Innovative Surgical Sciences最新文献

{"title":"Transoral thyroid surgery vestibular approach.","authors":"Elias Karakas,&nbsp;Günther Klein,&nbsp;Stefan Schopf","doi":"10.1515/iss-2021-0033","DOIUrl":"https://doi.org/10.1515/iss-2021-0033","url":null,"abstract":"<p><strong>Objectives: </strong>Transoral thyroid surgery vestibular approach (TOETVA) is a novel and feasible surgical technique that allows for cervical surgery without visible incisions. TOETVA represents a new frontier in endocrine surgery since aesthetic results play a more and more decisive role in elective surgery. However, acceptance is different around the world with widespread prevalence in Asian countries and some high-volume centres in the US. While inclusion criteria for TOETVA are limited regarding size and volume a combination with other extracervical techniques like the retroauricular endoscopic cephalic access thyroid surgery (EndoCATS) approach or transaxillary access is an option.</p><p><strong>Methods: </strong>TOETVA is carried out through a three-port technique placed at the oral vestibule. Originally one 10-mm port for a 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments are used. Alternatively, one 5-mm and one or two 3 mm ports can be used. CO2 insufflation pressure is set at 6 mmHg. An additional device to optimize gas outflow for optimum view might be helpful. An anterior cervical subplatysmal space is created by hydrodissection from the oral vestibule to the sternal notch, laterally to the sternocleidomastoid muscle. Conventional endoscopic instruments are used. Combination of TOETVA with a modified retroauricular access includes insertion of a 10-12 mm trocar placed subcutaneously via a skin incision on the scalp, behind the ear by blunt dissection.</p><p><strong>Results: </strong>Since Anuwong published the first case series of 60 patients who underwent scarless thyroidectomy via the lower vestibule of the mouth with excellent results in 2016 almost 1,000 cases are reported in literature to date with comparable results especially regarding traditional complications. In contrast to other extracervical approaches, areolar or axillary for example, the transoral access route is short and the dissection planes are rather like transcervical surgery. Surgical indications and contraindications have been modified since its first description and are partly institution specific to date. To amend indications combination with other extracervical techniques is an option. In addition, patients must carefully be selected for and surgeons` candidacy is of utmost importance in transoral surgery.</p><p><strong>Conclusions: </strong>Transoral surgery will likely continue to gain attraction as surgeons become more experienced with the technique. With increased operative use and surgeon experience the gap in conventional outcomes between transoral surgery and the transcervical approach will narrow, with both operative time and the incidence of specific complications diminishing. Experience in thyroid and endoscopic surgery is required to achieve excellent results with low complication rates. However, the new transoral technique is related to novel complications that must be evaluated.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 3-4","pages":"107-113"},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427785","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":"Developments to improve outcomes in thyroid surgery.","authors":"Thomas J Musholt","doi":"10.1515/iss-2022-2002","DOIUrl":"https://doi.org/10.1515/iss-2022-2002","url":null,"abstract":"Thyroid interventions are predominantly elective procedures with fortunately low mortality, but the associated surgical complications may have a significant impact on the quality of life (QOL) of patients. In Germany, 25,718 thyroidectomies and 21,320 hemithyroidectomies were performed in 2020 [1], corresponding to 72,756 recurrent laryngeal nerves (RLNs) “at risk”. Assuming a complication rate of about 0.5–5 % for permanent paresis, significant 360–3,600 new cases of RLN nerve damage occur per year in Germany alone. The complication of postoperative hypoparathyroidism after total thyroidectomy may even more severely impact the patients’ health and QOL. In the absence of a generally accepted definition, the frequency of postoperative hypoparathyroidism has so far been determined only inaccurately, based on surrogate parameters such as recorded postoperatively continued calcium medication. However, it is well known that thyroid surgery is a major cause of permanent hypoparathyroidism (&gt;75% of cases). If one estimates a complication rate of about 1–10% after thyroid surgery, in Germany alone, 260–2,570 patients newly suffer from hypoparathyroidism each year. Staggering numbers. This issue of Innovative Surgical Science summarizes current developments in the analysis and prevention of complications in thyroid surgery. To avoid especially bilateral RLN paresis, intraoperative neuromonitoring in intermittent form (iIONM) is widely used by thyroid surgeons. Continuous neuromonitoring (cIONM), on the other hand, is not yet as wide-spread or as consistently used in every single thyroid procedure. Amajor reason for the hesitance of surgeons to use cIONM is the necessary partial circular exposure of the vagus nerve in its cervical course, which potentially represents an additional operative risk. In this issue, Sinclair et al. describe a new method of intraoperative neuromonitoring that exploits the laryngeal adductor reflex and thus eliminates the need for direct stimulation of the vagus nerve. This innovation has the potential to simplify continuous neuromonitoring, to introduce cIONM in minimally invasive procedures, such as transoral thyroid surgery via a vestibular approach – described by Karakas et al. in this issue – or to enable cIONM in other surgical procedures, such as esophageal resections. In their review article, Demarchi et al. describe results of autofluorescence imaging of parathyroid glands, including intraoperative angiography with indocyanine green. The rate of postoperative hypoparathyroidism can be effectively reduced with this new technique. Currently, the method is only used in a few clinics due to the high acquisition costs of the device. However, the technique may become established in the long-term, in a comparable way that intraoperative neuromonitoring has conquered the operating room. Measures to improve the quality of surgical results begin with the correct (individualized) indication for surgery. With a proportion of 20–40% ","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 3-4","pages":"77-78"},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427787","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":"Thyroid surgery during the COVID-19 pandemic: difficulties - how to improve.","authors":"Christos K Stefanou,&nbsp;Georgios Papathanakos,&nbsp;Stefanos K Stefanou,&nbsp;Kostas Tepelenis,&nbsp;Aikaterini Kitsouli,&nbsp;Alexandra Barbouti,&nbsp;Stefanos Flindris,&nbsp;Periklis Tsoumanis,&nbsp;Panagiotis Kanavaros,&nbsp;Panagiotis Kitsoulis","doi":"10.1515/iss-2022-0015","DOIUrl":"https://doi.org/10.1515/iss-2022-0015","url":null,"abstract":"<p><p>In December 2019, the new coronavirus infection (COVID-19) was declared a pandemic by the World Health Organization after rapidly spreading over the world in just a few months. All elective operations and nonemergency treatments have been postponed worldwide. However, some patients require surgical therapy as well, and the time spent waiting should not have a negative impact on the surgical outcome or disease course. Following the initial onset of the COVID-19 epidemic, instructions for proper and safe surgery for healthcare staff and patients should develop. Thyroid surgeries have decreased during the COVID-19 pandemic. Most of them can be postponed for a long time. Assessment of thyroid nodules recommends clinical examination, imaging studies, fine needle aspiration (FNA) and vocal cord examination. All these procedures are necessary, and sometimes they cannot be postponed. To determine the best timing, a thorough preoperative assessment should be undertaken, taking into account both oncological and anatomical features. Furthermore, COVID-19 status must be negative prior to any intervention, and hospital infrastructure must be ready to deal with the demanding situation.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 3-4","pages":"125-132"},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427789","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":"Continuous intraoperative neuromonitoring of the recurrent laryngeal nerve by eliciting the laryngeal adductor reflex (LAR-CIONM).","authors":"Catherine F Sinclair,&nbsp;Maria J Tellez","doi":"10.1515/iss-2021-0008","DOIUrl":"https://doi.org/10.1515/iss-2021-0008","url":null,"abstract":"<p><p>The laryngeal adductor reflex (LAR) is a life-sustaining airway protective mechanism that serves to shield the lower airways from inhaled foreign bodies. Over the past half century, the LAR has been extensively investigated and its dysfunction has been linked to far-ranging pathologies, from dysphagia to sudden infant death syndrome. Over the past 6 years, specific electromyographic waves in the LAR response have been used to devise a methodology for monitoring the vagus and recurrently laryngeal nerves during surgical procedures. This methodology involves continuous intraoperative neuromonitoring of the laryngeal adductor reflex and isthus termed 'LAR-CIONM'. In this review paper, the physiology of the LAR will be summarized as it relates to LAR-CIONM and the technique of LAR-CIONM will be described. Applications of this technique and published outcomes of LAR-CIONM will be highlighted.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 3-4","pages":"79-85"},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427786","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":"Real-world EUROCRINE^® registry data challenge the reliability of Bethesda cytopathology for thyroid surgery indication.","authors":"Julia I Staubitz,&nbsp;Alicia Poplawski,&nbsp;Felix Watzka,&nbsp;Thomas J Musholt","doi":"10.1515/iss-2021-0004","DOIUrl":"https://doi.org/10.1515/iss-2021-0004","url":null,"abstract":"<p><strong>Objectives: </strong>Fine-needle aspiration cytology (FNAC) is recommended by international guidelines for the preoperative evaluation of suspicious thyroid nodules >1 cm. Despite robust evidence from endocrine centers demonstrating the key role of FNAC results for the indication of surgery, the method is not routinely used in European clinics. The database EUROCRINE^®, which was introduced in 2015 with the scope of registering operations of the endocrine system, allows for a large-scale analysis of the current service reality in Europe concerning FNAC use and associated accuracy.</p><p><strong>Methods: </strong>Operations performed to \"exclude malignancy\", registered from January 2015 to December 2018 in EUROCRINE^®, were analyzed. Parameters of accuracy were calculated for FNAC. FNAC results were considered \"test positive\" in the case of Bethesda category IV, V, and VI, since these categories usually prompt surgical interventions in European centers for thyroid surgery. Bethesda category II and III were considered \"test negative\".</p><p><strong>Results: </strong>Of 8,791 operations, 5,780 had preoperative FNAC (65.7%). The overall malignancy rate was 28.3% (2,488/8,791). Malignancy rates were 68.8% for Bethesda VI, 69.9% for Bethesda V, 32.6% for Bethesda IV, 28.2% for III, 20.2% for Bethesda II, and 24.5% for Bethesda I. After exclusion of papillary microcarcinomas (PTMCs), the sensitivity of FNAC was 71.7% and specificity 43.5%, the positive predictive value was 29.1% and the negative predictive value 82.7%.</p><p><strong>Conclusions: </strong>Although the indication to \"exclude malignancy\" was the predominant reason that prompted thyroid resection in the present cohort, FNAC was only used in about 65.7% of cases. When performed, FNAC was associated with unexpectedly low accuracy. Interestingly, in Bethesda II, 20.2% of malignant entities were present (13.3% after the exclusion of PTMCs).</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 3-4","pages":"99-106"},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427782","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":"Platelet-derived concentrates influence human keratinocyte proliferation <i>in vitro</i> and induce wound healing in a prospective case series of chronic wounds of different entities <i>in vivo</i>.","authors":"Anastasia Paulmann,&nbsp;Sarah Strauss,&nbsp;Anne Limbourg,&nbsp;Peter M Vogt","doi":"10.1515/iss-2022-0011","DOIUrl":"https://doi.org/10.1515/iss-2022-0011","url":null,"abstract":"<p><strong>Objectives: </strong>Soft tissues defects can extend into the fat layer or even deeper and can cause significant clinical disadvantages like pain, infections, and loss of function. In particular, chronic wounds are difficult to treat, as split-thickness skin grafts (STSGs) have varying success rates. To improve wound healing in chronic wounds, the authors have studied the application of platelet-mediator concentrate (PMC) in a human keratinocyte culture model <i>in vitro</i> and of autologous platelet concentrates (PRP) in a combination with surgical procedures <i>in vivo</i> as second line therapy in patients with initially failed wound closure.</p><p><strong>Methods: </strong>For <i>in vitro</i> testing on keratinocytes, a PMC was processed with a commercially available bedside system (ATR^®, Curasan, Germany). In a clinical, nonrandomized study, five in-house patients with chronic wounds were treated using a combination of surgical debridement and autologous PRP. Time of healing as determined by epithelization as well as laser Doppler imaging to visualize blood flow was analyzed. Additionally, changes in ease of surgical wound closure were determined. Finally, the quality of life of patients was assessed using a validated questionnaire (clinicaltrials.gov # NCT03667638).</p><p><strong>Results: </strong><i>In vitro</i> testing shows a significant effect of PMC on keratinocyte proliferation in cell culture. Clinical studies showed that patients treated with PRP had initiation of wound closure, higher blood flow after PRP injection, and easier wound closure as well as improved quality of life.</p><p><strong>Conclusions: </strong>The injection of platelet concentrates to treat chronic wound defects presents a favorable addition to treatment where single surgical procedures have failed and may improve current therapy options.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 2","pages":"45-58"},"PeriodicalIF":1.3,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659512","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":"Value of ¹⁸F FDG-PET/CT parameters on long term follow-up for patients with non-small cell lung cancer.","authors":"Mohammed Zoair,&nbsp;Samantha Taber,&nbsp;Roland Bittner,&nbsp;Gregor Foerster,&nbsp;Sergej Griff,&nbsp;Torsten T Bauer,&nbsp;Joachim Pfannschmidt","doi":"10.1515/iss-2022-0009","DOIUrl":"https://doi.org/10.1515/iss-2022-0009","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to investigate the value of PET/CT in the preoperative staging of non-small cell lung cancer in predicting long-term survival and diagnostic performance, validated by histopathology following surgical resection.</p><p><strong>Methods: </strong>Between 02/2009 and 08/2011, 255 patients with non-small cell lung cancer were included in this single-center prospective study. All underwent 18F FDG-PET/CT for pre-operative staging, and in 243 patients complete surgical resection was possible. Regarding lymph node involvement and extrathoracic metastases, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using the histopathological staging as reference. Median follow-up for censored patients was 9.1 years.</p><p><strong>Results: </strong>Overall 5-year survival rate of all patients was 55.6%, and of patients who had complete surgical resection it was 58.2%. In multivariate analysis of all surgically resected patients lymph node involvement (p=0.029) and age >61 years (p=<0.001) were significant independent prognostic factors. SUVmax and SUVmean cut-offs between SUV 2 and 11, however, were not associated with better or ;worse survival. The PET-CT sensitivity, specificity, positive predictive value and negative predictive value for predicting lymph node involvement were 57, 95, 88, and 76%, respectively. Furthermore, sensitivity, specificity, positive predictive value, and negative predictive value for detecting extrathoracic metastases were 100, 58, 98, and 100%, respectively.</p><p><strong>Conclusions: </strong>In this study, tumor 18F FDG-uptake values did not provide additional prognostic information. Age>61 years and lymph node metastasis were associated with worse long-term survival in surgically resected patients. 18F FDG-PET/CT scans allow for improved patient selection. However, in staging mediastinal lymph nodes, there is a high rate of false positives and false negatives, suggesting that tissue biopsy is still indicated in many cases.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 2","pages":"35-43"},"PeriodicalIF":1.3,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659510","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":"Editorial.","authors":"Udo Rolle","doi":"10.1515/iss-2022-2001","DOIUrl":"https://doi.org/10.1515/iss-2022-2001","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":" ","pages":"125"},"PeriodicalIF":1.3,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40593617","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":"Personalized approach for complex bilateral calcaneal osteomyelitis and defect reconstruction with bilateral abductor digiti minimi flaps.","authors":"Oana Grigorescu,&nbsp;Adrian Dragu,&nbsp;Florian Bönke,&nbsp;Martin Schreiber,&nbsp;Stefan Rammelt","doi":"10.1515/iss-2022-0010","DOIUrl":"https://doi.org/10.1515/iss-2022-0010","url":null,"abstract":"<p><strong>Objectives: </strong>The best treatment for displaced, intra-articular fractures of the calcaneus remains controversial and it is generally agreed, that there is no single method that is suitable for all patients.</p><p><strong>Case presentation: </strong>Here we report a rare case of bilateral calcaneal osteomyelitis with fistula formation following open reduction and plate fixation via an extensile lateral approach that could be salvaged with an interdisciplinary approach including orthopedic and plastic surgeons. We are not aware of a similar case in the literature. Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site. This treatment protocol resulted in minimal donor-site morbidity and good bone remodeling in the further course. We believe that it may be of use for complicated courses even with limited resources.</p><p><strong>Conclusions: </strong>Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 2","pages":"65-70"},"PeriodicalIF":1.3,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659514","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":"Hyperspectral imaging detects perfusion and oxygenation differences between stapled and hand-sewn intestinal anastomoses.","authors":"Tristan Wagner,&nbsp;Sonia Radunz,&nbsp;Felix Becker,&nbsp;Claire Chalopin,&nbsp;Hannes Kohler,&nbsp;Ines Gockel,&nbsp;Boris Jansen-Winkeln","doi":"10.1515/iss-2022-0007","DOIUrl":"https://doi.org/10.1515/iss-2022-0007","url":null,"abstract":"<p><strong>Objectives: </strong>Hand-sewn and stapled intestinal anastomoses are both daily performed routine procedures by surgeons. Yet, differences in micro perfusion of these two surgical techniques and their impact on surgical outcomes are still insufficiently understood. Only recently, hyperspectral imaging (HSI) has been established as a non-invasive, contact-free, real-time assessment tool for tissue oxygenation and micro-perfusion. Hence, objective of this study was HSI assessment of different intestinal anastomotic techniques and analysis of patients' clinical outcome.</p><p><strong>Methods: </strong>Forty-six consecutive patients with an ileal-ileal anastomoses were included in our study; 21 side-to-side stapled and 25 end-to-end hand-sewn. Based on adsorption and reflectance of the analyzed tissue, chemical color imaging indicates oxygen saturation (StO₂), tissue perfusion (near-infrared perfusion index [NIR]), organ hemoglobin index (OHI), and tissue water index (TWI).</p><p><strong>Results: </strong>StO₂ as well as NIR of the region of interest (ROI) was significantly higher in stapled anastomoses as compared to hand-sewn ileal-ileal anastomoses (StO₂ 0.79 (0.74-0.81) vs. 0.66 (0.62-0.70); p<0.001 NIR 0.83 (0.70-0.86) vs. 0.70 (0.63-0.76); p=0.01). In both groups, neither anastomotic leakage nor abdominal septic complications nor patient death did occur.</p><p><strong>Conclusions: </strong>Intraoperative HSI assessment is able to detect significant differences in tissue oxygenation and NIR of hand-sewn and stapled intestinal anastomoses. Long-term clinical consequences resulting from the reduced tissue oxygenation and tissue perfusion in hand-sewn anastomoses need to be evaluated in larger clinical trials, as patients may benefit from further refined surgical techniques.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"7 2","pages":"59-63"},"PeriodicalIF":1.3,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659513","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}