Surgery JournalPub Date : 2024-08-14eCollection Date: 2024-07-01DOI: 10.1055/s-0044-1789192
Dale Dangleben
{"title":"Editorial: Unifying the Global Surgical Community.","authors":"Dale Dangleben","doi":"10.1055/s-0044-1789192","DOIUrl":"https://doi.org/10.1055/s-0044-1789192","url":null,"abstract":"","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983496","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}
Surgery JournalPub Date : 2024-07-04eCollection Date: 2024-07-01DOI: 10.1055/s-0044-1788065
Abdulmenem Abualsel, Raja Nadeem, Fatema Abdulkarim Al-Ahmed, Ebrahim Adel Almahmeed, Roshan George Varkey, Sameer Almobarak, Ajaz A Wani
{"title":"Internal Hernia Post-Single Anastomosis Gastric Bypass: Case Series with Review of Literature.","authors":"Abdulmenem Abualsel, Raja Nadeem, Fatema Abdulkarim Al-Ahmed, Ebrahim Adel Almahmeed, Roshan George Varkey, Sameer Almobarak, Ajaz A Wani","doi":"10.1055/s-0044-1788065","DOIUrl":"10.1055/s-0044-1788065","url":null,"abstract":"<p><p>Obesity is an emerging worldwide health care issue. It has a direct and indirect bearing on health-related outcomes. Rates of overweight and obesity have grown manifold in the past few decades globally. Once considered a problem of the affluent societies only, obesity is now dramatically on the rise in low- and middle-income countries also. Single anastomosis gastric bypass (SAGB) is one of the combined bariatric procedures adopted for weight loss in patients failing maximal medical therapy. Internal hernia (IH) after SAGB is a less recognized clinical entity. We hereby report our experience with four such cases under light of current available literature. Bariatric procedures are associated with some short- and long-term limitations. IHs are among one of the dreaded complications associated with some bariatric procedures with rates reaching up to 16% after classic Roux-en-Y gastric bypass. The incidence of IH post-SAGB is comparatively rare and is very less frequently reported. Symptoms of IH post-SAGB are quite nonspecific and depend on the time and extent of herniation. The symptoms can vary from benign intermittent colicky pain to severe intra-abdominal pain presenting as a surgical emergency. Routine physical examination and biochemical investigations are nonspecific and unreliable in evaluating those patients. Computed tomography (CT) with intravenous and oral contrast is the most common imaging modality used for preoperative evaluation of those symptoms. The CT findings can be unremarkable in patients having intermittent symptoms/herniation. Diagnostic laparoscopy is the cornerstone for diagnosis and management of patients having high suspicion of IH.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11223885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555662","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":"Postoperative Nausea and Vomiting in Female Patients Undergoing Laparoscopic Gastrointestinal Surgery with Double Prophylactic Therapy.","authors":"Chunmeng Lin, Jing Li, Qian Wu, Tongfeng Luo, Zhinan Zheng","doi":"10.1055/s-0044-1787305","DOIUrl":"10.1055/s-0044-1787305","url":null,"abstract":"<p><p><b>Purpose</b> Postoperative nausea and vomiting (PONV) is a major problem after surgery. This study aimed to demonstrate the incidence of PONV and the potential associated factors in female patients undergoing laparoscopic gastrointestinal surgery against the background of double prophylactic therapy. <b>Methods</b> Our retrospective study recruited 109 female patients undergoing laparoscopic gastrointestinal surgery with double prophylactic therapy, combining palonosetron with dexamethasone, from October 2020 to March 2021, at the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Patient characteristics and perioperative management factors were included in univariate and multivariate analyses to identify factors influencing PONV. <b>Results</b> Four patients lacked complete records, and of the 105 patients included in the final analysis, 53 (50.5%) patients developed PONV. Two influencing factors for PONV were identified: a history of chemotherapy (odds ratio [OR] 0.325, 95% confidence interval [CI] 0.123-0.856; <i>p</i> = 0.023) and dosage of hydromorphone ≥ 0.02 mg/kg (OR 2.857, 95% CI 1.247-6.550; <i>p</i> = 0.013). The performance of the multivariate logistic regression was evaluated by analyzing receiver operating characteristic curves, resulting in an area under the curve value of 0.673. <b>Conclusion</b> The incidence of PONV remains high in female patients undergoing laparoscopic gastrointestinal surgery, even with double prophylactic therapy. A dosage of hydromorphone ≥ 0.02 mg/kg may increase risk of PONV, whereas a history of chemotherapy might be a protective factor.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248745","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}
Surgery JournalPub Date : 2024-03-14eCollection Date: 2024-01-01DOI: 10.1055/s-0044-1782655
Dimitrios Symeonidis, Ismini Paraskeva, Athina A Samara, Labrini Kissa, Alexandros Valaroutsos, Eleana Petsa, Konstantinos Tepetes
{"title":"Central Pancreatectomy: Balancing between the Favorable Functional Results and the Increased Associated Morbidity.","authors":"Dimitrios Symeonidis, Ismini Paraskeva, Athina A Samara, Labrini Kissa, Alexandros Valaroutsos, Eleana Petsa, Konstantinos Tepetes","doi":"10.1055/s-0044-1782655","DOIUrl":"10.1055/s-0044-1782655","url":null,"abstract":"<p><p><b>Introduction</b> Central pancreatectomy (CP) represents an organ-preserving type of pancreatic resection. The procedure has been associated with improved long-term functional results, but increased postoperative morbidity rates, compared with the more radical resection types. The purpose of the present study was to present the outcomes of three consecutive CPs performed in our department. <b>Materials and Methods</b> Between January 2021 and January 2022, three patients (A, B, and C) were submitted to a CP in our department. Relevant patient data including data of the detailed preoperative assessment, operations notes, and recovery charts were prospectively collected and reviewed for all subjects. A scheduled follow-up, at the outpatient clinic, was conducted to assess the long-term functional results. <b>Results</b> The postoperative course of patient A, a 56-year-old male, was complicated by a grade C postoperative pancreatic fistula that required a reoperation. Patient B, a 66-year-old female, developed a biochemical leak that resolved spontaneously while patient C, a 64-year-old male, had a completely uneventful recovery. The length of hospital stay for the three patients was 24, 12, and 8 days, respectively. Regarding the long-term results, patient B was lost to follow-up while both patient A and C were followed up, as outpatients, 21 and 10 months after the operation. During follow-up, in patient A, we did not record the presence of symptoms consistent with pancreatic exocrine insufficiency, the hemoglobin A1C (HbA1C) levels were 7.1% while no additional medications were needed to be prescribed to maintain the glycemic control following surgery. In patient C, a significant weight loss was recorded (body mass index reduction of 11 kg/m <sup>2</sup> ) without however the presence of malabsorption-specific symptoms. The HbA1C levels were 7.7% and optimal glycemic control was achieved with oral antiglycemic agents alone. <b>Conclusion</b> CP should be regarded as a type of pancreatic resection with certain and very limited oncological indications. An approach of balancing the advantages out of the superior postoperative functional results with the drawbacks of the increased procedure-associated morbidity could highlight the patient group that could potentially experience benefits out of this limited type of resection.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10965197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294903","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}
Surgery JournalPub Date : 2024-01-15eCollection Date: 2024-01-01DOI: 10.1055/s-0043-1778652
Veena K Singh, Ansarul Haq, Sarsij Sharma, Anupama Kumari
{"title":"Early Reconstruction with Locoregional-Free Flaps in Post-COVID-19 Rhino-orbital-cerebral Mucormycosis Craniofacial Deformities: A Single-Center Clinical Experience from India.","authors":"Veena K Singh, Ansarul Haq, Sarsij Sharma, Anupama Kumari","doi":"10.1055/s-0043-1778652","DOIUrl":"10.1055/s-0043-1778652","url":null,"abstract":"<p><p><b>Aim of the Study</b> Mucormycosis is a rare invasive and fatal fungal infection and its resurgence in coronavirus disease 2019 (COVID-19) patients has been a matter of grave concern. It is essentially a medical disease, but surgical debridement of necrotic tissues is of paramount importance leading to severe craniofacial deformities. In this case series, we present our experience with the feasibility of early reconstruction after surgical debridement. <b>Case Series</b> As a Dedicated COVID Center (DCH), the institute received the largest population of COVID-19 mucormycosis patients from the entire eastern region of the country between May 2021 and August 2021. More than 5,000 COVID-19 were admitted out of which 218 patients were diagnosed with mucormycosis. Nine patients, seven males and two females, with a mean age of 39 years with craniofacial mucormycosis underwent debridement and early reconstructions (2-4 weeks from first debridement and start of antifungal therapy) with free and pedicled flaps. All flaps survived and showed no evidence of recurrence. The average time of the early reconstruction after surgical debridement was 1.7 weeks once the course of systemic amphotericin B was received. <b>Conclusion</b> After aggressive surgical resection and a short course of antifungal therapy, early reconstruction can be done safely based on clinical criteria, as long as there is no evidence of hyphae invasion on wound edges in the intraoperative pathology examination.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289151","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":"Which Role for Muscle-Sparing Posterolateral Thoracotomy in the Treatment of Spontaneous Pneumothorax?","authors":"Ibrahim Issoufou, Rabiou Sani, Daouda Amadou, Kadre Alio, Kaled Adamou-Nouhou, Marouane Lakranbi, Rachid Sani, Yassine Ouadnouni, Habibou Abarchi, Mohamed Smahi","doi":"10.1055/s-0043-1770954","DOIUrl":"10.1055/s-0043-1770954","url":null,"abstract":"<p><p><b>Objective</b> This study aims to show the place of muscle-sparing posterolateral thoracotomy in the treatment of spontaneous pneumothorax. <b>Methods</b> It was a single-center study performed in the Department of Thoracic Surgery of Teaching hospital Hassan II of Fez for 8 years. We adopted the nosological definition, which classifies spontaneous pneumothorax into three categories. We included patients over 15 years of age with primary or secondary spontaneous pneumothorax operated by posterolateral thoracotomy without muscle section, and we analyzed the specific indications of this approach. It included 49 patients with primary or secondary spontaneous pneumothorax, operated by muscle-sparing posterolateral thoracotomy. Data were collected from regularly updated computer files of patients, entered by Excel 2013, and analyzed using SPSS.20 software. These data are: epidemiological, clinical, radiological, surgical exploration, surgical procedure, the result of the surgery and the evolution. <b>Results</b> The average age was 42 years. Smoking was found in 61% of cases and pulmonary tuberculosis in 10% of cases. Thoracic computed tomography (CT) showed bullae and blebs in 31% of cases, pleural adhesions and pachypleuritis in 50% of cases, and hydropneumothorax with pachypleuritis in 37% of cases. There is a statistical correlation between pleuropulmonary decortication and pachypleuritis ( <i>p</i> = 0.002) or hydropneumothorax ( <i>p</i> = 0.001) on CT. Bullae and blebs resection was performed in 53% of cases and pleuropulmonary decortication in 63% of cases. A right pleuropneumonectomy was performed in one case. The follow-up was uneventful in 82% of cases. <b>Conclusion</b> Muscle-sparing posterolateral thoracotomy remains the best approach and leads to good results.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404725","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}
Surgery JournalPub Date : 2023-12-06eCollection Date: 2023-10-01DOI: 10.1055/s-0043-1777329
Phillip Karsen, Joseph Brinkman, Jonathan Day, Daniel McGurren, Karan Patel
{"title":"Painful Unilateral Knee Snapping after Hyperextension Injury and Meniscus Tear.","authors":"Phillip Karsen, Joseph Brinkman, Jonathan Day, Daniel McGurren, Karan Patel","doi":"10.1055/s-0043-1777329","DOIUrl":"10.1055/s-0043-1777329","url":null,"abstract":"<p><p>This case involves a healthy male with painful lateral knee pain and snapping after a hyperextension injury. Initially, this was felt to be from a displaced lateral meniscus tear; however, he failed to improve after meniscal debridement. Further workup with an ultrasound and magnetic resonance imaging identified an aberrant biceps femoris anatomy. He was taken to the operating room and the aberrant slip was identified. A tenodesis of the aberrant slip to the biceps femoris was completed. This resolved the patient's pain and snapping, and he was able to return to all activities.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404724","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}
Surgery JournalPub Date : 2023-10-01DOI: 10.1055/s-0043-1776111
Emily Fellows, Joy Harris, Tania Kibble, Nicholas M. McDonald, Nabeel Azeem, James V. Harmon
{"title":"Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review","authors":"Emily Fellows, Joy Harris, Tania Kibble, Nicholas M. McDonald, Nabeel Azeem, James V. Harmon","doi":"10.1055/s-0043-1776111","DOIUrl":"https://doi.org/10.1055/s-0043-1776111","url":null,"abstract":"Abstract Gastrointestinal angiodysplasia is an uncommon condition often associated with significant gastrointestinal bleeding that is resistant to medical therapy. We report the clinical outcomes of two patients who successfully underwent simultaneous intraoperative endoscopic and surgical interventions for the treatment of angiodysplasia. Intraoperative endoscopic guidance was found to be useful in managing hemorrhage caused by angiodysplasia in both patients. Additionally, we performed an analysis of cases reported in the literature. Our review focused on the anatomic location of the resected bowel and the clinical outcomes of patients (n = 21) with angiodysplasia managed with intraoperative endoscopy reported in the literature.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135964028","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":"Efficacy of Continuous Saline Irrigation Therapy for Descending Necrotizing Mediastinitis.","authors":"Takuya Ohashi, Mitsumasa Kawago, Yoshimitsu Hirai, Yumi Yata, Aya Fusamoto, Hideto Iguchi, Takahito Nakaya, Megumi Kiyoi, Miwako Miyasaka, Mari Kawaji, Yuki Fujiwara, Yoshiharu Nishimura","doi":"10.1055/s-0043-1775559","DOIUrl":"10.1055/s-0043-1775559","url":null,"abstract":"<p><p><b>Objectives</b> Descending necrotizing mediastinitis (DNM) is a poor prognosis disease. This study aims to examine the patient background and treatment of DNM and to identify more effective treatments for DNM. <b>Methods</b> The patient background and treatment of 11 patients who underwent surgery for DNM between November 2010 and June 2021 were studied. The patients were divided into six patients who underwent continuous saline irrigation (group I) and five patients who did not (group N). The differences in the drainage duration and length of hospital stay between the two groups were retrospectively investigated. <b>Results</b> Eleven patients were treated for DNM: six male and five female, with a median age of 61 years (35-79). Comorbidities included diabetes mellitus in three cases; one patient was administered steroids. The pathways of occurrence were anterior tracheal gap/vascular visceral gap/posterior visceral gap in group I (2/1/2) and group N (0/2/4). Progression was I/IIA/IIB according to Endo's classification in group I (1/1/4) and group N (3/1/1). The mean duration of irrigation was 9.0 ± 3.7 days, and the drainage duration in group I was 17.5 ± 8.2 days, which was significantly shorter than 31 ± 13.6 days in group N ( <i>p</i> < 0.048). The hospital stays in group I was 29.3 ± 8.4 days, which was significantly shorter than that in group N (68 ± 27.1 days; <i>p</i> < 0.015). <b>Conclusions</b> Irrigation therapy significantly shortened the drainage duration and hospital stay. Irrigation is a useful treatment for DNM.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159034","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}
Surgery JournalPub Date : 2023-09-26eCollection Date: 2023-07-01DOI: 10.1055/s-0043-1775748
Chien Lin Soh, Madhumitha Pandiaraja, Michael P Powar
{"title":"3D-Printing Applications in Ostomy Device Creation and Complex Intestinal Fistula Management: A Scoping Review.","authors":"Chien Lin Soh, Madhumitha Pandiaraja, Michael P Powar","doi":"10.1055/s-0043-1775748","DOIUrl":"10.1055/s-0043-1775748","url":null,"abstract":"<p><p><b>Background</b> This scoping review aims to provide a summary of the use of three-dimensional (3D) printing in colorectal surgery for the management of complex intestinal fistula and ostomy creation. <b>Methods</b> A systematic database search was conducted of original articles that explored the use of 3D printing in colorectal surgery in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to March 2022. Original articles and case reports that discussed 3D printing in colorectal surgery relating to complex intestinal fistulae and ostomies were identified and analyzed. <b>Results</b> There were 8 articles identified which discussed the use of 3D printing in colorectal surgery, of which 2 discussed ostomy creation, 4 discussed complex fistulae management, and 2 discussed patient models. <b>Conclusion</b> 3D printing has a promising role in terms of management of these conditions and can improve outcomes in terms of recovery, fluid loss, and function with no increase in complications. The use of 3D printing is still in its early stages of development in colorectal surgery. Further research in the form of randomized control trials to improve methodological robustness will reveal its true potential.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159033","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}