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Yves Panis - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic subtotal colectomy with double end ileosigmoidostomy in right Iliac Fossa facilitates second stage surgery in patients with inflammatory bowel disease
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: D Mege, Léon Maggiori, Alice Frontali, Gianluca Pellino, S Adegbola, Janindra Warusavitarne, Yves PanisAbstract:Background There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double-end ileosigmoidostomy in the right Iliac Fossa for IBD. Methods All patients undergoing laparoscopic STC and double-end ileosigmoidostomy in the right Iliac Fossa for IBD in 2 European expert centres were included. Results From 1999 to 2017, laparoscopic STC and double-end ileosigmoidostomy in right Iliac Fossa was performed in 213 consecutive patients, including 74 patients in an emergency setting (35%). Conversion to laparotomy was necessary in 9 patients (4%). One patient died postoperatively (0.5%). Postoperative morbidity occurred in 53 patients (25%) after STC, and was major in 18 patients (8%). A second stage was performed in 199 patients (94%), with a mean delay of 4.7 ± 6 months (range 1.4-77). The second stage was an ileorectal anastomosis (n = 50/199; 25%), performed by an elective open incision in the right Iliac Fossa in 68% of cases; an ileal pouch-anal anastomosis (IPAA) (n = 139; 70%) successfully performed by laparoscopy in 96% of cases; or an abdominoperineal excision with end ileostomy (n = 10; 5%) successfully performed by laparoscopy in 8 cases. After this second stage, postoperative morbidity occurred in 53 patients (27%), and was major in 15 patients (8%). After a mean follow-up of 3.7 ± 3 years (range 0.1-15), stoma rate (end ileostomy and diverting stoma not closed) was 17%, and small bowel obstruction and incisional hernia occurred in 10 (5%) and 25 (12%) patients, respectively. Conclusions Laparoscopic STC and double-end ileosigmoidostomy in right Iliac Fossa is safe, feasible, and facilitates the second stage for intestinal continuity by either elective incision or laparoscopy in 100% of ileorectal anastomoses and by laparoscopy in 96% of IPAA.
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Laparoscopic subtotal colectomy for acute or severe colitis with double-end ileo-sigmoidostomy in right Iliac Fossa.
Surgical laparoscopy endoscopy & percutaneous techniques, 2010Co-Authors: Léon Maggiori, Frédéric Bretagnol, Arnaud Alves, Yves PanisAbstract:The aim of this study was to report an original technique of laparoscopic subtotal colectomy (STC) for acute colitis complicating inflammatory bowel disease where both ileostomy and sigmoidostomy are located in the right Iliac Fossa. Thirty-five consecutive laparoscopic STC cases with ileo-sigmoidostomy in right Iliac Fossa were retrospectively reviewed. There was no mortality. No patient was reoperated until stoma closure. Bowel continuity was restored by either ileorectal anastomosis (n=14) or secondary proctectomy with ileal-pouch-anal anastomosis (IPAA; n=21). Elective approach was performed in 11 of 14 ileorectal anastomoses (79%) and through iterative laparoscopy in 21 of 21 IPAA (100%). Laparoscopic STC with ileo-sigmoidostomy in right Iliac Fossa avoid a secondary wound incision for sigmoidostomy, and offers the possibility of an elective approach for ileorectal anastomosis as in 79% of the patients. It allowed, in all cases, a totally laparoscopic approach for the second step of IPAA.
Mahesh R Desai - One of the best experts on this subject based on the ideXlab platform.
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Iliac Fossa vs pfannenstiel retrieval incision in laparoscopic donor nephrectomy a critical analysis
Arab journal of urology, 2019Co-Authors: Chaitanya S Deshmukh, Arvind Ganpule, Balaji S Sudharsan, Abhishek Singh, Ravindra Sabnis, Mahesh R DesaiAbstract:Objective: To compare two retrieval incisions, Pfannenstiel vs Iliac Fossa incision, in terms of operative technique-related variables and variables related to patient satisfaction postoperatively, in patients undergoing laparoscopic donor nephrectomy (LDN). Patients and methods: This prospective randomised study was conducted between May 2016 and April 2017. All the voluntary kidney donors aged 18-60 years were randomised into two groups. Group 1, comprised patients undergoing graft retrieval via an Iliac Fossa incision, and Group 2 comprised those undergoing graft retrieval via a Pfannenstiel incision. Intraoperative assessment of the incision by the surgeon was done using a Likert scale-based questionnaire. Other variables studied were the operative time, retrieval time, warm ischaemia time, and length of incision. Postoperatively, visual analogue scale pain scores, analgesia consumption, and hospital stay were compared. During follow-up cosmetic outcome was compared. Results: In all, 108 patients were enrolled in the study with 54 patients in each group. The mean operative time was shorter in Pfannenstiel-incision group, at 155.2 vs 171.67 min (P = 0.01). The retrieval incision length was significantly less in the Pfannenstiel arm, at 9.29 vs 9.85 cm (P < 0.001). In the surgeon Likert scale-based questionnaire, the Pfannenstiel incision scored better than the Iliac Fossa incision for ease of specimen retrieval (P = 0.015), ease of immediate check laparoscopy (P = 0.002), and ease of incision closure (P < 0.001). The Pfannenstiel-incision group required less postoperative analgesia, at a mean (SD) of 7.03 (8.82) vs 15.55 (11.1) mg nalbuphine (P < 0.001). During follow-up the Manchester Scar Scores were lesser in the Pfannenstiel-incision group (P < 0.001). Conclusion: The Pfannenstiel incision was considered preferable during the critical steps of the LDN and had a smaller retrieval incision, lesser operative time and postoperative analgesia requirement, and better cosmesis than the Iliac Fossa incision. Abbreviations: BMI: body mass index; LDN: laparoscopic donor nephrectomy; VAS: visual analogue scale; WIT, warm ischaemia time.
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Iliac Fossa vs Pfannenstiel retrieval incision in laparoscopic donor nephrectomy: A critical analysis.
Arab journal of urology, 2019Co-Authors: Chaitanya S Deshmukh, Arvind Ganpule, Abhishek Singh, Ravindra Sabnis, S. Balaji Sudharsan, Mahesh R DesaiAbstract:Objective: To compare two retrieval incisions, Pfannenstiel vs Iliac Fossa incision, in terms of operative technique-related variables and variables related to patient satisfaction postoperatively, in patients undergoing laparoscopic donor nephrectomy (LDN). Patients and methods: This prospective randomised study was conducted between May 2016 and April 2017. All the voluntary kidney donors aged 18-60 years were randomised into two groups. Group 1, comprised patients undergoing graft retrieval via an Iliac Fossa incision, and Group 2 comprised those undergoing graft retrieval via a Pfannenstiel incision. Intraoperative assessment of the incision by the surgeon was done using a Likert scale-based questionnaire. Other variables studied were the operative time, retrieval time, warm ischaemia time, and length of incision. Postoperatively, visual analogue scale pain scores, analgesia consumption, and hospital stay were compared. During follow-up cosmetic outcome was compared. Results: In all, 108 patients were enrolled in the study with 54 patients in each group. The mean operative time was shorter in Pfannenstiel-incision group, at 155.2 vs 171.67 min (P = 0.01). The retrieval incision length was significantly less in the Pfannenstiel arm, at 9.29 vs 9.85 cm (P
Türkan Terkivatan - One of the best experts on this subject based on the ideXlab platform.
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Surgical Safety and Efficacy of Third Kidney Transplantation in the Ipsilateral Iliac Fossa.
Annals of transplantation, 2019Co-Authors: Piotr Domagala, Hendrikus J.a.n. Kimenai, Jan N. M. Ijzermans, Türkan Terkivatan, Tamar A J Van Den Berg, Khe T. C. Tran, Hermien Hartog, Dennis A. Hesselink, Stephan J. L. Bakker, Robert A. PolAbstract:BACKGROUND Kidney re-transplantation is a relevant option for patients who are returning to dialysis after graft failure. However, evidence is lacking to what extend a third kidney transplantation in the ipsilateral Iliac Fossa is safe and effective. The aim of this study was to investigate the outcomes of third kidney transplantations in the ipsilateral Iliac Fossa compared to first and second ipsilateral Fossa kidney transplantations. MATERIAL AND METHODS There were 2074 kidneys transplanted at the Erasmus MC Rotterdam and at the University Medical Centre Groningen. Donor, recipient, and surgical data were collected. The cohort was divided into 3 groups: recipients of a first graft (I KTx; n=1744), recipients of a second graft (II KTx; n=44), and recipients of a third graft (III KTx; n=7). RESULTS Recipients from the II KTx group had a significantly higher rate of primary non-function (PNF) compared to recipients in the I KTx group and recipients in the III KTx group (4.5% versus 0.7% and 0% respectively; P=0.006). The 1-year graft survival did not differ between groups: 96% for I KTx, 91% for II KTx, and 85% for III KTx (P=0.214). The 5-year graft survival did differ significantly between groups: 89% for I KTx, 82% for II KTx, and 68% for III KTx (P=0.029). There were no differences regards hospital stay and rate of complications between groups. CONCLUSIONS Third kidney transplantation in the ipsilateral Iliac Fossa is feasible and viable. Short-term results are comparable to the first and the second kidney transplantation, however, long-term results are inferior but acceptable compared to dialysis.
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kidney retransplantation in the ipsilateral Iliac Fossa a surgical challenge
American Journal of Transplantation, 2015Co-Authors: Liselotte S S Ooms, Joke I. Roodnat, F.j.m.f. Dor, T. C. K. Tran, Hendrikus J.a.n. Kimenai, Jan N. M. Ijzermans, Türkan TerkivatanAbstract:The aim of this study is to review the surgical outcome of kidney retransplantation in the ipsilateral Iliac Fossa in comparison to first kidney transplants. The database was screened for retransplantations between 1995 and 2013. Each study patient was matched with 3 patients with a first kidney transplantation. Just for graft and patient survival analyses, we added an extra control group including all patients receiving a second transplantation in the contralateral Iliac Fossa. We identified 99 patients who received a retransplantation in the ipsilateral Iliac Fossa. There was significantly more blood loss and longer operative time in the retransplantation group. The rate of vascular complications and graft nephrectomies within 1 year was significantly higher in the study group. The graft survival rates at 1 year and 3, 5, and 10 years were 76%, 67%, 61%, and 47% in the study group versus 94%, 88%, 77%, and 67% (p < 0.001) in the first control group versus 91%, 86%, 78%, and 57% (p = 0.008) in the second control group. Patient survival did not differ significantly between the groups. Kidney retransplantation in ipsilateral Iliac Fossa is surgically challenging and associated with more vascular complications and graft loss within the first year after transplantation. Whenever feasible, the second renal transplant (first retransplant) should be performed contralateral to the prior failed one.
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Kidney Retransplantation in the Ipsilateral Iliac Fossa: A Surgical Challenge.
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2015Co-Authors: Liselotte S S Ooms, Joke I. Roodnat, F.j.m.f. Dor, T. C. K. Tran, Hendrikus J.a.n. Kimenai, Jan N. M. Ijzermans, Türkan TerkivatanAbstract:The aim of this study is to review the surgical outcome of kidney retransplantation in the ipsilateral Iliac Fossa in comparison to first kidney transplants. The database was screened for retransplantations between 1995 and 2013. Each study patient was matched with 3 patients with a first kidney transplantation. Just for graft and patient survival analyses, we added an extra control group including all patients receiving a second transplantation in the contralateral Iliac Fossa. We identified 99 patients who received a retransplantation in the ipsilateral Iliac Fossa. There was significantly more blood loss and longer operative time in the retransplantation group. The rate of vascular complications and graft nephrectomies within 1 year was significantly higher in the study group. The graft survival rates at 1 year and 3, 5, and 10 years were 76%, 67%, 61%, and 47% in the study group versus 94%, 88%, 77%, and 67% (p
Chaitanya S Deshmukh - One of the best experts on this subject based on the ideXlab platform.
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Iliac Fossa vs pfannenstiel retrieval incision in laparoscopic donor nephrectomy a critical analysis
Arab journal of urology, 2019Co-Authors: Chaitanya S Deshmukh, Arvind Ganpule, Balaji S Sudharsan, Abhishek Singh, Ravindra Sabnis, Mahesh R DesaiAbstract:Objective: To compare two retrieval incisions, Pfannenstiel vs Iliac Fossa incision, in terms of operative technique-related variables and variables related to patient satisfaction postoperatively, in patients undergoing laparoscopic donor nephrectomy (LDN). Patients and methods: This prospective randomised study was conducted between May 2016 and April 2017. All the voluntary kidney donors aged 18-60 years were randomised into two groups. Group 1, comprised patients undergoing graft retrieval via an Iliac Fossa incision, and Group 2 comprised those undergoing graft retrieval via a Pfannenstiel incision. Intraoperative assessment of the incision by the surgeon was done using a Likert scale-based questionnaire. Other variables studied were the operative time, retrieval time, warm ischaemia time, and length of incision. Postoperatively, visual analogue scale pain scores, analgesia consumption, and hospital stay were compared. During follow-up cosmetic outcome was compared. Results: In all, 108 patients were enrolled in the study with 54 patients in each group. The mean operative time was shorter in Pfannenstiel-incision group, at 155.2 vs 171.67 min (P = 0.01). The retrieval incision length was significantly less in the Pfannenstiel arm, at 9.29 vs 9.85 cm (P < 0.001). In the surgeon Likert scale-based questionnaire, the Pfannenstiel incision scored better than the Iliac Fossa incision for ease of specimen retrieval (P = 0.015), ease of immediate check laparoscopy (P = 0.002), and ease of incision closure (P < 0.001). The Pfannenstiel-incision group required less postoperative analgesia, at a mean (SD) of 7.03 (8.82) vs 15.55 (11.1) mg nalbuphine (P < 0.001). During follow-up the Manchester Scar Scores were lesser in the Pfannenstiel-incision group (P < 0.001). Conclusion: The Pfannenstiel incision was considered preferable during the critical steps of the LDN and had a smaller retrieval incision, lesser operative time and postoperative analgesia requirement, and better cosmesis than the Iliac Fossa incision. Abbreviations: BMI: body mass index; LDN: laparoscopic donor nephrectomy; VAS: visual analogue scale; WIT, warm ischaemia time.
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Iliac Fossa vs Pfannenstiel retrieval incision in laparoscopic donor nephrectomy: A critical analysis.
Arab journal of urology, 2019Co-Authors: Chaitanya S Deshmukh, Arvind Ganpule, Abhishek Singh, Ravindra Sabnis, S. Balaji Sudharsan, Mahesh R DesaiAbstract:Objective: To compare two retrieval incisions, Pfannenstiel vs Iliac Fossa incision, in terms of operative technique-related variables and variables related to patient satisfaction postoperatively, in patients undergoing laparoscopic donor nephrectomy (LDN). Patients and methods: This prospective randomised study was conducted between May 2016 and April 2017. All the voluntary kidney donors aged 18-60 years were randomised into two groups. Group 1, comprised patients undergoing graft retrieval via an Iliac Fossa incision, and Group 2 comprised those undergoing graft retrieval via a Pfannenstiel incision. Intraoperative assessment of the incision by the surgeon was done using a Likert scale-based questionnaire. Other variables studied were the operative time, retrieval time, warm ischaemia time, and length of incision. Postoperatively, visual analogue scale pain scores, analgesia consumption, and hospital stay were compared. During follow-up cosmetic outcome was compared. Results: In all, 108 patients were enrolled in the study with 54 patients in each group. The mean operative time was shorter in Pfannenstiel-incision group, at 155.2 vs 171.67 min (P = 0.01). The retrieval incision length was significantly less in the Pfannenstiel arm, at 9.29 vs 9.85 cm (P
Léon Maggiori - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic subtotal colectomy with double end ileosigmoidostomy in right Iliac Fossa facilitates second stage surgery in patients with inflammatory bowel disease
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: D Mege, Léon Maggiori, Alice Frontali, Gianluca Pellino, S Adegbola, Janindra Warusavitarne, Yves PanisAbstract:Background There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double-end ileosigmoidostomy in the right Iliac Fossa for IBD. Methods All patients undergoing laparoscopic STC and double-end ileosigmoidostomy in the right Iliac Fossa for IBD in 2 European expert centres were included. Results From 1999 to 2017, laparoscopic STC and double-end ileosigmoidostomy in right Iliac Fossa was performed in 213 consecutive patients, including 74 patients in an emergency setting (35%). Conversion to laparotomy was necessary in 9 patients (4%). One patient died postoperatively (0.5%). Postoperative morbidity occurred in 53 patients (25%) after STC, and was major in 18 patients (8%). A second stage was performed in 199 patients (94%), with a mean delay of 4.7 ± 6 months (range 1.4-77). The second stage was an ileorectal anastomosis (n = 50/199; 25%), performed by an elective open incision in the right Iliac Fossa in 68% of cases; an ileal pouch-anal anastomosis (IPAA) (n = 139; 70%) successfully performed by laparoscopy in 96% of cases; or an abdominoperineal excision with end ileostomy (n = 10; 5%) successfully performed by laparoscopy in 8 cases. After this second stage, postoperative morbidity occurred in 53 patients (27%), and was major in 15 patients (8%). After a mean follow-up of 3.7 ± 3 years (range 0.1-15), stoma rate (end ileostomy and diverting stoma not closed) was 17%, and small bowel obstruction and incisional hernia occurred in 10 (5%) and 25 (12%) patients, respectively. Conclusions Laparoscopic STC and double-end ileosigmoidostomy in right Iliac Fossa is safe, feasible, and facilitates the second stage for intestinal continuity by either elective incision or laparoscopy in 100% of ileorectal anastomoses and by laparoscopy in 96% of IPAA.
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Laparoscopic subtotal colectomy for acute or severe colitis with double-end ileo-sigmoidostomy in right Iliac Fossa.
Surgical laparoscopy endoscopy & percutaneous techniques, 2010Co-Authors: Léon Maggiori, Frédéric Bretagnol, Arnaud Alves, Yves PanisAbstract:The aim of this study was to report an original technique of laparoscopic subtotal colectomy (STC) for acute colitis complicating inflammatory bowel disease where both ileostomy and sigmoidostomy are located in the right Iliac Fossa. Thirty-five consecutive laparoscopic STC cases with ileo-sigmoidostomy in right Iliac Fossa were retrospectively reviewed. There was no mortality. No patient was reoperated until stoma closure. Bowel continuity was restored by either ileorectal anastomosis (n=14) or secondary proctectomy with ileal-pouch-anal anastomosis (IPAA; n=21). Elective approach was performed in 11 of 14 ileorectal anastomoses (79%) and through iterative laparoscopy in 21 of 21 IPAA (100%). Laparoscopic STC with ileo-sigmoidostomy in right Iliac Fossa avoid a secondary wound incision for sigmoidostomy, and offers the possibility of an elective approach for ileorectal anastomosis as in 79% of the patients. It allowed, in all cases, a totally laparoscopic approach for the second step of IPAA.
