Journal of investigative surgery : the official journal of the Academy of Surgical Research最新文献

{"title":"The Adjunctive Effect of DuraSeal® vs. 2-Octyl-Cyanoacrylate on Delayed Repair of Gastric Perforation: An Experimental Study.","authors":"Fatih Akgunduz,&nbsp;Alper Sozutek,&nbsp;Oktay Irkorucu,&nbsp;Abit Yaman","doi":"10.1080/08941939.2021.1887414","DOIUrl":"https://doi.org/10.1080/08941939.2021.1887414","url":null,"abstract":"<p><strong>Objective: </strong>Delayed primary suture closure of gastric perforation is prone to dehiscence hence the repaired area should be buttressed to avoid re-operation. We aimed to investigate whether DuraSeal®(DS) has a potent adjunctive effect on delayed closure of gastric perforation comparing with 2-octly-cyanoacrylate(CYN) in an experimental model.</p><p><strong>Methods: </strong>Sixty rats were randomly divided into 6 groups. All subjected to gastric perforation, subsequently perforation areas were repaired by primary suturing, delayed repair was performed 12 h after surgery. According to DS or CYN application on anastomosis, the groups were classified as control(C), delayed control(CD), closure with CYN(CYN), delayed closure with CYN(D-CYN), closure with DS(DS), delayed closure with DS(D-DS).After euthanization on POD 7,anastomotic bursting pressure(ABP) were measured. Tissue samples were taken for histopathological examination and hydroxyproline(TH) assessment.</p><p><strong>Results: </strong>Delayed condition significantly reduced ABP and TH levels in CD group comparing with all groups(p < 0.01).Either CYN or DS application on delayed repaired area significantly raised the measure of ABP and TH up to the levels of C group(p < 0.05,comparing with CD).Microscopically,either CYN or DS application significantly improved tissue necrosis, submucosal bridging and collagen formation comparing with CD group(p < 0.012).There were no difference regarding ABP, TH and tissue healing between each CYN and DS groups.</p><p><strong>Conclusion: </strong>DuraSeal® application on sutured gastric perforation area yielded a significant adjunctive effect both in normal and delayed conditions. However, DuraSeal® revealed no superior effect to CYN in both condition.Our results demonstrated that the clinical use of DuraSeal® can be considered for reinforcing the sutured line in patients undergoing delayed surgery for gastric perforation.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"542-548"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1887414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25415828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Prognostic Value of Extranodal Extension in Esophageal Cancer from the Pathological Staging Perspective.","authors":"Masato Hayashi,&nbsp;Makoto Abe,&nbsp;Takeshi Fujita,&nbsp;Hisayuki Matsushita","doi":"10.1080/08941939.2021.1912221","DOIUrl":"https://doi.org/10.1080/08941939.2021.1912221","url":null,"abstract":"<p><strong>Background: </strong>Extranodal extension (ENE) is a prognostic factor for several types of malignant tumors, including esophageal cancer. Although the prognostic value of ENE has been investigated in esophageal cancer, its clinical utility warrants further investigation.</p><p><strong>Materials and methods: </strong>This retrospective single-center study evaluated 105 patients who underwent esophagectomy and had histologically node-positive metastasis between January 2007 and June 2017. The abilities of ENE to predict overall survival (OS) and disease-free survival (DFS) were evaluated using the Kaplan-Meier method and log-rank test, as well as Cox proportional hazard models. Subgroup analyses of ENE's prognostic value were performed according to each pathological tumor-node-metastasis category.</p><p><strong>Results: </strong>Significant differences according to ENE status were observed in the Kaplan-Meier analyses of OS (<i>p</i> = 0.001) and DFS (<i>p</i> = 0.001), as well as in the Cox proportional hazards models for OS (<i>p</i> = 0.009) and DFS (<i>p</i> = 0.012). Relative to patients without ENE, patients with ENE had significantly poorer OS if they also had pT3 status, pN1 status, or pathological stage III disease. However, no significant differences were observed in the subgroup analyses of pN3 status and pathological stage IV disease.</p><p><strong>Conclusions: </strong>Among patients with esophageal cancer, ENE status can predict a poor prognosis and may be useful for patient stratification. However, the prognostic value of ENE status may be limited to patients with specific pathological factors.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"698-706"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1912221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39069937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Radiological and Functional Results of Tight Rope and Clavicular Hook Plate Technique in the Treatment of Acute Acromioclavicular Joint Dislocation.","authors":"Emre Gültaç,&nbsp;Fatih İlker Can,&nbsp;Cem Yalın Kılınç,&nbsp;Hüseyin Aydoğmuş,&nbsp;Fatih Emre Topsakal,&nbsp;Ahmet Emrah Açan,&nbsp;Nevres Hurriyet Aydogan","doi":"10.1080/08941939.2021.1897196","DOIUrl":"https://doi.org/10.1080/08941939.2021.1897196","url":null,"abstract":"<p><p><b>Purpose/Aim:</b> Options for surgery for acromioclavicular (AC) joint dislocation vary considerably. This study aimed to examine the functional and radiological results of patients who were operated on using the tightrope (TR) or clavicular hook plate (CHP) technique in the treatment for AC joint dislocation. <b>Materials and methods:</b> The data gathered from 35 consecutive patients who were operated on for AC joint dislocation were analyzed retrospectively in terms of their radiological and functional outcomes. <b>Results:</b> Thirty-two (91.4%) of the 35 patients were male and 3 (8.6%) were female. Thirty (85.7%) patients were classified as Rockwood type 3 and 5 (14.3%) as type 5. Twenty-one patients operated on using the TR technique were categorized as group 1, and 14 patients treated with the CHP technique formed group 2. Functional results were evaluated using the Constant-Murley shoulder scoring system; no statistically significant difference was observed between type 3 and 5 AC separation (<i>p</i> = 0.337). The mean Constant scores of type 3 and 5 injuries were 82.96 and 88.6, respectively. A significant relationship was noted between reduction quality and functional scores (<i>p</i> = 0.006). Postoperative osteoarthritis was seen in 12 (57.14%) patients in group 1 and 7 (50.00%) patients in group 2. In terms of surgery duration, 50.57 minutes in group 1 and 35.71 minutes in group 2 were noted. A statistically significant difference was found between the two groups in terms of surgery duration (<i>p</i> < 0.05). <b>Conclusions:</b> TR and CHP techniques, which do not differ significantly in terms of their clinical results, can be used safely in the treatment of AC separation.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"693-696"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1897196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25453511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Patient Outcomes and Safety between Overlapping and Nonoverlapping Surgeries in Patients Undergoing Laparoscopic Common Bile Duct Exploration.","authors":"Xue Zhang,&nbsp;Jinhui Wang,&nbsp;Fubao Liu,&nbsp;Yong Zhao","doi":"10.1080/08941939.2020.1867674","DOIUrl":"https://doi.org/10.1080/08941939.2020.1867674","url":null,"abstract":"<p><strong>Purpose: </strong>Overlapping surgery or double-booking is a vital yet disputed issue in healthcare field. However, safety of the overlapping surgery during laparoscopic common bile duct exploration (LCBDE) remains unclear. This study aimed to assess the clinical outcomes and safety of overlapping surgery during laparoscopic cholecystectomy and LCBDE for gallbladder and common bile duct stones (CBDS).</p><p><strong>Material and methods: </strong>This study retrospectively reviewed 2736 laparoscopic cholecystectomy and LCBDE surgeries during 2013-2020. One thousand, two hundred eighty patients underwent LCBDE through cystic duct, including 867 receiving overlapping procedures, while 1456 underwent LCBDE through laparoscopic choledochotomy (LC), including 981 who underwent overlapping procedures. Data regarding patient sex, age, body mass index, the American Society of Anesthesiology grade, comorbidities, preoperative liver function test, previous upper abdominal surgery, presence of acute cholecystitis, cholangitis, pancreatitis, or jaundice, common bile duct (CBD) or CBDS diameter, CBDS number, LCBDE operation time, procedure duration, length of stay, stone clearance, CBD closure methods, conversion to open surgery, and complications were collected.</p><p><strong>Results: </strong>Differences in demographics and clinical variables between both groups were not significant, and the unadjusted outcomes were comparable, except for the total procedure duration (transcystic: <i>p</i> < .001; LC: <i>p</i> < .001). After adjusting for demographics and clinical variables, overlapping surgery showed an extended total surgical procedure duration (transcystic: standardized coefficient = 0.084, <i>p</i> = .004; LC: standardized coefficient = 0.072, <i>p</i> = .015). Other effects of overlapping surgery were also comparable.</p><p><strong>Conclusions: </strong>Overlapping surgery in laparoscopic cholecystectomy and LCBDE was safe at our institution. However, the association of patient outcomes with overlapping laparoscopic cholecystectomy and LCBDE should be further investigated.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"496-501"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1867674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25333865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness and Safety of Anterior Cervical Corpectomy with Fusion, Laminoplasty, and Laminectomy and Instrumented Fusion for Ossification of the Posterior Longitudinal Ligament: A Systematic Review and Network Meta-Analysis.","authors":"Hui Yu, Xian Li, Shu Chen, Li Zhang, Ge Yang, Kristian Welle, Martin Gathen, Koroush Kabir","doi":"10.1080/08941939.2020.1871535","DOIUrl":"10.1080/08941939.2020.1871535","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the comparative effectiveness and safety of anterior cervical corpectomy with fusion (ACCF), laminoplasty (LP), and laminectomy and instrumented fusion (LF) in the treatment of ossification of the posterior longitudinal ligament (OPLL).</p><p><strong>Methods: </strong>Embase, Pubmed, and Cochrane library were searched from their date of inception to June 13, 2020. Relevant randomized controlled trials (RCTs) and cohort studies comparing different procedures among ACCF, LP, and LF were identified, data were extracted to perform a network meta-analysis (NMA). The outcomes were the Japanese Orthopedic Association (JOA) score and complications.</p><p><strong>Results: </strong>We deemed 14 trials eligible, including 877 patients. In NMA, ACCF showed a significant improvement of JOA score compared with LP [MD= -0.89, 95% CI (-1.73, -0.18)], but no significant difference was found when compared LF with ACCF or LP. No significant differences in complications were found when compared LF with LP or ACCF, while ACCF showed significantly higher in complications than LP [OR = 1.99, 95% CI (1.10, 3.35)]. The surface under the cumulative ranking curves (SUCRA) showed that the rank of JOA score improvement is as follows: ACCF (82.5%), LF (79.5%), and LP (2.3%). And the rank of complication rate is as follows: LF (65.8%), ACCF (68.4%), and LP (2.1%).</p><p><strong>Limitation: </strong>The biggest limitation was that none of the included studies were RCTs.</p><p><strong>Conclusions: </strong>Despite the higher probability of complications than LP, ACCF was the more recommended procedure for its highest ranking spectrums of JOA score improvement to treat the OPLL.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"667-676"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38840275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on the Clinical Utility of Autoantibodies in Patients with Idiopathic Granulomatous Mastitis.","authors":"Sami Akbulut,&nbsp;Tevfik Tolga Sahin","doi":"10.1080/08941939.2021.1893413","DOIUrl":"https://doi.org/10.1080/08941939.2021.1893413","url":null,"abstract":"Dear Editor, We read the recent article “The Clinical Utility of Autoantibodies in Patients with Idiopathic Granulomatous Mastitis” published by Hande Koksal with great interest [1]. The author has stated that the she has analyzed the efficacy of various autoantibodies such as rheumatoid factor (RF), antinuclear antibody (ANA), anti-double stranded DNA antibody (anti-ds-DNA), anti-cyclic citrullinated peptides antibody (anti-CCP) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in patients with idiopathic granulomatous mastitis (IGM). We would like to commend the author for diagnosis and treating 61 patients with IGM in a small state hospital in only a year. It has been a immense experience for a surgeon to have followed up such a high number of patients in such a rare disease. We would like to emphasize a few points regarding the study. In the introduction section, the authors have stated that so far, there is only two studies evaluating the role of autoantibodies in patients with IGM. It is a matter of debate whether IGM develops secondary to autoimmune diseases or whether itself is a primary autoimmune disease. There are various studies investigating the role of cytokines in IGM [2,3]. The most important evidence that supports the fact that IGM is an autoimmune disease is related to the observation that majority of the pateints with IGM have a concomitant erythema nodosum which is considered to be sign of underlying inflammatory process (granulomatous infections, autoimmune diseases etc.) [4]. Furthermore, the patients with IGM show a more than 80% response to methotrexate and corticosteroid therapy which is also indicative of the autoimmune origins of the disease [5]. The author has stated that autoimmune antibodies such as RF, ANA, anti-ds-DNA, pANCA, and anti-CCP cannot be used in the diagnosis of IGM in accord with the results of the study very small number of patients showing no difference in these antibody titers with respect to the control group. As it is known very well, there is no specific biomarker for the diagnosis and the surveillance of the patients with autoimmune disease; and therefore, certain scoring systems and the findings of the physical examination guide the diagnosis of the diseases. The fact that autoantibodies were not different from the control subjects does not mean that this disease is not an autoimmune disease as the author has claimed. On the contrary, there are a lot of studies showing that these autoantibodies are elevated in normal healthy subjects [6]. For example, ANA titers have been shown to be elevated in 2.5–40% of the population [6]. The authors have stated that patients were grouped into patients with active disease or patients who were in remission. Remission implies that the disease and its symptoms are controlled and resolved with medical and surgical therapy. Analysis of Table 1 shows that some of the patients in remission group had symptoms such as abscess, ulcer, fistula or nipple disc","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"682-683"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1893413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25451271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roflumilast as a Potential Therapeutic Agent for Cecal Ligation and Puncture-Induced Septic Lung Injury.","authors":"Zafer Bayraktutan,&nbsp;Busra Dincer,&nbsp;Halil Keskin,&nbsp;Duygu Kose,&nbsp;Arzu Bilen,&nbsp;Erdem Toktay,&nbsp;Busra Sirin,&nbsp;Zekai Halici","doi":"10.1080/08941939.2021.1908462","DOIUrl":"https://doi.org/10.1080/08941939.2021.1908462","url":null,"abstract":"<p><strong>Purpose/aims: </strong>This study focused on delineating the possible effects of roflumilast (ROF), a selective phosphodiesterase 4 (PDE4) inhibitor, in rats with cecal ligation and puncture (CLP)-induced polymicrobial sepsis, and investigated whether ROF can act as a protective agent in sepsis-induced lung damage.</p><p><strong>Material and methods: </strong>Four experimental groups were organized, each comprising eight rats: Control, Sepsis, Sepsis + ROF 0.5 mgkg^-1, and Sepsis + ROF 1 mgkg^-1 groups. A polymicrobial sepsis model was induced in the rats by cecal ligation and puncture under anesthesia. Twelve hours after sepsis induction, the lungs were obtained for biochemical, molecular, and histopathological analyses.</p><p><strong>Results: </strong>In the sepsis group's lungs, the TNF-α, IL-1β, and IL-6 mRNA expression levels peaked in the sepsis group's lung tissues, and ROF significantly decreased these levels compared with the sepsis group dose-dependently. ROF also significantly decreased MDA levels in septic lungs and increased antioxidant parameters (SOD and GSH) compared with the sepsis group. Histopathological analysis results supported biochemical and molecular results.</p><p><strong>Conclusions: </strong>ROF, a PDE4 inhibitor, suppressed the expression levels of pro-inflammatory cytokines, alleviated lung damage (probably by blocking neutrophil infiltration), and increased the capacity of the antioxidant system.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"605-613"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1908462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25580845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helix Thigh Lift. A Novel Approach to Severe Deformities in Massive Weight Loss Patients.","authors":"Luigi Losco,&nbsp;Ana Claudia Roxo,&nbsp;Carlos Weck Roxo,&nbsp;Alessandro de Sire,&nbsp;Alberto Bolletta,&nbsp;Roberto Cuomo,&nbsp;Luca Grimaldi,&nbsp;Emanuele Cigna,&nbsp;Carlos Del Pino Roxo","doi":"10.1080/08941939.2021.1912220","DOIUrl":"https://doi.org/10.1080/08941939.2021.1912220","url":null,"abstract":"<p><strong>Background: </strong>After massive weight loss, the severe gynoid body contour deformities are not always faceable with optimal results. The thigh is one of the most demanding area to address; therefore, the approach should be virtually individualized. The authors describe the helix thigh lift: A novel technique that combines vertical with horizontal axis of pull. The goal of this ultimate customization is to dramatically impact physical functioning and esthetics of this patient population.</p><p><strong>Methods: </strong>Thigh lift patients from 2016 to 2019 were assessed retrospectively; fourteen patients were selected for helix thigh lift procedure. Preoperative markings, surgical technique and outcomes were described. The mean follow-up time was 14.8 ± 3.2 months. A questionnaire was administered to evaluate the results.</p><p><strong>Results: </strong>Fourteen female patients (mean age, 42 ± 4.8 years) underwent helix thigh lift after massive weight loss. The overall complication rate was 36 percent. They were all minor complications and were treated in an outpatient setting. Seroma formation was the most frequent, at 29 percent. No skin necrosis was reported. Complication development was straight related to the age of the patient (<i>p</i> = 0.0455). The patients were very satisfied with the overall outcome.</p><p><strong>Conclusions: </strong>Helix thigh lift effectively addresses the severe gynoid body contour deformities. The high satisfaction and the reasonable complication rate suggest that this is a safe and effective technique. The age of the patient was significantly associated to complication development. A dramatic improvement of ease in performing activities of daily living along with reduction of the skin problems leads to significant improvement of the quality of life.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"620-626"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1912220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39025840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Re: The Clinical Utility of Autoantibodies in Patients with Idiopathic Granulomatous Mastitis.","authors":"Hande Koksal","doi":"10.1080/08941939.2021.1893415","DOIUrl":"https://doi.org/10.1080/08941939.2021.1893415","url":null,"abstract":"Reply to the letter: The Clinical utility of autoantibodies in patients with idiopathic granulomatous mastitis To the Editor, I would like to thank the author(s) very much for their interest to my article entitled \"The clinical utility of autoantibodies in patients with idiopathic granulomatous mastitis\" [1]. Regarding the contributions and criticisms against this article, I realized that there are some points to be clarified to make sure that the article is understood as it must be. The author(s) defined our hospital as \"a small state hospital.\" However, our hospital is a prestigious training and research hospital with 385 specialists and capacity of 1250 patient beds. Our hospital is also the biggest hospital in Konya that has the patients not only from the city itself but also from the cities, towns, and villages nearby. There is a “Senology Clinic” that has been in service for more than ten years with 250 operations/year for breast cancer including oncoplastic surgery and reconstructions. There are two general surgery professors; one general surgery specialist and two general surgery residents working full-time on their working days in this clinic. In addition, this clinic has its own ultrasound, mammography, tomosynthesis, breast MR and interventional radiology units with a dedicated radiologist. There are many studies about idiopathic granulomatous mastitis published from our clinic [1–8]. Our hospital is a very important center in terms of breast diseases, considering both the bed capacity, the senology clinic and the publications on idiopathic granulomatous mastitis and other breast diseases. There were 61 patients included in the study. However, the missing point is that 30 of these patients were active patients during the study as emphasized in the Material and Method section, while remaining 31 patients were previously treated for IGM, were in remission for at least six months and under follow up and also in remission during the study period. The author(s), citing the article of Cetin et al. [9], stated that \"the most important evidence that supports the fact that IGM is an autoimmune disease is related to the observation that majority of the patients with IGM have a concomitant erythema nodosum.\" However, when the article of Cetin et al. [10] is examined carefully and closely, it is obviously seen that erythema nodosum is found in only 6.6% of patients with idiopathic granulomatous mastitis. Erythema nodosum is an important finding, although not in the “majority” of patients with idiopathic granulomatous mastitis. Another criticism of the author(s) was the pregnancy or breastfeeding status of the participants in the study. The author(s) missed this data in the Materials and Methods section, the last sentence of the “patients” subsection, \"In all IGM patients and in the control group, those who were pregnant or breastfeeding were excluded from the study.\" If the same section can be examined carefully; how the patients as “active” or “i","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"680-681"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1893415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microperc with Self-Assembled Fr 4.85 Visual Needle and Ureteral Access Sheath.","authors":"Jiqing Zhang,&nbsp;Ning Kang,&nbsp;Yuguang Jiang,&nbsp;Junhui Zhang","doi":"10.1080/08941939.2021.1902024","DOIUrl":"https://doi.org/10.1080/08941939.2021.1902024","url":null,"abstract":"<p><strong>Background: </strong>Micropercutaneous nephrolithotomy (microperc) is the least invasive among percutaneous nephrolithotripsy (PCNL) procedures. Although microperc has a high stone-free rate and certain advantages over other methods, modifications may be needed to improve the technique. We describe our experience performing microperc using a self-assembled visual needle and ureteral access sheath (UAS).</p><p><strong>Methods: </strong>Between June 2016 and April 2019, the data of 30 patients with kidney stones undergoing microperc with our self-assembled 4.8 Fr visual needle combined with a UAS was retrospectively analyzed. Patients were placed in an obilique spine lithotomy position.</p><p><strong>Results: </strong>Two cases were excluded: one due to conversion to mini PCNL and the other required flexible ureteroscopy during microperc. The remaining 28 cases included 18 men and 10 women, age 38.4 ± 7.5 years, stone size 1.7 ± 0.4 cm, and stone density on CT 969 ± 233 HU. Operative time was 47 ± 9.9 minutes, visual analogue scale score of tract pain on postoperative day 1 was 2.5 ± 1.0, hemoglobin decrease was 6.4 ± 1.0 g/L, and hospital stay was 3.1 ± 0.8 days. There was 1 case of fever and urinary infection, 2 cases of hematuria, and 1 case of flank pain. All symptoms resolved after conservative or antibiotic treatment. On postoperative day 1, 12 (42.9%) caseswere stone-free. The stone-free rates at postoperative month 1 and 3 were 92.9% (26/28) and 100% (28/28), respectively.</p><p><strong>Conclusions: </strong>Our self-assembled visual needle and UAS instrument is effective for microperc. Use of the UAS may improve the operative outcome.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"569-576"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2021.1902024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25512931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}