28 research outputs found
Effects of initial-state dynamics on collective flow within a coupled transport and viscous hydrodynamic approach
We evaluate the effects of preequilibrium dynamics on observables in
ultrarelativistic heavy-ion collisions. We simulate the initial nonequilibrium
phase within A MultiPhase Transport (AMPT) model, while the subsequent
near-equilibrium evolution is modeled using (2+1)-dimensional relativistic
viscous hydrodynamics. We match the two stages of evolution carefully by
calculating the full energy-momentum tensor from AMPT and using it as input for
the hydrodynamic evolution. We find that when the preequilibrium evolution is
taken into account, final-state observables are insensitive to the switching
time from AMPT to hydrodynamics. Unlike some earlier treatments of
preequilibrium dynamics, we do not find the initial shear viscous tensor to be
large. With a shear viscosity to entropy density ratio of , our model
describes quantitatively a large set of experimental data on Pb+Pb collisions
at the Large Hadron Collider(LHC) over a wide range of centrality: differential
anisotropic flow , event-plane correlations, correlation
between and , and cumulant ratio .Comment: 10 pages, v2: minor revisio
Appendiceal collision tumors: case reports, management and literature review
Appendiceal tumors are incidentally detected in 0.5% cases of appendectomy for acute appendicitis and occur in approximately 1% of all appendectomies. Here, we report two cases of appendiceal collision tumors in two asymptomatic women. In both cases, imaging revealed right-lower-quadrant abdominal masses, which were laparoscopically resected. In both cases, histological examinations revealed an appendiceal collision tumor comprising a low-grade appendiceal mucinous neoplasm and well-differentiated neuroendocrine neoplasm (NEN). For complete oncological control, right hemicolectomy was performed in one patient for the aggressive behavior of NEN; however, histology revealed no metastasis. The other patient only underwent appendectomy. No further treatment was recommended. According to the latest guidelines, exact pathology needs to be defined. Proper management indicated by a multidisciplinary team is fundamental
Laparoendoscopic Single Site Hysterectomy: Literature Review and Procedure Description
Laparoendoscopic single site surgery (LESS) refers to a spectrum of surgical techniques that allow the performance of laparoscopic surgery through consolidation of all ports into one surgical incision. LESS has emerged as a potentially less invasive alternative to multiport laparoscopy and in the last year in gynecology; hence, this approach has been largely applied for selective indications to perform total hysterectomy. We performed a literature review on single site hysterectomy and described indications and technique, highlighting practical problems, pointers, limitations and recent technical development as robotic assistance
Total laparoscopic hysterectomy for benign disease: outcomes and literature analysis
Abstract Objective To analyze surgical outcomes of total laparoscopic hysterectomy (TLH) for benign disease. Methods Retrospective analysis of 361 consecutive cases, prospectively collected from January 2012 to June 2016, of women who underwent TLH in St. Chiara Hospital in Trento, Italy. Clinical, demographic, surgical, and intra and perioperative data were recorded. Complications were graded on the Clavien-Dindo morbidity scale. Data were compared with literature. Statistical analysis was performed with SPSS (SPSS Chicago, IL). Findings Main indication for TLH was uterine fibromatosis (78.6%). Mean uterine size was 327 ± 249 g (range 30–1800 g). Mean operating time was 115 ± 36 min. No laparotomy conversion occurred. Mean length of hospital stay was 2.6 ± 1.1 days (range 1–12 days). Complications requiring surgical intervention in general anesthesia occurred in 3 patients (0.8%): 1 (0.3%) hydroureteronephrosis, 1 (0.3%) bowel adhesions, and 1 (0.3%) port side hernia; complication requiring surgical intervention without general anesthesia occurred in 6 patients (1.6%): 2 (0.6%) hydroureteronephrosis, 1 (0.3%) vaginal cuff dehiscence, and 3 (0.8%) vaginal cuff bleeding. Conclusions Total laparoscopic hysterectomy is a procedure with a low incidence of complications. Our data compare favorably with the data of the other listed studies
Oncological safety and perioperative morbidity in low-risk endometrial cancer with sentinel lymph-node dissection.
BACKGROUND
and Purpose: In endometrial cancer, staging is performed surgically. Controversy about the required extent of lymph node removal is ongoing. In low-risk endometrial cancer (FIGO Stage 1, endometrioid histology, Grades 1 and 2), the risk of lymph-node involvement is 4-17%. Since the introduction of near-infrared optics and the use of indocyanine green, the role of sentinel lymph node removal is increasing and could offer an appropriate balance between the morbidity of a complete lymph-node dissection and the risk of missing lymph-node involvement.
METHODS
In this retrospective comparative study on low-risk endometrial cancer, the extent of surgical lymph-node assessment (no lymphadenectomy vs removal vs lymphadenectomy) in two European institutions was compared and analyzed on the basis of perioperative data and oncological outcome.
RESULTS
The study included 279 patients from: 103 (36.9%) had no lymphadenectomy, 118 (42.3%) underwent SLN removal and 58 (20.8%) underwent pelvic and/or para-aortic lymphadenectomy. There were significant differences among the groups in blood loss (p = 0.000), operation time (p = 0.000), and severity of postoperative complications (p = 0.063). In comparing only sentinel lymph-node removal vs no lymphadenectomy, there were no significant differences. No significant difference was seen between the extent of lymphadenectomy removal and the risk of recurrence. Age and Lymphovascular space invasion positivity were significant risk factors for recurrence (p = 0.004 and p = 0.019).
CONCLUSIONS
In early-stage, endometrial cancer, Grade 1 and 2, sentinel lymph node removal offers a convincing balance between oncological safety and perioperative morbidity. Especially in LVSI-positive cases, lymph-node evaluation in any form is crucial
Anastomotic Leakage after Colorectal Surgery in Ovarian Cancer: Drainage, Stoma Utility and Risk Factors
Objective: to evaluate the incidence of anastomotic leakage (AL), risk factors and utility of drainage and stoma in patients undergoing intestinal surgery for ovarian cancer in a single institution and in a review of the literature. Methods: retrospective study that includes consecutive patients undergoing debulking surgery with en bloc pelvic resection with rectosigmoid colectomy for ovarian cancer between 1 November 2011 and 31 December 2021. Data regarding patient and tumour characteristics, surgical procedure, hospitalisation, complications and follow-up were recorded and analysed. The PubMed database was explored for recent publications on this topic. Results: Seventy-five patients were enrolled in the study. All anastomoses were performed at a distance of >6 cm from the anal margin, with negative leak tests and tension-free anastomosis. Diverting stoma were performed in just three patients (4%). At least one perianastomotic pelvic drain was positioned in 71 patients (94.7%) and was removed on average on postoperative day 7. Four patients (5.3%) experienced AL. In all cases, the drain content was not the only sign of complication, as the clinical signs were also highly suggestive. Just one patient received conservative treatment. Average postoperative hospitalisation was 14.6 days (SD: ±9.7). There were no deaths at 30 and 60 days after surgery. Between the AL and non-AL groups, statistically significant differences were observed for age, Charlson Comorbidity Index, length of the intestinal resection and fitness for chemotherapy at 30 days. In ovarian cancer, rectosigmoid resection is a standardised procedure with comparable results for AL, and risk factors for AL are discretely homogeneous. What is neither homogeneous nor standardised according to the literature is the use of stomas and/or drains. Conclusion: use in the future of protective stoma and/or intra-abdominal drains is to be explored in selected and standardised situations to verify their preventive role