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Surgery Journal

Mahmoud M Taha, Amr AlBakry, Magdy ElSheikh, Tarek H AbdelBary
Schwannomas are benign tumors, which arise from the Schwann cells of the central or peripheral nerves. They form 8% of all intracranial tumors and most of the cases arise from vestibular division of the 8 th cranial nerve. Rare cases are shown to arise from the olfactory or optic nerve, being devoid of myelin sheath. Up to date and according to our best of knowledge, 66 cases have been reported till now. Here we present a review of the literature and a case report of a 56-year-old male with an accidently discovered anterior cranial fossa schwannoma, following a road traffic accident...
July 2018: Surgery Journal
Steffen Sauer, Mark Clatworthy
Background  Increased tibial slope has been shown to be associated with higher anterior cruciate ligament (ACL) reconstruction failure rate. Little is known about the correlation of tibial slope and anterior tibial translation in ACL deficient and reconstructed knees as well as the correlation of tibial slope and ACL reconstruction outcome. Purpose/Hypothesis  The purpose of this study was to investigate the correlation of tibial slope with anterior tibial translation and ACL reconstruction outcome. It is hypothesized that increased medial tibial slope is associated with increased anterior tibial translation in the ACL deficient knee...
July 2018: The surgery journal
Steffen Sauer, Robert English, Mark Clatworthy
Background  A growing body of research is indicating that the tibial slope and the geometry of the tibiofemoral meniscal-cartilage interface may affect the risk of anterior cruciate ligament reconstruction (ACLR) failure. Increased lateral tibial posterior slope (LTPS) and reduced meniscal bone angle (MBA) are associated with increased risk of anterior cruciate ligament (ACL) injury. The significance of a LTPS-MBA ratio regarding the prediction of ACL failure risk remains unknown. As LTPS and MBA may eventually potentiate or neutralize each other, it is expected that a low LTPS-MBA ratio is associated with high chance of ACL graft survival while a high LTPS-MBA ratio is associated with high risk of ACL failure...
July 2018: Surgery Journal
Sarah Armenia, Loka Thangamathesvaran, Akia D Caine, Neil King, Anastasia Kunac, Aziz M Merchant
Introduction  High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods  The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula...
July 2018: Surgery Journal
María Fernández-Ibieta
Case Report  An 11-month-old female infant presented on the first postoperative (PO) day following an elective pyeloplasty, a dark bluish erythema of her lumbotomy wound, plus a satellite lesion of the same characteristics. Fever and sepsis developed, and despite broad spectrum antibiotics (meropenem and vancomycin) were started, a diagnosis of necrotizing soft-tissue infection (NSTI or necrotizing fasciitis) was established. Surgical debridement of both lesions was performed on day 3 PO, and a surgical contamination (ring retractor blade) was suspected, due to the particular geography of the lesion...
July 2018: Surgery Journal
John Mathew Manipadam, Lekha V, Vamsi Syamprasad, Ramesh H
Laparoscopic repair of a right paraduodenal hernia has been described sparingly in literature. We present an account of how we laparoscopically repaired a right paraduodenal hernia along with a review of the current literature as regards the various techniques that have been attempted. With the patient in supine position, and with umbilical camera port and three 5 mm ports, we mobilized the cecum and ascending colon up to the third part of the duodenum, thereby widening the neck of the hernia sac in the Waldeyer fossa...
July 2018: Surgery Journal
Jakob K Köstenbauer
Aim  Current literature emphasizes the effectiveness of computed tomography (CT) and water-soluble contrast agent, Gastrografin, in the investigation of adhesive small bowel obstruction (ASBO). As there is no management protocol for ASBO at our institution, the aim of this study was to determine the effect of imaging methods-CT, Gastrografin challenge (GC), or plain-film X-ray-on patient outcomes in a clinical setting. Methods  All 163 emergency presentations of ASBO during the study period between December 2010 and September 2012 were collected retrospectively...
July 2018: Surgery Journal
Akram H Aljahdali, James J Murphy
Introduction  Liver injury is common among pediatric abdominal trauma. Nonoperative management is the standard of care in isolated stable liver injuries. Bile leak is not an uncommon complication in moderate- and high-grade injuries. Case series  Three pediatric patients (age: 10-15 years) suffered grade IV liver injuries secondary to blunt abdominal trauma. All developed significant bile leak treated nonoperatively with endoscopic retrograde cholangiopancreatography (ERCP), and patients 1 and 2 were treated with bile duct stent alone...
July 2018: Surgery Journal
Dylan A Mistry, Amit Chandratreya, Paul Y F Lee
Background  The incidence of osteoarthritis is increasing and it is one of the most common causes of chronic conditions. Total knee replacement is the mainstay of treatment for end-stage knee osteoarthritis; however, with long waiting lists and high levels of dissatisfaction, a treatment like knee braces could potentially delay surgery. Unicompartmental knee osteoarthritis is associated with misalignment of the knee, and unloader bracing has been recommended by various guidelines to correct this misalignment...
July 2018: Surgery Journal
Paolo Castelnuovo, Giacomo Fiacchini, Francesca Romana Fiorini, Iacopo Dallan
Orbital lesions are traditionally managed through external approaches when laterally located, and through a transnasal approach or other external approaches when medially located. However, when the lesion is superomedially located, it may determine a technical challenge. In this study, we present the case of a patient with a superomedial intraconal venous malformation of the left eye. We addressed the mass through a combined approach, using the transnasal route as the main approach, and the superior eyelid approach to push down the lesion to facilitate the excision...
July 2018: Surgery Journal
Eric Donn, Ian Atkinson, Andrew McCague
Hemorrhagic cholecystitis is an uncommon form of acute cholecystitis which can be rapidly fatal. It may be hard to detect as it frequently presents with symptoms found in other, more common diagnoses. We report the case of a 63 year old man recently started on anticoagulation for deep vein thrombosis who was found to have hemorrhagic cholecystitis.
April 2018: Surgery Journal
Eline Huizing, Cornelis G Vos, Robin G Hulsebos, Peter J van den Akker, Gert Jan de Borst, Çağdaş Ünlü
Objectives  Guidelines recommend routine patching to prevent restenosis following carotid endarterectomy, mainly based on studies performed many years ago with different perioperative care and medical treatment compared with current standards. Aim of the present study was to compare primary closure (PRC) versus patch closure (PAC) in a contemporary cohort of patients. Methods  Consecutive patients treated by carotid endarterectomy for symptomatic stenosis between January 2006 and April 2016 were retrospectively analyzed...
April 2018: Surgery Journal
Shinichiro Teramoto, Akira Tsunoda, Kaito Kawamura, Natsuki Sugiyama, Rikizo Saito, Chikashi Maruki
A 70-year-old man, who had previously undergone surgical resection of left parasagittal meningioma involving the middle third of the superior sagittal sinus (SSS) two times, presented with recurrence of the tumor. We performed removal of the tumor combined with SSS resection as Simpson grade II. After tumor removal, since a left dominant bilateral chronic subdural hematoma (CSDH) appeared, it was treated by burr hole surgery. However, because the CSDH rapidly and repeatedly recurred and eventually changed to acute subdural hematoma, elimination of the hematoma with craniotomy was accomplished...
April 2018: Surgery Journal
Felix J Paprottka, Dalius Klimas, Detlev Hebebrand
Large and ulcerating skin tumors have become a rarity in the modern Western world. However, these conditions can cause serious life-threatening complications. The case of a 60-year-old male Caucasian patient is reported, who had suffered from an extensive basal cell carcinoma in the right shoulder region for several years. The patient kept the lesion secret from his friends and family and delayed presentation to health care services. After an episode of tumor-related heavy bleeding, the patient was referred to our clinic and received a radical surgical tumor resection-followed by defect coverage with a latissimus dorsi myocutaneous flap...
April 2018: Surgery Journal
Iqbal Ali, Vashisht Dikshit, Kshitij Manerikar, Mirat Dholakia, Maitreyee Save
Background  The open preperitoneal repair offers the benefits of placing the mesh in the preferred position while avoiding the disadvantages of laparoscopic repair. Methods  A total of 60 patients with bilateral inguinal hernias were randomized to undergo either the standard Lichtenstein meshplasty or the modified iliopubic tract repair in a teaching hospital. Outcomes measured were immediate postoperative pain, return to activity, and delayed neurological complications. Results  Patients who underwent the iliopubic tract repair walked out of bed faster than the Lichtenstein group (6...
April 2018: Surgery Journal
Hua Zhang
Posterior occipitocervicothoracic fusion in a flexed position may cause dyspnea, and the onset of obstructive sleep apnea after anterior upper cervical fusion. However, there are no reports of dyspnea occurring after anterior lower cervical fusion. Here, we present an unusual case of dyspnea in the supine position after a C5-C6 anterior cervical discectomy and fusion.
April 2018: Surgery Journal
Serra Akyar, Sarah J Armenia, Parita Ratnani, Aziz M Merchant
Background  The burden of frail patients undergoing emergency general surgery (EGS) is increasing rapidly and this population is particularly susceptible to postoperative cardiopulmonary complications and mortality. We aimed to determine the association between frailty, as defined by the previously described modified frailty index (mFI), and postoperative respiratory complications (unplanned reintubation, pneumonia, and prolonged ventilation), cardiac complications (myocardial infarction and cardiac arrest), and mortality...
April 2018: The surgery journal
Martin Salö, Pernilla Stenström, Magnus Anderberg, Einar Arnbjörnsson
Background  We determined time frames for dilatation of anastomotic strictures (ASs) occurring during the first 2 years after esophageal atresia (EA) repair. Methods  A retrospective study was conducted on children with EA (Gross type C) who underwent direct repair between January 2008 and March 2015 at a single tertiary center of pediatric surgery. Endoscopic signs of stricture were indications for dilatation because the endoscopy provides more reliable information than X-ray imagining methods. Results  Among our cohort of 49 children with EA, 19 (39%) required at least one esophageal dilatation...
April 2018: Surgery Journal
Collin Chen, Ruchin Patel, John Chi
Defects of the nasal ala are challenging to reconstruct, given its complex three-dimensional structure. Successful repair of these defects needs to provide aesthetic symmetry and preserve nasal function. A wide variety of reconstructive options have been described for nasal ala defects, ranging from skin grafts to locoregional flaps, and also includes the auricular composite graft. However, there are currently no comprehensive guidelines for nasal ala repair, and the versatile role of the auricular composite graft has not been well defined...
April 2018: Surgery Journal
Osman Akdag, Gokce Yildiran
Buschke-Loewenstein tumor (BLT) is a giant condyloma acuminatum which is very rare and commonly affects the anogenital region. The malignant transformation and localization in penis is very rare. This article aims to present a case with BLT with malignant transformation in penis. A 59-year-old male patient was referred, who has have been suffering from a cauliflower-like lesion in the penis for 8 years. Biopsies revealed a BLT with malignant transformation. The lesion was excised largely and reconstructed with local flaps and skin grafts...
April 2018: Surgery Journal
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