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https://www.readbyqxmd.com/read/29786117/the-relevance-of-the-hippocratic-oath-to-the-ethical-and-moral-values-of-contemporary-medicine-part-ii-interpretation-of-the-hippocratic-oath-today-s-perspective
#1
REVIEW
Helen Askitopoulou, Antonis N Vgontzas
This is the second part of a paper on the relevance and significance of the Hippocratic Oath to modern medical ethical and moral values with the aim at answering questions on controversial issues related to the Oath. Part I argued that the general attributes and ethical values of the Oath are relevant to the modern world. Part II attempts to elucidate the interpretation of the specific injunctions of the Oath from today's perspective in relation to ethical values concerning the duties of physicians to patients and society...
May 21, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29785528/a-rare-case-of-ascending-colon-adenocarcinoma-incarcerated-in-an-inguinoscrotal-hernia-case-report-and-literature-review
#2
Tien Yew Chern, Yeng Kwang Tay, Dayashan Shevantha Perera
BACKGROUND: Inguinal hernias and colorectal cancers are common conditions, but the presentation of a loop of bowel containing cancer within a hernia is rare. Principles of surgery include oncological resection of the involved colonic segment as well as lymphatic drainage. Based on case reports of the last several decades, there have been no reports of a case where the reduction of an inguinoscrotal hernia and oncological colectomy were performed completely laparoscopically. We present the first instance of a completely laparoscopically assisted resection and hernia repair on a patient with T4 ascending colon cancer...
May 21, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29785456/methylene-blue-fluorescence-of-the-ureter-during-colorectal-surgery
#3
Thomas G Barnes, Roel Hompes, Jacqueline Birks, Neil J Mortensen, Oliver Jones, Ian Lindsey, Richard Guy, Bruce George, Chris Cunningham, Trevor M Yeung
BACKGROUND: Iatrogenic ureteric injury is a serious complication of colorectal surgery. Incidence is estimated to be between 0.3 and 1.5%. Of all ureteric injuries, 9% occur during colorectal procedures. Ureteric stents are utilised as a method to reduce the risk of injury; however, these are not without risk and do not guarantee prevention of injury. Fluorescence is a safe and effective alternative for intraoperative ureteric localisation. This proof of principle study aims to assess the use of methylene blue to fluoresce the ureter during colorectal surgery...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29783888/patient-positioning-and-cup-orientation-during-total-hip-arthroplasty-assessment-of-current-uk-practice
#4
Megan Rutherford, John D O'Connor, Janet C Hill, David E Beverland, Alex B Lennon, Nicholas J Dunne
INTRODUCTION: Acetabular cup orientation during total hip arthroplasty (THA) remains a challenge. This is influenced by patient positioning during surgery and the method used to orientate the acetabular cup. The aim of this study was to assess current UK practice for patient positioning and cup orientation, particularly with respect to patient supports and techniques used to achieve target version and inclination. METHODS: A literature review and pilot study were initially conducted to develop the questionnaire, which was completed by British Hip Society members ( n = 183)...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29780916/visual-acuity-of-20-32-13-5-years-after-a-retinal-pigment-epithelium-and-choroid-graft-transplantation
#5
Elsbeth J T van Zeeburg, Kristel J M Maaijwee, Jan C van Meurs
Purpose: To present the 13.5-year-survival of an autologous retinal pigment epithelium (RPE) and choroid graft transplantation with good visual acuity results. Observations: A 72-year old patient presented with a 5-weeks-old visual acuity deterioration to excentric finger counting at half a meter. Fundoscopy showed a fibrotic macular scar, a large subretinal hemorrhage, partly recent, combined with intraretinal fluid, blood, and hard exudates. RPE-choroid graft surgery was performed, and visual acuity improved to 20/32, and maintained up until 13...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29780718/robotic-pancreas-drainage-procedure-for-chronic-pancreatitis-robotic-lateral-pancreaticojejunostomy-puestow-procedure
#6
Adeel S Khan, Imran Siddiqui, Dionisios Vrochides, John B Martinie
Lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) and a dilated pancreatic duct. Traditionally, this operation is performed through an open incision, however, recent advancements in minimally invasive techniques have made it possible to perform the surgery using laparoscopic and robotic techniques with comparable safety. Though we do not have enough data yet to prove superiority of one over the other, the robotic approach appears to have an advantage over the laparoscopic technique in better visualization through 3-dimensional (3D) imaging and availability of wristed instruments for more precise actions, which may translate into superior outcomes...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779307/-application-of-perihilar-surgical-techniques-in-perihilar-biliary-tract-tumours
#7
J Wang
Perihilar biliary tract tumours include hilar cholangiocarcinoma, gallbladder cancer invading the hepatic hilum and intrahepatic cholangiocarcioma invading the hepatic hilum.The tumours have the special characteristics such as strong invasion capability, the anatomic variant, the pathophysiological complexity, the biological behavior diversity and the difficulty of preoperative evaluation which result in low R0 resection rate, more postoperative complications, more mortality and poor prognosis.The perihilar surgical techniques system aims to set a reasonable and individual operation procedure on the principle of precision surgery by taking the key technique of hilar dissection and exposing, evaluting the hilar anatomy by the means of three-dimensional digital medical image evaluation system, evaluting the relationship between the tumour and hepatic artery and portal vein under the condition of hepatic hilum complete exposure by combining anterograde and retrograde route from intra and extra-hepatic direction to hepatic hilum...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#8
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29776645/effectiveness-and-safety-of-total-laparoscopic-distal-gastrectomy-versus-laparoscopy-assisted-distal-gastrectomy-for-gastric-cancer-a-retrospective-cohort-study
#9
Tenglong Tang, Weihui Peng, Leiyi Zhang, Zhongkun Zuo, Ding Cao, Jiangsheng Huang, Lunxi Duan
AIM: To compare the results of total laparoscopic distal gastrectomy (TLDG) and laparoscopy-assisted distal gastrectomy (LADG) and explore the safety and feasibility of TLDG. METHODS: Data were collected and analyzed from patients underwent TLDG and LADG from January 2009 to December 2011 at our institution. RESULTS: 127 LADG cases and 104 TLDG cases were included and balanced for age, sex, BMI, ASA scores, and CEA level in this study...
May 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29775639/surgical-management-of-lower-urinary-tract-symptoms-attributed-to-benign-prostatic-hyperplasia-aua-guideline
#10
Harris E Foster, Michael J Barry, Philipp Dahm, Manhar C Gandhi, Steven A Kaplan, Tobias S Kohler, Lori B Lerner, Deborah J Lightner, J Kellogg Parsons, Claus G Roehrborn, Charles Welliver, Timothy J Wilt, Kevin T McVary
Purpose; Male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is common in men and can have negative effects on quality of life (QOL). It is the hope that this Guideline becomes a reference on the effective evidence-based surgical management of LUTS/BPH. MATERIALS/METHODS: The evidence team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies indexed between January 2007 and September 2017...
May 15, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29774939/-feasibility-and-preliminary-technical-experience-of-single-incision-plus-one-port-laparoscopic-total-gastrectomy-combined-with-%C3%AF-shaped-esophagojejunal-anastomosis-in-surgical-treatment-of-gastric-cancer
#11
Guangsheng Du, Enlai Jiang, Yuan Qiu, Wensheng Wang, Shuai Wang, Yunbo Li, Ke Peng, Xiang Li, Hua Yang, Weidong Xiao
OBJECTIVE: To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer. METHODS: Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29774501/totally-robotic-complete-mesocolic-excision-for-right-sided-colon-cancer
#12
Volkan Ozben, Erman Aytac, Deniz Atasoy, Ilknur Erenler Bayraktar, Onur Bayraktar, Ipek Sapci, Bilgi Baca, Tayfun Karahasanoglu, Ismail Hamzaoglu
Complexity and operative risks of complete mesocolic excision (CME) seem to be important drawbacks to generalize this procedure in the surgical treatment of right colon cancer. Robotic systems have been developed to improve quality and outcomes of minimal invasive surgery. The aim of this study was to evaluate the feasibility of robotic right-sided CME and present our initial experience. A retrospective review of 37 patients undergoing totally robotic right-sided CME between February 2015 and November 2017 was performed...
May 17, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29770874/electronic-voting-to-improve-morbidity-and-mortality-conferences
#13
Joel Zindel, Reto M Kaderli, Manuel O Jakob, Michel Dosch, Franziska Tschan, Daniel Candinas, Guido Beldi
BACKGROUND: It is of major importance in clinical surgery to identify potential patterns and specific causes of complications. Therefore, morbidity and mortality meetings (M&M) are widely used to discuss and evaluate deviations from expected outcomes in order to improve surgical practice. Moreover, M&M represent an important tool for continuous medical education. In this study, we introduced an electronic voting system to assess whether anonymity during M&M could limit potential biases due to hierarchical structures or opinion leaders...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29770309/interventional-radiology-of-the-thyroid-gland-critical-review-and-state-of-the-art
#14
REVIEW
Antonio Barile, Simone Quarchioni, Federico Bruno, Anna Maria Ierardi, Francesco Arrigoni, Aldo Victor Giordano, Sergio Carducci, Marco Varrassi, Giampaolo Carrafiello, Ferdinando Caranci, Alessandra Splendiani, Ernesto Di Cesare, Carlo Masciocchi
Thyroid nodules are a common incidental finding during a routinely ultrasound (US) exam unrelated to the thyroid gland in the healthy adult population with a prevalence of 20-76%. As treated before with surgery, in the last years new minimally invasive techniques have been developed as an alternative to surgery. The aim of this review, based on newly revised guidelines, is to provide some information regarding the basic principles, indications, materials, techniques, and results of mini-invasive procedures or treatments for thyroid nodules...
April 2018: Gland Surgery
https://www.readbyqxmd.com/read/29768364/comparative-effectiveness-of-fragility-fracture-integrated-rehabilitation-management-for-elderly-individuals-after-hip-fracture-surgery-a-study-protocol-for-a-multicenter-randomized-controlled-trial
#15
Sang Yoon Lee, Jaewon Beom, Bo Ryun Kim, Seung-Kyu Lim, Jae-Young Lim
INTRODUCTION: Although it is essential to provide comprehensive rehabilitation after hip fracture to restore the patient to preoperative physical functioning, feasibility issues remain. Here, we describe a protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of fragility fracture integrated rehabilitation management (FIRM) for elderly individuals after hip fracture surgery. We also examine the feasibility of applying FIRM in a chronic-care hospital or community-based setting...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29763252/charcot-foot-clinical-clues-diagnostic-strategies-and-treatment-principles
#16
Valerie S Marmolejo, Jonathan F Arnold, Mario Ponticello, Charles A Anderson
Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing the risk of ulceration, infection, and major lower extremity amputation. Acute Charcot neuroarthropathy should be suspected in any patient 40 years or older with obesity and peripheral neuropathy who presents with an acutely swollen foot following minimal or no recalled trauma and who reports minimal to no pain, particularly if radiography and laboratory markers of infection are normal...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762120/readability-of-patient-educational-materials-for-total-hip-and-knee-arthroplasty
#17
Asa W Shnaekel, Kristie B Hadden, Tina D Moore, Latrina Y Prince, C Lowry Barnes
This study aimed to evaluate patient education materials that are focused on total hip arthroplasty (THA) and total knee arthroplasty (TKA) using health literacy best practices and plain language principles as frameworks. Readability assessments were conducted on a sample of nine patient education documents that are commonly given to THA and TKA surgery patients. Mean readability scores were compared across the sample. The mean readability grade level for the nine arthroplasty educational documents analyzed in this study was 11th grade (10...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29757565/-the-development-of-techniques-served-to-widen-the-lateral-velopharyngeal-space-for-treating-osahs
#18
REVIEW
Jing Yan Huang, Xiang Min Zhang
Since Fujita first described uvulopalatopharyngoplasty(UPPP)in 1981,UPPP and its modified procedures have been widely used to treat obstructive sleep apnea and hyponea syndrome(OSAHS).However,despite of its wide application,the success rates was uncertain,ranging from 20% to 80%,with patients of varing Friedman stages.It is well known that the principle of UPPP is to remove the redundant tissue of palate,elongated uvula and hypertrophic tonsils in order to widen the anteroposterior space at the level of palate...
January 20, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29754252/laparoscopic-single-incision-triangulated-umbilical-surgery-situs-pyeloplasty-a-description-of-the-first-32-cases
#19
Martin Habicher, Theodoros Tokas, Thomas Rw Herrmann, Udo Nagele
INTRODUCTION AND OBJECTIVES: Transumbilical laparoendoscopic (LESS) procedures reduce access trauma. Laparoendocopic single-incision triangulated umbilical surgery (SITUS) utilizes straight instruments in a triangulated fashion, via three trocars placed through a single umbilical incision. METHODS: Thirty-two consecutive patients underwent an SITUS pyeloplasty. Access is performed by incision of the umbilical fold by 3/4 of its circumference, a 5-mm camera port, and consequently, cranial and caudal 3 or 5 mm working trocars are placed at a distance of 3-6 cm, thus allowing triangulation...
May 12, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29744220/principles-and-indications-of-extracorporeal-life-support-in-general-thoracic-surgery
#20
REVIEW
Karen McRae, Marc de Perrot
The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA® Novalung® , Heilbronn, Germany), and extracorporeal CO2 removal (ECCO2 R)...
April 2018: Journal of Thoracic Disease
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