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Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis
Shahab Hajibandeh,Ahmed Kotb,Louis Evans,Emily Sams,Andrew Naguib,Shahin Hajibandeh,Thomas Satyadas 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.1
A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181–269 minutes), 134 mL (95% CI, 85–184 mL), and 7 days (95% CI, 5–9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%–5%). It was 3% (95% CI, 1%–6%) for conversion to open surgery, 6% (95% CI, 0%–19%) for need for intra-abdominal drain, 1% (95% CI, 0%–3%) for postoperative mortality, 2% (95% CI, 0%–4%) for biliary leakage, 2% (95% CI, 0%–4%) for intra-abdominal abscess, 1% (95% CI, 0%–4%) for biliary stenosis, 1% (95% CI, 0%–3%) for postoperative bleeding, 1% (95% CI, 0%–4%) for pancreatic fistula, 2% (95% CI, 1%–5%) for pulmonary complications, 1% (95% CI, 0%–4%) for paralytic ileus, and 1% (95% CI, 0%–4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.
Aaron J. Buckland,Bryan M. Beaubrun,Evan Isaacs,John Moon,Peter Zhou,Sam Horn,Gregory Poorman,Jared C. Tishelman,Louis M. Day,Thomas J. Errico,Peter G. Passias,Themistocles Protopsaltis 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.1
Study Design: Retrospective radiological review. Purpose: To quantify the effect of sitting vs supine lumbar spine magnetic resonance imaging (MRI) and change in anterior displacement of the psoas muscle from L1–L2 to L4–L5 discs. Overview of Literature: Controversy exists in determining patient suitability for lateral lumbar interbody fusion (LLIF) based on psoas morphology. The effect of posture on psoas morphology has not previously been studied; however, lumbar MRI may be performed in sitting or supine positions. Methods: A retrospective review of a single-spine practice over 6 months was performed, identifying patients aged between 18–90 years with degenerative spinal pathologies and lumbar MRIs were evaluated. Previous lumbar fusion, scoliosis, neuromuscular disease, skeletal immaturity, or intrinsic abnormalities of the psoas muscle were excluded. The anteroposterior (AP) dimension of the psoas muscle and intervertebral disc were measured at each intervertebral disc from L1–L2 to L4–L5, and the AP psoas:disc ratio calculated. The morphology was compared between patients undergoing sitting and/or supine MRI. Results: Two hundred and nine patients were identified with supine-, and 60 patients with sitting-MRIs, of which 13 patients had undergone both sitting and supine MRIs (BOTH group). A propensity score match (PSM) was performed for patients undergoing either supine or sitting MRI to match for age, BMI, and gender to produce two groups of 43 patients. In the BOTH and PSM group, sitting MRI displayed significantly higher AP psoas:disc ratio compared with supine MRI at all intervertebral levels except L1–L2. The largest difference observed was a mean 32%–37% increase in sitting AP psoas:disc ratio at the L4–L5 disc in sitting compared to supine in the BOTH group (range, 0%–137%). Conclusions: The psoas muscle and the lumbar plexus become anteriorly displaced in sitting MRIs, with a greater effect noted at caudal intervertebral discs. This may have implications in selecting suitability for LLIF, and intra-operative patient positioning.
Jungclaus, Johann H.,Bard, Edouard,Baroni, Mé,lanie,Braconnot, Pascale,Cao, Jian,Chini, Louise P.,Egorova, Tania,Evans, Michael,Gonzá,lez-Rouco, J. Fidel,Goosse, Hugues,Hurtt, George C.,Jo Copernicus GmbH 2017 Geoscientific model development Vol.10 No.11
<P><p><strong>Abstract.</strong> The pre-industrial millennium is among the periods selected by the Paleoclimate Model Intercomparison Project (PMIP) for experiments contributing to the sixth phase of the Coupled Model Intercomparison Project (CMIP6) and the fourth phase of the PMIP (PMIP4). The <i>past1000</i> transient simulations serve to investigate the response to (mainly) natural forcing under background conditions not too different from today, and to discriminate between forced and internally generated variability on interannual to centennial timescales. This paper describes the motivation and the experimental set-ups for the PMIP4-CMIP6 <i>past1000</i> simulations, and discusses the forcing agents orbital, solar, volcanic, and land use/land cover changes, and variations in greenhouse gas concentrations. The <i>past1000</i> simulations covering the pre-industrial millennium from 850 Common Era (CE) to 1849<span class='thinspace'></span>CE have to be complemented by <i>historical</i> simulations (1850 to 2014<span class='thinspace'></span>CE) following the CMIP6 protocol. The external forcings for the <i>past1000</i> experiments have been adapted to provide a seamless transition across these time periods. Protocols for the <i>past1000</i> simulations have been divided into three tiers. A default forcing data set has been defined for the Tier 1 (the CMIP6 <i>past1000</i>) experiment. However, the PMIP community has maintained the flexibility to conduct coordinated sensitivity experiments to explore uncertainty in forcing reconstructions as well as parameter uncertainty in dedicated Tier 2 simulations. Additional experiments (Tier 3) are defined to foster collaborative model experiments focusing on the early instrumental period and to extend the temporal range and the scope of the simulations. This paper outlines current and future research foci and common analyses for collaborative work between the PMIP and the observational communities (reconstructions, instrumental data).</p> </P>