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Advances in general surgery

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https://www.readbyqxmd.com/read/28727647/surgical-anatomy-of-the-uterosacral-ligament-colpopexy
#1
Lauren N Siff, Karl Jallad, Lisa C Hickman, Mark D Walters
OBJECTIVE: The aim of this study was to describe the relationship of the uterosacral ligament (USL) to the ureter and rectum along a surgeon's target location for suture placement under conditions simulating live surgery. METHODS: Dissections were performed in 11 unembalmed female cadavers. Steps were taken to identify the USL simulating USL colpopexy. Pins were placed in the midportion of the USL at the level of the IS, and at 1-cm, 2-cm, and 3-cm increments traveling proximally toward the sacrum (Fig...
July 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28722088/-evaluation-of-new-minimally-invasive-techniques-in-gastrointestinal-surgery-and-contemplation-on-health-economics
#2
Xishan Wang
With the widespread introduction of minimally invasive surgery (MIS) in late 1987 by laparoscopic cholecystectomy, the practice and expectation of general surgery were changed forever. As the development of scientific technology, new techniques of MIS have sprung up all around the world. 3D laparoscopy surgery, natural orifice transluminal endoscopic surgery, da Vinci surgical system and other new technologies also need time to be verified, and this is the only way all new things should get though. They are very unique in their own right, and all have advantages and disadvantages...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721284/performing-easy-prone-punction
#3
REVIEW
Ramón Cansino, Alejandra Portilla, Juan Gómez Rivas
INTRODUCTION: Percutaneous renal surgery has been considered one of the most important advances in urology. There are several possibilities to perform a kidney puncture such as using fluoroscopy, ultrasound or both. The aim of this article is to describe our puncture technique. MATERIAL AND METHODS: Correct puncture is one of the most critical and challenging steps during percutaneous surgery. Bull's eye technique and other similar techniques supported by fluoroscopy try to make triangulations and provide different views...
June 30, 2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28709919/morbidity-after-cardiac-surgery-in-patients-with-adult-congenital-heart-disease-in-comparison-with-acquired-disease
#4
Dimos Karangelis, Amine Mazine, Sreekanth Narsupalli, Shamarli Mendis, Gruschen Veldtman, Nicolas Nikolaidis
BACKGROUND: Due to the advancements in congenital cardiac surgery and interventional cardiology in the last five decades, more than 85% of congenital heart patients now survive to adulthood. METHODS: This retrospective study included 135 Adult Congenital Heart Disease (ACHD) patients, who had cardiac surgery at Southampton General Hospital over three consecutive years. We also included 42 patients with a structurally normal heart who had cardiac surgery for acquired cardiac conditions as a control group...
June 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28708230/short-course-radiotherapy-concomitant-with-temozolomide-in-gbm-patients-a-phase-ii-study
#5
Laura Fariselli, Lucia Cuppini, Paola Gaviani, Marcello Marchetti, Valentina Pinzi, Ida Milanesi, Giorgia Simonetti, Irene Tramacere, Francesco DiMeco, Andrea Salmaggi, Antonio Silvani
PURPOSE: Despite recent advances, the prognosis of glioblastoma (GBM) remains poor. The aim of this study was to assess the efficacy and tolerability of multiple daily fraction radiotherapy performed with multiple temozolomide (TMZ) administrations in newly diagnosed patients with GBM. METHODS: This trial was a prospective, open-label, monocentric, nonrandomized, single arm, phase II study. The primary endpoint was the proportion of progression-free patients at 12 months, and the secondary endpoints were overall survival (OS) and toxicity...
July 8, 2017: Tumori
https://www.readbyqxmd.com/read/28705174/extensive-colorectal-lymphomatous-polyposis-complicated-by-acute-intestinal-obstruction-a-case-report
#6
Jaques Waisberg, Amanda do Val Anderi, Pedro Augusto Soffner Cardoso, José Henrique Miranda Borducchi, Demetrius Eduardo Germini, Maria Isete Fares Franco, Cidia Vasconcellos
BACKGROUND: Multiple lymphomatous polyposis is a rare type of gastrointestinal lymphoma that extensively infiltrates the intestine. Multiple lymphomatous polyposis originates from the mantle zone of the lymphoma follicle and is considered to be a mantle cell lymphoma, which is a relatively aggressive type of B-cell non-Hodgkin's lymphoma. We report an unusual case of a patient with multiple lymphomatous polyposis with extensive colorectal involvement and acute intestinal obstruction, an atypical complication of this rare disease...
July 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28700995/extended-pancreatectomy-does-it-have-a-role-in-the-contemporary-management-of-pancreatic-adenocarcinoma
#7
Joerg Kaiser, Thilo Hackert, Markus W Büchler
BACKGROUND: Pancreatic cancer is a low-incident but highly mortal disease. Surgery is still the preferred treatment option for resectable pancreatic cancer as it offers the only realistic chance for cure. As many patients present with locally advanced disease, which is generally considered as not amenable to surgical treatment, it is important to know the limits of surgical therapy in this disease. METHODS: In this review, the indication and outcomes of extended pancreatectomies as well as the alternative treatment options for locally advanced pancreatic cancer are described...
July 13, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28697074/repair-of-bimalleolar-ankle-fracture
#8
Nina Fisher, Abiola Atanda, Stephanie Swensen, Kenneth A Egol
PURPOSE: The incidence of ankle fractures is rapidly increasing in geriatric populations. Of the 4 fracture patterns described by the Lauge-Hansen classification system, supination-external rotation (SER) accounts for most ankle fractures. This video demonstrates surgical repair of a SER type 4 ankle fracture in a geriatric patient. METHODS: SER type 4 ankle fractures are considered unstable and are generally treated with surgical fixation. After placement of plate and screws, intraoperative stress tests can be used to assess for syndesmotic widening...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28695876/impact-of-obesity-on-surgical-outcome-after-single-incision-laparoscopic-cholecystectomy
#9
Toru Obuchi, Noriaki Kameyama, Masato Tomita, Hiroaki Mitsuhashi, Ryohei Miyata, Shigeaki Baba
INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome. PATIENTS AND METHODS: Between May 2009 and February 2013, 237 patients underwent SILC at our institute...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28693792/cholangiocarcinoma
#10
REVIEW
Michela Squadroni, Luca Tondulli, Gemma Gatta, Stefania Mosconi, Giordano Beretta, Roberto Labianca
Biliary tract cancer accounts for <1% of all cancers and affects chiefly an elderly population, with predominance in men. We distinguish cholangiocarcinoma (intrahepatic, hilar and distal) and gallbladder cancer, with different pathogenesis and prognosis. The treatment is based on surgery (whenever possible), radiotherapy in selected cases, and chemotherapy. The standard cytotoxic treatment for advanced/metastatic disease is represented by the combination of gemcitabine and cisplatin, whereas fluoropyrimidines are generally administered in second line setting...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28693152/multicenter-research-into-the-quality-of-life-of-patients-with-advanced-oropharyngeal-carcinoma-with-long-term-survival-associated-with-human-papilloma-virus
#11
Giacomo Spinato, Marco Stellin, Giuseppe Azzarello, Deborah Bonazza, Fabrizio Zanconati, Doriano Politi, Salvatore Cocuzza, Paola Di Mauro, Simonetta Ausoni, Giovanni Tonoli, Giulio Costantini, Luigi Maiolino, Roberto Spinato, Maria Cristina Da Mosto, Lorena Baboci, Annarosa Del Mistro, Agostino Serra, Giancarlo Tirelli
The treatment of advanced-stage oropharyngeal squamous cell carcinoma may utilize various modes, including combining surgery with chemoradiotherapy (CTRT), or primary CTRT followed by rescue surgery. In previous literature it has been revealed how patients treated with combined modes report a low quality of life (QoL) and severe consequences following surgery, radiotherapy and chemotherapy, in the short and in the long-term. The decrease in the QoL of patients treated with high-intensity multi-modal strategies highlights the necessity of modifying treatments, particularly for young HPV-positive patients, where an increased survival rate has already been reported...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28688689/characterization-treatment-and-outcomes-of-salivary-ductal-carcinoma-using-the-national-cancer-database
#12
Virginia Osborn, Babak Givi, Anna Lee, Niki Sheth, Dylan Roden, David Schwartz, David Schreiber
OBJECTIVES: To analyze clinical, treatment and outcome data for patients with salivary ductal carcinoma in a large population-based sample. MATERIALS AND METHODS: The National Cancer Database was queried to identify patients diagnosed with salivary ductal carcinoma between 2004 and 2013. Kaplan Meier and Cox regression analysis were used to assess overall survival (OS) and identify impact of specific variables on OS. RESULTS: A total of 495 patients were identified...
August 2017: Oral Oncology
https://www.readbyqxmd.com/read/28678997/outcomes-and-costs-of-managing-appendicitis-at-safety-net-hospitals
#13
Roy P Won, Scott Friedlander, Steven L Lee
Importance: Safety-net hospitals serve vulnerable populations with limited resources. Although complex, elective operations performed at safety-net hospitals have been associated with inferior outcomes and higher costs, it is unclear whether a similar association has been seen with common emergency general surgery performed at safety-net hospitals. Objective: To evaluate the association of safety-net burden with the outcomes of appendectomy. Design, Setting, and Participants: A retrospective review was conducted of all nonfederally funded hospitals in the California state inpatient database that performed appendectomies from January 1, 2005, to December 31, 2011...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28677888/laparoscopic-total-gastrectomy-for-advanced-gastric-cancer-in-a-patient-with-situs-inversus-totalis
#14
Kengo Shibata, Hideki Kawamura, Nobuki Ichikawa, Kazuaki Shibuya, Tadashi Yoshida, Yosuke Ohno, Shigenori Homma, Akinobu Taketomi
Situs inversus totalis (SIT) is a rare congenital anomaly. Generally, laparoscopic surgery is difficult to perform in patients with SIT because of both the potential challenges associated with unexpected vascular anomalies and the lack of standardized strategy for handling such cases. This is the first report of laparoscopic total gastrectomy with lymph node dissection for advanced gastric cancer in a patient with SIT. A 79-year-old man with SIT was diagnosed with advanced gastric cancer. We performed laparoscopic total gastrectomy with modified D2 lymph node dissection (D2 without splenectomy) and esophagojejunal anastomosis using an overlap method involving retrocolic Roux-en-Y reconstruction...
July 5, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28675799/dr-snow-killed-a-bird-the-genesis-of-pharmacokinetics-and-pharmacodynamics-in-anaesthesia
#15
L E Mather
This essay presents a pharmacologist's perspective of what would be now called 'preclinical research' and 'uncontrolled clinical trials' surrounding the first public demonstration by William Thomas Green Morton of painless surgery achieved by the inhalation of ether in a patient at the Massachusetts General Hospital on 16 October 1846. Of the many people who made history in those earliest days of surgical anaesthesia in both the United States and Great Britain, John Snow stands out for his personal research that spanned basic science and clinical medicine...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28675797/delivery-of-anoxic-gas-mixtures-in-anaesthesia-case-report-and-review-of-the-struggle-towards-safer-standards-of-care
#16
M Pauling, C M Ball
In 1983 a patient at The Alfred Hospital, Melbourne died during general anaesthesia for emergency surgery, in the weeks following maintenance to the operating theatre gas supply. In the ensuing investigation, it was revealed that he had been given 100% nitrous oxide throughout the anaesthetic due to the inadvertent crossing of the nitrous oxide and oxygen pipelines during the repair work. In this article we review the published literature on the delivery of hypoxic and anoxic gas mixtures, and the associated morbidity and mortality...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28674482/feasibility-of-using-electrocochleography-for-objective-estimation-of-electro-acoustic-interactions-in-cochlear-implant-recipients-with-residual-hearing
#17
Kanthaiah Koka, Leonid M Litvak
Although cochlear implants (CI) traditionally have been used to treat individuals with bilateral profound sensorineural hearing loss, a recent trend is to implant individuals with residual low-frequency hearing. Patients who retain some residual acoustic hearing after surgery often can benefit from electro-acoustic stimulation (EAS) technologies, which combine conventional acoustic amplification with electrical stimulation. However, interactions between acoustic and electrical stimulation may affect outcomes adversely and are time-consuming and difficult to assess behaviorally...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28664224/complex-surgery-for-locally-advanced-bone-and-soft-tissue-sarcomas-of-the-shoulder-girdle
#18
Jan Lesenský, Andreas F Mavrogenis, Vasilios G Igoumenou, Zdenek Matejovsky, Karel Nemec, Panayiotis J Papagelopoulos, Nicola Fabbri
Surgical management of primary musculoskeletal tumors of the shoulder girdle is cognitively and technically demanding. Over the last decades, advances in the medical treatments, imaging and surgical techniques have fostered limb salvage surgery and reduced the need for amputation. Despite well-accepted general principles, an individualized approach is often necessary to accommodate tumor extension, anatomical challenges and patient characteristics. A combination of techniques is often required to achieve optimal oncologic and durable functional outcome...
August 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28661774/the-impact-of-physical-disability-on-pregnancy-and-childbirth
#19
Linda Long-Bellil, Monika Mitra, Lisa I Iezzoni, Suzanne C Smeltzer, Lauren Smith
BACKGROUND: Women with physical disabilities increasingly aspire to become pregnant and bear children. Limited information about the potential interaction of their disabling conditions with pregnancy and childbirth exists to guide these women and their clinicians. MATERIALS AND METHODS: The interview guide was created with questions on topics such as pregnancy complications and secondary conditions, the impact of prior surgeries, experiences with pain relief during labor, and the impact on women's independence and participation in life activities...
June 29, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28658124/diagnosis-and-management-of-head-and-neck-cancers-in-a-high-incidence-area-in-france-a-population-based-study
#20
Anne-Valerie N Guizard, Olivier J Dejardin, Ludivine C Launay, Simona Bara, Bénédicte M Lapôtre-Ledoux, Emmanuel B Babin, Guy D Launoy, Karine A Ligier
Head and neck cancers have a very poor prognosis and are common in France. They are subject to various recommendations for early detection and management, but there is no detailed data in the French general population to fuel the public health debate on it.A high-resolution population-based study about cancer management was conducted, using cancers registries in the north-west of France, on 1729 tumors diagnosed between 2008 and 2010.The tumors were diagnosed late (70.3% stage III-IV), mainly after the onset of symptoms (93...
June 2017: Medicine (Baltimore)
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