The Journal of Surgery最新文献

{"title":"The Treatment of Becker’s Nevus by Combination Therapy: Dr. Hoon Hur’s Golden Parameter Therapy and Dr. HOON Hur’s Optimal Melanocytic Suicide-1 Parameter Therapy","authors":"H. Hur, Jiensup Kim, Duck Taik Shim, Suk‐Jin Choi, Pyoung-Su Kim, Yu Ri Kim","doi":"10.11648/J.JS.20210901.13","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.13","url":null,"abstract":"Becker’s nevus, a cutaneous hamartoma, usually occurs as a large, unilateral, hyperpigmented and hypertrichotic patch on the shoulder or upper trunk, which can be present in childhood or adolescence. Becker’s nevus can be treated with traditional laser therapy using various types of lasers including a 532nm potassium titanyl phosphate (KTP) laser, 694nm ruby laser and 755nm alexandrite laser. However, this may cause harmful side effects such as scarring, mottled hypopigmentation, post-inflammatory hyperpigmentation (PIH), purpurae, and crusts. As a result, no standard for the treatment of Becker’s nevus using lasers has been established. Therefore, this study was implemented to investigate the safety and efficacy of treating Becker’s nevus using Dr. Hoon Hur’s Golden Parameter Therapy (GPT) followed by Dr. Hoon Hur’s Optimal Melanocytic Suicide-1 Parameter Therapy (OMS-1 PT) which uses a high fluence 1064nm Q-switched Nd: YAG laser (QSNL). Forty-two Koreans suffering from Becker’s nevus participated in the study and received treatment on a weekly basis for 75-100 sessions using the QSNL according to Dr. Hoon Hur’s GPT then followed by Dr. Hoon Hur’s OMS-1 PT. The parameters for this study were a spot size of 7 mm, a fluence of 2.2 J/cm2 and a pulse rate of 10 Hz using a sliding-stacking technique for a single pass over the Becker’s nevus, followed by Dr. Hoon Hur’s OMS-1 PT using a sliding technique for 5 passes with the QSNL over the Becker’s nevus. Upon completion of the last treatment, all 42 patients with Becker’s nevus were cured, having no side effects, and entirely removing the pigmented lesions. None of the 42 patients reported any recurrences after their follow-ups 6-15 months after the final treatment. As a result of this study, we propose therapy to safely and effectively treat Becker’s nevus using a fusion of Dr. Hoon Hur’s GPT and Dr. Hoon Hur’s OMS-1 PT with a high fluence 1064nm QSNL to avoid any recurrences or harmful side effects.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"11 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84184374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis","authors":"G. Nair, J. Virgin, Tim Kenyon-Smith, Bev Thomas, Karolina Juszczyk, H. Kroon, P. Hollington","doi":"10.11648/J.JS.20210901.12","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.12","url":null,"abstract":"Background: The decision to perform an appendicectomy is traditionally based on clinical findings. This approach, however, results in high rates of negative (non-inflamed) appendicectomies with procedure morbidity associated. Therefore, some consider a negative appendicectomy to be a complication since surgical morbidity could have been avoided. The aim of this study was to evaluate the effect of preoperative imaging on the negative appendicectomy rate in case of suspected appendicitis. Methods: The prospectively collected database for all patients who had undergone acute surgery for a suspected appendicectomy, with or without preoperative imaging, was analysed over a 5-year period. Patient and treatment characteristics, histopathology and postoperative outcomes were recorded and analyzed. Results: A total of 2,070 patients were included, 848 (41%) with preoperative imaging (CT, ultrasound or MRI) and 1,222 (59%) without. Imaged patients were older and suffered from more comorbities. The negative appendicectomy rate was 19.2% (n=235) for the non-imaged patients, and 12.4% (n=105) for imaged patients (p<0.0001). When preoperative imaging was performed, a CT-scan was most accurate to diagnose appendicitis correctly compared to ultrasound (93.6 vs. 30.2%, p<0.0001). Median hospital stay was 3.2 days in the imaged group compared to 2.1 days in the non-imaged group (p=0.171). Conclusion: Preoperative imaging significantly reduces the negative appendicectomy rate. In this time of modern imaging modalities readily available, it is recommended to perform preoperative imaging in case of suspected acute appendicitis to avoid unnecessary surgery and associated morbidity.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"15 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72796702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Open-Book Enucleation of Keloids (OBEK), a Novel Procedure in Reducing Wound Burden in Tension Prone Keloid Surgery","authors":"R. Karamanoukian, R. Samaha, H. Karamanoukian, Z. Obagi, Yasmina Samaha","doi":"10.37421/1584-9341.2021.17.006","DOIUrl":"https://doi.org/10.37421/1584-9341.2021.17.006","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"13 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88039215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on the Metastatic Colorectal Cancer: Review of Diagnosis and Treatment Options","authors":"M. Palaghia","doi":"10.37421/1584-9341.2021.17.004","DOIUrl":"https://doi.org/10.37421/1584-9341.2021.17.004","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"4 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75411899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Surgery during Pandemic Era – Evolving Strategies: A Cohort Study from a Tertiary Care Centre in North India","authors":"R. Wadhawan","doi":"10.13188/2332-4139.1000049","DOIUrl":"https://doi.org/10.13188/2332-4139.1000049","url":null,"abstract":"Due to Corona Virus disease 2019 (CoViD-19) pandemic, healthcare systems worldwide have been suffering in terms of their capability to manage affected people and the ability to provide standard treatment. Multiple vaccines have been developed and it is being implemented globally on a large scale. However, mutant strains of the virus are being detected from all parts of the world and pandemic and it’s associated concerns are continuing. With the majority of patients being asymptomatic and high infectivity, safety related concerns have been there both for patients as well as healthcare workers. Various academic associations have issued guidelines to address these issues. The authors aim to provide a comprehensive overview of essential measures that healthcare providers and surgeons adopted to ensure safe performance of both elective and emergency surgical procedures at their institute. Total of 506 patients underwent 512 general surgical elective and emergency procedures between 1st April 2020 to 31st December 2020 for different indications. The surgeries included both laparoscopic and open approaches. The strategies for preoperative testing for the presence of SARS nCov2 have been varying with availability of more evidence and techniques. For the initial six months, it was primarily RT PCR for both elective and emergency cases. However, in the last three months, the majority of the patients were tested for SARS nCov2 via RT PCR and emergency cases who were tested by CBNAAT Gene-Xpert. The pandemic has affected the patient care globally. Various guidelines have been issued by different academic associations. However, every institution has to improvise depending upon the local resources and infrastructure available. With continuing pandemic every institution shall require infrastructural changes to continue to deal with continuous inflow of infected patients.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79471170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacrocolpopexy's Progression and the Creation of Innovative Methods Using Natural Orifice Transluminal Endoscopic Surgery","authors":"T. Koythong, Xiao Ming","doi":"10.37421/1584-9341.2021.17.005","DOIUrl":"https://doi.org/10.37421/1584-9341.2021.17.005","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"42 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86257394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Note on Journal of Endocrine and Gynecologic","authors":"R. Chinnadorai","doi":"10.37421/1584-9341.2021.17.E036","DOIUrl":"https://doi.org/10.37421/1584-9341.2021.17.E036","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"39 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74445155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Note on Laparoscopic Surgery","authors":"N. Jayanthi","doi":"10.37421/1584-9341.2021.17.E035","DOIUrl":"https://doi.org/10.37421/1584-9341.2021.17.E035","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"3 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86075257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis","authors":"D. Feng, Luke Petschack, Georgia Marr, J. Gani","doi":"10.11648/J.JS.20200806.20","DOIUrl":"https://doi.org/10.11648/J.JS.20200806.20","url":null,"abstract":"Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (P<0.0001) in the ASU hospital and non-ASU hospitals respectively in patients with mild (Tokyo Grade I) disease. There was no difference between intraoperative cholangiogram rates between hospitals. The initial length of stay was on average 2.4 days shorter in the early ELC patients (MD=-2.4, 95% CI 1.3 to 3.4). The 2 Non-ASU hospitals varied significantly in ELC rates (19% and 48% P=0.0158), the hospital with the higher ELC rates shared senior surgical staff with the ASU hospital. Conclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"52 1","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79827466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Tract Lesions After Surgery for Gynecological Pelvic Cancers at the Conakry University Hospital","authors":"Koundouno Aly Mampan, Traoré Bangaly, C. Naby, Keita Mamady, Diakité Saikou Yaya, Camara Fode Lansana, Balde Abdoulaye Korse, Balde Oumar Taibata, D. A. Bobo, T. Aboubacar","doi":"10.11648/J.JS.20200806.19","DOIUrl":"https://doi.org/10.11648/J.JS.20200806.19","url":null,"abstract":"The aim of this study was to describe the urinary complications of surgery for gynecological pelvic cancers and their management at the university hospital in Conakry. Patients and methods: This was a descriptive multicenter study in the main surgical treatment services for gynecological pelvic cancer at the University Hospital of Conakry from 2007 to 2017. Results: Out of 22 cases collected, we found 10 (45.5%) cases during surgery and 12 cases of postoperative complications, including 8 (36.36%) early and 4 (18.18%) late. Direct suture on a ureteral probe in 3 cases and by reimplantation according to the Politano Leadbetter method in 2 cases. Laparotomy fistulorrhaphy was performed in 2 (9.1%) cases of VF. the Latzko technique for 6 (27.3%) other cases of FVV. The 2 cases of FUV were repaired by ureteral reimplantation according to the Lich-Gregoire method. In cases of stenosis, we proceeded to segmental resection followed by suturing on a ureteral probe. The morbidity consisted of: 2 cases of secondary VF, suppuration, 2 urinary incontinence, Operative mortality was 3 (13.6%) cases. Conclusion: The prevention of these lesions is the best way and requires a good knowledge of the anatomy and the surgical techniques. Early diagnosis of gynecologic pelvic cancer is necessary to minimize surgical risks.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"245 1","pages":"222"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76954409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}