European Surgical Research最新文献

{"title":"Microdialysis in Abdominal Organ Transplantation and the Potential for Integration with Dynamic Preservation Platforms and Post Transplant Monitoring.","authors":"Karim Hamaoui, Sally Gowers, Martyn Boutelle, Vassilios Papalois","doi":"10.1159/000535744","DOIUrl":"https://doi.org/10.1159/000535744","url":null,"abstract":"<p><p>The perpetual organ shortage crisis worldwide has meant a paradigm shift in global thinking with subsequent expansion of the accepted criteria for an organ donor to meet the demand. Robust pre-transplant organ viability assessment is the next great challenge in the field of transplantation today. Organ preservation in the nature of static cold storage has reached its limits, and machine perfusion both cold and warm offers theoretically superior preservation and the potential to assess organs. Microdialysis is a novel technique with proven ability to allow remote assessment of tissue biochemistry and metabolism. It has been used in various pre-clinical and clinical models of abdominal organ preservation and transplantation. This review focuses on the use of microdialysis in the assessment of the kidney, liver, and pancreas, and where this novel technology is heading in the context of the assessing organ viability prior to and after transplantation.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser speckle contrast imaging for intraoperative assessment of intestinal microcirculation in normo- and hypovolemic circulation in a porcine model","authors":"Rupan Paramasivam, Nickolai Malte Kristensen, R. Ambrus, Marie Stavsetra, Mai-Britt Ørntoft, Anders Husted Madsen","doi":"10.1159/000535525","DOIUrl":"https://doi.org/10.1159/000535525","url":null,"abstract":"Introduction: Healing is essential for successful colorectal surgery. Optimal microcirculation is needed to ensure this; however, this is only subjectively assessed by the surgeon. Laser Speckle Contrast Imaging (LSCI) is an objective non-contact, image-based method to quantify microcirculation in bowel ends. This study aimed to evaluate the application of LSCI in an open surgery porcine model, determine differences between normal and impaired microcirculation, and test the LSCI applicability to repeated measurements.\u0000Method: A midline laparotomy was made in ten healthy female pigs to expose the colon and small intestine. Subsequently, baseline measurements were conducted. A local arteria supplying the colonic or small intestine mesentery was clamped for 5 min. and LSCI measures were made again. After an hour’s rest, LSCI measurements were done in two unaffected areas on the colon and the small intestine, and baseline values were recorded. Hypotension was induced with rapid bleeding and LSCI measurements were done. After the mean arterial blood pressure (MAP) dropped to 50-60 mmHg, norepinephrine infusion was started. At a stable MAP of 85-100 mmHg, LSCI measurements were repeated at 0 min. and 30 min. during continuous norepinephrine infusion.\u0000Results: Cross-clamping caused LSCI levels to drop equally in both the colon and small intestine by 60% in the entire the clamped zone. Compared to baseline, the microcirculation measured by LSCI in the unclamped adjacent transition zone was diminished by 33% and 40%, colon and small intestines, respectively. During hypotension due to bleeding, LSCI decreased as expected. When MAP was stabilized by norepinephrine infusion, LSCI values dropped further: compared to baseline, measurements decreased with 24% and 20% in colon and small intestines, respectively.\u0000Conclusion: LSCI can be used as a quantitative, real-time, non-contact method to detect changes in the microcirculation during open intestinal surgery with large changes in microcirculation due to e.g., hypovolemic and norepinephrine infusion. It is simple to use and in contrast to the existing intraoperative microcirculation assessment techniques, LSCI stands out primarily for its elimination of the requirement for a dye. As our study has shown, this feature allows us to perform time-independent measurements and repeat them indefinitely in nearby regions without compromising the effectiveness of the method.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incisional Hernia Repair: Laparoscopy versus Open Surgery - A Prospective Study","authors":"LAMARA Abdelhak, BENYARABAH Saliha, GUADDA Mounir, BELHATEM Mohamed Salah, NINI Badereddine, BOUKHENE Mohamed, MEDJAHDI Sid Ahmed, NIBOUCHA Mohamed Lamine, Meriem Rayen LAMARA","doi":"10.33425/2689-1093.1056","DOIUrl":"https://doi.org/10.33425/2689-1093.1056","url":null,"abstract":"Objective: To assess the feasibility of laparoscopic incisional hernia repairs and to examine possible differences in operative time, morbidity, recurrence rates and length of hospital stay compared to repairs performed by open surgery. Patients: Between January 2016 and June 2019, sixty patients who underwent parietal repair were enrolled in this study. Patients were divided into two non-randomised groups. Data were collected prospectively and recorded in a database. The statistical analysis was performed using SPSS24 biomedical statistics software and Microsoft Excel. The statistical analysis was performed using the chi-two test, with calculation of the P value (Pearson test). Results: Thirty patients who underwent parietal repair by laparoscopic preperitoneal prosthesis placement (first group), and 30 patients who underwent open repair (2nd group). The two groups were comparable in terms of gender distribution and body mass index. No significant differences were observed in age and comorbidities between the two groups. In the first group, implantation of an intraperitoneal bifacial prosthesis was possible in 93.3% of patients. In the second group, the prosthesis was placed retromuscularly in 56.6% of patients and perifascial in 41% of patients. The conversion rate to open surgery was 6.6%. The average operating time was (81mn vs 92min). The complication rate was (26.6% vs 43.3%). The average length of hospital stay was 2 days 5.6 days. The recurrence rate at 3 years is (3.3% 6.6%; P< 0.05). Conclusion: The results of this study suggest that parietal repair by laparoscopic intraperitoneal prosthesis placement has some advantages over open surgery.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Traumatic Abdominal Surgical Emergencies in the Field of HIV: A Series of 22 Cases in the Visceral and Digestive Surgery Department of the Siguiri Prefectural Hospital","authors":"Mariama II Guirassy, Keita Doubany Mariame, Moussa Diakité, Nouhan Keita, Fofana Naby, Camara Naby Soriba","doi":"10.33425/2689-1093.1055","DOIUrl":"https://doi.org/10.33425/2689-1093.1055","url":null,"abstract":"Introduction: This study aimed to describe the epidemiological-clinical and therapeutic aspects of abdominal surgical emergencies on the ground of HIV in the department of visceral and digestive surgery of the prefectural hospital of Siguiri. Method: This was a descriptive prospective study which concerned patients operated on for abdominal surgical emergencies in the field of HIV, carried out in the visceral and digestive surgery department of the Siguiri prefectural hospital. Results: Out of a total of 88 cases of abdominal surgical emergencies operated on during our study, we collected 22 cases on HIV ground, i.e. 25%. The female sex dominated, including 14 women against 8 men, i.e. a sex ratio of 0.6 with an average age of 35 years. Miners were the most affected socio-professional layer, i.e. 31.80%, followed by traders and housewives, i.e. 27.30% each. HIV type I affected 77.27% against 22.73%. There were 41% of our patients who knew their serological status among which 66.66% were on ARV treatment and 33.33% were not on ARV treatment. The symptomatology was dominated by abdominal pain in 100% followed by fever in 77.27%. Appendicitis accounted for 40.09% followed by generalized acute peritonitis in 31.82%. The management was medico-surgical with pre-operative, intra-operative and post-operative resuscitation. The average length of hospitalization was 7 days. The postoperative course was favorable in 45.45%, we recorded 36.36% parietal suppuration and the mortality rate was 13.64%. Conclusion: Abdominal surgical emergencies in the field of HIV remain a major health problem in terms of care. The clinical pictures are dominated by acute appendicitis and generalized acute peritonitis.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PN HPT™ and Striae Albae-Exploratory Interim Analysis of a Randomised Prospective Study","authors":"Emanuele Bartoletti, Carmen De Luca, Laura Maioli, Leda Moro, Isabella Pia Palmieri, Simona Piscopo, Carolina Prussia, Ting Song Lim, Gloria Trocchi","doi":"10.33425/2689-1093.1057","DOIUrl":"https://doi.org/10.33425/2689-1093.1057","url":null,"abstract":"Introduction: The outcomes of striae albae remodelling are currently disappointing. Replenishing the fibroblast pool of nucleotide precursors through passive exposure to Polynucleotides Highly Purified Technology (PN HPT™) facilitates the dermal production of new fibres. The manuscript reports on the outcomes of a prospective study with an intradermal PN HPT™-based medical device. Methods: Intra-subject-controlled randomised real-world study to evaluate the efficacy and safety of a medical device containing 20 mg/mL of PN HPT™ (functional ingredient) intradermal gel as therapy for moderate-to-severe striae albae. Based on a preliminary sample size assessment, the study estimated the need to enrol at least 65 mature albae from 18-to-55-year-old male and female subjects seeking ambulatory treatment (mean age: 34.1 ± 10.65). Up to eight symmetrical striae albae in the target areas (breast, abdomen, buttocks, thighs) per enrolled subject underwent randomisation into the two parallel “PN HPT™ intradermal infiltration” active group and “no-treatment striae albae” intra-subject control group. Actively treated striae albae underwent a four-session intradermal therapy cycle with the PN HPT™ device. Comparative efficacy assessments, performed at the two final evaluation visits by independent evaluators: Width of actively treated and untreated control striae albae (digital calliper). Global Aesthetic Improvement Scale (GAIS) outcomes (by investigators and subjects, respectively; assessments on digital photographic documentation). Width and wrinkling of actively treated and control striae albae (quantitative Antera 3D CS skin imaging technology). Results: The digital-calliper-assessed width for the exploratory sample of the 44 actively treated striae albae (29 control striae) decreased, on average, from 4.6 ± 2.31 at the V1 baseline visit to 2.7 ± 1.42 at V5 (first follow-up visit) one month after the last PN HPT™ intradermal infiltration at V4 (–40.8% vs. baseline, p <0.01). In a subset of 17 striae (7 subjects), the mean digital-calliper-assessed width was still a significant 2.0 ± 0.94 at the final V6 follow-up visit, six months after V1 and three months after V4 (–54.5% vs control striae albae at V6, p <0.05). At the V5 assessment, three months after V1 and one month and a half after V4, investigators and treated subjects reported average GAIS scores of 3.8 ± 0.51 (median, 4.0) and 4.0 ± 0.66 (median, 4.0) out of 5.0 as GAIS maximum score for both. The occasional mild local pain and irritation at the injection site, expected and known in the previous PN HPT™ literature, were of no clinical significance and rapidly transitory. Discussion: PN HPT™ are an innovative option with a solid rationale for treating mature striae albae. The efficacy outcomes of PN HPT™ dermal infiltrations appear noteworthy, with excellent safety and ease of use, confirming the previous results. However, waiting for complete results and confirmation by other controlled studies is p","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Support for the Surgical Patient: The Experiences and Challenges, As Seen by Practitioners in Resource-Poor Setting","authors":"Rex Friday Ogoronte Alderton Ijah, Nkemsinachi M Onodingene, Linda U Iroegbu-Emeruem, Friday E Aaron, Michael Ogamba, Akpevweoghene D Maduka, Ibinabo Oboro","doi":"10.33425/2689-1093.1053","DOIUrl":"https://doi.org/10.33425/2689-1093.1053","url":null,"abstract":"Background: The input of laboratory medicine has no doubt improved surgical practice and will continue to impact positively on patient care. The aim of this study was to explore the experiences of practitioners and diagnostic challenges if any, encountered in the care of surgical patients in Port Harcourt in the last quarter of year 2022. Materials and Methods: A descriptive observational study was carried out among total population of consenting health workers (medical doctors, laboratory scientists / technologists, and technicians) in the Surgery and Diagnostic Services Departments in two teaching hospitals in Port Harcourt, using self-administered questionnaires. Data on experiences and challenges was analysed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The respondents had a male to female ratio of 1.3:1, mean age of 35.47 ± 8.44 years, mean years in practice of 7.58 ± 6.97 years, and 171 (98.3%) were Christians. One hundred and sixteen (66.7%) respondents were aware of delay in diagnostic services, in varying degrees. Lack of reagents (49 = 28.2%), inadequate personnel (18 = 10.3%), long processing time (15 = 8.6%) and poor electric power supply (9 = 5.2%) were the most common reasons for delay in diagnostic test results. Diagnostic challenges were highlighted, occurrence of medico-legal issues was reported, and solutions proffered. Conclusion: The professionals practicing in the diagnostic / surgical departments were aware and do experience delays in diagnostic test results and errors (reported by a few) that affects surgical services in our environment. Their experiences and challenges were highlighted and recommendations were made.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135802909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acne Scars, Stretch Marks, and Similar Skin Defects Qualify as Medical Problems. A Real-World Survey on a Hyaluronic Acid Medical Device","authors":"Lucia Cimarra","doi":"10.33425/2689-1093.1052","DOIUrl":"https://doi.org/10.33425/2689-1093.1052","url":null,"abstract":"Introduction: Beyond impacting the quality of life, unpleasant stretch marks, skin aging, the dermal scars secondary to acne and chickenpox, and wrinkles expose those harboring these skin defects to psychiatric problems like anxiety, depression, ADHD, and insomnia more often than one might suspect. Remodeling skin scarring and supporting the deteriorated networks of dermal elastic fibers also have medical value. The moisturizing properties and skin-protective scavenger action against free radicals rapidly developed by non-cross-linked hyaluronic acid offer a powerful rationale to help with those problems. Methods: The study focused on a survey questionnaire administered by the investigators to a prospective cohort of 45 subjects of both genders with stretch marks, dermal scars, and skin aging. Before the survey, all individuals had undergone a three-session treatment cycle with a Class-III CE-marked medical device containing 40 mg of non-cross-linked HA in 2-mL prefilled disposable syringes with 30G½ needles (IALEST®, Mastelli Srl, Sanremo, Italy). The primary observational efficacy assessment tool was the six-score Wrinkle Severity Rating Scale (WSRS); the secondary efficacy assessment tool was the five-score Global Aesthetic Improvement Scale (GAIS). Timing of WSRS and GAIS assessments: at baseline (T0), before the first intradermal treatment session, and three to four weeks after T2 (end of the treatment cycle). Results: The mean WSRS scores for skin quality significantly improved between the T0 baseline visit (2.8 ± 1.17) and the T2 final follow-up visit (1.6 ± 1.09; –42.9%, p <0.001). The cohort distribution of the GAIS skin quality descriptors assessed by the investigators improved by one severity level in 66.7% of surveyed subjects, two severity levels in 20.0%, and four levels in 2.2%. Only a tiny cohort minority (2 individuals out of 45, 4.4%) reported no subjective improvement in skin quality. Among surveyed participants, 95.6% reported a clinically meaningful skin quality improvement. The device safety was high. Conclusions: The real-world survey, performed within the framework of a long-term program to monitor the device’s clinical performance and safety over time, demonstrated that the HA-based medical device retains its long-standing record of efficient performance and excellent safety with no variations over time.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135802907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Surgical Patient and Nursing Care in a Low-Income Setting: Challenges and Way Forward","authors":"Rex Friday Ogoronte Alderton Ijah, Linda U Iroegbu-Emeruem, Mary Obidiya Okuku, Nwizor Monday Nkadam, Victoria Amagboruju","doi":"10.33425/2689-1093.1054","DOIUrl":"https://doi.org/10.33425/2689-1093.1054","url":null,"abstract":"Background: The newly developed Nigerian addition to the universal health coverage has surgery, obstetrics, anesthesia, and nursing as components of the plan. This study evaluated the challenges in the nursing care of the surgical patient in two public Teaching Hospitals in Port Harcourt, Nigeria. Materials and Methods: A cross sectional descriptive study was conducted among total population of consenting Nurses and Medical Doctors at the Surgery Departments two public Teaching Hospitals, using semi-structured selfadministered questionnaire. Data obtained was entered into Microsoft Excel Spreadsheet / Statistical Package for the Social Sciences, and formed into tables. Results: There were 67(26.1%) male and 190 (73.9%) female respondents. The mean age of respondents was 37.63 ± 10.22 years. The mean years in practice was 11.05 ± 9.26 years. One hundred and forty-nine (58.0%) of the respondents were nurses. Most challenging nursing issues were giving intravenous fluids according to schedule (75 = 29.2%), wound dressing (73 = 28.4%), inadequate equipment and manpower (51 = 19.8%), administration and charting of intravenous fluids (26 = 10.1%), and drug administration (26 = 10.1%). The most challenging surgeon / doctor-related issues was poor staff interpersonal relationship (103 = 40.1%) followed by poor supervision of the surgical team (97 = 37.7%). Conclusion: The challenges of nursing the surgical patient in our setting are of multiple origin. Administrative issues of inadequate employment of manpower and its multiplier effects are reported along with patient-related and health professional issues.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135802908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Pages","authors":"","doi":"10.1159/000529176","DOIUrl":"https://doi.org/10.1159/000529176","url":null,"abstract":"<br />Eur Surg Res 2023;64:1–4","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject Index Vol. 64, No. 1, 2023","authors":"","doi":"10.1159/000529175","DOIUrl":"https://doi.org/10.1159/000529175","url":null,"abstract":"","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44004680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}