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1دورية أكاديمية
المؤلفون: Burak Görgec, MD, Inez M. Verpalen, MD, PhD, Jasper P. Sijberden, MD, Mohammad Abu Hilal, MD, PhD, Shandra Bipat, PhD, Cornelis Verhoef, MD, PhD, Rutger-Jan Swijnenburg, MD, PhD, Marc G. Besselink, MD, MSc, PhD, Jaap Stoker, MD, PhD
المصدر: Annals of Surgery Open, Vol 5, Iss 1, p e401 (2024)
الوصف: Background:. Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added value of an additional liver MRI in the surgical workup of patients with CRLM. Therefore, this systematic review and meta-analysis aimed to evaluate the clinical added value of liver MRI in patients eligible for resection or ablation of CRLM based on CT. Methods:. A systematic search was performed in the PubMed, Embase, and Cochrane Library databases through June 23, 2023. Studies investigating the impact of additional MRI on local treatment plan following CT in patients with CRLM were included. Risk of bias was assessed using the QUADAS-2 tool. The pooled weighted proportions for the primary outcome were calculated using random effect meta-analysis. Results:. Overall, 11 studies with 1440 patients were included, of whom 468 patients (32.5%) were assessed for change in local treatment plan. Contrast-enhanced liver MRI was used in 10 studies, including gadoxetic acid in 9 studies. Liver MRI with diffusion-weighted imaging was used in 8 studies. Pooling of data found a 24.12% (95% confidence interval, 15.58%–32.65%) change in the local treatment plan based on the added findings of liver MRI following CT. Sensitivity analysis including 5 studies (268 patients) focusing on monophasic portal venous CT followed by gadoxetic acid-enhanced liver MRI with diffusion-weighted imaging showed a change of local treatment plan of 17.88% (95% confidence interval, 5.14%–30.62%). Conclusions:. This systematic review and meta-analysis found that liver MRI changed the preinterventional local treatment plan in approximately one-fifth of patients eligible for surgical resection or ablation of CRLM based on CT. These findings suggest a clinically relevant added value of routine liver MRI in the preinterventional workup of CRLM, which should be confirmed by large prospective studies.
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: Tessa Hellingman, MD, MSc, Boris Galjart, MD, Julia J. Henneman, MD, Burak Görgec, MD, Okker D. Bijlstra, MD, Martijn R. Meijerink, MD, PhD, Alexander L. Vahrmeijer, MD, PhD, Dirk J. Grünhagen, MD, PhD, Hans J. van der Vliet, MD, PhD, Rutger-Jan Swijnenburg, MD, PhD, Cornelis Verhoef, MD, PhD, Geert Kazemier, MD, PhD
المصدر: Annals of Surgery Open, Vol 3, Iss 2, p e164 (2022)
الوصف: Objectives:. The aim of this study was to determine the potential benefit of perioperative systemic therapy on overall and progression-free survival after repeat local treatment in patients suffering from recurrent colorectal cancer liver metastasis (CRLM). Background:. The optimal treatment strategy in patients with recurrent CRLM needs to be clarified, in particular for those suffering from early recurrence of CRLM. Methods:. In this multicenter observational cohort study, consecutive patients diagnosed with recurrent CRLM between 2009 and 2019 were retrospectively identified in 4 academic liver surgery centers. Disease-free interval after initial local treatment of CRLM was categorized into recurrence within 6, between 6 and 12, and after 12 months. Perioperative systemic therapy consisted of induction, (neo)adjuvant, or combined regimens. Overall and progression-free survival after repeat local treatment of CRLM were analyzed by multivariable Cox regression analyses, resulting in adjusted hazard ratios (aHRs). Results:. Out of 303 patients included for analysis, 90 patients received perioperative systemic therapy for recurrent CRLM. Favorable overall (aHR, 0.45; 95% confidence interval [CI], 0.26–0.75) and progression-free (aHR, 0.53; 95% CI, 0.35–0.78) survival were observed in patients with a disease-free interval of more than 12 months. No significant difference in overall and progression-free survival was observed in patients receiving perioperative systemic therapy at repeat local treatment of CRLM, stratified for disease-free interval, previous exposure to chemotherapy, and RAS mutation status. Conclusions:. No benefit of perioperative systemic therapy was observed in overall and progression-free survival after repeat local treatment of recurrent CRLM.
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Burak Görgec, author1, 2, Babs M. Zonderhuis, author2, 3, Marc G. Besselink, author1, 2, Joris Erdmann, author1, 2, 3, Geert Kazemier, author2, 3, Rutger-Jan Swijnenburg, author1, 2, 3
المصدر: Journal of Visualized Experiments. (184)
الإتاحة: http://www.jove.com/video/63265
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المؤلفون: Jasper P. Sijberden, Giuseppe Zimmitti, Simone Conci, Nadia Russolillo, Michele Masetti, Federica Cipriani, Jacopo Lanari, Burak Görgec, Andrea Benedetti Cacciaguerra, Fernando Rotellar, Mathieu D’Hondt, Bjørn Edwin, Robert P. Sutcliffe, Ibrahim Dagher, Mikhail Efanov, Santi López-Ben, John N. Primrose, Felice Giuliante, Antonino Spinelli, Manish Chand, Salud Alvarez, Serena Langella, Simone Nicosia, Andrea Ruzzenente, Marco Vivarelli, Umberto Cillo, Luca Aldrighetti, Elio Jovine, Alessandro Ferrero, Alfredo Guglielmi, Marc G. Besselink, Mohammad Abu Hilal
المساهمون: Graduate School, Surgery, CCA - Cancer Treatment and Quality of Life, Radiology and Nuclear Medicine, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
المصدر: International journal of surgery (London, England), 109(3), 244-254. Elsevier BV
مصطلحات موضوعية: Surgery, General Medicine
الوصف: BACKGROUND: The use of a simultaneous resection (SIMR) in patients with synchronous colorectal liver metastases (sCRLM) has increased over the past decades. However, it remains unclear when a SIMR is beneficial and when it should be avoided. The aim of this retrospective cohort study was therefore to compare the outcomes of a SIMR for sCRLM in different settings, and to assess which factors are independently associated with unfavorable outcomes.METHODS: To perform this retrospective cohort study, patients with sCRLM undergoing SIMR (2004-2019) were extracted from an international multicenter database, and their outcomes were compared after stratification according to the type of liver and colorectal resection performed. Factors associated with unfavorable outcomes were identified through multivariable logistic regression.RESULTS: Overall, 766 patients were included, encompassing colorectal resections combined with a major liver resection (n=122), minor liver resection in the anterolateral (n=407), or posterosuperior segments ('Technically major', n=237). Minor and technically major resections, compared to major resections, were more often combined with a rectal resection (29.2 and 36.7 vs. 20.5%, respectively, both P=0.003) and performed fully laparoscopic (22.9 and 23.2 vs. 6.6%, respectively, both P = 0.003). Major and technically major resections, compared to minor resections, were more often associated with intraoperative transfusions (42.9 and 38.8 vs. 20%, respectively, both P = 0.003) and unfavorable incidents (9.6 and 9.8 vs. 3.3%, respectively, both P≤0.063). Major resections were associated, compared to minor and technically major resections, with a higher overall morbidity rate (64.8 vs. 50.4 and 49.4%, respectively, both P≤0.024) and a longer length of stay (12 vs. 10 days, both P≤0.042). American Society of Anesthesiologists grades ≥3 [adjusted odds ratio (aOR): 1.671, P=0.015] and undergoing a major liver resection (aOR: 1.788, P=0.047) were independently associated with an increased risk of severe morbidity, while undergoing a left-sided colectomy was associated with a decreased risk (aOR: 0.574, P=0.013).CONCLUSIONS: SIMR should primarily be reserved for sCRLM patients in whom a minor or technically major liver resection would suffice and those requiring a left-sided colectomy. These findings should be confirmed by randomized studies comparing SIMR with staged resections.
وصف الملف: text
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المؤلفون: Nicky van der Heijde, Burak Görgec, Joal D. Beane, Francesca Ratti, Giulio Belli, Andrea Benedetti Cacciaguerra, Fulvio Calise, Umberto Cillo, Marieke T. De Boer, Alexander M. Fagenson, Åsmund A. Fretland, Elizabeth M. Gleeson, Michelle R. de Graaff, Niels F. M. Kok, Kristoffer Lassen, Marcel J. van der Poel, Andrea Ruzzenente, Robert P. Sutcliffe, Bjørn Edwin, Luca Aldrighetti, Henry A. Pitt, Mohammad Abu Hilal, Marc G. Besselink
المساهمون: Surgery, Graduate School, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
المصدر: Surgical endoscopy, 37(5), 3580-3592. Springer New York
مصطلحات موضوعية: Minimally invasive liver surgery, Surgery, Nationwide registries, Liver surgery, Laparoscopic liver surgery, Robotic liver surgery
الوصف: Background: Several registries focus on patients undergoing minimally invasive liver surgery (MILS). This study compared transatlantic registries focusing on the variables collected and differences in baseline characteristics, indications, and treatment in patients undergoing MILS. Furthermore, key variables were identified. Methods: The five registries for liver surgery from North America (ACS-NSQIP), Italy, Norway, the Netherlands, and Europe were compared. A set of key variables were established by consensus expert opinion and compared between the registries. Anonymized data of all MILS procedures were collected (January 2014–December 2019). To summarize differences for all patient characteristics, treatment, and outcome, the relative and absolute largest differences (RLD, ALD) between the smallest and largest outcome per variable among the registries are presented. Results: In total, 13,571 patients after MILS were included. Both 30- and 90-day mortality after MILS were below 1.1% in all registries. The largest differences in baseline characteristics were seen in ASA grade 3–4 (RLD 3.0, ALD 46.1%) and the presence of liver cirrhosis (RLD 6.4, ALD 21.2%). The largest difference in treatment was the use of neoadjuvant chemotherapy (RLD 4.3, ALD 20.6%). The number of variables collected per registry varied from 28 to 303. From the 46 key variables, 34 were missing in at least one of the registries. Conclusion: Despite considerable variation in baseline characteristics, indications, and treatment of patients undergoing MILS in the five transatlantic registries, overall mortality after MILS was consistently below 1.1%. The registries should be harmonized to facilitate future collaborative research on MILS for which the identified 46 key variables will be instrumental.
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المؤلفون: Burak, Görgec, Maurice, Zwart, Carolijn L, Nota, Okker D, Bijlstra, Koop, Bosscha, Marieke T, de Boer, Roeland F, de Wilde, Werner A, Draaisma, Michael F, Gerhards, Mike S, Liem, Daan J, Lips, Hendrik A, Marsman, J Sven D, Mieog, Quintus I, Molenaar, Maarten, Nijkamp, Wouter W, Te Riele, Türkan, Terkivatan, Alexander L, Vahrmeijer, Marc G, Besselink, Rutger-Jan, Swijnenburg, Jeroen, Hagendoorn
المساهمون: Surgery
المصدر: Annals of Surgery, 277(6), E1269-E1277. Lippincott Williams & Wilkins
الوصف: Objective: To determine the nationwide implementation and surgical outcome of minor and major robotic liver surgery (RLS) and assess the first phase of implementation of RLS during the learning curve. Background: RLS may be a valuable alternative to laparoscopic liver surgery. Nationwide population-based studies with data on implementation and outcome of RLS are lacking. Methods: Multicenter retrospective cohort study including consecutive patients who underwent RLS for all indications in 9 Dutch centers (August 2014-March 2021). Data on all liver resections were obtained from the mandatory nationwide Dutch Hepato Biliary Audit (DHBA) including data from all 27 centers for liver surgery in the Netherlands. Outcomes were stratified for minor, technically major, and anatomically major RLS. Learning curve effect was assessed using cumulative sum analysis for blood loss. Results: Of 9437 liver resections, 400 were RLS (4.2%) procedures including 207 minor (52.2%), 141 technically major (35.3%), and 52 anatomically major (13%). The nationwide use of RLS increased from 0.2% in 2014 to 11.9% in 2020. The proportion of RLS among all minimally invasive liver resections increased from 2% to 28%. Median blood loss was 150 mL (interquartile range 50-350 mL] and the conversion rate 6.3% (n=25). The rate of Clavien-Dindo grade ≥III complications was 7.0% (n=27), median length of hospital stay 4 days (interquartile range 2-5) and 30-day/in-hospital mortality 0.8% (n=3). The R0 resection rate was 83.2% (n=263). Cumulative sum analysis for blood loss found a learning curve of at least 33 major RLS procedures. Conclusions: The nationwide use of RLS in the Netherlands has increased rapidly with currently one-tenth of all liver resections and one-fourth of all minimally invasive liver resections being performed robotically. Although surgical outcomes of RLS in selected patient seem favorable, future prospective studies should determine its added value.
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::03e55227c19c5323934646089007d358
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المؤلفون: Jasper Paul Sijberden, Antonino Spinelli, Alessandro Ferrero, Manish Chand, Steven Wexner, Marc G. Besselink, Ibrahim Dagher, Giuseppe Zimmitti, Burak Görgec, Antonio de Lacy, Mayank Roy, Pieter Tanis, Carlo Tonti, Mohammed Abu Hilal
المساهمون: Surgery, Graduate School, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and Nuclear Medicine
المصدر: Surgical Endoscopy, 37(6), 4658-4672. Springer New York
Surgical endoscopy, 37(6), 4658-4672. Springer New Yorkمصطلحات موضوعية: Synchronous colorectal liver metastases, Surgical procedures, SDG 3 - Good Health and Well-being, Surgery, Survey, Clinical practice pattern, Colorectal cancer
الوصف: Background Consensus on the best surgical strategy for the management of synchronous colorectal liver metastases (sCRLM) has not been achieved. This study aimed to assess the attitudes of surgeons involved in the treatment of sCRLM. Methods Surveys designed for colorectal, hepato-pancreato-biliary (HPB), and general surgeons were disseminated through representative societies. Subgroup analyses were performed to compare responses between specialties and continents. Results Overall, 270 surgeons (57 colorectal, 100 HPB and 113 general surgeons) responded. Specialist surgeons more frequently utilized minimally invasive surgery (MIS) than general surgeons for colon (94.8% vs. 71.7%, p p p = 0.005). In patients with an asymptomatic primary, the liver-first two-stage approach was preferred in most respondents’ centres (59.3%), while the colorectal-first approach was preferred in Oceania (83.3%) and Asia (63.4%). A substantial proportion of the respondents (72.6%) had personal experience with minimally invasive simultaneous resections, and an expanding role for this procedure was foreseen (92.6%), while more evidence was desired (89.6%). Respondents were more reluctant to combine a hepatectomy with low anterior (76.3%) and abdominoperineal resections (73.3%), compared to right (94.4%) and left hemicolectomies (90.7%). Colorectal surgeons were less inclined to combine right or left hemicolectomies with a major hepatectomy than HPB and general surgeons (right: 22.8% vs. 50% and 44.2%, p = 0.008; left: 14% vs. 34% and 35.4%, p = 0.002, respectively). Conclusion The clinical practices and viewpoints on the management of sCRLM differ between continents, and between and within surgical specialties. However, there appears to be consensus on a growing role for MIS and a need for evidence-based input. Graphical abstract
وصف الملف: application/pdf
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المؤلفون: Marianne C. Kalff, Sofie P.G. Henckens, Daan M. Voeten, David J. Heineman, Maarten C.C.M. Hulshof, Hanneke W.M. van Laarhoven, Wietse J. Eshuis, Peter C. Baas, Renu R. Bahadoer, Eric J.T. Belt, Baukje Brattinga, Linda Claassen, Admira Ćosović, David Crull, Freek Daams, Annette D. van Dalsen, Jan Willem T. Dekker, Marc J. van Det, Manon Drost, Peter van Duijvendijk, Stijn van Esser, Marcia P. Gaspersz, Burak Görgec, Richard P.R. Groenendijk, Henk H. Hartgrink, Erwin van der Harst, Jan W. Haveman, Joos Heisterkamp, Richard van Hillegersberg, Wendy Kelder, B. Feike Kingma, Willem J. Koemans, Ewout A. Kouwenhoven, Sjoerd M. Lagarde, Frederik Lecot, Philip P. van der Linden, Misha D.P. Luyer, Grard A.P. Nieuwenhuijzen, Pim B. Olthof, Donald L. van der Peet, Jean-Pierre E.N. Pierie, E.G.J.M. Robert Pierik, Victor D. Plat, Fatih Polat, Camiel Rosman, Jelle P. Ruurda, Johanna W. van Sandick, Rene Scheer, Cettela A.M. Slootmans, Meindert N. Sosef, Odin V. Sosef, Wobbe O. de Steur, Hein B.A.C. Stockmann, Fanny J. Stoop, Guusje Vugts, Guy H.E.J. Vijgen, Víola B. Weeda, Marinus J. Wiezer, Martijn G.H. van Oijen, Mark I. van Berge Henegouwen, Suzanne S. Gisbertz
المساهمون: Surgery, Cardio-thoracic surgery, Cancer Center Amsterdam, Internal medicine, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, Plastic, Reconstructive and Hand Surgery, CCA - Cancer Treatment and Quality of Life, Other Research, Graduate School, Radiotherapy, Oncology, Radiology and Nuclear Medicine, APH - Methodology, APH - Quality of Care
المصدر: Annals of Surgery, 276, 5, pp. 806-813
Kalff, M C, Henckens, S P G, Voeten, D M, Heineman, D J, Hulshof, M C C M, van Laarhoven, H W M, Eshuis, W J, Baas, P C, Bahadoer, R R, Belt, E J T, Brattinga, B, Claassen, L, Ćosović, A, Crull, D, Daams, F, van Dalsen, A D, Dekker, J W T, van Det, M J, Drost, M, van Duijvendijk, P, van Esser, S, Gaspersz, M P, Görgec, B, Groenendijk, R P R, Hartgrink, H H, van der Harst, E, Haveman, J W, Heisterkamp, J, van Hillegersberg, R, Kelder, W, Kingma, B F, Koemans, W J, Kouwenhoven, E A, Lagarde, S M, Lecot, F, van der Linden, P P, Luyer, M D P, Nieuwenhuijzen, G A P, Olthof, P B, van der Peet, D L, Pierie, J-P E N, Pierik, E G J M R, Plat, V D, Polat, F, Rosman, C, Ruurda, J P, van Sandick, J W, Scheer, R, Slootmans, C A M, Sosef, M N, Sosef, O V, de Steur, W O, Stockmann, H B A C, Stoop, F J, Vugts, G, Vijgen, G H E J, Weeda, V O B, Wiezer, M J, van Oijen, M G H, van Berge Henegouwen, M I & Gisbertz, S S 2022, ' Recurrent Disease After Esophageal Cancer Surgery : A Substudy of The Dutch Nationwide Ivory Study ', Annals of Surgery, vol. 276, no. 5, pp. 806-813 . https://doi.org/10.1097/SLA.0000000000005638
Annals of Surgery, 276(5), 806-813. LIPPINCOTT WILLIAMS & WILKINS
Annals of Surgery, 276(5), 806-813. Lippincott Williams and Wilkins
Annals of Surgery, 276(5), 806-813. Lippincott Williams & Wilkins
Annals of surgery, 276(5), 806-813. Lippincott Williams and Wilkins
Annals of Surgery, 276, 806-813مصطلحات موضوعية: Male, Neoadjuvant treatment, Esophageal Neoplasms, Palliative treatment, Esophageal cancer, Adenocarcinoma, Prognosis, Cohort Studies, Survival Rate, Esophagectomy, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], SDG 3 - Good Health and Well-being, Lymphatic Metastasis, Humans, Recurrences, Surgery, Neoplasm Recurrence, Local, Retrospective Studies
الوصف: Objective: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery.Background: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission.Methods: This nationwide cohort study included patients with distal esophageal and gastroesophageal junction adenocarcinoma and squamous cell carcinoma after curatively intended esophagectomy in 2007 to 2016 (follow-up until January 2020). Patients with distant metastases detected during surgery were excluded. Univariable and multivariable logistic regression were used to identify predictors of recurrent disease. Multivariable Cox regression was used to determine the association of recurrence site and treatment intent with postrecurrence survival.Results: Among 4626 patients, 45.1% developed recurrent disease a median of 11 months postoperative, of whom most had solely distant metastases (59.8%). Disease recurrences were most frequently hepatic (26.2%) or pulmonary (25.1%). Factors significantly associated with disease recurrence included young age (≤ 65 y), male sex, adenocarcinoma, open surgery, transthoracic esophagectomy, nonradical resection, higher T-stage, and tumor positive lymph nodes. Overall, median postrecurrence survival was 4 months [95% confidence interval (95% CI): 3.6–4.4]. After curatively intended recurrence treatment, median survival was 20 months (95% CI: 16.4–23.7). Survival was more favorable after locoregional compared with distant recurrence (hazard ratio: 0.74, 95% CI: 0.65–0.84).Conclusions: This study provides important prognostic information assisting in the surveillance and counseling of patients after curatively intended esophageal cancer surgery. Nearly half the patients developed recurrent disease, with limited prospects of survival. The risk of recurrence was higher in patients with a higher tumor stage, nonradical resection and positive lymph node harvest.
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::23458e31ebcad102e55a681651d843fc
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المؤلفون: Frederik Berrevoet, Carolijn L.M.A. Nota, Luca Aldrighetti, Ronald M. van Dam, Emir Hoti, Jeroen Hagendoorn, Maurice J. W. Zwart, Rutger-Jan Swijnenburg, Burak Görgec, R. Fichtinger, Marcel J. van der Poel, David Fuks, Bjørn Edwin, Mohammed Abu Hilal, Marc G. Besselink, Abdullah Arabiyat
المساهمون: Graduate School, Surgery, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Radiology and Nuclear Medicine, Zwart, M. J. W., Gorgec, B., Arabiyat, A., Nota, C. L. M., van der Poel, M. J., Fichtinger, R. S., Berrevoet, F., van Dam, R. M., Aldrighetti, L., Fuks, D., Hoti, E., Edwin, B., Besselink, M. G., Abu Hilal, M., Hagendoorn, J., Swijnenburg, R. -J., RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Heelkunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
المصدر: HPB, 24(3), 322-331. John Wiley and Sons Inc.
HPB
HPB, 24(3), 322-331. ELSEVIER SCI LTDمصطلحات موضوعية: Liver surgery, CLINICAL-OUTCOMES, medicine.medical_specialty, RESECTION, IMPACT, HEPATECTOMY, Liver resections, Resection, Robotic Surgical Procedures, Pan european, Medicine and Health Sciences, Hepatectomy, Humans, Minimally Invasive Surgical Procedures, Medicine, Robotic surgery, Hepatology, business.industry, General surgery, Gastroenterology, Center volume, surgical procedures, operative, Liver, EXPERIENCE, Laparoscopy, business
الوصف: BACKGROUND: Laparoscopic and robotic minimally invasive liver surgery (MILS) is gaining popularity. Recent data and views on the implementation of laparoscopic and robotic MILS throughout Europe are lacking.METHODS: An anonymous survey consisting of 46 questions was sent to all members of the European-African Hepato-Pancreato-Biliary Association.RESULTS: The survey was completed by 120 surgeons from 103 centers in 24 countries. Median annual center volume of liver resection was 100 [IQR 50-140]. The median annual volume of MILS per center was 30 [IQR 16-40]. For minor resections, laparoscopic MILS was used by 80 (67%) surgeons and robotic MILS by 35 (29%) surgeons. For major resections, laparoscopic MILS was used by 74 (62%) surgeons and robotic MILS by 33 (28%) surgeons. The majority of the surgeons stated that minimum annual volume of MILS per center should be around 21-30 procedures/year. Of the surgeons performing robotic surgery, 28 (70%) felt they missed specific equipment, such as a robotic-CUSA. Seventy (66%) surgeons provided a formal MILS training to residents and fellows. In 5 years' time, 106 (88%) surgeons felt that MILS would have superior value as compared to open liver surgery.CONCLUSION: In the participating European liver centers, MILS comprised about one third of all liver resections and is expected to increase further. Laparoscopic MILS is still twice as common as robotic MILS. Development of specific instruments for robotic liver parenchymal transection might further increase its adoption.
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المؤلفون: Leendert Blankevoort, C. Niek van Dijk, Ruben Zwiers, Burak Görgec
المساهمون: Graduate School, Orthopedic Surgery and Sports Medicine, APH - Personalized Medicine, APH - Quality of Care, Radiology and Nuclear Medicine, Amsterdam Movement Sciences, AMS - Sports, APH - Societal Participation & Health
المصدر: Foot and ankle surgery, 27(6), 650-654. Elsevier Limited
مصطلحات موضوعية: Synchondrosis, Asymptomatic, Talus, Arthroscopy, 03 medical and health sciences, 0302 clinical medicine, Impingement, medicine, Animals, Humans, Orthopedics and Sports Medicine, In patient, Tibia, Fibula, os trigonum, 030222 orthopedics, business.industry, 030229 sport sciences, Anatomy, Os Trigonum, medicine.anatomical_structure, Calcaneus, Ankle, medicine.symptom, Tomography, X-Ray Computed, business, Ankle Joint
الوصف: Background Posterior ankle impingement is strongly associated with the presence of an os trigonum, however, most patients with an os trigonum will never develop symptoms. It is hypothesized that the os trigonum is larger in the symptomatic ankle than in the non-symptomatic ankle, the distance between os trigonum and tibia is smaller and there are more degenerative changes in ankles with symptoms of posterior impingement. In this study the geometrical characteristics of the ipsilateral and contralateral os trigonum are compared in patients with a bilateral os trigonum and unilateral posterior impingement symptoms. Methods Patients with a bilateral os trigonum and unilateral posterior impingement complaints were included. Comparison between the symptomatic and asymptomatic ankles was done within each patient. From the CT-scan of each ankle, the tibia, fibula, calcaneus, talus and os trigonum were segmented and a geometric model was created. Based on these bone models, the volume of the os trigonum and talus, the size of the os trigonum, the distance between os trigonum and surrounding bones (talus, calcaneus, fibula and tibia) were calculated. In addition, the CT images were assessed for the type of os trigonum, the presence of cysts, irregular synchondrosis, calcifications and whether the os trigonum consisted of more than one fragment. Results A total of 22 patients were included in this study. In seventeen of the 22 patients, the symptomatic os trigonum was larger in comparison with the non-symptomatic side in terms of length (median Δ 2.4 mm, 8.9 versus 10.6 mm) and relative volume (median Δ 0.09%, 0.30 versus 0.45% of talar volume). Distances between the ossa trigona and surrounding bones were not statistically significantly different between both sides. Calcifications were more frequently found around the os trigonum in the symptomatic side (10 versus 3/22). Conclusions The findings in this study support the hypothesis that symptomatic ossa trigona are larger in comparison with asymptomatic ossa trigona. Calcifications around the os trigonum were found more frequently in symptomatic than in non-symptomatic ossa trigona. Level of Evidence III.
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