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Frontiers in Surgery

Efstratios Georgakarakos
No abstract text is available yet for this article.
2018: Frontiers in Surgery
Efthymios D Avgerinos, Emmanouil Pikoulis
No abstract text is available yet for this article.
2018: Frontiers in Surgery
Ioannis Karavokyros, Adamantios Michalinos
The role of extended lymphadenectomy in the surgical treatment of gastric cancer has been debated for many years. So far six prospective randomized trials and a number of meta-analyses comparing D1 - to D2 -lymphadenectomy in open surgery have been published with contradicting results. The possible oncologic benefit of radical lymphadenectomy has been blurred by a number of reasons. In most of the trials the strategies under comparison were made similar after protocol violations. Imperfect design of the trials could not exclude the influence of cofounding factors...
2018: Frontiers in Surgery
Chrysovalantis Vergadis, Dimitrios Schizas
Node stage (N stage) is of paramount importance for gastric cancer staging. Radiologically node status implies detection and characterization of suspect malignant lymph nodes. Clinically it might determine survival and alter therapeutic plans. A number of modalities, including computerized tomography, MRI, PET and endoscopic ultrasound are currently available. Using a multimodality strategy, accuracy ranges between 50-90% across various studies. Specificity and sensitivity varies with respect to method, number of positive lymph nodes, their location and other characteristics...
2018: Frontiers in Surgery
Vicente Martinez, Shu-Ching Hu, Thomas J Foutz, Andew Ko
Holmes tremor (HT) is a rare movement disorder that is typically associated with cerebellar, thalamic or brainstem lesions following a delay. Treatment of HT with deep brain stimulation (DBS) has yielded positive results however; it is unclear which deep brain targets provide optimal therapeutic effects. Here we describe a case report in which a 34 year old man with HT treated successfully with DBS. The ventrointermediate nucleus (VIM) of the thalamus was considered as the initial target. Following electrode placement we determined that the ventral-most electrode contacts were located in the prelemniscal radiations (Raprl)...
2018: Frontiers in Surgery
Ferdinand Köckerling, Hubert Scheuerlein, Christine Schug-Pass
Introduction: In a systematic review of the surgical treatment of large incisional hernia sublay repair, the sandwich technique and aponeuroplasty with intraperitoneal mesh displayed the best results. In this systematic review only the sandwich technique, which used the hernia sac as an extension of the posterior and anterior rectus sheath and placement of a non-absorbable mesh in the sublay position, was included. Other modifications of the sandwich technique are published in the literature and were also analyzed in this literature review...
2018: Frontiers in Surgery
René H Fortelny
Introduction: The risk of developing an incisional hernia after primary elective median laparotomy is reported in the literature as being between 5 and 20 percent. The goal of this systematic review was to evaluate different closure techniques for midline laparotomies and the use of additional prophylactic mesh augmentation for midline closure in high risk patients. Method: A systematic literature search was performed until September 2017. The quality of the RCTs was evaluated and analysed...
2018: Frontiers in Surgery
Jovanna Thielker, Maria Grosheva, Stephan Ihrler, Andrea Wittig, Orlando Guntinas-Lichius
To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed...
2018: Frontiers in Surgery
Angela L D'Rozario, Clarice J Field, Camilla M Hoyos, Sharon L Naismith, George C Dungan, Keith K H Wong, Ronald R Grunstein, Delwyn J Bartlett
Objective/Background: Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA), it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA. Patients/Methods: 204 patients with untreated OSA [age 49.3 (12.5) years; body mass index, [BMI] 33...
2018: Frontiers in Surgery
Firuz G Feturi, Matthias Weinstock, Wenchen Zhao, Wei Zhang, Jonas T Schnider, Vasil E Erbas, Sinan Oksuz, Jan A Plock, Lisa Rohan, Alexander M Spiess, Lydia M Ferreira, Mario G Solari, Raman Venkataramanan, Vijay S Gorantla
Mycophenolic acid (MPA), is the active form of the ester prodrug mycophenolate mofetil (MMF). MMF is an FDA approved immunosuppressive drug that has been successfully used in systemic therapy in combination with other agents for the prevention of acute rejection (AR) following solid organ transplantation (SOT) as well as in vascularized composite allotransplantation (VCA). Systemic use of MMF is associated with gastrointestinal adverse effects. Topical delivery of the prodrug could thus provide graft-targeted immunosuppression while minimizing systemic drug exposure...
2018: Frontiers in Surgery
Dustin Jon Richter, Roger Lyon, Scott Van Valin, Xue-Cheng Liu
The incidence of anterior cruciate ligament (ACL) injuries in the pediatric population has risen in recent years. These injuries have historically presented a management dilemma in skeletally immature patients with open physes and significant growth remaining at time of injury. While those nearing skeletal maturity may be treated with traditional, transphyseal adult techniques, these same procedures risk iatrogenic damage to the growth plates and resultant growth disturbances in younger patients with open physes...
2018: Frontiers in Surgery
Georgios Psychogios, Monika Jering, Johannes Zenk
Diffuse idiopathic skeletal hyperostosis (DISH) is a rare but well known cause of dysphagia. In very few cases aspiration and dyspnea are described as a clinical manifestation. An 82-year-old man presented himself in our clinic with severe dyspnea, aspiration, and pneumonia. After performing a microlaryngoscopy an emergency tracheotomy became necessary. In laryngoscopy a severe bulging of the posterior oropharyngeal and hypopharyngeal wall was detected. The glottis area was not observable and immobilisation of the right vocal cord could be detected...
2018: Frontiers in Surgery
Gerassimos N Douridas, Stefanos K Pierrakakis
Although D2 constitutes the level of lymph node dissection which most surgical associations endorse in their treatment guidelines for gastric cancer more extended D3 dissection has also been attempted to improve oncologic outcomes. Existing literature pertinent with the provisional therapeutic impact of D3 lymphadenectomy in advanced gastric cancer is studied in this mini review. Seven non-randomized comparisons, three randomized trials and five meta-analyses, almost exclusively of Asian origin, were identified and examined...
2018: Frontiers in Surgery
Alessandro Nini, Alessandro Larcher, Francesco Cianflone, Francesco Trevisani, Carlo Terrone, Alessandro Volpe, Federica Regis, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Roberto Bertini, Umberto Capitanio
Background: Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). Objective: To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM)...
2018: Frontiers in Surgery
Ido Badash, Daniel J Gould, Ketan M Patel
Supermicrosurgery, a technique of dissection and anastomosis of small vessels ranging from 0.3 to 0.8 mm, has revolutionized the fields of lymphedema treatment and soft tissue reconstruction. The technique offers several distinct benefits to microsurgeons, including the ability to manipulate small vessels that were previously inaccessible, and to minimize donor-site morbidity by dissecting short pedicles in a suprafascial plane. Thus, supermicrosurgery has become increasingly popular in recent years, and its applications have greatly expanded since it was first introduced 20 years ago...
2018: Frontiers in Surgery
Youri P A Tan, Philippe Liverneaux, Jason K F Wong
Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet  benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery...
2018: Frontiers in Surgery
Beatriz Bañuelos Marco, Tom Florian Fuller, Frank Friedersdorff, Ricardo González, Anja Lingnau
Introduction and Objectives: Open dismembered pyeloplasty has been the gold standard treatment for ureteropelvic junction obstruction in children. Laparoscopic pyeloplasty (LP) is becoming a standard procedure, but its acceptance is slow. We report our method for minilaparoscopy (MLP) in children using a tansperitoneal approach with the patient in the lateral flank decubitus which we found technically advantageous. Materials and Methods: Retrospective review of the records of 52 children and adolescents up to 18 years of age who underwent transperitoneal MLP at our institution during March 2012-October 2017 A 5 mm trocar is placed for the camera at the site of the umblicus by open technique, two 3 mm trocars placed in the upper and lower quadrants of the abdomen...
2018: Frontiers in Surgery
Lucy Sulzberger, Elysia M S Tan, Paul F Davis, Helen D Brasch, Swee T Tan, Tinte Itinteang
We have recently demonstrated the expression of embryonic stem cell markers on the endothelium of infantile hemangioma, a functional hemogenic endothelium with the capacity for primitive erythropoiesis in vitro . Despite recent work characterizing stem cells within proliferating infantile hemangioma, the expression of STAT proteins, well documented for their roles in stem cell signaling, has not been investigated. 3,3-Diaminobenzidine and immunofluorescence immunohistochemical staining revealed expression of pSTAT1, pSTAT3 and pSTAT5 in proliferating infantile hemangioma samples with the strongest expression of pSTAT3...
2018: Frontiers in Surgery
Tony Young, Michelle M Dowsey, Marcus Pandy, Peter F Choong
Background: Medial stabilized total knee joint replacement (TKJR) construct is designed to closely replicate the kinematics of the knee. Little is known regarding comparison of clinical functional outcomes of patients utilising validated patient reported outcome measures (PROM) after medial stabilized TKJR and other construct designs. Purpose: To perform a systematic review of the available literature related to the assessment of clinical functional outcomes following a TKJR employing a medial stabilized construct design...
2018: Frontiers in Surgery
Zhi Cheng, Lifu Zhao, Deepti Dhall, Paul M Ruegger, James Borneman, Philip K Frykman
Purpose: Hirschsprung-associated enterocolitis (HAEC) is the most frequent potentially life-threatening complication in children with Hirschsprung disease (HSCR) even after definitive corrective surgery. Mounting evidence suggests that intestinal microbiota likely contribute to the etiology of enterocolitis, so the aim of this study was to use a mouse model of post pull-through HAEC to compare the fecal bacterial communities of animals which developed HAEC to those free of enterocolitis...
2018: Frontiers in Surgery
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