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

{"title":"Comparison of Centrifugal and Pulsatile Perfusion to Preserve Donor Kidneys Using <i>Ex Vivo</i> Subnormothermic Perfusion.","authors":"Patrick P W Luke,&nbsp;Larry Jiang,&nbsp;Aushanth Ruthirakanthan,&nbsp;Daniel Lee,&nbsp;Qizhi Sun,&nbsp;Mahms Richard-Mohamed,&nbsp;Justin Kwong,&nbsp;Shahid Aquil,&nbsp;Rafid Alogaili,&nbsp;Aaron Haig,&nbsp;Alp Sener,&nbsp;Rabindra N Bhattacharjee","doi":"10.1080/08941939.2020.1829212","DOIUrl":"https://doi.org/10.1080/08941939.2020.1829212","url":null,"abstract":"<p><p><b>Objective</b> We have previously demonstrated benefits of kidney preservation utilizing an oxygenated subnormothermic <i>ex vivo</i> perfusion platform. Herein, we aim to compare pulsatile versus centrifugal (steady and uniform flow) perfusion with the goal of optimizing renal preservation with these devices. <b>Materials and methods:</b> Pig kidneys were procured following 30 min of warm ischemia by cross-clamping both renal arteries. Paired kidneys were cannulated and underwent either: oxygenated pulsatile or centrifugal perfusion using a hemoglobin oxygen carrier at room temperature with our <i>ex vivo</i> machine perfusion platform for 4 hr. Kidneys were reperfused with whole blood for 4 hr at 37° C. Renal function, pathology and evidence of inflammation were assessed post-perfusion. <b>Results:</b> Both pump systems performed equally well with organs exhibiting similar renal blood flow, and function post-reperfusion. Histologic evidence of renal damage using apoptosis staining and acute tubular necrosis scores was similar between groups. This was corroborated with urinary assessment of renal damage (NGAL 1) and inflammation (IL-6), as levels were similar between groups. <b>Conclusion:</b> In our porcine model with added warm ischemia simulating the effects of reperfusion after transplantation, pulsatile perfusion yielded similar renal protection compared with centrifugal perfusion kidney preservation. Both methods of perfusion can be used in <i>ex vivo</i> kidney perfusion systems.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"104-110"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1829212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38782848","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":"Depth of the Epidural Space in Children.","authors":"Aki Uemura","doi":"10.1080/08941939.2020.1780518","DOIUrl":"https://doi.org/10.1080/08941939.2020.1780518","url":null,"abstract":"To the Editor, I read with great interest the original research “Estimating the Lumbar Puncture Needle Depth in Children” by Dr. Derbys Celik in the journal (J Invest Surg. 2019:1–7). I will absolutely support author’s research that it is necessary to estimate the correct depth of the needle insertion based on age weight or height when we do lumbar puncture in children. And clinically useful formulae must be simple even, such formulae would never be 100% accurate as author mentioned in the article. Epidural anesthesia is also an essential technique in pediatric anesthesia, and we also reported formula for determining the distance from the skin to the lumbar epidural space in infants and children in 1992 [1]. Our formula for determining the depth of epidural needle insertion at L3 is D 1⁄4 (Wþ 10) x 0.8, where D is the depth in mm and W is the weight in kg [1,2]. There are several reports that evaluated the distance from the skin to the epidural space and subarachnoid space from different parts of the world [3–6]. And one of them evaluated the precision of several formulae using the mean absolute deviation and the newly estimated formulae using MRI for the distance from the skin to the epidural space were compared with each of the B€ osenberg, Uemura, and Hasan formulae [4]. Our formula made less deviation from the formula using MRI that is not simple like ours and difficult to calculate. When we perform epidural anesthesia or spinal anesthesia, especially in infants and children, estimating the distance from the skin to the epidural space or subarachnoid space is special importance because of the great differences in size of the patients. The body habitus is not the same in all over the world, so those formulae based on anthropometric measures have to be calculate in each area where they practice [2]. Also, in recent tendency, pediatric population are overweight and we need up to date the formula to keep up to with the times.","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"186"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1780518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38068840","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":"EFEMP1 in Direct Inguinal Hernia: correlation with TIMP3 and Regulation Toward Elastin Homoeostasis as Well as Fibroblast Mobility.","authors":"Xiaohui Peng,&nbsp;Zhongwu Guo,&nbsp;Yinlong Zhang,&nbsp;Baichen Sun,&nbsp;Qi Zhang","doi":"10.1080/08941939.2020.1811812","DOIUrl":"https://doi.org/10.1080/08941939.2020.1811812","url":null,"abstract":"<p><strong>Aim: </strong>This basic research aimed to detect the inner-correlation of EGF containing fibulin extracellular matrix protein 1 (EFEMP1), TIMP metallopeptidase inhibitor 3 (TIMP3), matrix metalloprotease 9 (MMP9), elastin (ELN) in direct inguinal hernia (IH), and their effect on fibroblasts motility.</p><p><strong>Methods: </strong>Transversalis fascia samples from 20 direct IH patients and 20 varicocele (served as controls) patients were collected for detecting EFEMP1, TIMP3, MMP9 and ELN expressions by immunohistochemistry assay. Fibroblasts L929 cells were transfected with EFEMP1 overexpression plasmid or knock-down plasmid to investigate the influence of EFEMP1 dysregulation on L929 cell migration, invasion, TIMP3, MMP9 and ELN expressions. Additionally, rescue experiments were performed by adding TIMP3 knockdown plasmid to the EFEMP1-overexpressed L929 cells.</p><p><strong>Results: </strong>Transversalis fascia EFEMP1, TIMP3 and ELN expressions were decreased, but MMP9 expression was increased in IH patients compared with controls. In IH patients, EFEMP1 was not correlated with TIMP3, but positively correlated with ELN and negatively correlated with MMP9; TIMP3 negatively correlated with MMP9, but positively correlated with ELN. Overexpression of EFEMP1 did not affect TIMP3 expression but increased ELN expression and decreased MMP9 expression in L929 cells. In addition, EFEMP1 suppressed L929 cell migration and invasion. The following rescue experiments indicated that silencing TIMP3 attenuated the effect of EFEMP1 overexpression on MMP9 and ELN expressions as well as the effect of EFEMP1 overexpression on cell migration and invasion in L929 cells.</p><p><strong>Conclusions: </strong>EFEMP1 is downregulated in direct IH, and it regulates ELN homoeostasis as well as fibroblast mobility via interacting with TIMP3.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"203-211"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1811812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38551670","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":"Is Uterine Myomectomy a Real Contraindication to Vaginal Delivery? Results from a Prospective Study.","authors":"Marco La Verde,&nbsp;Luigi Cobellis,&nbsp;Marco Torella,&nbsp;Maddalena Morlando,&nbsp;Gaetano Riemma,&nbsp;Antonio Schiattarella,&nbsp;Anna Conte,&nbsp;Domenico Ambrosio,&nbsp;Nicola Colacurci,&nbsp;Pasquale De Franciscis","doi":"10.1080/08941939.2020.1836289","DOIUrl":"https://doi.org/10.1080/08941939.2020.1836289","url":null,"abstract":"<p><strong>Objectives: </strong>The main goal of our research was to explore correlations between a history of uterine myomectomy and maternal-fetal outcomes, throughout a comparison between vaginal deliveries in patients with or without a history of uterine myoma excision.</p><p><strong>Materials and methods: </strong>A prospective study was carried out at two tertiary care hospitals between January 2019 and January 2020. Women were assigned into two groups according to the history of laparoscopic or laparotomic myomectomy (Group 1) or without myomectomy (Group 2).</p><p><strong>Results: </strong>80 women successfully delivered after myomectomy. Pregnancies with previous laparoscopic or laparotomic myomectomy were associated with a minor rate of spontaneous labor onset (RR 1.17; 95% CI 1.04 - 1.31) and with an increased rate of emergency cesarean section (RR 1.22; 95% CI 1.09 - 1.36). Moreover, myomectomy group had a significant number of indications to emergency cesarean section correlated to suspected uterine rupture (RR 1.19; 95% CI 1.02-1.39). There were no uterine ruptures or neonatal deaths recorded. First stage of labor was longer in the myomectomy group (316 vs 204 mins, p = 0.01). No differences in the rates of the prolonged first and second stage of labor, postpartum hemorrhage and vaginal laceration, and no neonatal adverse outcomes were found between groups.</p><p><strong>Conclusions: </strong>Pregnancies after myomectomy might be associated with an elevated rate of emergency cesarean section only due to a higher percentage of suspected uterine rupture, without a real hazard of adverse obstetric or neonatal outcomes.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"126-131"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1836289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38526897","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":"Relationship between <i>MTHFR</i> Gene Polymorphisms and Gastrointestinal Tumors Development: Perspective from Eastern Part of Turkey.","authors":"Ersoy Öksüz,&nbsp;Gökhan Görgişen,&nbsp;Gökhan Oto,&nbsp;Hülya Özdemir,&nbsp;Abbas Aras,&nbsp;Murat Öksüz,&nbsp;İsmail Musab Gülaçar,&nbsp;Muhammet Hamdi Demirkol","doi":"10.1080/08941939.2020.1824249","DOIUrl":"https://doi.org/10.1080/08941939.2020.1824249","url":null,"abstract":"<p><strong>Background: </strong>Gastric and esophageal cancers are 2 of the most prevalent cancer types worldwide. Polymorphisms in the genes that code the methylenetetrahydrofolate reductase (MTHFR) enzyme increase the formation of both cancer types. In this study, it was aimed to research the relationship between the existence of <i>MTHFR</i> <i>C677T</i> and <i>A1298C</i> polymorphisms in patients with gastric and esophageal cancer and the lifespans of patients.</p><p><strong>Methods and materials: </strong>This prospective study was performed at Van Yuzuncu Yil University. Included in the study were 30 patients with esophageal tumors, 70 patients with gastric tumors, and 61 healthy volunteers. From each of the patients, 5 mL of blood was drawn. DNA was isolated via kits with spin-column technology.</p><p><strong>Results: </strong>It was concluded that the risk of developing gastric cancer was 4.13 times higher in individuals who had the <i>AC</i> genotype of the <i>A1298C</i> polymorphism when compared to those who had the <i>AA</i> genotype, while the risk was 2.91 times higher in individuals who had the <i>CC</i> genotype when compared to those who had the <i>AA</i> genotype (P = 0.001, P = 0.027). Carriers of the <i>AC</i> genotype of the <i>A1298C</i> polymorphism had 2.89 times higher risk of developing esophageal cancer when compared to those who had the <i>AA</i> genotype (P = 0.033). It was determined that individuals who had the 1298 <i>CC</i> genotype were not at higher risk of developing esophageal cancer when compared to those with the <i>AA</i> genotype (P = 0.863). It was concluded that individuals who had the <i>TT</i> genotype of the <i>C677T</i> polymorphism were not at higher risk of developing gastric and esophageal cancers when compared to those who had the <i>677CC</i> genotype (P > 0.05). There was no difference in terms of the life spans of the patients with regards to the genotypes (P > 0.05).</p><p><strong>Conclusion: </strong>The results showed that the <i>A1298C</i> polymorphism on the MTHFR gene can be a risk factor for gastric and esophageal cancer in eastern Turkey. These polymorphisms may have no effect on the life spans of the patients.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"83-91"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1824249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38717214","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":"Cuff Anastomosis of Both Renal Artery and Vein to Minimize Thrombosis: A Novel Method of Kidney Transplantation in Mice.","authors":"Yi Yu,&nbsp;Jun Li,&nbsp;Zirong Bi,&nbsp;Chenglin Wu,&nbsp;Shicong Yang,&nbsp;Qifeng Jiang,&nbsp;Ronghai Deng,&nbsp;Qian Fu,&nbsp;Longshan Liu,&nbsp;Changxi Wang","doi":"10.1080/08941939.2020.1821264","DOIUrl":"https://doi.org/10.1080/08941939.2020.1821264","url":null,"abstract":"<p><strong>Objectives: </strong>Anastomosis of renal artery and renal vein in mouse models of kidney transplantation is technically challenging. Conventional technique using suture may result in vascular thrombosis. We developed a simple cuff method to anastomose both renal artery and vein.</p><p><strong>Materials and methods: </strong>Briefly, the left renal artery was occluded at the junction with abdominal aorta using a small vessel clip, transected at the renal hilum, irrigated with heparinized saline, and passed through the lumen of a seamless tubing made of polyimide. The loose end of the artery was everted over the cuff and secured using an 8-0 silk suture. The cuffed artery was inserted into the donor renal artery and secured with an 8-0 suture. Anastomosis of the renal vein was performed similarly. Isograft transplantation was conducted using BALB/c mice as donor and recipient mice (n = 20). The total operative time was 77 ± 3 min, and the cold ischemic time of the graft kidney was minimized to 20 min. One animal was excluded due to anatomic variant vessels and another one died at three day after surgery without thrombosis.</p><p><strong>Results: </strong>Serum creatinine increased insignificantly after transplantation and remained stable over 12 weeks posttransplant. Five recipient mice were sacrificed for histologic examination at 12 weeks after transplantation. No vascular thrombosis was observed at the site of anastomosis. The isografts showed no evidence of acute and chronic lesions such as extinctive ischemic sclerosis and interstitial fibrosis.</p><p><strong>Conclusion: </strong>In summary, cuff anastomosis can be used to eliminate thrombosis formation in the mouse model of kidney transplantation.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"56-60"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1821264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38412667","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":"Sublabial Approach to Tip Rhinoplasty: A Cadaver Model.","authors":"Jason E Cohn,&nbsp;Tyler Pion,&nbsp;Sammy Othman,&nbsp;Timothy M Greco","doi":"10.1080/08941939.2020.1824042","DOIUrl":"https://doi.org/10.1080/08941939.2020.1824042","url":null,"abstract":"<p><strong>Objectives: </strong>The main objective of this study was to investigate the utility of the sublabial approach in gaining proper exposure for tip rhinoplasty maneuvers in a cadaver model. Additional objectives included identifying types of grafts that can be placed sublabially and whether these methods can be translated successfully to human subjects.</p><p><strong>Methods: </strong>Ten (N = 10) fresh-preserved cadavers were dissected at our academic institution from August 18, 2019 through February 5, 2020. Photographs of the cadavers were taken with permission from the anatomy laboratory manager using an iPhone 10 (Apple Inc., Cupertino, CA). Standard rhinoplasty views were taken of all ten cadavers.</p><p><strong>Results: </strong>Grafts were harvested and designed from septal (80%), auricular (50%) and rib cartilage (40%). The division of depressor septi muscle was accomplished in all ten (100%) cadavers to address tip ptosis. Placement of the columellar strut and shield grafts resulted primarily in the improvement of nasal projection as well as rotation in all (100%) cadavers. Premaxillary augmentation was not always indicated but helped to improve an acute, retrodisplaced nasolabial angle in three (30%) cadavers. Lateral osteotomies via this approach addressed the nasal bony pyramid in all ten (100%) cadavers. The swinging door technique enabled correction of the caudal septum in six (60%) cadavers.</p><p><strong>Conclusions: </strong>Several rhinoplasty techniques can be successfully performed on cadavers via the sublabial approach and we hope this work can be translated to human subjects.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"61-69"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1824042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38404884","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 Letter to Editor RE: Idiopathic Granulomatous Mastitis with Skin Rupture: A Retrospective Cohort Study of 200 Patients Who Underwent Surgical and Nonsurgical Treatment.","authors":"Jiangfen Wang,&nbsp;Yafen Zhang,&nbsp;Xiaoting Lu,&nbsp;Chunfang Xi,&nbsp;Keda Yu,&nbsp;Runfang Gao,&nbsp;Kaixin Bi","doi":"10.1080/08941939.2020.1780519","DOIUrl":"https://doi.org/10.1080/08941939.2020.1780519","url":null,"abstract":"Dear editor, We thank the authors for their letter [1] on our article entitled “Idiopathic Granulomatous Mastitis with Skin Rupture: A Retrospective Cohort Study of 200 Patients Who Underwent Surgical and Nonsurgical Treatment” [2]. Based on your comment and request, we have carefully reassessed our article and now we answer the comments one-by-one. Questions about GLM therapy drugs.There are no standard guidelines for the treatment of GLM [3]. MTX therapy mentioned by scholars is also an important method [4], but it is not enabled in our center. I’m sorry for the clerical error in the use unit of levofloxacin. It should be “0.2 g”. The detection of tuberculosis bacilli in our center is carried out by the department of pathology. Pathological diagnosis of the disease will be carried out before treatment, and tuberculosis infection should be excluded. In China, tuberculosis infection needs to be treated in a special hospital, so all the patients admitted to our center are nontuberculosis patients. Incision and drainage were performed on patients with abscess formation accompanied by skin undulation. Biopsy was performed prior to all treatments. Statistical analysis of data The detection of recurrence rate in the two groups are tested by continuous correction chi-square, p1⁄4 0.001. This statistical method is more suitable. When we wrote it, we did the phi correlation test on this group of data, but we did not show the data analysis result in the end, because the continuous correction chi-square test result has already shown the problem.","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"187"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1780519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38068838","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":"Estimating the Depth of Lumbar and Epidural Space in Children.","authors":"Ozkan Onal,&nbsp;Semiha Arik,&nbsp;Emine Aslanlar","doi":"10.1080/08941939.2020.1780520","DOIUrl":"https://doi.org/10.1080/08941939.2020.1780520","url":null,"abstract":"We appreciate the interest in our study [1] from Drs. Uemura and Yamashita. Our response to their comments will allow us to clear key points to this exciting field concerning the estimating the cor...","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"188"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1780520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38070311","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":"Does the Performance of Splenectomy as Part of Cytoreductive Surgery Carry a Worse Prognosis Than in Patients Not Receiving Splenectomy? A Propensity Score Analysis and Review of the Literature.","authors":"James Davies,&nbsp;Viren Asher,&nbsp;Anish Bali,&nbsp;Summi Abdul,&nbsp;Andrew Phillips","doi":"10.1080/08941939.2020.1824043","DOIUrl":"https://doi.org/10.1080/08941939.2020.1824043","url":null,"abstract":"<p><strong>Background & objectives: </strong>Ultra-radical (UR) procedures, including splenectomy, are utilized to increase complete cytoreduction rates during Cytoreductive Surgery (CRS) performed with the aim of complete macroscopic clearance of disease. The purpose of this study was to investigate if splenectomy negatively impacts survival when undertaken during CRS for advanced ovarian cancer (AOC) and compare published splenectomy and cytoreduction rates.</p><p><strong>Methods: </strong>A retrospective review of all consecutive patients who underwent cytoreductive surgery for AOC between 16/05/2013-28/01/2019. Survival, baseline patient characteristics, complications and surgical parameters were recorded. Propensity scored matching (PSM) was performed to reduce bias.</p><p><strong>Results: </strong>154 patients identified over 71 months. 97 underwent standard, 57 underwent UR surgery, 27 patients received splenectomy (17.5%) No difference was seen in overall survival (OS) between all patients (median OS 34 months (95%CI 25.9-41.1) and patients who underwent splenectomy (median OS not yet reached) (p = >0.05). After PSM for various baseline covariates, no significant difference in splenectomy versus non-splenectomy patients (3-year survival 54% compared to 56%) (P > 0.05). Three splenectomy specific complications occurred; one each of pancreatic tail injury, left pleural effusion and streptococcal pharyngitis during chemotherapy. We found wide variation in utilization of splenectomy in published case series; from 9% to 35%.</p><p><strong>Conclusions: </strong>Splenectomy performed as part of CRS is not detrimental to survival in AOC. There is a wide variation in utilization of splenectomy in published case series with little correlation with cytoreduction rates.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"70-76"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08941939.2020.1824043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38759627","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}