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  1 / 3099 MEDLINE  
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[PMID]:29223272
[Au] Autor:Linnik YA; Hoegemann Savellano D; Phillips JD; Black CC
[Ad] Endereço:Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: yevgeniy.a.linnik@hitchcock.org.
[Ti] Título:A 49-Year-Old Woman With Right Apical Thoracic Mass.
[So] Source:Chest;152(6):e133-e138, 2017 12.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 49-year-old woman with a medical history of essential hypertension presented to the ED with severe pain in the left superior chest and dull aching pain in the upper flank, lasting for the last 2 days.
[Mh] Termos MeSH primário: Ganglioneuroma/diagnóstico
Neoplasias do Mediastino/diagnóstico
Toracoscopia/métodos
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Feminino
Ganglioneuroma/cirurgia
Seres Humanos
Imagem por Ressonância Magnética
Neoplasias do Mediastino/cirurgia
Meia-Idade
Radiografia Torácica
Procedimentos Cirúrgicos Robóticos/métodos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


  2 / 3099 MEDLINE  
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[PMID]:28464554
[Au] Autor:Khene ZE; Peyronnet B; Bosquet E; Pradère B; Robert C; Fardoun T; Kammerer-Jacquet SF; Verhoest G; Rioux-Leclercq N; Mathieu R; Bensalah K
[Ad] Endereço:Department of Urology, Rennes University Hospital, Rennes, France.
[Ti] Título:Does training of fellows affect peri-operative outcomes of robot-assisted partial nephrectomy?
[So] Source:BJU Int;120(4):591-599, 2017 10.
[Is] ISSN:1464-410X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group). Peri-operative data were compared between the two groups. Linear and logistic regression analyses were performed to assess the impact of fellows' involvement on peri-operative and postoperative outcomes. Trifecta and margins ischaemia complications (MIC) score achievement rates were used to assess the quality of surgery in both the expert and fellow groups. Trifecta was defined as a combination of warm ischaemia time <25 min, negative surgical margins and no peri-operative complications. MIC score was defined as negative surgical margins, ischaemia time <20 min, and absence of complications grade ≥3. RESULTS: Fellows were involved in a total of 89 procedures (41%). Patients' characteristics were similar in the two groups. Operating time and warm ischaemia time (WIT) were longer in the fellow group (180 vs 120 min, P < 0.001, and 18 vs 14 min, P = 0.002, respectively). Length of hospital stay (LOS) was longer in the fellow group (5 vs 4.3 days; P = 0.05) and patients in this group had higher estimated blood loss (EBL; 400 vs 300 mL; P = 0.01), but this had no impact on transfusion rate (14% vs 11%; P = 0.43). Positive surgical margin rates were similar in the fellow and expert groups (2.2% vs 3.1%; P = 0.70). Major complications were more frequent in the fellow group (12.3% vs 6.3%), but the difference was not significant (P = 0.10). In multivariable analysis, fellow involvement was predictive of longer WIT (ß = 0.22; P = 0.003) and operating time (ß = 0.49; P < 0.001), but was not associated with EBL (ß = 0.12, P = 0.09) or LOS (ß = 0.12, P = 0.11). Finally, fellow involvement was associated with a lower rate of trifecta and MIC score accomplishment (odds ratio [OR] 0.53, P = 0.05 and OR 0.46, P = 0.01, respectively). CONCLUSION: Training fellows to perform RAPN is associated with longer operating time and WIT but does not appear to compromise other peri-operative outcomes.
[Mh] Termos MeSH primário: Competência Clínica
Educação de Pós-Graduação em Medicina/métodos
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Procedimentos Cirúrgicos Robóticos/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Bases de Dados Factuais
Feminino
Seguimentos
França
Hospitais Universitários
Seres Humanos
Neoplasias Renais/patologia
Masculino
Meia-Idade
Nefrectomia/efeitos adversos
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/fisiopatologia
Estudos Retrospectivos
Medição de Risco
Procedimentos Cirúrgicos Robóticos/métodos
Resultado do Tratamento
Isquemia Quente
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/bju.13901


  3 / 3099 MEDLINE  
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[PMID]:29360840
[Au] Autor:Roh HF; Nam SH; Kim JM
[Ad] Endereço:Department of Biomedical Science, Hanyang University College of Medicine and Graduate School of Biomedical Science and Engineering, Seoul, Korea.
[Ti] Título:Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery in randomized controlled trials: A systematic review and meta-analysis.
[So] Source:PLoS One;13(1):e0191628, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: This review provides a comprehensive comparison of treatment outcomes between robot-assisted laparoscopic surgery (RLS) and conventional laparoscopic surgery (CLS) based on randomly-controlled trials (RCTs). OBJECTIVES: We employed RCTs to provide a systematic review that will enable the relevant community to weigh the effectiveness and efficacy of surgical robotics in controversial fields on surgical procedures both overall and on each individual surgical procedure. EVIDENCE REVIEW: A search was conducted for RCTs in PubMed, EMBASE, and Cochrane databases from 1981 to 2016. Among a total of 1,517 articles, 27 clinical reports with a mean sample size of 65 patients per report (32.7 patients who underwent RLS and 32.5 who underwent CLS), met the inclusion criteria. FINDINGS: CLS shows significant advantages in total operative time, net operative time, total complication rate, and operative cost (p < 0.05 in all cases), whereas the estimated blood loss was less in RLS (p < 0.05). As subgroup analyses, conversion rate on colectomy and length of hospital stay on hysterectomy statistically favors RLS (p < 0.05). CONCLUSIONS: Despite higher operative cost, RLS does not result in statistically better treatment outcomes, with the exception of lower estimated blood loss. Operative time and total complication rate are significantly more favorable with CLS.
[Mh] Termos MeSH primário: Laparoscopia/métodos
Ensaios Clínicos Controlados Aleatórios como Assunto
Procedimentos Cirúrgicos Robóticos/métodos
Robótica
[Mh] Termos MeSH secundário: Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191628


  4 / 3099 MEDLINE  
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[PMID]:27778128
[Au] Autor:Chen PD; Wu CY; Hu RH; Chou WH; Lai HS; Liang JT; Lee PH; Wu YM
[Ad] Endereço:Department of Surgery, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
[Ti] Título:Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison.
[So] Source:Ann Surg Oncol;24(4):1021-1028, 2017 Apr.
[Is] ISSN:1534-4681
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Robotic hepatectomy has been suggested to be a safe and effective approach for liver disease; however, studies comparing robotic hepatectomy with the conventional open approach regarding oncologic outcomes for hepatocellular carcinoma (HCC) are limited. Accordingly, we performed a matched comparison of surgical and oncological outcomes between robotic and open hepatectomy. METHODS: Between January 2012 and October 2015, a total of 183 patients underwent robotic hepatectomy and 275 patients underwent open hepatectomy by the same surgical team in our center. Eighty-one newly diagnosed HCC cases in each group were compared under propensity score matching (PSM) in a 1:1 ratio. RESULTS: With robotic hepatectomy, the conversion rate was 1.6 % and the complication rate was 4.4 %. On PSM, the groups had a comparable percentage of major liver resections (41.9 vs. 39.5 %) and liver cirrhosis (45.7 vs. 46.9 %). Compared with the open group, the robotic group required longer operation times (343 vs. 220 min), shorter hospital stays (7.5 vs. 10.1 days), and lower dosages of postoperative patient-controlled analgesia (350 vs. 554 ng/kg). The 3-year disease-free survival of the robotic group was comparable with that of the open group (72.2 % vs. 58.0 %; p = 0.062), as was the 3-year overall survival (92.6 vs. 93.7 %; p = 0.431). CONCLUSIONS: This is the first oncological study comparing robotic liver resection for HCC with open resection. Robotic hepatectomy can be applied for challenging major resections in patients with cirrhotic liver disease with less postoperative pain and shorter hospital stays without compromising oncological outcomes.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/cirurgia
Hepatectomia/métodos
Neoplasias Hepáticas/cirurgia
Procedimentos Cirúrgicos Robóticos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Analgesia Controlada pelo Paciente
Analgésicos/administração & dosagem
Intervalo Livre de Doença
Feminino
Seres Humanos
Tempo de Internação
Masculino
Meia-Idade
Duração da Cirurgia
Dor Pós-Operatória/tratamento farmacológico
Pontuação de Propensão
Taxa de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1245/s10434-016-5638-9


  5 / 3099 MEDLINE  
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[PMID]:29443740
[Au] Autor:Su CS; Chen YW; Shen CH; Liu TJ; Chang Y; Lee WL
[Ad] Endereço:Cardiovascular Center, Taichung Veterans General Hospital, Taichung.
[Ti] Título:Clinical outcomes of left main coronary artery disease patients undergoing three different revascularization approaches.
[So] Source:Medicine (Baltimore);97(7):e9778, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013.Of the 472 LM disease patients, 139 received R-CABG, 147 received C-CABG, and 186 received PCI. The need for target vessel revascularization (TVR) was highest in the PCI group. The R-CABG group had significantly lower rates of in-hospital and follow-up all-cause deaths compared with the other 2 groups (1.4% vs. 3.4% and 9.7%, P = .0058; 13.7% vs. 29.3% and 29.6%, P = .0023, respectively). Patients in the R-CABG group had significantly lower rates of intra-aortic balloon pump assistance, and shorter duration of ICU and total hospital stay compared to patients in the C-CABG group. However, revascularization modality, SYNTAX scores, and residual SYNTAX scores were not independent predictors of in-hospital or long-term mortality.In this cohort of LM disease patients treated at a tertiary medical center, PCI is a reasonable choice in patients with less lesion complexity but who are older and have comorbidities. R-CABG is feasible in stable LM disease patients with high SYNTAX scores, and is an effective alternative to C-CABG in LM disease patients with few risk factors. However, revascularization modality per se was not a determinant for long-term mortality in our real-world practice.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Intervenção Coronária Percutânea/métodos
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença da Artéria Coronariana/patologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Stents
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009778


  6 / 3099 MEDLINE  
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[PMID]:29391100
[Au] Autor:O'Connor VV; Vuong B; Yang ST; DiFronzo A
[Ad] Endereço:Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
[Ti] Título:Robotic Minor Hepatectomy Offers a Favorable Learning Curve and May Result in Superior Perioperative Outcomes Compared with Laparoscopic Approach.
[So] Source:Am Surg;83(10):1085-1088, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Minorhepatectomy (MH) is a common type of robotic-assisted liver resection, but few studies compared it with laparoscopic. We compared the perioperative outcomes of patients who underwent robotic (RH) or laparoscopic (LH) minor hepatectomy and evaluated the effect of surgeon's experience on outcomes. A prospective database was used to identify patients from 2009 through 2016 who underwent RH or LH. Two surgeons performed RH starting in 2014, whereas LH had been established before that. Of the 93 patients, 42 were in RH and 51 in LH group. The mean patient age, gender, race, American Society of Anesthesiologists score, proportion of patients with cirrhosis and hepatocellular carcinoma were similar. Operative time, estimated blood loss (EBL), conversion to open, 30-day complication rate, Clavien-Dindo grade ≥ 3 complications, and length of hospital stay (LOS) were similar. There was no difference in average tumor size, specimen volume, or achievement of R0 margin. In RH group, after completing 15 cases, there were no conversions to open. After 25 cases, EBL, LOS, and 30-day complication rate were improved as compared with LH. Perioperative outcomes of robotic MH are equivalent to laparoscopic. After approximately 25 cases, robotic-assisted MH may result in superior outcomes compared with laparoscopic.
[Mh] Termos MeSH primário: Hepatectomia/métodos
Laparoscopia
Curva de Aprendizado
Procedimentos Cirúrgicos Robóticos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Bases de Dados Factuais
Feminino
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Duração da Cirurgia
Avaliação de Resultados (Cuidados de Saúde)
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  7 / 3099 MEDLINE  
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[PMID]:29390591
[Au] Autor:Kan HC; Pang ST; Wu CT; Chang YH; Liu CY; Chuang CK; Lin PH
[Ad] Endereço:Department of Surgery, Division of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan.
[Ti] Título:Robot-assisted laparoendoscopic single site adrenalectomy: A comparison of 3 different port platforms with 3 case reports.
[So] Source:Medicine (Baltimore);96(51):e9479, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Laparoscopic adrenalectomy is currently the standard of care for adrenal lesion. Minimal invasive laparoscopic surgery such as laparoendoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) have been developed to improve cosmetic outcomes and reduce postoperative pain. However, there are still some problems related to instruments and port limitation during LESS surgery. Robot-assisted laparoscopic surgery may help to overcome these problems, and port platforms selection is an important issue. PATIENT CONCERNS: Three cases received robot-assisted LESS adrenalectomy due to adrenal tumor were enrolled. Blood loss, hospital stay, and analgesia injection were compared. DIAGNOSES: Preoperative evaluations were done in a usual manner. Benign tumors were suspect for two patients, while metastatic tumor could not be excluded for the other patient with prior malignancy history. The pathology reports were all benign adrenal cortical adenoma after operation. INTERVENTIONS: Three different port platforms, Da Vinci Single-Site Surgical Platform, GelPOINT, and homemade glove port were used. Trans-peritoneal approach was used for two patients, while the other one received trans-retroperitoneal approach. The advantage and disadvantage of different port platforms were discussed. OUTCOMES: All patients underwent the operation smoothly without major complications or conversion to open surgery. Blood loss amount was small, hospital stay was short, and only one patient received one single dose of opioid analgesia injection after the surgery. LESSONS: The main problems of LESS are the loss of a working triangle and the limitations of the instruments. Robot-assisted LESS may help surgeons overcome part of these problems. Many different port platforms are available, and based on our initial experience, we believe that the GelPoint may be a more suitable platform, for it maintains the endo-wrist function of the Da Vinci instruments, and allows the surgeon to design the position of ports freely to minimize external and internal collision.
[Mh] Termos MeSH primário: Adrenalectomia/métodos
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Adenoma/cirurgia
Neoplasias das Glândulas Suprarrenais/cirurgia
Adrenalectomia/instrumentação
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Robóticos/instrumentação
[Pt] Tipo de publicação:CASE REPORTS; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009479


  8 / 3099 MEDLINE  
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[PMID]:29215511
[Au] Autor:Yeung J; Crisp CC; Mazloomdoost D; Kleeman SD; Pauls RN
[Ad] Endereço:Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital, Cincinnati, Ohio.
[Ti] Título:Liposomal Bupivacaine During Robotic Colpopexy and Posterior Repair: A Randomized Controlled Trial.
[So] Source:Obstet Gynecol;131(1):39-46, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair. METHODS: This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital. Starting on postoperative day 1, participants completed twice-daily pain scales and a pain medication diary up until the evening of postoperative day 3. The primary outcome was a 20-mm change in the visual analog scale 18 hours postoperatively. Secondary measures included additional pain scores, satisfaction, and narcotic use. Sample size calculation revealed that 32 patients per arm were required to detect the 20-mm difference with 90% power and an α of 0.05. To allocate for dropout, a goal of 70 was set. RESULTS: Between March 2015 and April 2016, 100 women were screened and 70 women were enrolled: 35 women were randomized to liposomal bupivacaine and 35 to placebo, of whom 64 (91%) were included in the final analysis: 33 liposomal bupivacaine and 31 placebo. No difference in demographics, surgical data, or satisfaction between groups was noted. Median VAS at 18 hours after surgery was not statistically different in those who received liposomal bupivacaine compared with normal saline (15 mm compared with 20 mm; P=.52). Other pain scales and total morphine equivalents were also similar (P=.90). CONCLUSION: In this study of robotic sacrocolpopexy with posterior repair, there were no differences in pain scores or narcotic use between liposomal bupivacaine and placebo injected into laparoscopic and vaginal incisions. Given its lack of clinical benefit, routine use of liposomal bupivacaine is not supported for this surgical intervention. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02449915.
[Mh] Termos MeSH primário: Bupivacaína/administração & dosagem
Colposcopia/métodos
Dor Pós-Operatória/tratamento farmacológico
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais
Colposcopia/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Lipossomos/administração & dosagem
Meia-Idade
Medição da Dor
Dor Pós-Operatória/fisiopatologia
Prolapso de Órgão Pélvico/cirurgia
Medição de Risco
Procedimentos Cirúrgicos Robóticos/efeitos adversos
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Liposomes); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002375


  9 / 3099 MEDLINE  
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[PMID]:29240357
[Au] Autor:Gadler T; Crist C; Brandstein K; Schneider SM
[Ti] Título:The Effects of a Take-Home Educational Video on Patient Knowledge Retention, Anxiety, Satisfaction, and Provider Time.
[So] Source:Urol Nurs;36(6):297-302, 2016 Nov-Dec.
[Is] ISSN:1053-816X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patient anxiety related to prostate cancer surgery may lead to reduced patient satisfaction. Repeated reinforcement of pre-operative education to reduce anxiety greatly impacts provider time. Improved knowledge retention of what to expect postoperatively may reduce patient anxiety. This quality improvement project demonstrated that a take-home educational video supports patient knowledge retention, reduces patient anxiety, increases patient satisfaction, and saves postoperative provider time
[Mh] Termos MeSH primário: Ansiedade/psicologia
Conhecimentos, Atitudes e Prática em Saúde
Educação de Pacientes como Assunto/métodos
Satisfação do Paciente
Prostatectomia/psicologia
Neoplasias da Próstata/psicologia
[Mh] Termos MeSH secundário: Recursos Audiovisuais
Seres Humanos
Laparoscopia
Masculino
Neoplasias da Próstata/cirurgia
Melhoria de Qualidade
Procedimentos Cirúrgicos Robóticos
Fatores de Tempo
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  10 / 3099 MEDLINE  
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[PMID]:28742709
[Au] Autor:Diana M; Soler L; Agnus V; D'Urso A; Vix M; Dallemagne B; Faucher V; Roy C; Mutter D; Marescaux J; Pessaux P
[Ad] Endereço:*IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France †IRCAD, Research Institute against Cancer of the Digestive System, Strasbourg, France ‡University Hospital of Strasbourg, Department of General, Digestive, and Endocrine Surgery, Strasbourg, France §University Hospital of Strasbourg, Department of Radiology B, Strasbourg, France.
[Ti] Título:Prospective Evaluation of Precision Multimodal Gallbladder Surgery Navigation: Virtual Reality, Near-infrared Fluorescence, and X-ray-based Intraoperative Cholangiography.
[So] Source:Ann Surg;266(5):890-897, 2017 11.
[Is] ISSN:1528-1140
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We aimed to prospectively evaluate NIR-C, VR-AR, and x-ray intraoperative cholangiography (IOC) during robotic cholecystectomy. BACKGROUND: Near-infrared cholangiography (NIR-C) provides real-time, radiation-free biliary anatomy enhancement. Three-dimensional virtual reality (VR) biliary anatomy models can be obtained via software manipulation of magnetic resonance cholangiopancreatography, enabling preoperative VR exploration, and intraoperative augmented reality (AR) navigation. METHODS: Fifty-eight patients were scheduled for cholecystectomy for gallbladder lithiasis. VR surgical planning was performed on virtual models. At anesthesia induction, indocyanine green was injected intravenously. AR navigation was obtained by overlaying the virtual model onto real-time images. Before and after Calot triangle dissection, NIR-C was obtained by turning the camera to NIR mode. Finally, an IOC was performed. The 3 modality performances were evaluated and image quality was assessed with a Likert-scale questionnaire. RESULTS: The three-dimensional VR planning enabled the identification of 12 anatomical variants in 8 patients, of which only 7 were correctly reported by the radiologists (P = 0.037). A dangerous variant identified at VR induced a "fundus first" approach. The cystic-common bile duct junction was visualized before Calot triangle dissection at VR in 100% of cases, at NIR-C in 98.15%, and in 96.15% at IOC.Mean time to obtain relevant images was shorter with NIR-C versus AR (P = 0.008) and versus IOC (P = 0.00000003). Image quality scores were lower with NIR-C versus AR (P = 0.018) and versus IOC (P < 0.0001). CONCLUSIONS: This high-tech protocol illustrates the multimodal imaging of biliary anatomy towards precision cholecystectomy. Those visualization techniques could complement to reduce the likelihood of biliary injuries (NCT01881399).
[Mh] Termos MeSH primário: Colecistectomia/métodos
Colecistolitíase/cirurgia
Procedimentos Cirúrgicos Robóticos/métodos
Cirurgia Assistida por Computador/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Colangiografia
Colangiopancreatografia por Ressonância Magnética
Feminino
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
Modelos Anatômicos
Imagem Óptica
Cuidados Pré-Operatórios/métodos
Estudos Prospectivos
Radiografia Intervencionista
Espectroscopia de Luz Próxima ao Infravermelho
Resultado do Tratamento
Interface Usuário-Computador
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/SLA.0000000000002400



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