Surgical Stress after Open and Transumbilical Laparoscopic-Assisted Appendectomy in Children

Montalto, Angela Simona; Impellizzeri, Pietro; Grasso, Maria; Antonuccio, Pietro; Crisafi, Caterina; Scalfari, Gianfranco; Arena, Francesco; Salpietro, Carmelo; Lima, Mario; Romeo, Carmelo

doi:10.1055/s-0033-1333634

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…Apart from the costs, in children the benefits of one-trocar surgery (low invasivity and cosmesis) are more important than adults, especially in adolescent females, since TULAA can be defined as almost scarless surgery [ 20 ]. Moreover in a recent study Montalto et al founded a significant reduction in the postoperative cytokines in TULAA compared to OA, suggesting a less surgical trauma in children [ 21 ]. Finally in our series an histopathologic examination of appendix was always performed and was important for correct diagnosis and postoperative treatment of 2 cases of Enterobius vermicularis infection and 2 cases of acute lymphoblastic leukemia.…”

Section: Discussionmentioning

confidence: 99%

Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children

Noviello

Romano

Martino

et al. 2015

Gastroenterology Research and Practice

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Transumbilical laparoscopic-assisted appendectomy (TULAA) is increasingly being performed worldwide. The authors report their experience in the treatment of acute uncomplicated appendicitis in children with TULAA. From January 2008 to December 2012 all types of acute appendicitis were divided, according to the clinical and ultrasonographic findings, into complicated (appendiceal mass/abscess, diffuse peritonitis) and uncomplicated. Complicated appendicitis was treated by open appendectomy (OA). All patients with the suspicion of uncomplicated appendicitis were offered TULAA by all surgeons of the team. Conversion to open or laparoscopic appendectomy (LA) was performed in case of impossibility to complete TULAA, depending on the choice of surgeon. The histopathologic examination of appendix was always performed. 444 children (252 males) with acute appendicitis were treated. The mean age was 9.2 years (range, 2 to 14 years). Primary OA was performed in 144 cases. In 300 patients a transumbilical laparoscopic-assisted approach was performed. TULAA was completed in 252 patients. Conversion to OA was performed in 45 patients and to LA in 3. Conversion was related to the impossibility to adequately expose the appendix in 47 patients and bleeding in 1. The mean operative time for TULAA was 42 minutes. Histopathologic examination of the appendix removed by TULAA showed a phlegmonous/gangrenous type in 92.8% of cases. Among the 252 TULAA there were 11 cases of umbilical wound infection. TULAA is a feasible and effective procedure for uncomplicated appendicitis in children. It combines the advantages of open and laparoscopic technique (low operative time, low complications rate, and excellent cosmetic results).

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Section: Discussionmentioning

confidence: 99%

Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children

Noviello

Romano

Martino

et al. 2015

Gastroenterology Research and Practice

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“…In breast cancer, incomplete surgical resection of tumor is responsible for ERBB2 overexpression in cancer cells, resulting in stimulation of growth and poorer prognosis [ 19 , 20 ]. Increased secretion of inflammatory cytokines such as IL6 and IL8 has been observed following intra-abdominal surgical stress [ 21 ]. Autocrine production of IL6 and IL8 confers cisplatin and paclitaxel resistance in ovarian cancer cells, due to increased expression of both multidrug resistance-related genes and apoptosis inhibitory proteins [ 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

Are Early Relapses in Advanced-Stage Ovarian Cancer Doomed to a Poor Prognosis?

Vidal

Guerby²,

Luyckx

et al. 2016

PLoS ONE

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ObjectiveEarly recurrence (ER) after completion of therapeutic regimen in advanced-stage ovarian cancer is a challenging clinical situation. Patients are perceived as invariably having a poor prognosis. We investigated the possibility of defining different prognostic subgroups and the parameters implicated in prognosis of ER patients.Study DesignWe analyzed a multi-centric database of 527 FIGO stage IIIC and IV ovarian cancer patients. We defined patients relapsing within 12 months as ER and investigated using Cox logistic regression the prognostic factors in ER group. We subsequently divided ER patients into good and poor prognosis groups according to a lower or higher overall survival (OS) at 12 months after relapse and determined parameters associated to poor prognosis.ResultsThe median follow up was 49 months. One hundred and thirty eight patients recurred within 12 months. OS and Disease Free Survival (DFS) were 24.6 and 8.6 months, respectively, in this group of patients. Among the ER patients, 73 had a poor prognosis with an OS after relapse below 12 months (mean OS = 5.2 months) and 65 survived after one year (mean OS = 26.9 months). Residual disease (RD) after debulking surgery and mucinous histological subtype negatively impacted prognosis (HR = 1.758, p = 0.017 and HR = 8.641, p = 0.001 respectively). The relative risk of death within 12 months following relapse in ER patients was 1.61 according to RD status. However, RD did not affect DFS (HR = 0.889, p = 0.5).ConclusionER in advanced-stage ovarian cancer does not inevitably portend a short-term poor prognosis. RD status after initial cytoreduction strongly modulates OS, that gives additional support to the concept of maximum surgical effort even in patients who will experience early recurrence. The heterogeneity in outcomes within the ER group suggests a role for tumor biology in addition to classical clinical parameters.

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3-Dimensional (3D) laparoscopy improves operating time in small spaces without impact on hemodynamics and psychomental stress parameters of the surgeon

Morandi

Boehne

et al. 2015

Surg Endosc

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Surgical Stress after Open and Transumbilical Laparoscopic-Assisted Appendectomy in Children

Abstract: A significant reduction in the postoperative cytokines in TULAA group suggests that this approach causes less surgical trauma in children.

Cited by 6 publications

References 31 publications

Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children

Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children

Are Early Relapses in Advanced-Stage Ovarian Cancer Doomed to a Poor Prognosis?

3-Dimensional (3D) laparoscopy improves operating time in small spaces without impact on hemodynamics and psychomental stress parameters of the surgeon

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