01 to -0.60, P<0.0001) and transfused red blood cell volume (SMD 0.92, 95% CI -1.30 to -0.53, P<0.0001). Two studies reported that complication rates were comparable between patients receiving IABO and patient receiving conventional surgery (Odds ratio=1.29, 95% CI 0.59 to 2.83, P=0.52). All studies descriptively reported improved visualization of the operative field with IABO.

Our findings demonstrated that IABO is an effective technique to decrease blood loss and transfusion requirements during sacral and pelvic tumor surgery. Future clinical trials should be conducted to establish the safety of this method and explore potential contraindications.

Our findings demonstrated that IABO is an effective technique to decrease blood loss and transfusion requirements during sacral and pelvic tumor surgery. Future clinical trials should be conducted to establish the safety of this method and explore potential contraindications.

Inguinofemoral lymphadenectomy (IFL) is part of the surgical treatment of different malignancies of the genital tract and/or the lower limb including vulvar carcinoma, penile carcinoma and melanoma. IFL is associated with morbidity in up to 85% of the patients. The aims of this MAMBO-IC study (Morbidity And Measurement of the Body) are to study the feasibility of using LigaSure for IFL and to assess the differences in the incidence of short-term complications using LigaSure versus conventional IFL randomized within each individual patient.

In this multicenter randomized controlled trial (RCT), women diagnosed with squamous cell carcinoma of the vulva with an indication for bilateral IFL were included. It was randomly assigned for which groin the LigaSure was used; the other groin was treated with conventional IFL (sharp/diathermia). We estimated the incidence of ≥1 complication(s) per groin using logistic regression and compared this between the two surgical methods, adjusting for possible confounders.

We included 40 groins of 20 patients. The estimated incidence of ≥1 complication(s) was 29% after LigaSure versus 70% after conventional IFL (risk difference 41% (95% CI 19-62), p<0.001). Patients’ reported restriction of daily living activities and maximum pain score were equal for both treatment methods. There were no differences in the surgeon reported workload scores.

This RCT shows that LigaSure for IFL is feasible and associated with significantly less short-term surgical complications compared to conventional IFL. Further studies with a larger sample size are needed to validate our findings. ISRCTN15057626.

This RCT shows that LigaSure for IFL is feasible and associated with significantly less short-term surgical complications compared to conventional IFL. ETC159 Further studies with a larger sample size are needed to validate our findings. ISRCTN15057626.Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with favorable pathological and clinical features may be considered as indolent lesions, and therefore be amenable to conservative management. According to the primary tumor site, different non-aggressive approaches, based on endoscopic resection or simple active surveillance, can be proposed to selected patients fulfilling specific criteria. Tumor size, Ki67 proliferative index and depth of invasion are markers that can be used in order to identify these subjects. Patients with type I gastric NENs less then 1 cm as well as those with non-ampullary duodenal NENs less then 1 cm with no associated syndrome can be safely managed by endoscopic resection. On the other hand, an active surveillance approach is preferred over surgery for patients with asymptomatic, non-functioning pancreatic NENs ≤2 cm without dilation of the main pancreatic duct or bile duct. As far as NENs of the appendix are concerned, appendectomy should be considered as curative when a R0 resection has been achieved in the presence of a tumor ≤1.5 cm, graded as G1 and without lymphovascular invasion. Finally, G1 rectal NENs ≤1 cm without invasion of the muscular layer can be safely treated by endoscopic resection. Therefore, surgeons should be aware of the existence of indolent GEP-NENs, in order to avoid unnecessary operations with associated postoperative complications.

Exposing the middle hepatic vein (MHV) is required in left hemihepatectomy [1]. Laparoscopy enables us to perform unique approach in performing hepatectomy [2,3]. Herein we show a video of dorsal approach in left hemihepatectomy and measure anatomical parameters useful for approaching to the MHV.

A 79-year-old man with colorectal liver metastasis underwent laparoscopic left hemihepatectomy.

After mobilizing left lateral section and encircling left Glissonian trunk, we firstly flipped up left lateral section inside and began parenchymal transection from dorsal surface around the root of left hepatic vein (LHV). Immediately we touched the MHV and, by cutting the left Glissonian trunk, could extend complete MHV exposure in central-to-peripheral direction without split injuries of MHV branches [2]. Next, we flipped down the left lateral section and divided ventral remaining parenchyma in caudal-to-cranial direction without risk of MHV injury. As this is not one-way procedure [4], as if open a book, we adjusted the ventral cutting plane to match with the dorsal one. Finally, by cutting the LHV, we completed left hemihepatectomy.

We divided a sectional image into four zones (cranio-dorsal, caudal-dorsal, caudal-ventral, and cranio-ventral zones) and measured each anatomical parameter to expose the MHV. The area of cranio-dorsal zone was smallest to expose the MHV (3.5cm

). The distance from the Arantius’ ligament to the MHV was also shortest (1.1cm).

Dorsal approach might be the nearest and safe road way to the MHV. This approach might make it easy to complete laparoscopic left hemihepatectomy.

Dorsal approach might be the nearest and safe road way to the MHV. This approach might make it easy to complete laparoscopic left hemihepatectomy.

Epilepsy is among the more stigmatising diseases, leading to a negative impact on the quality of life (QoL) of people with epilepsy (PWE). Assessment of the QoL and stigma in PWE reflects the outcome of their disease, and the findings can be used to improve the management of epilepsy. To fill a gap in the literature, our primary aim is to evaluate the QoL and stigma in Lebanese PWE, and our secondary aim is to identify factors affecting these parameters.

A cross-sectional study was conducted for 1 year in Greater Beirut. PWE were interviewed by using a standardised questionnaire. QoL was evaluated by the QoL in Epilepsy Inventory-10 (QOLIE-10), and the stigma was evaluated by the Jacoby scale. Multivariate analyses were used to identify the factors associated with QoL and stigma.

The sample was 404 PWE. More than half of the PWE (61.4 %) had a better QoL than the other PWE (mean QOLIE-10 score of 26.9 ± 11.3), and 47.8 % of PWE felt stigmatised. Linear regression showed that presence of psychiatric comorbidities (p = 0.