Journal of Surgery & Anesthesia Research最新文献

{"title":"Evaluation of Patients with Gall Bladder Perforation: Experience at a Tertiary Centre","authors":"Emad Alvi","doi":"10.47363/jsar/2023(4)160","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)160","url":null,"abstract":"Introduction: Gall bladder perforation is a rare but serious complication that presents to our emergency setup. It is usually a sequelae of acute cholecystitis. It requires urgent intervention, failing which mortality can be as high as more than 50%. Neimeier classification of GB perforation has since become the guide to its management. Because of infrequent and rare occurrence of GB perforation the data regarding incidence and management of it is lacking. We present our experience at a tertiary centre of 35 cases of gall bladder perforation that presented to us since January 2020 till June 2022","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126580021","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":"Mucinous Cytadenoma of the Pancreas: A Case Report with Review of the Literature","authors":"Ouhammou Yousra","doi":"10.47363/jsar/2023(4)156","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)156","url":null,"abstract":"Mucinous cystadenomas are a rare entity of cystic lesions of the pancreas, often discovered incidentally and posing a preoperative diagnostic challenge. Women are more often affected than men and these lesions are often asymptomatic, discovered by imaging and biological means. Benign pancreatic mucinous cystadenomas have a very high cure rate with a reduced rate of degeneration. Simple excision of benign pancreatic cysts is considered safe and effective with a very low recurrence rate.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134154968","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":"Epidural Labor Analgesia and Epidural Surgical Anesthesia in a Patient with Idiopathic Intracranial Pressure with Lumbo-peritoneal Shunt: a rare case report","authors":"N. Caidi, H. Ziani, Hanaa Lazhar","doi":"10.47363/jsar/2023(4)154","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)154","url":null,"abstract":"Background: Idiopathic Intracranial Hypertension (IIH) is due to an increased intracranial pressure with no secondary cause of intracranial hypertension and normal Cerebrospinal fluid (CSF) composition. IIH’s prevalence is high among obese women of childbearing age and subsequently coincides with pregnancy. Symptoms vary among patients and commonly present headaches and visual impairment. If untreated, it may steer persistent headaches and lasting visual impairment such as diplopia and scotoma or even blindness. Case Report: We hereby present the uncommon case of an epidural anesthesia for cesarean section in a patient with idiopathic intracranial hypertension and Lumbo-peritoneal shunt that presented to our obstetrics department in labor. First, epidural labor anesthesia (ELA) with a catheter placed above the LP shunt scar was the chosen course of action. However, ELA was converted to an epidural surgical anesthesia (ESA) for acute fetal distress secondary to a placental abruption. Conclusion: IIH usually occurs in pregnant women at any trimester. If undiagnosed or poorly managed, it can lead to drastic complications. As uncommon as it may be, all medical practitioners should be familiar with this pathology even though its diagnostic and treatment are exacting. While the optimal anesthetic management is still controversial, epidural anesthesia proved to be very effective.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127503036","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":"Skin Expander to Enhance Anterior Coverage in Knee Liberation Surgery One Case Report","authors":"L. Phuc","doi":"10.47363/jsar/2023(4)150","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)150","url":null,"abstract":"A female 11 years old, right knee stiffness since childhood. Able walking, but unable running, difficult sitting. Right knee Range of Motion 0-0-3°. Thigh muscle atrophy 2cm. Right lower limb axes well aligned. Rectus femoris muscle very tense, easy to feel under skin. Patella alta, 3 cm above normal position. Skin of anterior knee is in normality, but predictorily when flexion 120°, skin closure is impossible. Nerves and vessels are in normal condition. MRI shows severe contracture of Rectus Femoris. Vastus intermedius, lateralis and medialis are almost normal. Few adhesions inside the joint. Patellofemoral articulation smooth. First operation: placing a 300ml skin expander at prepatellar space, then inflate 300ml water by 10 times. Second operation: remove skin expander, lengthening Rectus Femoris 6 cm. Knee flexion 130°.Easy skin closure. 28th postoperative day, closed manipulation was performed under general anesthesia to achieve knee flexion 130°, then knee kept flexed for 2 hours. Knee flexion-extension was crucial exercise in longterm physical therapy. Last examination at 8th month postoperatively: almost normal walking, slight running, Knee Range of Motion 0-0-115°. By this case, presumable conclusion is skin expander may enhance the anterior coverage for the patients in knee liberation surgery","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"483 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116179319","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":"Intramedullary Kuntscher Nailing Intensified With Cerclage Wiring to Treat Acute Closed Shaft Fractures of Femur: A Series Cases","authors":"L. Phuc","doi":"10.47363/jsar/2023(4)151","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)151","url":null,"abstract":"Between March 1985 and March 1987, we performed 98 surgeries (96 patients) of Intramedullary Kuntscher Nailings Intensified with Cerclage Wiring (if fractures unstable) to treat the fresh closed Fractures of Shaft Femur. Accessing the fractures by Posterolateral Approach, remove soft tissues, hematoma interposing between fragments, reaming medullary canal, performing good reduction, then stabilizing by an Intramedullary Kuntscher Nail. If the fractures not stable enough, Loops of Wiring were intensified. Postoperatively,walking with crutches, and gradual weight bearing according to the extent of bone healing. Physical Therapy focused on Range of Motion (ROM) of hip, knee and ankle. Loss of follow-up: 20 patients (22 femurs). 76 patients (76 femurs) were followed-up for a mean of 27 months (6 to 108). 61 femurs achieved complete bone healing (evaluated on patients and Xrays) with no incidents.18 femurs /patients were removed Kuntscher nail after in average 32 months (22- 48). Allowing Full Weight Bearing in average after 50 days if fracture simple, after 70 days if there were additional fractures. All 13 patients who lost ROM of hip or knee more than 200 , sustained associated injuries of pelvis or legs. Reoperation: 5 femurs (5 %) including delayed and nonunion: 2 femurs (2 %), deep infection: 2 femurs (2%).Surgical fixation not stable enough needed one or more interventions: 1 case (1%). One patient remained rotational displacement 100 ; 3 others with angulation 30 -60 . Leg shortening in average 2,4cm [1-4 ] : 6 femurs ( patients) in which 2 had shortening more than 2 cm. In Vietnam at that time, for the femoral shaft fractures, Intramedullary Kuntscher Nailing with Cerclage Wiring (if fractures unstable) were resumably an acceptable good treatment.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134643292","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":"Case report of a lesser sac intestinal herniation through a defect in the gastro-hepatic omentum and novel repair technique using biological glue","authors":"Hamad Al-ajmi","doi":"10.47363/jsar/2023(4)153","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)153","url":null,"abstract":"Internal hernia is a clinical genus that poses diagnostic and therapeutic challenges and is often omitted from the differential diagnoses because of its relative rarity. We report a case of extremely rare and atypical lesser sac intestinal herniation through a small defect in the gastro-hepatic omentum. This report details the preoperative and intraoperative diagnostic challenges and shortcomings, and also describe a novel repair technique using fibrin glue to address the culprit defect and prevent future recurrence. In this report we attempt to map out our experience against the published literature on similar cases and clinical genera and propose an anatomical and pathological model that may be used to scaffold our understanding of this clinical entity and inform relevant clinical decisions.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124258698","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 Case of Hutch Diverticulum Leading To Non-Functioning Kidney Due To Vesico-Ureteric Reflux","authors":"Ojas Vijayanand Potdar, Mohammed Ayub Karamnabi Siddiqui, Kaustubh Vaidya","doi":"10.47363/jsar/2023(4)155","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)155","url":null,"abstract":"Bladder diverticulum is caused by herniation of the urothelium through the muscular layer of the bladder wall, being formed by mucosa, lamina propria, few muscular fibres and adventitia. Bladder diverticula are classified as congenital or acquired. Congenital ones usually appear in young ages with a maximum incidence before 10 years and are usually unique, almost exclusively in males, located posteromedially to the ureteral ostium and resulting from the weakness of the bladder wall in this portion. Acquired ones generally are due to high intra-vesical pressure caused by infra-vesical obstruction or detrusor-sphincter dyssynergia. More rarely are due to wall debility after bladder surgery. Often develop in males after sixth decade, in about 12% of patients with infra-vesical obstruction. Usually multiple and associated with important trabeculation of the bladder wall. If the ureteral ostium is included in the bladder diverticulum, it is called Hutch diverticulum, which is a rare entity, typically in young ages, with few cases identified in the adult. We hereby present a case of a patient with acquired hutch diverticulum leading to non-functioning kidney due to vesico-ureteric reflux.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128129255","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 Skin-to-Epidural Space Distance at the three Thoracic levels in Children using Magnetic Resonance Imaging for Epidural Anesthesia","authors":"","doi":"10.47363/jsar/2023(4)152","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)152","url":null,"abstract":"Background: Several ways were used to assess the distance from the skin to the epidural space, with the aim of increasing the success of the technique. MRI is the most significant technological advancement in the diagnostic examination of the pediatric spine. The aim of this study was to evaluate the distance between the skin and the epidural space through MRI at three thoracic segments in children aged 0 to 13 years. Methods: Retrospective study with 105 children aged 0 to 13 years in the supine position underwent MRI, and the 2nd, 5th, and 10th thoracic segments were measured. The following parameters were evaluated: skin and the epidural space; needle entry angle between the skin and intervertebral space; and distance corrected by an angle between skin and the epidural space. To compare the proposed data between the samples, we used the Kruskal-Wallis test. The Kruskal-Wallis rank test is a non-parametric method for testing whether samples come from the same distribution. Results: This study evaluated 60 male and 45 female children. The mean distance between Skin-EpiS was 29.27 mm at T2, 26.52 mm at T5, and 24.28 mm at T10, with a significant difference, being the greatest distance found in T2. The Skin-EpiS at T10 was shorter than the other two measurements. Regarding needle entry angle between skin and the three intervertebral spaces, the smallest angle was observed (T2=27.16º) significantly smaller than in the other two spaces (T5=38.68º, T10=39.08º). However, this difference in angle did not result in a significant difference in the distance between the skin and epidural space corrected by the entry angle in the three intervertebral spaces, being practically the same, T2=33.0 mm, T5=34.60 mm, T10=32.1 mm. Conclusion: Precise Skin-EpiS distance information can facilitate accurate needle placement in children’s epidural space and thus decrease the risk of complications. This study in children aged 0 to 13 years provided important information for performing single shots or continuous thoracic epidurals, reducing the potential for complications during its performance.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125867603","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":"Quadruple Assessment using Transrectal Ultrasound Scan is Effective at Accurately Facilitating Choice of Excision Plane by Tems in the Complex Specc Lesion","authors":"C. Blane","doi":"10.47363/jsar/2023(4)149","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)149","url":null,"abstract":"Background: There is currently no consensus as to the optimal imaging modality for Significant Polyps and Early Colorectal Cancer (SPECC). This study describes the use of transrectal ultrasound (TRUSS) as part of a quadruple assessment process to evaluate the depth of invasion of SPECC lesions and guide local excision. Method: Pre-operative imaging and histology were reviewed for all patients undergoing transanal endoscopy microsurgery (TEMS) at Cheltenham General Hospital between 2013 and 2019. Treatment options included mucosectomy, partial thickness excision and full thickness excision. The dataset was studied specifically to evaluate the risk that malignancy will be present at the deep margin. ‘Failure’ of assessment was thus defined as the failure to detect and achieve complete local excision of malignancy. Results: 400 patients were included: 319 primary lesions and 81 secondary lesions. Amongst the primary lesions 93.7% (n=299) had successful R0 excisions. Of the primary lesions with incomplete excisions 50% (N=10) had undergone mucosectomy, 40% (n=8) full thickness excision and 10% (n=2) partial thickness excision","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124851956","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":"Enduring Combat to Develop New Trauma Protocols","authors":"P. Strube","doi":"10.47363/jsar/2023(4)147","DOIUrl":"https://doi.org/10.47363/jsar/2023(4)147","url":null,"abstract":"In the waning days of World War II, Michael DeBakey was quoted as saying, “the only winner in war is medicine”. Revolutionary innovations and technical advances in the disciplines of medicine, surgery, and anesthesia of medicine and nursing are inextricably connected to military conflict. The last decade of war has likewise produced evolution of long accepted concepts, including prehospital trauma care, acute resuscitation, and forward deployed surgical care teams. The demonstrated life-saving value of these novel approaches in high acuity trauma has provided the impetus for translation of these elements into injury care in the civilian environment.","PeriodicalId":380400,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114073878","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}