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Surgical site

Orawee Chinthakanan, John R Miklos, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: 1) Evaluate the most common indication for sling removal in patients with synthetic mesh slings; 2) identify the location of pain for each of the three types of synthetic sling procedures including retropubic (RP) sling, transobturator (TOT) sling, and single incision slings (SIS), and 3) describe the surgical approach to each of the above and its associated complications. MATERIALS AND METHODS: A retrospective chart review of all patients who underwent surgical removal of a sling due to a mesh-related complications from 2011 to 2013 at three referral centers...
October 26, 2016: Surgical Technology International
Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
Kyle G Cologne, Sean Byers, David R Rosen, Grace S Hwang, Adrian E Ortega, Glenn T Ault, Sang W Lee
A prospectively maintained database of 415 patients undergoing colectomy was evaluated. We performed a logistic regression analysis to identify factors associated with 1) length of stay (LOS) of 2 days or less and 2) LOS of 10 days or more. Investigated variables included demographics, American Society of Anesthesiology (ASA) score, diagnosis, operative procedure, approach and time, transfusion requirements, and occurrence of any complications. Factors associated with a LOS of two days or less included ASA [odds ratio (OR): 0...
October 2016: American Surgeon
Ahmed Dehal, Sunal Patel, Hanna Park, Patrick Nguyen, Robert Yuhan, Joseph Ruan
Robotic colorectal surgery was first performed at our institution in January 2014. The objective of this study is to present our initial experience with robotic colorectal surgery. This is a retrospective review of the prospectively collected data of all patients who underwent robotic colorectal surgery from January 2014 to April 2015. Baseline, perioperative, and postoperative data were obtained for analysis. A total of 101 patients with a mean age of 56 and a body mass index of 31 underwent robotic colorectal surgery between January 2014 and April 2015...
October 2016: American Surgeon
C Esposito, M Escolino, B Troncoso Solar, R Iacona, R Esposito, A Settimi, I Mushtaq
OBJECTIVES: To document the imaging follow-up of laparoscopic partial nephrectomy (LPN) in children and to investigate the natural history of cystic lesions post-LPN. MATERIALS AND METHODS: We reviewed the US imaging reports performed during follow-up in 125 children (77 girls, 48 boys - average age 3.2 years) underwent LPN in 2 centers of pediatric surgery in the period 2005-2015. RESULTS: Transperitoneal approach was adopted in 83 cases while retroperitoneoscopy in 42 cases...
October 25, 2016: BJU International
Paula Ferrada, Rao R Ivatury, David A Spain, Kimberly A Davis, Michel Aboutanos, John J Fildes, Thomas M Scalea
INTRODUCTION: Acute Care Surgery (ACS), Trauma and Surgical Critical Care (SCC) fellowships graduate fellows deemed qualified to perform complex cases immediately upon graduation. We hypothesize international fellow rotations (IFR) can be a resource to supplement operative case exposure METHODS: A survey was sent to all program directors of ACS and SCC fellowships via email. Data was captured and analyzed using the Research Electronic Data Capture (REDCap) tool. RESULTS: The survey was sent to 113 program directors (PDs) with a response rate of 42%...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Hong Tao, Yiran Cai, Liang Shi, Junfang Tang, Zhidong Liu, Zitong Wang, Lianqi Bai, Zhe Liu
BACKGROUND: Recent research into lung cancer-related driver genes has identified a distinctive molecular subtype of non-small cell lung cancer (NSCLC) - anaplastic lymphoma kinase (ALK)-positive NSCLC. We evaluated the clinical features and survival rates of ALK-positive lung adenocarcinoma patients who had undergone surgery but had not received ALK inhibitor therapy, along with the characteristics of patients with distant metastases. METHODS: Clinical data of 40 patients with ALK-positive, postsurgical lung adenocarcinoma were retrospectively analyzed...
October 24, 2016: Thoracic Cancer
M Moschini, F Soria, A Briganti, S F Shariat
BACKGROUND: Surgical treatment of the primary tumor in patients with metastatic prostate cancer (mPCa) is gaining traction. We discuss the biological rational and the existing literature on this approach. METHODS: We reviewed the literature regarding surgical management of advanced and mPCa disease. RESULTS: Surgical removal of the primary tumor despite metastases is becoming a standard in an increasing number of malignancies. Basic science data support the use of surgical removal of the prostate in metastatic PCa...
October 25, 2016: Prostate Cancer and Prostatic Diseases
Michalis Koullouros, Nadir Khan, Emad H Aly
BACKGROUND: Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics. AIM: The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery...
October 24, 2016: International Journal of Colorectal Disease
Ehab M Elzawawy, Melad N Kelada, Ahmed F Al Karmouty
Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length...
2016: Anatomy Research International
E J Kyriopoulos, A Kyriakopoulos, A Karonidis, A Gravvanis, I Gamatsi, C Tsironis, D Tsoutsos
Mucor fungus infection is a rare opportunistic infection, rapidly progressive and often fatal in immunocompromised patients, or in patients with chronic debilitating diseases. We report six cases of trauma patients with mucormycosis. Three had severe thermal burns, one of them with a medical history of diabetes mellitus. The other three patients suffered from severe soft tissue injuries caused by traffic accidents. In all cases there had been spontaneous exposure and contact of the wounds with soil. During hospitalization, fungi cultures and/or biopsies of all wounds were performed and all resulted positive...
December 31, 2015: Annals of Burns and Fire Disasters
Fatima Aloraifi, Stephen Mulgrew, Nick K James
Merkel cell carcinoma (MCC) is a highly aggressive cutaneous neuroendocrine tumour that is increasing in incidence. We report a case of a 92-year-old white man on long-term immunosuppression for temporal arteritis who presented with a Merkel cell tumour on his left cheek. A wide local excision was performed and the defect was reconstructed with a full-thickness skin graft. Four years later, the patient re-presented with a Merkel cell tumour arising from the right supraclavicular donor site. To our knowledge, this is the first report of a recurrence of MCC into a donor site...
October 24, 2016: Journal of Cutaneous Medicine and Surgery
Georg D Strbac, Albrecht Schnappauf, Katharina Giannis, Michael H Bertl, Andreas Moritz, Christian Ulm
INTRODUCTION: The aim of this study was to introduce an innovative method for autotransplantation of teeth using 3-dimensional (3D) surgical templates for guided osteotomy preparation and donor tooth placement. METHODS: This report describes autotransplantation of immature premolars as treatment of an 11-year-old boy having suffered severe trauma with avulsion of permanent maxillary incisors. This approach uses modified methods from guided implant surgery by superimposition of Digital Imaging and Communications in Medicine files and 3D data sets of the jaws in order to predesign 3D printed templates with the aid of a fully digital workflow...
October 21, 2016: Journal of Endodontics
Stijn van Weert, Rinze Reinhard, Elisabeth Bloemena, Jan Buter, Birgit I Witte, Marije R Vergeer, C René Leemans
BACKGROUND: We examined the assumption in conventional teaching about metastatic adenoid cystic carcinoma (ACC) being an indolent type of disease. METHODS: A single center analysis of 105 cases of ACC was performed. Radiographs were reviewed and tumor response to chemotherapy was measured. Distant disease-free survival (DDFS) and time to death since distant metastases diagnosis were analyzed. RESULTS: Forty-two percent of the patients were diagnosed with distant metastases...
October 24, 2016: Head & Neck
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Jung-Won Cho, Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
BACKGROUND: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. CASE REPORT: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Nicholas Brandmeir, Elena Nehrbass, James McInerney
INTRODUCTION:  Deep brain stimulator (DBS) infections are a persistent problem for patients undergoing this procedure. They may require further surgery, treatment with antibiotics, or even removal of the device. To date, no consensus exists on the best practices to avoid DBS infections or what factors predispose patients to an eventual infection. The goal of this study was to examine several patient factors for association with DBS infection. METHODS:  A single-center, single-surgeon quality improvement database was queried...
September 20, 2016: Curēus
Travis E Wright, K Keely Boyle, Thomas R Duquin, John K Crane
BACKGROUND: Many studies have noted an increase in the number of recognized cases of invasive infections due to Propionibacterium acnes, especially after shoulder replacement surgery. The increase in the number of recognized cases of P. acnes, a nonspore-forming, anaerobic, Gram-positive organism, appears due to both an increase in the number of shoulder operations being performed and more specimens being sent for anaerobic cultures. Nevertheless, the optimal surgical and antibiotic management of P...
2016: Infectious Diseases
Nishant Ganesh Kumar, Adil A Faqih, Michael P Feng, Richard S Miller, Richard A Pierce, Kenneth W Sharp, Michael D Holzman, Benjamin K Poulose
INTRODUCTION: Ventral hernia repair (VHR) is a commonly performed surgical procedure. Unfortunately, long term prospective information about quality of life and outcomes after VHR has been challenging to obtain. Decoupling follow up from clinical visits via patient reported outcomes (PROs) has been proposed as a means of achieving better long term assessments after VHR. The Americas Hernia Society Quality Collaborative (AHSQC) is a national quality improvement (QI) effort in hernia repair which uses PROs to obtain long term follow up...
October 20, 2016: Journal of the American College of Surgeons
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