1,720,956 research outputs found
IMPLEMENTATION OF A TOTALLY MINIMALLY INVASIVE ESOPHAGECTOMY PROGRAM FOR CANCER IN A HIGH-VOLUME CENTER: COMPARISON OF INITIAL SERIES RESULTS WITH TRADITIONAL OPEN TECHNIQUE
Get PDFopenThe minimally invasive approach is becoming increasingly popular; in fact, it has demonstrated non-inferior surgical and oncologic outcomes compared with open esophagectomy, with better short-term outcomes. Advantages include shorter hospital and ICU stays, fewer pulmonary infections, and less intraoperative blood loss. However, minimally invasive esophagectomy requires highly developed minimally invasive surgical skills and is a technically difficult procedure. Even in a tertiary center, developing a minimally invasive program takes time and has a protracted learning curve before a plateau of ideal results is reached. The purpose of this study is to evaluate the safety and efficacy of implementing a totally minimally invasive esophagectomy program for cancer in a high-volume center. In addition, it aimed to evaluate the impact of the learning curve on perioperative and oncologic outcomes. Survival and disease-free survival were included as secondary endpoints. This study is a prospective non-randomized control study from a single center. From the start of the minimally invasive program in June 2018 to October 2022, data were gathered on all consecutive patients who underwent elective Ivor Lewis esophagectomy at the Upper G.I. Surgery Unit “General surgery I” of Padova University. Patients undergoing Minimally Invasive Ivor Lewis Esophagectomy were assigned to the MIE group, those undergoing Open Ivor Lewis Esophagectomy to the OE group. By comparing the perioperative and oncological outcomes of patients who underwent MIE to those of patients treated with OE during the same period, we evaluated the safety and efficacy of the minimally invasive approach in the treatment of esophageal cancer. Subsequently, the MIE group was divided into two groups: Early Experience and Late Experience group. By comparing the perioperative and oncological outcomes between the two groups we evaluated the presence and the impact of a learning curve. During the inclusion period, 61 patients underwent MIE and 138 underwent OE. The mean operative time was shorter for the OE than for the MIE group (295 vs 363 min). The average number of lymph nodes harvested was higher during MIE than during OE (27,4 vs 20,8 lymph nodes). The number of total blood transfusions was lower in the OE compared to the MIE group (0,1 vs 0,7 blood units). No differences were found regarding surgical radicality or postoperative complications type and severity. Hospital stay, ICU stay and 90-days mortality and readmission rates were similar between the two groups. Comparing the patients undergone MIE in the early experience period (31 patients) to the ones of the late experience period (30 patients) we observed a decrease in the mean number of metastatic lymph nodes extracted (2,7 vs 0,3 lymph nodes), in the infective and thromboembolic complications rates (respectively 54,8% vs 13,3%, and 16,1% vs 0%), and in the average ICU total stay (1,6 vs 0,6 days). The findings of this study support the safety and efficacy of implementing a totally minimally invasive esophagectomy program for cancer in a high-volume center. In comparison to open technique, surgical and oncological outcomes, postoperative complication rates, morbidity and mortality rates were not compromised by the learning curve effect and met current international standards. According to our observations, MIE results in higher rates of lymph node yield, both in the abdominal and thoracic fields. We therefore propose that the effect of laparoscopic magnification can aid in a more accurate and precise lymph node dissection. Comparing the outcomes of the early experience with those of the late experience, we discovered improving trends in postoperative complication and recovery rates. In our high-volume center's experience, improving these outcomes has required 25 to 30 cases.The minimally invasive approach is becoming increasingly popular; in fact, it has demonstrated non-inferior surgical and oncologic outcomes compared with open esophagectomy, with better short-term outcomes. Advantages include shorter hospital and ICU stays, fewer pulmonary infections, and less intraoperative blood loss. However, minimally invasive esophagectomy requires highly developed minimally invasive surgical skills and is a technically difficult procedure. Even in a tertiary center, developing a minimally invasive program takes time and has a protracted learning curve before a plateau of ideal results is reached. The purpose of this study is to evaluate the safety and efficacy of implementing a totally minimally invasive esophagectomy program for cancer in a high-volume center. In addition, it aimed to evaluate the impact of the learning curve on perioperative and oncologic outcomes. Survival and disease-free survival were included as secondary endpoints. This study is a prospective non-randomized control study from a single center. From the start of the minimally invasive program in June 2018 to October 2022, data were gathered on all consecutive patients who underwent elective Ivor Lewis esophagectomy at the Upper G.I. Surgery Unit “General surgery I” of Padova University. Patients undergoing Minimally Invasive Ivor Lewis Esophagectomy were assigned to the MIE group, those undergoing Open Ivor Lewis Esophagectomy to the OE group. By comparing the perioperative and oncological outcomes of patients who underwent MIE to those of patients treated with OE during the same period, we evaluated the safety and efficacy of the minimally invasive approach in the treatment of esophageal cancer. Subsequently, the MIE group was divided into two groups: Early Experience and Late Experience group. By comparing the perioperative and oncological outcomes between the two groups we evaluated the presence and the impact of a learning curve. During the inclusion period, 61 patients underwent MIE and 138 underwent OE. The mean operative time was shorter for the OE than for the MIE group (295 vs 363 min). The average number of lymph nodes harvested was higher during MIE than during OE (27,4 vs 20,8 lymph nodes). The number of total blood transfusions was lower in the OE compared to the MIE group (0,1 vs 0,7 blood units). No differences were found regarding surgical radicality or postoperative complications type and severity. Hospital stay, ICU stay and 90-days mortality and readmission rates were similar between the two groups. Comparing the patients undergone MIE in the early experience period (31 patients) to the ones of the late experience period (30 patients) we observed a decrease in the mean number of metastatic lymph nodes extracted (2,7 vs 0,3 lymph nodes), in the infective and thromboembolic complications rates (respectively 54,8% vs 13,3%, and 16,1% vs 0%), and in the average ICU total stay (1,6 vs 0,6 days). The findings of this study support the safety and efficacy of implementing a totally minimally invasive esophagectomy program for cancer in a high-volume center. In comparison to open technique, surgical and oncological outcomes, postoperative complication rates, morbidity and mortality rates were not compromised by the learning curve effect and met current international standards. According to our observations, MIE results in higher rates of lymph node yield, both in the abdominal and thoracic fields. We therefore propose that the effect of laparoscopic magnification can aid in a more accurate and precise lymph node dissection. Comparing the outcomes of the early experience with those of the late experience, we discovered improving trends in postoperative complication and recovery rates. In our high-volume center's experience, improving these outcomes has required 25 to 30 cases
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Implementierung des da Vinci Single-Port Robotersystems in der Klinik für Allgemein-, Viszeral- und Transplantationschirurgie der Universitätsmedizin Mainz
Get PDF62 Seiten ; Diagramm
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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