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Peñafiel JAR, Valladares G, Cyntia Lima Fonseca Rodrigues A, Avelino P, Amorim L, Teixeira L, Brandao G, Rosa F. Robotic-assisted versus laparoscopic incisional hernia repair: a systematic review and meta-analysis. Hernia 2024; 28:321-332. [PMID: 37725188 DOI: 10.1007/s10029-023-02881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE This study aimed to perform a systematic review and meta-analysis comparing the efficacy and safety outcomes of robotic-assisted and laparoscopic techniques for incisional hernia repair. METHODS PubMed, Embase, Scopus, Cochrane databases, and conference abstracts were systematically searched for studies that directly compared robot-assisted versus laparoscopy for incisional hernia repair and reported safety or efficacy outcomes in a follow-up of ≥ 1 month. The primary endpoints of interest were postoperative complications and the length of hospital stay. RESULTS The search strategy yielded 2104 results, of which four studies met the inclusion criteria. The studies included 1293 patients with incisional hernia repairs, 440 (34%) of whom underwent robot-assisted repair. Study follow-up ranged from 1 to 24 months. There was no significant difference between groups in the incidence of postoperative complications (OR 0.65; 95% CI 0.35-1.21; p = 0.17). The recurrence rate of incisional hernias (OR 0.34; 95% CI 0.05-2.29; p = 0.27) was also similar between robotic and laparoscopic surgeries. Hospital length of stay (MD - 1.05 days; 95% CI - 2.06, - 0.04; p = 0.04) was significantly reduced in the robotic-assisted repair. However, the robot-assisted repair had a significantly longer operative time (MD 69.6 min; 95% CI 59.0-80.1; p < 0.001). CONCLUSION The robotic approach for incisional hernia repair was associated with a significant difference between the two groups in complications and recurrence rates, a longer operative time than laparoscopic repair, but with a shorter length of stay.
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Affiliation(s)
- J A R Peñafiel
- Department of Surgery, University of Cuenca, Cuenca, Ecuador
- Health Sciences Faculty, Universidad Internacional, Quito, Ecuador
| | - G Valladares
- Department of Mathematics, University Central of Ecuador, Quito, Ecuador.
- Francisco Viteri and Gato Sobral, Universidad Central of Ecuador, Campus Universitario, Pichincha, Ecuador.
| | - Amanda Cyntia Lima Fonseca Rodrigues
- Department of Medicine, Positivo University, Curitiba, Brazil
- Department of Statistics and Biostatistics, Anhembi Morumbi University, Curitiba, Brazil
| | - P Avelino
- Department of Surgery, Federal University of Rio Grande do Norte, Natal, Brazil
| | - L Amorim
- Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - L Teixeira
- Department of Surgery, University of UniEvangelica, Anapolis, Brazil
| | - G Brandao
- Department of Surgery, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - F Rosa
- Department of Surgery, Instituto Tocantinense Presidente Antônio Carlos, Palmas, Tocantins, Brazil
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Le P, Garg A, Brandao G, Abu-Sanad A, Panasci L. Hormonal manipulation with letrozole in the treatment of metastatic malignant pecoma. ACTA ACUST UNITED AC 2014; 21:e518-20. [PMID: 24940112 DOI: 10.3747/co.21.1849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perivascular epithelioid cell tumours (pecomas) are rare mesenchymal tumours. Some have a benign course; others metastasize. Treatment of malignant pecomas is challenging, and little is known about treatment for patients with metastatic disease. Here, we report a case of metastatic malignant pecoma with estrogen and progesterone receptor expression that showed a favourable and sustained response to letrozole.
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Affiliation(s)
- P Le
- Department of Medical Oncology, Jewish General Hospital (a McGill University affiliate), Montreal, QC
| | - A Garg
- Department of Medical Oncology, Jewish General Hospital (a McGill University affiliate), Montreal, QC
| | - G Brandao
- Department of Pathology, Jewish General Hospital (a McGill University affiliate), Montreal, QC
| | - A Abu-Sanad
- Department of Medical Oncology, Jewish General Hospital (a McGill University affiliate), Montreal, QC
| | - L Panasci
- Department of Medical Oncology, Jewish General Hospital (a McGill University affiliate), Montreal, QC
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Speranza G, Cohen V, Agulnik JS, Chong G, Meilleur F, Brandao G, Kasymjanova G, Small D, Miller WH. Molecular changes in epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) biopsies at time of progression compared to initial biopsy. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22066 Background: EGFR mutations predict sensitivity and clinical outcome to tyrosine kinase inhibitors (TKI) in NSCLC. The two most commonly described mutations are Exon 19 deletion and Exon 21 L858R missense mutations. Genetic alterations over time have been described in other tumour types, but studies assessing EGFR genotypic changes with lung cancer progression are lacking. We sought to compare EGFR mutational status from lung tumors at time of recurrence or progression with the primary tumor. Methods: Using the Jewish General Hospital lung cancer database, of all patients diagnosed with NSCLC since 1999, those with biopsies at two different points in time were identified. All tumour samples were genotyped for EGFR exons 19 and 21 mutations using denaturing high performance liquid chromatography (dHPLC). Results: 29 patients were identified. Data for 12 patients, whose time of recurrence or progression varied between 4 months and 6 years, are available at this time. Of 12 patients, one had EGFR exon 19 mutation at time of diagnosis. One patient who initially displayed no EGFR mutation was found to have an exon 19 deletion at time of recurrence. The one with exon 19 at time of initial diagnosis continued to express exon 19 in the second biopsy. Conclusions: To our knowledge, this is the only study assessing changes in molecular genotype using dHPLC between primary and recurrent or progressive lung cancer biopsy specimens. Although sample size is small, it is evident that changes in EGFR mutational status can occur. Further prospective studies are required to determine how commonly molecular changes occur. No significant financial relationships to disclose.
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Affiliation(s)
- G. Speranza
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - V. Cohen
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - J. S. Agulnik
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - G. Chong
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - F. Meilleur
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - G. Brandao
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - G. Kasymjanova
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - D. Small
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - W. H. Miller
- Jewish General Hospital, Segal Cancer Center, McGill University, Montreal, QC, Canada; Jewish General Hospital, McGill University, Montreal, QC, Canada
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Agulnik JS, Cohen V, Sun S, Ang C, Kasymjanova G, Chong G, Brandao G, Pepe C, Small D, Miller WH. Epidermal growth factor receptor ( EGFR) mutations detected by denaturing high performance liquid chromatography (dHPLC) in non-small cell lung cancer (NSCLC): Correlation with disease stage and response to tyrosine kinase inhibitors (TKI) therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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