Surgery: Current Trends and Innovations最新文献

{"title":"Our Experiences With Bi-Planar Mastopexy-Augmentation","authors":"R. Anlatıcı","doi":"10.24966/scti-7284/100019","DOIUrl":"https://doi.org/10.24966/scti-7284/100019","url":null,"abstract":"Aims: By observing some restrictions with the widely performed mastopexy-augmentation operation solely involving the subglandular plane, we modified the method into a two-plane intervention in a number of selected cases. In this retrospective clinical study, we aimed to share our experiences with single stage bi-planar mas-topexy-augmentation. Methods: We performed a vertical mammoplasty and dissected both the subglandular plane, to fix the glandular tissue to a higher pectoral fascial level, and the submuscular plane to insert the implant. Additionally, we utilized either the superior-median dermofat or the dermoglandular flap to cover the implants completely or incom- pletely, aiming for a more stabilized vertical closure. The results were assessed retrospectively and statistically. Results: Thirty-six cases (72 breasts) were included in the study. The average age was 42 years and the average follow-up period was 13 months. The mean sizes of the implants were 211.81±67.48cc for the right breasts and 213.19±66.41cc for the left breasts. Twenty-eight cases (77.78%) were classified as primary and the remaining eight (22.22%) as secondary. Revision operations were demanded in five (13.89%) cases, three (10.71%) in the primary and two (25%) in the secondary group. Postoperative complications were observed in 50% of the study population and also 50% of each group. However, whereas all complications were identified as major in the secondary group, only three cases (10.71%) of major complications were reported in the primary group. There was a significant statistical relationship between the grade of ptosis and minor complications (for which the grade 3 ptosis group was responsible). Problems due to previous breast operations of the secondary group were significantly correlated with the major problems in our study population. However, the grade of ptosis, implant volume, and previous mastopexy-aug- mentation operation were not related with the revision operations and postoperative complications. it is feasible to per- form bi-planar mastopexy-augmentation to overcome the limitations of the widely performed one-plane method. However, potential postoperative complications should be taken into consideration and more caution in secondary cases is needed due to higher complication rates.","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134188425","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":"Factors Contributing To Unsuccessful Central Line Placement In The Neck And Chest","authors":"Manuel E Portalatin","doi":"10.24966/scti-7284/100015","DOIUrl":"https://doi.org/10.24966/scti-7284/100015","url":null,"abstract":"Objective: To date, no prospective studies have analyzed which multivariate factors correlate to a successful placement. We ques-tion whether MAP and obesity are contributors to central line place- ments in the IJ and subclavian veins. Methods: All trauma patients aged 14 to 90 requiring central venous access were considered. Data on obesity, diabetes mellitus, hypotension, ventilator dependency, contractures, inline cervical spine immobilization, placement site, and emergency cases was collected. Pediatrics cases and those in which the form was incorrect or incomplete were excluded. Of the 145 cases, 134 were included in the analysis. Logistic regression was used to analyze the raw data, using IBM SPSS 2014 software. Results: The study population was 134 patients. BMI and MAP did not contribute to line failure (p<0.297, p<0.915), but MAP >60 was correlated with increase success in line placement (p<0.002). Medical residents and surgical residents were more likely to have failures over emergency medicine residents. Conclusion: There are inherent risks which need to be outlined to the patient. Lack of preparation and experience increases the like-lihood of devastating complications. Central venous catheter placement can be done safely and provide much needed access for criti- cally ill patients, with time, guidance, and volume.","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128322845","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":"Marfan Syndrome And Dsyphagia Lusoria: The Hustle","authors":"N. Marziliano","doi":"10.24966/scti-7284/100018","DOIUrl":"https://doi.org/10.24966/scti-7284/100018","url":null,"abstract":"","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131022131","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":"Effectiveness And Safety Of Sleeve Gastrectomy In Elderly Patients Above 60 Years","authors":"Awadh R. Alqahtani, Fahad Almadi, Emad Aljohani","doi":"10.24966/scti-7284/100016","DOIUrl":"https://doi.org/10.24966/scti-7284/100016","url":null,"abstract":"Background: As the obesity is pandemic, the requisite for bariatric treatment and novel interventions has surged substantially. Among various bariatric strategies to cope with the obesity challenge, sleeve gastrectomy has proved to be the most effective. Aim: To evaluate the effectiveness and safety of sleeve gastrectomy for weight loss in morbidly obese elderly Saudi patients (60 years). Methodology: A prospective cohort study on 205 patients undergoing Laparoscopic Sleeve Gastrectomy (LSG) was carried out from January 2013 to August 2016, with a follow up time of 6 months and then 1 year. The study included patients of >60 years of age who have a Body Mass Index (BMI) of >40 kg/m2. The primary objective of this study includes the percent Excess Weight Loss (%EWL), Length of Stay (LOS), 30-days and 1-year mortality and morbidity rates. Results: The mean age of patients was 65 years, of which 60% were females. The Mean weight before the surgery was 120 Kg with a pre-operative BMI of 44 kg/m2. Patients underwent vertical sleeve gastrectomy laparoscopically with a mean LOS of 2 days. Follow-up was performed twice, within 6 months and then 1 year after the operation, which showed statistically significant reduction in the average weight and BMI (P-value= <0.001). Percent EWL was 48% and 59% at the 6 and 12 months follow ups, respectively. In all patients, the 30-days and 1-year mortality and morbidity rate was 0%. Conclusion: laparoscopic sleeve gastrectomy is effective and safe surgery for significant %EWL in morbidly obese elderly patients in Saudi Arabia.","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116984910","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":"Endovascular Management of Supra Hepatic IVC Budd-Chiari Syndrome in a 12 year old Boy: Case Report","authors":"S. Mahmoud","doi":"10.24966/scti-7284/s1002","DOIUrl":"https://doi.org/10.24966/scti-7284/s1002","url":null,"abstract":"Primary Budd-Chiari Syndrome (BCS) is a rare condition affect-ing one in a million adults, even more rare in children. It is a rare form of hepatic venous outpatient obstruction at the supra hepatic Inferior Vena Cava (IVC), the hepatic veins or both. As this syndrome is un-common, especially in paediatric age group, misdiagnosis and delay in diagnosis are frequent. A high index of clinical suspicion along the radiological and histological correlation can lead to early diagnosis and appropriate management. The most common BCS symptom is ascites. Our case was a 12 year old Sudanese boy, suffering of man-ifestations of portal hypertension, ascites, and hepatosplenomegaly. He was treated by Angioplasty and Stenting of the supra hepatic IVC, with good outcome and improvement of symptoms. Published literature on interventional procedure for Budd-Chiari Syndrome in children and adolescents is scare. The management of such cases was not unified in all the reports. Percutaneous endovascular angio plasty and stenting of the suprahepatic IVC","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"188 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115181625","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":"Hybrid Endovascular Repair for Dysphagia Lusoria in a Patient with Marfan Syndrome","authors":"Halim Yammine","doi":"10.24966/scti-7284/s1005","DOIUrl":"https://doi.org/10.24966/scti-7284/s1005","url":null,"abstract":"Hybrid En- dovascular Repair for Dysphagia Lusoria in a Patient with Marfan Syndrome. aberrant subclavian artery focal dissection aneurysmal degeneration The aorta measured 33mm both proximally and distally, and the right subclavian artery the aorta 15mm distal to a widely patent left subclavian artery. There was moderate dilatation of the left subclavian artery, and it was unclear whether it would be possible to clamp this both proximally and distally. Therefore, the right carotid artery was identified and an open right subclavian to carotid artery trans position was performed through a standard neck incision. Then, a 38mm×38mm×100mm proximal free flow Valiant™ (Medtronic Inc, Santa Rosa, CA) device was used to cover the origin of the aberrant right subclavian artery. Completion arteriography and intravascular ultrasound were performed, demonstrating excellent proximal and distal fixation with no evidence of endoleak or dissection. There was antegrade flow through both carotids as well as the left subclavian artery. Abstract Objective: We present the case of a 51-year-old male with dysphagia lusoria and Marfan syndrome treated with a hybrid repair. Methods: Review of chart and pre- and post-operative imaging was performed. Results: The patient presented with a seven-year history of","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132814215","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":"A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic Purposes Comparing Optical Coherence Tomography and Intravascular Ultrasound Imaging (SCAN)","authors":"E. Pavillard","doi":"10.24966/scti-7284/s1003","DOIUrl":"https://doi.org/10.24966/scti-7284/s1003","url":null,"abstract":"Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease. Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying lMann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoringof plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p<0.001, p=0.001, p=0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p=0.19, p=0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during thestudy. Conclusions: Imaging byOCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease.","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128451929","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":"Inadvertent Arterial Catheterization during Central Venous Catheter Insertion Same Problem with Different Management Modalities","authors":"Amr Awad Albayomy","doi":"10.24966/scti-7284/s1004","DOIUrl":"https://doi.org/10.24966/scti-7284/s1004","url":null,"abstract":"","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121511678","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":"Colonic Infarction Following Open and Endovascular Abdominal Aortic Aneurysm Repair in Patients with Dolicosigma-2 Case Reports and Revision of Literature","authors":"L. Garriboli","doi":"10.24966/scti-7284/s1001","DOIUrl":"https://doi.org/10.24966/scti-7284/s1001","url":null,"abstract":"Colonic Infarc- tion Following Open and Endovascular Abdominal Aortic Aneurysm Repair in Patients with Dolicosigma-2 Case Reports and Revision of Literature. J Surg Curr Trend Innov: S1001. Abstract Background: Colonic ischemia is a major adverse event after ab- dominal aortic aneurysm repair, both in open surgical or endovascular procedures, with poor prognosis and high mortality rates. Case Report: We report two different cases of colonic infarction, the first following a standard EVAR procedure and the second following open abdominal aortic aneurysm repair. Both patients had a patent Inferior Mesenteric Artery (IMA), intact patent iliac hypogastric arter ies pre and post-operatively and had in common a dolicosigma as additional anatomical finding. Informed consent for aneurysm repair and publishing of our case studies was obtained for both patients. Discussion: Colon ischemia accompanying aortic surgery may be an intra-operative finding or a postoperative diagnosis and may be due to several causative factors. The impact of IMA exclusion on colonic perfusion has been largely evaluated, as well as the impor- tance in maintaining adequate blood supply with the preservation of at least one hypogastric artery in case of chronic occlusion of the iliac arteries or distal aorta. Laboratory and clinical parameters may heighten suspicion of bowel ischemia, but they don’t have high enough sensitivity and therefore can’t be considered the only diagnostic modality. Colonoscopy still remains the gold standard for doc- umenting ischemic bowel after aneurysm repair. Conclusion: Early diagnosis is an essential aspect when colonic ischemia occurs as an adverse event after abdominal aortic surgery. Colonscopy has to be performed as early as possible for a certain diagnosis, while clinical parameters and radiological exams, even useful, sometimes may represent confusing factors that could delay the exact diagnosis. Angio-CT scan may be helpful as well in iden tifying patients with predisposing factors or anatomical variants that can increase the risk of colon ischemia.","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116297254","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":"Two-Stage Hybrid Open and Endovascular with Uncovered Stents Repair of a Crawford Type V Aortic Aneurysm","authors":"C. A. Neto","doi":"10.24966/SCTI-7284/100013","DOIUrl":"https://doi.org/10.24966/SCTI-7284/100013","url":null,"abstract":"","PeriodicalId":299081,"journal":{"name":"Surgery: Current Trends and Innovations","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121959213","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}