Surgical Innovation最新文献

Improved Gynecomastia Surgery: Power-Assisted Liposuction With Stab-Flatten Technique Without Resection. 改良的男性乳房发育手术：不切除刺压技术的动力辅助吸脂术。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2024-12-09 DOI: 10.1177/15533506241307270

Bingwen Yan, Dongyue Hao, Liming Sun, Zhengqiang Cang, Bofu Xiao, Yongjun Chen, Haixia Qiao, Ying Ma, Baoqiang Song, Chaohua Liu

{"title":"Improved Gynecomastia Surgery: Power-Assisted Liposuction With Stab-Flatten Technique Without Resection.","authors":"Bingwen Yan, Dongyue Hao, Liming Sun, Zhengqiang Cang, Bofu Xiao, Yongjun Chen, Haixia Qiao, Ying Ma, Baoqiang Song, Chaohua Liu","doi":"10.1177/15533506241307270","DOIUrl":"10.1177/15533506241307270","url":null,"abstract":"BackgroundGynecomastia, the enlargement of male breast tissue, significantly impacts both physical and psychological health. Surgical intervention is often necessary, utilizing various techniques to reduce glandular and fatty tissue. This paper introduces an innovative surgical method combining power-assisted liposuction with the stab-flatten technique to enhance precision and cosmetic results. We present our clinical experience and evaluate its effectiveness in gynecomastia treatment.MethodsFrom June 2021 to January 2023, 128 gynecomastia patients underwent power-assisted liposuction and the stab-flatten method via a single axillary incision. We collected demographic and clinical data, including surgery duration, complications, and patient satisfaction regarding physical appearance, mental state, and social interactions. The BODY-Q questionnaire was used preoperatively and 3 months postoperatively for assessment.ResultsThe study included 128 male patients, treating 252 breasts, with an average age of 35 years and a mean BMI of 27.7 kg/m2. Most procedures were bilateral (96.9%), with an average fat removal of 224.5 mL and a surgery duration of 147 minutes. The complication rate was low at 2.0%, with bruises in 5 breasts. The average hospital stay was 2 days. Significant improvements were noted in BODY-Q scores for appearance satisfaction and health-related quality of life, with increased appearance satisfaction and reduced appearance-related distress.ConclusionSince June 2021, the combined use of power-assisted liposuction and the stab-flatten technique has been effective in managing gynecomastia. This synergistic approach not only achieves aesthetically pleasing outcomes but also minimizes the surgical risks associated with traditional methods.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"118-126"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801597","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}

引用次数: 0

A Nomogram for Predicting Perirenal Hematoma After Percutaneous Nephrolithotomy. 预测经皮肾镜取石术后肾周血肿的Nomogram。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2025-01-09 DOI: 10.1177/15533506241313173

Chi Feng, Jun-Tao Tan, Qi-Hua Jiang, Zhi-Hua Li, Bei Mo

{"title":"A Nomogram for Predicting Perirenal Hematoma After Percutaneous Nephrolithotomy.","authors":"Chi Feng, Jun-Tao Tan, Qi-Hua Jiang, Zhi-Hua Li, Bei Mo","doi":"10.1177/15533506241313173","DOIUrl":"10.1177/15533506241313173","url":null,"abstract":"BackgroudPerirenal hematoma (PRH) is a notable complication following percutaneous nephrolithotomy (PCNL) with significant implications for patient outcomes. This study aimed to develop a nomogram predictive model for PRH after PCNL.MethodsRetrospective data from patients who underwent PCNL were analyzed. Patient demographics, stone characteristics, and operative details were assessed for their association with PRH using univariate and multivariate analyses. A nomogram was constructed based on identified predictors.ResultsAmong 1047 patients, 6.2% developed PRH. Factors significantly associated with PRH included age, urine culture, stone surface area, operative time and estimate blood loss. These factors were incorporated into the nomogram, providing a user-friendly tool for preoperative risk assessment of PRH following PCNL.ConclusionWe developed a nomogram predictive model for PRH after PCNL, facilitating individualized risk assessment and preventive strategies. Implementation of this nomogram may enhance patient safety and optimize surgical outcomes in PCNL procedures. Further validation studies are warranted to assess its generalizability and accuracy.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"109-117"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955577","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}

引用次数: 0

Use of a Novel Steerable Tip Suction Cannula in Large and Giant Pituitary Adenomas: A Cadaveric Feasibility Study. 一种新型可操纵尖端吸引管在大、巨型垂体腺瘤中的应用：尸体可行性研究。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2025-01-09 DOI: 10.1177/15533506251313861

Mustafa Selim Sahin, Cafer Ikbal Gulsever, Metehan Ozturk, Duygu Dolen, Ilyas Dolas, Latif Saglam, Osman Coskun, Ozcan Gayretli, Pulat Akin Sabanci

{"title":"Use of a Novel Steerable Tip Suction Cannula in Large and Giant Pituitary Adenomas: A Cadaveric Feasibility Study.","authors":"Mustafa Selim Sahin, Cafer Ikbal Gulsever, Metehan Ozturk, Duygu Dolen, Ilyas Dolas, Latif Saglam, Osman Coskun, Ozcan Gayretli, Pulat Akin Sabanci","doi":"10.1177/15533506251313861","DOIUrl":"10.1177/15533506251313861","url":null,"abstract":"ObjectiveThe endoscopic transsphenoidal approach is commonly used for sellar and suprasellar pathologies. However, reaching above the diaphragma sella, especially for posterosuperior and retrocavernous orientation, still poses some challenges. We designed and developed a steerable tip suction cannula (STSC) that has distinct leverage for endoscopic resection of such pathologies.MethodsThe entire suction cannula is made of stainless steel. The instrument consists of a handle, vacuum tube, suction tip bed, suction tip, finger knuckle, wire path, countersunk headpin, and isolated steel wire. The working principle of the product is to enable the surgeon to move the aspiration tip in the desired direction by steering the finger knuckle. Five cadaveric specimens fixed with the saturated salt solution were used to evaluate the instrument and obtain measurements.ResultsIn the straight position, the STSC aspirated 2.67% slower than the control aspirator tip and 13.24% faster than that at 30° angulation. Based on the CT measurements, the mean angulation of the instrument from the frontobasal axis was 38.3°. The mean distance from the frontobasal axis was 1.3 cm. The average angulation of the tip of the instrument in the cranium was 25.5°.ConclusionThe designed STSC might effectively resect large to giant pituitary adenomas, especially those with supradiaphragmatic extension. Its suction capability is comparable to that of conventional suction tubes.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"149-154"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955583","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}

引用次数: 0

A Comparison Between Combined Ultrasonic and Bipolar Shears to Other Energy-Based Devices in Otolaryngology: A Systematic Review and Meta-Analysis. 联合超声和双极剪切器与其他能量型耳鼻喉科设备的比较：系统综述和荟萃分析。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2025-01-03 DOI: 10.1177/15533506241313171

Kenny Do, Kurtis Young, Eric Kawana, Jo-Lawrence Bigcas

{"title":"A Comparison Between Combined Ultrasonic and Bipolar Shears to Other Energy-Based Devices in Otolaryngology: A Systematic Review and Meta-Analysis.","authors":"Kenny Do, Kurtis Young, Eric Kawana, Jo-Lawrence Bigcas","doi":"10.1177/15533506241313171","DOIUrl":"10.1177/15533506241313171","url":null,"abstract":"ObjectiveThe Thunderbeat (TB) is a new surgical device that combines ultrasonic and bipolar energy. The objective of this study is to examine how the combined ultrasonic and bipolar shears affect surgical outcomes when compared to other methods.Data Sources and Review MethodsUsing the PRISMA guidelines, the researchers used broad search terms in PubMed, Embase, and Web of Science, which produced a total of 2823 initial results, with years ranging from 1955 to June 2024. After applying inclusion and exclusion criteria, 8 final studies were included in this systematic review and meta-analysis.ResultsThis meta-analysis analyzes energy-based devices used on patients into 2 major groups: (1) thyroidectomy group and (2) neck dissection group. The researchers found that the use of the TB in thyroidectomies reduces operative time when compared to the Harmonic scalpel (HS) and Ligasure (LS). The pooled mean difference in thyroidectomy operation time for the TB vs HS was -5.77 min (95% CI: -11.07 to -.48, P-value: .03) and for the TB vs LS was -4.41 min (95% CI: -8.86 to .04, P-value: .05). We also found reduced operative time with the use of the TB vs standard electrocautery for neck dissection, where the mean difference was -39.76 min (95% CI: -63.00 to -16.51, P-value: .00). No significant differences were seen in blood loss or postoperative complications when comparing TB to other methods.ConclusionThis meta-analysis demonstrated that TB can be equivalent to other energy-based devices and shows potential advantages over traditional electrocautery.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"165-179"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928005","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}

引用次数: 0

Subcutaneous Implantation of Open Microwell Islet Delivery Devices in Pigs. 猪开放微孔胰岛输送装置的皮下植入。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2024-12-13 DOI: 10.1177/15533506241306491

Maarten C Tol, Rick H W de Vries, Marten A Engelse, Françoise Carlotti, Aart A van Apeldoorn, Eelco J P de Koning, Volkert A L Huurman

{"title":"Subcutaneous Implantation of Open Microwell Islet Delivery Devices in Pigs.","authors":"Maarten C Tol, Rick H W de Vries, Marten A Engelse, Françoise Carlotti, Aart A van Apeldoorn, Eelco J P de Koning, Volkert A L Huurman","doi":"10.1177/15533506241306491","DOIUrl":"10.1177/15533506241306491","url":null,"abstract":"BackgroundIntraportal pancreatic islet transplantation is a treatment option for patients with severe beta cell failure and unstable glycemic control. However, this procedure is associated with loss of beta cells after intrahepatic transplantation. Islet delivery devices (IDDs) implanted at extrahepatic sites may support engraftment and improve survival of pancreatic islets. We assessed the surgical feasibility, tolerability and safety of implantation of open microwell devices at subcutaneous sites with varying friction in pigs.MethodsOpen, non-immunoisolating microwell islet delivery devices were made from polyvinylidene fluoride (PVDF). Empty (n = 26) and islet-seeded devices (n = 8) were implanted subcutaneously in 6 immunocompetent pigs in low-friction sites (abdomen and lateral hip) and high-friction sites (anterior neck) for 3 months. Retrieved grafts were analyzed histologically with haematoxylin and eosin, and Masson's Trichrome staining.ResultsIslet-seeding and transportation of IDDs was free from complications with minimal islet spillage. IDDs were implanted subcutaneously using standard surgical equipment, without complications during the surgeries. IDDs implanted in the neck and IDDs co-transplanted with human islets were expelled and retrieved after 10 days. Empty IDDs were removed after 3 months. The abdominal site showed reduced signs of inflammation as compared to the neck region, while similar tissue ingrowth and vascularization of devices were found in the two locations.ConclusionsOpen microwell IDDs can safely be implanted with standard surgical equipment and successful islet-loading can be performed. Low-friction sites are preferable over high-friction sites for subcutaneous implantation in the porcine model since these lead to the least amount of foreign body reaction.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"141-148"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Automated Bone Cancer Detection Using Deep Learning on X-Ray Images. 利用深度学习在 X 光图像上自动检测骨癌。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2024-12-16 DOI: 10.1177/15533506241299886

Sasanka Sekhar Dalai, Bharat Jyoti Ranjan Sahu, Jyotirmayee Rautaray, M Ijaz Khan, Bander A Jabr, Yasser A Ali

{"title":"Automated Bone Cancer Detection Using Deep Learning on X-Ray Images.","authors":"Sasanka Sekhar Dalai, Bharat Jyoti Ranjan Sahu, Jyotirmayee Rautaray, M Ijaz Khan, Bander A Jabr, Yasser A Ali","doi":"10.1177/15533506241299886","DOIUrl":"10.1177/15533506241299886","url":null,"abstract":"In recent days, bone cancer is a life-threatening health issue that can lead to death. However, physicians use CT-scan, X-rays, or MRI images to recognize bone cancer, but still require techniques to increase precision and reduce human labor. These methods face challenges such as high costs, time consumption, and the risk of misdiagnosis due to the complexity of bone tumor appearances. Therefore, it is essential to establish an automated system to detect healthy bones from cancerous ones. In this regard, Artificial intelligence, particularly deep learning, shows increased attention in the medical image analysis process. This research presents a new Golden Search Optimization along with Deep Learning Enabled Computer Aided Diagnosis for Bone Cancer Classification (GSODL-CADBCC) on X-ray images. The aim of the GSODL-CADBCC approach is to accurately distinguish the input X-ray images into healthy and cancerous. This research presents the GSODL-CADBCC technique that leverages the bilateral filtering technique to remove the noise. This method uses the SqueezeNet model to generate feature vectors, and the GSO algorithm efficiently selects the hyperparameters. Finally, the extracted features can be classified by improved cuckoo search with a long short-term memory model. The experimental results demonstrate that the GSODL- CADBCC approach attains highest performance with an average accuracy of 95.52% on the training set data and 94.79% on the testing set data. This automated approach not only reduces the need for manual interpretation but also minimizes the risk of diagnostic errors and provides a viable option for precise medical imaging-based bone cancer screening.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"94-108"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829865","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}

引用次数: 0

Developing an Indocyanine Green Angiography Protocol for Predicting Flap Necrosis During Breast Reconstruction. 建立预测乳房重建期间皮瓣坏死的吲哚菁绿血管造影方案。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2025-01-06 DOI: 10.1177/15533506241313172

Chu Luan Nguyen, Nirmal Dayaratna, Neshanth Easwaralingam, Jue Li Seah, Farhad Azimi, Cindy Mak, Carlo Pulitano, Sanjay Kumar Warrier

{"title":"Developing an Indocyanine Green Angiography Protocol for Predicting Flap Necrosis During Breast Reconstruction.","authors":"Chu Luan Nguyen, Nirmal Dayaratna, Neshanth Easwaralingam, Jue Li Seah, Farhad Azimi, Cindy Mak, Carlo Pulitano, Sanjay Kumar Warrier","doi":"10.1177/15533506241313172","DOIUrl":"10.1177/15533506241313172","url":null,"abstract":"BackgroundAlthough there is evidence that indocyanine green angiography (ICGA) can predict mastectomy skin flap necrosis during breast reconstruction, consensus on optimal protocol is lacking. This study aimed to evaluate various technical factors which can influence ICG fluorescence intensity and thus interpretation of angiograms.MethodSingle institution retrospective study (2015-2021) of immediate implant-based breast reconstructions postmastectomy using a standardized technique of ICGA, controlling for modifiable factors of ambient lighting, camera distance and ICG dose. \"Time to perfusion\" assessment was defined as elapsed time from ICG administration to perfusion assessment. Intraoperative \"absolute\" and \"relative\" IGCA perfusion values of mastectomy flaps, taken at different time points (30, 60 and 90 seconds), were correlated with postoperative flap outcomes.ResultsThere were 260 breast reconstructions with a 3.1% necrosis rate. ICGA perfusion values, when measured at 60 and 90 seconds, were significantly lower for cases that developed necrosis compared to cases that did not, and were both good predictors of necrosis (area under ROC curves, 0.84 and 0.85, respectively). Fluorescence intensity increased as \"time to perfusion\" assessment increased for flaps that did not develop necrosis (correlation coefficient, 0.9, P < 0.001). Perfusion value cut-off thresholds for predicting necrosis were higher for a longer \"time to perfusion\" assessment.ConclusionsA standardized ICGA protocol is recommended as ICG fluorescence intensity increased with \"time to perfusion\" assessment, and ≤30 seconds did not allow for accurate perfusion analysis. Using a perfusion recording of 60 or 90 seconds, and the corresponding perfusion value cut-off, may optimize reliability of perfusion assessments.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"77-84"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and Safety of LigaSure in Breast Surgery With Axillary Lymph Node Dissection in Patients With Breast Cancer: A Systematic Review and Meta-Analysis. LigaSure在乳腺癌患者腋窝淋巴结清扫乳腺手术中的疗效和安全性：一项系统综述和荟萃分析。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2024-12-02 DOI: 10.1177/15533506241305892

Muhammad Imran, Mansab Ali, Tungki Pratama Umar, Shujaat Ali, Saba Khalil, Hamza Irfan, Aiman Muhammad, Amna Javed, Fatima Shahzadi, Seemab Ara, Amir Usman, Ubaid Khan

{"title":"Efficacy and Safety of LigaSure in Breast Surgery With Axillary Lymph Node Dissection in Patients With Breast Cancer: A Systematic Review and Meta-Analysis.","authors":"Muhammad Imran, Mansab Ali, Tungki Pratama Umar, Shujaat Ali, Saba Khalil, Hamza Irfan, Aiman Muhammad, Amna Javed, Fatima Shahzadi, Seemab Ara, Amir Usman, Ubaid Khan","doi":"10.1177/15533506241305892","DOIUrl":"10.1177/15533506241305892","url":null,"abstract":"BackgroundConventional axillary lymph node dissection (ALND) is associated with significant post-operative morbidity in patients undergoing breast surgery due to increased lymphatic leakage. LigaSure, an electrothermal bipolar vessel sealing system, provides better closure of the leakage. This study aims to compare the efficacy and safety of LigaSure against conventional techniques in patients with breast cancer underwent ALND and breast surgery.MethodsWe conducted a comprehensive search across the databases to identify relevant studies. The search results were imported into Covidence for article eligibility screening, and all relevant outcomes data were synthesized using odd ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) in meta-analysis models using RevMan 5.4.ResultsTwelve studies with the total of 895 patients (LigaSure = 441; Conventional technique = 454) with breast cancer underwent breast surgery with ALND were included. LigaSure was associated with significantly lower post-operative drain volume (SMD: -0.39, 95% CI [-0.53, -0.24], P < 0.00001), shortened duration of drain (SMD: -0.51, 95% CI [-0.67, -0.34], P < 0.00001), and reduced hospital stay length (SMD: -0.57, 95% CI [-0.96, -0.18], P = 0.004) compared to conventional techniques. However, no difference observed in total operation time, intra-operative blood loss, seroma related outcomes and post-operative complications between the two groups.ConclusionLigaSure significantly reduced the lymphorrhea, duration of drain and hospital stay, however, it did not prove be effective in seroma-related outcomes.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"155-164"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772532","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}

引用次数: 0

Perianastomotic pH Monitoring for Early Detection of Anastomotic Leaks in Gastrointestinal Surgery: A Systematic Review of the Literature. 吻合口周围pH监测对胃肠道手术吻合口瘘早期发现的系统文献综述。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2025-01-07 DOI: 10.1177/15533506241313168

Josephine Walshaw, Katherine Hugh, Jack Helliwell, Joshua Burke, David Jayne

{"title":"Perianastomotic pH Monitoring for Early Detection of Anastomotic Leaks in Gastrointestinal Surgery: A Systematic Review of the Literature.","authors":"Josephine Walshaw, Katherine Hugh, Jack Helliwell, Joshua Burke, David Jayne","doi":"10.1177/15533506241313168","DOIUrl":"10.1177/15533506241313168","url":null,"abstract":"IntroductionAnastomotic leak (AL) represents a significant complication following gastrointestinal (GI) surgery, contributing to increased morbidity and mortality. pH monitoring has emerged as a potential diagnostic tool for the early detection of AL, but its effectiveness and clinical utility remain to be fully elucidated. This review aims to summarise the evidence regarding perianastomotic pH monitoring for AL detection.MethodsA systematic search of relevant databases was conducted to identify pre-clinical and clinical studies investigating pH monitoring for AL detection following GI surgery. Studies were screened by two independent reviewers based on predefined inclusion and exclusion criteria. Data were extracted and presented as a narrative synthesis.ResultsA total of 10 studies were included in the review, comprising animal studies (n = 2), and human studies in upper GI (n = 3) and colorectal (n = 5) patients. Consistent findings of lower pH values in patients with AL across various postoperative time points were demonstrated. There was diversity in the pH detection method, in addition to variable frequency and timing of pH monitoring. Four studies reported a shorter time for AL detection with pH monitoring vs conventional methods, although no statistical comparisons were used. No standard pH cut-off value for AL detection was identified.ConclusionpH monitoring shows potential as a diagnostic tool for the early detection of AL following GI surgery. While the existing evidence supports its potential utility, further research is required to establish standardised protocols and assess its clinical impact.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"180-195"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Veress Needle as a Liver Retraction Technique in Laparoscopic Sleeve Gastrectomy. Veress针在腹腔镜袖式胃切除术中肝回缩技术的评价。

IF 1.2 4区医学

Surgical Innovation Pub Date : 2025-04-01 Epub Date: 2024-12-05 DOI: 10.1177/15533506241305894

Suleyman Caglar Ertekin, Gökhan Akbulut, Emre Turgut, Hüseyin Akyol, Muhammer Ergenç, Cumhur Yeğen

{"title":"Evaluation of Veress Needle as a Liver Retraction Technique in Laparoscopic Sleeve Gastrectomy.","authors":"Suleyman Caglar Ertekin, Gökhan Akbulut, Emre Turgut, Hüseyin Akyol, Muhammer Ergenç, Cumhur Yeğen","doi":"10.1177/15533506241305894","DOIUrl":"10.1177/15533506241305894","url":null,"abstract":"BackgroundLiver retraction management in laparoscopic sleeve gastrectomy (LSG) is challenging for surgeons, especially in patients with enlarged livers. Traditional methods, such as the Nathanson retractor (NR), often necessitate additional incisions, potentially increasing liver enzymes and increasing the risk of complications. The aim of this study was to evaluate the efficacy of the use of a Veress needle (VN), an alternative liver retraction technique, in LSG surgery compared with NR.Materials and MethodsThis study was conducted at a university-affiliated hospital between May 2022 and December 2022. Patients who underwent LSG were divided into two groups: one utilizing the NR and the other employing the VN for liver retraction. Parameters such as operation duration, retraction time, liver laceration, trocar-induced hemorrhage, subxiphoid trocar site infections, pain scores measured via the visual analog scale (VAS) at various time points, pre- and postoperative liver enzyme levels (AST, ALT, GGT, ALP) and CRP levels were analyzed.ResultsData from 151 patients were analyzed. The AST/ALT elevations (P < 0.001) were significantly lower in the VN group (73 patients) than in the NR group (78 patients), while there was no significant difference in GGT/ALP levels. Retraction-related bleeding was significantly greater in the NR group than in the VN group (6.4% vs 0%, P = 0.035). Postoperative infection rate was lower in the VN group but not statistically significant (0% vs 3.8%, P = 0.135). CRP differences were significant on the first postoperative day (P < 0.001). Postoperative VAS scores were significantly lower in the VN group at all measured time points except at the 48th hour and 10th day.ConclusionsThe VN technique in LSG significantly reduces liver enzyme elevation and the need for an extra trocar and incision, potentially lowering complication risk and enhancing patient outcomes.","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"85-93"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787056","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}

引用次数: 0