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Updates in Surgery

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https://www.readbyqxmd.com/read/29313248/functional-outcomes-with-handsewn-versus-stapled-anastomoses-in-the-treatment-of-ultralow-rectal-cancer
#1
Lisa Ramage, Paul Mclean, Constantinos Simillis, Shengyang Qiu, Christos Kontovounisios, Emile Tan, Paris Tekkis
Adequate oncological outcomes have been demonstrated with rectal resection and handsewn coloanal anastomosis (CAA) in tumours in close proximity to the internal anal sphincter. Our aim was to assess functional differences between handsewn CAA and ultralow stapled anastomosis. Participants were identified from a single-surgeon series. Included participants underwent anorectal physiology testing of anal sphincter function, in addition to completion of several questionnaires: Wexner Incontinence Score (WIS); Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ); Low Anterior Resection Syndrome (LARS) Score; SF36...
January 8, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29290046/post-surgical-fecal-incontinence
#2
Filippo Pucciani
The primary endpoint of this work was to understand the pathophysiology of fecal incontinence manifested after rectal and anal surgery. A retrospective cohort study with negative colonoscopy patients was created and 169 postoperative incontinent patients were analyzed (114 women and 55 men: mean age 58.9 ± 6.3): clinical evaluation, endoanal ultrasound and anorectal manometry reports were scanned. The duration of incontinence was very long, with a mean of 21.7 months. The mean number of bowel movements/week was 18...
December 30, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29264771/face-and-content-validity-of-xperience%C3%A2-team-trainer-bed-side-assistant-training-simulator-for-robotic-surgery
#3
Luca Sessa, Cyril Perrenot, Song Xu, Jacques Hubert, Laurent Bresler, Laurent Brunaud, Manuela Perez
In robotic surgery, the coordination between the console-side surgeon and bed-side assistant is crucial, more than in standard surgery or laparoscopy where the surgical team works in close contact. Xperience™ Team Trainer (XTT) is a new optional component for the dv-Trainer® platform and simulates the patient-side working environment. We present preliminary results for face, content, and the workload imposed regarding the use of the XTT virtual reality platform for the psychomotor and communication skills training of the bed-side assistant in robot-assisted surgery...
December 20, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29255962/can-we-correlate-pelvic-floor-dysfunction-severity-on-mr-defecography-with-patient-reported-symptom-severity
#4
Lisa Ramage, Panagiotis Georgiou, Shengyang Qiu, Paul McLean, Nasir Khan, Christos Kontnvounisios, Paris Tekkis, Emile Tan
MR defecography (MRD) is an alternative to conventional defecography (CD) which allows for dynamic visualisation of the pelvic floor. The aim of this study was to assess whether MRI features indicative of pelvic floor dysfunction correlated with patient-reported symptom severity. MR proctograms were matched to a prospectively-maintained functional database. Univariate and multivariate analyses were performed using pre-treatment questionnaire responses to the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score (WIS), and modified Obstructed Defecation Symptom (ODS) Score...
December 19, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29255961/laparoscopic-cholecystectomy-with-two-mini-cosmetic-incisions
#5
Alireza Tavassoli, Sajad Noorshafiee
Minimally invasive surgery gained popularity between general surgeons especially laparoscopic four-port cholecystectomy. By introducing different methods such as NOTES and SILS, the costs elevated with its cosmetics. We aim to study a new technique of laparoscopic cholecystectomy by two incisions with best cosmetics, and same quality and lower cost as conventional four-port laparoscopic cholecystectomy and make a comparison between them. In a double-blind clinical trial from December 2012 to September 2014, patients with cholelithiasis who presented to general surgery clinic and candidate for laparoscopic cholecystectomy were studied...
December 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29226299/correction-to-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
A technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows.
December 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29222632/preoperative-platelet-lymphocyte-ratio-is-an-independent-factor-of-poor-prognosis-after-curative-surgery-for-colon-cancer
#7
Martin Bailon-Cuadrado, Ekta Choolani-Bhojwani, Francisco J Tejero-Pintor, Javier Sanchez-Gonzalez, Mario Rodriguez-Lopez, Baltasar Perez-Saborido, Jose L Marcos-Rodriguez
Interaction between tumour and host triggers a systemic inflammatory response. This situation has been associated to cancer progression. Several peripheral blood inflammatory scores have been recently developed, as PLR. Data about the relationship between these scores and cancer prognosis are contradictory. Therefore, the aim of our work is to evaluate the capability of PLR to predict long-term outcomes (OS and RFS) in patients who underwent curative surgery for colon cancer. A retrospective study was designed with patients who underwent curative surgery for colon cancer between September 2008 and January 2012 at Rio Hortega University Hospital, Valladolid (Spain)...
December 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29197038/barbed-versus-traditional-suture-for-enterotomy-closure-after-laparoscopic-right-colectomy-with-intracorporeal-mechanical-anastomosis-a-case-control-study
#8
Francesco Feroci, Iacopo Giani, Maddalena Baraghini, Luca Romoli, Tiku Zalla, Roberto Quattromani, Stefano Cantafio, Marco Scatizzi
Our aim was to establish the safety and efficacy of barbed suture for enterotomy closure after laparoscopic right colectomy with intracorporeal anastomosis. This study included 47 patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and barbed suture enterotomy closure (barbed suture closure-BSC) for adenocarcinoma (with the exception of T4 lesions and metastasis), compared with 47 matched patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and conventional suture enterotomy closure (conventional suture closure-CSC) during the same period...
December 1, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29147959/port-site-hernia-after-laparoscopic-sleeve-gastrectomy-a-retrospective-cohort-study-of-352-patients
#9
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
#10
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/29086192/intraoperative-pouch-stricture-during-laparoscopic-one-anastomosis-gastric-bypass-case-report-salvage-description-and-follow-up
#11
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
#12
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/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#13
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...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29067634/best-practice-in-major-elective-rectal-pelvic-surgery-enhanced-recovery-after-surgery-eras
#14
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.
December 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. This is a retrospective cohort analysis study with a prospectively collected database from two different Italian hospitals...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28975541/a-proposal-for-thyroid-surgery-criteria-to-identify-the-references-of-endocrine-surgery
#16
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...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28918603/tumor-markers-of-uterine-cervical-cancer-a-new-scenario-to-guide-surgical-practice
#17
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...
December 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
#18
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)...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28808913/modified-double-barrelled-wet-colostomy-after-total-pelvic-exenteration
#19
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.
December 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
#20
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...
December 2017: Updates in Surgery
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