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State of the art surgery

Katelyn G Bennett, Theodore A Kung, James A Hayman, David L Brown
BACKGROUND: Management of keloids has remained a conundrum, because an optimum treatment regimen has yet to be elucidated. Currently, treatment varies widely between more conservative measures, such as steroid injections, topical medications, and silicone sheeting, to more aggressive options, such as surgery and postoperative radiation. The latter combination has been touted to have superior results, with the lowest rates of pathologic scar recurrence. METHODS: We performed a retrospective review to critically evaluate the effectiveness of surgical excision and radiation treatment in patients with keloids...
October 19, 2016: Annals of Plastic Surgery
Jonathan S Abelson, Joshua D Spiegel, Cheguevara Afaneh, Jialin Mao, Art Sedrakyan, Heather L Yeo
BACKGROUND: Although there is a large body of published data demonstrating improved outcomes for complex operations when performed by high-volume surgeons at high-volume hospitals, the literature is mixed regarding whether this same relationship applies in less complex and more common surgeries such as laparoscopic cholecystectomy. METHODS: This study utilized the New York State Department of Health Statewide Planning and Research Cooperative System database to identify patients undergoing laparoscopic cholecystectomy for acute and chronic biliary pathology...
October 19, 2016: Surgery
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
October 14, 2016: Journal of Craniofacial Surgery
Wolfgang Fuhl, Thiago Santini, Carsten Reichert, Daniel Claus, Alois Herkommer, Hamed Bahmani, Katharina Rifai, Siegfried Wahl, Enkelejda Kasneci
Modern microsurgery is a long and complex task requiring the surgeon to handle multiple microscope controls while performing the surgery. Eye tracking provides an additional means of interaction for the surgeon that could be used to alleviate this situation, diminishing surgeon fatigue and surgery time, thus decreasing risks of infection and human error. In this paper, we introduce a novel algorithm for pupil detection tailored for eye images acquired through an unmodified microscope ocular. The proposed approach, the Hough transform, and six state-of-the-art pupil detection algorithms were evaluated on over 4000 hand-labeled images acquired from a digital operating microscope with a non-intrusive monitoring system for the surgeon eyes integrated...
October 7, 2016: Computers in Biology and Medicine
Frederic Picard, Kamal Deep, Jean Yves Jenny
PURPOSE: Computer-assisted surgery in orthopaedics is passing through the initial adapter phase of technology adoption. It started more than 20 years ago, but the uptake of technology is still not widespread. The purpose of this article is to introduce the reader to the basic technology and familiarize with the terminology used in the computer navigation. METHODS: During this time, the technology has matured and we have the evidence to prove its benefits for patients...
October 4, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Rishabh Sethia, Thomas F Kerwin, Gregory J Wiet
OBJECTIVE: The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment tools available in the literature, and to summarize the evidence for their validity. DATA SOURCES: The MEDLINE database was accessed via PubMed. REVIEW METHODS: Inclusion criteria consisted of English-language published articles that reported use of a mastoidectomy performance assessment tool...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Christian Graß, Federica Stretti, Waseem Zakhary, Edwin Turton, Sophia Sgouoropoulou, Meinhard Mende, Joerg Ender
BACKGROUND: Fast track (FT) treatment in cardiac anaesthesia is state of the art. Aim of our study was to compare FT treatment in a post anaesthetic care unit (PACU) with limited opening hours with a PACU opened for unlimited hours. Primary endpoints were extubation time (ET), length of stay (LOS) in PACU and LOS in intermediate care unit (IMC). Secondary endpoints were FT success/failure, hospital LOS, re- intubation and in hospital mortality. METHODS: At our institution, FT is usually managed in a PACU with limited opening hours from 10am to 10pm, Monday to Friday (PACU12)...
September 27, 2016: Minerva Anestesiologica
X Tillou, M-O Timsit, F Sallusto, T Culty, G Verhoest, A Doerfler, R Thuret, F Kleinclauss
OBJECTIVES: To perform a state of the art about autosomal dominant polykystic kidney disease (ADPKD), management of its urological complications and end stage renal disease treatment modalities. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database ( and Embase ( using different associations of the following keywords (MESH): "autosomal dominant polykystic kidney disease", "complications", "native nephrectomy", "kidney transplantation"...
September 21, 2016: Progrès en Urologie
Eric J Lehr, T Sloane Guy, Robert L Smith, Eugene A Grossi, Richard J Shemin, Evelio Rodriguez, Gorav Ailawadi, Arvind K Agnihotri, Trevor M Fayers, W Clark Hargrove, Brian W Hummel, Junaid H Khan, S Chris Malaisrie, John R Mehall, Douglas A Murphy, William H Ryan, Arash Salemi, Romualdo J Segurola, J Michael Smith, J Alan Wolfe, Paul W Weldner, Glenn R Barnhart, Scott M Goldman, Clifton T P Lewis
Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program.
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Eric M Lucas, Nicholas C Marais, John D DesJardins
BACKGROUND: The incidence and prevalence of knee arthrodesis (fusion) in the United States is largely unknown, in spite of numerous case reports and review articles that have called attention to this life altering procedure. PURPOSE: This study was conducted to determine long-term knee arthrodesis incidence and patient populations, and to characterize the associated healthcare burden. METHODS: The Nationwide Inpatient Sample was used to evaluate knee arthrodesis procedures performed in the United States between 1993 and 2011...
2016: SpringerPlus
Massimiliano Fabozzi, Pia Cirillo, Francesco Corcione
This work is a topic highlight on the surgical treatment of the right colon pathologies, focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures. Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy, laparoscopic assisted right colectomy, laparoscopic facilitated right colectomy, hand-assisted right colectomy, single incision laparoscopic surgery colectomy, robotic right colectomy...
August 27, 2016: World Journal of Gastrointestinal Surgery
Eduardo Martinez-Enriquez, Mengchan Sun, Miriam Velasco-Ocana, Judith Birkenfeld, Pablo Pérez-Merino, Susana Marcos
PURPOSE: Measurement of crystalline lens geometry in vivo is critical to optimize performance of state-of-the-art cataract surgery. We used custom-developed quantitative anterior segment optical coherence tomography (OCT) and developed dedicated algorithms to estimate lens volume (VOL), equatorial diameter (DIA), and equatorial plane position (EPP). METHODS: The method was validated ex vivo in 27 human donor (19-71 years of age) lenses, which were imaged in three-dimensions by OCT...
July 1, 2016: Investigative Ophthalmology & Visual Science
B B Lörincz, C Simon, N Möckelmann, R Knecht
The annual meeting of the American Society of Clinical Oncology (ASCO) took place at the beginning of June 2016 in Chicago. This year a total of 28 studies on the treatment of patients with thyroid cancer were presented, described in this review article according to the degree of cancer cell differentiation. The leading curative treatment modality is still surgery. In contrast, kinase inhibitors are being used increasingly within palliative concepts. The latest state of the art of thyroid cancer treatment, both surgical and medical, is summarized in this review...
October 2016: HNO
A Sainfort, I Denis Hallouard, D Hartmann, G Aulagner, Y Francois, O Tiffet, G Barabino, O Nuiry, X Armoiry
STUDY AIM: To describe the main technical characteristics of biologic prostheses used for parietal reinforcement and to present the state of the art on their risk/benefit ratio. METHODS: We conducted a technical analysis of manufacturer specifications of the biologic prostheses that are currently available in France accompanied by a literature review by selecting meta-analyses and systematic reviews, randomized controlled trials and publications of health technology rating agencies...
September 8, 2016: Journal of Visceral Surgery
Clemens B Tempfer, Matthias W Beckmann
Depending on the stage at initial presentation, cervical cancer will recur in 25-61% of women. Typical manifestations of recurrent cervical cancer include the central pelvis and the pelvic side walls as well as retroperitoneal lymph node basins in the pelvis and the para-aortic region, and - more rarely - supraclavicular lymph nodes. There are no typical symptoms of recurrent cervical cancer. Women with suspected recurrence after cervical cancer based on gynecological examination or organ-specific symptoms must undergo imaging studies and - if technically feasible - biopsy with histological verification, especially in cases of distant metastases, in order to rule out a second primary...
2016: Oncology Research and Treatment
M O Timsit, F Kleinclauss, R Thuret
OBJECTIVES: To perform a state of the art about the history of kidney transplantation. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database ( and Embase ( using different associations of the following keywords (MESH): kidney transplantation, history, vascular anastomosis. RESULTS: From the first vascular ligations to the discovery of ciclosporin, the history of organ transplantation was made of surgical bets and medical discoveries, such as blood group, HLA-system, immunity, etc...
September 7, 2016: Progrès en Urologie
A A Khan, D A Hanley, R Rizzoli, J Bollerslev, J E M Young, L Rejnmark, R Thakker, P D'Amour, T Paul, S Van Uum, M Zakaria Shrayyef, D Goltzman, S Kaiser, N E Cusano, R Bouillon, L Mosekilde, A W Kung, S D Rao, S K Bhadada, B L Clarke, J Liu, Q Duh, E Michael Lewiecki, F Bandeira, R Eastell, C Marcocci, S J Silverberg, R Udelsman, K Shawn Davison, J T Potts, M L Brandi, J P Bilezikian
The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH)...
September 9, 2016: Osteoporosis International
C Caviezel, D Franzen, I Inci, W Weder
In a number of large case series in the mid-1990s, lung volume reduction surgery (LVRS) was shown to reduce dyspnoea and improve pulmonary function and quality of life in patients with advanced pulmonary emphysema. The large randomised National Emphysema Treatment Trial (NETT) confirmed this in the early 2000s and also demonstrated that selected patients live longer after surgery. Patient selection is crucial to the success of the procedure and should be performed at a specialised experienced centre with a multidisciplinary team approach on emphysema treatment...
September 2016: Zentralblatt Für Chirurgie
Nicolò Pecorelli, Sara Nobile, Stefano Partelli, Luca Cardinali, Stefano Crippa, Gianpaolo Balzano, Luigi Beretta, Massimo Falconi
Pancreatic surgery is being offered to an increasing number of patients every year. Although postoperative outcomes have significantly improved in the last decades, even in high-volume centers patients still experience significant postoperative morbidity and full recovery after surgery takes longer than we think. In recent years, enhanced recovery pathways incorporating a large number of evidence-based perioperative interventions have proved to be beneficial in terms of improved postoperative outcomes, and accelerated patient recovery in the context of gastrointestinal, genitourinary and orthopedic surgery...
July 28, 2016: World Journal of Gastroenterology: WJG
Lucia Signorini, Serena Delbue, Pasquale Ferrante, Marco Bregni
Colorectal cancer (CRC) is one of the most common malignancies throughout the world and the leading cause of cancer-related mortality in Western countries. Recent progress in CRC treatment options, such as surgery, chemotherapy, radiotherapy and target therapy, has improved the prognosis, but advanced disease with recurrence or distant metastasis is usually incurable and has an unfavorable prognosis. The introduction of immunotherapy-associated strategies, both active and passive, to the treatment of CRC aims to overcome the limits of classical treatments...
October 2016: Immunotherapy
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