International journal of surgery最新文献

{"title":"Relationship between post-ablation fever and prognosis in initial hepatocellular carcinoma: A 15-year multicenter, retrospective cohort study.","authors":"Qian Cai, Chuan Pang, Zhen Wang, Jianming Li, Yuqing Dai, Fang-Ying Fan, Zhong-Qi Wang, Xin Hu, Lijuan Li, Xu-Wei Chen, Ran Ji, Qian Mei, Chao Zhang, Ping Liang, Xiaoling Yu, Fang-Yi Liu, Zhigang Cheng, Jie Yu","doi":"10.1097/JS9.0000000000002066","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002066","url":null,"abstract":"<p><strong>Background: </strong>Fever is a common side effect following thermal ablation in patients with hepatocellular carcinoma (HCC), yet its impact on prognosis remains unclear.</p><p><strong>Materials and methods: </strong>This retrospective study included initial HCC patients who underwent US-guided percutaneous microwave ablation at 13 hospitals between January 2006 and February 2021. All patients were categorized into afebrile, transient low-grade fever (TLF), and prolonged or high-grade fever (PHF) groups. Primary outcomes included very early recurrence (VER) and early recurrence (ER), secondary outcomes were disease-free survival (DFS) and overall survival (OS). Fever cut-offs for VER/ER were established using restrictive cubic splines and adjusted Cox model. Survival analyses used the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 1458 initial HCC patients (mean age, 59±11[SD]; 1146 men). Compared to afebrile individuals, patients with TLF (temperatures ranging 37.0-38.8°C for 1-2 d), showed independent protective effects against VER (HR, 0.73; 95% CI: 0.57,0.95; P=0.02) and ER (HR, 0.66; 95% CI: 0.54,0.81; P<0.001), however, PHF showed no differences in VER (HR, 0.99; 95% CI: 0.76,1.30; P=0.96) and ER (HR, 0.86; 95% CI: 0.69,1.07; P=0.17). With a median follow-up of 47 months (IQR:26-79), the median DFS for TLF patients was 40 months, superior to afebrile (30 mo, P=0.019) and PHF patients (33 mo, P=0.049). The 5-year OS rate for TLF patients was 73.2%, higher than afebrile (69.3%, P=0.02) and PHF patients (66.7%, P=0.03). No significant difference was found in DFS and OS between afebrile and PHF patients (P=0.90 and 0.71). Notably, TLF patients exhibited the highest lymphocyte counts increasing median 7 days after ablation (P<0.001 vs. afebrile and P=0.01 vs. PHF).</p><p><strong>Conclusion: </strong>Transient low-grade fever following percutaneous microwave ablation in hepatocellular carcinoma patients demonstrated protection against early recurrence, possibly attributed to the short-term activation of lymphocytes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epineurectomy of extracranial facial nerve trunk for non-flaccid sequelae following Bell's palsy: A single-arm trial.","authors":"Hua Zhao, Xiaomin Cai, Zhongding Zhang, Tingting Ying, Yinda Tang, Haopeng Wang, Baimiao Wang, Shiting Li","doi":"10.1097/JS9.0000000000002080","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002080","url":null,"abstract":"<p><strong>Background: </strong>Non-flaccid facial palsy sequelae manifest as sequelae following Bell's palsy. Currently, there are no effective remedies for addressing this issue. In this study, we proposed a new surgical solution, epineurectomy of the extracranial facial nerve trunk, and assessed its safety and efficacy as a potential remedy..</p><p><strong>Methods: </strong>In this single-arm trial, adult patients with non-flaccid facial palsy sequelae were enrolled and subjected to epineurectomy of the extracranial facial nerve trunk. The primary efficacy endpoint was the Sunnybrook scores at months 12 postoperatively. The secondary endpoints included non-flaccid facial palsy sequelae symptom scores, such as facial tightness or facial stiffness, facial synkinesis, eyefissures narrowing or difficulty in opening the eyes, House-Brackmann grade scale, and Facial Disability Index.</p><p><strong>Results: </strong>A total of 22 patients were enrolled between July 2020 and January 2021. One patient was lost to follow up. One year after surgery, the Sunnybrook score was 72.0 (63.0 - 75.0) at 12 months versus 68.0 (58.0 - 70.8) at baseline. The mean difference was -5.4 (-7.2 to -3.6). The scores of facial tightness or facial stiffness, synkinesis, eye fissures narrowing or difficulty in opening eyes were 0.0 (0.0 - 1.0), 1.0 (1.0 - 1.0), 1.0 (1.0 - 2.0) at 12 months versus 3.0 (1.3 - 3.0), 2.0 (1.0 - 2.8), 2.0 (2.0 - 3.0) at baseline, respectively. The median (IQR) values of the Facial Disability Index physical function were 92.0 (90.0 - 95.0) at months 12, and the mean difference (95% CI) was -32 (-38 to -26) compared to baseline. The mean difference (95% CI) in the Facial Disability Index social/well-being function between month 12 and baseline was -38 (-46 to -31).</p><p><strong>Conclusions: </strong>Epineurectomy of the extracranial facial nerve trunk can effectively and safely alleviate the sequelae of non-flaccid facial palsy.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative tissue analysis reveals AK2, COL1A1, & PLG protein signatures: Targeted therapeutics for meningioma.","authors":"Swati Sharma, Shamjetsabam Nandibala Devi, Kirti Chauhan, M H Yashavarddhan, Poonam Gautam, Prem Prakash, Priyanka Choudhary, Satnam Singh Chhabra, Rajesh Acharya, Samir Kumar Kalra, Anshul Gupta, Sunila Jain, Nirmal Kumar Ganguly, Rashmi Rana","doi":"10.1097/JS9.0000000000002054","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002054","url":null,"abstract":"<p><strong>Background: </strong>Meningioma is the most prevalent primary intracranial brain tumor and accounts for one-third of all CNS tumors. Meningioma is known to be the most common yet life-threatening brain tumor with a higher recurrence rate. Globally, there is an increase in the healthcare burden due to meningioma and hence in its research. The present clinical approach includes surgical resection, chemotherapy, and radiation therapies to which the malignancy does not seem to respond efficiently. Targeted therapies and molecular markers provide elite patient treatment and care for individuals suffering from meningiomas as compared to conventional measures. Although there is proteomic data on meningioma the knowledge of potential biomarkers differentiating the grades is scarce. To identify the best set of biomarkers, validation of reported markers in large and independent sample cohorts in the future is necessary.</p><p><strong>Methods: </strong>A total of 12 samples, 3 each of control (which made pool 1) Meningioma grade I (which made 2 sets: pool 2 and pool 3), and Meningioma grade II (which made pool 4) were taken for LC-MS/MS. After this, the expression of three proteins was checked by immunocytochemistry, flow cytometry, and western blotting.</p><p><strong>Results: </strong>Protein expression was analyzed using various techniques like mass spectrometry, immunocytochemistry, flow cytometry, and western blotting. Mass spectrometry is the most commonly used standard and reliable technique for identifying and quantifying protein expression. We got three highly upregulated proteins namely AK2, COL1A1, and PLG using this technique. The biomarker potential of these proteins was further checked by ICC, western blotting, and flow cytometry. Three important proteins were found to be upregulated namely AK2 (Adenylate Kinase 2), COL1A1 (Collagen 1A1), and PLG (Plasminogen). The order of increased protein expression was control < MG grade I < MG grade II according to mass spectrometry and western blotting. In immunocytochemistry, we found that COL1A1 expression increases significantly with grades in comparison to control. Similarly, AK2 and PLG also showed little increase but not as much as COL1A1. In flow cytometry, PLG showed higher upregulation in grades than control. While AK2 and COL1A1 showed little increase in expression in grades than control. All techniques, especially mass spectrometry and western blotting presented higher expression of these proteins in grades as compared to control.</p><p><strong>Conclusions: </strong>In the quest to find a suitable therapeutic marker, this study incorporates quantitative labeling and detection followed by flow cytometry, Immunocytochemistry, and western blotting for early diagnosis and treatment of meningioma. The article further explores the efficacy of some proteins namely AK2, COL1A1 & PLG to be the targeted molecules.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 characteristics, management and clinical outcome of blood blister-like aneurysms treated with flow diverter devices: a systematic review and meta-analysis of 30 studies.","authors":"Dianshi Jin, Zheming Zhang, Xin Su, Guoliang Li","doi":"10.1097/JS9.0000000000002072","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002072","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aim: &lt;/strong&gt;Because of relatively little data for blood blister-like aneurysms (BBAs) treated with flow diverter (FD) devices, existing studies failed to provide comprehensive analysis for the characteristics, management, clinical outcome of the disease. Therefore, we collected and analyzed current evidence aiming to provide quantitatively pooled results for the management, complication, clinical and angiographic outcomes as well as the risk factors of prognosis of BBAs treated with FD devices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, SCOPUS, Cochrane Library and Web of Science up to May 1, 2024 was conducted for relevant studies. The primary outcomes were to expound the management, characteristics and clinical outcomes of BBAs treated with FD devices. The secondary outcomes were to determine the difference of characteristics and outcomes, as well as risk factors of BBAs treated with FD devices. Two reviewers assessed trial quality and extracted the data independently. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2 and Stata 12.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 30 reports with 311 of 783 BBA patients were identified. The pooled results indicated that 76.3% BBAs located in internal carotid artery (ICA) and 85% and 84% patients experienced complete occlusion and modified Rankin scale (mRS) score 0-2 respectively at follow-up time. Female BBAs patients (69.9%) were more prevalent and 88.5% patients experienced a favorable outcome at discharge. The overall and periprocedural complications account for 16.8% and 9.1% respectively. The pooled results showed that the incidence of complete occlusion was 50% (95% CI: 31%－69%), 80% (95% CI: 67%－92%) and 84% (95% CI: 77%－91%) at immediate, short and longterm angiographic results respectively. In addition, the favorable, moderate and poor clinical outcomes evaluated with mRS were 89% (95% CI: 85%－94%), 13% (95% CI: 5%－21%), and 8% (95% CI: 3%－13%) respectively. We found that compared to moderate or poor outcomes, patients with good outcomes experienced significantly lower preoperative scores (MD -1.24; 95% CI -1.94－-0.53), more complete occlusion (OR 5.17; 95% CI 1.26－21.15) and less complications (OR 0.20; 95% CI 0.08－0.47) respectively. It was observed that patients experienced a complication had higher onset Hunt-Hess scale (MD 0.49; 95% CI 0.03－0.96) and Fisher's score (MD 1.43; 95% CI 0.72－2.13) respectively. Patients with good outcomes experienced younger age (MD -5.76 years; 95% CI -11.31－-0.21) and lower onset Hunt-Hess scale (MD -0.96; 95% CI -1.45－-0.47) respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;BBA was middle-aged female predominant and common in ICA. The majority of patients generally experienced favorable outcome with low incidence of periprocedural complications. In addition, good outcomes benefited from lower preoperative scores, more complete occlusion, less c","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the feasibility of preoperative tumor-bed boost, oncoplastic surgery, and adjuvant radiotherapy schedule in early-stage breast cancer: A phase II clinical trial.","authors":"Hao Dong, Hao Jing, Xiang-Yu Wang, Xiang-Yi Kong, Yi-Peng Wang, Yi-Rui Zhai, Shu-Nan Che, Yi Fang, Shu-Lian Wang, Jing Wang","doi":"10.1097/JS9.0000000000002073","DOIUrl":"10.1097/JS9.0000000000002073","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast-conserving surgery (OBCS) improves satisfaction in patients who would fare otherwise sub-optimal cosmetic outcome, while brings challenge in tumor-bed identification during adjuvant radiotherapy. The ultra-hypofractionated breast radiotherapy further shortens treatment sessions from moderately hypofractionated regimens. To circumscribe the difficulty in tumor-bed contouring and the additional toxicity from larger boost volumes, we propose to move forward the boost session preoperatively from the adjuvant radiation part. Thus, the present study aims to evaluate the feasibility of a new treatment paradigm of preoperative primary-tumor boost before breast-conserving surgery (BCS) or OBCS followed by adjuvant ultra-hypofractionated whole-breast irradiation (u-WBRT) for patients with early-stage breast cancer.</p><p><strong>Methods: </strong>There was a phase II study. Patients younger than 55 years old, with a biopsy confirmed mono-centric breast cancer, without lymph node involvement were enrolled. Preoperative primary-tumor boost was given by a single 10 Gy in 1 fraction, and BCS or OBCS was conducted within two weeks afterwards. Adjuvant u-WBRT (26 Gy/5.2 Gy/5 f) was given in 6 weeks postoperatively without any boost, after the full recovery from surgery. Surgical complications and patient-reported outcomes, as assessed via Breast-Q questionnaires, were documented. A propensity score matching approach was employed to identify a control group at a 1:1 ratio for BREAST-Q outcomes comparison.</p><p><strong>Results: </strong>From May 2022 to September 2023, 36 patients were prospectively enrolled. Surgical complications were observed in 7 cases (19.4%), including 3 cases with Clavien-Dindo (CD) grade 1-2 and 4 cases with CD grade 3 complications. All but four patients (11.1%) started the planned u-WBRT within one week after the pre-defined due dates postoperatively (≤49 d). Four patients (11.1%) developed grade 2 radiodermatitis after chemotherapy initiation. Compared to the study group, the control patients reported higher scores in chest physical well-being ( P =0.045) and in their attitudes towards arm swelling ( P =0.01). No significant difference was detected in the other of domains (Satisfaction with Breasts, Sexual and Psychosocial Well-Being, and Adverse Effects of Radiation). With a median follow-up period of 9.8 months (2.4-18.9 mo), none had any sign of relapse.</p><p><strong>Conclusion: </strong>This Phase II clinical trial confirmed the technical and safety feasibility of novel radiation schedule in patients undergoing BCS or OBCS. According to the BREAST-Q questionnaire, patients who underwent novel radiation schedules reported lower satisfaction in chest physical well-being. A randomized controlled trial is necessary to further investigate these findings. Additionally, long-term follow-up is required to assess oncological outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational cohort study on safety and efficacy of robotic thyroidectomy with super-meticulous capsular dissection versus open surgery for thyroid cancer: Postoperative dynamic risk assessment of radioactive iodine therapy.","authors":"Xiangquan Qin, Yufan Zhang, Jia Luo, Lingjuan Zeng, Xia Liu, Ting Zhang, Lin Ren, Linjun Fan, Dingde Huang","doi":"10.1097/JS9.0000000000002071","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002071","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and safety of robotic thyroidectomy (RT) with super-meticulous capsular dissection (SMCD) versus open thyroidectomy (OT) we used a dynamic risk assessment system incorporating 131I-WBS along with radioactive iodine (RAI) efficacy evaluation.</p><p><strong>Background: </strong>Currently, the therapeutic efficacy of robotic surgery remains controversial. The 131I whole-body scan (131I-WBS) dynamic risk assessment system can detect small residual thyroid tissues and lesions, which may be used as indicators for the surgical efficacy of RT or OT thyroidectomy in differentiated thyroid cancer (DTC).</p><p><strong>Methods: </strong>This retrospective cohort study included 2,349 patients who underwent total thyroidectomy followed by RAI therapy in our department between August 2017 and June 2023. Propensity score matching was performed at a ratio of 1:3 based on surgical type and mean follow-up duration to minimize selection bias after excluding those lost to follow-up. The primary outcome was surgical completeness, assessed using a dynamic risk system incorporating 131I-WBS along with RAI efficacy evaluation.</p><p><strong>Results: </strong>There was no significant difference in the number of metastatic lymph nodes removed between the two groups (P=0.45). The incidence rate of parathyroid gland transplantation was 395 (68.7%) in the OT group and 8 (3.8%) in the RT group (P<0.001). There were no differences in the thyroidectomy completeness based on the 3-hour iodine uptake rate and 99mTcO4- thyroid imaging between the two groups. The dynamic risk assessment with and without 131I-WBS showed significant differences (P<0.001). The postoperative and post-RAI dynamic risk scores, evaluated at the time of RAI and 6 months after RAI, did not differ significantly between the two groups (P>0.05). The rates of transient and permanent hypoparathyroidism were higher in the OT group than in the RT group (P<0.05). The local recurrence rates showed no significant difference between the groups.</p><p><strong>Conclusions: </strong>This study demonstrates that RT with SMCD can achieve outcomes equivalent to those of traditional open surgery when integrating the 131I-WBS dynamic evaluation system and the therapeutic effects of RAI. Additionally, robot surgery demonstrated a notable advantage in protecting parathyroid function.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of extracorporeal shock wave therapy on the microbial community in burn scars: retrospective case-control study.","authors":"Yeongyun Jung, Ryeong-Hui Kim, Eun Kyung Lee, Cheong Hoon Seo, So Young Joo, Jae-Ho Shin, Yoon Soo Cho","doi":"10.1097/JS9.0000000000002083","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002083","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of extracorporeal shock wave therapy (ESWT) has been demonstrated in various medical fields, including burn medicine. It promotes wound healing, improves blood flow, and modulates the inflammatory responses. The recovery speed and outcomes of skin diseases are influenced by the skin microbiome; however, studies examining the effects of specific treatments on the skin microbiome are lacking. This study investigated the impact of ESWT on the skin microbiome of burn patients, focusing on the microbial diversity and community structure within burn scars.</p><p><strong>Materials and methods: </strong>In the retrospective case-control study, nineteen patients with burn scars were treated with ESWT, and changes in their skin microbiome were evaluated. ESWT was administered weekly for three months, and samples were collected from the ESWT-treated burn scars and untreated normal skin. Blood chemistry, and pain and itching scores were evaluated during sample collection. The collected samples were then subjected to 16S rRNA sequencing. Microbial community analysis was conducted using the QIIME2 and R packages.</p><p><strong>Results: </strong>After ESWT, changes in alpha diversity indices were observed in burn scars. Faith phylogenetic diversity (P<0.05) and observed features (P<0.01) increased, whereas the evenness index decreased (P<0.01); no marked changes were noted in untreated skin. Beta diversity analysis showed stable microbial community structures in both the treated and untreated areas. A considerable increase in Micrococcus and Staphylococcus abundance was observed. Network analysis revealed a more open microbial network structure after ESWT, indicating adaptive changes in the microbial community.</p><p><strong>Conclusion: </strong>ESWT enhances microbial diversity and modifies microbial community structure in burn scars, promoting a more balanced and functionally supportive microbiome. ESWT aids in scar remodeling and positively influences skin microbiome dynamics, contributing to improved skin health and recovery.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using computed tomography to evaluate anatomic landmarks in taiwanese trauma patients for insertion of resuscitative endovascular balloon occlusion of the aorta: A retrospective cohort study.","authors":"Chih-Ying Chien, Yueh-Lin Lee, Mei-Jy Jeng, Chia-Jen Liu","doi":"10.1097/JS9.0000000000002079","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002079","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhage, particularly from non-compressible torso hemorrhage (NCTH) in the abdominopelvic region, is a leading cause of preventable trauma deaths. Resuscitative endovascular balloon occlusion of the aorta (REBOA), designed for aortic occlusion, has emerged as a tool for temporary hemorrhage control in recent years. However, attaining optimal REBOA placement in diverse demographic groups, such as Asian populations, may pose challenges owing to unique anatomical and physiological differences.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed trauma patients who underwent torso computed tomography (CT) at tertiary hospitals in Taiwan from January 2014 to January 2017. The OsiriX software was used to measure the endovascular lengths in the CT images.</p><p><strong>Results: </strong>Among the 223 patients, the median vascular lengths and body measurements were higher in males. The optimal fixed insertion length was identified as 47.5 cm for zone 1 with 99.43% accuracy and 25.5 cm with 82.1% accuracy for zone 3. The landmark-guided method showed 100% accuracy for zone 1 when using the mid-sternum and 94.6% for zone 3 with the umbilicus as the guide with the distance between the umbilicus, xiphoid process, and pubic ramus. External validation confirmed the accuracy of the landmark-guided method.</p><p><strong>Conclusions: </strong>For zone 1 occlusions, a range of 44-48 cm insertion length cross-referenced with the mid-sternal landmark is recommended. For zone 3 occlusions, using the umbilicus as a guide with the distance between the umbilicus, xiphoid process, and pubic ramus provided the highest accuracy.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, sonographic and molecular changes in calcific tendinitis of the shoulder following extracorporeal shockwave therapy: a prospective case-control study.","authors":"Wen-Yi Chou, Kuan-Ting Wu, Po-Cheng Chen, Shun-Wun Jhan, Chia-Feng Wu, Jai-Hong Cheng","doi":"10.1097/JS9.0000000000002078","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002078","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shockwave therapy (ESWT) is the primary treatment for calcific tendinitis of the shoulders, but what are the effects of clinical, sonographic, and molecular markers following ESWT in treating calcific tendinitis of the shoulder?</p><p><strong>Methods: </strong>Twenty-eight patients were categorized into radiodense and radiolucent subgroups. In addition, clinical assessments included the visual analogue scale (VAS), Constant-Murley (CM) score, American Shoulder and Elbow Surgeon (ASES) score, sonographic evaluation, and serum enzyme-linked immunosorbent assay (ELISA). The participants completed a one-year follow-up. All data were collected before and after treatment.</p><p><strong>Results: </strong>After one year of follow-up, all patients showed notable improvement in VAS, CM, and ASES scores, with no significant clinical variations among the subgroups. However, the radiolucent group showed significant complete resorption and size reduction at the final follow-up. Sonographic evaluation revealed improved tissue perfusion and reduced calcification from 3 to 12 months in all patients, including those in the radiolucent group, but complete resorption of calcific deposits did not occur. The percentage of tissue perfusion was improved at 1 and 3 months after ESWT. There were no significant differences in the levels of the molecular markers interleukin-1 beta (IL-1 β) or IL-33, but the level of insulin-like growth factor 1 (IGF-1) was notably increased at 1 and 3 months post-ESWT. The BMP7 level was increased at 3 months and was then decreased significantly at 6 and 12 months.</p><p><strong>Conclusion: </strong>ESWT improved symptoms, reduced calcification, enhanced tissue perfusion, and promoted angiogenesis and BMP7 activity. In particular, it benefited radiolucent type patients with better calcification resorption. Partial resorption led to improvements in transparency, and a second ESWT session at 3 months was recommended for optimal results.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and all-cause mortality outcomes of adrenalectomy versus medical treatment in primary aldosteronism: an umbrella review.","authors":"Sandeep Samethadka Nayak, Ehsan Amini-Salehi, Farahnaz Joukar, Pubali Biswas, Sara Nobakht, Negin Letafatkar, Parham Porteghali, Erfan Mohammadi-Vajari, Fariborz Mansour-Ghanaei, Mona Javid, Arian Mirdamadi, Daniyal Ameen, Behrang Motamed, Soheil Hassanipour, Mohammad-Hossein Keivanlou","doi":"10.1097/JS9.0000000000002048","DOIUrl":"10.1097/JS9.0000000000002048","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) is now recognized as the most prevalent form of secondary hypertension globally, contributing significantly to cardiovascular morbidity and mortality. This umbrella review aims to systematically compare cardiovascular outcomes and all-cause mortality in PA patients undergoing adrenalectomy versus mineralocorticoid receptor antagonist (MRA) treatment, aiming to inform optimal management strategies.</p><p><strong>Method: </strong>Following PRISMA guidelines, Supplemental Digital Content 1, http://links.lww.com/JS9/D386, Supplemental Digital Content 2, http://links.lww.com/JS9/D387, a comprehensive search strategy was employed across multiple databases. Meta-analyses focusing on cardiovascular outcomes or all-cause mortality, comparing adrenalectomy and MRAs treatment in PA patients, were included. Studies were independently screened and assessed for quality using AMSTAR 2, Supplemental Digital Content 3, http://links.lww.com/JS9/D388 and GRADE checklists.</p><p><strong>Results: </strong>A total of 8 studies met the inclusion criteria. Adrenalectomy showed potential benefits over MRAs in reducing the risk of arrhythmias (OR=2.17; 95% CI: 1.25-3.76) and major adverse cardiovascular events (OR=1.81; 95% CI: 1.33-2.46). Patients treated with MRAs exhibited a higher risk of cardiovascular events (OR=1.23; 95% CI: 1.05-1.44), hypertension (OR=3.22; 95% CI: 1.15-8.97), and all-cause mortality (OR=3.03; 95% CI: 1.36-6.70) compared to adrenalectomy.</p><p><strong>Conclusion: </strong>Adrenalectomy appears to offer favorable outcomes compared to MRAs treatment in PA patients, particularly in reducing the risk of major adverse cardiovascular events and all-cause mortality. These findings suggest the importance of considering surgical intervention as a primary treatment modality for PA.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}