The most common appendicular disease is acute appendicitis,with a lifetime risk of 7%–8%.Complicated cases,which can occur in 2%–7%of patients,can signi-ficantly impact the severity of the condition and may require ...The most common appendicular disease is acute appendicitis,with a lifetime risk of 7%–8%.Complicated cases,which can occur in 2%–7%of patients,can signi-ficantly impact the severity of the condition and may require different manage-ment approaches.Nonoperative management with possible delayed appende-ctomy has been suggested for selected patients,however,there is a non-negligible risk of missing an underlying malignancy,which is reported to be as high as 11%.Diagnostic work-up is paramount to achieve optimal treatment with good results.展开更多
Indocyanine green(ICG)fluorescence imaging is widely used in abdominal surgery.The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of op...Indocyanine green(ICG)fluorescence imaging is widely used in abdominal surgery.The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of optical systems.In that setting,ICG fluorescence optimizes intraoperative vision of anatomical structures by improving blood and lymphatic flow.The purpose of this review was to summarize all potential applications of this upcoming technology in rectal cancer surgery.Each type of use has been separately addressed and the evidence was investigated.During rectal resection,ICG fluorescence angiography is mainly used to evaluate the perfusion of the colonic stump in order to reduce the risk of anastomotic leaks.In addition,ICG fluorescence imaging allows easy visualization of organs such as the ureter or urethra to protect them from injury.This intraoperative technology is a valuable tool for conducting lymph node dissection along the iliac lymphatic chain or to better identifying the rectal dissection planes when a transanal approach is performed.This is an overview of the applications of ICG fluorescence imaging in current surgical practice and a synthesis of the results obtained from the literature.Although further studies are need to investigate the real clinical benefits,these findings may enhance use of ICG fluorescence in current clinical practice and stimulate future research on new applications.展开更多
The management of locally advanced rectal cancer involving adjacent organs and extending beyond the surgical planes of total mesorectal excision has evolved over the past few decades both in terms of the effectiveness...The management of locally advanced rectal cancer involving adjacent organs and extending beyond the surgical planes of total mesorectal excision has evolved over the past few decades both in terms of the effectiveness of preoperative treatments and surgical innovation.The use of a robotic platform is increasing,even in complex surgery such as pelvic exenteration together with the advantages of minimally invasive procedures.However,satisfactory surgical,oncological,and functional outcomes are achieved not only minimizing the impact of a demolitive surgery but also when a multidisciplinary specialized team focuses on experienced surgeons,mandatory rules of surgical oncology,appropriate medical treatments,accurate preoperative planning,and an acceptable quality of life.展开更多
文摘The most common appendicular disease is acute appendicitis,with a lifetime risk of 7%–8%.Complicated cases,which can occur in 2%–7%of patients,can signi-ficantly impact the severity of the condition and may require different manage-ment approaches.Nonoperative management with possible delayed appende-ctomy has been suggested for selected patients,however,there is a non-negligible risk of missing an underlying malignancy,which is reported to be as high as 11%.Diagnostic work-up is paramount to achieve optimal treatment with good results.
文摘Indocyanine green(ICG)fluorescence imaging is widely used in abdominal surgery.The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of optical systems.In that setting,ICG fluorescence optimizes intraoperative vision of anatomical structures by improving blood and lymphatic flow.The purpose of this review was to summarize all potential applications of this upcoming technology in rectal cancer surgery.Each type of use has been separately addressed and the evidence was investigated.During rectal resection,ICG fluorescence angiography is mainly used to evaluate the perfusion of the colonic stump in order to reduce the risk of anastomotic leaks.In addition,ICG fluorescence imaging allows easy visualization of organs such as the ureter or urethra to protect them from injury.This intraoperative technology is a valuable tool for conducting lymph node dissection along the iliac lymphatic chain or to better identifying the rectal dissection planes when a transanal approach is performed.This is an overview of the applications of ICG fluorescence imaging in current surgical practice and a synthesis of the results obtained from the literature.Although further studies are need to investigate the real clinical benefits,these findings may enhance use of ICG fluorescence in current clinical practice and stimulate future research on new applications.
文摘The management of locally advanced rectal cancer involving adjacent organs and extending beyond the surgical planes of total mesorectal excision has evolved over the past few decades both in terms of the effectiveness of preoperative treatments and surgical innovation.The use of a robotic platform is increasing,even in complex surgery such as pelvic exenteration together with the advantages of minimally invasive procedures.However,satisfactory surgical,oncological,and functional outcomes are achieved not only minimizing the impact of a demolitive surgery but also when a multidisciplinary specialized team focuses on experienced surgeons,mandatory rules of surgical oncology,appropriate medical treatments,accurate preoperative planning,and an acceptable quality of life.
