Background: En bloc liver and adjacent organs resections are technically demanding procedures. Few case series and nonmatched comparative studies reported the outcomes of multivisceral liver resections (MLRs). Objectives: To compare the short and long-term outcomes of patients submitted MLRs with those submitted to isolated hepatectomies. Methods: From a prospective database, a case-matched 1:2 study was performed comparing MLRs and isolated hepatectomy. Additionally, a risk analysis was performed to evaluate the association between MLRs and perioperative morbidity, mortality, and long-term survival. Results: Fifty-three MLRs were compared with 106 matched controls. Patients undergoing MLRs had longer operative time (430 [320-525] vs 360 [270-440] minutes,
Background:
Vein resection pancreatoduodenectomy (VRPD) may be performed in selected pancreatic cancer patients. However, the main risks and benefits related to VRPD remain controversial.
Objective:
This review aimed to evaluate the risks and survival benefits that the VRPD may add when compared with standard pancreatoduodenectomy (PD).
Methods:
A systematic review and meta-analysis of studies comparing VRPD and PD were performed.
Results:
VRPD was associated with a higher risk for postoperative mortality (risk difference: −0.01; 95% confidence interval [CI] −0.02 to −0.00) and complications (risk difference: −0.05; 95% CI −0.09 to −0.01) than PD. The length of hospital stay was not different between the groups (mean difference [MD]: −0.65; 95% CI −2.11 to 0.81). In the VRPD, the operating time was 69 minutes higher on average (MD: −69.09; 95% CI −88.4 to −49.78), with a higher blood loss rate (MD: −314.04; 95% CI −423.86 to −195.22). In the overall survival evaluation, the hazard ratio for mortality during follow-up on the group of VRPD was higher compared to the PD group (hazard ratio: 1.13; 95% CI 1.03–1.23).
Conclusion:
VRPD is associated with a higher risk of short-term complications and mortality and a lower probability of survival than PD. Knowing the risks and potential benefits of surgery can help clinicians to properly manage pancreatic cancer patients with venous invasion. The decision for surgery with major venous resection should be shared with the patients after they are informed of the risks and prognosis.
The histological and molecular analysis of biopsy samples are fundamental steps for the understanding of physiopathology, diagnosis and prognosis of the diseases. However, harvest of tissue biopsies from hoof lamellar tissue is a procedure with limitations due to lack of effective surgical instruments and techniques. The aim of the current study is to develop and test in vivo a surgical instrument with the specific purpose of harvesting lamellar tissue in cattle. A prototype called Falcão-Faleiros’ lamellotome (INPIBR102013018765-8) was designed, produced and tested. After sedation, five adult cattle were restrained in lateral recumbency and locally anesthetized in two digits. The stratum corneum was worn down using a rotary tool coupled to a 3/8” high-speed cutter until the soft tissue proximity was reached. Next, the inner edge of the worn area was bounded with a scalpel. The lamellotome was introduced to obtain and hold the sample. The histological specimens of 16mm length by 6mm depth were stained with HE, PAS, Masson’s thricome and Shorr. The structures of interest were differentiated in the histological analysis without technical artifacts and a mean number of 85 epidermal laminae per sample were counted. No relevant lameness or wound complication were seen following the procedure. In conclusion the technique using the lamellotme was effective in obtaining lamellar tissue biopsy samples without causing clinical harm in cattle. The procedure showed potential to be used in clinical research or even as a supplementary diagnosis method for routine bovine podiatry.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.