Surgical Practice最新文献

{"title":"Transurethral water vapour therapy (Rezūm) for catheter-dependent men secondary to benign prostatic hyperplasia: A retrospective study in a Hong Kong population","authors":"Henry Chow MBChB, FRCSEd (Urol), FCSHK, FHAKM (Surgery),&nbsp;Chi Ho Ip MBBS, FRCSEd (Urol), FCSHK, FHAKM (Surgery),&nbsp;Yiu Chung Lam MBBS, FRCSEd (Urol), FCSHK, FHAKM (Surgery)","doi":"10.1111/1744-1633.12689","DOIUrl":"https://doi.org/10.1111/1744-1633.12689","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Rezūm is a novel treatment for patients with moderate to severe lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH). Recently, it has expanded to patients with urinary retention causing catheter dependence and the results are promising in Whites. However, it is unclear how effective Rezūm is in the Chinese population. Here, we report our experience in performing Rezūm on catheter-dependent Chinese men with BPH and evaluate its safety and efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of catheter-dependent patients with BPH who underwent Rezūm from January to August 2022 was conducted. We evaluated the success rate of trial without catheter (TWOC) and compared pre- and post-operative (at 6 months) uroflowmetry results, International Prostate Symptoms Score (IPSS), IPSS Quality of Life Score (IPSS QoL), and prostate volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three patients had Rezūm performed (44 and 19 patients had refractory urinary retention and obstructive uropathy, respectively) with a mean age of 74 years and a mean prostate size of 53.9 mL. The first attempt at TWOC was successful in 53 patients (85.5%; range 15–44 days post-operation). By 98 days after the operation, all patients could void spontaneously. The 6-month follow-up showed that IPSS and IPSS QoL scores decreased by a mean of 9.0 and 1.8 points, respectively (both <i>P</i> &lt; .01). The mean pre-operative post-voided residual urine was reduced by 559 mL (<i>P</i> &lt; .01), with a mean prostate size reduction of 9.4 mL (<i>P</i> &lt; .01). Seven patients had non-serious complications (Grade 1–2 Clavien–Dindo classification) within 30 days of operation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rezūm was shown to be effective and safe in catheter-dependent Chinese men with BPH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"87-92"},"PeriodicalIF":0.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488472","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":"Buttressed pancreaticogastrostomy for a soft pancreas and/or small pancreatic duct in pancreaticoduodenectomy: A retrospective cohort study","authors":"Mostafa M. Sayed MD,&nbsp;Mohamad Raafat MD,&nbsp;Abdallah M. Taha MD","doi":"10.1111/1744-1633.12687","DOIUrl":"10.1111/1744-1633.12687","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Post-operative pancreatic fistula (POPF) has a major impact on the post-operative outcomes after pancreaticoduodenectomy (PD). Soft pancreas and small pancreatic duct diameter are major risk factors for POPF. In this study, we aimed to evaluate the short-term outcomes of our technique of buttressed pancreaticogastrostomy (PG) as a method of pancreatic anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted on patients who underwent PD with a soft pancreas and/or small pancreatic duct diameter ≤5 mm. The study period spanned from January 2018 to December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 69 patients were included in the study, comprising 30 females and 39 males. The mean age of the patients was 57 ± 14.3 years. The mean operative time of the whole procedure was 335 ± 43.7 min and that of buttressed PG was 22 ± 4.6 min. Two patients had early post-operative bleeding. Only 5 (7.24%) patients developed a grade A POPF. Eight (11.8%) patients had delayed gastric emptying.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Buttressing PG represents a simple and safe reconstruction technique following PD, particularly for patients with a soft pancreas and/or small pancreatic duct. This approach is associated with a low incidence of POPF. However, prospective randomised trials with large sample sizes are required to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"144-151"},"PeriodicalIF":0.3,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673717","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 governance revisited","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.12683","DOIUrl":"https://doi.org/10.1111/1744-1633.12683","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"3-4"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544486","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 insights: Assessing acute appendicitis in a fifth-wave COVID-19 cluster—A retrospective cohort analysis","authors":"Ahmed Gawash,&nbsp;David F. Lo MBS","doi":"10.1111/1744-1633.12684","DOIUrl":"https://doi.org/10.1111/1744-1633.12684","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"38"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544389","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":"10.1111/1744-1633.12685","DOIUrl":"https://doi.org/10.1111/1744-1633.12685","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"50-51"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544388","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 2023 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12682","DOIUrl":"https://doi.org/10.1111/1744-1633.12682","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"48-49"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544381","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":"Comparing the safety and effectiveness of surgical approaches in thymectomy","authors":"Rebecca Lau HonsBMSc,&nbsp;Katherine Aw HonsBMSc,&nbsp;Sami Aftab Abdul HonsBSc,&nbsp;Caitlin Anstee BA,&nbsp;Sebastien Gilbert MDCM,&nbsp;Daniel Jones MD, Msc,&nbsp;Andrew J. E. Seely MDCM, PhD,&nbsp;R. Sudhir Sundaresan MD,&nbsp;Patrick J. Villeneuve MDCM, PhD,&nbsp;Donna E. Maziak MDCM, MSc","doi":"10.1111/1744-1633.12688","DOIUrl":"10.1111/1744-1633.12688","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the safety and effectiveness of different surgical approaches in thymectomy: robotics, subxiphoid, lateral video-assisted thoracoscopy surgery (LVATS) and open.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We retrospectively reviewed 68 cases of thymectomy with a robot-assisted, subxiphoid, LVATS, open sternotomy or thoracotomy approach for thymic lesions or myasthenia gravis between July 2017 and May 2023 at a single centre. Peri-operative outcomes (operating time, estimated blood loss, conversion rates, R0 resection, adverse events and length of stay [LOS]) were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed six conversions to open (from five LVATS and one robot assisted). The median estimated blood loss was lower for LVATS (100.00 [50.0–100.0] mL) compared with open thymectomies (200.0 [150.0–400.0]; <i>P</i> &lt; .001). No intra-operative adverse events were reported in the robotics, subxiphoid or LVATS groups. In patients with thymic tumours (<i>n</i> = 34), R0 resection was achieved in 100% (2/2) of robotics, 83% of subxiphoid (5/6), 93% (13/14) of LVATS and 75% (<i>n</i> = 9/12) of open cases. The median LOS was shortest for robot assisted (1.0 [interquartile range (IQR) 1.0–3.0]), then subxiphoid (2.0 [IQR 1.0–3.0]), LVATS (2.0 [IQR 1.0–3.0]) then open (5.0 [IQR 4.0–6.0]; <i>P</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that with a shorter LOS, robotics, subxiphoid and LVATS thymectomies are safe. Larger size studies are required to compare R0 resection rates between these less invasive surgical approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"152-158"},"PeriodicalIF":0.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730570","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":"Use of surgical procedure manager to standardise operation steps and monitor surgeon performance in open repair of inguinal hernia","authors":"Yue Sun Cheung,&nbsp;Hon Ting Lok,&nbsp;Andrew Kai Yip Fung,&nbsp;Paul Bo San Lai","doi":"10.1111/1744-1633.12686","DOIUrl":"10.1111/1744-1633.12686","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study the feasibility of using surgical procedure manager (SPM), a digital checklist platform, to standardise surgical steps of open hernia repair and monitor the operative performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A retrospective study on all open mesh repair of inguinal hernia under local anaesthesia from September 2019 to November 2021 at the Prince of Wales Hospital was performed. The operative outcomes of patients having operations with or without the use of SPM were compared. Procedures using SPM had operation steps shown as a digital checklist inside the theatre. The time used for each surgical step was recorded and analysed. The operative performance of the surgeons was analysed by observing the trend of the mean operation time over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 123 patients were recruited, of which 52 were using the SPM. The median age of patients was 75 (range 49–93) years. A decreasing trend in the mean operation time for dissection, mesh placement, wound closure and total operation time was observed in surgeries using SPM. There was no significant difference in the operation time, theatre time, total length of stay, blood loss and readmission rate between the SPM and non-SPM groups. The proportion of basic surgical trainees as coached surgeons in the SPM group was significantly higher (SPM = 52% vs non-SPM = 28%, <i>P</i> = .07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of SPM did not significantly prolong the operation time and produce comparable operative outcomes in open hernia repair. It provided the additional advantage of standardising operation steps and monitoring the performance of surgical trainees during their training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"139-143"},"PeriodicalIF":0.3,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744493","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":"Diabetic mastopathy: A case report and literature review on a mimic of breast carcinoma in patients with diabetes","authors":"Wai Si Crystal Li MBChB,&nbsp;Shun Yan Chan MBBS","doi":"10.1111/1744-1633.12681","DOIUrl":"10.1111/1744-1633.12681","url":null,"abstract":"<p>Diabetic mastopathy is a rare benign breast condition that mimics breast carcinoma in patients with diabetes. Clinicians must differentiate it from malignant causes because of differences in prognosis and management. This paper presents a case report of an 87-year-old lady with type 2 diabetes and diabetic mastopathy. We also review the literature on the pathogenesis, clinical presentation, diagnostic workup and management of diabetic mastopathy.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"109-111"},"PeriodicalIF":0.3,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231104","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":"Colonoscopy combined with laparoscopy can improve post-operative quality of life in patients with colon cancer","authors":"Suyan Ding,&nbsp;Buluan Zhu,&nbsp;Tiantian Sun,&nbsp;Lili Qu","doi":"10.1111/1744-1633.12680","DOIUrl":"10.1111/1744-1633.12680","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The study aimed to elucidate the clinical efficacy of colonoscopy combined with laparoscopic radical resection for patients with colon cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cases with colon cancer were divided into the control group (received laparoscopic radical resection) and the experimental group (received colonoscopy combined with laparoscopic radical resection). Inflammatory cytokines’ levels and immune functions were evaluated before and after the operation. The 36-item Short Form Health Survey (SF-36) was used to evaluate the living quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to the control group, individuals in the experimental group had a shorter hospital stay and post-operative anal exhaust, and reduced intraoperative blood loss. Changes in serum interferon-gamma (IFN-γ), interleukin-8 (IL-8) and IL-10 levels were minimal in the experimental group. Serum CD3⁺%, CD4⁺% and CD4⁺/CD8⁺ values of the two groups were significantly decreased compared with the preoperative values, which increased more significantly in the experimental group relative to the control group. After the operation, individuals in the experimental group presented higher SF-36 scores than those in the experimental group. The experimental group presented a low incidence of post-operative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Colonoscopy combined with laparoscopic radical resection for colon cancer had only a little effect on immune function and inflammatory response. It can shorten the recovery time of patients and reduce post-operative complications, which is worthy of further clinical promotion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"132-138"},"PeriodicalIF":0.3,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232816","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}