Laparoscopic Hepatectomy for Liver Cancer

2015 ◽  
Vol 33 (5) ◽  
pp. 691-698 ◽  
Author(s):  
Akishige Kanazawa ◽  
Tadashi Tsukamoto ◽  
Sadatoshi Shimizu ◽  
Satoshi Yamamoto ◽  
Akihiro Murata ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Standard Procedure ◽  
Laparoscopic Hepatectomy ◽  
Surgical Techniques ◽  
Laparoscopic Approach ◽  
Technological Innovations ◽  
Rapid Progress ◽  
Hepatic Surgery ◽  
Novel Approach ◽  
Near Future

This chapter covers a range of important topics of laparoscopic hepatectomy as a novel approach toward treatment of liver cancer. Although laparoscopic hepatectomy was performed in a limited number of centers in the 1990s, technological innovations, improvements in surgical techniques and accumulation of experience by surgeons have led to more rapid progress in laparoscopic hepatectomy in the late 2000s for minimally invasive hepatic surgery. Currently, laparoscopic hepatectomy can be performed for all tumor locations and several diseases via several approaches. The laparoscopic approach can be applied to several types of resection, not only for tumors but also for liver transplantation, with equivalent or better results compared with those obtained with open surgery. Therefore, laparoscopic hepatectomy will become a standard procedure for treatment of liver cancer in the near future.

scholarly journals Totally laparoscopic liver resection: new brazilian experience

2014 ◽  
Vol 27 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Croider Franco LACERDA ◽  
Paulo Anderson BERTULUCCI ◽  
Antônio Talvane Torres de OLIVEIRA
Keyword(s):  
Laparoscopic Hepatectomy ◽  
Surgical Techniques ◽  
Laparoscopic Approach ◽  
Right Hepatectomy ◽  
Open Technique ◽  
Liver Resections ◽  
Simultaneous Operations ◽  
Simultaneous Procedures ◽  
The Mean ◽  
Totally Laparoscopic

BACKGROUND: Despite the increasing number of laparoscopic hepatectomy, there is little published experience. AIM: To evaluate the results of a series of hepatectomy completely done with laparoscopic approach. METHODS: This is a retrospective study of 61 laparoscopic liver resections. Were studied conversion to open technique; mean age; gender, mortality; complications; type of hepatectomy; surgical techniques applied; and simultaneous operations. RESULTS: The conversion to open technique was necessary in one case (1.6%). The mean age was 54.7 years (17-84), 34 were men. Three patients (4.9%) had complications. One died postoperatively (mortality 1.6%) and no deaths occurred intraoperatively. The most frequent type was right hepatectomy (37.7%), followed by bisegmentectomy (segments II-III and VI-VII). Were not used hemi-Pringle maneuvers or assisted technic. Six patients (8.1%) underwent simultaneous procedures (hepatectomy and colectomy). CONCLUSION: Laparoscopic hepatectomy is feasible procedure and can be considered the gold standard for various conditions requiring liver resections for both benign to malignant diseases.

scholarly journals Prebiotics: A Novel Approach to Treat Hepatocellular Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Naz Fatima ◽  
Tasleem Akhtar ◽  
Nadeem Sheikh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Antitumor Effect ◽  
Gut Permeability ◽  
Gut Flora ◽  
Effective Barrier ◽  
The Third ◽  
Oncogenic Pathways ◽  
Novel Approach ◽  
Genetic Modifications

Hepatocellular carcinoma is one of the fatal malignancies and is considered as the third leading cause of death. Mutations, genetic modifications, dietary aflatoxins, or impairments in the regulation of oncogenic pathways may bring about liver cancer. An effective barrier against hepatotoxins is offered by gut-liver axis as a change in gut permeability and expanded translocation of lipopolysaccharides triggers the activation of Toll-like receptors which stimulate the process of hepatocarcinogenesis. Prebiotics, nondigestible oligosaccharides, have a pivotal role to play when it comes to inducing an antitumor effect. A healthy gut flora balance is imperative to downregulation of inflammatory cytokines and reducing lipopolysaccharides induced endotoxemia, thus inducing the antitumor effect.

Airship Piloting

1921 ◽  
Vol 25 (122) ◽  
pp. 47-93
Keyword(s):  
Atmospheric Conditions ◽  
Rapid Progress ◽  
Scientific Interest ◽  
The World ◽  
The Subject ◽  
Near Future

I feel it a great honour to have the privilege of addressing the members of the Royal Aeronautical Society on the subject of Airship Piloting, especially in view of the interest you have taken in furthering and generally assisting in the development of all types of aircraft.Although the airship has hitherto not occupied the thought and brains of Aeronautical Engineers to the same extent as the aeroplane and seaplane, I feel sure the confidence and support of the Society will lead to a more general and scientific interest being taken in lighter-than-air craft, which is bound to result in more rapid progress in the near future.I hope the discussion to follow will provide the foundation for solving some of the problems that will have to be faced, when piloting the airships over routes to various parts of the world, where totally different atmospheric conditions are likely to be encountered.

scholarly journals Tracheal surgery

2016 ◽  
Vol 73 (3) ◽  
Author(s):  
A. D'Andrilli ◽  
E.A. Rendina ◽  
F. Venuta
Keyword(s):  
Surgical Resection ◽  
Surgical Techniques ◽  
Treatment Modalities ◽  
Malignant Neoplasms ◽  
New Techniques ◽  
Multidisciplinary Cooperation ◽  
Post Traumatic ◽  
Post Intubation ◽  
Near Future

Surgical resection and reconstruction of the trachea can be performed both for benign and malignant diseases. The main indications for surgery include inflammatory (generally post-intubation), congenital or post-traumatic stenoses, degenerative lesions, benign or malignant neoplasms. Success can be pursued only by accurate patient selection and timing, meticulous surgical techniques, careful follow up and, when required, multidisciplinary cooperation. Although surgical resection has now become part of our surgical practice, other treatment modalities are approaching a new clinical application era, in particular tracheal transplantation and bioengineering. These new techniques will certainly offer, in the near future, improved chances to treat difficult cases.

scholarly journals Laparoscopic Approach to Left Hepatectomy Using a Standardized Technique

2021 ◽  
pp. 1-3
Author(s):  
Chang Stephen Kin Yong ◽  
◽  
R Ang ◽  
Keyword(s):  
Surgical Technique ◽  
Traditional Approach ◽  
Hepatic Duct ◽  
Laparoscopic Hepatectomy ◽  
Vena Cava ◽  
Laparoscopic Approach ◽  
Liver Parenchyma ◽  
Left Hepatic Duct ◽  
Patient Selection Criteria ◽  
Key Steps

Introduction: The laparoscopic approach in liver surgery has been preferred over the traditional approach in the resection of segments 2 and 3, as laparoscopic surgical technique can be standardized for easy adoption and is minimally invasive. This paper describes the laparoscopic surgical technique and recommends the patient selection criteria in the resection of segments 2, 3 and 4. Methods: This technique involves 2 key steps – early division of the left pedicle before the division of the liver parenchyma and the placement of an instrument beneath the transection plane to simulate a ‘hanging manoeuvre’ with reduced blood loss and allows the expeditious division of the liver parenchyma. Apart from the usual contraindications to liver resections, specific contraindications to this technique include patients with aberrant biliary drainage of right liver segments into the left hepatic duct, patients with tumours abutting the hilar plate and patients with tumours located near the junction of the left hepatic vein and the vena cava. Conclusion: The authors recommend these steps to serve as a standardized technique for laparoscopic hepatectomy of segments 2,3 and 4 in selected patients, allowing the learning curve for this technique to be markedly shortened

scholarly journals Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

2020 ◽  
Vol 9 (2) ◽  
pp. 97-103
Author(s):  
Fouad Khalil ◽  
Konstantinos Siontis ◽  
Gabor Bagameri ◽  
Ammar M Killu ◽  
◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Surgical Techniques ◽  
Hybrid Technique ◽  
Surgical Ablation ◽  
Safety And Efficacy ◽  
Energy Delivery ◽  
Novel Approach ◽  
Growing Body

Catheter ablation is a rapidly expanding and evolving field. The advent of interventional techniques and advances in technology have allowed catheter ablation to supplant antiarrhythmic surgery for ventricular arrhythmia treatment. However, issues related to access and energy delivery limit the use of catheter ablation in some cases. Hybrid catheter-based and surgical techniques represent a novel approach to overcome these limitations. The hybrid technique combines the strengths and minimises the limitations of either catheter or surgical ablation alone. There is a growing body of evidence in the literature supporting the safety and efficacy of the hybrid surgical technique. This review aims to provide an overview of hybrid surgical-catheter ablation for ventricular arrhythmia.

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

2020 ◽  
Author(s):  
Jiao Yuan ◽  
Li Zeng ◽  
min tian ◽  
Sisi Chen ◽  
Huai yi Yao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Survival Rate ◽  
Liver Cancer ◽  
Laparoscopic Hepatectomy ◽  
Rank Test ◽  
Log Rank Test ◽  
Open Hepatectomy ◽  
Disease Free

Abstract BackgroundHepatocellular carcinoma (HCC) ranks as the fourth most common cancer and the third leading cause of cancer-related mortality worldwide. With the development of minimally invasive surgical techniques, laparoscopic hepatectomy is becoming more prevalent in liver surgery. There are multiple reports to evaluate the safety and feasibility of laparoscopic liver resection. Unfortunately, the jury is still out on whether laparoscopic hepatectomy is better than open hepatectomy. The aim of this study is to compare the perioperative and postoperative long-term outcomes of open hepatectomy and laparoscopic hepatectomy for hepatocellular carcinoma, and to evaluate the safety and efficacy of the two surgical methods for hepatocellular carcinoma.MethodsA prospective cohort study of patients who underwent major hepatectomy for hepatocellular carcinoma between October 2017 and September2018 was performed. And these patients were followed for 24 months after surgery. There are158 patients involved in the present study and they were randomly divided into two groups, LH group (n=60), and OH group (n=98). And all of 158 patients underwent hepatectomy. Continuous data were compared by one-way ANOVA, and categorical data were compared by Fisher’s exact test or the c2 test. Survival curves were calculated by the Kaplan–Meier method and compared using the log-rank test. The study was approved by the ethics committee of Union Hospital. (No. WHUH2018S002) and registered in the International Clinical Trial Registry (No. NCT03585166). Informed consent was signed by all patients.ResultsIncision lengths of LH (5.14±3.11cm) were shorter than OH(20.92±6.44cm), P<0.001. Operating time of LH (398.53±170.51 minutes) were longer than OH(257.74±91.31 minutes), P=0.003. Hospital stay of LH(17.72±5.82 days) were shorter than OH(21.42±8.44 days), P<0.001. The average hospitalization costs of LH group (82741.18±26128.81￥) were significantly less than OH group (94998.75±30499.64￥), p=0.011<0.05. The incidence of total complications was also lower in LH group than in OH group (P<0.001). Postoperatively, the leukocyte was significantly lower at 1st day in LH group (9.79±2.92G/L) than in OH group (12.6±4.85 G/L), p<0.001.The aspartate aminotransferase (AST) was significantly lower at 7th day in LH group (39.25±16.63 U/L) than in OH group (62.49±67.77 U/L), p=0.01<0.05. The albumin was significantly higher at 3rd day in LH group (34.21±3.94 g/L) than in OH group (31.24±5.23 g/L), p<0.001. The albumin was significantly higher at 7th day in LH group (35.26±3.73 g/L) than in OH group (33.31±4.51 g/L), p=0.006<0.05. Direct bilirubin was significantly higher at 1st day in LH group (10.28±10.70 µmol /L) than in OH group (315.03±15.71 µmol /L), p=0.04<0.05. The follow-up time after surgery was 24 months (1-24). The mean follow-up time after surgery was 17.94±9.132. Log rank test was performed to compare overall survival rates between the two groups. There were no statistically significant differences with 2-year survival rate between LH and OH group for liver cancer patients, nor was disease-free survival.ConclusionsLaparoscopic hepatectomy surgery supplied a lower incision lengths, hospital stay and incidence of total complications. Laparoscopic hepatectomy was cheaper the open hepatectomy.There were no statistically significant differences with 2-year survival rate between the two group for liver cancer patients, nor was disease-free survival.

The Federal Communication Commission’s National Broadband Plan

2011 ◽  
pp. 57-72
Author(s):  
John B. Meisel ◽  
John Navin ◽  
Timothy S. Sullivan
Keyword(s):  
Federal Policy ◽  
Federal Communications Commission ◽  
Technological Innovations ◽  
Critical Questions ◽  
Open Networks ◽  
The Us ◽  
Legal Arguments ◽  
Near Future

The American Recovery and Reinvestment Act of 2009 charged the US Federal Communications Commission (FCC) to develop and deliver to Congress a national broadband plan by February 17, 2010. The FCC formally commenced the process of developing the plan by issuing a Notice of Inquiry (NOI) on April 8, 2009. The NOI identified broadband issues and critical questions and asked stakeholders to respond to these issues and questions with data and analysis. The purpose of this chapter is to analyze the written documents generated by stakeholders’ responses concerning the specific issues of open networks and competition and to make recommendations to the FCC in its formulation of federal policy as to the position that makes the most economic sense on these issues. We find that many of the arguments and concerns of stakeholders are dependent upon predictions regarding the competitiveness of ISP markets. We predict with confidence that technological innovations are likely to make many legal arguments (on all sides) obsolete in the near future.

scholarly journals Perspective: Cellular and Molecular Profiling Technologies in Personalized Oncology

2019 ◽  
Vol 9 (3) ◽  
pp. 44 ◽  
Author(s):  
Andrea Cruz ◽  
Weng Kung Peng
Keyword(s):  
Public Health ◽  
Point Of Care ◽  
Molecular Profiling ◽  
Technological Innovations ◽  
Self Monitoring ◽  
Health Concerns ◽  
Important Public Health ◽  
One Step ◽  
Personalized Oncology ◽  
Near Future

Cancer is a leading cause of death worldwide and therefore one of the most important public health concerns. In this contribution, we discuss recent key enabling technological innovations (and their challenges), including biomarker-based technologies, that potentially allow for decentralization (e.g., self-monitoring) with the increasing availability of point-of-care technologies in the near future. These technological innovations are moving the field one step closer toward personalized oncology.

Advances in Laser Cooling of Solids

2006 ◽  
Vol 129 (1) ◽  
pp. 3-10 ◽  
Author(s):  
X. L. Ruan ◽  
M. Kaviany
Keyword(s):  
Laser Cooling ◽  
Nonradiative Recombination ◽  
Rapid Progress ◽  
Cooling Process ◽  
Theoretical Limit ◽  
Rare Earth Ion ◽  
Cooling Performance ◽  
Theoretical Predictions ◽  
Anti Stokes ◽  
Near Future

We review the progress on laser cooling of solids. Laser cooling of ion-doped solids and semiconductors is based on the anti-Stokes fluorescence, where the emitted photons have a mean energy higher than that of the absorbed photons. The thermodynamic analysis shows that this cooling process does not violate the second law, and that the achieved efficiency is much lower than the theoretical limit. Laser cooling has experienced rapid progress in rare-earth-ion doped solids in the last decade, with the temperature difference increasing from 0.3to92K. Further improvements can be explored from the perspectives of materials and structures. Also, theories need to be developed, to provide guidance for searching enhanced cooling performance. Theoretical predictions show that semiconductors may be cooled more than ion-doped solids, but no success in bulk cooling has been achieved yet after a few attempts (due to the fluorescence trapping and nonradiative recombination). Possible solutions are discussed, and net cooling is expected to be realized in the near future.

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