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Updates in Surgery

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https://www.readbyqxmd.com/read/29147959/port-site-hernia-after-laparoscopic-sleeve-gastrectomy-a-retrospective-cohort-study-of-352-patients
#1
Ilhan Ece, Huseyin Yilmaz, Husnu Alptekin, Serdar Yormaz, Bayram Colak, Mustafa Sahin
Port site hernia (PSH) following laparoscopic procedures is a rare but serious complication. The aim of this study was to evaluate the rate of PSH after laparoscopic sleeve gastrectomy (LSG), and the efficacy of closure of the port site as a means of preventing PSH. A retrospective analysis was performed on 386 patients who underwent LSG between December 2009 and January 2015. 352 (91.2%) of the patient were followed up for at least 24 months. In the first 206 patients, the fascial layers of the trocar incisions were not closed, while in the next 146 cases, routine closure of the trocar sites was performed...
November 16, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29103209/internal-hernia-after-proximal-gastrectomy-with-jejunal-interposition
#2
Yuichi Takayama, Yuji Kaneoka, Atsuyuki Maeda, Yasuyuki Fukami, Takamasa Takahashi, Shunsuke Onoe, Masahito Uji
Although internal hernia (IH) has been reported after laparoscopic distal or total gastrectomy with Roux-en-Y reconstruction, there are few reports of IH after proximal gastrectomy with jejunal interposition (PG-JI). The aim of this study was to analyze the incidence and clinical features of IH after PG-JI. This study retrospectively reviewed 71 patients who underwent PG-JI for gastric cancer at a single institution between July 2007 and December 2016. The median follow-up period after PG-JI was 50 months...
November 4, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#3
Gaetano Poillucci, Lorenzo Mortola, Mauro Podda, Salomone Di Saverio, Laura Casula, Chiara Gerardi, Nicola Cillara, Luigi Presenti
Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively...
November 3, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29086192/intraoperative-pouch-stricture-during-laparoscopic-one-anastomosis-gastric-bypass-case-report-salvage-description-and-follow-up
#4
LETTER
Stefano Cristiano, Domenico Ivan Fico, Salvatore Tolone
No abstract text is available yet for this article.
October 31, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29086238/a-systematic-review-of-sacral-nerve-stimulation-for-faecal-incontinence-following-ileal-pouch-anal-anastomosis
#5
REVIEW
E Kong, S Nikolaou, S Qiu, G Pellino, P Tekkis, C Kontovounisios
Faecal incontinence is a common complication of ileal pouch anal anastomosis (IPAA) and seems to worsen with time. The aim of this paper is to review the evidence of the use of sacral nerve stimulation (SNS) for patients with faecal incontinence after IPAA. A literature search was performed on PubMed and Cochrane databases for all relevant articles. All studies, which reported the outcome of SNS in patients with faecal incontinence after IPAA, were reviewed. Three papers were identified, including a case report, cohort study and retrospective study...
October 30, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29067634/best-practice-in-major-elective-rectal-pelvic-surgery-enhanced-recovery-after-surgery-eras
#6
REVIEW
Josefin Segelman, Jonas Nygren
Within traditional clinical care, the postoperative recovery after pelvic/rectal surgery has been slow with high morbidity and long hospital stay. The enhanced recovery after surgery program is a multimodal approach to perioperative care designed to accelerate recovery and safely reduce hospital stay. This review will briefly summarize optimal perioperative care, before, during and after surgery in this group of patients and issues related to implementation and audit.
October 24, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29019098/gallstone-ileus-monocentric-experience-looking-for-the-adequate-approach
#7
Vincenzo Scuderi, Vincenzo Adamo, Marco Naddeo, William Di Natale, Ljevin Boglione, Sebastiano Cavalli
Common complications of biliary lithiasis are cholecystitis, bile duct lithiasis, and acute biliary pancreatitis. Gallstone ileus is uncommon complications often requiring surgical approach. It is a mechanical bowel obstruction caused by a biliary calculus usually originating from a bilioenteric fistula. Because of the limited number of reported cases, the optimal surgical method of treatment has been the subject of ongoing debate. A retrospective, observational, descriptive study was conduct on patients diagnosed with non-neoplastic bowel occlusion...
October 10, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28980164/prognostic-risk-factors-for-conversion-in-laparoscopic-cholecystectomy
#8
Karla V Chávez, Horacio Márquez-González, Itzé Aguirre, Juan C Orellana
Laparoscopic cholecystectomy (LC) is the gold standard technique for the treatment of gallbladder disease. However, in some cases, conversion to open surgery is still necessary. Identification of patients with high risk of conversion is of great importance to prepare the surgical scenario and to anticipate the convalescence. The objective of this study is to identify the factors that may predict a conversion to an open procedure. A total of 1386 LC were performed in Dr. Manuel Gea González General Hospital, from January 2009 to May 2013...
October 4, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28975541/a-proposal-for-thyroid-surgery-criteria-to-identify-the-references-of-endocrine-surgery
#9
Luca Panier Suffat, Guido Mondini, Federica Demaria, Paola Perino, Lorenza Bertotti, Lodovico Rosato
Indicators of effectiveness and quality of care are needed to improve the outcomes in many surgical fields. International and national studies in thyroid surgery have not clearly documented an association between number of cases and outcome quality, but it is essential for the figure of a highly experienced surgeon, able to provide proof of positive outcomes. Therefore, we try to underline the structural and technical requirements in thyroid surgery. Moreover, the need for an accreditation program is outlined...
October 3, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28918603/tumor-markers-of-uterine-cervical-cancer-a-new-scenario-to-guide-surgical-practice
#10
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
#11
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
#12
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
#13
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
#14
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/29030835/a-new-technique-for-tension-free-reconstruction-in-large-incisional-hernia
#15
Gabriele Munegato, Landino Fei, Michele Schiano di Visconte, Danilo Da Ros, Luana Moras, Gabriele Bellio
In the surgical management of large incisional hernias, the main target is the closure of the abdominal wall defect on the midline without a dangerous increase in the intraabdominal pressure. In this setting, new intraperitoneal prosthesis and components separation techniques were proposed to solve this problem. Both solutions present some critical issues. A new surgical approach with a free lateral double layer prosthesis totally in polypropylene both sides (FLaPp(®)) is proposed to overcome this problem...
December 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
#16
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...
September 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#17
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]...
September 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
#18
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)...
September 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28710718/complications-after-gastrectomy-for-cancer-italian-perspective
#19
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...
September 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
#20
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)...
September 2017: Updates in Surgery
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