1,721,163 research outputs found
Chirurgia robotica colorettale: esperienza iniziale
Full text linkIntroduction
Robotc surgery was performed at the Department "Pietro Valdoni" of the "Umberto I" University Hospital of Rome since 2019. The aim of the current study is to present a retrospective review of the collected data of patients undergoing robotic surgery for colorectal diseases.
Materials and methods
From October 2020 to September 2022, 35 patients underwent to robotic colorectal surgery with da Vinci X IS4200 system. Surgery team was the same for all the procedures. Indications for surgery included both benign and malignant colorectal diseases: colorectal cancer, endoscopically unresectable adenomas and complicated diverticular disease. Data about patients demographics, perioperative outcomes, pathological analysis have been prospectively recorded in the Department database and were subsequently analysed. All procedures were performed with five ports, three robotic and two laparoscopic, respectively.
Results
Thirty-five patients (14 males and 21 females) were included. Mean age was 70 years (range 52-90), BMI 24kg/m2. Indications for surgery were cancer (82,8% of cases), complicated diverticular disease (8,6%), benign adenomas (8,6%). The most frequent operation was right hemicolectomy (45,5%) followed by low anterior resection (21,2%) and left hemicolectomy (33,3%). Median operative time was 259 minutes (range 180-390), 25 minutes (range 10-35) were necessary for the preoperative robot preparation (docking). There were two conversions to laparotomy. All patients operated for colorectal cancer underwent an appropriate oncological procedure. The median time to discharge was 7 days (range: 6-11). Four patients (12,1%) experienced postoperative complications (Clavien-Dindo I, two patients; Clavien Dindo II/III one patient, respectively).
Conclusions
In our experience colorectal robotic surgery is feasible and safe. The magnified 3-D vision and the enhanced robotic freedom of movements compared to laparoscopic surgery increases the precision of basic surgical gestures such as traction, counter-traction and improves anatomic dissection. Operating times are still longer than laparoscopic surgery, especially at the start of the learning curve, and their significance is a topic of discussion.
However, the experience in robotic surgery can lead to a significant improvement in operating times. Furthermore, low complication rate and consequently a reduced lenght of stay can decrease overall costs. It is necessary to continue gathering data
Case report Autoimmune pancreatitis: a case of difficult diagnosis
No full textAutoimmune pancreatitis (AIP) is an insidious disease of non-specific symptomatology. To make correct diagnosis three
different findings must correlate: radiological imaging, serological markers, and histology. This is not easy, and furthermore an
incorrect diagnosis can lead to incorrect management and even patient death. We present our experience with a case of AIP in
a young woman (34 years old) affected by different autoimmune pathologies with a history of abdominal pain. The diagnosis
was made correlating histological findings and anamnestic data, although there were no radiological or serological findings.
However, the management of this case was complicated by acute pancreatitis. In our case, we had only a histological sample
and anamnestic data. So in these cases of positive history for autoimmune disorders and unclear clinical signs, AIP should be
considered in differential diagnosis
Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Efficacy and safety of laparo-endoscopic resections of colorectal neoplasia: A systematic review
No full textVariations on the Author
Full text link“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
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