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Frontiers in Surgery

Frederik Berrevoet
Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%...
2018: Frontiers in Surgery
David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
Rosemarijn Jansen, Kim Urgel, Maarten J Cramer, Egidius E H L van Aarnhem, Peter P M Zwetsloot, Pieter A Doevendans, Jolanda Kluin, Steven A J Chamuleau
Background: Clinical decision-making in symptomatic patients after mitral valve (MV) repair remains challenging as echocardiographic reference values are lacking. In native MV disease intervention is recommended for mean transmitral pressure gradient (TPG) >15 mmHg or systolic pulmonary artery pressure (SPAP) >60 mmHg at peak exercise. Insight into standard stress echo parameters after MV repair may therefore aid to clinical decision-making during follow-up. Hypothesis: Stress echocardiography derived parameters in asymptomatic patients after successful MV repair differ from current guidelines for native valves...
2018: Frontiers in Surgery
Simon Zimmermann, Richard M Fakin, Pietro Giovanoli, Maurizio Calcagni
Introduction: The management of painful end-neuromas of the superficial branch of the radial nerve (SBRN) remains challenging due to high levels of pain relapse. The novel technique of stromal vascular fraction (SVF)-enriched fat grafting showed continuous pain relief, although failed to prove statistically significant. Besides acting as a mechanical barrier, SVF-enriched fat grafting might also affect the cellular level. The aim of this study was to compare clinical outcomes of SVF to the widely popular intramuscular transposition technique...
2018: Frontiers in Surgery
Núria Argudo, Miguel Pera, Manuel López-Cano, Lourdes Hernández, Juan José Sancho, Luis Grande, José Antonio Pereira
No abstract text is available yet for this article.
2018: Frontiers in Surgery
Jan-Philipp Minol, Payam Akhyari, Udo Boeken, Alexander Albert, Philipp Rellecke, Vanessa Dimitrova, Stephan Urs Sixt, Hiroyuki Kamiya, Artur Lichtenberg
Background: Cardiac redo surgery, especially after a full sternotomy, is considered a high-risk procedure. Minimally invasive mitral valve surgery (MIMVS) is a potential therapeutic approach. However, current developments in interventional cardiology necessitate additional discussion regarding the therapy of choice in high-risk patients. In this context, it is necessary to clarify the perioperative and postoperative risks induced by the factor previous sternotomy in the setting of MIMVS...
2018: Frontiers in Surgery
Osama Hussein, Khaled Abdel Wahab, Omar Hamdy, Mohammad Arafa, Emad-Eldeen Hamed, Shady Awny, Sameh Roshdy, Adel Denewer, Mahmoud Mosbah
Aim: Pleomorphic adenoma is the most common benign tumor of the parotid gland and is classically treated with superficial or total parotidectomy. Less radical surgeries have been proposed to minimize the risk of facial nerve injury. The oncological safety of these procedures remains controversial. We conducted this study to evaluate the safety of superficial hemi-lobectomy (quadrantectomy). Patients and methods: Retrospective analysis was conducted on the paraffin sections of archived superficial parotidectomy specimens from 11 male and 6 female patients (median age 33 years)...
2018: Frontiers in Surgery
Stephanie Volpi, Francesco Doenz, Salah D Qanadli
Superior vena cava (SVC) syndrome is a group of clinical signs caused by the obstruction or compression of SVC and characterized by edema of the head, neck, and upper extremities, shortness of breath, and headaches. The syndrome may be caused by benign causes but most of the cases are caused by lung or mediastinal malignant tumors. Stenting of SVC has become widely accepted as the palliative treatment for this condition in malignant diseases, as it offers rapid relief of symptoms and improves the quality of life...
2018: Frontiers in Surgery
Hakan Kulacoglu
Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable...
2018: Frontiers in Surgery
Katharina Boehm, Fabian P Siegel, Laila Schneidewind, Jennifer Kranz, Philipp Spachmann, Tanja Frank, Nina Huck, Florian Imkamp, Alexandre Pelzer
Purpose: Prostate biopsy (pbx) is the most common outpatient procedure in urology. Complications are urinary tract infections, including hospitalization and sepsis. Recommendations on antibiotic prophylaxis (apx) are scarce, and healthcare data are not available. The study addressed the following endpoints: the duration and spectrum of antimicrobial prophylaxis in transrectal and transperineal pbx in the hospital and the practice setting. Methods: A questionnaire compiled data about age, gender, board certification, and place of work...
2018: Frontiers in Surgery
Jon Kolkin
As health-care professionals, there often comes a time in our career when we are intrigued by the possibility of participating in humanitarian work in underserved countries. However, the desire to serve is often tempered by some ambivalence about whether our skill sets are applicable in less technologically advanced health-care settings. Furthermore, there may be some concern about the cultural and logistical challenges one might face while working overseas. A volunteer may also be worried that, despite their best intentions, the medical personnel in the host country will not take advantage of our knowledge and their patients will not achieve the best results...
2017: Frontiers in Surgery
Lester Wai Mon Chan, Jungo Imanishi, Damien Glen Grinsell, Peter Choong
Background: Surgery in combination with radiotherapy (RT) has become the standard of care for most soft tissue sarcomas. The choice between pre- and postoperative RT is controversial. Preoperative RT is associated with a 32-35% rate of major wound complications (MWC) and 16-25% rate of reoperation. The role of vascularized soft tissue "flaps" in reducing complications is unclear. We report the outcomes of patients treated with preoperative RT, resection, and flap reconstruction...
2017: Frontiers in Surgery
Friedrich Kallinowski, F Harder, D Gutjahr, R Raschidi, T G Silva, M Vollmer, Regine Nessel
Recurrences are frequently observed after ventral hernia repair. Based on clinical data, the mesh-defect area ratio (MDAR) can lead to lower recurrence rates. Using dynamic intermittent strain (DIS) in a pig tissue model, MDAR can be modified to give a measure called grip to better assess the mechanical stability of ventral hernia repair. The focus of this experimental study is to assess the different aspects of mesh overlap (OL) and fixation only in bridging repair of ventral hernias. DIS mimics coughing actions in an ex vivo model with the repetition of submaximal impacts delivered via a hydraulically driven plastic containment...
2017: Frontiers in Surgery
Hugo N Humphries, Susrutha K Wickremesekera, Reginald W Marsh, Helen D Brasch, Shreeja Mehrotra, Swee T Tan, Tinte Itinteang
Background: Fifty percent of colorectal cancer (CRC) patients develop liver metastasis. This study identified and characterized cancer stem cells (CSCs) within colon adenocarcinoma metastasis to the liver (CAML). Methods: 3,3-Diaminobenzidine immunohistochemical (IHC) staining was performed on nine CAML samples for embryonic stem cell (ESC) markers OCT4, SOX2, NANOG, c-Myc, and KLF4. Immunofluorescence (IF) IHC staining was performed to investigate coexpression of two markers...
2017: Frontiers in Surgery
Hester F Shieh, C Jason Smithers, Thomas E Hamilton, David Zurakowski, Gary A Visner, Michael A Manfredi, Christopher W Baird, Russell W Jennings
Purpose: We review outcomes of posterior tracheopexy for tracheomalacia in esophageal atresia (EA) patients, comparing primary treatment at the time of initial EA repair versus secondary treatment. Methods: All EA patients who underwent posterior tracheopexy from October 2012 to September 2016 were retrospectively reviewed. Clinical symptoms, tracheomalacia scores, and persistent airway intrusion were collected. Indication for posterior tracheopexy was the presence of clinical symptoms, in combination with severe tracheomalacia as identified on bronchoscopic evaluation, typically defined as coaptation in one or more regions of the trachea...
2017: Frontiers in Surgery
Su Jung Oh, Philipp Mandel, Felix K H Chun, Pierre Tennstedt, Sven Peine, Jan Lukas Hohenhorst, Jens Hiller, Markus Graefen, Derya Tilki, Thomas Steuber
Objectives: AB0 blood group is an inherited characteristic that has been associated with the incidence as well as the prognosis of several malignancies. The aim of the current study was to clarify the role of the blood group in cancer epidemiology and clinical outcome of patients with prostate cancer (PCa). Methods: Data from 3,574 patients undergoing radical prostatectomy between 2009 and 2010 at a single European institution were retrospectively analyzed. The correlation of AB0 and Rhesus blood group with PCa-related characteristics and oncological outcome were evaluated using univariable and multivariable Cox proportional hazard models...
2017: Frontiers in Surgery
Francois Pugin, Jean Bouquet De Jolinière, Attila Major, Fathi Khomsi, Louis Guillou, Mathias Peter, Nordine Ben Ali, Bernhard Egger, Anis Feki
The authors report a case of pseudomyxoma peritonei with gelatinous peritoneum in a 47-year-old-woman. The main symptom for discovery was a chronic pelvic abdominal pain. This disease is particularly rare. The gelatinous substance is often associated with a malignant ovarian tumor or appendicitis perforated. Currently, on the whole, an exploratory laparoscopy allows diagnosis, biopsies, and appendectomy. The treatment is essentially surgical. The prognosis depends on grade (1/3) and response to chemotherapy...
2017: Frontiers in Surgery
Emmanouil Pikoulis, Karim M Salem, Efthymios D Avgerinos, Anastasia Pikouli, Anastasios Angelou, Antreas Pikoulis, Sotirios Georgopoulos, Ioannis Karavokyros
Early management of vascular injury, starting at the field, is imperative for survival no less than any operative maneuver. Contemporary prehospital management of vascular trauma, including appropriate fluid and volume infusion, tourniquets, and hemostatic agents, has reversed the historically known limb hemorrhage as a leading cause of death. In this context, damage control (DC) surgery has evolved to DC resuscitation (DCR) as an overarching concept that draws together preoperative and operative interventions aiming at rapidly reducing bleeding from vascular disruption, optimizing oxygenation, and clinical outcomes...
2017: Frontiers in Surgery
Hubert Scheuerlein, Frank Henschke, Ferdinand Köckerling
Wilhelm Waldeyer was, at his time, one of the most well-known authors in the field of Anatomy, Pathology, and Embryology. He held various distinguished academic positions. He was Professor of (Pathological) Anatomy in Breslau, Strasbourg, and Berlin. He remained in Berlin for the unusually long period of 33.5 years, as Full Professor for Anatomy and Director of the Anatomical Institute. His great talent as a teacher ensured that his lectures were always filled to the brim. Between 1862 and 1920, he published 270 works, including classics such as "Das Becken" (The Pelvis)...
2017: Frontiers in Surgery
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