Surgery Journal最新文献

{"title":"The Efficiency of Antiosteoporosis Medicine after Intertrochanteric Fracture Surgery: A Retrospective Study of Refracture Rate, Function Recovery, Complications, and Mortality in the Chinese Elderly Population.","authors":"Weidong Zhao, Shengbao Chen, Chao Tang, Changqing Zhang","doi":"10.1055/s-0044-1779681","DOIUrl":"10.1055/s-0044-1779681","url":null,"abstract":"<p><p><b>Objective</b>  This research aimed to discern the effects of antiosteoporosis medication on postoperative functional recovery, refracture incidence, complications, and mortality in geriatric patients with intertrochanteric fractures. <b>Methods</b>  A retrospective study was conducted on 250 patients aged 65 years and above who underwent surgery for intertrochanteric fractures between January 2013 and December 2014. Intertrochanteric fracture is diagnosed with International Classification of Diseases 10th Revision code (S72.101) and classified by the Evans-Jensen system. Collected data encompassed demographic details, pre- and postoperative histories of antiosteoporotic medication, functional outcomes (measured using Harris hip score, Parker Mobility Score, and EuroQol-5 Dimension [EQ-5D] scores), refracture incidences, complications, and survival rates. The antiosteoporotic regimen was categorized into essential (calcium, vitamin D) and advanced medications (bisphosphonate, calcitonin, etc.). Outcomes between patients on antiosteoporosis treatment (AO group) and those without (control group) were compared. <b>Results</b>  The cohort comprised 250 patients, with a gender distribution of 85 males (34%) and 165 females (66%), and a mean age of 79.8 ± 7.0 years. The median follow-up period was 15.82 months (maximum 31.13 months). Postoperatively, 126 (50.4%) patients were administered antiosteoporotic treatment. The refracture incidence in the AO group (2.4%, <i>n</i>  = 3) was notably lower than the control group (8.9%, <i>n</i>  = 11), manifesting a substantial risk reduction (odds ratio 0.251, 95% confidence interval 0.068-0.920, <i>p</i>  = 0.024). While no marked differences in functional outcomes between the AO and control groups were observed (Harris score [96.17 ± 7.77 vs. 97.29 ± 6.74, <i>p</i>  = 0.074), Parker score [8.54 ± 1.26 vs. 8.62 ± 1.18, <i>p</i>  = 0.411], EQ-5D [0.83 ± 0.05 vs. 0.82 ± 0.06, <i>p</i>  = 0.186]), patients administered a combination of essential and advanced drugs showcased significantly improved Harris and EQ-5D scores compared to those on essential drugs alone (Harris score [77.93 ± 2.04 vs. 84.94 ± 2.73, <i>p</i>  = 0.015], EQ-5D [0.65 ± 0.03 vs. 0.75 ± 0.04, <i>p</i>  = 0.015]). <b>Conclusion</b>  Postoperative antiosteoporosis treatment acts as a deterrent against refracture following intertrochanteric fracture surgeries, evidenced by a decline in refracture rates. However, the treatment's impact on functional recovery, quality of life, complications, and mortality remains indistinct. Interestingly, the combined administration of essential and advanced antiosteoporotic drugs seems to foster enhanced functional outcomes, warranting further exploration in future studies.</p>","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"10 1","pages":"e11-e19"},"PeriodicalIF":0.8,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773342","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":"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":"10 1","pages":"e1-e10"},"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":"9 4","pages":"e149-e155"},"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}

{"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":"9 4","pages":"e118-e122"},"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}

{"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":"34 1","pages":"0"},"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,&nbsp;Mitsumasa Kawago,&nbsp;Yoshimitsu Hirai,&nbsp;Yumi Yata,&nbsp;Aya Fusamoto,&nbsp;Hideto Iguchi,&nbsp;Takahito Nakaya,&nbsp;Megumi Kiyoi,&nbsp;Miwako Miyasaka,&nbsp;Mari Kawaji,&nbsp;Yuki Fujiwara,&nbsp;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":"9 3","pages":"e107-e111"},"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}

{"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":"9 3","pages":"e97-e106"},"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}

{"title":"Primary Breast Tuberculosis Mastitis Manifested as Nonhealing Abscess","authors":"Huu Hoang, E. El-helou, C. Pop, Ammar Shall, M. Zaiter, Jessica Naccour, Tran T H Nguyen, X. D. Ho, V. C. Nguyen","doi":"10.1055/s-0042-1749123","DOIUrl":"https://doi.org/10.1055/s-0042-1749123","url":null,"abstract":"Primary breast tuberculosis (TB) is a rare extrapulmonary TB mainly affecting young women of childbearing age from endemic countries. Its incidence is increasing in immunocompromised and HIV-infected people and with the emergence of drug-resistant strains of Mycobacterium tuberculosis (MTB). There are no specific clinical signs suggestive of this disease, it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis and malignant neoplasms of the breast. The detection of MTB remains the gold standard for diagnosis. Several other diagnostic modalities are used, with varying lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman, presented for a nonhealing breast abscess, and diagnosed with breast TB based on the patient's ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to anti-TB treatment.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"8 1","pages":"e123 - e126"},"PeriodicalIF":0.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42747830","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":"Persistent Left Superior Vena Cava Associated with Right Aberrant Subclavian Artery Detected during Totally Implantable Vascular Access Device Insertion","authors":"E. El-helou, M. Zaiter, Ammar Shall, Y. Sleiman, G. Liberale, C. Pop","doi":"10.1055/s-0042-1749124","DOIUrl":"https://doi.org/10.1055/s-0042-1749124","url":null,"abstract":"Introduction  Persistent left superior vena cava (PLSVC) is a rare vascular malformation, with several cases reported in the English literature. The diagnosis is made incidentally, during cardiovascular imaging or when a catheter is placed in the left jugular or subclavian vein. They are without associated hemodynamic alterations, except if they have left atrial drainage or an associated dilation of the coronary sinus. If necessary, long-term PSLVC catheterization with right atrial drainage is safe. Case Presentation  We report the case of 40-year-old man, admitted for placement of totally implantable vascular access device (TIVAD) on the same day of his first chemotherapy. A disease localized to the right neck made it impossible to puncture on the right. During the puncture of the left internal jugular vein, the diagnosis of PLSVC was made. Postoperative investigations confirmed the diagnosis and showed the presence of the right superior vena cava to which it was connected by the left brachiocephalic vein. They also confirmed the drainage of PLSVC into the coronary sinus. In addition, they demonstrated the presence of an associated right aberrant subclavian artery of direct aortic origin. Chemotherapy was administered safely and the port was removed 9 months after insertion without any problem. Conclusion  This is one of the rare cases reported in the English literature of PLSVC diagnosed during TIVAD insertion and the first to report an associated vascular malformation. We publish it to encourage physicians to think about this differential diagnosis and to carefully perform the appropriate investigations before using the port.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"8 1","pages":"e117 - e122"},"PeriodicalIF":0.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43842162","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":"Intracranial Hemorrhage following Spinal Surgery: A Systematic Review of a Rare Complication","authors":"T. Al-Saadi, Yahya Al-Kindi, Moosa Allawati, H. Al-Saadi","doi":"10.1055/s-0042-1743525","DOIUrl":"https://doi.org/10.1055/s-0042-1743525","url":null,"abstract":"Introduction  Intracranial hemorrhage (ICH) is a potentially severe complication of spinal surgeries. The occurrence of such complications causes deterioration of the patient's clinical status and delayed discharge from the hospital. Although no specific etiological factors were identified for this complication, but multiple risk factors might play role in its development, they include the use of anticoagulants, presence of uncontrolled hypertension, and perioperative patient positioning. Aim  A systematic review of the literature to investigate the prevalence of different types of intracranial hemorrhages in patients who underwent spinal surgeries. Methods  A literature review was conducted using multiple research databases. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. Results  A total of 79 studies were included in our analysis after applying the exclusion criteria and removing of repeated studies, 109 patients were identified where they were diagnosed with intracranial hemorrhage after spine surgery with a mean age of 54 years. The most common type of hemorrhage was cerebellar hemorrhage (56.0%) followed by SDH and intraparenchymal hemorrhage; 23.9 and 17.4%, respectively. The most common spine surgery was laminectomy (70.6%), followed by fixation and fusion (50.5%), excision of spinal lesions was done in 20.2% of the patient, and discectomy (14.7%). Conclusion  The data in this study showed that out of 112 patients with ICH, cerebellar hemorrhage was the most common type. ICH post–spine surgery is a rare complication and the real etiologies behind this complication are still unknown, cerebrospinal fluid drain and durotomy were suggested.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"8 1","pages":"e98 - e107"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49151054","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}