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Langenbeck's Archives of Surgery

Carsten Engelmann, Gudela Grote, Siegfried Geyer, Dzifa Ametowobla
PURPOSE: Algorithms for surgical operation planning are evidence-based. However, choices sometimes have to be made between medically equal solutions e.g. for staffing of sought-after operations. Such decisions are heavily influenced by micropolitics and power. The article examines the array of highly manipulated processes around operation theatre allocation of convenient time slots or staff, which play out in various ways in all of the world's main regional surgical cultures. METHOD: Essay supported by empiric data from an ethnographic power-analysis targeted to senior executive surgeons...
October 14, 2016: Langenbeck's Archives of Surgery
Andreas Selberherr, Marcus Hörmann, Gerhard Prager, Philipp Riss, Christian Scheuba, Bruno Niederle
PURPOSE: The purpose of this study was to demonstrate the high number of kidney stones in primary hyperparathyroidism (PHPT) and the low number of in fact "asymptomatic" patients. METHODS: Forty patients with PHPT (28 female, 12 male; median age 58 (range 33-80) years; interquartile range 17 years [51-68]) without known symptoms of kidney stones prospectively underwent multidetector computed tomography (MDCT) and ultrasound (US) examinations of the urinary tract prior to parathyroid surgery...
October 12, 2016: Langenbeck's Archives of Surgery
David Martin, Didier Roulin, Valérie Addor, Catherine Blanc, Nicolas Demartines, Martin Hübner
PURPOSE: Enhanced recovery after surgery (ERAS) implementation has proven to reduce complication rate and length of hospital stay. Little is known about the sustainability of these results over time. The study aim was to assess the application of ERAS pathway over the first 4 years after initial implementation. METHODS: This retrospective study analyzed data collected prospectively from 482 consecutive elective colorectal patients operated in 2011 during the ERAS implementation process (n = 66), and after initial implementation in 2012 (n = 136), 2013 (n = 152), and 2014 (n = 128)...
October 11, 2016: Langenbeck's Archives of Surgery
J I González-Muñoz, G Franch-Arcas, M Angoso-Clavijo, M Sánchez-Hernández, A García-Plaza, M Caraballo-Angeli, L Muñoz-Bellvís
PURPOSE: Age and comorbidities increase the surgical risk for patients with acute cholecystitis and impact on the initial treatment selection. The aim of this article is the implementation of objective risk criteria that may be used to select the most appropriate treatment. METHODS: We carried out a prospective cohort study of all patients who were admitted to the hospital with a diagnosis of acute cholecystitis during 2014. They were initially allocated to three different treatment groups according to cholecystitis grade, number of days from clinical onset, and surgical risk scores as follows: immediate surgery by sepsis (EmergS), early surgery (EarlyS), or medical treatment group (MedT)...
October 4, 2016: Langenbeck's Archives of Surgery
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No abstract text is available yet for this article.
October 4, 2016: Langenbeck's Archives of Surgery
Stefan Gilg, Ernesto Sparrelid, Bengt Isaksson, Lars Lundell, Greg Nowak, Cecilia Strömberg
PURPOSE: The objectives of this study were to analyze the outcome after hepatectomy and to identify contributing factors to mortality and long-term survival in a population-based setting. METHOD: A retrospective, nationwide register study was performed. All patients who underwent hepatectomy in Sweden between 2002 and 2011 were identified in the Swedish Hospital Discharge Registry using their unique personal identification numbers. This cohort was linked to the National Cancer Registry (cancer diagnosis), the National Registry of Causes of Death, and the Migration Registry...
October 1, 2016: Langenbeck's Archives of Surgery
Nils Hansson, Annette Tuffs
PURPOSE: The Heidelberg surgeon Vincenz Czerny (1842-1916) is remembered as pioneer of innovative operations as well as entrepreneur of interdisciplinary cancer therapy. The purpose of this paper is to describe his role during the early history of the Nobel Prize in physiology or medicine. METHOD: Based on documents from the Nobel Archive, this paper investigates how Czerny contributed, both as nominee and nominator, in shaping the early years of Nobel Prize history...
September 30, 2016: Langenbeck's Archives of Surgery
G F Giannakopoulos, T P Saltzherr, L F M Beenen, G J Streekstra, J B Reitsma, F W Bloemers, J C Goslings, F C Bakker
BACKGROUND: During the initial assessment of patients with potential severe injuries, radiological examinations are performed in order to rapidly diagnose clinically relevant injuries. Previous studies have shown that performing these examinations routinely is not always necessary and that trauma patients are exposed to substantial radiation doses. The aim of this study was to assess the amount and findings of radiological examinations during the initial assessment of trauma patients and to determine the radiation doses to which these patients are exposed to...
September 29, 2016: Langenbeck's Archives of Surgery
Chris Braumann, Verena Müller, Moritz Knies, Birgit Aufmesser, Wolfgang Schwenk, Gerold Koplin
BACKGROUND: Although ostomies are sometimes necessary, it is unclear which type of ostomy is advantageous for quality of life (QoL). In an observational study of 2647 patients, QoL after colostomy (CS) and small bowel stoma (SBS) formation was evaluated. METHODS: The European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30 and CR-38 questionnaires were used. Patient characteristics, retrospective information about the ostomy and previous treatments, and current stoma-related complications were recorded...
September 22, 2016: Langenbeck's Archives of Surgery
Michal Mik, Maciej Berut, Radzislaw Trzcinski, Lukasz Dziki, Jaroslaw Buczynski, Adam Dziki
AIM: The objectives were to recognize the risk factors for surgical site infections (SSIs) after surgery due to colorectal cancer and to assess the impact of mechanical bowel preparation (MBP) and oral antibiotic prophylaxis (ABX) on SSIs. METHODS: Records from two colorectal centers were used. Risk factors of SSIs were categorized into patient-, disease-, and treatment-dependent. RESULTS: A group of 2240 patients was included. SSIs were noted in 364 patients (16...
September 20, 2016: Langenbeck's Archives of Surgery
Andreas Volk, Philipp Nitschke, Franziska Johnscher, Nuh Rahbari, Thilo Welsch, Christoph Reißfelder, Jürgen Weitz, Marius Distler, Soeren Torge Mees
BACKGROUND: The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs. METHODS: A questionnaire evaluating the perioperative management-especially the use of somatostatin analogs-and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center)...
September 15, 2016: Langenbeck's Archives of Surgery
Claudio Ricci, Riccardo Casadei, Vincenzo Alagna, Elia Zani, Giovanni Taffurelli, Carlo Alberto Pacilio, Francesco Minni
PURPOSE: Two main techniques are commonly used during laparoscopic right hemicolectomy in order to perform the ileocolic anastomosis: intracorporeal (IA) and extracorporeal (EA). The aim of this study was to evaluate the safety of the two techniques. METHODS: A systematic review was carried out to identify studies comparing IA and EA. The primary endpoint was anastomotic leakage. The secondary endpoints were intra- and postoperative results. A meta-analysis was carried out using the random-effects model...
September 5, 2016: Langenbeck's Archives of Surgery
Azin Jafari, Sven Wehner, Jörg C Kalff, Steffen Manekeller
PURPOSE: In recent years, multimodal treatment approaches have led to an increased median survival time of patients with colorectal liver metastases. In particular, this results from new perioperative chemotherapy regimens, which in turn are accompanied by an increased risk of perioperative bleeding and/or liver failure due to the hepatotoxic side effects. Nineteen to 58 % of patients treated with oxaliplatin develop sinusoidal obstruction syndrome (SOS). The influence of preexisting SOS on liver surgery remains controversial...
September 1, 2016: Langenbeck's Archives of Surgery
Dan Damian Axente, Nicolae Augustin Constantea
PURPOSE: The vast majority of studies published on robot-assisted thyroid surgery are South Korean. This study aims to assess the impact of certain anthropometric parameters on performing robot-assisted thyroid surgery on Caucasian patients. MATERIALS AND METHODS: A total of 91 patients underwent robot-assisted surgery by the axillary approach in the Fifth Surgical Clinic, City Hospital Cluj-Napoca, between 2010 and 2015. Besides the specific clinical and pathological parameters, a series of anthropometric parameters and the postoperative occurrence of skin disorders in the cervical or subclavicular region were determined for each patient...
August 26, 2016: Langenbeck's Archives of Surgery
Sofia Westermark, Elena Rangelova, Christoph Ansorge, Lars Lundell, Ralf Segersvärd, Marco Del Chiaro
BACKGROUND: The recent development of new neo-adjuvant treatment regimens associated with a higher success rate of down-staging has increased the interest of pancreatic surgeons on the role of extended surgery for patients affected by locally advanced pancreatic cancer. Pancreatectomy together with resection of the portal/superior mesenteric vein is considered nowadays standard of care for patients affected by pancreatic cancer. However, the resection of major abdominal arteries is still debatable...
August 25, 2016: Langenbeck's Archives of Surgery
Emanuele F Kauffmann, Niccolò Napoli, Francesca Menonna, Fabio Vistoli, Gabriella Amorese, Daniela Campani, Luca Emanuele Pollina, Niccola Funel, Carla Cappelli, Davide Caramella, Ugo Boggi
PURPOSE: This study aims to define the current status of robotic pancreatoduodenectomy (RPD) with resection and reconstruction of the superior mesenteric/portal vein (RPD-SMV/PV). METHODS: Our experience on RPD, including RPD-SMV/PV, is presented along with a description of the surgical technique and a systematic review of the literature on RPD-SMV/PV. RESULTS: We have performed 116 RPD and 14 RPD-SMV/PV. Seven additional cases of RPD-SMV/PV were identified in the literature...
August 24, 2016: Langenbeck's Archives of Surgery
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
PURPOSE: Data on the incidence, risk factors, and oncologic impact of chylous ascites after colorectal cancer surgery are scarce. In this study, we aimed to assess the risk factors and the short-term and long-term impact of chylous ascites after colorectal cancer surgery. METHODS: We retrospectively examined 2917 primary colorectal cancer patients who underwent surgical resection between January 2008 and December 2013. The short-term and long-term outcomes were compared between patients with and those without postoperative chylous ascites, and the risk factors for chylous ascites were analyzed...
August 24, 2016: Langenbeck's Archives of Surgery
Shinichiro Sakata, Philip M Grove, Andrew Hill, Marcus O Watson, Andrew R L Stevenson
PURPOSE: Surgeons conventionally assume the optimal viewing position during 3D laparoscopic surgery and may not be aware of the potential hazards to team members positioned across different suboptimal viewing positions. The first aim of this study was to map the viewing positions within a standard operating theatre where individuals may experience visual ghosting (i.e. double vision images) from crosstalk. The second aim was to characterize the standard viewing positions adopted by instrument nurses and surgical assistants during laparoscopic pelvic surgery and report the associated levels of visual ghosting and discomfort...
August 19, 2016: Langenbeck's Archives of Surgery
Jishu Wei, Xinchun Liu, Junli Wu, Wenbin Xu, Wentao Gao, Kuirong Jiang, Zhihong Zhang, Yi Miao
PURPOSE: The purpose of this study was to evaluate the diagnosis and surgical management of insulinomas in a single-center setting. METHODS: Demographic details, clinical presentation, preoperative diagnosis, surgical strategy, and outcomes of 33 consecutive patients who underwent surgery for insulinoma were analyzed retrospectively. RESULTS: The median time from the first onset of symptoms to diagnosis was 24 months (range 3 days to 50 years)...
August 19, 2016: Langenbeck's Archives of Surgery
Francesco Tonelli, Giovanni Alemanno, Carmela Di Martino, Adriana Focardi, Giorgio Gronchi, Francesco Giudici
PURPOSE: The jejunum is a relatively uncommon localization of Crohn's disease (CD) compared to the terminal ileum or the large bowel. The type of surgery and the short and long-term results after surgery have not been extensively investigated. A review of patients who underwent surgery for jejunal CD in our center was examined. METHODS: Between 1986 and 2011, 110 patients underwent surgery for jejunal CD. Thirty patients (27.3 %) were surgically treated with resection, 29 patients (26...
August 17, 2016: Langenbeck's Archives of Surgery
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