Journal of Investigative Surgery最新文献

{"title":"Relationship between Primary Tumor Resection for Metastatic Small Intestine Neuroendocrine Tumors and Survival: A Propensity Score-Matched Analysis.","authors":"Haihao Yan,&nbsp;Linlin Yin,&nbsp;Hao Han,&nbsp;Ye Jin,&nbsp;Zheng Liu","doi":"10.1080/08941939.2021.2024306","DOIUrl":"https://doi.org/10.1080/08941939.2021.2024306","url":null,"abstract":"<p><strong>Background: </strong>At present, it has been controversial whether primary tumor resection (PTR) can bring survival advantage to patients with metastatic small intestine neuroendocrine tumors (SI-NETs). To answer this question, we conducted a retrospective cohort study to evaluate the effect of PTR on the survival of patients with metastatic SI-NETs.</p><p><strong>Methods: </strong>Information on SI-NETs patients from 2004 to 2015 was extracted from Surveillance, Epidemiology, and End Results (SEER) databases. Demographics, tumor characteristics, treatment, and survival were compared. Propensity score-matched (PSM) was used 1:1 in the filtered queue. Cox proportional hazard regression model was used to evaluate the correlation between PTR and treatment results.</p><p><strong>Results: </strong>Before PSM, survival analysis showed that PTR significantly prolonged the survival of metastatic SI-NETs patients. After PSM, there was no significant difference in overall survival (OS) and cancer-specific survival (CSS) between the PTR group and the non-PTR group. Multivariate analysis showed no significant difference in OS and CSS between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>Our study shows that OS and CSS are comparable between the PTR group and the non-PTR group. Thus, we believe that PTR should not be actively performed on such patients. Meanwhile, it is undeniable that properly selected patients may also benefit from PTR. Therefore, prospective randomized controlled trials are still needed to verify the effect of PTR on patients in the future.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1239-1247"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39790425","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":"RIP1 Regulates Mitochondrial Fission during Skeletal Muscle Ischemia Reperfusion Injury.","authors":"Yu Cao,&nbsp;Shunli Chen,&nbsp;Xiangqing Xiong,&nbsp;Lina Lin,&nbsp;Wantie Wang,&nbsp;Liangrong Wang","doi":"10.1080/08941939.2022.2036880","DOIUrl":"10.1080/08941939.2022.2036880","url":null,"abstract":"<p><strong>Background: </strong>Dynamin related protein-1 (Drp1)-mediated mitochondrial fission relates to ischemia reperfusion (IR) injury, and its association with necroptosis is implied. We hypothesized that receptor-interacting protein 1 (RIP1), a key kinase in necroptosis, acted as an upstream of Drp1-mediated mitochondrial fission during skeletal muscle IR.</p><p><strong>Methods: </strong>Thirty rats were randomized into the SM, IR, NI, MI, and DI group (<i>n</i> = 6). The rats in the SM group were shamly operated, and those in the IR group were subjected to 4-hour ischemia of the right hindlimb that was followed by 4-hour reperfusion. Intraperitoneal administration of Nec-1 1 mg/kg, Mdivi-1 1.2 mg/kg and same volume of DMSO were given before ischemia in the NI, MI and DI groups, respectively. Upon reperfusion, the soleus muscles were harvested to determine morphological changes and the expression of RIP1, total Drp1 and p-Drp1 (Ser616). Moreover, the muscular oxidative stress indicators and plasma muscle damage biomarkers were detected.</p><p><strong>Results: </strong>IR led to impaired histopathological structures and mitochondrial fragmentation in the soleus muscle tissue, accompanied with increased muscular oxidative stress and muscle injury biomarkers, which could be similarly alleviated by Mdivi-1 and Nec-1 (<i>p</i> < 0.05). RIP1 and p-Drp1 (Ser616) protein levels were significantly upregulated in the soleus muscle subjected to IR injury, this upregulation was attenuated in the NI group, and Mdivi-1 downregulated the protein expression of p-Drp1 (Ser616) but not of RIP1 (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>RIP1 functions as an upstream of Drp1-mediated mitochondrial fission in the execution of necroptosis during skeletal muscle IR.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1269-1274"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46386104","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":"Clinical, Histological, and Profibrotic Extracellular Matrix Protein Changes in a Model of Tracheal Stenosis Induced by Cervical Tracheal Autotransplantation","authors":"M. Silva-Martínez, J. R. Olmos-Zúñiga, J. Calyeca, M. Baltazares-Lipp, M. Gaxiola-Gaxiola, Andrea Nachón-Acosta, L. E. Pensado-Piedra, F. Juárez-Hernández, R. Sotelo-Robledo, R. Jasso-Victoria, Antonia Luna-Flores, J. C. Vázquez-Minero","doi":"10.1080/08941939.2022.2081388","DOIUrl":"https://doi.org/10.1080/08941939.2022.2081388","url":null,"abstract":"Abstract Background Tracheal stenosis (TS) is a complication of prolonged intubation, tracheotomy, and tracheal surgery that compromises the vascular supply. Animal models are essential for studying its pathophysiology and the effect of interventions. Objective To establish a TS model in rats secondary to tracheal autotransplantation with a graft submerged in bleomycin (Atx-Bleo). Additionally, to evaluate the clinical and histological changes, as well as the expression of newly formed collagen (NFC), isoforms of transforming growth factor beta (TGFβ), fibronectin (FN), elastin (ELN), integrin β1 (ITGβ1), and matrix metalloproteinase 1 (MMP1) in TS. Methods Twenty Wistar rats were divided into three groups: group I (n = 20) control; group II (n = 10) end-to-end anastomosis of the trachea (tracheoplasty); and group III (n = 10) Atx-Bleo. The animals were evaluated clinically, tomographically, macroscopically, morphometrically, and microscopically. NFC deposition, and the expression of profibrotic and antifibrotic proteins were evaluated in tracheal scars. Results All animals survived the surgical procedure and the study period. Compared with the other study groups, the Atx-Bleo group developed TS and fibrosis, exhibited higher expression of NFC, TGFβ1, TGFβ2, FN, ELN, and ITGβ1, and mild expression of TGFβ3 and MMP1 (p < 0.005; analysis of variance, Dunnett and Tukey tests). Conclusion Atx-Bleo in TS model rats produces tomographic and histological changes, and induces the upregulation of profibrotic proteins (TGFβ1, TGFβ2, collagen, FN, ELN, ITGβ1) and downregulation of antifibrotic proteins (TGFβ3, MMP1). Therefore, this model may be used to test new pharmacological treatments for reversing or preventing TS, and conduct basic studies regarding its pathophysiology.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1551 - 1561"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41368627","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":"Feasibility of Magnetic Technique for Axillary Staging after Neoadjuvant Therapy in Breast Cancer Patients.","authors":"Osman Cem Yılmaz,&nbsp;Veli Vural","doi":"10.1080/08941939.2022.2038737","DOIUrl":"https://doi.org/10.1080/08941939.2022.2038737","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal axillary staging after neoadjuvant chemotherapy (NAC) in node-negative breast cancer is an area of controversy. Sentinel node biopsy with Technetium-sulphur colloid (99m Tc) alone or with blue dye is the recommended technique for evaluating axilla in these patients. However, this technique has drawbacks such as limited access to nuclear departments and timing limitations related to Tc injection exposing patients to unnecessary radiation. Superparamagnetic iron oxide nanoparticles (SPIO) may represent a valid option for SLN biopsy. In this study, we assessed the feasibility of the magnetic technique (Sentimag) with combination of isosulfan blue dye in breast cancer patients who received NAC.</p><p><strong>Methods: </strong>The study sample consisted of 54 female breast cancer patients who received NAC. Sentinel node localization was performed using magnetic technique and blue dye. Sentinel node identification rate (IFR) of magnetic technique was calculated and postoperative complications were assessed.</p><p><strong>Results: </strong>Sentinel lymph node was detected in 52 patients with Sentimag method (identification rate = 96.3%, 95% CI: 87.4-98.9%). Blue dye was successful to find SLN in 38 patients (identification rate = 70%). The most common histologic type was invasive ductal (<i>n</i> = 51; 94.4%). Mean tumor size was 2.1 cm after NAC. Most of patients had T2 (<i>n</i> = 30; 55.5%) and HER2 + positive (<i>n</i> = 49; 90.7%) cancer.</p><p><strong>Conclusion: </strong>Sentimag which is a magnetic technique appears to be safe, easy to perform with minimal adverse effects, may be an alternative and accurate technique in patients with NAC, especially in breast units where nuclear medicine unit is not available.</p><p><p>Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2022.2038737 .</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1275-1278"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39808908","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":"S2-Alar-Iliac Screw Fixation versus Iliac Screw Fixation in the Treatment of Sacral Fractures.","authors":"Yangxing Luo,&nbsp;Yue Li,&nbsp;Li He,&nbsp;Chengla Yi","doi":"10.1080/08941939.2021.2022253","DOIUrl":"https://doi.org/10.1080/08941939.2021.2022253","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the short-term therapeutic effects of S2-alar-iliac (S2AI) screw fixation and iliac screw fixation techniques in managing sacral fractures.</p><p><strong>Methods: </strong>From September 2015 to May 2020, 42 patients with sacral fractures who underwent lumbopelvic fixation by a single surgeon were analyzed. The patients were divided into the S2AI screw group (19 patients) and the iliac screw group (23 patients). Operative data, reduction quality, postoperative complications, and functional outcomes were evaluated.</p><p><strong>Results: </strong>The incidence of unplanned reoperation was significantly different between patients treated with S2AI screws than in those treated with iliac screws (0 versus 6, p = 0.02). The mean intraoperative estimated blood loss was 405.26 ± 229.67 mL in the S2AI screw group and 539.13 ± 246.32 mL in the iliac screw group (P = 0.08). No significant difference was observed in either group regarding the quality of reduction, functional outcome, or low back pain. The reduction quality based on the Matta criteria and excellent/good outcomes were 21/2 in the iliac screw group and 17/2 in the S2AI screw group. The functional outcomes based on the Majeed score and excellent/good/fair outcomes were 17/3/3 in the iliac screw group and 17/1/1 in the S2AI screw group. No complications, including implant breakage, loosening of the implant, or loss of reduction were found in either group during follow-up.</p><p><strong>Conclusion: </strong>Both S2AI screws and iliac screws were effective in the treatment of sacral fractures. The use of S2AI screws, however, was independently associated with fewer unplanned reoperations for surgical site infection, wound dehiscence, and symptoms of screw protrusion than the use of iliac screws.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1224-1230"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39777687","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 Anti-TNF Therapy is Associated with a Shorter Length of Resected Bowel in Patients Undergoing Ileocolic Resection for Crohn's Disease.","authors":"Yuhua Huang,&nbsp;Danhua Yao,&nbsp;Feilong Guo,&nbsp;Zhiyuan Zhou,&nbsp;Yousheng Li","doi":"10.1080/08941939.2021.2023713","DOIUrl":"https://doi.org/10.1080/08941939.2021.2023713","url":null,"abstract":"<p><strong>Background: </strong>Massive or repeated intestinal resections for Crohn's disease (CD) could lead to disabling consequences. The present study aimed to assess the effect of preoperative anti-TNF therapy on the length of resected bowel and identify risk factors for postoperative morbidity following ileocolic resection for CD.</p><p><strong>Methods: </strong>Patients undergoing elective ileocolic resection for CD were included prospectively. Medical variables including demographics, Montréal classification, preoperative treatment, surgical details and 30-day postoperative morbidity were collected. Potential impact of preoperative anti-TNF treatment on length of ileocolic specimen and risk factors for postoperative morbidity were investigated.</p><p><strong>Results: </strong>One hundred and eight-four patients were included in this study, and 66 (35.9%) of them received anti-TNF agents within 8 weeks prior to surgery. Primary anastomosis was performed in 145 patients (78.8%). The mean length of resected intestine was 10 cm shorter in subjects receiving preoperative anti-TNF treatment than those without preoperative anti-TNF therapy (<i>P</i> < 0.001). The rates of postoperative overall, infectious and intra-abdominal septic morbidity were 29.9%, 19.0% and 7.6%, respectively. In multivariate analysis, anti-TNF therapy < 8 weeks before surgery was independently associated with a shorter length of resected bowel but didn't increase overall and septic complications, while systemic steroids use within 8 weeks prior to surgery independently increased overall complications and intra-abdominal sepsis.</p><p><strong>Conclusions: </strong>Preoperative anti-TNF therapy was associated with a shorter length of resected bowel but not the overall and septic postoperative complications in ileocolic resection for CD. Weaning off systemic steroids before surgery may improve postoperative outcomes in patients with CD.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1357-1365"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873964","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 Use of Social Media to Deliver Surgical Education in Response to the COVID-19 Pandemic.","authors":"Shijie Yang,&nbsp;Chao Jin,&nbsp;Jinhui Wang,&nbsp;Xiequn Xu","doi":"10.1080/08941939.2022.2035859","DOIUrl":"https://doi.org/10.1080/08941939.2022.2035859","url":null,"abstract":"<p><strong>Background: </strong>As clinical rotations were disrupted by the COVID-19 pandemic, with surgical specialty being the one most severely affected among all disciplines, social media had become increasingly used for surgical education. We aimed to identify and present the application of social media as an essential tool for surgical education during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>A literature review was conducted using PubMed/MEDLINE and EMBASE databases for potentially eligible articles published until April 2021. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>A total of 23 articles were identified and systematically reviewed that related to the application of social media use in surgical education during the COVID-19 pandemic. These may be grouped into 3 discrete categories (online learning, scientific research, networking) and 14 topics (online resources, virtual conferencing, preparing for exams, etc.).</p><p><strong>Conclusions: </strong>Social media has played a multidimensional critical role in training surgical students and residents in the COVID-19 era, with special superiority that cannot be substituted by other online tools.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1350-1356"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39897122","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":"Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study.","authors":"Guifang Zeng,&nbsp;Baojia Zou,&nbsp;Yongliang Li,&nbsp;En Lin,&nbsp;Xialei Liu,&nbsp;Peiping Li,&nbsp;Jiafan Chen,&nbsp;Baimeng Zhang,&nbsp;Yingbin Jia,&nbsp;Chaonong Cai,&nbsp;Jian Li","doi":"10.1080/08941939.2021.2021334","DOIUrl":"https://doi.org/10.1080/08941939.2021.2021334","url":null,"abstract":"<p><p><b>Background:</b> More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. <b>Methods:</b> Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. <b>Results:</b> Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (<i>P</i> = 0.977) but worse DFS compared with the No TACE group (<i>P</i> = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (<i>P</i> = 0.466, <i>P</i> = 0.864, <i>P</i> = 0.488, respectively) but even worse DFS (<i>P</i> = 0.035, <i>P</i> = 0.040, <i>P</i> = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (<i>P</i> = 0.342, <i>P</i> = 0.941, respectively). <b>Conclusions:</b> PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1208-1216"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963519","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 Simulation and Three-Dimensional Model for the Operative Treatment of Forearm Double Fracture: A Randomized Controlled Clinical Trial.","authors":"Yin Zhang,&nbsp;Junchao Luo,&nbsp;Li Cao,&nbsp;Shuijun Zhang,&nbsp;Yu Tong,&nbsp;Qing Bi,&nbsp;Qiong Zhang","doi":"10.1080/08941939.2021.2024305","DOIUrl":"https://doi.org/10.1080/08941939.2021.2024305","url":null,"abstract":"<p><strong>Background: </strong>To assess the safety and efficacy of preoperative simulation and three-dimensional (3D) models in the treatment of ulnoradial diaphyses fracture. It was hypothesized that preoperative simulation and 3D printing might significantly shorten the mean operative time, intraoperative bleeding, and intraoperative fluoroscopy.</p><p><strong>Material and methods: </strong>Forty patients with forearm double fracture were divided into 3D printing group and conventional surgery group. Preoperative simulation and 3D printing were performed on patients in the 3D printing group to examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, and frequency of fluoroscopies were recorded.</p><p><strong>Results: </strong>In the conventional surgery group, the operative time, intraoperative bleeding, and the frequency of fluoroscopy were 106.2 ± 15.92 min, 61.45 ± 11.33 ml and 5.65 ± 1.23 times, whereas in the 3D printing group, values of all the three parameters were better than those of the conventional surgery group (91.3 ± 14.85 min, 48.6 ± 10.39 ml and 3.85 ± 1.04 times, respectively). The forearm pronation and supination of the 3D printing group improved to 79.55 ± 5.12° and 76.80 ± 3.96°, respectively. In the conventional surgery group, patients also had significant improvement in these indicators, which improved to 78.60 ± 5.18° and 75.4 ± 5.30°.</p><p><strong>Conclusions: </strong>The results showed that preoperative simulation and 3D printing can enhance the safety as well as personalization of the surgical process during the treatment of forearm double fracture and therefore holds potential for future application in clinical practice.</p><p><strong>Trial registry: </strong>Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100045790.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1231-1238"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873966","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":"Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial.","authors":"Jalaluddin Khoshnevis,&nbsp;Roberto Cuomo,&nbsp;Farzaneh Karami,&nbsp;Terifeh Dashti,&nbsp;Alireza Kalantar Motamedi,&nbsp;Mohammadreza Kalantar Motamedi,&nbsp;Eznollah Azargashb,&nbsp;Negaar Aryan,&nbsp;Payam Sadeghi","doi":"10.1080/08941939.2021.2022252","DOIUrl":"https://doi.org/10.1080/08941939.2021.2022252","url":null,"abstract":"<p><strong>Background: </strong>The treatment of anal fistula has been a conundrum for surgeons over the years. Various methods such as fistulotomy, fistulectomy, seton, ligation of the intersphincteric fistula tract (LIFT), advancement flaps, fibrin glue, and plugs are well-known techniques. Yet, they may be followed by several considerable complications, including incontinency and recurrence.</p><p><strong>Methods: </strong>In this study, the outcomes of the \"Jump\" and \"Seton\" techniques are compared. A randomized controlled trial consisting of 130 cases with cryptoglandular anal fistula randomly sorted into two groups was conducted. Group A underwent the \"Jump technique\" while group B underwent the \"Seton technique.\" Outcomes, incontinency and recurrences in particular, were evaluated after a year of treatment. Data were analyzed by Fisher Exact, Chi-Square and Mann Whitney Tests.</p><p><strong>Results: </strong>Group A with 65 cases underwent the \"Jump technique\" while group B with 65 cases underwent the \"Seton Method.\" Recurrence was reported in 12 (20%) cases in group A and 10 (15.6%) cases in group B (<math><mi>p</mi><mo>=</mo><mn>0.687</mn></math>). Overall incontinence was reported in 3 (4.6%) cases in group A and 18 (27.7%) cases in group B (<math><mi>P</mi><mo>=</mo><mn>0.001</mn></math>). The total St. Mark's scores for incontinency of group A (<math><mn>0.092</mn><mo>±</mo><mn>0.52</mn></math>) and group B (<math><mn>1.8</mn><mo>±</mo><mn>02.47</mn></math>) significantly differed (<math><mi>p</mi><mo><</mo><mn>0.001</mn></math>).</p><p><strong>Conclusions: </strong>The \"Jump technique\", named after a runner who jumped over hurdles, has obviated these complications. The \"Jump technique\" had satisfactory results and can be utilized as a first-line approach for all types of fistulas. Moreover, it can be redone for cases with recurrences without affecting the continence, paving the way to change the technique during operations.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1217-1223"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879977","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}