Surgical Techniques Development最新文献

{"title":"Increased Postoperative Glycemic Variability Is Associated with Increased Revision Surgery Rates in Diabetic Patients Undergoing Hip Fracture Fixation","authors":"I. Ashkenazi, N. Amzallag, S. Factor, Nadav Graif, O. Shaked, Y. Warschawski, T. Ben-Tov, Amal Khoury","doi":"10.3390/std13030018","DOIUrl":"https://doi.org/10.3390/std13030018","url":null,"abstract":"Background: An association between increased postoperative glycemic variability (GV) and inferior postoperative outcomes following hip arthroplasty procedures has been previously reported. However, the utilization of the GV to project surgical outcomes following the fixation of hip fractures has not been well established. The aim of this study is to assess the association between the postoperative GV of patients with diabetes mellitus (DM) and surgical outcomes following the fixation of a hip fracture. Methods: This is a retrospective analysis of 3117 consecutive cases of patients who underwent the fixation of hip fractures between 2011 and 2020. Patients with a DM diagnosis who had ≥3 postoperative glucose measurements during the first week after surgery and had a minimum of one-year follow-up were included. The coefficient of variation (the ratio of the standard deviation to the mean) was utilized to assess the GV. The final study population included 605 patients who were divided into three groups according to the extent of their GV. Short- and mid-term outcomes, including mortality, reoperations, readmissions, and postoperative infection rates were compared between the groups. Results: There was a non-significant trend towards increased rates of mortality (p = 0.06), readmissions (p = 0.22) and postoperative infections (p = 0.09) in the high GV group. The rate of revisions at the latest follow-up was significantly higher in the high GV group when compared to the two other groups (p = 0.04). Conclusion: For diabetic patients undergoing hip fracture fixation, a higher GV in the postoperative period was associated with increased rates of all-cause revision surgery and may be associated with increased mortality, readmission rates, and surgical site infections. Glucose levels of diabetic patients should be meticulously monitored and controlled in the postoperative period in an effort to contain the sequelae associated with elevated GV and to identify patients in need of closer observation and follow-up.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822852","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":"Simultaneous Laparoscopic Surgery for Esophageal Achalasia Combined with Epiphrenic Diverticulum: A Case Report","authors":"K. Okamoto, Jun Kinoshita, H. Saito, Itasu Ninomiya, Noriyuki Inaki, Hiroyuki Takamura","doi":"10.3390/std13030017","DOIUrl":"https://doi.org/10.3390/std13030017","url":null,"abstract":"We report a case in which a 74-year-old man suffering from esophageal achalasia complicated with epiphrenic esophageal diverticulum was successfully treated with a simultaneous laparoscopic surgery. The gentleman was referred with symptoms suggestive of a passage disorder in the lower esophagus for the past 5 years. Esophagogastroduodenoscopy demonstrated an epiphrenic diverticulum at the left wall of the lower esophagus, and esophagography led to the suspicion of a combined esophageal achalasia. A simultaneous laparoscopic surgery with an abdominal approach was performed in which, following the opening of the esophageal hiatus, the diverticular wall was separated from the mediastinal organs and diverticulectomy was performed with linear staplers. After Heller’s myotomy, Dor’s fundoplication was subsequently performed in which both the incisional line of muscle layer and the suturing line of diverticulectomy were wrapped by the fornix of the stomach to make up for the wall strength and avoid the suture leakage. It was theoretically considered logical and effective to reinforce this vulnerable site with Dor’s fundoplication. He had an uneventful recovery and a rapid relief from symptoms following surgery.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656582","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":"Modified Tension Band Wiring Using Only Non-Absorbable Braided Polyblend Sutures for the Treatment of Patellar Fractures","authors":"Annalisa Itro, A. De Cicco, Gianluca Conza, Luca Schiavo, Niccolò Garofalo, A. Braile, Francesco Nappi, G. Toro","doi":"10.3390/std13020015","DOIUrl":"https://doi.org/10.3390/std13020015","url":null,"abstract":"Patellar fractures represent approximately 1% of all fractures and the pattern is influenced by the quality of the bone and the energy of the trauma. Transverse fractures are associated with extensor mechanism failure and interruption of joint congruence. Patellar fractures are generally fixed using tension band principles, through K-wires and metal cerclage. The tension band was conceived to transform the considerable tensile force applied to the patella into a compressive one to obtain a stable fixation. The use of metal implants might be associated with a significant discomfort, mostly related to the irritating action of K-wires and cerclage on the surrounding soft tissues, often leading to the need for implant removal. Therefore, we introduced an original technique for fix patellar fractures by using only a non-adsorbable braided polyblend suture. Postoperative care included progressive range of motion recovery using an articulated knee brace and a specific protocol. The suture-only tension band technique seems to be a useful technique in terms of complications and reoperation rate while allowing secure and early mobilization.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346186","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":"The Method of 3D C-arm Navigated AC Joint Stabilization-Surgical Technique","authors":"A. Böhringer, Carlos Pankratz, A. Eickhoff, Florian Gebhard, K. Schütze","doi":"10.3390/std13020014","DOIUrl":"https://doi.org/10.3390/std13020014","url":null,"abstract":"Background: The arthroscopically assisted stabilization of AC joint dislocations with a suture button system is an established procedure that is widely and successfully used in everyday practice. The main advantages of this one-step method are the minimally invasive procedure and the anatomical reconstruction of the ruptured coracoclavicular ligaments with a permanent implant. With this technical note study, for the first time, the new method of navigated suture button implantation in everyday clinical practice is described with the future goal of further reducing invasiveness and increasing precision. Materials and Methods: The surgical technique is explained using precise descriptions and illustrations, photos, X-rays, and 3D reconstructions based on clinical cases. The step-by-step system setup and patient positioning, AC joint reduction and retention, 3D scan and drill tunnel planning, stab incision and Kirschner wire navigation, and cannulated drilling and implant positioning, as well as closure and documentation are described in detail. Results: The standard coracoclavicular stabilization of AC joint dislocations with the 3D C-arm navigated suture button method is described in detail. Furthermore, the feasibility of an additive horizontal acromioclavicular suture cerclage, the implantation of an additional coracoclavicular suture button system, and the single-stage cannulated screw fixation of non-displaced fractures is demonstrated. Conclusion: The navigated suture button method aims to be simple, safe, minimally invasive, and precise. Prospective clinical studies with a long follow-up should be carried out to determine the clinical and radiological outcome in comparison with current methods.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368930","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":"Locoregional vs. General Anaesthesia for Minimally Invasive Video-Assisted Parathyroidectomy (MIVAP) Using Propensity Score Matching Analysis: A Feasibility Study","authors":"F. Pennestri', P. Procopio, Francesca Prioli, P. Gallucci, L. Sessa, Annamaria Martullo, A. Laurino, L. Revelli, Cristina Modesti, C. De Crea, M. Raffaelli","doi":"10.3390/std13020012","DOIUrl":"https://doi.org/10.3390/std13020012","url":null,"abstract":"Focused parathyroidectomy is the preferred surgical method for treating primary hyperparathyroidism (pHPT) sustained by the pre-operatively well-localized parathyroid adenoma. We aimed to compare the effectiveness, safety, and short-term clinical outcome of minimally invasive video-assisted parathyroidectomy (MIVAP) in locoregional anaesthesia (LA) vs. general anaesthesia (GA) by means of propensity score matching (PSM) analysis. Retrospective research of patients who underwent MIVAP between January 2014 and December 2022 was carried out. Patients were divided into two groups based on the anaesthesiologic procedure (LA vs. GA). Overall, 553 patients underwent MIVAP. After PSM, 115 patients in the LA group and 230 patients in the GA group were included. MIVAP under LA was associated with shorter median operative time (16 vs. 35 min, p < 0.001), shorter median operative room occupation time (44 vs. 73 min, p < 0.001), and lesser median post-operative visual analogue scale pain, with comparable post-operative hospital stay and complication rate. MIVAP under LA is a safe and feasible procedure with significant advantages over GA in terms of post-operative pain and operative room occupation time. This last step can finally result in more efficient utilisation of the operative room and the health care system’s resources.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140989165","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":"Analysing Pre-Operative Gait Patterns Using Inertial Wearable Sensors: An Observational Study of Participants Undergoing Total Hip and Knee Replacement","authors":"Egidio Riggio, Federico Canavese, Pragadesh Natarajan, A. Lim, Cha Yin, R. D. Fonseka, David Abi-Hanna, Kaitlin Rooke, L. Sy, Monish M. Maharaj, David Broe, Lianne Koinis, R. Mobbs","doi":"10.3390/std13020011","DOIUrl":"https://doi.org/10.3390/std13020011","url":null,"abstract":"Background. Knee and hip arthroplasty are two of the most frequently performed procedures in orthopaedic surgery. They are associated with positive patient-reported outcomes and significant improvements in quality of life for patients. Despite this, there may be room for further progress by quantifying functional improvements with gait analysis. Our study therefore aims to characterise the disease-specific gait pattern of participants with knee and hip osteoarthritis undergoing total joint replacement using a single chest-based wearable sensor. Methods. Twenty-nine participants awaiting total hip replacement and 28 participants awaiting total knee replacement underwent three-dimensional motion analysis with inertial wearable sensors. These gait metrics were then compared with 28 healthy controls of similar ages. Differences in gait metrics were evaluated using a T-test. The participants were recruited through a single centre to participate in this cross-sectional observational study. Participants with osteoarthritis severity sufficient to warrant surgical intervention were considered for inclusion in our study. The participants were instructed to walk 15–120 m in a hospital environment while fitted with a chest-based wearable sensor. Results. In total, three domains were evaluated, including spatiotemporal, variability and asymmetry parameters. There were marked variations in the gait asymmetry parameters and step length variation in both the hip and knee osteoarthritis patients compared with the healthy controls. The magnitude of gait deterioration in terms of step length asymmetry was greater on average in the hip osteoarthritis group than the knee group. The hip osteoarthritis (+180%, p < 0.001) and knee osteoarthritis (+129%, p = 0.001) groups demonstrated marked differences in step length asymmetry. Discussion. A single chest-based sensor was found to be capable of detecting pathological gait signatures in osteoarthritis patients when compared with age-matched controls. Future studies should compare pre- and postoperative changes to disease-specific gait impairments to validate the use of wearable sensors as a clinical adjunct.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010972","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":"Report on the 11th National Congress AICPE (Associazione Italiana di Chirurgia Plastica Estetica) Held in Rimini, Italy, 12–14 April 2024","authors":"E. Riggio","doi":"10.3390/std13020009","DOIUrl":"https://doi.org/10.3390/std13020009","url":null,"abstract":"The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE) is one of the most relevant conference meetings in Europe concerning aesthetic plastic surgery as there are a number of participants and a parterre of invited speakers chosen for their renowned scientific value. [...]","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674085","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":"Anterior Cervical and Upper Thoracic Column Reconstruction Using an Expandable Poly-Ether-Ether-Ketone Vertebral Body Replacement: A Retrospective Single Center Cohort Analysis","authors":"Martin Štefanides, Katharina A. C. Oswald, Anaïs K. Luyet, Christoph E. Albers, L. Benneker, Moritz C. Deml","doi":"10.3390/std13020008","DOIUrl":"https://doi.org/10.3390/std13020008","url":null,"abstract":"This study aimed to evaluate the safety and efficacy of a novel Poly-Ether-Ether-Ketone (PEEK) expandable vertebral body replacement (VBR) for anterior cervico-thoracic vertebral column reconstruction in patients with metastatic, traumatic, or degenerative diseases. Radiographic and clinical outcomes, as well as complication rates, were analyzed in a retrospective analysis of 28 patients (61 ± 13 years; 64% female) who underwent an anterior cervical corpectomy and fusion (ACCF) with the Expandable Corpectomy Device (ECD) from DePuy/Synthes (2011–2020). Correction of the bisegmental kyphotic angle (BKA) was chosen as the primary outcome. Bony fusion, loss of device height, and implant subsidence were evaluated additionally. Clinical outcome was assessed using Odom’s criteria, the numerical pain rating scale (NRS), the American Spinal Injury Association Impairment Scale (AIS), and the Karnofsky Performance Status Scale (KPSS). Our study found a significant improvement in the BKA (12.3° ± 9.6°; p = 0.0002) at the last follow-up with no statistically relevant loss of device height (p = 0.96) or implant subsidence (p = 0.99). Successful bony fusion was observed in all patients. The KPSS significantly improved in patients with a tumorous disease at the time of discharge (p = 0.0009), and the sensation of pain showed significant improvement at six months post-operatively and at the final follow-up (p = 0.004; p = 0.021). However, four patients needed further secondary posterior stabilization, and one ECD was explanted due to a severe surgical site infection after an accidental esophageal lesion. In conclusion, the ECD proofed the radiographic stability for the anterior column reconstruction of the cervico-thoracic spine with significantly improved clinical outcome.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708999","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":"Novel Concept for the Expansion of the Fibula Bone as an Autologous Bone Graft: Experimental Tests on an Animal Implant Prototype—In Memoriam Volker Buehren","authors":"Matthias Militz, Volker Buehren, Christoph Miethke, C. Gabler, Josephine Mauck, W. Mittelmeier, Robert Bialas, Rainer Bader","doi":"10.3390/std13020007","DOIUrl":"https://doi.org/10.3390/std13020007","url":null,"abstract":"The current reconstructive surgical procedures implemented after the resection of extended bone segments are associated with high complication rates and long-term treatments. By transplanting an autologous, vascularized and stabilized bone segment, these challenges can be managed. Thus, we propose a novel procedure to expand the currently available autologous bone grafts to the dimensions of the recipient bone using an implantable device. The objective of the present study was to characterize the feasibility of developing an implant prototype for fibula expansion in an in vitro model using a porcine fibula. A balloon catheter, as the part of the implant responsible for expansion, was proven to expand while being periodically filled with sodium chloride. Therefore, the expansion of the balloon catheter was analyzed in an experimental test setup with a 3D-printed porcine fibula with a closure film simulating callus formation to simulate the in vivo situation. Our experimental testing proved the successful expansion of the porcine fibula by the balloon catheter. Hence, the feasibility of the concept for subsequent animal testing was confirmed.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140213329","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 Detailed Exploration of the Ex Utero Intrapartum Treatment Procedure with Center-Specific Advancements","authors":"Marta Domínguez-Moreno, Á. Chimenea, María Remedios Viegas-González, Clara Morales-Muñoz, L. García-Díaz, Guillermo Antiñolo","doi":"10.3390/std13010005","DOIUrl":"https://doi.org/10.3390/std13010005","url":null,"abstract":"The Ex Utero Intrapartum Treatment (EXIT) procedure has long been an invaluable tool in managing complex fetal conditions requiring airway interventions during the transition from intrauterine to extrauterine life. This technical note offers an in-depth examination of the EXIT procedure, emphasizing the refinements and innovations introduced at our center. The technique focuses on meticulous preoperative assessment and uses distinctive techniques and anesthetic methodologies. A multidisciplinary team assembles to plan the EXIT procedure, emphasizing patient communication and risk discussion. Our technique involves atraumatic access to the uterine cavity, achieved through the application of a uterine progressive distractor developed for this purpose. Following the use of this distractor, vascular clamps and a stapling device (Premium Poly Cs-57 Autosuture®, Medtronic) are employed. Our anesthetic approach employs general anesthesia with epidural catheter placement. Maternal operation involves low transverse laparotomy and intraoperative ultrasonography-guided hysterotomy. Fetal exposure includes gentle extraction or external version, ensuring airway access. After securing fetal airway access, umbilical cord clamping and maternal abdominal closure conclude the procedure. By revisiting the core principles of EXIT and incorporating center-specific advancements, we enhance our understanding and technical expertise. To our knowledge, this is the first time a detailed description of the technique has been published.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435424","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}