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https://www.readbyqxmd.com/read/28331137/evaluation-of-surgical-procedures-for-t2-gallbladder-cancer-in-terms-of-recurrence-and-prognosis
#1
Ryuichi Kawahara, Takahisa Shirahama, Shyoichirou Arai, Daisuke Muroya, Yoriko Nomura, Shogo Fukutomi, Nobuhisa Shirahama, Katsuaki Takagi, Yuichi Goto, Masanori Akashi, Yuichirou Maruyama, Hisamune Sakai, Hiroto Ishikawa, Toru Hisaka, Masafumi Yasunaga, Hiroyuki Horiuchi, Koji Okuda, Yoshito Akagi, Hiroyuki Tanaka
T2 (tumor invades perimuscular connective tissue; no extension beyond serosa or into liver) gallbladder cancer has generally been treated by S4aS5 subsegmentectomy (S4aS5 HR). We investigated the therapeutic effect of full-thickness cholecystectomy (FC) and gallbladder bed resection (GBR), in terms of tumor location and resection margin (distance from the tumor). At our department we employ the following protocol to determine the extent of resection needed to achieve R0 status: (1) A tumor located in the gallbladder fundus (Gf) or body (Gb) and only on the free peritoneal side was classified as P-type, for which full-thickness cholecystectomy and regional lymph node dissection were performed...
March 22, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28327002/use-of-imaging-to-predict-complete-response-of-colorectal-liver-metastases-after-chemotherapy-mr-imaging-versus-ct-imaging
#2
Min Jung Park, Nurhee Hong, Kyunghwa Han, Min Ju Kim, Yoon Jin Lee, Yang Shin Park, Sung Eun Rha, Sumi Park, Won Jae Lee, Seong Ho Park, Chang Hee Lee, Chung Mo Nam, Chansik An, Hye Jin Kim, Honsoul Kim, Mi-Suk Park
Purpose To compare the diagnostic performances of contrast agent-enhanced computed tomography (CT) and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced liver magnetic resonance (MR) imaging (referred to as EOB MR imaging) in the evaluation of disappearing colorectal liver metastases (CRLMs) after chemotherapy. Materials and Methods The eight institutional review boards approved this retrospective study and waived the requirement for informed consent. On the basis of retrospective searches in eight hospitals, 87 patients with 393 CRLMs, each patient with one or more CRLM that later disappeared on contrast-enhanced CT scans after chemotherapy, and subsequently underwent surgery for the CRLMs, were enrolled...
March 22, 2017: Radiology
https://www.readbyqxmd.com/read/28299215/intra-abdominal-actinomycosis-mimicking-malignant-abdominal-disease
#3
Ali Ridha, Njideka Oguejiofor, Sarah Al-Abayechi, Emmanuel Njoku
Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#4
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28292628/the-role-of-minimally-invasive-surgery-in-the-treatment-of-cholangiocarcinoma
#5
REVIEW
G B Levi Sandri, G Spoletini, G Mascianà, M Colasanti, P Lepiane, G Vennarecci, V D'Andrea, G M Ettorre
Cholangiocarcinoma (CC) is the second most common type of primary liver cancer after hepatocellular carcinoma. Surgical resection is considered the only curative treatment for CC. In general, laparoscopic liver surgery (LLS) is associated with improved short-term outcomes without compromising the long-term oncological outcome. However, the role of LLS in the treatment of CC is not yet well established. In addition, CC may arise in any tract of the biliary tree, thus requiring different types of treatment, including pancreatectomies and extrahepatic bile duct resections...
March 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28282599/severe-fatal-protein-malnutrition-and-liver-failure-in-a-morbidly-obese-patient-after-mini-gastric-bypass-surgery-case-report
#6
Mohammad Ali Kalantar Motamedi, Maryam Barzin, Mohammadreza Ebrahimi, Reza Ebrahimi, Alireza Khalaj
INTRODUCTION: Mini-gastric bypass (MGB) is a bariatric surgical technique popular in many centers due to shorter duration, easier technique, and excellent weight loss results. However, it may be associated with postoperative malnutrition. This case describes the clinical course and unfortunate outcome of a morbidly obese patient who underwent MGB and developed malnutrition in the first postoperative year. PRESENTATION OF CASE: A 37 year-old female patient with a BMI of 44kg/m(2) successfully underwent MGB surgery in June 2015 and was discharged uneventfully...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28278560/hepatogastric-fistula-as-a-rare-complication-of-pyogenic-liver-abscess
#7
Kyu Won Lee, Hee Yeon Kim, Chang Wook Kim, Young Ki Kim, Ohbeom Kwon, Min Ah Kim, Youngyun Cho, Keungmo Yang
Hepatogastric fistula following a pyogenic liver abscess is extremely rare, and only a handful of cases have been reported. An 88-year-old female presented with generalized weakness, fever and chills. An abdominal computed tomography scan revealed a 5cm-sized hypodense lesion with internal septa in the left lateral section of the liver. Due to initial suspicion of early liver abscess, she was treated with empirical intravenous antibiotics. Initially, aspiration or drainage of the liver abscess was not performed due to immature lesion characteristics...
March 9, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28273656/animal-models-for-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-achievements-and-future-perspectives
#8
Andras Budai, Andras Fulop, Oszkar Hahn, Peter Onody, Tibor Kovacs, Tibor Nemeth, Miklos Dunay, Attila Szijarto
BACKGROUND: Since 2012, Associated Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has been standing in the limelight of modern liver surgery and numerous questions have been raised regarding this novel approach. On the one hand, ALPPS has proved to be a valuable method in the treatment of hepatic tumors, while on the other hand, there are many controversies, such as high mortality and morbidity rates. Further surgical research is essential for a better understanding of underlying mechanisms and for enhancing patient safety...
March 9, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28260430/anesthetic-and-perioperative-management-of-nontransplant-surgery-in-patients-after-liver-transplant
#9
Zeynep Ersoy, Asude Ayhan, Aycan Ozdemirkan, Gulsi Gulsah Polat, Pinar Zeyneloglu, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28224207/-differentiated-application-of-recommended-guideline-techniques-for-treatment-of-inguinal-hernia
#10
H Niebuhr, M Pawlak, F Köckerling
The new worldwide guidelines of all international hernia societies only recommend the mesh-based methods TEP, TAPP and Lichtenstein. The best mesh-free technique, the Shouldice operation, should only be used if the patient has declined the use of a mesh or no mesh is available. The systematic use of the Shouldice technique for smaller inguinal hernias and younger men should be confined to study settings. A tailored approach should be taken for mesh-based procedures to minimize the risk to patients. Due to lower pain rates the laparoendoscopic techniques TEP and TAPP are the methods of choice for primary male unilateral inguinal hernia...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28213624/oligometastatic-colorectal-cancer-is-single-site-bony-colorectal-metastasis-a-treatable-condition
#11
Noel Cassar, Adrian Ben Cresswell, Brendan Moran
INTRODUCTION: A potentially resectable bony metastasis in the context of oligometastatic colorectal cancer is uncommon. Bony metastases are usually considered a late event with poor prognosis and generally associated with liver and/or lung metastases. INDEX CASE: A previously healthy 33-year-old gentleman, with no family history of colorectal cancer, presented with rectal bleeding and at colonoscopy had a biopsy-proven adenocarcinoma of the rectum, 7 cm from the anal verge...
February 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28207547/planning-for-operating-room-efficiency-and-faster-anesthesia-wake-up-time-in-open-major-upper-abdominal-surgery
#12
Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chih-Shung Wong, Chen-Hwan Cherng, Zhi-Fu Wu
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28199752/effect-of-transversus-abdominis-plane-block-in-combination-with-general-anesthesia-on-perioperative-opioid-consumption-hemodynamics-and-recovery-in-living-liver-donors-the-prospective-double-blinded-randomized-study
#13
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Rıdvan Yalin, Yusuf Ziya Colak, Cemil Çolak, Huseyin Ilksen Toprak
BACKGROUND: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic and recovery time in living liver donors. METODS: The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy...
February 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#14
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28196354/effect-of-age-on-liver-function-in-patients-undergoing-partial-hepatectomy
#15
T M Lodewick, P H Alizai, R M van Dam, A A J Roeth, M Schmeding, C Heidenhain, A Andert, N Gassler, C H C Dejong, U P Neumann
BACKGROUND: Postresectional liver failure is the most frequent cause of fatal outcome following liver surgery. Diminished preoperative liver function in the elderly might contribute to this. Therefore, the aim of the present study was to evaluate preoperative liver function in patients <60 or >70 years of age scheduled for liver resection. METHODS: All consecutive patients aged <60 or >70 years who are about to undergo elective liver surgery between 2011 and 2013 and underwent the methacetin breath liver function test (LiMAx) preoperatively were included...
February 15, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#16
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28179708/a-rare-congenital-liver-anomaly-hypoplasia-of-left-hepatic-lobe
#17
Tugrul Ormeci, Secil Telli Erdogan, Asli Ormeci, Cem Aygun
Morphologic anomalies of liver, as opposed to many other visceral organs, are very rare. Hypoplasia or agenesis of left lobe of the liver is defined as the absence of liver tissue on the left side of liver without previous disease or surgery. It is usually an incidental finding revealed by imaging exams or during abdominal surgery. A 44-year-old female patient was admitted to the hospital for abdominal pain and discomfort. Physical examination revealed no specific abnormality. Routine laboratory tests were normal...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28160267/third-line-treatment-of-colorectal-liver-metastases-using-debiri-chemoembolization
#18
Germano Scevola, Giorgio Loreni, Marco Rastelli, Stefano Sposato, Sara Ramponi, Vittorio Miele
To evaluate safety, efficacy of drug-eluting beads with irinotecan (DEBIRI) on local response and survival of patients affected by colorectal liver metastases (CRLM) progressing during or after second line was evaluated. Sixty-two patients, with colorectal liver metastases, not suitable for surgery or thermal ablation treatments, progressing during or within 6 month from the end of second-line chemotherapy, were treated with DEBIRI chemoembolization between February 2009 and July 2014. CRLM were histologically confirmed...
March 2017: Medical Oncology
https://www.readbyqxmd.com/read/28154343/surgical-outcome-of-cerebral-aneurysm-clipping-treated-with-immunosuppressants-report-of-11-cases-and-review-of-the-literature
#19
Masaaki Hokari, Naoki Nakayama, Ken Kazumata, Toshiya Osanai, Hideo Shichinohe, Takeo Abumiya, Kiyohiro Houkin
There are no reports on the outcomes of clippings in patients who receive immunosuppressants, for example, due to connective tissue diseases or following organ transplantation. We thoroughly reviewed these cases focusing on the perioperative management phase. The study included 11 patients with intracranial aneurysms who were taking immunosuppressants; between 2007 and 2014. We performed 12 clipping surgeries. Their clinical records were reviewed for age and gender, aneurysms' location and size, perioperative management of the immunosuppressive drugs, and surgical complications...
January 31, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28144393/percutaneous-drainage-as-a-first-therapeutic-step-prior-to-surgery-in-liver-hydatid-cyst-abscess-is-it-worth-it
#20
Aylhin J Lopez-Marcano, Jose M Ramia, Vladimir Arteaga, Roberto De la Plaza, Jhonny D Gonzales, Anibal Medina
AIM: To delay surgery until the patient is in a better condition, and thus to decrease postoperative morbidity. METHODS: Using this algorithm we treated three patients aged 55, 75 and 80 years. In all three patients the clinical presentation was fever without a clear source of infection; all had nonspecific symptoms such as general malaise, dyspnea, and abdominal discomfort in the previous 15 d. They came to the emergency room at our hospital due to deterioration of their general condition...
January 18, 2017: World Journal of Hepatology
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