Innovative Surgical Sciences最新文献

{"title":"Two giant retroperitoneal schwannomas mimicking adrenal malignancy - a case report.","authors":"Isabelle Fülber,&nbsp;Katharina Peer,&nbsp;Elisabeth Maurer,&nbsp;Detlef K Bartsch,&nbsp;Jannis Görlach,&nbsp;Joachim Nils Göbel,&nbsp;Marion Roeßler,&nbsp;Katharina Holzer","doi":"10.1515/iss-2020-0008","DOIUrl":"https://doi.org/10.1515/iss-2020-0008","url":null,"abstract":"<p><p>Schwannomas are benign tumors in 95% of cases and very rarely occur in the retroperitoneum. We report the cases of a 35-year-old man with abdominal discomfort and a 50-year-old asymptomatic woman with large retroperitoneal masses. Both underwent multivisceral surgery to exclude an adrenal carcinoma, and the pathologic diagnosis showed schwannomas in both cases. Despite morphological imaging, it was not possible to get a clear diagnosis preoperatively.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"5 1-2","pages":"75-79"},"PeriodicalIF":1.3,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/iss-2020-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of subventricular zone involvement in extent of resection and tumor growth pattern of glioblastoma.","authors":"Yahya Ahmadipour, Julie-Inga Krings, Laurèl Rauschenbach, Oliver Gembruch, Mehdi Chihi, Marvin Darkwah Oppong, Daniela Pierscianek, Ramazan Jabbarli, Ulrich Sure, Nicolai El Hindy","doi":"10.1515/iss-2020-0011","DOIUrl":"10.1515/iss-2020-0011","url":null,"abstract":"<p><strong>Objectives: </strong><i>Isocitrate dehydrogenase</i> (<i>IDH1/2</i>) mutations and <i>O6-alkylguanine DNA methyltransferase</i> (<i>MGMT</i>) promoter methylations are acknowledged survival predictors in patients with glioblastoma (GB). Moreover, tumor growth patterns like multifocality and subventricular zone (SVZ) involvement seem to be associated with poorer outcomes. Here, we wanted to evaluate the influence of the SVZ involvement and the multifocal tumor growth on the extent of surgical resection and its correlation with overall survival (OS) and molecular characteristics of patients with GB.</p><p><strong>Methods: </strong>Adult patients with primary GB who underwent surgery at our department between 2012 and 2014 were included. Preoperative magnetic resonance imaging findings were analyzed with regard to tumor location, presence of multifocality and SVZ involvement. The extent of surgical resection as well as clinical and molecular parameters was collected from electronic patient records. Univariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Two hundred eight patients were retrospectively analyzed, comprising 90 (43.3%) female individuals with a mean age of 62.9 (±12.26) years and OS of 10.2 months (±8.9). Unifocal tumor location was a predictor for better OS with a mean of 11.4 (±9.4) months (vs. 8.0 [±7.4] months, p=0.008)<i>.</i> Affection of the SVZ was also associated with lower surgical resection rates (p<0.001). SVZ involvement revealed with 7.8 (±7.0) months a significant worse OS [vs. 13.9 (±10.1) months, p<0.001]<i>.</i> All six <i>IDH1/2</i> wildtype tumors showed an unifocal location (p=0.066). <i>MGMT</i> promoter methylation was not associated with multifocal tumor growth (p=0.649) or SVZ involvement (p=0.348). Multivariate analysis confirmed independent association between the SVZ involvement and OS (p=0.001).</p><p><strong>Conclusion: </strong>The involvement of the SVZ appears to have an influence on a lower resection rate of GB. This negative impact of SVZ on GB outcome might be related to lesser extent of resection, higher rates of multifocality and greater surgical morbidity but not inevitably to <i>IDH1/2</i> mutation and <i>MGMT promoter</i> methylation status.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"5 3-4","pages":"127-132"},"PeriodicalIF":1.7,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39860545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the 8th lung cancer TNM classification and clinical staging system in a German cohort of surgically resected patients.","authors":"Samantha Taber, Joachim Pfannschmidt","doi":"10.1515/iss-2020-0010","DOIUrl":"10.1515/iss-2020-0010","url":null,"abstract":"<p><strong>Objectives: </strong>The updated 8th edition of the tumor, node, metastases (TNM) classification system for non-small cell lung cancer (NSCLC) attempts to improve on the previous 7th edition in predicting outcomes and guiding management decisions. This study sought to determine whether the 8th edition was more accurate in predicting long-term survival in a European population of surgically treated NSCLC patients.</p><p><strong>Methods: </strong>We scanned the archives of the Heckeshorn Lung Clinic for patients with preoperative clinical stages of IIIA or lower (based on the 7th edition), who received surgery for NSCLC between 2009 and 2014. We used pathologists' reports and data on tumor size and location to reassign tumor stages according to the 8th edition. We then analyzed stage specific survival and compared the accuracy of the two systems in predicting long-term survival. We excluded patients with neoadjuvant treatment, incomplete follow-up data, tumor histologies other than NSCLC, or death within 30 days of surgery.</p><p><strong>Results: </strong>The final analysis included 1,013 patients. Overall five-year survival was 47.3%. The median overall survival (OS) was 63 months (range 1-222), and the median disease-free survival (DFS) was 50 months (0-122). The median follow-up time for non-censored patients was 84 months (range 60-122).</p><p><strong>Conclusions: </strong>We found significant survival differences between the newly defined stages 1A1, 1A2 and 1A3 (previously 1A). We also found that the 8th edition of TMN classification was a significantly better predictor of long-term survival, compared to the 7th edition.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"5 1-2","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts VBC","authors":"","doi":"10.1515/iss-2020-3001","DOIUrl":"https://doi.org/10.1515/iss-2020-3001","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"3 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75276973","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":"Abstracts DGPRÄC","authors":"","doi":"10.1515/iss-2020-2006","DOIUrl":"https://doi.org/10.1515/iss-2020-2006","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"96 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90634841","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":"Abstracts DGKCH","authors":"","doi":"10.1515/iss-2020-2004","DOIUrl":"https://doi.org/10.1515/iss-2020-2004","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81147484","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":"Abstracts DGT","authors":"","doi":"10.1515/iss-2020-2007","DOIUrl":"https://doi.org/10.1515/iss-2020-2007","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"93 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74958645","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":"Abstracts DGAV","authors":"","doi":"10.1515/iss-2020-2001","DOIUrl":"https://doi.org/10.1515/iss-2020-2001","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"19 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82164970","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":"Women in surgery: a web-based survey on career strategies and career satisfaction.","authors":"Sonia Radunz,&nbsp;Hülya Pustu,&nbsp;Katja Marx,&nbsp;Laura Mazilescu,&nbsp;Agnes Braun,&nbsp;Tamas Benkö,&nbsp;Mark Banysch,&nbsp;Gernot M Kaiser","doi":"10.1515/iss-2019-0016","DOIUrl":"https://doi.org/10.1515/iss-2019-0016","url":null,"abstract":"<p><p>Women represent the majority of medical students in several countries. In any surgical specialty and above all in surgical leadership positions, women still remain disproportionally underrepresented. The objective of this study was to investigate female surgeons' career advancement and satisfaction with training. A standardized questionnaire was devised and sent out via the web-based survey tool SurveyMonkey^® to female surgeons in the German federal state of North Rhine-Westphalia. A total of 125 completed questionnaires were analyzed (response rate 40.8%). Female surgeons are at least largely (76%) satisfied with their surgical training. Increased time (>5 h/week) as the principal surgeon in the operating room significantly stimulates the satisfaction with the surgical training (86% vs. 68%, p = 0.0384). At the participants' current workplace, the heads of departments are predominantly male surgeons (91%). Respondents not satisfied with their surgical training prefer a female head of department more frequently (24% vs. 2%, p = 0.0085). The majority of the respondents themselves aspire to become a consultant surgeon (56%), while only 12% intend to become a head of a department. Female surgeons aiming at leadership positions work overtime (≥50 h/week) significantly more frequently (81% vs. 57%, p = 0.0041). Favoritism of male colleagues is perceived by 34%. Respondents who do not perceive any preferential treatment are significantly more satisfied with their surgical training (88% vs. 57%, p = 0.0004). In conclusion, female surgeons seem positive about their career choice, once in the surgical profession, and aptly fill upcoming positions. Women interested in surgery are likely to pursue a surgical career despite the alleged workload, demonstrating the importance of professional self-fulfillment among female surgeons.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"5 1-2","pages":"11-19"},"PeriodicalIF":1.3,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/iss-2019-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative medicine - a vital but neglected part of success in surgery.","authors":"Wolfgang Schwenk,&nbsp;Stephan M Freys","doi":"10.1515/iss-2019-2036","DOIUrl":"https://doi.org/10.1515/iss-2019-2036","url":null,"abstract":"This issue of Innovative Surgical Sciences (ISS) is dedicated to the perioperative treatment of surgical patients. A topic that has been neglected by many surgeons for far too long. While new surgical techniques are quickly adopted, implementing modern perioperative therapies seems to be much more difficult. The introduction of minimally invasive surgery (MIS) is a good example of the rapid spread of a new operative technique. Despite the early lack of high-level evidence [1] MIS was introduced for many abdominal operations within a few years after the initial reports of successful laparoscopic cholecystectomy. More recently, a great desire in the surgical community can be observed to implement robotic surgery into the clinical routine although there is no high-level evidence from randomized controlled trials that robotic surgery will have any benefit for the patient. While the benefits of MIS are proven beyond any doubt today, we will have to see whether the same will be true for robotics in the future. In contrast to these examples optimized perioperative treatment is being adopted by surgeons very slowly. Twenty-five years ago Henrik Kehlet and colleagues published their initial case series of eight elderly patients undergoing resection of colonic cancer in a fast-track regimen with a postoperative hospital stay of only 2 days [2]. Since then numerous clinical trials and randomized controlled studies have demonstrated the major benefits for patients undergoing surgery with optimized perioperative treatment: enhanced recovery, lesser morbidity, improved mobilization, shortened time to normal daily activities, and massively reduced the duration of postoperative hospital stay [3]. These results of fast-trackor enhanced recovery after surgery (ERAS)-regimens were shown in open as well as MIS [4] and a vast variety of operations in general, abdominal [5], gynaecological [6], urological [7] and orthopedic or trauma surgery [8]. In this issue of ISS some of the cornerstones of optimal perioperative medicine are highlighted: perioperative nursing care, perioperative nutrition, acute pain medicine and rational treatment of patients under anticoagulation therapy. Furthermore, a thorough review of the past, present, and future of perioperative medicine is provided. We do hope that readers of ISS will adopt the strategies given in these articles to optimize the perioperative treatment of their patients. Optimal results of surgery will always be based on a perfect surgical technique. However, striving for optimal technique alone while neglecting optimal perioperative therapy will never achieve the best outcome possible for our patients. We have to embrace and implement modern perioperative medicine because surgery is so much more than just operating the patient!","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"4 4","pages":"121-122"},"PeriodicalIF":1.3,"publicationDate":"2019-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/iss-2019-2036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38972691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}