Surgical Practice最新文献

{"title":"Surgical Practice May 2024 issue CME for Fellows","authors":"","doi":"10.1111/1744-1633.12703","DOIUrl":"https://doi.org/10.1111/1744-1633.12703","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"114-115"},"PeriodicalIF":0.3,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488600","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":"Risk management in surgical practice","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.12701","DOIUrl":"https://doi.org/10.1111/1744-1633.12701","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"55-56"},"PeriodicalIF":0.3,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488601","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 February 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12696","DOIUrl":"https://doi.org/10.1111/1744-1633.12696","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"112-113"},"PeriodicalIF":0.3,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488599","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":"Feasibility of airway replacement using stented aortic matrices: Bench to TRITON-01 study","authors":"Shixiong Wei PhD,&nbsp;Yiyuan Zhang PhD,&nbsp;Linan Fang MD,&nbsp;Lijun Fang PhD","doi":"10.1111/1744-1633.12704","DOIUrl":"10.1111/1744-1633.12704","url":null,"abstract":"<p>Patients with long-segment tracheal defects, deemed technically inoperable, constitute a population in critical need of airway replacement. Regardless of the underlying cause—be it benign or malignant processes—this patient category requires either a tracheal transplant or admission to a palliative care facility. Despite over 50 years of exploration in thoracic surgery and regenerative medicine, airway transplantation remains a significant challenge. Various tracheobronchial substitutes, such as synthetic prostheses, bioprostheses, allografts, autografts, and bioengineered conduits, have been experimentally tested, yet none have provided a standardized method for airway replacement. Aortic grafts were suggested by Aortic grafts have been suggested as a biological matrix for extensive airway reconstruction as a biological matrix for extensive airway reconstruction. Cryopreserved aortic allografts, because of their availability in tissue banks and the lack of need for immunosuppressive therapy, were first used in clinical applications. The TRITON-01 study (NCT04263129) focuses on patients who received airway replacement to determine the routine applicability of this novel approach. The primary objective of this review is to provide information on advancements in the use of aortic allografts as tracheal replacements.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"129-131"},"PeriodicalIF":0.3,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354550","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":"Extraperitoneal sigmoidopexy versus sigmoidectomy for sigmoid volvulus: A prospective comparative study","authors":"Mostafa Ibrahim,&nbsp;Mohamad Raafat","doi":"10.1111/1744-1633.12702","DOIUrl":"10.1111/1744-1633.12702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Extraperitoneal sigmoidopexy is a simple, safe and effective non-resective procedure with minimal morbidity and mortality rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This prospective comparative study involved 105 patients with uncomplicated sigmoid volvulus at Asyut University Hospitals, Egypt, from June 2021 to January 2023. The study population was divided into two groups: Group A, which underwent extraperitoneal sigmoidopexy, and Group B, which was treated with sigmoidectomy and primary anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 105 cases. A total of 56 (53.4%) patients underwent extraperitoneal sigmoidopexy (Group A) and 49 (46.6%) patients underwent sigmoidectomy (Group B). The mean age was 61.33 (standard deviation [SD] 1.65) for Group A and 67.9 (SD 1.69) for Group B (<i>P</i> = .36). The mean operative time (minutes) was 62.25 (SD 1.38) for Group A and 87.60 (SD 2.38) for Group B (<i>P</i> &lt; .0001). The mean hospital stay (days) was 6.25 (SD 0.29) for Group A and 9.04 (SD 0.34) for Group B (<i>P</i> &lt; .0001). There was a significant difference in overall morbidity and recurrence rate, while no significant difference was observed in intensive care unit admission, additional surgery and mortality between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Extraperitoneal sigmoidopexy emerges as a simple, safe and effective treatment option for non-complicated sigmoid volvulus. Despite a higher recurrence rate, it demonstrates lower morbidity and mortality compared with sigmoidectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"204-208"},"PeriodicalIF":0.3,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141360874","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":"Split liver transplantation: Current status and future trend","authors":"Lijin Zhao MD,&nbsp;Zhihong Zheng","doi":"10.1111/1744-1633.12692","DOIUrl":"https://doi.org/10.1111/1744-1633.12692","url":null,"abstract":"<p>Liver transplantation (LT) remains the most effective treatment for end-stage liver disease. However, there continues to be a severe shortage of liver donors worldwide, resulting in a significant disparity between the number of patients on the liver transplant waiting list and the available donor organs. Split liver transplantation (SLT) enables a single whole liver graft to be divided into two partial grafts, which can then be transplanted into two recipients. This approach expands the pool of available liver donors and reduces the waiting time for LT. Since its inception, SLT has undergone continuous development and research. As a complex variant of LT, SLT requires a high level of surgical expertise, and many aspects of SLT have not yet reached a consensus or clear definition within the transplantation community. In addition, it represents a smaller proportion among all LT techniques, which hampers the further development of SLT technology. This review concludes recent developments in SLT, offering a comprehensive summary of current practices regarding donor selection criteria, surgical techniques, and clinical outcomes. Its purpose is to serve as a reference for real clinical scenarios and explore potential future trends in SLT.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"93-102"},"PeriodicalIF":0.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488319","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":"Magnetic resonance cholangiopancreatography in acute cholecystitis: Is it necessary for patients with normal common bile duct diameter?","authors":"Adel Zeinalpour,&nbsp;Hamed Ebrahimibagha,&nbsp;Morteza Amestejani,&nbsp;Sara Shojaei-Zarghani,&nbsp;Faramarz Pakravan,&nbsp;Ali Reza Safarpour","doi":"10.1111/1744-1633.12695","DOIUrl":"10.1111/1744-1633.12695","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Investigating concurrent choledocholithiasis in patients with acute cholecystitis (AC) and normal common bile duct (CBD) diameter on ultrasound by performing magnetic resonance cholangiopancreatography (MRCP) can be challenging. This study aims to determine the conditions that necessitate MRCP before surgery and its potential impact on the course of treatment for these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We included 100 patients with AC and normal CBD diameter who were admitted to Shahid Modarres Hospital from September 2019 to September 2022. Patients with elevated levels of any liver serum markers above the upper limit of normal underwent MRCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MRCP results were positive in 45.16% of cases and altered the type of treatment in 35.48% of them. The findings indicated that direct [area under the curve (AUC) = 0.782; 95% confidence interval (CI) 0.597–0.909] and total bilirubin (AUC = 0.697; 95% CI 0.507–0.849) were significantly effective in predicting the positive findings for concurrent CBD stone or Mirizzi's syndrome on MRCP. The optimal cutoff values for direct and total bilirubin were found to be above 1.02 and 2.19 mg/dL. Concerning the alteration of treatment approaches, direct bilirubin demonstrated predictive value (<i>P</i> = .014) at levels above 1.02 mg/dL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In cases of AC with a normal CBD diameter on ultrasound and mild elevations in liver function parameters, including total and direct bilirubin, it is not routinely necessary to perform MRCP. However, if these laboratory values exceed a certain threshold, MRCP is recommended as it may reveal alternative diagnoses that could alter the clinical management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"190-196"},"PeriodicalIF":0.3,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005604","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":"Assessing the value of a pelvic drain for urinary leak after robotic radical prostatectomy","authors":"Eugenio Bologna,&nbsp;Hilly Perlman,&nbsp;Idan Zeeman,&nbsp;Tomer Bashi,&nbsp;Karin Lifshitz,&nbsp;Avi Beri,&nbsp;Roy Mano,&nbsp;Ofer Yossepowitch,&nbsp;Snir Dekalo,&nbsp;Yuval Bar-Yosef,&nbsp;Ziv Savin","doi":"10.1111/1744-1633.12693","DOIUrl":"10.1111/1744-1633.12693","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The value of post-operative pelvic drain placement after robot-assisted radical prostatectomy (RARP) for the purpose of diagnosing post-operative complications is undetermined. The aim of this study was to assess the yield of pelvic drain outputs in predicting post-operative early-onset urinary leaks from a vesicourethral anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of 204 consecutive patients who underwent RARP in our institution between 2018 and 2022. The daily outputs of the drain and the urinary catheter were measured, and patients with early-onset anastomotic urinary leak were compared with those who were free of any leak. The association between post-operative drain output and the presence of urinary leak was investigated by regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-operative early-onset leak was present in six patients (3.4%) whose baseline characteristics were not different from those of patients with no leak. The median pelvic drain output on post-operative day 1 (D-POD1) was 80 mL (interquartile range [IQR] 51–150 mL) and 122 mL (IQR 62–200 mL) on D-POD2. The median D-POD1 of patients with a leak was significantly higher than those without one (250 mL vs 80 mL, respectively; <i>P</i> &lt; .001). The threshold to predict an anastomotic urinary leak was 227 mL on D-POD1 (area under the curve 0.88; <i>P</i> &lt; .001), and an association between D-POD1 &gt;227 mL and the presence of urinary leak (odds ratio 35; <i>P</i> &lt; .001) was found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pelvic drain output on POD1 can predict early-onset urinary leak. Given the relatively low rate of this complication via a robotic approach, however, we consider that, unless otherwise indicated, the routine placement of a pelvic drain may be safely avoided.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"159-163"},"PeriodicalIF":0.3,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12693","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141008968","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}

{"title":"Beta-hCG–producing malignant phyllodes tumour","authors":"Laura Lok Wa Leung,&nbsp;Monalyn Marabi,&nbsp;Violet Yee Kei Tsoi","doi":"10.1111/1744-1633.12694","DOIUrl":"10.1111/1744-1633.12694","url":null,"abstract":"<p>Phyllodes tumours (PTs) of the breasts are rare fibroepithelial tumours accounting for less than 1% of all breast tumours. They have a wide range of presentations, ranging from benign-natured tumours that behave similarly to fibroadenomas, to aggressive malignant tumours that can rapidly advance both locally and distally. Histologically, PTs are classified into benign, borderline, or malignant based on a combination of the following five features: degree of stromal cellularity, stromal cell atypia, mitotic activity, infiltrative or circumscribed margins, and presence or absence of stromal overgrowth. Malignant tumours demonstrate high levels of stromal cellularity and atypia, infiltrative margins, high mitotic rate (&gt;10 mitoses per 10 high-power fields), and the presence of stromal overgrowth. Treatment predominantly relies on complete excision of the lesion, although treatment regimens for malignant PTs with adjuvant chemoradiation lack standardization as a result of its rarity. Malignant tumours are also often associated with paraneoplastic syndromes such as recurrent hypoglycaemia and hypertrophic osteoarthropathy. Here, we report a case of recurrent malignant PT with serum beta-human chorionic gonadotrophin secretion.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"170-172"},"PeriodicalIF":0.3,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016060","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":"Management of giant colorectal polyps (≥3 cm) by endoscopic submucosal dissection (ESD) versus surgery: a propensity score–based analysis","authors":"Michelle Hau Ching Lo,&nbsp;Michael Chi Ming Poon","doi":"10.1111/1744-1633.12690","DOIUrl":"https://doi.org/10.1111/1744-1633.12690","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Giant colorectal polyps (≥3 cm) can be managed by endoscopic excision or surgical resection. There has been a shift to endoscopic submucosal dissection (ESD) for the treatment of such lesions as the expertise in advanced therapeutic endoscopy develops. This study aims to compare the outcome and safety profile of ESD against surgical resection for patients with giant colorectal polyps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective review on patients with giant colorectal polyps removed by either ESD or surgery over a 10-year period (from May 2010 to September 2020) in a regional hospital in Hong Kong. Propensity score matching was performed based on patient demographics and polyp characteristics. Outcomes including polyp histology, complication rates, length of hospital stay, and re-admission rates were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-one patients (ESD group: 34, surgery group: 17) were included in the analysis. The mean polyp diameter was 3.35 cm (ESD group) and 3.53 cm (surgery group). The median procedure time was comparable (160 vs 167 min; <i>P</i> = .251) and the most common polyp histological type was tubulovillous adenoma (44.1% vs 47.1%; <i>P</i> = .130) for both groups. A shorter median length of stay (1 day vs 6 days; <i>P</i> = .028) and lower re-admission rate (0% vs 5.9%; <i>P</i> &lt; .001) were observed in the ESD group, whereas a higher major complication rate (Clavien–Dindo classification grade IIIa or above; 2.9% vs 11.7%; <i>P</i> = .013) was observed in the surgery group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ESD is a safe and effective treatment for giant colonic polyps with ESD size ≥3 cm. It has the advantage of lower complication rates, shorter length of hospital stays, and lower re-admission rates compared with surgical resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"57-62"},"PeriodicalIF":0.3,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141489022","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}