Surgical Practice最新文献

{"title":"Three-dimensional stoma model education programme for robotic total mesorectal excision: A single-centre experience","authors":"Sze Yuet Joyce Kwong,&nbsp;Pak Tat Chan,&nbsp;Yuk Kam Pang","doi":"10.1111/1744-1633.12739","DOIUrl":"https://doi.org/10.1111/1744-1633.12739","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Stoma education is an essential part of perioperative management in colorectal surgery. Recently, three-dimensional (3D) printed stoma models have been developed as useful adjuncts to conventional stoma teaching. This study aims to evaluate the impact of the introduction of a 3D stoma model education programme on patients undergoing elective robotic total mesorectal excision (TME).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Between April 2021 and October 2021, 12 patients who underwent elective robotic TME in Queen Elizabeth Hospital were recruited into the 3D stoma model education programme. They were compared with 30 patients who had robotic TME before the introduction of the programme from January 2020 to December 2020. Their demographics, length of stay, self-stoma care skills, and feedback regarding the programme were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a reduction of 2.7 days in the mean length of stay before (10.8 days) and after (8.1 days) the introduction of the 3D stoma model education programme. A statistically significant difference was observed (<i>P</i> = .0236). The programme was well received among participants. All patients agreed that it relieved their anxiety, increased their understanding and confidence in self-stoma care, and enhanced their self-stoma care ability. This was supported by their excellent performance in the first post-operative stoma care session, where their stoma care skills were assessed by a stoma nurse specialist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preliminary results from our 3D stoma model education programme for patients undergoing elective robotic TME are promising. The use of 3D stoma models may contribute to a shorter length of hospital stay and self-stoma care proficiency, and are well accepted by patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"73-78"},"PeriodicalIF":0.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness and research: A cornerstone of surgical excellence","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.12737","DOIUrl":"https://doi.org/10.1111/1744-1633.12737","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"179-180"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Practice November 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12736","DOIUrl":"https://doi.org/10.1111/1744-1633.12736","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"246-247"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on ‘Extraperitoneal sigmoidopexy versus sigmoidectomy for sigmoid volvulus: A prospective comparative study’","authors":"Sabri Selcuk Atamanalp,&nbsp;Esra Disci,&nbsp;Rifat Peksoz","doi":"10.1111/1744-1633.12717","DOIUrl":"https://doi.org/10.1111/1744-1633.12717","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"227-228"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Practice August 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12731","DOIUrl":"https://doi.org/10.1111/1744-1633.12731","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"244-245"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen enhances stability and viability of diced cartilage as an injectable implant: An experimental study in rabbits","authors":"Yanghonghong Fei,&nbsp;Shengxian Shen,&nbsp;Zhao Chen,&nbsp;Wenjia Lv,&nbsp;Haishan Lu,&nbsp;Lina Shi,&nbsp;Xudong Hong,&nbsp;Jian Jin","doi":"10.1111/1744-1633.12732","DOIUrl":"https://doi.org/10.1111/1744-1633.12732","url":null,"abstract":"<p>The use of diced cartilage has become increasingly popular in rhinoplasty; however, the viability of the graft can vary. This study aimed to investigate the use of fillers for diced cartilage, evaluate their morphology and viability, and provide a foundation for their clinical use. Six rabbits were used in this experiment. Ear cartilage was excised and diced into pieces and mixed with different fillers, including collagen (COLD), hyaluronic acid (HAD), and normal saline (NSD), or used alone (COND) as a control. They were embedded in the backs of rabbits. After 3 months, the weight and volume of grafts were measured. The cellular viability and morphology were assessed. The HAD group showed the most significant volume change, followed by the NSD group. There was no significant weight change between the COLD and COND groups. Grossly, the COLD group appeared as a smooth block, while the COND and NSD groups appeared rough. Microscopically, fibrous tissue and collagen were arranged regularly in the COLD and HAD groups, and chondrocytes were arranged neatly. By contrast, collagen was less and arranged messily in the NSD and COND groups. There was better cell viability and angiogenesis around cartilage in the COLD group than in the HAD and NSD groups. When mixed with collagen, diced cartilage can maintain its basic shape and smooth appearance, and there is better cell viability and angiogenesis than when mixed with hyaluronic acid or normal saline, or used alone. These findings may provide implications for the clinical use of diced cartilage as injectable implants.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"79-85"},"PeriodicalIF":0.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring GPT-4.0's efficiency in handling paediatric appendicitis questions","authors":"Defeng Zeng,&nbsp;Guoqiang Chen,&nbsp;Guoyong Wang,&nbsp;Hai Zhou MD, PhD,&nbsp;Chunbao Guo MD, PhD","doi":"10.1111/1744-1633.12733","DOIUrl":"https://doi.org/10.1111/1744-1633.12733","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the potential and accuracy of the generative dialogue artificial intelligence tool GPT-4.0 in answering questions related to paediatric emergency appendicitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional observational study design was used. We collected 134 appendicitis-related questions from authoritative websites, such as Mayo Medical and APSA, covering all aspects of appendicitis, including simple and complex questions. These questions were answered by GPT-4.0, and then evaluated by three paediatric surgical experts using a quality score ranging from 0 to 5. The answers were generated by GPT-4.0 and then similarly evaluated by three experts for accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that GPT-4.0 could achieve a high accuracy rate on simple questions with a quality score of 4.65 (standard deviation 0.51). For complex questions, the average score was 3.77 (standard deviation 0.68), and there was a significant difference between the two (<i>P</i> &lt; .05). On clinical questions, the accuracy score of GPT-4.0 was 4.00 (standard deviation 0.21). When answering actual questions from families of children with appendicitis, the accuracy score was 4.12 (standard deviation 0.59). Its accuracy lies between simple questions and complex questions, and it can basically meet the accuracy requirements of clinical questions. It's worth noting that GPT-4.0 demonstrated empathy in answering some questions, which might further enhance patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GPT-4.0 showed its potential and accuracy in handling paediatric appendicitis questions, especially in simple and clinical questions. However, improvements are still needed in handling complex questions and updating information. Despite the limitations, this model is expected to improve the quality of medical services and enhance patient satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"13-18"},"PeriodicalIF":0.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of gunshot wound infection in the eastern Democratic Republic of the Congo: A hospital-based cross-sectional study","authors":"Paul Munguakonkwa Budema,&nbsp;Jean de Dieu Tumusifu Manegabe,&nbsp;Victoire Urbain Hatu'm,&nbsp;Fabrice Cikomola Gulimwentuga,&nbsp;Georges Kuyigwa Toha,&nbsp;Olivier Mukuku,&nbsp;Zacharie Kibendelwa Tsongo,&nbsp;Theophile Barhwamire Kabesha,&nbsp;Stanislas Okitotsho Wembonyama","doi":"10.1111/1744-1633.12735","DOIUrl":"https://doi.org/10.1111/1744-1633.12735","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Survivors of gunshot injuries are at high risk of developing infections at the injury site. However, data on gunshot wound infections and their associated burdens are limited. This study aims to determine the prevalence of gunshot wound infections and identify the risk factors associated with them in a tertiary hospital located in the eastern part of the Democratic Republic of the Congo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective observational study was conducted at the Provincial General Reference Hospital of Bukavu in the Democratic Republic of the Congo, reviewing data from patients hospitalised between January 1, 2019, and December 31, 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 549 patients were included in the study, with wound infections occurring in 26.6% of cases. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [CI] 1.12–2.92; <i>P</i> = .0146), nerve damage (aOR = 2.65; 95% CI 1.70–4.14; <i>P</i> &lt; .0001), trunk injuries (aOR = 5.64; 95% CI 2.61–12.16; <i>P</i> &lt; .0001), lower extremity injuries (aOR = 2.71; 95% CI 1.39–5.28; <i>P</i> = .0034), and multiple injuries (&gt;2; aOR = 2.35; 95% CI 1.05–5.25; <i>P</i> = .0378) as independent predictors of gunshot wound infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The main factors predisposing gunshot wounds to infection, identified in this study, require thorough evaluation and urgent management. In cases of abdominal gunshot trauma, fractures, and vascular or nerve lesions, management procedures are aimed at reducing the infection burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"19-25"},"PeriodicalIF":0.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Benign lateral neck ectopic thyroid tissue mimicking cervical lymph node metastasis","authors":"Wang-Lin Ng MBBS, MRCSEd,&nbsp;Man-Hin Chan FRCSEd (ORL), FHKCORL, FHKAM (Otorhinolaryngology),&nbsp;Ka-Chun Wong FRCSEd (ORL), FHKCORL, FHKAM (Otorhinolaryngology)","doi":"10.1111/1744-1633.12734","DOIUrl":"https://doi.org/10.1111/1744-1633.12734","url":null,"abstract":"<p>We herein report a rare case of benign lateral neck ectopic thyroid tissue that presentation micmicked cerivcal lymph node metastasis of follicular thyroid cancer and discuss its management pearl.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"50-52"},"PeriodicalIF":0.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transanal total mesorectal excision: Understanding indications, managing complications, and effective prevention methods","authors":"Christos K. Stefanou,&nbsp;Stefanos K. Stefanou,&nbsp;Kostas Tepelenis,&nbsp;Theocharis Chatzoglou,&nbsp;Thomas Iraklis Smyris,&nbsp;Marini Aikaterini,&nbsp;Alexandra Barbouti,&nbsp;Dimitrios N. Varvarousis,&nbsp;Panagiotis Kanavaros,&nbsp;Panagiotis Kitsoulis","doi":"10.1111/1744-1633.12730","DOIUrl":"https://doi.org/10.1111/1744-1633.12730","url":null,"abstract":"<p>Transanal total mesorectal excision (TaTME) has emerged as a surgical method for treating rectal malignancies in the middle and lower third of the rectum over the past 15 years. This approach was adopted because of the challenges encountered in secure total mesorectal excision (TME). Patient selection criteria and the rationale for TaTME have evolved, leading to improved oncological outcomes and patient quality of life. The procedure includes inserting a unique platform through the anus, forming a purse-string closure, and endoscopically sealing the lower rectum. The mesorectum is then removed laparoscopically following a ‘down-to-up’ approach, finalised with a transabdominal laparoscopic phase and anastomosis. Pelvic anatomy complexity poses challenges, including potential injuries to the urinary tract, surgical site leakage, sinus damage, sagittal vein harm, nerve injury, carbon dioxide embolism, bowel function disturbance, sphincter mechanism issues, and rectal abscess formation. Proficient anatomy knowledge, precise surgical techniques, and advanced technologies contribute to their prevention. In conclusion, TaTME offers a promising approach to rectal surgery with satisfactory oncological outcomes. However, vigilance is required to eliminate potential complications.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"219-226"},"PeriodicalIF":0.3,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}