Journal of Investigative Surgery最新文献

{"title":"Impact of Diameter of Perforator in Pedicle and Different Managements of Intermediate Non-Pedicle Perforator on Flap Survival in Rats.","authors":"Donghong Liu,&nbsp;Fang Fang,&nbsp;Yuehong Zhuang","doi":"10.1080/08941939.2022.2097345","DOIUrl":"https://doi.org/10.1080/08941939.2022.2097345","url":null,"abstract":"<p><strong>Backgrounds: </strong>The quantified relationship between perforator diameter and flap length can be supported, and the impact of different strategies of managements of a non-pedicled perforator with two major subfascial divisions on flap survival has never been explored.</p><p><strong>Materials and methods: </strong>This study was divided into two parts. In Part I, 48 Sprague-Dawley rats underwent flap harvesting based on six perforators with a diameter gradient. Then, the flap length and perforator diameter were measured for establishment of an equation. In Part II, 32 rats underwent harvest of a transverse flap based on the right superficial epigastric perforator. In 16 rats the right intermediate iliolumbar perforator was severed in a distal-to-division approach, whereas, in the other 16 rats, it was severed with in a proximal-to-division approach. Necrosis rates and blood perfusion were also compared.</p><p><strong>Results: </strong>The equation y = 13.02 × x + 2.29 could be established between the perforator diameter in the pedicle (x) and the flap length (y) that could be supported with R²=0.8963 and P < 0.001.The transverse flap with a distal-to-division management of the intermediate iliolumbar perforasome was weaker in perfusion and had a necrosis rate of 49±4%, whereas the flap with a proximal-to division management had a significantly stronger perfusion and a lower necrosis rate of 21±2% (P<0.001).</p><p><strong>Conclusions: </strong>The safe flap length that can be estimated based on a perforator with a known diameter can be calculated using y=13.02× x +2.29. A short segment of the stem of an intermediate perforator with two major subfascial branches should be preserved to augment flap survival.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 9","pages":"1686-1693"},"PeriodicalIF":1.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40519707","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":"Systemic Inflammation Response Index and Systemic Immune Inflammation Index Are Associated with Clinical Outcomes in Patients with Acute Pancreatitis?","authors":"Murat Biyik,&nbsp;Zeynep Biyik,&nbsp;Mehmet Asil,&nbsp;Muharrem Keskin","doi":"10.1080/08941939.2022.2084187","DOIUrl":"https://doi.org/10.1080/08941939.2022.2084187","url":null,"abstract":"<p><strong>Objectives: </strong>The inflammatory response is critically important in acute pancreatitis (AP). Systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI), which are novel inflammatory markers, have been linked to determining outcomes in various diseases. The goal of the current study was to examine the relation of the SII index and SIRI with disease severity and acute kidney injury (AKI) in subjects with AP.</p><p><strong>Methods: </strong>A total of 332 subjects with AP were analyzed retrospectively. SII index was calculated using the formula; platelet (P)×neutrophil (N)/lymphocyte (L), while SIRI was calculated as N × monocyte (M)/L count. Multivariate regression (MR) was done to determine the independent risk factors for AKI and severe AP (SAP).</p><p><strong>Results: </strong>Statistical analyses showed that both median SII index and median SIRI increased gradually with higher AP severity (<i>p</i> < 0.001). Both SII index and SIRI were higher in subjects with AKI compared to controls (<i>p</i> < 0.001). Using MR analysis, the SII index was found to independently predict both SAP (OR = 1.004, 95% CI: 1.001-1.008, <i>p</i> = 0.018) and AKI (OR = 1.005, 95% CI: 1.003-1.008, <i>p</i> < 0.001). ROC analysis showed that the SII index could accurately differentiate SAP (AUC = 0.809, <i>p</i> < 0.001) and AKI (AUC = 0.820, <i>p</i> = 0.001) in patients with acute pancreatitis. ROC analysis also showed that SIRI could also accurately differentiate SAP (0.782, <i>p</i> < 0.001) and AKI (AUC = 0.776, <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>SIRI and the SII indexes can be used as potential biomarkers in predicting both disease severity and AKI development in subjects with AP.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 8","pages":"1613-1620"},"PeriodicalIF":1.9,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10441638","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 Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study.","authors":"Hakan Anıl,&nbsp;Nevzat Can Şener,&nbsp;Kaan Karamık,&nbsp;İbrahim Erol,&nbsp;Ediz Vuruşkan,&nbsp;Hakan Erçil,&nbsp;Zafer Gökhan Gürbüz","doi":"10.1080/08941939.2022.2062496","DOIUrl":"https://doi.org/10.1080/08941939.2022.2062496","url":null,"abstract":"<p><strong>Purpose: </strong>Comparing the two different drainage methods of percutaneous nephrostomy (PCN) versus retrograde ureteral double - J (DJ) stent insertion in patients with obstructive pyelonephritis cases.</p><p><strong>Material and methods: </strong>In this retrospective study, patients with obstructive pyelonephritis secondary to urolithiasis who underwent PCN or DJ insertion were included in the study. Patients were divided into two groups according to drainage method. After exclusion criteria, the study included 105 patients. The groups were compared for intraoperative outcomes, duration of fluoroscopy usage, the time needed for normalization of infection parameters (white blood cells (WBC), C - reactive protein (CRP), procalcitonin), and complications were observed.</p><p><strong>Results: </strong>From 105 patients, 56 patients were in DJ stent group and 49 patients were in PCN group. According to intraoperative data, operative time and fluoroscopy duration were significantly shorter in the DJ ureteral stent group (<i>P</i> < .001). WBC returned to normal range in mean 3.5 ± 1.3 days in the DJ stent group and 3.2 ± 1.1 days in the PCN group (95% CI: -0.76-0.21, <i>P</i> = .268). There were no statistically significant differences identified for the duration for CRP, PCT and fever to return to normal range between the drainage methods. The complication rates was 51.8% for DJ stent group and, 30.6% in PCN group (<i>P</i> = .028).</p><p><strong>Conclusion: </strong>Both methods are effective and safe in obstructive pyelonephritis. Despite the higher complication rate in DJ stent group, these complications were minor.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 7","pages":"1445-1450"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439942","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":"Mild Hypothermia via External Cooling Improves Lung Function and Alleviates Pulmonary Inflammatory Response and Damage in Two-Hit Rabbit Model of Acute Lung Injury.","authors":"Onat Akyol,&nbsp;Serdar Demirgan,&nbsp;Aslıhan Şengelen,&nbsp;Hasan Cem Güneyli,&nbsp;Duygu Sultan Oran,&nbsp;Funda Yıldırım,&nbsp;Damla Haktanır,&nbsp;Mehmet Salih Sevdi,&nbsp;Kerem Erkalp,&nbsp;Ayşin Selcan","doi":"10.1080/08941939.2022.2064010","DOIUrl":"https://doi.org/10.1080/08941939.2022.2064010","url":null,"abstract":"<p><strong>Objectives: </strong>Targeted temperature management (TTM) with therapeutic hypothermia (TH) has an organ-protective effect by mainly reducing inflammatory response. Here, our objective was to determine, for the first time, whether mild TH with external cooling, a simple and inexpensive method, could be safe or even beneficial in two-hit rabbit model of acute lung injury/acute respiratory distress syndrome (ALI/ARDS).</p><p><strong>Methods: </strong>Twenty-two New Zealand rabbits (6-month-old) were randomly divided into healthy control (HC) with conventional ventilation, but without injury, model group (ALI), and hypothermia group with external cooling (ALI-HT). After induction of ALI/ARDS through mild lung-lavages followed by non-protective ventilation, mild hypothermia was started in ALI-HT group (body temperature of 33-34 °C). All rabbits were conventionally ventilated for an additional 6-h by recording respiratory parameters. Finally, lung histopathology and inflammatory response were evaluated.</p><p><strong>Results: </strong>Hypothermia was associated with higher oxygen saturation, resulting in partial improvement in the P/F ratio (PaO₂/FiO₂), oxygenation index, mean airway pressure, and PaCO₂, but did not affect lactate levels. The ALI-HT group had lower histopathological injury scores (hyperemia, edema, emphysema, atelectasis, and PMN infiltration). Further, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 and -8 levels in lung tissue and serum samples markedly reduced due to hypothermia.</p><p><strong>Conclusion: </strong>Mild TH with external cooling reduced lung inflammation and damage, whereas it resulted in partial improvement in gas exchanges. Our findings highlight that body temperature control may be a potentially supportive therapeutic option for regulating cytokine production and respiratory parameters in ALI/ARDS.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 7","pages":"1472-1483"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114981","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":"Measuring the Systemic Inflammatory Response to On- and Off-Pump Coronary Artery Bypass Graft (CABG) Surgeries Using the Tryptophan/Kynurenine Pathway","authors":"A. Farouk, R. Hamed, S. Elsawy, Nashwa F Abd El Hafez, F. Moftah, M. Nassar, Fify Alfy Gabra, T. Saleem","doi":"10.1080/08941939.2022.2084188","DOIUrl":"https://doi.org/10.1080/08941939.2022.2084188","url":null,"abstract":"Abstract Background: Cardiac surgeries induce many inflammatory responses with remarkable clinical implications. Tryptophan (Trp) is a precursor for serotonin, melatonin and kynurenine (Kyn). Plasma kynurenic acid (Kyna) and Kyn concentrations are thought to be related to the severity of inflammation. Plasma Trp/Kyn ratio is used to measure inflammatory cytokine activity. Methods: We performed the current longitudinal study in a tertiary care center and included 62 patients divided into two groups; group A (on-pump CABG patients) and group B (off-pump CABG patients). Plasma Trp and Kyn were measured using the high-performance liquid chromatography (HPLC) technique. Serum interlukin-6 (IL-6) and white blood cells (WBCs) were measured using ELISA and routine blood count, respectively. Results: The present study revealed that the intraoperative levels of plasma Kyn, IL-6 and WBCs were significantly increased while the plasma Trp/Kyn ratio was significantly decreased in both the groups; however, the changes were more significant in the on-pump CABG group. Moreover, the levels in both the groups returned to preoperative levels 72 h postoperative. Our study has shown that WBCs is positively correlated with IL-6, but has negative correlation with Trp/Kyn ratio. Conclusions: Kyn and Trp/Kyn ratio might be utilized as markers of the severity of inflammation in major surgery. In addition, off-pump CABG might be more preferable than on-pump CABG regarding stress and release of inflammatory markers.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1621 - 1625"},"PeriodicalIF":1.9,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42739965","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":"Mechanical Bowel Preparation Can Be Omitted in the Modern Era of Minimally Invasive Gynaecological Surgery and ERAS Pathways","authors":"C. Iavazzo, I. Gkegkes","doi":"10.1080/08941939.2022.2084190","DOIUrl":"https://doi.org/10.1080/08941939.2022.2084190","url":null,"abstract":"Dear Editor, With great deal of interest, we read the article entitled “The effect of mechanical bowel preparation on the surgical field in laparoscopic gynecologic surgeries: A prospective randomized controlled trial” by Ozturk et al. [1] The study evaluates the effects of mechanical bowel preparation (MBP) prior to laparoscopic gynecologic operation and whether it can offer advantages intraoperatively. As already discussed, MBP is discouraged in such operations by ERAS guidelines [2]. It should be highlighted that MBP was applied for two days prior to surgery. A fact that could raise the cost and patient’s dissatisfaction. Moreover, the evaluation of the intraoperative visualization of the surgical field, intestinal load and overall case of surgery were based on the subjective opinion of an experienced laparoscopic surgeon, and this is similar to other studies, using for example the Likert scale [3]. A recent literature review showed that MBP of any type seems to offer no advantage to any of the above mentioned intraoperative parametres [4]. Another metanalysis proposed that MBP should be abandoned prior to benign laparoscopic gynecological operations [5]. Furthermore, in the subgroup analysis of your study, no significant differences were identified in either patients with malignant diseases or those with high body mass index. Such a finding is crucial and highlights that there is no role of MBP in gynecologic laparoscopy independent of the difficulty of the planned surgery. Although, the findings of your study as well as other studies on the field are not supportive for MBP use, we should also mention that there is a gap between guidelines and reality/current medical practise as the approach is based on surgeon’s preference worldwide [6]. Nevertheless, the role of MBP could be debated by some surgeons in their contemporary practise, based on the existing data, we recommend that MBP could be abandoned in the modern era of minimally invasive gynecologic surgery and enhanced recovery pathways. Once again, we would like to thank the authors for their excellent contribution. Data availability statement","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1609 - 1609"},"PeriodicalIF":1.9,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42326183","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":"Does Arterialization of Portal Vein Have Any Effects in Large-for-Size Liver Transplantation? Hemodynamic, Histological, and Biomolecular Experimental Studies.","authors":"Rafael Rodrigues Torres,&nbsp;Ana Cristina Aoun Tannuri,&nbsp;Suellen Serafini,&nbsp;Alessandro Belon,&nbsp;Josiane Oliveira Gonçalves,&nbsp;Celso di Loreto,&nbsp;Uenis Tannuri","doi":"10.1080/08941939.2021.2021333","DOIUrl":"https://doi.org/10.1080/08941939.2021.2021333","url":null,"abstract":"<p><strong>Background: </strong>In pediatric liver transplantation, the optimal size of the transplanted liver ranges between 0.8% and 4.0% of the recipient's weight. Sometimes, the graft weight exceeds this upper limit, characterizing the large-for-size condition potentially associated with reduced blood flow and worsening of ischemia-reperfusion injury. Therefore, it would be beneficial to increase the portal flow through arterialization of the portal vein. <b>Materials and methods:</b> Fifteen pigs underwent large-for-size liver transplants. They were divided into two groups: control (CTRL 6 animals - conventional technique) and arterialization - a shunt was established between the portal vein and the splenic artery (ART 9 animals). Hemodynamic, biochemical, histological, and molecular variables were compared. <b>Results</b>: Arterialization resulted in a significant increase in portal vein pressure but no changes in other hemodynamic variables, as shown in the analysis of variance. It was observed lower ALT values (<i>p</i> = 0.007), with no differences regarding the values of blood pH and lactate (<i>p</i> = 0.54 and <i>p</i> = 0.699 respectively) or histological variables (edema, steatosis, inflammation, necrosis, and IRI - <i>p</i> = 1.0, <i>p</i> = 0.943, <i>p</i> = 0.174, <i>p</i> = 0.832, <i>p</i> = 0.662, respectively). The molecular studies showed significantly increased expression of IL6 after 3 hours of reperfusion (<i>p</i> = 0.048) and decreased expression of ICAM immediately after reperfusion (<i>p</i> = 0.03). The regression analysis suggested a positive influence of portal flow and pressure on biochemical parameters. <b>Conclusion</b>: Arterialization of the portal vein showed no histological, biochemical, or molecular benefits in large-for-size transplantation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1197-1207"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39648129","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":"Acute-Phase Serum Amyloid A May Predict Microvascular Invasion and Early Tumor Recurrence in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Undergoing Liver Resection.","authors":"Xinggang Guo,&nbsp;Wenli Zhang,&nbsp;Jin Du,&nbsp;Rongsuo Tao,&nbsp;Wei Dong,&nbsp;Jian Huang,&nbsp;Jinmin Zhang,&nbsp;Zeya Pan,&nbsp;Weiping Zhou,&nbsp;Xiuli Zhu,&nbsp;Hui Liu,&nbsp;Fuchen Liu","doi":"10.1080/08941939.2022.2035858","DOIUrl":"https://doi.org/10.1080/08941939.2022.2035858","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the impact of acute-phase protein serum amyloid A (aSAA) on microvascular invasion (MVI) and early recurrence in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>HBV-related HCC patients (<i>n</i> = 192) undergoing liver resection were included in the study. The protein levels of aSAA were analyzed by immunohistochemical staining in 172 tumor specimens, and further detected via western blotting in HCC and their corresponding portal vein tumor thrombus (PVTT) (<i>n</i> = 20). Cox and logit regression analysis was performed. Exploratory subgroup analysis was used to balance the potential confounders.</p><p><strong>Results: </strong>HBV-related HCC patients with high aSAA levels tended to have high HBV-DNA loads. Logit and Cox regression analyses revealed high expression of aSAA is an independent risk factor not only for MVI (OR 5.384, 95% CI 2.286-13.301, <i>P</i> < 0.001) but also for early recurrence (HR 6.040, 95% CI 1.970-18.540, <i>P</i> = 0.002), overall recurrence (HR 3.720, 95% CI 2.140-6.450, <i>P</i> < 0.001), and overall survival (HR 4.15, 95% CI 2.380-7.230, <i>P</i> < 0.001). Subgroup analysis showed that the effects of aSAA were consistent across all subgroups examined. Additionally, the aSAA protein level was significantly higher in PVTT than that in its corresponding tumor specimen. A high HBV-DNA level and large tumor size were the independent risk factors for early HCC recurrence in patients with high levels of aSAA.</p><p><strong>Conclusions: </strong>High expression of aSAA was an independent risk factor for MVI and early tumor recurrence in HBV-related HCC patients after liver resection. The aSAA protein level could thus be a promising biomarker for predicting MVI and early recurrence in these patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1368-1376"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39782988","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":"Growth of Intestinal Neomucosa on Pedicled Gastric Wall Flap, a Novel Technique in an Animal Model.","authors":"Panagiotis Sakarellos,&nbsp;Apostolos Papalois,&nbsp;Harikleia Gakiopoulou,&nbsp;Iro Zacharioudaki,&nbsp;Michalis Katsimpoulas,&nbsp;Marina Belia,&nbsp;Dimitrios Moris,&nbsp;Kyveli Aggelou,&nbsp;Ilias Vagios,&nbsp;Spiridon Davakis,&nbsp;Michail Vailas,&nbsp;Theodoros Liakakos,&nbsp;Theodoros Diamantis,&nbsp;Evangelos Felekouras,&nbsp;Michael Kontos","doi":"10.1080/08941939.2022.2034196","DOIUrl":"https://doi.org/10.1080/08941939.2022.2034196","url":null,"abstract":"<p><p><b>Background:</b> Short bowel syndrome (SBS) remains an unsolved issue in modern medicine. Numerous experimental surgical techniques have been proposed in the attempt to increase the intestinal absorptive capacity.<b>Materials and Methods:</b> Ten female Landrace pigs, divided in two groups of 5 (A and B), were explored through a midline incision. A spindle-shaped vascularized full-thickness gastric wall flap (GWF) consisting of part of the major curvature with the gastroepiploic arch preserved was de-epithelialized and then placed as a \"patch\" to cover an antimesenteric border defect of either a nonfunctional blind intestinal loop (group A) or a functional intestinal loop of the gastrointestinal tract (group B). A spindle-shaped curved, rigid, low density polyethylene (LDPE) splint was sutured on the external surface of the patch in order to prevent shrinkage of GWF and collapse of the intestinal wall in group A.<b>Results:</b> There was a decrease of both dimensions of the patch. Microscopically a thin layer of columnar epithelial cells covered the center of the patch, evolving in shorter, blunt, poorly developed villi with increasing maturation laterally. The patch surface was covered by nearly 90%. In the three animals that died prematurely the coverage of GWF was negligent or suboptimal directly dependent on the length of survival.<b>Conclusions:</b> The hereby-described patching technique demonstrated the growth of intestinal neomucosa on the GWF. The capability of the stomach to provide large flaps and the advantages of the use of native tissues render this animal model valuable for the future research in the field.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1329-1339"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39947252","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":"Eye-Tracking Indicators of Workload in Surgery: A Systematic Review.","authors":"Otto Tolvanen,&nbsp;Antti-Pekka Elomaa,&nbsp;Matti Itkonen,&nbsp;Hana Vrzakova,&nbsp;Roman Bednarik,&nbsp;Antti Huotarinen","doi":"10.1080/08941939.2021.2025282","DOIUrl":"https://doi.org/10.1080/08941939.2021.2025282","url":null,"abstract":"<p><p>BackgroundEye tracking is a powerful tool for unobtrusive and real time assessment of workload in clinical settings. Before the complex eye tracking derived surrogates can be proactively utilized to improve surgical safety, the indications, validity and reliability requires careful evaluation.MethodsWe conducted a systematic review of literature from 2010 to 2020 according to PRISMA guidelines. A search on PubMed, Cochrane, Scopus, Web of science, PsycInfo and Google scholar databases was conducted on July 2020. The following search query was used\" (\"eye tracking\" OR \"gaze tracking\") AND (surgery OR surgical OR operative OR intraoperative) AND (workload OR stress)\". Short papers, no peer reviewed or papers in which eye-tracking methodology was not used to investigate workload or stress factors in surgery, were omitted.ResultsA total of 17 (N = 17) studies were identified eligible to this review. Most of the studies (<i>n</i> = 15) measured workload in simulated setting. Task difficulty and expertise were the most studied factors. Studies consistently showed surgeon's eye movements such as pupil responses, gaze patterns, blinks were associated with the level of perceived workload. However, differences between measurements in operational room and simulated environments have been found.ConclusionPupil responses, blink rate and gaze indices are valid indicators of workload. However, the effect of distractions and non-technical factors on workload is underrepresented aspect in the literature even though recognized as underlying factors in successful surgery.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1340-1349"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39689951","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}