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Updates in Surgery

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https://www.readbyqxmd.com/read/28918603/tumor-markers-of-uterine-cervical-cancer-a-new-scenario-to-guide-surgical-practice
#1
REVIEW
Gaetano Valenti, Salvatore Giovanni Vitale, Alessandro Tropea, Antonio Biondi, Antonio Simone Laganà
Since the introduction of Pap smear screening, the incidence and mortality of cervical cancer (CC) have been reduced drastically in USA and in other western states. Nevertheless, CC still remains the main cause of death from gynecological cancer in developing countries where screening programs are scant or inexistent. This evidence highlights the efficacy of screening, and the wide use of Human Papilloma Viruses (HPV) vaccines in developed countries. More and more people are, consequentially, undergoing a screening procedure, usually combined with HPV DNA test, increasing the early diagnosis of intraepithelial HPV-related lesions...
September 16, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28916899/impact-of-surgical-complications-on-the-risk-of-hepatocellular-carcinoma-recurrence-after-hepatic-resection
#2
Riccardo Pravisani, Umberto Baccarani, Miriam Isola, Gianluigi Adani, Dario Lorenzin, Giovanni Terrosu, Andrea Risaliti
Surgery-related morbidity has been identified as prognostic risk factor for tumor recurrence for several tumor types, but data regarding hepatocellular carcinoma (HCC) are limited and controversial. The aim of this study was to analyze the impact of surgical complications on the risk of HCC recurrence after hepatic resection (HR). A Retrospective study was conducted on a cohort of patients submitted to HR in a tertiary teaching hospital, between January 2006 and December 2015. 112 patients were submitted to HR during the study period...
September 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#3
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28864848/lessons-learned-from-300-consecutive-pancreaticoduodenectomies-over-a-25-year-experience-the-safety-net-improves-the-outcomes-beyond-surgeon-skills
#4
Roberto Santoro, Roberto Luca Meniconi, Pasquale Lepiane, Giovanni Vennarecci, Gianluca Mascianà, Marco Colasanti, Eugenio Santoro, Giuseppe Maria Ettorre
Pancreaticoduodenectomy (PD) is associated with high postoperative morbidity. The management of postoperative complications is paramount for reducing the mortality rate. The aim of this study was to evaluate the importance of surgical and hospital experience on outcomes by comparing postoperative results in three different hospitals with increasing resources for supporting the same surgical team. Patients data and surgical outcome of 300 consecutive patients undergoing PD were collected prospectively in the department database and divided into three periods (A = 1990-2000, B = 2001-March 2007, C = April 2007-2015)...
September 1, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28861859/sodium-hydroxide-as-a-sclerosing-agent-in-patients-with-neoplastic-pleural-effusion-non-candidates-for-vats-results-of-a-minimally-invasive-protocol
#5
Micaela Raices, Matías E Czerwonko, Agustin Dietrich, Alejandro Da Lozzo, Enrique Beveraggi, David Smith
Symptomatic neoplastic pleural effusion (SNPE) is a significant cause of morbidity in patients with advanced neoplastic disease. These patients often present a deteriorated general condition which prevents them from undergoing pleurodesis with video-assisted thoracic surgery (VATS). We developed a minimally invasive therapeutic protocol specially designed for this population, achieved by combining chemical pleurodesis with placement of small-bore pleural catheters (PC), which resulted in early hospital discharge, low morbimortality and good therapeutic results...
August 31, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28861759/diffusion-outcomes-and-implementation-of-minimally-invasive-liver-surgery-a-snapshot-from-the-i-go-mils-italian-group-of-minimally-invasive-liver-surgery-registry
#6
Luca Aldrighetti, Francesca Ratti, Umberto Cillo, Alessandro Ferrero, Giuseppe Maria Ettorre, Alfredo Guglielmi, Felice Giuliante, Fulvio Calise
The Italian Group of MILS (I Go MILS) prospective registry was established in 2014 with the goals to create a hub for data and projects on a national basis and to promote the diffusion and implementation of MILS programs on a national scale. The primary endpoint of the present study is to give a snapshot of the real diffusion and outcomes of MILS in Italy, while analyzing the role of the registry in the implementation of MILS programs nationwide. The I Go MILS Registry is a prospective and intention-to-treat registry opened to any Italian center performing MILS, without restriction criteria based on number of procedures...
August 31, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28808913/modified-double-barrelled-wet-colostomy-after-total-pelvic-exenteration
#7
Antonio Macrì
Pelvic exenteration is a radical surgery that can require urinary and faecal diversions. Double-barreled wet colostomy, a viable alternative to the traditional ileal conduit with separate colostomy technique, is not always applicable due to the shortness of an ureter. To overcome this problem, I modified the original technique, replacing the two uretero-colic anastomoses with an ureteroureterostomy and an uretero-colic anastomosis.
August 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#8
Stéphanie Truant, Clio Baillet, Anne Claire Deshorgue, Mehdi El Amrani, Damien Huglo, François-René Pruvot
To reduce post-hepatectomy liver failure (PHLF), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently developed for patients with a limited future remnant liver (FRL). Nevertheless, high morbi-mortality rates have been reported . The current study aimed to analyze the kinetics of FRL function in patients who were offered ALPPS. Serial SPECT (99 m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) was performed in all patients before and after surgery as well as at inter-stage to quantitatively assess hepatic function [total liver (TL) and FRL]...
August 9, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28791628/mitomycin-c-hypoxic-pelvic-perfusion-for-unresectable-recurrent-rectal-cancer-pharmacokinetic-comparison-of-surgical-and-percutaneous-techniques
#9
Stefano Guadagni, Giammaria Fiorentini, Marco Clementi, Paola Palumbo, Andrea Mambrini, Francesco Masedu
Patients with unresectable recurrent rectal cancer that progresses after standard and multi-modular treatments are candidates for hypoxic pelvic perfusion. Hypoxic pelvic perfusion can be performed using a surgical or percutaneous approach. The aim of this study was to examine whether the surgical and percutaneous approaches are comparable with respect to tumor drug exposure in the pelvis. A pharmacokinetic study was performed in 18 patients. Both the surgical and percutaneous procedures were performed using mitomycin C (MMC) at a dose of 25 mg/m(2)...
August 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28791610/pain-and-quality-of-life-after-inguinal-hernia-surgery-a-multicenter-randomized-controlled-trial-comparing-lightweight-vs-heavyweight-mesh-supermesh-study
#10
Stefano Bona, Riccardo Rosati, Enrico Opocher, Barbara Fiore, Marco Montorsi
Mesh repair has significantly reduced recurrence rate after groin hernia surgery. Recently, attention has shifted to issues such as chronic pain and discomfort, leading to development of lightweight and partially re-absorbable meshes. The aim of the study was to evaluate the effect of lightweight mesh vs heavyweight mesh on post-operative pain, discomfort and quality of life in short and medium term after inguinal hernia surgery. Eight hundred and eight patients with primary inguinal hernia were allocated to anterior repair (Lichtenstein technique) using a lightweight mesh (Ultrapro(®)) or a heavyweight mesh (Prolene(®))...
August 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28791600/laparoscopic-repair-of-ventral-incisional-hernias-with-the-slim-mesh-technique-without-transabdominal-fixation-sutures-preliminary-report-on-short-midterm-results
#11
Silvio Alen Canton, Claudio Pasquali
This study details our experience with a new laparoscopic technique called "Slim-Mesh" without using transabdominal full-thickness stitches, to treat ventral and incisional hernias (V/IH). Since 2009-May 2015, 28 consecutive patients with V/IH were treated in our center, with this new SM technique. Fifty percent males were included in this retrospective study, averaging 59 years (range 31-81 years). Mean body mass index was 26 and VH size was <10 cm in 24 cases and in 4 cases was larger, up to 22 cm...
August 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28710718/complications-after-gastrectomy-for-cancer-italian-perspective
#12
Gian Luca Baiocchi, Simone Giacopuzzi, Daniele Marrelli, Maria Bencivenga, Paolo Morgagni, Fausto Rosa, Mattia Berselli, Elena Orsenigo, Ferdinando Cananzi, Guido Tiberio, Stefano Rausei, Luca Cozzaglio, Maurizio Degiuli, Alberto Di Leo, Uberto Fumagalli, Nazario Portolani, Riccardo Rosati, Franco Roviello, Giovanni De Manzoni
Surgery for gastric cancer is associated with significant major morbidity and an estimated mortality rate of about 5%. A reliable comparison of post-operative outcomes is hampered by the lack of a clear, universally recognized, definition of the most frequent complications. This paper reports the final results of a project launched by the Italian Research Group for Gastric Cancer in September 2015, whose goal was to propose a comprehensive list of surgical-related, gastric cancer-specific complications, with their definitions...
July 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28681283/the-visualization-of-gastro-esophageal-junction-vascular-supply-during-a-laparoscopic-sleeve-gastrectomy-role-of-a-new-device
#13
Mario Musella, Marco Milone, Paolo Bianco, Francesco Milone
Leaks arising at the level of gastro-esophageal junction remain a major complication in patients who undergo a laparoscopic sleeve gastrectomy. Besides technical pitfalls, these fistulas are mainly attributable to tissue ischemia following the preparation of the gastric sleeve, explained by the irregular vascularization often present in the area of the gastro-esophageal junction. This video presentation shows how, the utilization of a new model of bougie can be of help in preventing a leak, allowing a better visualization of the particular vascular anatomy present at the level of the gastro-esophageal junction area...
July 5, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28646423/updates-in-primary-hyperparathyroidism
#14
REVIEW
Guido Gasparri
This is a review of the latest papers on PHPT with the purpose of assessing the most recent evidence in the management of PHPT and to give updated recommendations for its evaluation, diagnosis, and treatment. I used my personal experience to collect papers that reinforce my ideas for the diagnosis and treatment of PHPT. Perhaps, in the near future, we will have more information about genetics, localization studies, surgical techniques, medical treatments, and statements that we have presented today will be obsolete...
June 23, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28623603/endocrine-surgery-an-update
#15
EDITORIAL
Rocco Bellantone, Celestino Pio Lombardi, Paolo Miccoli
No abstract text is available yet for this article.
June 16, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28620897/enhanced-recovery-pathway-in-elderly-patients-undergoing-colorectal-surgery-is-there-an-effect-of-increasing-ages-results-from-the-perioperative-italian-society-registry
#16
Marco Braga, Luigi Beretta, Nicolò Pecorelli, Marianna Maspero, Umberto Casiraghi, Felice Borghi, Luca Pellegrino, Stefano Bona, Roberta Monzani, Gianluigi Ferrari, Danilo Radrizzani, Riccardo Iuliani, Carlo Bima, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Andrea Muratore, Michele Crespi, Hedayat Bouzari, Andrea Pisani Ceretti, Ferdinando Ficari
Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed...
June 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28620896/video-assisted-endocrine-neck-surgery-state-of-the-art
#17
REVIEW
Luca Sessa, Celestino Pio Lombardi, Carmela De Crea, Marco Raffaelli, Rocco Bellantone
During the last two decades, several minimally invasive approaches for endocrine neck surgery have been developed. Minimally invasive video-assisted approaches (minimally invasive video-assisted parathyroidectomy and minimally invasive video-assisted thyroidectomy) gained a quite large worldwide diffusion, maybe because these techniques combine the advantages related to the endoscopic magnification with those due to the close similarity with the conventional surgery that makes these surgical approaches reproducible and feasible in different surgical settings...
June 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28600712/from-six-thousand-transaminases-level-to-three-hundred-after-liver-transplantation-a-new-era-seems-to-be-open
#18
LETTER
Matteo Ravaioli, Vanessa De Pace, Antonio D Pinna
No abstract text is available yet for this article.
June 9, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28597183/discrepancies-between-nccn-and-esmo-guidelines-in-the-management-of-anal-cancer-a-qualitative-review
#19
REVIEW
Natalie Johnson, Gianluca Pellino, Constantinos Simillis, Shengyang Qiu, Stella Nikolaou, Daniel L Baird, Shahnawaz Rasheed, Paris P Tekkis, Christos Kontovounisios
There is an ever-growing need, with the ongoing developments in research and the progress towards patient centered care, to delineate standardized protocols of management of anal cancer. However, guidelines from different societies show some degree of disagreement. This is a systematic review of the literature to identify similarities and discrepancies between the guidelines for the management of anal cancer drafted by the European Society for Medical Oncology (ESMO) and by the National Comprehensive Cancer Network (NCCN)...
June 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28593459/impact-of-surgery-and-surveillance-in-the-management-of-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-according-to-fukuoka-guidelines-the-bologna-experience
#20
Riccardo Casadei, Claudio Ricci, Giovanni Taffurelli, Carlo Alberto Pacilio, Marina Migliori, Francesco Minni
The objective of the study was to evaluate the Fukuoka guidelines in indicating the proper management for recognising the risk factors of malignancy. Data of patients with branch duct intraductal papillary mucinous neoplasms who underwent pancreatic resection or surveillance according to the Fukuoka risk parameters were collected in a prospective database. The clinical outcome (development of pancreatic cancer, overall and disease-specific survival) and pathological results were evaluated in all patients and in resected cases, respectively...
June 7, 2017: Updates in Surgery
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