Minimally invasive approaches, including laparoscopic procedures, have increasingly been applied in surgery because of their advantages such as reduced surgical trauma, better quality of life, shorter hospital stay, and less postoperative morbidity compared with open surgeries. (1) Minimally invasive approaches in liver transplantation (LT) may have similar advantages for the recipients, including less pain and a shorter hospital stay, which could facilitate rehabilitation. However, there is only 1 reported case of a laparoscopic explant hepatectomy during deceased donor LT (DDLT), which indeed requires left lateral sectionectomy for completion of the procedure. (2) Based on the experience of the surgeon and the transplant team, we initiated a minimally invasive living donor LT (LDLT) program. Here we present our initial experience of pure laparoscopic explant hepatectomy without liver fragmentation followed by graft implantation using an upper midline incision. To the best of our knowledge, no previous study has reported a successful experience of minimally invasive LDLT, including pure laparoscopic explant hepatectomies.

Minimally invasive approaches are increasingly being applied in surgeries and have recently been used in living donor hepatectomy. We have developed a safe and reproducible method for minimally invasive living donor liver transplantation, which consists of pure laparoscopic explant hepatectomy and pure laparoscopic implantation of the graft, which was inserted through a suprapubic incision. Pure laparoscopic explant hepatectomy without liver fragmentation was performed in a 60-year-old man with alcoholic liver cirrhosis and hepatocellular carcinoma. The explanted liver was retrieved through a suprapubic incision. A modified right liver graft, procured from his 24-year-old son using the pure laparoscopic method, was inserted through a suprapubic incision, and implantation was performed intracorporeally throughout the procedure. The time required to remove the liver was 369 min, and the total operative time was 960 min. No complications occurred during or after the surgery. The patient recovered well, and his hospital stay was of 11 days. Pure laparoscopic living donor liver transplantation from explant hepatectomy to implantation was performed successfully. It is a feasible procedure when performed by a highly experienced surgeon and transplantation team. Further studies with larger sample sizes are needed to confirm its safety and feasibility.

PurposeThis study investigated the incidence trends and associated factors of type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents under 15 years of age in Busan and Gyeongnam, Korea from 2001 to 2010.MethodsMedical records of newly diagnosed diabetes patients (n=328; 160 males, 168 females) were collected in questionnaire form from 5 tertiary and 42 general hospitals in Busan and Gyeongnam.ResultsThe average crude incidence rate of T1DM and T2DM was 2.01/100,000 (95% confidence interval [CI], 1.76-2.28) and 0.75/100,000 (95% CI, 0.60-0.92), respectively. The incidence rate ratio (IRR) of T1DM was 1.31 (95% CI, 1.01-1.69), and that of T2DM was 1.97 (95% CI, 1.25-3.11) in the latter half-decade (2006 to 2010) compared to the early half-decade (2001 to 2005). There were gradually increasing incidence trends in both T1DM and T2DM over the 10-year period (P for trend: T1DM, 0.0009; T2DM, <0.0001). Age-specific IRR was highest in the 10- to 14-year-old group, regardless of diabetes type. In particular, a rapid increase in incidence of T2DM occurred in the 10- to 14-year-old group. IRR for females was 1.07 (95% CI, 0.83-1.38) for T1DM and 1.56 (95% CI, 1.01-2.41) for T2DM. IRR for Busan (urban) was 1.41 (95% CI, 1.09-1.83) for T1DM and 1.49 (95% CI, 0.96-2.30) for T2DM.ConclusionT1DM and T2DM incidence both increased over time in youth under age 15 living in Busan and Gyeongnam; in particular, the incidence of T2DM in adolescents increased more rapidly.

Introduction: Minimally invasive approaches have increasingly been applied in surgeries and have even recently been used in live donor hepatectomy. We have developed a safe and reproducible method for minimally invasive living donor liver transplantation (LDLT), which consists of pure laparoscopic explant hepatectomy and graft implantation using an upper midline incision. Methods: From March 2020 to June 2020, minimally invasive LDLT was attempted in five patients. Explant hepatectomy was performed using the pure laparoscopic method, and graft implantation was performed using an upper midline incision. Results: The procedure was completed in three of the five patients. The first two patients required open conversion due to bleeding. In the three successful procedures, the time required to remove the liver was 285, 180, and 166 minutes, respectively, and the total operative time was 640, 575, and 499 minutes, respectively. All patients recovered well, and the duration of hospital stay was 30, 26, and 15 days, respectively. Conclusions: According to the data of the present study, minimally invasive LDLT in properly selected recipients is a feasible and safe procedure when performed by a highly experienced surgeon and transplantation team. Further studies with larger series are needed to confirm the safety and feasibility.

ABSTRACT. A 10-year-old Maltese dog was presented with abdominal distention and dyspnea. Cytological examination of pleural and peritoneal effusion was suggestive of malignant effusion of glandular origin. Numerous, multifocal, tan to white nodules were disseminated throughout the surface of the abdominal organs and peritoneum at biopsy. Histologically, the tumors were revealed to be an epithelial type of mesothelioma. Neoplastic cells co-expressed cytokeratin and vimentin. Intravenous administration of cisplatin was chosen as the treatment. During treatment, the dog's overall body condition improved and the clinical signs were relieved without significant side effects. The survival time from diagnosis to sudden death by unknown cause was 153 days.