğlu, Mehmet Ali Uzun, Serkan Senger
doi: 10.14744/less.2013.69775 Pages 34 - 38
INTRODUCTION: The purpose of this study was to present and share experience with lumbar hernia repair.
METHODS: Between 2004 and 2013, 5 lumbar hernia repairs were performed. Mean follow-up period was 41 months, and no recurrence was encountered.
RESULTS: Following the repair, results were good with respect to body balance, but cosmetic results, even with laparoscopic approach, were questionable.
DISCUSSION AND CONCLUSION: Lumbar hernia should be repaired, but results are not 100% reliable. Patients will have good results for body balance following the repair, but cosmetic results, even in laparoscopic approach, are less satisfactory.
|4.||Laparoscopic repair of Morgagni hernia in adults: Report of 2 cases|
M. Mahir Özmen, T. Tolga Şahin, Serkan Özen, Şahnaz Isgenderova, Emir Güldoğan, Emre Gündoğdu
doi: 10.14744/less.2014.21939 Pages 39 - 42
Morgagni hernia is a congenital, retrosternally situated, diaphragmatic defect usually seen on the right, but which may also affect the left side. It is very rare in adulthood and old age. As result of developing techniques in laparoscopy, congenital diaphragmatic hernia can now be repaired with minimally invasive means. Presently described are cases of 2 elderly female patients with subtle abdominal symptoms incidentally diagnosed with Morgagni hernia after abdominal computed tomography scan. Both patients were operated on using minimally invasive approach and laparoscopic repair was performed with synthetic material reinforcement in both cases. Patients were discharged after uneventful postoperative period. In conclusion, laparoscopic repair can be performed safely in selected cases at centers experienced in advanced laparoscopy.
|5.||Laparoscopic adrenalectomy for metastatic adrenal cancer with vena cava inferior resection|
Nihat Aksakal, Mustafa Tükenmez, Selim Doğan, Orhan Ağcaoğlu, Umut Barbaros, Yeşim Erbil, Rıdvan Seven, Selçuk Özarmağan, Selçuk Mercan
doi: 10.14744/less.2013.80299 Pages 43 - 45
The adrenal glands are a potential site of metastasis for various malignancies. Although laparoscopic adrenalectomy is the gold standard approach for adrenal gland diseases, it is controversial for primary or metastatic adrenal cancers because when adrenal metastases are symptomatic, the adrenal mass is usually adjacent to or has invaded the vena cava inferior (VCI), liver, or kidney. Laparoscopic adrenalectomy is difficult to perform in such cases. Described herein is laparoscopic adrenalectomy for metastatic right adrenal cancer adjacent to VCI. Abdominal magnetic resonance imaging and computed tomography of 66-year-old male patient treated for lung cancer demonstrated mass in right adrenal gland adjacent to IVC. Laparoscopic exploration revealed mass adjacent to VCI. For curative resection, lateral side of VCI was partially resected using endoscopic vascular staples and adrenalectomy was performed. The patient was discharged uneventfully at postoperative third day. Laparoscopic adrenalectomy can be performed safely with endoscopic vascular staples to remove adrenal tumor in patients with cancer, even with invasion of VCI.
|6.||Laparoscopic distal pancreatectomy: Techniques, pearls, and pitfalls|
M. Mahir Özmen, T. Tolga Şahin, Emre Gündoğdu
doi: 10.14744/less.2014.07269 Pages 46 - 52
Abstract | Full Text PDF