Archives of Clinical and Experimental Surgery最新文献

{"title":"In-hospital and mid-term outcomes of patients operated on for type A acute aortic dissection complicated by postoperative malperfusion","authors":"P. Nardi, D. Colella, M. Russo, G. Saitto, A. Scafuri, C. Bassano, A. Pellegrino, G. Ruvolo","doi":"10.5455/aces.20160816012549","DOIUrl":"https://doi.org/10.5455/aces.20160816012549","url":null,"abstract":"Aims: To evaluate the effect of postoperative malperfusion (PM) on operative mortality and on late survival in patients who underwent surgery for acute type A aortic dissection in a referred center for aortic emergency surgery. Patients and Methods: From January 2005 to September 2015, 237 patients were referred for aortic emergency surgery at our center. We examined complete data available on 214 patients (mean age 62.5±12.6 years, 156 males). At presentation, various types of preoperative malperfusion (cerebral, renal, mesenteric) were observed in 119 patients (55.6%). Arterial access for cardiopulmonary bypass was via femoral artery (n = 99), via axillary artery (n = 99), or into the ascending aorta (n = 22). Aortic repair was performed using an open technique in 124 patients (58%). Results: Fifty-five patients (25.7%) presented PM; operative mortality was 29% (62/214): 47.3% in PM patients vs. 22.6% in non-PM patients (P 75 years at the time of operation (OR: 1.1, P = 0.0004) and renal PM (OR: 53.5, P = 0.0027). Five-year survival was 79±7% in PM vs. 94±3% in non-PM patients (P = 0.002). Independent predictors for reduced survival were age >75 years (OR: 375, P = 0.05) and renal PM (OR: 28.6, P = 0.01). All types of PM and the location of intimal tear distal to the ascending aorta were found as risk factors for survival in the univariate analysis only (P < 0.05). Conclusions: Surgery for acute aortic dissection is effective in reducing preoperative malperfusion by about 50%. Renal PM is associated with higher operative mortality, whereas all types of PM, in particular renal PM, negatively affected late survival. Surgical techniques, site of arterial cannulation, and more complex interventions requiring an open technique did not appear to be predictors of increased risk.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765625","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":"Rectal tumor recurrence: What more may we learn?","authors":"A. Manenti, M. Salati, A. Farinetti, M. Zizzo, E. Simonini","doi":"10.5455/ACES.20160816012602","DOIUrl":"https://doi.org/10.5455/ACES.20160816012602","url":null,"abstract":"","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765630","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":"Outcome of the lay open vs. excision and primary closure treatment modalities for chronic sacrococcygeal pilonidal sinus in the local Saudi Arabian community","authors":"B. Shirah, H. Shirah","doi":"10.5455/ACES.20160324071019","DOIUrl":"https://doi.org/10.5455/ACES.20160324071019","url":null,"abstract":"Background and Objectives: Sacrococcygeal pilonidal sinus is a chronic condition for which the treatment options remain controversial based on the high recurrence rates. Before 1997, excision and primary closure was the most popular method offered in our local community surgical practice. In this study, we aim to evaluate the results of treatment outcomes of the lay open method offered in 1997 to our local community patients and compare it to the excision and primary closure method, hoping it may help in opening up wider frontiers in the surgical practice on our local community to provide the best health care. Materials and Methods: Between January 1997 and December 2011, 600 patients with chronic sacrococcygeal pilonidal sinus were included in our study. 443 were male and 157 were female (age range: 16–39). The lay open method was performed on 300 patients who agreed to the newly offered procedure, and excision with primary closure was performed on the other 300 patients that refused surgery with the lay open method. Results: The recurrence rate was 0% for the lay open technique, and 3% for the excision with primary closure method. All patients had undergone 5 years of follow-up. Conclusion: When the lay open technique is performed in a meticulous and carefully prepared manner with superb postoperative care and regular follow-up, it is more promising than excision with primary closure in treating chronic sacrococcygeal pilonidal sinus, and may successfully achieve a zero (0%) recurrence rate, low postoperative complications, and acceptable cosmetic wounds.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765909","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":"Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study","authors":"M. Kassem","doi":"10.5455/aces.20170503081122","DOIUrl":"https://doi.org/10.5455/aces.20170503081122","url":null,"abstract":"Objective: The purpose of this research was to compare surgical consequences of early versus delayed laparoscopic cholecystectomy for complicated acute calculous cholecystitis. Patients and Methods: This prospective randomized work was conducted on 150 patients complaining of complicated acute calculous cholecystitis; presented to the Emergency Department, Alexandria Main University Hospital, Egypt, be tween January 2011 and January 2017. They were distributed randomly into two groups (75 patients each): Group (A) for early laparoscopic cholecystectomy and Group (B) for delayed laparoscopic cholecystectomy. Results: There were 42 men and 108 women. Their mean age at diagnosis was 39.6±10.27 years. The timing of surgery since onset of patients’ complains was ranged from 1.0 to 7.0 days in Group A and from 6 to 10 weeks in Group B. Acute abdominal pain was present in both groups patients. Preoperative CT scan was done for 60 patients (40%) to verify the presence of complications. The mean operative time in Group A and Group B patients were 71.0±26.93 and 38.0±26.25 minutes respectively and there was a statistically significant difference (p>0.054). Laparoscopic cholecystectomy was con verted to open procedure in ten patients. The mean hospital stay in patients of Group A was 1.76±1.05 while in patients of Group B was 3.87±2.43 in the first admission and 2.72±1.41 in second admission. There was no major bile duct injury or post-operative obstructive jaundice in either group. In six patients (2 in Group A and 4 in Group B) bile leak was noted from the drain and port sites’ infections were found in eight patients. Conclusion: Early laparoscopic cholecystectomy one week from start of symptoms of complicated acute calculous chol -ecystitis; was safe, feasible, and considered an acceptable indication.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"1 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70766096","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 comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty","authors":"M. Wani, Azher Mushtaq, M. Bhat, S. Mir","doi":"10.5455/ACES.20170125125700","DOIUrl":"https://doi.org/10.5455/ACES.20170125125700","url":null,"abstract":"Background: In open anterior inguinal mesh hernioplasty, the commonly used method for mesh fixation is by polypropylene sutures which involves extensive mesh fixation and placement of sutures into periosteum of pubic symphysis, thereby increasing the operative time with attendant risk of infection of the prosthetic material. An alternative to sutures is the use of staples which are easy to use and quick to apply. We explored the use of staples in securing the mesh in inguinal hernioplasty. Methodology: A prospective comparative study of 400 patients who underwent inguinal mesh hernioplasty with 200 patients selected randomly each in polypropylene suture (PPSG) and staple group (SG) was performed. Postoperatively patients were made ambulatory on the same day of surgery and discharged from hospital on 1st or 2nd day in both the groups. Follow-up was carried out in 1 week, 2 months, 6 months, 1 year, 2 years, and 3 years and the patients were assessed for wound infection, hematomas, local pain, return to work, recurrence if any, and other miscellaneous complications if any. Results: The mean age of patients in our study in polypropylene suture group and staple group was 46.75 years and 46 years, respectively. 80% (160 patients) in polypropylene suture group and 75% (150 patients) in stapler group had indirect hernia. The mean operative time in PPSG and SG group was 59.25 minutes and 45 minutes, respectively (p value0.05). Overall the complication rate was the same in the two groups with no statistically significant differences observed (P value >0.05). There was 0% recurrence rate in 6 months and 1 year of follow-up in both groups. However, in 3-year follow-up 20 patients (10%) in PPSG and 2 patients (1%) in SG had recurrence (P value=0.0001). Conclusion: The technique of mesh fixation with skin staples is as effective as conventional fixation with polypropylene sutures, with an important added advantage of a significant reduction in the operative time and an early return to work. At the same time this technique does not have any additional complications compared to traditional Lichtenstein method. Good tissue penetrance and effective mesh anchorage are achieved when staples are utilized to secure the mesh.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70766364","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 seven-toed central polydactyl in an adult: A neglected, unclassifiable case","authors":"K. Koca, B. Demiralp, Y. Yurttaş, Inan Guven, E. Koseoglu, S. Akpancar, M. Başbozkurt","doi":"10.5455/aces.20150516031930","DOIUrl":"https://doi.org/10.5455/aces.20150516031930","url":null,"abstract":"The aim of this study was to present a neglected, unclassifiable case that involved a central type polydactyl adult with 7 toes and metatarsals, 4 cuneiforms and 1 cuboid. A 22 year-old male soldier with a right polydactyl was referred to our hospital. He suffered from the need of excessively wide-shoes and occasional shoe irritation. He was evaluated with plain radiography and 3D tomography. The patient had central-type polydactyl with 7 toes and metatarsals, and 4 cuneiforms and 1 cuboid. Ankles and hind feet were completely normal. All toes were capable of tendon flexion and extension. His medical and family history was unremarkable. We planned to excise the excessive toes and metatarsals, but the patient denied the surgery. We present a very rare case with a central polydactyl having 7 toes and metatarsals, 4 cuneiforms and 1 cuboid. The striking point in our case was that he was a neglected, unclassifiable case.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"45-48"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70764578","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":"Ectopic lymphocytic thyroiditis: A case report and treatment options","authors":"I. Araújo-Filho, Amália Cinthia Menezes Rêgo, Francisco Irochima Pinheiro","doi":"10.5455/ACES.20160520030148","DOIUrl":"https://doi.org/10.5455/ACES.20160520030148","url":null,"abstract":"The presence of ectopic thyroid tissue is a rare entity. Non-gland migration occurs during the early stages of embryogenesis to the normal cervical location. Thus, ectopic tissue is lodged, in general, in the path of the thyroglossal duct in the middle line of the neck. The most common location is in the lingual zone, being the lingual thyroid. This, in most cases, will be asymptomatic. However, it is able to manifest itself with symptoms of dysphagia, dysphonia, obstruction of the upper airways or hemorrhage at any moment between childhood and adulthood. This article is a review of this disease, targeting mainly conduct, still very controversial in the literature.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"221-227"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765575","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":"Haematological splenomegaly does not directly relate to portal hypertension: From a clinical study to surgical choice","authors":"A. Manenti, F. Forghieri, M. Zizzo, D. Colasanto, M. Luppi","doi":"10.5455/ACES.20160402123939","DOIUrl":"https://doi.org/10.5455/ACES.20160402123939","url":null,"abstract":"Background: Splenomegaly induces an increased inflow into the portal venous system; however, in the absence of pathology of the liver and of a portal vein system, secondary portal hypertension is unusual. We analyzed this problem through a clinical observational method. Methods: We selected 20 patients with splenomegaly secondary to B-cell chronic lymphocytic leukaemia; their imaging tests and clinical pathways were re-examined. Results: In the absence of diseases of the liver or of the portal venous system, an increased portal blood flow, secondary to the splenomegaly, could not be considered the sole cause of portal hypertension. Conclusions: The normal liver has a high venous capacity, and in the absence of other factors, the sole increase in portal venous flow cannot directly justify portal hypertension. This conclusion is still well founded, even if multiple humoral mediators, some of which are also released from the spleen in a number of pathological conditions, can differentially modulate the haemodynamics of hepatic sinusoids.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"6 1","pages":"86-90"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765856","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":"Characteristics of anatomical landmarks in the maxillary palatal region: A cone beamed computed tomography study","authors":"S. Kasabah, Sridhara Reddy","doi":"10.5455/ACES.20170125125019","DOIUrl":"https://doi.org/10.5455/ACES.20170125125019","url":null,"abstract":"","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"1 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70766302","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":"Folk medicine: Is the solution or problem?","authors":"F. Ceran, S. Basat, Asli Datli, E. Kapı, M. Bozkurt","doi":"10.5455/ACES.20171111013423","DOIUrl":"https://doi.org/10.5455/ACES.20171111013423","url":null,"abstract":"Aim: A variety of traditional first aid methods in the treatment of burns have been developed. These treatment modalities can bring unusual medical issues. We present a traditional burns first aid method ‘shoe polish applying’ for scald burns. Methods: 5 patients (Male: 3, Female: 2), who applied shoe polish to burns due to scald burns, were admitted to our burn centre between 2002 and 2015. The mean age was 29.8 (range: 20 -53). Olive oil impregnated gauzes were applied to facilitate removing the paint at the night before the operation. Mechanical debridement by using Versajet (Smith & Nephew, London,UK) was performed while patients were under general anesthesia. Results: The shoe polish was removed from all of the patients. Burned areas healed after appropriate dressings and no skin graft application was needed. Conclusion: The Versajet Hydrosurgery System and olive oil or other oily substances usage has strong effects on the treatment. Permanent black tattoos can occur in the later stages, if patients do not take proper treatment.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"25 1","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70766565","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}