Surgical Practice最新文献

{"title":"The Best Original Paper Award","authors":"Paul B.S. Lai","doi":"10.1111/1744-1633.12711","DOIUrl":"https://doi.org/10.1111/1744-1633.12711","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"119"},"PeriodicalIF":0.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231092","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":"Moving beyond isolated complications: surgical audit as a pillar of clinical governance","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.12718","DOIUrl":"https://doi.org/10.1111/1744-1633.12718","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"120-121"},"PeriodicalIF":0.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231096","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 May 2024 CME for fellows","authors":"","doi":"10.1111/1744-1633.12712","DOIUrl":"https://doi.org/10.1111/1744-1633.12712","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"173-174"},"PeriodicalIF":0.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231097","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":"The cat-scratch procedure: A new technique for surgical management of primary spontaneous pneumothorax","authors":"Davor Stamenovic","doi":"10.1111/1744-1633.12719","DOIUrl":"https://doi.org/10.1111/1744-1633.12719","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Surgery is an option as the primary treatment for patients with primary spontaneous pneumothorax. Talc pleurodesis and subtotal parietal pleurectomy have demonstrated virtually equal effectiveness in reducing recurrence but result in significant scarring, hindering further chest access if necessary. This paper introduces a new, less invasive technique for the surgical management of primary spontaneous pneumothorax.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The procedure can easily be conducted via a uniportal thoracoscopic approach. Following the standard identification of the air leak and subsequent bullectomy, short intermittent incisions are made in the parietal pleura, each following the course of the first, second, and third ribs, respectively. Subsequently, a paravertebral block catheter and a pleural drain are inserted, completing the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients underwent surgery using this approach. All five were discharged without any post-operative complications and showed no signs of recurrence within 2 weeks following surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This paper presents a new, less invasive, and less extensive form of pleurectomy for primary spontaneous pneumothorax. The primary advantage of this technique is its ability to maintain chest accessibility, especially considering that some patients with pneumothorax may require further lung surgery in the future. In addition, the procedural time is shorter, and it is expected to have a smaller negative impact on respiratory mechanics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"216-218"},"PeriodicalIF":0.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143114425","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":"Macrophage M2 polarisation empowered reduction of abdominal adhesions via recombinant human type III collagen","authors":"Xin Lu,&nbsp;Yin-Jia Ding,&nbsp;Yang Wang,&nbsp;Xu-Dong Hong,&nbsp;Yang-Hong-Hong Fei,&nbsp;Ting-Ting Si,&nbsp;Jin-Fang Wu,&nbsp;Yue Zhou,&nbsp;Ai-Fen Chen,&nbsp;Xu-Dong Zhang,&nbsp;Jian Jin","doi":"10.1111/1744-1633.12714","DOIUrl":"https://doi.org/10.1111/1744-1633.12714","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to investigate the role of recombinant human type III collagen (RHC3) in preventing abdominal adhesion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The amino acid sequence was analysed to determine the content of GPP fragments. RHC3 was co-cultured with macrophages, and the phenotypic classification of macrophages was based on immunofluorescence detection of inducible nitric oxide synthase for M1 macrophages and arginase 1 for M2 macrophages. This approach was used to assess the impact of RHC3 on promoting M2 polarisation. Levels of inflammatory factor levels, including interleukin 1-beta (IL-1β), tumour necrosis factor-alpha (TNF-α), and IL-10, were quantified using enzyme-linked immunosorbent assay to evaluate the improvement in inflammatory response. The capability of RHC3 to prevent abdominal adhesions was assessed by rinsing the abdominal cavity in an animal model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RHC3 contains GPP fragments that account for over 5% of its amino acid sequence. Cell studies indicated that RHC3 induced M2 polarisation in macrophages, significantly reduced levels of pro-inflammatory factors (IL-1β and TNF-α), and significantly increased levels of the anti-inflammatory factor IL-10. Similarly, animal studies demonstrated a significant reduction in abdominal adhesion scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results suggest that RHC3 exhibits notable inflammation-ameliorating activity and effectively prevents abdominal adhesions when used as a lavage solution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"209-215"},"PeriodicalIF":0.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120044","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":"Optimal timing of surgery for inguinal hernia in premature neonates","authors":"Guoqiang Chen,&nbsp;Hai Zhou,&nbsp;Jian Yang,&nbsp;Bingshan Xia,&nbsp;Jia Gao,&nbsp;Qianming Xiang,&nbsp;Chunbao Guo MD, PhD,&nbsp;Gongli Chen","doi":"10.1111/1744-1633.12713","DOIUrl":"https://doi.org/10.1111/1744-1633.12713","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The surgical repair of inguinal hernias represents a significant risk for premature infants. Despite ongoing discourse, the optimal approach to hernia management remains contentious. Our investigation aims to establish the most favourable timing for inguinal repair in premature neonates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Our investigation involved the analysis of medical records for 536 neonates, born prematurely, who underwent inguinal hernia repair from January 2018 to December 2023. We dichotomised the cohort into two groups: those who received early repair and those who underwent late repair. The timing of the surgery was primarily determined by the surgeon's decision, in conjunction with familial consent to the surgical intervention. The primary endpoints were the incidence of recurrence or incarceration within 1 year after surgery. The secondary endpoints encompassed length of neonatal intensive care unit stay, post-operative ventilator dependency, and frequency of return visits, whether to the inpatient and emergency department or an outpatient clinical setting, for hernia-related issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis encompassed a total of 454 neonates born prematurely, of which 163 underwent early repair, while 291 received late repair for inguinal hernia. The demographic data between the two groups demonstrated no significant differences. The occurrences of hernia recurrence and post-operative apnoea presented similar trends across both cohorts. Notably, the late repair group exhibited an increased incidence of preoperative incarceration and return visits due to hernia complications. In this group, testicular atrophy or ovarian necrosis was observed in five cases, despite the overall absence of significant differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that the surgical repair of inguinal hernia in preterm neonates, performed at the time of presentation to our clinics, is both safe and feasible. However, a delay in hernia repair appears to be associated with a heightened risk of severe complications, such as testicular atrophy or ovarian necrosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"197-203"},"PeriodicalIF":0.3,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143117258","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":"Drain amylase values for clinically relevant post-operative pancreatic fistulae","authors":"Pipit Burasakarn MD, PhD,&nbsp;Sermsak Hongjinda MD,&nbsp;Anuparp Thienhiran MD,&nbsp;Pusit Fuengfoo MD","doi":"10.1111/1744-1633.12715","DOIUrl":"https://doi.org/10.1111/1744-1633.12715","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to identify the cut-off drain amylase (DA) values on the first, third, and fifth post-operative days (POD1-DA, POD3-DA, and POD5-DA) that are correlated with clinically relevant post-operative pancreatic fistula (CR-POPF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>All data were retrospectively collected from patients who underwent pancreatectomy at the Department of Surgery, Phramongkutklao Hospital, from January 2015 to December 2023. A total of 195 patients were included in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 195 patients were analysed, including 35 patients with CR-POPF, with a mean age of 60.84 years. There were no statistically significant differences in demographic data between patients with CR-POPF and those without. In addition, no statistical differences were observed in pancreatic duct diameter (3 mm vs 2 mm), operative time (468.9 min vs 500.29 min), or blood loss (600 mL vs 600 mL) between the CR-POPF and no CR-POPF groups. Length of hospital stays was longer in the CR-POPF group compared with the no CR-POPF group (33 days vs 11 days, <i>P</i> = .001). In addition, the CR-POPF group had significantly higher rates of post-operative pancreatic haemorrhage (20% vs 2.5%), bile leakage (5.71% vs 0%), delayed gastric emptying (45.71% vs 3.13%), wound complications (34.29% vs 5%), and mortality (17.14% vs 1.88%) compared with the no CR-POPF group. The optimal cut-off values for CR-POPF were 1313 U/L on day 1 (D1; area under the curve [AUC] 0.72, 95% confidence interval [CI] 0.65–0.84, sensitivity 91%, specificity 52%), 492 U/L on D3 (AUC 0.77, 95% CI 0.70–0.83, sensitivity 91%, specificity 64%), and 360 U/L on D5 (AUC 0.65, 95% CI 0.52–0.75, sensitivity 69%, specificity 61%). There were no significant perioperative factors associated with CR-POPF in our study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DA levels of 1313, 492, and 360 U/L on post-operative D1, D3, and D5, respectively, were associated with CR-POPF. Drain removal can be safely performed without the risk of CR-POPF when these levels are met.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"6-12"},"PeriodicalIF":0.3,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707492","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":"Posterior components separation with transversus abdominis release and sublay mesh reinforcement in large ventral hernia repair","authors":"Ahmed Hassan El-Halby MBBCh,&nbsp;Tamer M. Elmahdy MD,&nbsp;Ahmed Fakhr El-Deen El-Samongy MD,&nbsp;Osama Helmy Elkhadrawy MD","doi":"10.1111/1744-1633.12709","DOIUrl":"10.1111/1744-1633.12709","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Ventral abdominal hernia is a prevalent condition among surgical patients. Large ventral hernias with defects &gt;10 cm that cannot be closed primarily, often with loss of domain requiring abdominal wall reconstruction, pose a surgical challenge. Our study aimed to evaluate the outcomes of posterior components separation (PCS) with transversus abdominis release (TAR) and sublay mesh reinforcement in large ventral hernia repair, particularly in terms of surgical site occurrences (SSOs) and hernia recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Our study included 40 adult patients presented to Tanta University Hospitals with a large ventral hernia (defect width ≥10 cm) from December 2021 to January 2023. All patients were submitted to PCS with TAR and sublay mesh reinforcement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the study population was 47.32 (standard deviation [SD] 9.31) years (range 36–65 years) with a mean body mass index of 33.55 (SD 3.42) kg/m² (range 28.35–38.72 kg/m²). The major risk factors were obesity (95.00%), smoking (45.00%), and multiparity (45.00%). Midline incisional hernia was the most common type in 28 patients (70.00%). Thirty-four patients (85%) achieved successful midline closure, while six patients required additional anterior components separation technique to achieve tensionless midline closure and an onlay mesh for functional reconstruction. Post-operative SSOs occurred in 12 patients (30.00%), with subcutaneous seroma in 8 patients (20.00%) and wound dehiscence and necrosis in 4 patients (10.00%). Two patients (5.00%) experienced recurrence after a mean follow-up period of 19.25 (SD 3.52) months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PCS with TAR and sublay mesh reinforcement is a reliable and durable technique for complex ventral hernia repair with low morbidity and recurrence rates. However, long-term clinical outcomes with more cases are required to properly evaluate this technique.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"181-189"},"PeriodicalIF":0.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814260","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":"Joint replacement and peroneal nerve flap transfer repair surgery for deficiency in the fifth metatarsal bone of the right foot","authors":"Dawei Wang,&nbsp;Chen Xie,&nbsp;Baoguo Cheng,&nbsp;Hongyue Men,&nbsp;Nanfei Zheng,&nbsp;Zongyu Li","doi":"10.1111/1744-1633.12707","DOIUrl":"10.1111/1744-1633.12707","url":null,"abstract":"<p>The use of 3D printing technology for prosthetic treatment of forefoot bone defects is relatively uncommon. In December 2021, our research team successfully treated a patient presenting with a bone defect in the fifth metatarsal of the right foot, along with accompanying soft tissue and tendon defects. Following an initial debridement treatment, in April 2022, the patient underwent a right foot flap transfer repair. This procedure, performed under general anaesthesia, also included the implantation of a 3D-printed titanium metatarsophalangeal joint replacement for the fifth toe. After a 12-month post-operative assessment, the donor site displayed normal characteristics and the affected foot exhibited a complete and intact appearance. The patient reported no pain or discomfort during weight-bearing activities and exhibited a normal gait pattern without signs of limping. Both aesthetic and functional recovery outcomes were deemed satisfactory.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"239-243"},"PeriodicalIF":0.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656480","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":"Does the COVID-19 pandemic change clinic features and treatment of intussusception in children?","authors":"Begüm Pişiren,&nbsp;Özlem Boybeyi,&nbsp;Tutku Soyer MD","doi":"10.1111/1744-1633.12706","DOIUrl":"10.1111/1744-1633.12706","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Social restrictions during the coronavirus disease 2019 (COVID-19) pandemic decreased the incidence of viral diseases. Intussusception may exhibit seasonal variation, and viral aetiology is a common cause of idiopathic cases. This retrospective study was conducted to evaluate the impact of the COVID-19 pandemic on the clinical course and treatment of intussusception in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients admitted between March 2017 and December 2021 were retrospectively evaluated for age, gender, clinical findings, symptoms, length and localisation of intussusception, and treatment. They were categorised into two groups: before the pandemic (BP) and during the pandemic (DP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 55 patients were included in the study, with 54 (78%) in the BP group and 11 (22%) in the DP group. The median age of the patients was significantly younger in the DP group (<i>P</i> &lt; .05). Contrast enema reduction was a common treatment choice in the BP group, whereas ultrasound-guided hydrostatic reduction was more popular in the DP group (<i>P</i> &lt; .05). The median time to start oral feeding and length of hospitalisation were significantly shorter in the DP group (<i>P</i> &lt; .05). While there was no difference in seasonal occurrences of intussusception, idiopathic causes were more common in the BP group (<i>P</i> &lt; .05). The incidence of intussusception with a leading point as an underlying aetiology was significantly higher in the DP group (<i>P</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>During the pandemic, the rate of idiopathic intussusception significantly decreased, with leading points accounting for half of the cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"68-72"},"PeriodicalIF":0.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680787","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}