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Denise S Coelho da Mota, Fernando L Sicuro, Angela C Resende, Roberto S De Moura, Daniel A Bottino, Eliete Bouskela
BACKGROUND: Tissue necrosis caused by insufficient perfusion is a major complication in flap transfer. This study evaluated whether treatment with cilostazol or hydroalcoholic extract of seeds of Euterpe oleracea Mart. (açaí) protects the transverse rectus abdominis myocutaneous (TRAM) flap against ischemic damage in hamsters. MATERIALS AND METHODS: Fifty-four hamsters were divided into three oral treatment groups: placebo, açaí, or cilostazol. Caudally based, unipedicled TRAM flaps were raised, sutured back, classified into four vascular zones (I-IV), and evaluated for tissue viability, capillary blood flow (CBF), perfused vessel density (PVD), and microvascular flow index (MFI) by orthogonal polarization spectral imaging at three time points: immediately postoperatively (IPO), 24 h postoperatively (24hPO), and 7 d postoperatively (7POD)...
August 2018: Journal of Surgical Research
Ingrid M Ganske, Joseph M Firriolo, Laura C Nuzzi, Oren Ganor, Thomas E Hamilton, C Jason Smithers, Russell W Jennings, Joseph Upton, Brian I Labow, Amir H Taghinia
BACKGROUND: A variety of surgical techniques exist to manage long-gap esophageal atresia (LGEA), including gastric pull-up (GPU), colonic interposition (CI), jejunal interposition (JI), and distraction lengthening. Salvage reconstruction for late failure of any conduit type is a complex surgical problem fraught with technical difficulty and significant risk. Jejunal interposition can be used as a salvage procedure in the management of LGEA. However, the opposing requirements of conduit length and adequate perfusion make the procedure technically challenging...
June 13, 2018: Annals of Plastic Surgery
Igor Paredes, Irene Panero, Santiago Cepeda, Ana M Castaño-Leon, Luis Jimenez-Roldan, Ángel Perez-Nuñez, Jose A Alén, Alfonso Lagares
BACKGORUND: This study aimed to compare the accuracy of screw placement between open pedicle screw fixation and percutaneous pedicle screw fixation (MIS) for the treatment of thoracolumbar spine fractures (TSF). MATERIALS AND METHODS: Forty-nine patients with acute TSF who were treated with transpedicular screw fixation from January 2013 to December 2016 were retrospectively reviewed. The patients were divided into Open and MIS groups. Laminectomy was performed in either group if needed...
June 14, 2018: Journal of Neurosurgical Sciences
Dajiang Song, Zan Li, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Chunliu Lü, Wen Peng, Huangxing Mao
Objective: To explore the clinical application of combined transverse upper gracilis flap and adductor magnus perforator flap in breast reconstruction of breast cancer patients after mastectomy. Methods: Between August 2016 and February 2017, the combined transverse upper gracilis flap and adductor magnus perforator flap was used in 12 cases of breast cancer patients who received modified radical surgery for breast reconstruction. All patients were females with the age of 32 to 59 years (mean, 41...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Bassel Bashjawish, Shreya Patel, Suat Kılıç, Wayne D Hsueh, James K Liu, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Our aim in this study was to assess the impact of the turnover of residents in July on patients undergoing pituitary surgery. METHODS: This work was a retrospective cohort study of cases from the National Inpatient Sample (NIS). Patients who underwent pituitary surgery from 2005 to 2012 were selected in the NIS. Patients undergoing surgery in July and in non-July months were compared to determine differences in demographics, comorbidities, and complications...
June 15, 2018: International Forum of Allergy & Rhinology
N Huang, Y M Zhu, C M An, Y Liu, Z G Xu, S Y Liu, Z M Zhang
Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A retrospective cohort study was conducted, including 52 patients underwent total laryngectomy, plus partial tongue base resection ( n =2), partial pharyngectomy ( n =1), or pedicle flap ( n =2) between January 2012 and October 2017. Patients who had a history of preoperative radiotherapy, chemotherapy or chemoradiotherapy, previous surgery for larynx or pharynx and who had severe complications were excluded...
June 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Rosario Maugeri, Luigi Basile, Carlo Gulì, Aurelia Banco, Giovanna Giordano, Antonella Giugno, Francesca Graziano, Roberto Giuseppe Giammalva, Domenico Gerardo Iacopino
BACKGROUND:  Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal due to spinal degeneration, and its main clinical symptom is neurogenic claudication. Surgical treatment is pursued for patients who do not improve with conservative care. Patients with symptomatic LSS who also have significant medical comorbidities, although clearly in need of intervention, are unattractive candidates for traditional open lumbar decompressive procedures. Thus it is important to explore minimally invasive surgical techniques to treat select patients with LSS...
June 14, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Yujin Myung, Bomi Choi, Heeyeon Kwon, Chan Yeong Heo, Eun-Kyu Kim, Eunyoung Kang, Jae Hoon Jeong, Eun Joo Yang
Immediate breast reconstruction (IBR) after mastectomy has been proven to affect patient quality of life, psychological well-being, and functional capacities. In the present study, we aimed to investigate the effect of breast reconstruction on postoperative shoulder function and muscle performance by evaluating isokinetic muscle performance tests.A retrospective chart review to collect data on shoulder function analysis with isokinetic muscle performance testing was performed among patients who received mastectomy with IBR from July 2013 to March 2015...
June 2018: Medicine (Baltimore)
Junhao Liu, Wei Ji, Zucheng Huang, Ganggang Kong, Qi Liu, Zhiping Huang, Xiuhua Wu, Qingan Zhu
STUDY DESIGN: Retrospective analysis of computed tomographic images of 92 normal pediatric cervical vertebrae. OBJECTIVE: To ascertain the feasibility of the pedicle, intralaminar, and lateral mass screws fixation in children. SUMMARY OF BACKGROUND DATA: Fixation techniques of C7 vertebrae is technically challenging in the pediatric population. Although the techniques offer alternatives to screws placement at C7 spine in adult, there is no consensus to apply these screws in children...
June 12, 2018: Spine
Hui-Yi Hsiao, Chin-Yu Yang, Jia-Wei Liu, Eric M Brey, Ming-Huei Cheng
Periosteal osteogenic capacity can be exploited to enhance bone formation in the fields of tissue engineering and regenerative medicine. Despite this importance, there have been no studies examining the composition, structure and osteogenic capacity of periostea from different bone sources. In this study, structure and osteogenic factor content were compared among periostea from calvarial, rib, femoral and tibial bone, in which the native bones of these four regions were harvested and subjected to histological analysis...
June 14, 2018: Tissue Engineering. Part A
Federico Landriel, Santiago Hem, Jorge Rasmussen, Eduardo Vecchi, Claudio Yampolsky
Objective: The aim of this study was to estimate the learning curve needed for correct placement of minimally invasive percutaneous pedicle screws (PPS). Introduction: PPS are the most common system used for instrumentation of spinal lesions that require stabilization. Methods: We retrospectively assessed the insertion of 422 PPS (T5 to S1) in 75 patients operated between 2013-2016 under two-dimensional fluoroscopic guidance. The surgeon 1 always placed the PPS on the right side and the surgeon 2 on the left side...
2018: Surgical Neurology International
Pooja Reddy, Quynh-Giao Nguyen, Ikue Shimizu
No abstract text is available yet for this article.
June 1, 2018: JAMA Dermatology
Pravin Salunke, Sushanta K Sahoo
The management for congenital atlantoaxial dislocation (AAD) and basilar invagination (BI) has significantly changed in the last 2 decades. Authors operate these cases through a direct posterior approach by opening and manipulating the C1-2 joints (irrespective of C1 assimilation), modifying Goel's technique. The joints in these cases are often oblique in both sagittal and coronal planes giving rise to anteroposterior and vertical slip of C1 on C2. Asymmetry on either side gives rise to coronal/lateral angular tilt along with rotational component...
June 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Emily A Van Kouwenberg, Alan Yan, Ashit Patel, Rick L McLaughlin, Patricia Northrup, Melanie Cintron, Richard L Agag
BACKGROUND:  The radial forearm free flap (RFFF) remains a workhorse flap but can have significant donor site morbidity. The authors developed a novel technique for endoscopic-assisted RFFF (ERFFF) harvest and hypothesized improved donor site morbidity. METHODS:  A retrospective cohort study was conducted evaluating patients who underwent ERFFF or RFFF by a single surgeon for head and neck reconstruction between November 2011 and July 2016; outcomes and complications were compared...
June 12, 2018: Journal of Reconstructive Microsurgery
Hiroki Oba, Shigeto Ebata, Jun Takahashi, Kensuke Koyama, Masashi Uehara, Hiroyuki Kato, Hirotaka Haro, Tetsuro Ohba
STUDY DESIGN: Observational cohort study. OBJECTIVE: To compare the rate of pedicle perforation while inserting screws (PS) using O-arm navigation during surgery for scoliosis with that reported previously, and to determine risk factors specific to O-arm navigation. SUMMARY OF BACKGROUND DATA: O-arm navigation provides intraoperative three-dimensional fluoroscopic imaging with an image quality similar to that of computed tomography. Surgeons have started using O-arm navigation in treatment of adolescent idiopathic sclerosis (AIS)...
June 11, 2018: Spine
Juan M Revuelta Barbero, Alaa S Montaser, Mostafa Shahein, André Beer-Furlan, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
The endoscopic endonasal approach (EEA) provides direct access to foramen magnum meningiomas; however, it often requires extensive exposure including septal flap elevation with septum removal, complete sphenoidotomy, and panclivectomy.We present a case of a 54-yr-old-female with an incidental foramen magnum lesion followed up with serial imaging who presented 10 mo later with progressive neck discomfort and episodes of dizziness, with confirmed tumor progression and further brainstem compression. A focal transclival EEA with medial condylectomy was performed preserving the upper two-thirds of the clivus, the nasal septum, and the sphenoid sinus...
June 11, 2018: Operative Neurosurgery (Hagerstown, Md.)
Evan Luther, Timur Urakov, Steven Vanni
BACKGROUND AND STUDY OBJECTIVE:  Complex traumatic lumbar spine fractures are difficult to manage and typically occur in younger patients. Surgical immobilization for unstable fractures is an accepted treatment but can lead to future adjacent-level disease. Furthermore, large variations in fracture morphology create significant difficulties when attempting fixation. Therefore, a surgical approach that considers both long-term outcomes and fracture type is of utmost importance. We present a novel technique for percutaneous fixation without interbody or posterolateral fusion in a young patient with bilateral pedicle dissociations and an acute-onset incomplete neurologic deficit...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Luca Viganò, Andrea Laurenzi, Luigi Solbiati, Fabio Procopio, Daniel Cherqui, Guido Torzilli
BACKGROUND: Patients with a single hepatocellular carcinoma (HCC) ≤3 cm and preserved liver function have the highest likelihood to be cured if treated. The most adequate treatment methods are yet a matter that is debated. METHODS: We reviewed the literature about open anatomic resection (AR), laparoscopic liver resection (LLR), and percutaneous thermal ablation (PTA). RESULTS: PTA is effective as resection for HCC < 2 cm, when they are neither subcapsular nor perivascular...
June 11, 2018: Digestive Surgery
P Sarat Chandra, Pankaj Singh, Rajender K, Deepak Agarwal, Vivek Tandon, S S Kale, Chitra Sarkar
BACKGROUND: Vertebral body (VH) hemangiomas with myelopathy are difficult to manage. OBJECTIVE: To evaluate the role of intra-operative ethanol embolization, surgical decompression and instrumented short segment fusion in VH with myelopathy and long-term outcome (>24 months). METHODS: Prospective study: Symptomatic VH with cord compression with myelopathy. Excluded: pathological fractures, and/or deformity or multi-level pathologies. Surgery consisted of intra-operative bilateral pedicular absolute alcohol (<1% hydrated ethyl alcohol) injection, laminectomy and cord decompression at the level of pathology followed by a short segment instrumented fusion using pedicle screws...
June 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Juho T K Salo, Erkki J Tukiainen
OBJECTIVE: The study aim was to analyse chest wall reconstruction following oncological resection by a single surgeon over an 19 year period. METHODS: A retrospective review was performed for 135 patients who underwent oncological chest wall resection during 1997-2015. RESULTS: Average patient age was 57.8 years. Indications for resection were: advanced breast cancer n=44, soft tissue sarcoma n=38, bone or chondrosarcoma n=28, desmoid tumour n=11, metastasis from other cancers n=7, and other primary tumours n=7...
May 22, 2018: Plastic and Reconstructive Surgery
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