International surgery最新文献

{"title":"Ischemic Bowel Mimicking a Colonic Mass in RS3PE Syndrome","authors":"B. Yıldız","doi":"10.9738/intsurg-d-15-00272.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-15-00272.1","url":null,"abstract":"Remitting seronegative symmetrical synovitis with pitting edema syndrome is characterized by symmetrical synovitis involving wrists and flexor digitorum tendon sheaths associated with marked pitting edema of the dorsum of hands. It is considered a paraneoplastic syndrome. Here we describe a middle-aged patient with this syndrome presenting with acute abdomen and ischemic bowel mimicking a colonic mass. Rheumatologists and surgeons should consider mesenteric vascular events in patients with remitting seronegative symmetrical synovitis with pitting edema who present with acute abdomen, even in patients younger than 50 years. Our case is the first case in the literature reporting the association between ischemic infarction of colon and remitting seronegative symmetrical synovitis with pitting edema. Remitting seronegative symmetrical synovitis with pitting edema needs to be listed among other rheumatologic diseases associated with mesenteric vascular occlusion.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47690866","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":"Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Delirium in Elderly Patients Undergoing Total Hip Arthroplasty","authors":"Chen Yan, Dai Ti-jun","doi":"10.9738/intsurg-d-17-00029.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00029.1","url":null,"abstract":"\u0000 \u0000 To investigate the effects of dexmedetomidine on postoperative delirium in elderly patients undergoing total hip arthroplasty.\u0000 \u0000 \u0000 \u0000 A total of 100 patients, 42 male and 58 female, ages 60 to 85 years, American Society of Anesthesiologists grade I or II, who were undergoing total hip arthroplasty were randomly divided into 2 groups: a dexmedetomidine group (group D; n = 50) and a control group (group C; n = 50). Group D patients were infused with 0.3 μg · kg−1 · h−1 of dexmedetomidine from 5 minutes prior to anesthesia induction until the end of surgery. Group C patients received an equal volume of saline. Heart rate and mean arterial pressure (MAP) were recorded before anesthesia induction (T0), 1 minute before extubation (T1), and 30 minutes after extubation (T2). The Visual Analog Score (VAS) at 1, 2, and 3 days after surgery, the incidence and duration of postoperative delirium, and the length of hospital stay were recorded. Adverse reactions, such as nausea, vomiting, and lethargy, were also recorded.\u0000 \u0000 \u0000 \u0000 The Visual Analog Scores in the 2 groups were similar. In group D, there was no significant difference in heart rate (P = 0.232) and MAP (P = 0.056) between T0 and T1. However, in group C, heart rate significantly increased by 15.3 bpm (P = 0.000) and MAP significantly increased by 10.7 mmHg (P = 0.001) at T1 compared with those at T0. The incidence of postoperative delirium in group D (10%) was significantly lower than that in group C (26%; P = 0.037). The duration of delirium in group D (1.3 ± 0.6 days) was shorter than that in group C (3.0 ± 0.5 days; P = 0.000). The length of hospital stay in group D (13.2 ± 0.9 days) was shorter than that in group C (16.1 ± 0.7 days; P = 0.000). No significant differences were observed in adverse effects between the 2 groups.\u0000 \u0000 \u0000 \u0000 Intravenous infusion of dexmedetomidine can not only reduce the incidence and duration of postoperative delirium, but also shorten the length of hospital stay in elderly patients undergoing total hip arthroplasty.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48200241","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":"Roux-en-Y Reconstruction Following Distal Gastrectomy Reduced Endoscopic Reflux Esophagitis in Older Adults: Propensity Score–Matching Analysis","authors":"M. Inokuchi, Taichi Ogo, S. Kato, H. Nagano, T. Irie, Y. Kawachi","doi":"10.9738/intsurg-d-20-00045.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00045.1","url":null,"abstract":"\u0000 \u0000 This study aimed to examine the functional outcomes of Roux-en-Y (RY) and Billroth I (BI) reconstruction methods following distal gastrectomy in patients ages ≥75 years with gastric cancer.\u0000 \u0000 \u0000 \u0000 RY and BI reconstructions are commonly performed after distal gastrectomy. However, no study has compared the 2 procedures in older adults.\u0000 \u0000 \u0000 \u0000 We identified older patients who underwent RY (n = 103) or BI (n = 71) reconstruction following distal gastrectomy from 2011 to 2018 in our database. Patients in the RY and BI groups were matched by propensity scores, and each group included 62 patients. We compared short-term surgical outcomes and clinical findings at 1 year postoperatively. Additionally, risk factors for endoscopic reflux esophagitis following distal gastrectomy were evaluated.\u0000 \u0000 \u0000 \u0000 Reflux esophagitis, bile reflux, and remnant gastritis were significantly less frequent in RY reconstruction than in BI reconstruction. Moreover, both BI reconstruction and preoperative hiatus hernias were independent risk factors for postoperative endoscopic reflux esophagitis. Although the incidence of postoperative surgical complications following RY and BI was similar, RY was found to cause delayed gastric emptying more frequently than BI.\u0000 \u0000 \u0000 \u0000 RY reconstruction is a favorable procedure to prevent reflux esophagitis in older patients, particularly in those with hiatal hernia.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44329916","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":"A case of sigmoid colon cancer prolapsed through the anus in a young woman","authors":"M. Enomoto, K. Katsumata, K. Kasahara, T. Tago, Naoto Okazaki, H. Kuwabara, J. Mazaki, Hideaki Kawakita, T. Ishizaki, Y. Nagakawa, A. Tsuchida","doi":"10.9738/intsurg-d-21-00004.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00004.1","url":null,"abstract":"Intussusception in which colon cancer acts as a lead point has been previously reported in a number of cases, but prolapse of the tumor through the anus has rarely been reported, and most of those few previous reports have involved elderly individuals. Case presentation: The patient in this case was a 26-year-old Japanese woman who presented to our emergency department with severe pain after her intestinal tract prolapsed through the anus during defecation. The intussusception was released laparoscopically, and we were able to perform complete mesocolic excision in a manner similar to conventional laparoscopic sigmoidectomy for sigmoid colon cancer prolapse through the anus in a young woman. Since liver metastases were identified on computed tomography, the patient underwent partial hepatectomy twice. The patient has been followed-up for eight years since the initial surgery and remains alive without recurrence.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"67 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71208088","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":"Total Amylase Value in Drains After Gastrectomy for Predicting Postoperative Pancreatic Fistula","authors":"T. Sugawara, H. Shinohara, S. Haruta, J. Shindo, M. Ueno, H. Udagawa","doi":"10.9738/intsurg-d-17-00127.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00127.1","url":null,"abstract":"Objective: Postoperative pancreatic fistula (POPF) is defined using the ratio of the bilirubin concentration in abdominal drainage fluid to the upper normal range of serum amylase level. However, we hypothesized that the total amylase value in discharge (AVD) on POD 3 may be more sensitive for predicting grade II or higher severe POPF sPOPF, and compared the predictive power of the conventional definition of POPF and AVD for sPOPF. Methods: One hundred and fifty-one patients who underwent gastrectomy between October 2011 and February 2013 were analyzed. A drainage tube was placed in all the cases through the stump of the right gastroepiploic vein and the front of the pancreas to the back of the anastomotic site. The drainage volume and amylase concentration in the discharge were examined on POD 1, 3, and 5. AVD was calculated by multiplying the volume by the amylase concentration. Results: Eight patients (5.3%) developed sPOPF. In univariate analysis, both AVD and the amylase concentration ratio was significantly correlated with sPOPF (P = 0.002 and 0.007, respectively). AVD on POD 3 showed the best predictive performance compared with the amylase concentration ratio on POD 3 (area under the curve 0.876 vs. 0.844). Based on the cutoff values calculated from the ROC curves, AVD was more specific than amylase concentration ratio in predicting sPOPF (specificity: 97.6% vs. 86.0%; PPV: 62.5% vs. 23.1%). Conclusion: AVD on POD 3 is a more specific parameter than conventional amylase concentration ratio in predicting sPOPF.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46673366","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":"Pancreatic trauma: proposal for management algorithm","authors":"D. Hashimoto, Tomohisa Yamamoto, S. Yamaki, Kazuhito Sakuramoto, Rintaro Yui, T. Okawa, Fujio Matsumura, H. Horiuchi, S. Satoi","doi":"10.9738/intsurg-d-20-00015.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00015.1","url":null,"abstract":"IntroductionPancreatic trauma is potentially lethal despite recent improvements in surgical techniques and conservative management. However, no guidelines for the management of pancreatic trauma have been established. In this report, we propose an algorithm for the management of pancreatic trauma based on our experience of nine cases and a literature review.Case presentationThis study included nine patients with pancreatic trauma (five men and four women). The patients’ median age was 40 years (range, 17–75 years). The overall mortality rate was 22.2%, and the postoperative mortality rate was 16.7%. Superficial trauma was present in two patients. Deep trauma without injury to the main pancreatic duct was present in one patient, and this patient was treated successfully with endoscopic nasopancreatic drainage. Active bleeding was present in two patients and controlled by interventional radiology. Deep trauma with injury to the main pancreatic duct was present in six patients. Among them, one patient died after conservative treatment with endoscopic nasopancreatic drainage. The other five patients underwent surgery (pancreatic resection in four and necrosectomy in one).ConclusionThe herein-described algorithm recommends interventional radiology for active arterial bleeding, conservative management for trauma without ductal injury, and surgery for trauma with ductal injury. This algorithm may provide a basis for future establishment of guidelines.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48908792","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":"Effects of catalpa alcohol from Rehmannia glutinosa on calcium-binding protein, interleukin-1β and galectin-3 in synovial tissues of rats with knee osteoarthritis","authors":"Qiang He, Yi-Xin Liu, H. Yin, Weiqing Qian, Nianwei Yao, Zhen Wang, Lei Xu, Da-peng Zhang, Kun Yan, F. Dai","doi":"10.9738/intsurg-d-20-00016.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00016.1","url":null,"abstract":"We aimed to evaluate the effects of catalpa alcohol from Rehmannia glutinosa on the expressions of calcium-binding protein (S100A12), interleukin-1β (IL-1β) and galectin-3 in the synovium of rats with early knee osteoarthritis (KOA). Fifty-two adult male Wistar rats aged 3-8 weeks were divided into normal control (n=16), model (n=12), low-dose (n=12) and high-dose groups (n=12). On the 10th day after modeling, 6 rats in normal control group and 6 in other three groups were randomly selected. X-ray and three-dimensional CT images of left knee joint were taken under live anesthesia. The joint cavity of sacrificed rats was opened to observe cartilage surface. After 28 consecutive days of administration, the synovial tissue of left knee joint was collected. S100A12, IL-1β and galectin-3 levels in synovial tissue were detected by immunohistochemistry and ELISA. There were articular cartilage defects in left knees. Radiological examination showed significant joint space narrowing and hyperplasia, and 3D CT joint space value decreased (P < 0.05). The Mankins and OARSI scores of synovial histopathology were significantly different (P < 0.05). The S100A12, IL-1β and galectin-3 levels in synovial tissue of model group significantly exceeded those of normal control group (P < 0.01). Compared with model group, such levels of low-dose (P < 0.05) and high-dose groups (P < 0.01) were significantly lower. The S100A12, IL-1β and galectin-3 levels in synovium tissue decreased with rising concentration of catalpa alcohol from R. glutinosa . Therefore, this drug is potentially suitable for inhibiting inflammatory response to delay the progression of KOA.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43757405","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":"Significance of neutrophil-lymphocyte ratio (NLR) as a prognostic factor in Stage II colorectal cancer","authors":"M. Sagawa, H. Yokomizo, K. Yoshimatsu, S. Okayama, Y. Yamada, A. Ida, Hiroyuki Maeda, M. Satake, T. Usui, T. Shimakawa, T. Katsube, S. Ohigashi, H. Kato, S. Shiozawa","doi":"10.9738/intsurg-d-20-00025.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00025.1","url":null,"abstract":"Objective : To evaluate the significance of preoperative neutrophil-lymphocyte ratio (NLR) for the analysis of disease-free survival (DFS) and overall survival (OS) in patients with stage II colorectal cancer (CRC).Summary of Background Data: Previous reports have indicated the association of NLR with a poor prognosis and tumor progression in patients with CRC. However, the role of NLR as a prognostic marker specifically in patients with stage II CRC has not been well studied.Methods : A total of 124 colon cancer patients were included in the study. The OS and DFS of patients were compared using preoperative NLR. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the prognostic value of NLR.Results : The OS and DFS of patients with an NLR ≥ 4.0 were significantly lower when compared with those of patients with an NLR< 4.0. Multivariate analysis showed that NLR ≥ 4.0, PS score ≥ 1, and depth of tumor invasion T4 were independent prognostic factors for DFS, whereas age above 80 years, NLR ≥ 4.0, and PS score ≥ 1 were independent prognostic factors for OS.Conclusions : NLR can be considered a poor prognostic factor in patients with stage II CRC after curative surgery.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71208078","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":"Clinicopathological features of patients with primary hepatocellular carcinoma surviving without recurrence more than 10 years after primary hepatic resection","authors":"Y. Yonemura, T. Yoshizumi, T. Tomiyama, Norifumi Iseda, A. Morinaga, K. Yugawa, N. Harada, K. Takeishi, T. Toshima, Y. Nagao, Mohamed Elshawy, M. Ninomiya, T. Iguchi, S. Itoh, K. Mimori, M. Mori","doi":"10.9738/intsurg-d-20-00034.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00034.1","url":null,"abstract":"Objective:  The aim of this study was to clarify the predictive factors of recurrence-free time more than 10 years after primary hepatic resection for hepatocellular carcinoma (HCC).Summary of Background data:  Surgical resection is a curative treatment for HCC patients with hepatic functional reserve; however, the high recurrence rate must be addressed.Methods:  The study included 595 patients who had undergone curative resection for HCC. Multivariate analysis was performed to identify factors associated with recurrence-free survival more than 10 years.Results:  Multivariate analysis revealed that tumor size ≤2 cm ( P  = 0.004), ALBI grade 1 ( P  = 0.03), FIB-4 index ≤3.3 ( P = 0.002), and histological inflammation grade ≤1 ( P  = 0.03) were independent predictive factors for recurrence-free survival for more than 10 years. Predictive points were scored as follows: 2 points, tumor size ≤2 cm or FIB-4 index ≤3.3, and 1 point, ALBI grade 1 or histological inflammation grade ≤1. Patients were divided into three groups according to their total points: Group 1, 0–2 points (n = 317); Group 2, 3–4 points (n = 239); and Group 3, 5–6 points (n = 39). Recurrence-free survival rates among the three groups were significantly different ( P  <0.0001). Conclusions:  Tumor size, ALBI, FIB-4 index, and histological inflammation grade were independent predictive factors for recurrence-free survival longer than 10 years after curative hepatic resection for HCC.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43217913","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":"Preoperative intake of carbohydrate-rich drinks is associated with postoperative pulmonary complications in patients after gastric cancer surgery","authors":"Miyeong Park, S. Ok, Jiyoung Park, H. Yu, S. Bae, Tae-Han Kim, J. Min, Sangho Jeong","doi":"10.9738/intsurg-d-20-00007.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00007.1","url":null,"abstract":"Background: The aims of this study were: 1) to investigate the correlation between carbohydrate-rich drinks (CRDs) before gastric cancer surgery and postoperative nutrition laboratory findings; and 2) to determine whether CRDs affect the incidence of postoperative complications.Materials and methods: A retrospective study was conducted on 142 patients who underwent radical stomach cancer surgery. The patients were divided into two groups (NPO group vs. CRD group) according to the intake of CRDs prior to surgery. We performed statistical analysis using Student’s t-test, the Chi-square test and a binary logistic regression model (SPSS Statistics software, version 24).Results: Laboratory analysis of the nutrition status showed a significant increase in serum protein and albumin levels in the CRD group after postoperative day 1 (POD#1) (p<0.05).The overall morbidity rate showed no difference between the two groups, but pulmonary complications showed significant differences of 1/72 and 9/70 (p=0.008). In the univariate analysis, there were significantly increased pulmonary complications in patients with higher Eastern Cooperative Oncology Group (ECOG) scores (p = 0.001), existing pulmonary disease (p = 0.003), anastomotic leakage (p = 0.03), and CRD intake (p=0.008). In the multivariate analysis, CRD intake was the only independent factor.ConclusionWe found that administering a CRD is effective in improving albumin and protein levels in the short-term period after surgery but is an independent factor for pulmonary complications after gastrectomy. We recommend that patients with no medications for pulmonary disease and with low ECOG scores can safely ingest CRDs and expect short-term nutritional effects.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42731522","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}