Journal of Investigative Surgery最新文献

{"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":null,"pages":null},"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":"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":null,"pages":null},"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":"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":null,"pages":null},"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":"The Future of Surgical Education Today.","authors":"Georgios Tsoulfas","doi":"10.1080/08941939.2022.2053253","DOIUrl":"https://doi.org/10.1080/08941939.2022.2053253","url":null,"abstract":"In the paper “A standardized workshop for Peer-Teaching simple interrupted sutures to medical students: Analysis of the student factors that affect outcomes.” the authors demon-strate and assess the implementation of standardized Peer Assisted Learning (PAL) suturing workshops in helping medical students attain technical competence in surgical suturing [1]. They were able to show in an elegant manner that surgical peer teaching is an effective method, with factors such as previous workshop experience and recent completion of a general surgery rotation being a factor in achieving better results [1]. These findings underscore the importance of active learning methods in surgical education, thus benefiting both the trainees and the trainers.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312469","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":null,"pages":null},"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":"The Comparative Effects of Inulin and <i>Bacillus clausii</i> on LPS-Induced Endotoxemic Rat Liver.","authors":"Ibrahim Sogut,&nbsp;Fatih Kar,&nbsp;Sevda Tanrikulu-Kucuk,&nbsp;Tarık Talha Gozden,&nbsp;Sumeyye Asena Can,&nbsp;Aslı Kandil","doi":"10.1080/08941939.2022.2052210","DOIUrl":"https://doi.org/10.1080/08941939.2022.2052210","url":null,"abstract":"<p><strong>Background: </strong>This paper sought to investigate the modifies of inulin and Bacillus clausii on the lipopolysaccharides (LPS) inducing oxidative stress signaling pathway in the endotoxemic rat model.</p><p><strong>Methods: </strong>Wistar albino male rats (n = 36), divided into six groups, were formed randomly in the following stages: the control group; the prebiotic group (Inulin; 500 mg/kg); the probiotic group (<i>Bacillus clausii</i>; 1x10⁹ CFU); the LPS group (1.5 mg/kg) as the endotoxemic model; the prebiotic group + LPS; and the probiotic group + LPS as treatment groups.</p><p><strong>Results: </strong>The reactive oxygen species (ROS), advanced oxidation products of protein (AOPP), thiobarbituric acid reactive substances (TBARS), total oxidant status (TOS), oxidative stress index (OSI), and myeloperoxidase activity (MPO) levels increased in LPS-induced toxicity. Prebiotic treatment decreased LPS-induced hepatotoxicity on rat liver as observed in the decrease in the levels of oxidative stress parameters, such as ROS, TBARS, TOS, and OSI. The effect of the probiotic treatment on the ROS, AOPP, TOS, OSI levels was not statistically significant. However, it was determined that probiotic application was effective in the TBARS, TAS, and GSH levels. When the biochemical results of the prebiotic and probiotic treatment applications were compared, it was found that the prebiotic treatment was more effective on oxidative stress parameters (ROS, TBARS, TOS, and OSI). In addition, the histological damage score and MPO-staining results of the prebiotic treatment group were found to be more effective than the probiotic group.</p><p><strong>Conclusion: </strong>In this first study, where inulin and <i>Bacillus clausii</i> spores are used against liver damage caused by LPS, inulin provides much more effective protection than <i>Bacillus clausii</i> spores.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40310996","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":"Tissue Adhesive: Current Uses and Strengths.","authors":"Francesca Allegra Waldner,&nbsp;Payam Sadeghi,&nbsp;Luca Grimaldi,&nbsp;Giuseppe Nisi,&nbsp;Natale Calomino,&nbsp;Roberto Cuomo","doi":"10.1080/08941939.2022.2052211","DOIUrl":"https://doi.org/10.1080/08941939.2022.2052211","url":null,"abstract":"Tissue adhesives are increasingly important elements in modern medicine, with rapid development over the past 30 years. They enable the innate wound healing processes to occur through the adhesion of tissue to the tissue on-site or tissue to non-tissue surfaces on-site, thus exhibiting some attractive characteristics in the clinic, such as less traumatic closure and suffering, easy application, no stitches required after surgery, excellent cosmetic results, and localized drug release [1]. These tissue adhesives are extensively used for different tissues, including skin, breast, cardiac, gastrointestinal, head and neck, hepatic, orthopedic, pediatric, thoracic, bone, neurological and vascular surgery [2]. After several decades of intensive research activities, a wide variety of tissue adhesives have been developed to increase the ability of tissue adhesives to meet different clinic requirements. The current clinical tissue adhesives could be divided into three groups: natural tissue adhesives, synthetic and semisynthetic tissue adhesive, and biomimetic tissue adhesives. The advantages of tissue adhesives include easy and rapid use with no follow-ups for removal of any residual components as is the case with sutures or staples. Until now, many tissue adhesives synthetic and semi-synthetic in origin with biomimetic characteristics and good biocompatibility have been developed and applied into clinical setting [3]. However, some challenges in the form of poor mechanical strength, swelling, and low stability limited their further applications in the field [4]. Polyurethanes are polymers formed through poly-addition reactions of isocyanates. The medical use of polyurethane was previously limited due to carcinogenicity and toxicity of intermediate chemicals and catalysts. However, after improvement in biosafety by modifying isocyanates from aromatic to lysine-derived, polyurethane adhesives have been introduced for surgical application. A novel lysine-derived urethane adhesive (TissuGlu® Surgical Adhesive, Cohera Medical, Inc., Pittsburgh, PA) has recently been developed which adheres large tissue flaps to the underlying tissue during surgical procedures. TissuGlu is the only FDA-approved polyurethane adhesive for intracorporeal use and it was studied for large flap surgeries such as abdominoplasty [5]. TissuGlu was utilized on patients undergoing abdominoplastic surgery and the results showed that it effectively binds tissue layers together in comparison to standard surgical closure techniques. Thereby reducing dead spaces where seroma can occur, while it also reduces post-surgery wound drainage [6, 7]. Recently, a long-term evaluation of TissuGlu showed that it can prevent the formation of seroma in a canine abdominoplasty model [8, 9]. This glue is described as resorbable and nontoxic; it forms a strong bond between tissue layers, and it eliminates or reduces fluid accumulation and the need for postsurgical drains. The use of the adhesive may provide","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40324305","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":null,"pages":null},"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":"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":null,"pages":null},"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":null,"pages":null},"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}