Universität zu Köln

Bulian, Dirk R., Kaehler, Georg, Magdeburg, Richard, Butters, Michael, Burghardt, Jens, Albrecht, Roland, Bernhardt, Joern, Heiss, Markus M., Buhr, Heinz J. and Lehmann, Kai S. (2017). Analysis of the First 217 Appendectomies of the German NOTES Registry. Ann. Surg., 265 (3). S. 534 - 539. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1528-1140

Full text not available from this repository.

Abstract

Objective: To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. Background: Laparoscopic appendectomy has rare but relevant complications, namely incisional hernias and neuralgia at the trocar sites, which can potentially be avoided by the NOTES techniques. Methods: The first 217 data sets of the largest NOTES registry worldwide-the German NOTES registry-were analyzed with respect to demographic data, procedural data, and short-term outcomes. Furthermore, TVAEs were compared with TGAEs. Results: Almost all procedures were performed in hybrid technique (median of percutaneous trocars: 1). Median age (TVAE: 30.5 yrs vs TGAE: 25 yrs; P = 0.017), body mass index (TVAE: 22.8 kg/m(2) vs TGAE: 24.1 kg/m(2); P = 0.016), and American Society of Anesthesiologists (ASA) classification (I/II/III; TVAE: 57.1%/41.8%/1.0% vs TGAE: 27.8%/69.4%/2.8%; P = 0.003) significantly differed between both access techniques. Whereas the median number of percutaneous trocars (TVAE: 1 vs TGAE: 1; P = 0.450), the need of additional trocars (TVAE: 6.6% vs TGAE: 13.9%; P = 0.156), the intra, and also postoperative rate of complications (TVAE: 0%/5.5% vs TGAE: 0%/11.1%; P = 1.000/0.258), and the median postoperative hospital stay (TVAE: 3 d vs TGAE: 3 d; P = 0.152) were comparable; the median procedural time (TVAE: 35 minutes vsTGAE: 96 minutes; P < 0.001) and conversion to laparotomy rate (TVAE: 0% vs TGAE: 5.6%; P = 0.023) were significantly less after TVAE. Conclusions: The evaluation of the largest patient collective so far indicates that hybrid NOTES appendectomy is a safe procedure, with advantages for the transvaginal technique with respect to procedural time and conversion rate.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bulian, Dirk R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaehler, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Magdeburg, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Butters, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Burghardt, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Albrecht, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Bernhardt, Joern UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, Markus M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buhr, Heinz J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Kai S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-238419
DOI:	10.1097/SLA.0000000000001742
Journal or Publication Title:	Ann. Surg.
Volume:	265
Number:	3
Page Range:	S. 534 - 539
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1528-1140
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSLUMINAL ENDOSCOPIC SURGERY; LAPAROSCOPIC APPENDECTOMY; ACUTE APPENDICITIS; HUMANS; COMPLICATIONS; COHORT Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23841