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https://www.readbyqxmd.com/read/29342445/case-report-of-an-uncommon-case-of-drain-site-hernia-after-colorectal-surgery
#1
M Manigrasso, P Anoldo, F Milone, G D De Palma, M Milone
BACKGROUND: trocar site herniation is a rare but potentially serious complication of laparoscopic surgery. Data about drain site hernia after laparoscopic surgery is scarce and anecdotal. CASE PRESENTATION: we report an uncommon case of drain site hernia in a man undergone laparoscopic left colectomy for a colonic adenocarcinoma who developed small bowel herniation in a 10 mm port site, in which a 24 FR drain was inserted leaving a real free space of 2 mm. DISCUSSION: laparoscopic approach has gained widespread acceptance in each surgical fields because of the perceived better postoperative outcomes in terms of less pain, faster recovery, and lower risk of incisional hernia...
January 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29342430/tissue-expander-stimulated-lengthening-of-arteries-for-the-treatment-of-midaortic-syndrome-in-children
#2
Heung Bae Kim, Gabriel J Ramos-Gonzalez, Khashayar Vakili, Deborah R Stein, Michael A Ferguson, Diego Porras, James E Lock, Gulraiz Chaudry, Ahmad Alomari, Steven J Fishman
BACKGROUND: Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experience with a novel approach using a tissue expander (TE) to lengthen the normal native arteries in children with MAS, allowing primary aortic repair without the need for prosthetic graft material...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#3
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29342417/a-study-of-the-cost-effectiveness-of-fenestrated-branched-evar-compared-with-open-surgery-for-patients-with-complex-aortic-aneurysms-at-2-years
#4
Morgane Michel, Jean-Pierre Becquemin, Jean Marzelle, Céline Quelen, Isabelle Durand-Zaleski
OBJECTIVES: The aim was to assess the cost-effectiveness of fenestrated and branched stent grafts (f/b EVAR) compared with open surgical repair (OSR) in thoraco-abdominal or complex abdominal aortic aneurysms (TAAA/AAA) at 2 years. METHODS: Two matched cohorts of patients with TAAA or complex AAA were compared after a follow-up of two years. Patients included in the WINDOW French multicentre prospective registry were treated by f/b EVAR, and OSR patients were extracted from the French national hospital discharge database...
January 13, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29342196/low-fitness-is-associated-with-abdominal-adiposity-and-low-grade-inflammation-independent-of-bmi
#5
Anne-Sophie Wedell-Neergaard, Louise Eriksen, Morten Grønbæk, Bente Klarlund Pedersen, Rikke Krogh-Madsen, Janne Tolstrup
OBJECTIVE: Up to 30% of obese individuals are metabolically healthy. Metabolically healthy obese (MHO) individuals are characterized by having low abdominal adiposity, low inflammation level and low risk of developing metabolic comorbidity. In this study, we hypothesize that cardiorespiratory fitness (fitness) is a determinant factor for the MHO individuals and aim to investigate the associations between fitness, abdominal adiposity and low-grade inflammation within different BMI categories...
2018: PloS One
https://www.readbyqxmd.com/read/29342108/different-lipid-regulation-in-ovarian-cancer-inhibition-of-the-immune-system
#6
Christina Wefers, Tjitske Duiveman-de Boer, Petra L M Zusterzeel, Leon F A G Massuger, David Fuchs, Ruurd Torensma, Craig E Wheelock, I Jolanda M de Vries
Lipid metabolism is altered in several cancer settings leading to different ratios of intermediates. Ovarian cancer is the most lethal gynecological malignancy. Cancer cells disperse in the abdominal space and ascites occurs. T cells obtained from ascites are unable to proliferate after an antigenic stimulus. The proliferation of ascites-derived T cells can be restored after culturing the cells for ten days in normal culture medium. No pathway aberrancies were detected. The acellular fraction of ascites can inhibit the proliferation of autologous as well as allogeneic peripheral blood lymphocytes, indicating the presence of soluble factors that interfere with T cell functionality...
January 17, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29341948/biochemical-changes-in-experimental-rat-model-of-abdominal-compartment-syndrome
#7
Raina G Ardasheva, Mariana D Argirova, Valentin I Turiiski, Athanas D Krustev
BACKGROUND: Increased intra-abdominal pressure (IAP) causes tissue ischemia, subsequent hypoxia, and impairment of normal tissue metabolism. Elevation of IAP above 20 mmHg leads to progression of abdominal compartment syndrome (ACS) that is associated with organ dysfunction or failure not previously manifested. AIM: To evaluate the eff ects of diff erent grades and time of exposure to IAP on biochemical parameters and oxidative stress in organs aff ected by ischemia using previously developed rat model...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29341844/empiric-antibiotics-for-sepsis
#8
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#9
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29341044/antenatal-medical-therapies-to-improve-lung-development-in-congenital-diaphragmatic-hernia
#10
Aidan Kashyap, Philip DeKoninck, Kelly Crossley, Marta Thio, Graeme Polglase, Francesca Maria Russo, Jan Deprest, Stuart Hooper, Ryan Hodges
Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29341038/-the-use-of-deep-inferior-epigastric-vessels-to-revascularise-free-flaps-for-reconstruction-of-complex-oncosurgical-defects-of-the-thigh-and-the-abdomen
#11
F Simunovic, U Wittel, B Passlick, S Wiesemann, M Czerny, M Südkamp, G B Stark, H Bannasch
BACKGROUND: The resection of large soft-tissue sarcoma requires reconstruction with free flaps. The choice of recipient vessels is crucial for the success of surgery. PATIENTS: We report four cases with large soft-tissue sarcomas with complex anatomical relationships: two tumors of the thigh surrounding the femoral neurovascular structures and two tumors of the abdomen with infiltration of the thorax and the abdomen. All cases received multimodal interdisciplinary treatment...
January 16, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29341013/rodent-abdominal-adipose-tissue-imaging-by-mr
#12
Bhanu Prakash Kn, Jadegoud Yaligar, Sanjay K Verma, Venkatesh Gopalan, S Sendhil Velan
Rodents including rats and mice are important models to study obesity, diabetes, and metabolic syndrome in a preclinical setting. Translational and longitudinal imaging of these rodents permit investigation of metabolic diseases and identification of imaging biomarkers suitable for clinical translation. Here we describe the imaging protocols for achieving quantitative abdominal imaging in small animals followed by segmentation and quantification of fat volumes.
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29340993/laparoscopic-assisted-modified-intersphincter-resection-for-ultralow-rectal-cancer
#13
Haiyang Zhou, Canping Ruan, Zhiguo Wang, Zhiqian Hu
BACKGROUND: Intersphincter resection (ISR) is considered to be a superior technique offering sphincter preservation in patients with ultralow rectal cancer.1 Because high-definition laparoscopy offers wider and clearer vision into the narrow pelvic cavity and intersphincteric space, ISR has been further refined.2 However, functional outcome after ISR has not been optimal. More than half of patients receiving ISR suffer partial or even complete anal incontinence.3 We therefore propose a laparoscopic-assisted modified ISR, with the aim of improving sphincter function following ISR...
January 16, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29340917/biliary-bypass-with-laparoscopic-choledochoduodenostomy
#14
Joshua K Kays, Leonidas G Koniaris, Daniel P Milgrom, Attila Nakeeb
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340839/the-cumulative-incidence-and-risk-factors-of-postoperative-inguinal-hernia-in-patients-undergoing-radical-prostatectomy
#15
Ja Yoon Ku, Chan Ho Lee, Won Young Park, Nam Kyung Lee, Seung Hyun Baek, Hong Koo Ha
BACKGROUND: The aim of this study is to investigate the cumulative incidence and risk factors of postoperative inguinal hernia (PIH) in patients undergoing radical prostatectomy, i.e., laparoscopic prostatectomy (LRP) and robot-assisted laparoscopic prostatectomy (RARP). METHODS: This study included 1124 patients who had undergone radical prostatectomy or transurethral resection of bladder tumor from 2011-2016. We compared the cumulative incidence of PIH in the radical prostatectomy groups (460; LRP 341, RARP 119) and the control group (664; transurethral resection of bladder tumor), and we then analyzed the risk factors (age, operative methods, previous abdominal operative history, thickness and width of external oblique muscle and rectus muscle, thickness of abdominal subcutaneous fat layer at Hesselbach's triangle level, body mass index, prostate-specific antigen, operative time, specimen weight, Gleason score, and pathology T-stage) of PIH in the radical prostatectomy groups...
January 16, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29340827/single-incision-laparoscopic-hepaticojejunostomy-for-children-with-perforated-choledochal-cysts
#16
Mei Diao, Long Li, Wei Cheng
BACKGROUND: Conventionally, perforated choledochal cyst (CDC) is a contraindication of laparoscopic treatment. The current study is to evaluate efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) in children with perforated CDCs. METHODS: One hundred and thirty-three children with perforated CDCs who underwent SILHs in our hospital between August 2011 and August 2017 were reviewed. RESULTS: Fifteen (11.3%) patients were converted to open procedures due to severe adhesions and oozing...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340823/endoscopic-perforations-what-are-the-indications-for-surgery
#17
Diane Mege, Laura Beyer-Berjot, Walid Ezzedine, Anderson Loundou, Jean-Charles Grimaud, Marc Barthet, Stéphane Berdah
BACKGROUND: Despite their low occurrence, endoscopic perforations (EPs) are concerning. Some predictive factors have been identified, and EP management is debated, whether non-surgical (medical and/or endoscopic) or surgical. The objective was to elaborate a predictive score for surgical management of EP. METHODS: All the patients addressed for upper and lower EP, except oesophageal EP, were retrospectively included (2004-2015). Demographic data, endoscopic features (indication, location, type), clinical, biological and radiological presentations of EP were reviewed...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340821/a-novel-and-safe-approach-middle-cranial-approach-for-laparoscopic-right-hemicolon-cancer-surgery-with-complete-mesocolic-excision
#18
Songtao Du, Bomiao Zhang, Yanlong Liu, Peng Han, Chengxin Song, Fangjie Hu, Tianyi Xia, Xiangxin Wu, Binbin Cui
BACKGROUND: Mastering right hemicolectomy techniques using laparoscopy in colorectal cancer surgery is very difficult. Although the long-term prognosis of laparoscopic right hemicolectomy (LRH) and complete mesocolic excision is unquestionable, different surgeons have their own opinions on routes of conducting LRH. OBJECTIVES: LRH surgery is very complex due to the upper abdominal anatomical structure and vascular variation. Therefore, it has been considered the most difficult of all colorectal cancer surgeries...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340808/does-advancement-in-stapling-technology-with-triple-row-and-enhanced-staple-configurations-confer-additional-safety-a-matched-comparison-of-340-stapled-ileocolic-anastomoses
#19
Chi Chung Foo, Alston Ho On Chiu, Jeremy Yip, Wai Lun Law
BACKGROUND: Over the past few decades, studies have focused on the safety of stapled anastomosis, especially when compared to that of the handsewn technique. However, studies on the improvement of stapling technology are limited. This study aimed to investigate whether linear triple-row staples (tri-staples) had any advantage over double-row staples. METHODS: This is a retrospective review of all cases of functional end-to-end anastomoses with linear staplers performed at two centers between 2005 and 2015...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340628/the-importance-of-umbilical-blood-supply-and-umbilical-delay-in-secondary-abdominoplasty-a-case-report
#20
Fereydoun Don Parsa, Justin Cheng, Michael S Hu, Leslie Kim, Nikki Castel, Alan A Parsa
The umbilicus is an important aesthetic landmark of the abdomen. It possesses a dual blood supply that allows it to survive either on its stalk if the skin surrounding the umbilicus is incised, or through the surrounding subdermal circulation if the stalk is transected. This is an important concept to consider in order to avoid umbilical ischemia and necrosis during abdominoplasty, especially if there is any past surgical history suggesting alteration to its blood supply. This case study depicts this importance and the importance of the use of delay in order to improve perfusion to the umbilicus prior to secondary abdominoplasty...
January 11, 2018: Aesthetic Surgery Journal
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