World Journal of Surgery最新文献_第5页

Biliary atresia in Uganda: Current ethical challenges and advancement of public policy. 乌干达的胆道闭锁：当前的伦理挑战与公共政策的推进。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-04-01 DOI: 10.1002/wjs.12166

Nasser Kakembo, J Isaac Loy, Tamara N Fitzgerald, Ryan M Antiel

{"title":"Biliary atresia in Uganda: Current ethical challenges and advancement of public policy.","authors":"Nasser Kakembo, J Isaac Loy, Tamara N Fitzgerald, Ryan M Antiel","doi":"10.1002/wjs.12166","DOIUrl":"10.1002/wjs.12166","url":null,"abstract":"Biliary atresia is a progressive cholangiopathy in neonates, which often results in liver failure. In high-income countries, initial treatment requires prompt diagnosis followed by Kasai portoenterostomy. For those with a late diagnosis, or those in whom Kasai portoenterostomy fails, liver transplantation is the only lifesaving treatment. Unfortunately, in low- and middle-income countries, timely diagnosis is a challenge and liver transplantation is rarely accessible. Here, we discuss the ethical dilemmas surrounding treatment of babies with biliary atresia in Uganda. Issues that require careful consideration include: risk of catastrophic health expenditure to families, ethical dilemmas of transplant tourism, medical risks of maintaining the transplant in a low-resourced health system, and difficult decisions encountered by the surgeon caring for these patients. Four distinct models of the patient-physician relationship are applied to biliary atresia in Uganda. These models describe differences in patient and physician roles, and patient values and autonomy. Solid organ transplantation is a rapidly evolving segment of healthcare in Uganda and ongoing policy advancements may shift ethical considerations in the future.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Prognostic value of the postoperative carcinoembryonic antigen level in colorectal cancer: A meta-analysis. 结直肠癌术后癌胚抗原水平的预后价值：荟萃分析。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1002/wjs.12349

Furui Liu, Shuai Jiang, Jianli Cui, Yueqiao Wu, Shuhui Chen, Zhan Yu

{"title":"Prognostic value of the postoperative carcinoembryonic antigen level in colorectal cancer: A meta-analysis.","authors":"Furui Liu, Shuai Jiang, Jianli Cui, Yueqiao Wu, Shuhui Chen, Zhan Yu","doi":"10.1002/wjs.12349","DOIUrl":"10.1002/wjs.12349","url":null,"abstract":"Background: Carcinoembryonic antigen (CEA) is one of the commonly used preoperative biomarkers for colorectal cancer (CRC), but no meta-analysis has evaluated the findings of all recently published studies to determine whether its postoperative level can serve as a prognostic indicator.Methods: We conducted a systematic search for eligible literature from the PubMed, EMBASE, and Web of Science databases in October 2023. Studies that investigated the relationship between postoperative serum CEA levels and prognosis in CRC patients were included. Outcome indicators, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS)/recurrence-free survival (RFS), were analyzed using a fixed-effects or random-effects model. The pooled hazard ratios (HR) with 95% confidence intervals (CI) were used as effective values.Results: This meta-analysis included 20 eligible studies involving 10,114 CRC patients from the East Asian and Western countries. A comprehensive analysis revealed that elevated postoperative CEA levels were associated with low OS (HR: 2.92, 95% CI: 2.36-3.62, and p < 0.000), DFS (HR: 2.81, 95% CI: 2.01-3.94, and p < 0.000), and RFS/PFS (HR: 2.52, 95% CI: 1.75-3.62, p < 0.000). A subgroup analysis by region, analysis type, distant metastasis, HR obtain method, sample size, postoperative measurement date, and study design demonstrated that the negative correlation observed between high serum CEA levels after surgery and poor prognosis was not significantly different between the subgroups.Conclusion: When CEA levels are found to be elevated during postoperative follow-up, more active intervention measures should be implemented to further improve the patient's survival outcomes.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 time out for prayer. 祈祷时间

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-03-19 DOI: 10.1002/wjs.12149

Patrick J Javid, Shahrzad Joharifard, Muma J K Nyagetuba, Erik N Hansen

引用次数: 0

Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons. 利比里亚腹腔镜手术实践、知识和培训目标评估：一项针对利比里亚外科医生的混合方法研究。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI: 10.1002/wjs.12330

Christopher W Reynolds, Tresor Mabanza, Ayun Cassell, Deborah M Rooney, Yarvoh Moore-Wilson, Aaron Ketia, Ronald Kollie, David Jeffcoach, Erin Kim, Serena Bidwell, Marcy Zatz, Ahmad Hider, Grace J Kim

{"title":"Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons.","authors":"Christopher W Reynolds, Tresor Mabanza, Ayun Cassell, Deborah M Rooney, Yarvoh Moore-Wilson, Aaron Ketia, Ronald Kollie, David Jeffcoach, Erin Kim, Serena Bidwell, Marcy Zatz, Ahmad Hider, Grace J Kim","doi":"10.1002/wjs.12330","DOIUrl":"10.1002/wjs.12330","url":null,"abstract":"Background: Laparoscopy training remains inaccessible in many low- and middle-income countries, including Liberia. We assessed the availability of laparoscopy and feasibility of implementing a laparoscopic program among Liberian surgeons and trainees.Methods: This mixed-methods study utilized a 32-item survey and semi-structured interviews on laparoscopic experience, knowledge, desires, barriers, patient perceptions, and training opportunities among surgeons and trainees at Liberia's two main teaching hospitals in March 2023. Data analysis utilized summed knowledge and desirability scores, descriptive statistics, and qualitative content analysis.Results: 31 interns, residents, and consultants participated, comprising 60% of Liberia's surgeons. Laparoscopic training (32%) and experience (16%) was low, with exposure limited to those training outside Liberia (p = 0.001). While laparoscopy knowledge varied (29% low, 55% medium, 16% high), participants expressed high interest in training (100%) and willingness to pay (52%). Interviews revealed four themes: desires for training, patient acceptability, feasibility of technology-based training, and barriers including limited equipment and expert trainers. At the time of survey, the only minimally invasive surgeries ever performed in Liberia were two diagnostic laparoscopies.Conclusions: This is the first mixed-methods study assessing laparoscopy in Liberia. Our sample, though small, comprised approximately 60% of Liberian surgeons in both rural and urban hospitals. Findings demonstrated limited experience, variable knowledge, and high desires for training, showing feasibility for laparoscopy implementation in Liberia.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 needs assessment for simulation-based training in emergency urological skills in Ethiopia. 埃塞俄比亚泌尿科急诊技能模拟培训需求评估。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI: 10.1002/wjs.12350

Anteneh Tadesse Kifle, Matthew Trail, Tizazu Abebayehu Tsega, Tilaneh Leyeh Demilow, Getaneh Tesfaye Teferi, Stephen R Payne, Chandra Shekhar Biyani

{"title":"A needs assessment for simulation-based training in emergency urological skills in Ethiopia.","authors":"Anteneh Tadesse Kifle, Matthew Trail, Tizazu Abebayehu Tsega, Tilaneh Leyeh Demilow, Getaneh Tesfaye Teferi, Stephen R Payne, Chandra Shekhar Biyani","doi":"10.1002/wjs.12350","DOIUrl":"10.1002/wjs.12350","url":null,"abstract":"Background: Urologic emergencies are common and complications from their management are high. Simulation-based education (SBE) is a highly effective training method, allowing trainees to learn both technical and nontechnical skills in a safe environment. Training in the management of urological emergencies is limited in many healthcare settings, so we performed a needs assessment for a urological emergencies SBE course in Ethiopia.Methods: This study presents data from a descriptive cross-sectional, survey-based survey of consultants and residents in the Ethiopian surgical community. The survey was disseminated using online Google Forms, through social media (WhatsApp), and to colleagues in the College of Surgeons of East, Central and Southern Africa (COSECSA) via email and social media.Results: One hundred-seven results were received; two were discarded due to incomplete data. Fifty three of the respondents were general surgeons and 38 of the respondents were urologists. Sixty nine respondents strongly agreed that simulation-based training was important for first-year surgical residents, whereas twenty-five respondents agreed and nine respondents strongly disagreed; one respondent disagreed and one was neutral. Eighty seven respondents suggested a 3-day training course, whereas 17 respondents suggested a two-day course. More than 80 of the respondents rated training in the management of acute urinary retention, acute scrotum, urethral, and suprapubic catheterization as extreme or very important and 79 respondents wanted education about urologic trauma and Fournier's gangrene.Conclusion: Surgical and urology residents in Ethiopia have expressed a need for, and a strong interest in, simulation-based urological emergency training.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Blood on the drapes: A multispecialty comparison of blood spill estimates. 窗帘上的血迹：多专科血液溢出估计值比较。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-01 DOI: 10.1002/wjs.12315

Henry B G Baird, Gabriella Rivas, Ryan Horn, Prudhvi Kodali, Evert A Eriksson, Langdon A Hartsock, Kristoff R Reid

{"title":"Blood on the drapes: A multispecialty comparison of blood spill estimates.","authors":"Henry B G Baird, Gabriella Rivas, Ryan Horn, Prudhvi Kodali, Evert A Eriksson, Langdon A Hartsock, Kristoff R Reid","doi":"10.1002/wjs.12315","DOIUrl":"10.1002/wjs.12315","url":null,"abstract":"Introduction: Estimated blood loss (EBL) is an important part of the perioperative process. This project aims to determine the accuracy of perioperative team members to estimate blood volume on drapes and the operating room floor.Methods: Aliquots of unused human blood were used to create surgical scenarios, and standardized pictures and videos were taken. Physicians, residents, nurses, medical students, and surgical technicians were surveyed and asked to estimate the blood volume for each series. Accuracy and consistency of responses was analyzed.Results: One hundred and forty five responses were recorded: 57 attending physicians, 36 residents, 27 registered nurses, 17 medical students, and seven circulating surgical techs. Median percent error (PE) for all cases was 211.11%, demonstrating a global overestimation of blood volume. PE for the 150 mL images was statistically significantly lower than that of the 50 and 100 mL images. Circulating Surgical Technicians were the most accurate group, with a median PE of 125%, followed closely by Medical Students (PE = 158.33%). The most accurate specialty was Orthopedics (PE = 168.06%). The least accurate groups were Attending Physicians (PE = 286.11%) and General surgery (GSGY) (PE = 327.78%). The most accurate orthopedic surgery and GSGY subspecialties were Hand (PE = 237.64%) and Vascular (PE = 108.33%), respectively. Statistical analyses showed no significant differences by clinical role, surgical specialty, or subspecialty.Conclusion: This study demonstrates a global overestimation of blood volume when using the visual method, with improved accuracy at higher volumes. Our findings highlight the limitations of visual estimation methods for EBL.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Comment on: Magnetic single-anastomosis side-to-side duodeno-ileostomy for revision of sleeve gastrectomy in adults with severe obesity: 1-year outcomes. 评论用于重度肥胖成人袖状胃切除术翻修的磁性单吻合侧对侧十二指肠-回肠造口术：1 年疗效。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-12 DOI: 10.1002/wjs.12341

Dan Eisenberg

引用次数: 0

Sociopolitical, clinical, and ethical challenges of sustainable fracture care in Haiti. 海地可持续骨折护理所面临的社会政治、临床和伦理挑战。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-15 DOI: 10.1002/wjs.12323

Antoinette J Charles, Mikhail A Bethell, Marc-Alain Pean, Brielle Ochoa, Bernard Nau, Christian A Pean

{"title":"Sociopolitical, clinical, and ethical challenges of sustainable fracture care in Haiti.","authors":"Antoinette J Charles, Mikhail A Bethell, Marc-Alain Pean, Brielle Ochoa, Bernard Nau, Christian A Pean","doi":"10.1002/wjs.12323","DOIUrl":"10.1002/wjs.12323","url":null,"abstract":"Introduction: In low- and middle-income countries such as Haiti, musculoskeletal injuries are the leading cause of morbidity and mortality. Untreated injuries can contribute to decreased mobility, leading to disability and reduced productivity for individuals. The accessibility of timely fracture care poses a substantial challenge in Haiti, where socioeconomic instability and recent surges in gang violence exacerbate an already strained healthcare infrastructure. This manuscript delves into the intricate barriers to sustainable fracture care in Haiti, shedding light on the sociopolitical landscape and clinical challenges that influence the delivery of orthopedic services.Ethical discussion: The ethical considerations in providing fracture care in Haiti are multifaceted, including classic medical principles, self-preservation in the face of violence, issues of justice in resource and service allocation, and concerns of nonmaleficence in the context of international volunteers. These ethical dilemmas arise from the complex interplay of limited resources, the dangers posed by the current sociopolitical climate, and the involvement of international aid in a vulnerable healthcare system.Conclusion: To address the clinical and ethical conflicts of providing fracture care in Haiti, solutions include education and training of Haitian orthopedic surgeons, capacity building of healthcare facilities, and establishing ethical standards for international volunteers. This comprehensive approach is vital for advancing sustainable fracture care in Haiti and other resource-limited settings.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Vacuum-assisted wound closure and mesh-mediated fascial traction for temporary closure in open abdomen: A single-arm meta-analysis. 真空辅助伤口闭合术和网片辅助筋膜牵引术用于开腹手术的临时闭合：单臂荟萃分析。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-07 DOI: 10.1002/wjs.12336

Gabriele Eckerdt Lech, Brian Henriques Neves, Gilson Tenório Oliveira, Carlos André Balthazar da Silveira, Julia Adriana Kasmirski, Diego L Lima, Leandro Totti Cavazzola

{"title":"Vacuum-assisted wound closure and mesh-mediated fascial traction for temporary closure in open abdomen: A single-arm meta-analysis.","authors":"Gabriele Eckerdt Lech, Brian Henriques Neves, Gilson Tenório Oliveira, Carlos André Balthazar da Silveira, Julia Adriana Kasmirski, Diego L Lima, Leandro Totti Cavazzola","doi":"10.1002/wjs.12336","DOIUrl":"10.1002/wjs.12336","url":null,"abstract":"Introduction: Open abdomen (OA) therapy is used in the management of patients who require surgery for severe abdominal conditions. This meta-analysis aims to evaluate the VAWCM technique regarding short and long-term outcomes.Methods: PubMed, Embase, and Cochrane Central were systematically searched for studies that analyzed VAWCM therapy in OA. Primary outcomes were the complete fascial closure rate and mean duration of OA treatment. Statistical analyses were performed using R statistical software.Results: Seven studies comprising 535 patients were included. We found a complete fascial closure rate of 77.3 per 100 patients (80.1%; 95% CI 59.6-88.7; I2 = 76%), with an overall mortality of 30.3 per 100 (33.5%; 95% CI 9.3-19.4; I2 = 78%). The pooled mean duration of OA treatment was 14.6 days (95% CI 10.7-18.6; I2 = 93%), while the mean length of hospital stay was 43.3 days (95% CI 21.2-65.3; I2 = 96%). As additional outcomes, we found an enteroatmospheric fistula rate of 5.6 per 100 patients (5.4%; 95% CI 2.3-13.3; I2 = 45%) and incisional hernia rate of 34.7 per 100 (34.6%; 95% CI 28.9-41.1; I2 = 0%). The subgroup analysis of mesh materials (polypropylene or polyglactin) showed a higher complete fascial closure rate for the polyglactin (89.1% vs. 66.6%; p = 0.02).Conclusion: Our findings showed that VAWCM is a viable option for OA treatment, successfully reaching complete fascial closure, with a low duration of the technique, even though it presented a high heterogeneity between the studies.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low-resource setup: A retrospective cohort study at Jimma University Medical Center. 评估低资源环境下回肠乙状结肠打结术的临床概况、手术经验和结果：吉马大学医疗中心的回顾性队列研究。

IF 2.3 3区医学

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-06-19 DOI: 10.1002/wjs.12261

Sabri Selcuk Atamanalp, Mecit Kantarci, Esra Disci, Rifat Peksoz

引用次数: 0