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Cristian Conti,Corrado Pedrazzani,Giulia Turri,Eduardo Fernandes,Enrico Lazzarini,Raffaele De Luca,Alessandro Valdegamberi,Andrea Ruzzenente,Alfredo Guglielmi 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.3
Purpose: Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infre- quently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME col- ectomy compared to standard colectomy for right-sided colon cancer in a Western series. Methods: Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were com- pared to the ones of 55 patients who underwent laparoscopic standard right colectomy. Results: No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P=0.708), and unplanned readmission in 5.0% vs. 5.5% (P=1) after CME and standard colec- tomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), prox- imal (P=0.018), and distal margins (P=0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037). Conclusion: In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to ob- tain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.
Laparoscopic double mesh repair of a large Morgagni hernia: a video vignette
Matteo Rivelli,Giulia Turri,Cristian Conti,Alessandro Valdegamberi,Corrado Pedrazzani 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.2
Morgagni hernia (MH) is a rare congenital diaphragmatic hernia (CDH) that accounts for less than 2% of surgically repaired CDH in adulthood. Even if this condition is often asymptomatic, surgery is advised due to the risk of life-threatening complications such as volvulus or bowel strangulation. Surgery for MH repair can be performed by transthoracic, transabdominal, laparoscopic, or thoracoscopic approaches. Though laparoscopy has recently improved surgical outcomes, the use of prosthetic meshes and the need for reduction of the hernia sac are still the most debated issues. We present the video of a laparoscopic repair of a large MH with the use of a double mesh technique and no resection of the hernia sac.
Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
Jessica Cassiani,Stefano Francesco Crinò,Erminia Manfrin,Matteo Rivelli,Armando Gabbrielli,Alfredo Guglielmi,Corrado Pedrazzani 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectionalimaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenalgland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture thecyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histologicalanalysis of the retrieved fragments revealed a fibrous wall lined by “respiratory-type” epithelium with ciliated columnar cells,consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed basedon the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis iscommonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectionalimaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperativehistological diagnosis, thus supporting the decision-making process.