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Bao T, Chen P, Yu J, Cai DH, He XD, Wang YJ, Xie XF, Li KK, Zhao XY, Guo W. Learning curve in relation to health-related quality of life in long-term, disease free survivors after McKeown minimally invasive esophagectomy. Surg Endosc 2024; 38:671-678. [PMID: 38012442 DOI: 10.1007/s00464-023-10553-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The potential impact of learning curve on long-term health-related quality of life (QoL) after esophagectomy for cancer has not been investigated. The aim of this article is to investigate the relationship between learning curve for McKeown minimally invasive esophagectomy (MIE) and health-related quality of life (QoL) in long-term, disease free survivors up to 10 years after esophageal cancer resection. METHODS Esophageal cancer patients who underwent McKeown MIE between 2009 and 2019 were identified in which 280 who were free of disease at the time of survey and completed health-related QoL and symptom questionnaires, including EORTC QLQ-C30, EORTC QLQ-OES18, and Digestive Symptom Questionnaire. Patients were assessed in 3 cohorts according to the learning phases of expertise reported by our previous study: initial phase; plateau phase, and; experienced phase. RESULTS Median time from operation to survey was 5.8 years (interquartile range 4.6-8.2). The QLQ-C30 mean scores of functional scales, and symptom scales of respiratory and digestive systems including dyspnea (P = 0.006), shortness of breath (P = 0.003), and dysphagia (P = 0.031) were significantly better in experienced phase group. Furthermore, in the subgroup analyses for patients without postoperative major complications, patients in the initial learning phase remained suffering from more symptoms of dyspnea (P = 0.040) and shortness of breath (P = 0.001). CONCLUSION Esophageal cancer patients undergoing McKeown MIE in initial learning phase tend to suffer from a deterioration in long-term health-related QoL and higher symptomatic burden as compared to experienced learning phase, which did not improved over time and warranted more attention.
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Affiliation(s)
- Tao Bao
- Army Medical University, Gaotanyan Route 30#, Chongqing, 400038, People's Republic of China
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Ping Chen
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Jun Yu
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Dao-Hong Cai
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xian-Dong He
- Army Medical University, Gaotanyan Route 30#, Chongqing, 400038, People's Republic of China
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Ying-Jian Wang
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xian-Feng Xie
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Kun-Kun Li
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xiao-Ying Zhao
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Wei Guo
- Army Medical University, Gaotanyan Route 30#, Chongqing, 400038, People's Republic of China.
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.
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Bao T, Wang YJ, Li KK, Zhao XL, Liu B, He XD, Xie XF, Zhang L, Li KL, Guo W. Safety and feasibility of three-dimensional McKeown minimally invasive esophagectomy. Surg Endosc 2023; 37:6908-6914. [PMID: 37322359 DOI: 10.1007/s00464-023-10172-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/30/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND To compare the perioperative outcomes from McKeown minimally invasive esophagectomy (MIE) when performed in three-dimensional versus two-dimensional visualization system, and investigate the learning curve of a single surgeon who implemented three-dimensional McKeown MIE. METHODS A total of 335 consecutive cases (three-dimensional or two-dimensional) were identified. Perioperative clinical parameters were compared and cumulative sum learning curve was plotted. Propensity score matching was used to reduce selection bias from confounding factors. RESULTS Patients in three-dimensional group were associated with more chronic obstructive pulmonary disease (23.9% vs 3.0%, p < 0.01). After propensity score matching (108 matched patients in each groups), this finding was no longer statistically significant. Comparing to two-dimensional group, significant improvement in total retrieved lymph nodes (28 vs 33, p = 0.003) was observed in three-dimensional group. In addition, more lymph nodes around the right recurrent laryngeal nerve were harvested in three-dimensional group than that in two-dimensional group (p = 0.045). However, there were no significantly differences were found between the two groups in terms of other intraoperative parameters (e.g., operative time) and postoperative relevant outcomes (e.g., lung infection). Furthermore, the change point in the cumulative sum learning curves for intraoperative blood loss and thoracic procedure time was 33 procedures, respectively. CONCLUSION Three-dimensional visualization system appears to be superior in performing lymphadenectomy during McKeown MIE to that of a two-dimensional technique. For surgeons proficient in performing two-dimensional McKeown MIE, the learning curve for a three-dimensional procedure appears to begin near proficiency after more than 33 cases.
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Affiliation(s)
- Tao Bao
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Ying-Jian Wang
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Kun-Kun Li
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Xiao-Long Zhao
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Bi Liu
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Xian-Dong He
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Xian-Feng Xie
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Liang Zhang
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China
| | - Kun-Lin Li
- Department of Respiration, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China.
| | - Wei Guo
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People's Republic of China.
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Kanamori K, Koyanagi K, Ozawa S, Oguma J, Kazuno A, Ninomiya Y, Yamamoto M, Shoji Y, Yatabe K, Mori M. Usefulness of three-dimensional thoracoscope for prone position thoracoscopic esophagectomy improves mediastinal lymph node dissection and prognosis for esophageal cancer. Cancer Rep (Hoboken) 2023; 6:e1850. [PMID: 37339941 PMCID: PMC10432463 DOI: 10.1002/cnr2.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/12/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVES This study aimed to assess the superiority of 3D flexible thoracoscope against 2D thoracoscope for lymph node dissection (LND) and prognosis for prone-position thoracoscopic esophagectomy (TE) in esophageal cancer. METHODS Three hundred and sixty-seven esophageal cancer patients who underwent prone-position TE with 3-field LND between 2009 and 2018 were evaluated. 2D and 3D thoracoscope was used in 182 (2D group) and 185 cases (3D group), respectively. Short-term surgical outcomes, numbers of retrieved mediastinal lymph node (LN), and rates of LN recurrence were compared. Risk factors for mediastinal LN recurrence and long-time prognosis were also evaluated. RESULTS No differences in postoperative complications were observed between the groups. The numbers of retrieved mediastinal LN were significantly higher, and the rates of LN recurrence were significantly lower in the 3D group compared to 2D group. Use of 2D thoracoscope was a significant independent factor of middle mediastinal LN recurrence by multivariable analysis. Survival was compared by cox regression analysis, and the 3D group had a significantly better prognosis than the 2D group. CONCLUSIONS Prone position TE using 3D thoracoscope may improve the accuracy of mediastinal LND and prognosis without increasing postoperative complications for esophageal cancer.
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Affiliation(s)
- Kohei Kanamori
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Kazuo Koyanagi
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Soji Ozawa
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Junya Oguma
- Department of Esophageal SurgeryNational Cancer Center HospitalTokyoJapan
| | - Akihito Kazuno
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Yamato Ninomiya
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Miho Yamamoto
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Yoshiaki Shoji
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Kentaro Yatabe
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
| | - Masaki Mori
- Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
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Wei R, Ding X, Chen Z, Xin N, Liu C, Fang Y, Xu Z, Huang K, Tang H. Clinical comparative study of glasses-free 3D and 2D thoracoscopic surgery in minimally invasive esophagectomy. Front Oncol 2022; 12:959484. [PMID: 35992851 PMCID: PMC9389333 DOI: 10.3389/fonc.2022.959484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the safety and efficacy of glasses-free three-dimensional (3D) thoracoscopic surgery in minimally invasive esophagectomy (MIE). Methods The clinical data of 98 patients, including 81 men and 17 women aged 45–77 years, with esophageal squamous cell carcinoma who underwent minimally invasive thoracoscopic esophagectomy from January 2017 to December 2019 [3 years, with clinical follow-up time: 1 year~4 years (2017.01–2020.12)] were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a glasses-free 3D thoracoscopic group (G-3D group: 38 patients) and a two-dimesional (2D) thoracoscopic group (2D group: 60 patients). The clinical outcome of the two groups were compared. Results The operation time of the thoracoscopic part in the G-3D group was significantly shorter than that in the 2D group (P<0.05). The total number of lymph node dissection in the G-3D group was more than that in the 2D group (P<0.05). The thoracic indwelling time, postoperative hospital stay, severe pulmonary infection, arrhythmia, anastomotic leakage, chylothorax, and recurrent laryngeal nerve injury were not significantly different between the two groups (P>0.05). There was also no significant difference between the two groups on the progression-free survival (P>0.05). Conclusion Glasses-free 3D thoracoscopic surgery for esophageal cancer is a safe and effective surgical procedure. Compared with 2D thoracoscopic MIE, glasses-free 3D thoracoscopic MIE for esophageal cancer has higher safety, more lymph node dissection, and higher operation efficiency through the optimized surgical operations. We believe that glasses-free 3D thoracoscopy for MIE is worthy of clinical promotion.
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Affiliation(s)
- Rongqiang Wei
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xinyu Ding
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Zihao Chen
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Ning Xin
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Chengdong Liu
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yunhao Fang
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Zhifei Xu
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Kenan Huang
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Hua Tang, ; Kenan Huang,
| | - Hua Tang
- Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Naval Medical University, Shanghai, China
- *Correspondence: Hua Tang, ; Kenan Huang,
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Xin N, Ding X, Huang K, Wei R, Chen Z, Liu C, Fang Y, Xu Z, Tang H. Three-dimension versus two-dimension video-assisted thoracoscopic surgery for esophageal cancer: a meta-analysis. Transl Cancer Res 2021; 10:3448-3457. [PMID: 35116649 PMCID: PMC8797774 DOI: 10.21037/tcr-21-644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/21/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND It still remains unclear whether three-dimension (3D) video-assisted thoracoscopic surgery (VATS) for esophageal cancer is safe and reasonable. This meta-analysis aims at assessing the effectiveness and safety of 3D VATS for esophageal cancer in comparison with that of two-dimension (2D) VATS. METHODS All the relevant data systematically analyzed in this thesis is from PubMed, Embase, The Cochrane Library, Web of Science and clinicaltrials.gov, and the time span for retrieval is from the date of the database establishment to February 2021. The research on the efficacy and safety of 3D VATS for esophageal cancer and 2D VATS is consistent with our meta-analysis. Continuous variables and dichotomy variables are compared using odds ratio, average or standard average differences with 95% confidence interval (95% CI), and P values, respectively. RESULTS In five studies of this paper, there were 553 patients in total (3D VATS group, n=266 and 2D VATS group, n=287). Patients in the 3D group had shorter operation time [standardized mean difference (SMD) =-0.99, 95% CI: -1.66 to -0.32; P=0.004], and less bleeding (SMD =-0.88, 95% CI: -1.66 to -0.10; P=0.03) than those in the 2D group. The total amount of dissected lymph node and post-operative complications in the 2D group and the 3D group were nearly the same, showing no significant difference. DISCUSSION The results of this meta-analysis showed that 3D VATS for esophageal cancer will be more applied and developed in the future. REGISTRATION NUMBER OF PROSPERO CRD42021238863.
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Affiliation(s)
- Ning Xin
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Xinyu Ding
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Kenan Huang
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Rongqiang Wei
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Zihao Chen
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Chengdong Liu
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Yunhao Fang
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Zhifei Xu
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
| | - Hua Tang
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai, China
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Abbassi O, Patel K, Jayanthi NV. Three-Dimensional vs Two-Dimensional Completely Minimally Invasive 2-Stage Esophagectomy With Intrathoracic Hand-Sewn Anastomosis for Esophageal Cancer: Comparison of Intra-and Postoperative Outcomes. Surg Innov 2020; 28:582-589. [PMID: 33225834 DOI: 10.1177/1553350620972546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Completely minimally invasive esophagectomy (CMIE) has been associated with reduced morbidity compared to open esophagectomy in the treatment of esophageal cancer. Three-dimensional (3D) vision can enhance depth perception during minimally invasive surgery when compared to two-dimensional (2D) vision. We aimed to compare outcomes from 2-stage CMIEs when performed in 2D vs 3D. Method. All consecutive 2-stage CMIEs performed for esophageal or gastroesophageal junctional cancer at a single-centre between 2016 and 2018 were identified from a prospectively maintained database. All operations were completed in either 2D or 3D. All esophagogastric anastomoses were hand-sewn thoracoscopically. Intraoperative and postoperative clinical parameters were compared between 2D and 3D CMIE. Results. Overall, 98 patients underwent a 2-stage CMIE, of which 59 (60.2%) were in 2D and 39 (39.8%) in 3D. Median operative blood loss was less in the 3D group compared to the 2D group (283 mls vs 409 mls, P = .016). A higher number of lymph nodes were retrieved from 3D CMIE (30 vs 25, P = .010). The median duration of surgery was 407 minutes (interquartile ranges (IQR): 358-472 minutes) and 426 minutes (IQR: 369-509 minutes) when performed in 2D and 3D, respectively (P = .162). There were no significant intergroup differences in 30-day postoperative complications, short-term mortality, and hospital stay. Conclusion. We report reduced blood loss and higher lymph node yield when performing 3D CMIE than 2D CMIE. Other intraoperative and postoperative clinical outcomes were similar in both groups. A randomized controlled trial is needed to validate these findings of superior outcomes from CMIE performed in 3D over 2D.
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Affiliation(s)
- Omar Abbassi
- Essex Upper GI, Regional Centre for Oesophagogastric Surgery, 156638Broomfield Hospital, UK
| | - Krashna Patel
- Essex Upper GI, Regional Centre for Oesophagogastric Surgery, 156638Broomfield Hospital, UK
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Bracale U, Merola G, Rizzuto A, Pontecorvi E, Silvestri V, Pignata G, Pirozzi F, Cuccurullo D, Sciuto A, Corcione F. Does a 3D laparoscopic approach improve surgical outcome of mininvasive right colectomy? A retrospective case-control study. Updates Surg 2020; 72:445-451. [PMID: 32232743 DOI: 10.1007/s13304-020-00755-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/20/2020] [Indexed: 12/16/2022]
Abstract
Laparoscopy has gained wide acceptance due its benefits for patients. However, advanced laparoscopic procedures are still challenging. One critical issue is lack of stereoscopic vision. Despite its diffusion, the totally laparoscopic approach for right hemicolectomy (TLRC) is still debated due to its difficulty, particularly for fashioning of the ileocolic anastomosis. The aim of this multicenter study is to investigate whether 3D vision offers any advantages on surgical performance over 2D vision during TLRC. All data of consecutive patients who underwent elective TLRC for cancer at three Italian surgical centers with either 2D or 3D technology from January 2013 to December 2018 were retrieved from a computer-maintained database. A case-matched analysis using the Mantel-Haenszel method was performed. After matching, a total of 106 patients were analyzed with 53 patients in each group. Mean operative time was significantly longer for 2D-TLRC than for 3D-TLRC (153.2 ± 52.4 vs. 131 ± 51 min, p = 0.029) and a statistically significant difference in anastomosing time (p = 0.032, 19.2 ± 5.9 min vs. 21.7 ± 6.2 min for 3D and 2D group, respectively) was also recorded. No difference in the median number of harvested nodes (23 ± 11 vs. 21 ± 7 for 3D and 2D group, respectively; p = 0.48) was found. Neither intraoperative complications nor conversions occurred in the two groups. In conclusion, 3D vision appears to improve the performance of a TLRC by reducing operative time and making intracorporeal anastomosis easier. Prospective randomized studies are required to determine the real beneficial effects.
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Affiliation(s)
- Umberto Bracale
- Department of General Surgery and Specialities, School of Medecine Federico II of Naples, Via Pansini 5, 7th Building, Naples, Italy.
| | - Giovanni Merola
- Department of General Surgery and Specialities, School of Medecine Federico II of Naples, Via Pansini 5, 7th Building, Naples, Italy
| | - Antonia Rizzuto
- Medical and Surgical Science, University "Magna Graecia" of Catanzaro Medical School, Catanzaro, Italy
| | - Emanuele Pontecorvi
- Department of General Surgery and Specialities, School of Medecine Federico II of Naples, Via Pansini 5, 7th Building, Naples, Italy
| | - Vania Silvestri
- Department of General Surgery and Specialities, School of Medecine Federico II of Naples, Via Pansini 5, 7th Building, Naples, Italy
| | - Giusto Pignata
- Department of General Surgery II, Spedali Civili of Brescia, Brescia, Italy
| | - Felice Pirozzi
- Department of General Surgery, Santa Maria delle Grazie Hospital, Pozzuoli, Naples, Italy
| | - Diego Cuccurullo
- Department of General Surgery, Ospedali dei Colli Monaldi Hospital, Naples, Italy
| | - Antonio Sciuto
- Department of General Surgery, Santa Maria delle Grazie Hospital, Pozzuoli, Naples, Italy
| | - Francesco Corcione
- Department of General Surgery and Specialities, School of Medecine Federico II of Naples, Via Pansini 5, 7th Building, Naples, Italy
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Yamashita K, Mine S, Toihata T, Fukudome I, Okamura A, Yuda M, Hayami M, Imamura Y, Watanabe M. The usefulness of three-dimensional video-assisted thoracoscopic esophagectomy in esophageal cancer patients. Esophagus 2019; 16:272-277. [PMID: 30888533 DOI: 10.1007/s10388-019-00661-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/08/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND The three-dimensional video-assisted (3D-VA) system is known to provide depth perception and the precise measurement of anatomical spaces, unlike the two-dimensional video-assisted (2D-VA) system. However, the advantages of the 3D-VA system in thoracoscopic esophagectomy remains unclear. METHODS We retrospectively analyzed data from 104 patients who underwent thoracoscopic esophagectomy for esophageal cancer from 2016 to 2017. We performed thoracic esophagectomy using either the 2D-VA or 3D-VA system during this period. Whenever the 3D-VA system was available in our surgical center, we performed 3D-VA thoracoscopic esophagectomy. Perioperative parameters, including operation times, blood loss, the number of dissected lymph nodes, postoperative complications, and the duration of postoperative hospital stays, were compared between the 2D-VA and 3D-VA system groups. RESULTS There were 51 and 53 patients in the 2D-VA and 3D-VA system groups, respectively. Preoperative parameters, including age, sex, tumor location, clinical stage and the distribution of preoperative treatment, were not significantly different between the groups. Although intraoperative blood loss did not differ between the two groups, operation times were significantly shorter in the 3D-VA system group than the 2D-VA system group (P = 0.023). The number of dissected mediastinal lymph nodes was similar in both groups. The incidences of postoperative complications, including pneumonia, recurrent nerve palsy, anastomotic leakages and chylothorax, were similar between the groups. The duration of postoperative hospital stays was also comparable between the groups. CONCLUSIONS An introduction of 3D-VA endoscopy into minimally invasive esophagectomies may contribute to the shortening of the duration of thoracoscopic procedures.
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Affiliation(s)
- Kotaro Yamashita
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinji Mine
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Tasuku Toihata
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ian Fukudome
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akihiko Okamura
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masami Yuda
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masaru Hayami
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yu Imamura
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masayuki Watanabe
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Zang X, Huang HL, Xie B, Liu J, Guo HM. A comparative study of three-dimensional high-definition and two-dimensional high-definition video systems in totally endoscopic mitral valve replacement. J Thorac Dis 2019; 11:788-794. [PMID: 31019766 DOI: 10.21037/jtd.2019.02.27] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Three-dimensional vision with improved depth perception and spatial orientation has already proved its superiority to the two-dimensional vision in endoscopic surgery. However, those benefits remain unidentified in cardiac surgery. For the first time, we compare performance of a three-dimensional high-definition video system with a two-dimensional high-definition video system in patients undergoing totally endoscopic mitral valve replacement. Methods We enrolled 90 patients with mitral valve disease in a single institution, from June 2013 to June 2016. Totally endoscopic mitral valve replacement was performed by the same surgeon using either a three-dimensional high-definition (n=43) or a two-dimensional high-definition (n=47) video system with the same surgical technique. Short-term outcomes were compared between the two groups. All medical records were retrieved from a prospectively maintained database of minimally invasive cardiac surgery. Results All surgeries were successfully completed under totally endoscopic guidance. There were no intraoperative complications in either group. The use of three-dimensional video system reduced aortic cross-clamp time by approximately 10% (3D vs. 2D: 65.74±14.32 vs. 72.67±14.67 min, P=0.027). No significant differences were observed in cardiopulmonary bypass time, postoperative ventilation duration, length of surgical intensive care unit stay, length of hospital stay, and major complications between the two groups. There were no perioperative deaths in either group. Conclusions Compared with the two-dimensional video system, the three-dimensional high-definition video system provided a better surgical experience with the same operative safety for totally endoscopic mitral valve replacement.
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Affiliation(s)
- Xin Zang
- Department of Adult Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Huan-Lei Huang
- Department of Adult Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Bin Xie
- Department of Adult Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jian Liu
- Department of Adult Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Hui-Ming Guo
- Department of Adult Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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10
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The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surg Endosc 2018. [PMID: 30515610 DOI: 10.1007/s00464-018-06612-x.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
BACKGROUND The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community. METHODS Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018. RESULTS 9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I2 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I2 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I2 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D. CONCLUSION We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).
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11
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Arezzo A, Vettoretto N, Francis NK, Bonino MA, Curtis NJ, Amparore D, Arolfo S, Barberio M, Boni L, Brodie R, Bouvy N, Cassinotti E, Carus T, Checcucci E, Custers P, Diana M, Jansen M, Jaspers J, Marom G, Momose K, Müller-Stich BP, Nakajima K, Nickel F, Perretta S, Porpiglia F, Sánchez-Margallo F, Sánchez-Margallo JA, Schijven M, Silecchia G, Passera R, Mintz Y. The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surg Endosc 2018; 33:3251-3274. [PMID: 30515610 DOI: 10.1007/s00464-018-06612-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/27/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community. METHODS Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018. RESULTS 9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I2 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I2 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I2 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D. CONCLUSION We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).
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Affiliation(s)
- Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
| | - Nereo Vettoretto
- Montichiari Surgery, ASST Spedali Civili Brescia, Montichiari, Italy
| | - Nader K Francis
- Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, UK
| | - Marco Augusto Bonino
- Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy
| | - Nathan J Curtis
- Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, UK.,Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Daniele Amparore
- Division of Urology, ESUT Research Group, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy
| | - Simone Arolfo
- Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy
| | - Manuel Barberio
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS Cà Granda, Policlinico Hospital, University of Milan, Milan, Italy
| | - Ronit Brodie
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Nicole Bouvy
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elisa Cassinotti
- Department of Surgery, Fondazione IRCCS Cà Granda, Policlinico Hospital, University of Milan, Milan, Italy
| | - Thomas Carus
- Department of Surgery, Center for Minimally Invasive Surgery, Asklepios Westklinikum Hamburg, Hamburg, Germany
| | - Enrico Checcucci
- Division of Urology, ESUT Research Group, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy
| | - Petra Custers
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michele Diana
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Marilou Jansen
- Department of Surgery, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Joris Jaspers
- Department of Medical Technology and Clinical Physics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Gadi Marom
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Kota Momose
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Beat P Müller-Stich
- General-, Visceral-and Transplant Surgery, University of Heidelberg Hospital, Heidelberg, Germany
| | - Kyokazu Nakajima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Felix Nickel
- General-, Visceral-and Transplant Surgery, University of Heidelberg Hospital, Heidelberg, Germany
| | - Silvana Perretta
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Francesco Porpiglia
- Division of Urology, ESUT Research Group, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy
| | | | | | - Marlies Schijven
- Department of Surgery, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Gianfranco Silecchia
- Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberto Passera
- Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy
| | - Yoav Mintz
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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12
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Liang H, Liang W, Lei Z, Liu Z, Wang W, He J, Zeng Y, Huang W, Wang M, Chen Y, He J. Three-Dimensional Versus Two-Dimensional Video-Assisted Endoscopic Surgery: A Meta-analysis of Clinical Data. World J Surg 2018; 42:3658-3668. [PMID: 29946785 DOI: 10.1007/s00268-018-4681-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There have been no studies to systematically evaluate the two display (3D vs. 2D) systems regarding both laparoscopic and thoracoscopic surgeries in clinical settings; thus, we conducted one to evaluate the safety and efficacy of different visualization systems (two-dimensional and three-dimensional) during endoscopic surgery (laparoscopy or thoracoscopy) in clinical settings. METHODS A comprehensive search of online databases was performed. Perioperative outcomes were synthesized. Cumulative meta-analysis was performed to evaluate the temporal trend of pooled outcomes. Specific subgroups (laparoscopy vs. thoracoscopy, prospective vs. retrospective study, malignant vs. benign diseases) were examined. Meta-regression was conducted to explore the source of heterogeneity. RESULTS Twenty-three articles were considered in this analysis, of which 7 were thoracoscopic and 16 were laparoscopic surgeries. A total of 2930 patients were recorded, of which 1367 underwent 3D video-assisted surgery and 1563 underwent 2D display. Overall, significantly shorter operating time (SMD -0.69; p = <0.001), less blood loss (SMD -0.26; p = 0.028) and shorter hospital stays (SMD -0.16; p = 0.016) were found in the 3D display group. Meanwhile, the perioperative morbidity (OR 0.92; p = 0.487), retrieved lymph nodes (SMD 0.09; p = 0.081), drainage duration (SMD -0.15; p = 0.105) and drainage volume (SMD 0.00; p = 0.994) were similar between the two groups. Comparison of the overall outcomes in each subset showed consistency in all groups. CONCLUSIONS This up-to-date meta-analysis reveals that the 3D display system is superior to the 2D system in clinical settings with significantly shorter operating time, less blood loss and shorter hospital stay. These findings suggest that, in laparoscopic or thoracoscopic surgeries, 3D endoscopic system is preferable when condition permits. Future efforts should be made on decreasing the side effects of 3D display and increasing its cost-effectiveness.
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Affiliation(s)
- Hengrui Liang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Wenhua Liang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Zhao Lei
- The Sixth Affiliated Hospital, School of Basic Medical Sciences, Functional Experiment Center, Guangzhou Medical University, Guangzhou, 511436, China
| | - Zhichao Liu
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Wei Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Jiaxi He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Yuan Zeng
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Weizhe Huang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Manting Wang
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yuehan Chen
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
- State Key Laboratory of Respiratory Diseases, Guangzhou, 510120, China.
- National Clinical Research Center for Respiratory Center for Respiratory Disease, Guangzhou, 510120, China.
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13
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Xu Y, Chen N, Ma A, Wang Z, Zhang Y, Liu C, Liu L. Three-dimensional versus two-dimensional video-assisted thoracic surgery for thoracic disease: a meta-analysis. Interact Cardiovasc Thorac Surg 2017; 25:862-871. [DOI: 10.1093/icvts/ivx219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/24/2017] [Indexed: 12/28/2022] Open
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14
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Ali MJ, Naik MN. First intraoperative experience with three-dimensional (3D) high-definition (HD) nasal endoscopy for lacrimal surgeries. Eur Arch Otorhinolaryngol 2017; 274:2161-2164. [PMID: 28154929 DOI: 10.1007/s00405-017-4466-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/12/2017] [Indexed: 12/26/2022]
Abstract
The aim of this study is to report our preliminary experiences with regard to safety and feasibility of three-dimensional (3D) endoscopic lacrimal surgeries with a recently launched latest generation 3D endoscope. A 4-mm rigid three-dimensional (3D) endoscope (TIPCAM 1S 3D ORLR, Karl Storz, Tuttlingen, Germany) was used. Fifteen patients who underwent various endoscopic lacrimal procedures by a single surgeon (MJA) were included. The procedures included probing with nasolacrimal intubation, cruciate marsupialization of intranasal cysts for congenital dacryoceles, powered endoscopic dacryocystorhinostomy, post-operative stent removal with ostium granuloma excision. The implementation, visualization, optical performance, ease of tissue handling and complications were noted. Ten surgical observers filled a questionnaire to rate their experiences. Enhanced depth perception was found to be very beneficial intraoperatively. Greater anatomical delineation facilitated improved hand-eye coordination and dexterity. Intraoperative assessment and handling of tissues and surgical manoeuvring were precise and did not require the additional spatial cues that the surgeon derives from a two-dimensional image. These benefits were more appreciated in the complex cases. The setup was easy on previous endoscopic platforms and did not consume any additional time. All the surgical procedures were completed successfully without any complications. The surgical observers unanimously noted enhanced anatomical understanding and surgical learning as compared to the routine 2D planes. Operating in 3D planes enhances depth perception, dexterity and precision. Although initial results are promising, further randomized studies with head-on comparisons between 3D and 2D would help formulate specific guidelines.
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Affiliation(s)
- Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L. V. Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, 500034, India.
| | - Milind N Naik
- Govindram Seksaria Institute of Dacryology, L. V. Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, 500034, India
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