The Depth from the Skin to the Celiac Artery Measured Using Computed Tomography is a Simple Predictive Index for Longer Operation Time During Laparoscopic Distal Gastrectomy

Goto, Hironobu; Kanaji, Shingo; Yasuda, Takashi; Oshikiri, Taro; Yamamoto, Masashi; Matsuda, Takeru; Suzuki, Satoshi; Fujino, Yasuhiro; Tominaga, Masahiro; Kakeji, Yoshihiro

doi:10.1007/s00268-017-4282-2

Cited by 8 publications

(4 citation statements)

References 33 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, VFA affected visualization in the surgical field leading to increased blood loss during the introductory period. In laparoscopic distal gastrectomy, the depth of the celiac artery was reported to be associated with a longer operation time . Similarly, in this study, the depth of the duodenum and/or common hepatic duct negatively affected the range of motion of the laparoscopic instruments and made delicate dissection more difficult, leading to increased blood loss during LPD.…”

Section: Discussionmentioning

confidence: 57%

Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy

Nagakawa

Nakamura

Honda

et al. 2018

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Background Laparoscopic pancreaticoduodenectomy (LPD) requires sufficient laparoscopic training for optimal outcomes. Our aim is to determine the learning curve and investigate the factors influencing surgical outcomes during the learning curve. Methods We analyzed surgical results of 150 consecutive cases of LPD performed by three hepatopancreatobiliary surgeons during their 50 first cases. Learning curves were constructed by cumulative sum (CUSUM) analysis. Preoperative factors influencing resection time and blood loss were investigated in the introductory and stable periods. Results The learning curve could be divided into three phases: initial (1–20 cases), plateau (21–30), and stable (31–50). Resection time with lymph node dissection was significantly longer during the introductory period (initial and plateau periods) (P < 0.01) but not the stable phase (P = 0.51). Multivariate analysis revealed that patients with pancreatitis had longer resection times and massive blood loss in both the introductory and stable periods (stable phase). High visceral fat area was also significantly related to massive blood loss in the introductory period (P = 0.04). Conclusions Hepatopancreatobiliary surgeons need more than 30 cases until LPD becomes stable. Lymph node dissection and patients with high visceral fat area and concomitant pancreatitis should be avoided during the introductory period of the learning curve.

show abstract

Section: Discussionmentioning

confidence: 57%

Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy

Nagakawa

Nakamura

Honda

et al. 2018

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

show abstract

“…Bariatric surgery in super-obese patients (BMI > 60 kg/m 2 ) can be technically challenging for the surgeon to perform because of the excessive visceral obesity and enlarged (fatty) liver [ 10 , 11 ]. Since these patients are also more likely to be diagnosed with more advanced comorbidities including end-organ damage, bariatric surgery is associated with increased perioperative morbidity and mortality [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of preoperative weight loss achieved by gastric balloon on peri- and postoperative outcomes of bariatric surgery in super-obese patients: a retrospective matched-pair analysis

Hering

Dörries

Flemming

et al. 2022

Langenbecks Arch Surg

View full text Add to dashboard Cite

Background An intragastric balloon is used to cause weight loss in super-obese patients (BMI > 60 kg/m2) prior to bariatric surgery. Whether weight loss from intragastric balloon influences that from bariatric surgery is poorly studied. Methods In this retrospective, single-center study, the effects of intragastric balloon in 26 patients (BMI 69.26 ± 6.81) on weight loss after bariatric surgery (primary endpoint), postoperative complications within 30 days, hospital readmission, operation time, and MTL30 (secondary endpoints) were evaluated. Fifty-two matched-pair patients without intragastric balloon prior to bariatric surgery were used as controls. Results Intragastric balloon resulted in a weight loss of 17.3 ± 14.1 kg (BMI 5.75 ± 4.66 kg/m2) with a nadir after 5 months. Surgical and postoperative outcomes including complications were comparable between both groups. Total weight loss was similar in both groups (29.0% vs. 32.2%, p = 0.362). Direct postoperative weight loss was more pronounced in the control group compared to the gastric balloon group (29.16 ± 7.53% vs 23.78 ± 9.89% after 1 year, p < 0.05 and 32.13 ± 10.5% vs 22.21 ± 10.9% after 2 years, p < 0.05), who experienced an earlier nadir and started to regain weight during the follow-up. Conclusion A multi-stage therapeutic approach with gastric balloon prior to bariatric surgery in super-obese patients may be effective to facilitate safe surgery. However, with the gastric balloon, pre-treated patients experienced an attenuated postoperative weight loss with an earlier nadir and earlier body weight regain. This should be considered when choosing the appropriate therapeutic regime and managing patients’ expectations.

show abstract

“…Zhu et al 14 reported that the rate of concealed type of splenic artery, where the lowest point of the splenic artery exists at the inferior margin of the pancreas, is 14.2% and that this type has a tendency to longer total operative times and higher morbidity rates. Goto et al 15 also reported that the depth from the skin to the celiac artery was related to suprapancreatic dissection time. We considered that the dorsal landmark type might be related to the difficulty in No.…”

Section: Discussionmentioning

confidence: 95%

Significance of prediction of the dorsal landmark using three-dimensional computed tomography during laparoscopic lymph node dissection along the proximal splenic artery in gastric cancer

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objectives: Dissection of the No. 11p lymph nodes is technically challenging because of variations in anatomical landmarks. This study aimed to determine the accuracy and efficacy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography simulation. Methods: Laparoscopic gastrectomy with No. 11p lymph node dissection with preoperative simulation using three-dimensional computed tomography was performed in 24 patients at our institution from October 2016 to May 2018. Initially, preoperative three-dimensional computed tomography findings with operative videos in these 24 patients were compared. The dorsal landmark was defined as an anatomical structure behind the splenic artery on preoperative three-dimensional computed tomography and operative videos. The dorsal landmark of No. 11p lymph node was divided into four types: (1) splenic vein type, (2) splenic vein and pancreas type, (3) pancreas type, and (4) unclear type. Then, to investigate the efficacy of three-dimensional computed tomography, we compared the clinical and pathological features and surgical outcomes of nine patients who underwent preoperative three-dimensional computed tomography simulation (three-dimensional computed tomography group) and 23 patients who did not undergo three-dimensional computed tomography simulation from August 2014 to September 2016 (non-three-dimensional computed tomography group). All procedures were performed by one surgeon certified by the Endoscopic Surgical Skill Qualification System in Japan. Results: The concordance rate between three-dimensional computed tomography and operative videos of the dorsal landmark using three-dimensional computed tomography was 79% (19/24). The operative time of No. 11p lymph node dissection was significantly shorter in the three-dimensional computed tomography group than in the non-three-dimensional computed tomography group (7.7 versus 15.8 min, P = 0.044). Conclusion: The accuracy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography was extremely high. Preoperative simulation with three-dimensional computed tomography was useful in shortening the operative time of No. 11p lymph node dissection.

show abstract

The Depth from the Skin to the Celiac Artery Measured Using Computed Tomography is a Simple Predictive Index for Longer Operation Time During Laparoscopic Distal Gastrectomy

Abstract: This study demonstrated that SCD is a simple predictive index for longer operation time during LDG.

Cited by 8 publications

References 33 publications

Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy

Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy

Impact of preoperative weight loss achieved by gastric balloon on peri- and postoperative outcomes of bariatric surgery in super-obese patients: a retrospective matched-pair analysis

Significance of prediction of the dorsal landmark using three-dimensional computed tomography during laparoscopic lymph node dissection along the proximal splenic artery in gastric cancer

Contact Info

Product

Resources

About