Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence an...Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours≥10 cm.Methods:This was a retrospective review of 971 patients who underwent LLR and RLR for huge(≥10 cm)tumors at 42 international centers between 2002-2020.Results:One hundred RLR and 699 LLR which met study criteria were included.The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated with significantly increased frequency of previous abdominal surgery,malignant pathology,liver cirrhosis and increased median blood.After PSM,RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative length of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes.There was no significant difference in perioperative outcomes after RLR or LLR.展开更多
<span style="line-height:1.5;">Up until the recent past, zoos served limited function, primarily existing for entertainment value. Today’s zoos, however, are serving many roles, chief among them: spec...<span style="line-height:1.5;">Up until the recent past, zoos served limited function, primarily existing for entertainment value. Today’s zoos, however, are serving many roles, chief among them: species conservation of captive animals. The biggest zoo in Brazil, S?o Paulo Zoological Park Foundation, has among its 2000 animals and many species of wild cats. The presence of domestic cats living freely in zoos </span><span style="line-height:1.5;">is</span><span style="line-height:1.5;"> common and can be a source of spreading disease. The aim of this study was to verify the variety and prevalence of parasites found in the feces of felids (feral and wild) living in the S<span style="white-space:nowrap;">?</span>o Paulo Zoo. The results of this parasitological analysis have been obtained from the laboratory of clinical analysis and correspond to the 4-year period beginning January/2009 and ending December/2012. Eight species of parasites were identified in the feces of captive wild cats and three in the feces of feral cats. For those captive</span><span style="line-height:1.5;">s</span><span "="" style="line-height:1.5;">, <i>Toxocara cati</i> (7.95%) had the highest prevalence, followed by <i>Toxascaris leonina</i> (7.58%), <i>Isospora</i> sp. (2.03%), <i>Hymenolepis nana</i> (0.92%), <i>Eimeria</i> sp., <i>Giardia</i> sp. and <i>Blastocystis</i> sp. (0.37% each) and <i>Ascaris</i> sp. (0.18%). Among the feral cats, we found <i>Toxocara cati</i> (59.26%), <i>Giardia</i> sp. (22.22%) and <i>Isospora</i> sp. (11.11%). For the captive group, we also distinguished natives from exotic species, finding native species to be more frequently parasitized than the exotic ones. Key to our findings, though, was the fact that a few parasite species were found among all groups of </span><span style="line-height:1.5;">f</span><span "="" style="line-height:1.5;">elids, specifically (<i>Toxocara cati</i>, <i>Giardia</i> sp. and <i>Isospora</i> sp). Further research is needed, however, to confirm that transmission of these parasite展开更多
Over the past 20 years the use of laparoscopy has revolutionized hepatic surgery and,in recent years,robotic assistance to the laparoscopic approach has been explored by some centres.Since its approval,there has been ...Over the past 20 years the use of laparoscopy has revolutionized hepatic surgery and,in recent years,robotic assistance to the laparoscopic approach has been explored by some centres.Since its approval,there has been a prodigious increase in robotic utilization for surgical operations worldwide[1,2].As its use continues to increase,assessment of efficacy and outcomes is an area of active study.展开更多
基金Dr.T.P.Kingham was partially supported by the US National Cancer Institute MSKCC Core Grant number P30 CA00878 for this study.
文摘Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours≥10 cm.Methods:This was a retrospective review of 971 patients who underwent LLR and RLR for huge(≥10 cm)tumors at 42 international centers between 2002-2020.Results:One hundred RLR and 699 LLR which met study criteria were included.The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated with significantly increased frequency of previous abdominal surgery,malignant pathology,liver cirrhosis and increased median blood.After PSM,RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative length of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes.There was no significant difference in perioperative outcomes after RLR or LLR.
文摘<span style="line-height:1.5;">Up until the recent past, zoos served limited function, primarily existing for entertainment value. Today’s zoos, however, are serving many roles, chief among them: species conservation of captive animals. The biggest zoo in Brazil, S?o Paulo Zoological Park Foundation, has among its 2000 animals and many species of wild cats. The presence of domestic cats living freely in zoos </span><span style="line-height:1.5;">is</span><span style="line-height:1.5;"> common and can be a source of spreading disease. The aim of this study was to verify the variety and prevalence of parasites found in the feces of felids (feral and wild) living in the S<span style="white-space:nowrap;">?</span>o Paulo Zoo. The results of this parasitological analysis have been obtained from the laboratory of clinical analysis and correspond to the 4-year period beginning January/2009 and ending December/2012. Eight species of parasites were identified in the feces of captive wild cats and three in the feces of feral cats. For those captive</span><span style="line-height:1.5;">s</span><span "="" style="line-height:1.5;">, <i>Toxocara cati</i> (7.95%) had the highest prevalence, followed by <i>Toxascaris leonina</i> (7.58%), <i>Isospora</i> sp. (2.03%), <i>Hymenolepis nana</i> (0.92%), <i>Eimeria</i> sp., <i>Giardia</i> sp. and <i>Blastocystis</i> sp. (0.37% each) and <i>Ascaris</i> sp. (0.18%). Among the feral cats, we found <i>Toxocara cati</i> (59.26%), <i>Giardia</i> sp. (22.22%) and <i>Isospora</i> sp. (11.11%). For the captive group, we also distinguished natives from exotic species, finding native species to be more frequently parasitized than the exotic ones. Key to our findings, though, was the fact that a few parasite species were found among all groups of </span><span style="line-height:1.5;">f</span><span "="" style="line-height:1.5;">elids, specifically (<i>Toxocara cati</i>, <i>Giardia</i> sp. and <i>Isospora</i> sp). Further research is needed, however, to confirm that transmission of these parasite
文摘Over the past 20 years the use of laparoscopy has revolutionized hepatic surgery and,in recent years,robotic assistance to the laparoscopic approach has been explored by some centres.Since its approval,there has been a prodigious increase in robotic utilization for surgical operations worldwide[1,2].As its use continues to increase,assessment of efficacy and outcomes is an area of active study.
