Current statement and safe implementation of minimally invasive surgery in the pancreas

Hayashi, Hiromitsu; Baba, Hideo

doi:10.1002/ags3.12366

Cited by 10 publications

(16 citation statements)

References 84 publications

(228 reference statements)

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“…In this study we investigated the real-world performance of laparoscopy in patients who underwent surgery for acute diffuse peritoni- Many studies, including ones that have used data from the NCD, have demonstrated the effectiveness of laparoscopy in the elective treatment of abdominal disease. [1][2][3] Laparoscopy is occasionally used for both diagnosis and treatment of abdominal disease in the emergency setting. 8,9,11 Diagnostic laparoscopy has been reported to be useful in the emergency setting because it can overcome the difficulty sometimes encountered in identification of the cause of acute abdomen by preoperative assessment using abdominal imaging methods such as ultrasound and computed tomography.…”

Section: Discussionmentioning

confidence: 99%

“…Elective laparoscopic surgery is now widely performed for both benign and malignant disease because it is less invasive than open surgery and postoperative recovery is more rapid. 1 , 2 , 3 Laparoscopy has been reported to be useful in various surgical procedures, including gastrectomy and colectomy. 4 , 5 , 6 , 7 However, its usefulness in the emergency setting is still unclear.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database

Hoshino

Endo

Hida

et al. 2021

Annals of Gastroent Surgery

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Background Elective laparoscopic surgery is now widely accepted in the treatment of abdominal diseases because of its minimal invasiveness and rapid postoperative recovery. It is also used in the emergency setting for the diagnosis and treatment of acute diffuse peritonitis regardless of the causative disease. However, the value of laparoscopy in acute diffuse peritonitis remains unclear. In this study we aimed to show trends in the use of laparoscopy over time and compare the real‐world performance of laparoscopic surgery with that of open surgery for acute diffuse peritonitis due to gastrointestinal perforation. Methods We extracted data from the National Clinical Database, a nationwide surgery registration system in Japan, for patients with a diagnosis of acute diffuse peritonitis due to gastroduodenal or colorectal perforation between 2016 and 2019. Trends in the use of laparoscopy over time were identified. Patient characteristics, laboratory findings, surgical findings, and postoperative complications were compared between laparoscopic surgery and open surgery. Results Patients in poor condition and those with abnormal laboratory findings tended to undergo open surgery. Anesthesia time and operating time were longer for laparoscopic surgery in patients with gastroduodenal perforation but shorter in those with colorectal perforation. Fewer complications occurred in patients who underwent laparoscopic surgery. The number of institutions where laparoscopic surgery was performed and the proportion of the use of laparoscopy at each institution increased over time. Conclusion The use of laparoscopy is becoming common in surgery for acute diffuse peritonitis due to gastrointestinal perforation. This approach may be a useful option for acute diffuse peritonitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database

Hoshino

Endo

Hida

et al. 2021

Annals of Gastroent Surgery

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“…Analysen von High-Volume-Zentren legen sogar einen Vorteil der robotischen Technik in Bezug auf die postoperative Morbidität, sobald die Lernkurve, die sich auf bis zu 250 Fälle erstrecken kann, durchlaufen ist [15,16]. Etablierung der robotischen Pankreaschirurgie -Hürden und Fallstricke Die Etablierung der minimalinvasiven Pankreaschirurgie, robotisch oder laparoskopisch, erfordert zuallererst fundierte Expertise des Operateurs und des Zentrums in der offenen Pankreaschirurgie [17]. Wie bei allen komplexen viszeralchirurgischen Operationen wird eine Etablierung der robotischen Pankreaschirurgie durch begleitende Trainingsprogramme vereinfacht und beschleunigt [18,19].…”

Section: Hintergrundunclassified

Robotische Pankreaschirurgie – Lernkurve und Etablierung

et al. 2022

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ZusammenfassungMinimalinvasive Resektionstechniken zur Behandlung verschiedener Pathologien des Pankreas sind potenziell vorteilhaft für die behandelten Patienten in Bezug auf Rekonvaleszenzzeit und postoperative Morbidität, stellen jedoch eine besondere technische Herausforderung für den behandelnden Chirurgen dar. Der Einzug der robotischen Technik in die Viszeralchirurgie bietet eine prinzipielle Möglichkeit zur weitreichenden Verbreitung minimalinvasiver Verfahren in der Pankreaschirurgie.Ziel dieser Arbeit war es, die Entwicklungsmöglichkeiten der robotischen Pankreaschirurgie in Deutschland zu überprüfen. Datengrundlage sind die Qualitätsberichte der Krankenhäuser der Jahre 2015–2019 kombiniert mit einer selektiven Literaturrecherche.Die Anzahl der vorliegenden Qualitätsberichte reduzierte sich von 2015 bis 2019 von 1635 auf 1594. Im Median führten 96 Kliniken 11–20, 56 Kliniken 21–50 und 15 Kliniken mehr als 50 Pankreaskopfresektionen jährlich durch. Bei den Linksresektionen waren es 35 Kliniken mit 11–20, 14 Kliniken mit 21–50 und 2 Kliniken mit mehr als 50 Eingriffen. Unter Berücksichtigung aller Kliniken, die 5 oder mehr Linksresektionen pro Jahr durchführen, wurden an nur 29 Kliniken minimalinvasive Verfahren eingesetzt. Der Anteil an laparoskopischen Linksresektionen über 50% wurde an nur 7 Kliniken beschrieben.Nach Datenlage in der Literatur divergieren die Lernkurven für die robotische Pankreaslinks- und Pankreaskopfresektion. Während die Lernkurve für die robotische Pankreaslinksresektion nach etwa 20 Eingriffen durchlaufen ist, hat die Lernkurve für die robotische Pankreaskopfresektion mehrere Plateaus, die etwa nach 30, 100 und 250 Eingriffen erreicht werden.Aufgrund der dezentralen Struktur der Pankreaschirurgie in Deutschland scheint ein flächendeckendes Angebot robotischer Verfahren aktuell in weiter Ferne. Insbesondere die Etablierung der robotischen Pankreaskopfresektion wird zunächst Zentren mit entsprechend hoher Fallzahl vorbehalten bleiben.

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“…Late diagnosis of PDAC can cause to lose the chance of surgical treatment and lead to a high mortality rate[ 78 ]. On the other hand, surgical treatments for PDAC can have a high morbidity and mortality rate.…”

Section: Ai In Survival Prediction and Response To Chemotherapymentioning

confidence: 99%

Recent advances in artificial intelligence for pancreatic ductal adenocarcinoma

Hayashi¹,

Uemura²,

Matsumura³

et al. 2021

WJG

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Pancreatic ductal adenocarcinoma (PDAC) remains the most lethal type of cancer. The 5-year survival rate for patients with early-stage diagnosis can be as high as 20%, suggesting that early diagnosis plays a pivotal role in the prognostic improvement of PDAC cases. In the medical field, the broad availability of biomedical data has led to the advent of the “big data” era. To overcome this deadly disease, how to fully exploit big data is a new challenge in the era of precision medicine. Artificial intelligence (AI) is the ability of a machine to learn and display intelligence to solve problems. AI can help to transform big data into clinically actionable insights more efficiently, reduce inevitable errors to improve diagnostic accuracy, and make real-time predictions. AI-based omics analyses will become the next alterative approach to overcome this poor-prognostic disease by discovering biomarkers for early detection, providing molecular/genomic subtyping, offering treatment guidance, and predicting recurrence and survival. Advances in AI may therefore improve PDAC survival outcomes in the near future. The present review mainly focuses on recent advances of AI in PDAC for clinicians. We believe that breakthroughs will soon emerge to fight this deadly disease using AI-navigated precision medicine.

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Current statement and safe implementation of minimally invasive surgery in the pancreas

Cited by 10 publications

References 84 publications

Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database

Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database

Robotische Pankreaschirurgie – Lernkurve und Etablierung

Recent advances in artificial intelligence for pancreatic ductal adenocarcinoma

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