Application of the Left Lateral Decubitus Position in Laparoscopic Right Posterior Lobectomy.

OBJECTIVE: To investigate the value of the left lateral decubitus position in laparoscopic right posterior lobe tumor resection. PATIENTS AND METHODS: The clinical data of patients who underwent laparoscopic right posterior lobectomy from January 2020 to March 2023 were retrospectively collected and divided into group A (left lateral decubitus position group, n=30) and group B (conventional position group, n=35) according to different body positions. Intraoperative and postoperative data were collected and compared between the 2 groups. RESULTS: The operation time (210.43±57.56 vs. 281.97±65.89, t =5.887, P <0.05), hilar occlusion time (23.97±14.25 vs. 35.79±12.62, t =4.791, P <0.05), intraoperative blood loss (162.14±72.61 vs. 239.65±113.56, t =5.713, P <0.05), postoperative feeding time (1.13±0.36 vs. 1.57±0.67, t =3.681, P <0.05), postoperative visual analog scale score (5.16±0.89 vs. 7.42±1.31, t =3.721, P <0.05), postoperative abdominal drainage tube indwelling time (4.58±1.34 vs. 5.42±1.52, t =4.553, P <0.05), incidence rate of complications (43.33% vs. 82.86%, χ 2 =11.075, P <0.05) in group A were lower than those in group B ( P <0.05). Symptoms/side effects (32.42±3.42 vs. 27.44±3.31, t =4.331, P <0.05), and there were significant differences in social function (33.55±2.56 vs. 29.31±3.32, t =4.863, P <0.05). CONCLUSION: For right posterior lobe tumors of the liver, the left lateral decubitus position has many advantages in laparoscopic right posterior lobectomy, such as a wide field of view, simple steps, a short operation time, less bleeding, and a high postoperative quality of life. It is an effective treatment for right posterior lobe tumors of the liver and is worthy of being widely popularized.

Laparoscope-assisted intestinal lengthening using an anterior flap in jejunal atresia.

BACKGROUND: Jejunal atresia with short bowel syndrome is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. In this paper, we report our preliminary experience to emphasize the advantages and feasibility of enteroplasty for intestinal lengthening and primary anastomosis with an anterior flap in jejunal atresia with short bowel syndrome in neonates. METHODS: Between January 2014 and December 2014, four neonates with jejunal atresia and short bowel syndrome were submitted to this procedure in our hospital. Enteroplasty for intestinal lengthening procedures was accomplished in all the neonates by laparoscopic-assisted procedure. The procedure was manually performed after exteriorization of the atretic bowel via the slightly enlarged umbilical port site incision. RESULTS: The mean operative time was 80 min (range 65-110 min). Blood loss was minimal. There was no mortality or surgical complication so far. The median follow-up duration was 14.5 months (range 9-20 months). In all the cases, the autonomy for oral/enteric feeding was obtained within 1 month after surgery. One neonate was readmitted because of associated cholestasis 1 month after the operation, and was cured by conservative therapy. CONCLUSIONS: Enteroplasty for intestinal lengthening and primary anastomosis with an anterior flap is a safe and feasible technique that could allow increased tolerance to oral/enteric feeding, thereby improves their chances for quality survival.

Laparoscopic diagnosis and treatment of neonates with duodenal obstruction associated with an annular pancreas: report of 11 cases.

PURPOSE: Laparoscopic procedures involving a neonatal annular pancreas have only been sporadically reported in the literature. We herein present our initial experience with an annular pancreas in newborns treated via a laparoscopic approach. METHODS: A retrospective review of the laparoscopic methods used for an annular pancreas in 11 neonates from September 2009 to April 2013 was performed. Among the patients, seven were male and four were female. The age of the patients ranged from 1 to 13 days (mean 4.2 days). An annular pancreas was diagnosed under laparoscopic vision. In all of the cases, the surgical procedures were performed laparoscopically. RESULTS: The operation was accomplished by a laparoscopic procedure in all cases. The length of the operation ranged from 70 to 145 min (mean, 96.6 min). Feedings started on postoperative days 4-7 (mean, day 5), and patients were discharged on postoperative days 9-15 (mean, day 10.6). Ten cases were followed up for 4-39 months (mean, 15.2 months). The case complicated with anal atresia died of pneumonia 6 months later after the procedure, but the other patients were doing well at the most recent follow-up examination. CONCLUSION: The laparoscopic approach for an annular pancreas can be securely performed in the neonatal period. Our early experience suggests the outcomes were excellent.

Single-site umbilical laparoscopic pyloromyotomy in neonates less than 21-day old.

PURPOSE: Single-site umbilical laparoscopic pyloromyotomy for hypertrophic pyloric stenosis in neonates <3-week old has rarely been reported in the literature. This article reports our initial experience with this procedure. METHODS: Overall, 13 cases of hypertrophic pyloric stenosis occurred in neonates <3-week old from January 2010 to April 2013 in our hospital. All neonates were treated by a single-site laparoscopic procedure. A 5-mm trocar and endoscope were introduced through an incision in the center of the umbilicus, and two 3-mm working instruments were inserted directly into the abdomen via separate lateral fascial stab incisions in the umbilical fold, and a single-site umbilical laparoscopic pyloromyotomy was then performed. RESULTS: The procedure was performed in 13 infants (12 male) with mean age of 17.3 days. The average length of the operation was 26 min. The mean postoperative hospital stay was 4.5 days. All patients were discharged home on full feeds. Follow-up examinations were scheduled 2 to 6 weeks after discharge, and no postoperative complications were noted in any of the patients. CONCLUSION: These cases had shorter and thinner pylori than their older counterparts. However, the laparoscopic procedure was safe and feasible, with good postoperative results and excellent cosmesis. Surgeons should have a firm foundation of advanced minimal access surgical skills prior to attempting the procedure.

[Research advances on directional induction and differentiation in vitro from human pluripotent stem cells into erythrocytes].

Red blood cell transfusion is an effective method to treat acute hemorrhage and severe anemia. However, blood source from donors is very limited, and transfusion-transmitted diseases occurred frequently, thus threatening human health. Therefore, the safe, abundant and functional blood source is needed. Generation of blood cells from human pluripotent stem cells(hPSC) will offer alternative approach. Lots of studies have been focused on erythroid cell differentiation in vitro, including how to enhance efficiency and improve their function. In this review, the research advances on differentiation methods and the regulatory mechanism are summarized. In addition, the progress in PSC differentiation into erythrocytes and the problems to be solved are discussed briefly.

Laparoscope-assisted diagnosis and treatment for Amyand's hernia in children-report of six cases.

Laparoscope-assisted diagnosis and treatment of Amyand's hernia in children are rarely reported in literature. We report our preliminary experiences to emphasize the advantages and feasibility of this procedure in six cases. Laparoscope-assisted diagnosis and treatment of Amyand's hernias in six children from October 2010 to February 2012 were performed. A retrospective analysis of clinical data of these patients was performed. The mean age of the six patients was 234 days (ranging from 40 days to 13 months). Four cases were operated with laparoscope-assisted method urgently as incarcerated hernia. To the two cases with normal appendix, only herniorrhaphy was performed. Average follow-up was 14 months (9-24 months), with no wound infection and no recurrent hernias. In conclusion, diagnosis of Amyand's hernia before operation is difficult, and laparoscopic method is safe and effective in these cases with good outcomes, and worth introduced.