Frontiers in Surgery最新文献

{"title":"Advancements in facial implantology: a review of hydroxyapatite applications and outcomes","authors":"Martin Kauke-Navarro, Leonard Knoedler, Samuel Knoedler, Ali Farid Safi","doi":"10.3389/fsurg.2024.1409733","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1409733","url":null,"abstract":"BackgroundThe search for an ideal bone substitute in reconstructive surgery has led to the exploration of various materials, with hydroxyapatite (HaP) emerging as a promising candidate due to its biocompatibility, osteoconductive properties, and structural similarity to human bone. Despite its potential, there is a paucity of data on the long-term safety and efficacy of HaP in facial skeletal reconstruction and augmentation.MethodsWe conducted a systematic review following PRISMA 2020 guidelines, searching PubMed/MEDLINE, Google Scholar, CENTRAL, and Web of Science databases for studies on hydroxyapatite facial implants in reconstruction and augmentation.ResultsOur search yielded 12 studies that met our inclusion criteria, encompassing 74 patients treated with HaP implants for various indications including facial fractures/defects, aesthetic facial balancing, and after tumor resection. The studies reported on outcomes such as implant integration, complications, aesthetic results, and patient satisfaction, with a general trend indicating positive outcomes for the use of HaP in facial reconstruction.ConclusionHydroxyapatite appears to be a viable and effective material for facial skeletal reconstruction and augmentation, offering benefits in terms of biocompatibility, osteoconductivity, and patient outcomes. However, limitations such as low mechanical strength and the need for further research on long-term safety and efficacy were identified. This review underscores the potential of HaP in craniofacial surgery while highlighting areas for future investigation.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745283","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":"Initial experience of ureteric visualization using methylene blue during laparoscopy for gynecological surgery","authors":"Ruyu Shao, Faquan Shen, Hooman Soleymani majd, Xiaoqing Qin, Desheng Yao, Ying Long, He Wang, Yousheng Wei, Xin Chang","doi":"10.3389/fsurg.2024.1387038","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1387038","url":null,"abstract":"ObjectivesIatrogenic ureteral injury is a severe surgical complication, with a highest incidence of 1.5% in gynecological surgeries. The purpose of this report is to document our initial experience with using methylene blue (MB) to label the ureter in gynecological laparoscopic surgeries and to explore its effectiveness and safety. This is also a novel description of simultaneously visualizing ureteral MB fluorescence and sentinel lymph nodes (SLN's) Indocyanine Green (ICG) fluorescence using the same camera.MethodsThis study included patients undergoing gynecological laparoscopic surgeries, with the same surgeon performing all cases. During the early stages of each surgery, rapid intravenous infusion of MB was administered. For cases requiring SLN imaging, we also injected ICG solution into the cervix. Assessment of the included cases was conducted both intraoperatively and postoperatively. The group that had MB fluorescence (Group A) was compared to a control group that did not have it (Group B).ResultsA total of 25 patients (Group A) received MB during surgery, demonstrating 45 ureters clearly, with an imaging success rate of 90%. Continuous and clearer fluorescence imaging was achieved in cases with ureteral hydronephrosis. In most patients, ureteral fluorescence was visible 15–20 min after intravenous infusion of MB, and 64% still exhibited fluorescence at the end of the surgery. In patients who had both ICG and MB, dual fluorescence imaging was achieved clearly. Among the included cases, there were no iatrogenic ureteral injuries (0%), which we observed to be lower than in patients who did not receive MB (1.3%). The rate of adverse events was similar in both groups.ConclusionUsing MB fluorescence is an effective and safe method of visualizing the ureters during gynecological surgeries, and can diminish iatrogenic ureteral injury without increased associated adverse events. It therefore may offer promising prospects for clinical application.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745441","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":"Case Report: Atypical visual presentation caused by a large convexity meningioma—a nerve stretching and stalk indentation effect","authors":"Chia-Hsun Chiu, Ko-Ting Chen","doi":"10.3389/fsurg.2024.1399163","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1399163","url":null,"abstract":"Visual field defects are commonly present in patients with brain tumors, particularly due to direct compression on the optic apparatus. However, there are instances where brain tumors, despite not directly compressing the optic pathway, can still cause visual symptoms, albeit rarely reported but not uncommonly observed. These mechanisms are thought to be associated with increased intracranial pressure (IICP). We report a case of a 32-year-old man who presented with right blurred vision and was diagnosed with a right convexity meningioma. Upon reviewing his magnetic resonance images, we hypothesized that the indentation of the pituitary stalk on the optic chiasm and the stretching of the optic nerve, combined with a focal effect of IICP, could be responsible for his atypical visual field defect.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745442","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 application of gradually expanding pedicle technology in the placement of screws in thinner pedicle of patients with idiopathic scoliosis","authors":"Fei Chen, Jianyi Li, Tao Li, Yongming Xi","doi":"10.3389/fsurg.2024.1388534","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1388534","url":null,"abstract":"ObjectiveTo propose a technique of gradual expansion of pedicle diameter to place screws on the thinner pedicle that is difficult to place screws in scoliosis orthopedic surgery, in order to place thicker pedicle screws in the premise of good safety to achieve good stability and orthopaedic effect.MethodsThe authors reviewed that 36 patients with Adolescent idiopathic scoliosis (AIS) (20 females, 16 males) in our department from June 2020 to March 2024 underwent posterior spinal correction and internal fixation were enrolled in the present study. 194 pedicles had narrower diameter ranging from 0 mm to 4.5 mm. After analysis, 155 pedicles (internal diameter: 2.5 mm–4.5 mm) were treated with gradually expanding pedicles technology. The angle between the inserted screws and the upper endplate of the vertebral body was measured 1 week after operation and 3 months after operation to evaluate the placement of the screws after pedicle expansion.ResultsAll operations were completed without dura mater rupture, nerve root injury, infection and poor incision healing. There was no screw breaking or screw pull-out in DR film at 3 months after operation compared with 1 week after operation. There was no significant difference in the angle between screw and upper endplate measured by the three observers at 3 months and 1 week after operation (Wilcoxon's signed rank test, <jats:italic>p</jats:italic> &amp;gt; 0.05). In the measurement at 1 week or 3 months after operation, there was no statistically significant difference among the three observers. There is a good consistency between the observers (Cronbach's alpha &amp;gt; 0.80).ConclusionIn AIS patients, the thinner pedicle with a diameter range of 2.5 mm to 4.5 mm can be safely inserted with relatively thicker pedicle screws after gradually expanding pedicle technology.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745439","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":"Rebuilding strength: surgical intervention and rehabilitation for bilateral spontaneous quadriceps tendon rupture—a case report","authors":"Huaize Dong, Jin Yang, Hao Yu, Jinsong Zhu, Jibin Yang","doi":"10.3389/fsurg.2024.1430774","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1430774","url":null,"abstract":"The quadriceps tendon, crucial for body movement, is among the body's strongest tendons. Factors like diabetes or hormone use can weaken it, making even minor trauma potentially causing rupture. Bilateral spontaneous quadriceps tendon rupture, where both tendons tear simultaneously, is rare. Prompt diagnosis and treatment are crucial. We present a case of a 44-year-old woman who experienced bilateral rupture after falling while doing chores. She had immediate pain and limited knee movement. Diagnosis via physical examination and CT/MRI scans confirmed the rupture. Surgical repair followed by rehabilitation led to significant pain reduction and improved function within two months. Overall, her postoperative outcome was satisfactory. This study underscores the importance of clear diagnosis, timely surgery, and thorough rehabilitation for optimal patient recovery from bilateral quadriceps tendon rupture.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745443","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":"Comparison of the clinical effect of unilateral transverse process extrapedicular and bilateral transpedicular percutaneous kyphoplasty for thoracolumbar osteoporotic vertebral compression fracture","authors":"Dingli Xu, Chaoyue Ruan, Yang Wang, Xudong Hu, Weihu Ma","doi":"10.3389/fsurg.2024.1395289","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1395289","url":null,"abstract":"BackgroundOsteoporosis vertebral compression fractures (OVCF) are common with the aging process. This study aimed to compare the effects of unilateral transverse process extrapedicular (UEPKP) and bilateral transpedicular percutaneous kyphoplasty (BTPKP) for patients with thoracolumbar OVCF.MethodsData from 136 patients with OVCF treated with single-level PKP in our hospital between May 2019 and April 2021 were studied. Patients were grouped based on surgical procedure: there were 62 patients in the UEPKP group and 74 in the BTPKP group. All clinical and radiological data were collected from medical records. Clinical outcomes, including visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores of the lumbar spine, were evaluated preoperatively, postoperatively, and at the follow-up visit. The radiological evaluations (anterior vertebral height rate and local kyphosis angle) and complications were also collected.ResultsAll patients had successfully improved after surgery. In the UEPKP group, patients showed a significantly shorter operating time and lower fluoroscopy frequency than patients in the BTPKP group (<jats:italic>p</jats:italic> &amp;lt; 0.05). However, a significantly better distribution score and cement volume were found in the BTPKP group (<jats:italic>p</jats:italic> &amp;lt; 0.05). The UEPKP group achieved a significantly better VAS score (0.6 ± 0.5 vs. 0.9 ± 0.8) and ODI (24.7 ± 3.1 vs. 27.5 ± 1.8) at the final follow-up visit than the BTPKP group (<jats:italic>p</jats:italic> &amp;lt; 0.05). The UEPKP group showed significantly worse radiological outcomes (anterior height rate and local kyphosis angle) at the 6- and 12-month follow-ups (<jats:italic>p</jats:italic> &amp;lt; 0.05). As for complications, the UEPKP group showed significantly fewer facet joint violations and intraspinal leakages (<jats:italic>p</jats:italic> &amp;lt; 0.05).ConclusionUEPKP could be a safe and effective alternative procedure for patients with thoracolumbar osteoporotic vertebral compression fracture, which possesses an apparent advantage in reducing intraspinal leakage and facet joint violation over BTPKP.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745444","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":"Editorial: Minimally invasive pediatric surgery: how to improve and overcome limitations","authors":"E. Bindi, Gabriele Lisi, G. Lauriti, Giovanni Cobellis","doi":"10.3389/fsurg.2024.1446901","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1446901","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831302","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":"Comparative analysis of the degree of patient satisfaction after breast-conserving surgery with or without oncoplastic surgery: systematic review and meta-analysis","authors":"Fabiana Christina Araújo Pereira Lisboa, Lucimara Priscila Campos Veras Giorgi, Ana Claudia Morais Godoy Figueiredo, Régis Resende Paulinelli, João Batista de Sousa","doi":"10.3389/fsurg.2024.1396432","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1396432","url":null,"abstract":"IntroductionConservative surgery is the gold standard for the treatment of single and small tumors and, combined with the concept of oncoplastic tumors, brings good aesthetic results while maintaining cancer safety. The objective was to comparatively analyze the degree of satisfaction of patients undergoing breast conserving surgery (BCS), with and without oncoplastic surgery (OPS) using level II OPS techniques.MethodsReview with a search in the databases MEDLINE (by PubMed), EMBASE, Clinical Trials, Scopus, Web of Science, BVS and Oppen gray. The meta-analysis of random effects was performed using the Der Simonian-Laird method considering the odds ratio (OR) with a 95% confidence interval (95% CI).ResultsThere was no statistically significant difference in the aesthetic outcome between women who underwent OPS and BCS (OR 0.90; 95% CI 0.62–1.30). The staging (OR 1.93; 95% CI 0.97–3.84; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 15.83%); tumor location [central (OR 1.28; 95% CI 0.06–27.49; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 17.63%); lower (OR 0.75; 95% CI 0.21–2.65; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 2.21%); superior (OR 0.67; 95% CI 0.26–1.74; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0.00%] and tumor size (OR 8.73; 95% CI −11.82–29.28; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 93.18%) showed no association with the type of BCS performed, with or without OPS. The degree of satisfaction remains even in cases of extreme oncoplasty.ConclusionThe level of patient satisfaction in relation to BCS was similar to that of the group undergoing OPS, highlighting that OPS allows the patient's satisfaction rate to be maintained even in the case of large or multicentric tumors.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745445","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":"Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation","authors":"İlkay Işıkay, Efecan Çekiç, Baylar Baylarov, Osman Tunç, Ş. Hanalioğlu","doi":"10.3389/fsurg.2024.1427844","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1427844","url":null,"abstract":"Recent advances in medical imaging, computer vision, 3-dimensional (3D) modeling, and artificial intelligence (AI) integrated technologies paved the way for generating patient-specific, realistic 3D visualization of pathological anatomy in neurosurgical conditions. Immersive surgical simulations through augmented reality (AR), virtual reality (VR), mixed reality (MxR), extended reality (XR), and 3D printing applications further increased their utilization in current surgical practice and training. This narrative review investigates state-of-the-art studies, the limitations of these technologies, and future directions for them in the field of skull base surgery. We begin with a methodology summary to create accurate 3D models customized for each patient by combining several imaging modalities. Then, we explore how these models are employed in surgical planning simulations and real-time navigation systems in surgical procedures involving the anterior, middle, and posterior cranial skull bases, including endoscopic and open microsurgical operations. We also evaluate their influence on surgical decision-making, performance, and education. Accumulating evidence demonstrates that these technologies can enhance the visibility of the neuroanatomical structures situated at the cranial base and assist surgeons in preoperative planning and intraoperative navigation, thus showing great potential to improve surgical results and reduce complications. Maximum effectiveness can be achieved in approach selection, patient positioning, craniotomy placement, anti-target avoidance, and comprehension of spatial interrelationships of neurovascular structures. Finally, we present the obstacles and possible future paths for the broader implementation of these groundbreaking methods in neurosurgery, highlighting the importance of ongoing technological advancements and interdisciplinary collaboration to improve the accuracy and usefulness of 3D visualization and reality technologies in skull base surgeries.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643372","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":"Frontiers | Long-term obstetric, perinatal, and surgical complications in singleton pregnancies following previous cesarean myomectomy: a retrospective multicentric study","authors":"Oğuz Güler, Şafak Hatırnaz, Radmila Sparic, Alper Basbug, Onur Erol, Üzeyir Kalkan, Hasan Ulubaşoğlu, Giuseppe Trojano, Sebati Sinan Ürkmez, Andrea Tinelli","doi":"10.3389/fsurg.2024.1430439","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1430439","url":null,"abstract":"ObjectivesThe safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques.Material and methodsThis retrospective multicentric case–control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted.ResultsThere was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS (p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus (p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization (p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups.ConclusionThis study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870160","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}