Surgical Practice最新文献

{"title":"Surgical Practice August 2023 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12647","DOIUrl":"https://doi.org/10.1111/1744-1633.12647","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"27 3","pages":"199-200"},"PeriodicalIF":0.8,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50154497","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":"Robotic distal splenopancreatectomy","authors":"Andrea González De Godos,&nbsp;Pablo Marcos Santos,&nbsp;Pilar Pinto Fuentes,&nbsp;David Pacheco Sánchez","doi":"10.1111/1744-1633.12650","DOIUrl":"10.1111/1744-1633.12650","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The use of minimally invasive approaches for pancreaticobiliary surgery has recently gained wider acceptance. Surgical arms with unparalleled flexibility, manual dexterity, 3D imaging and tremor elimination have increased anatomical access and decreased the difficulty of surgery. We describe a case of mucinous cystadenoma treated with robotic distal splenopancreatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A 72-year-old woman presented with anorexia, nausea, constipation and weight loss of 9 kg in 3 months. Imaging and histological studies indicated it likely to be a mucinous cystadenoma of the body–tail of the pancreas. Robotic distal splenopancreatectomy was performed with intraoperative identification and splenic artery ligation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient made an uneventful recovery and was discharged on postoperative day 7. A pathology study confirmed mucinous cystadenoma with focal low-grade epithelial dysplasia and clear margins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Robotic distal pancreatectomy is a safe and feasible approach in appropriately selected patients. Although the procedural cost is higher with the robotic approach, some argue that this is balanced by the shorter overall length of stay, thus making robotic distal pancreatectomy a cost-effective option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"27 4","pages":"248-249"},"PeriodicalIF":0.8,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73286516","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":"A short report regarding an economic and anatomy-based simulated skin model","authors":"Billy Ho Hung Cheung,&nbsp;Valerie Wai Yee Ho,&nbsp;Kent-Man Chu","doi":"10.1111/1744-1633.12649","DOIUrl":"10.1111/1744-1633.12649","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conventionally, the Objective Structured Clinical Examination (OSCE) requires the recruitment of patients with appropriate physical signs, which became impossible during the fifth wave of the local COVID-19 pandemic. To host the final OSCE without any actual patients, our department developed a skin model from readily available materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>One of the final-year surgical OSCE stations focused on the identification and management of benign subcutaneous lesions, including sebaceous cysts (also called epidermal inclusion cysts) and lipomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> The design</h3>\u0000 \u0000 <p>The model starts with a low-cost skin model from Limbs &amp; Things (cost: US $6.9–10/piece). The sebaceous cyst model involved dissection of the superficial ‘skin’ flap. The lesion was re-created using gel held by a plastic wall created by a glove fingertip sealed off by silk sutures. Additional modifications were made to the lipoma model to differentiate these two types of lesions. The pass rate in this station was similar to that of actual patients. Assessment of the models by experienced surgeons showed that they were easy to differentiate and suitable for teaching and assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This anatomy-based, low-cost skin model is easily reproducible and might serve as a good adjunct for clinical year teaching and assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"27 4","pages":"244-247"},"PeriodicalIF":0.8,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76162638","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":"Arthroscopic repair of the supraspinatus tendon with single-stage decompression of the suprascapular nerve at the superscapular notch","authors":"A. R. Giniyatov, A. Ivanov, K. Egiazaryan, V. O. Tamazyan, A. P. Ratiev","doi":"10.38181/2223-2427-2023-2-6","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-6","url":null,"abstract":"The history of shoulder problems dates back to ancient times, and the shoulder joint plays a significant role in various aspects of human life. Throughout history, doctors have been providing assistance to individuals experiencing shoulder pain. In the 20th century, significant advancements were made in shoulder surgery, driven by an improved understanding of joint biomechanics and the recognition of new diagnostic methods. Arthroscopy, a minimally invasive surgical technique, was first used for diagnosing shoulder conditions only about 30 years ago. Since then, it has replaced many open surgical procedures due to its enhanced visualization capabilities and lower invasiveness, leading to reduced injury rates. Suprascapular nerve decompression at the suprascapular notch is an example of a procedure that has benefited from arthroscopy. Dr. Laurent Lafosse's detailed description of arthroscopic manipulation in 2007 has been crucial in advancing this technique.This article aims to shed light on the pathogenesis of suprascapular nerve compression at the suprascapular notch following supraspinatus tendon retraction and examine the potential complications of suprascapular neuropathy. The principal author of this article has successfully performed 20 supraspinatus tendon repair operations with simultaneous decompression of the suprascapular nerve at the suprascapular notch, achieving positive outcomes in the postoperative period.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"9 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81210079","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":"Distal biceps tendon ruptures: clinical features, diagnostic strategy and treatment options","authors":"K. Egiazaryan, A. P. Ratiev, D. S. Ershov, O. A. Okhanov, E. S. Mikhaylova","doi":"10.38181/2223-2427-2023-2-5","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-5","url":null,"abstract":"Relevance. This paper reviews the latest evidence concerning distal biceps tendon repair, particularly aspects such as tear type, patient demographics, diagnostic clues, surgical indications, the anatomy of distal tendon insertion, radial tuberosity, single- vs double-incision reconstruction, fixation techniques (bone tunnels, distal biceps button, interference screw, button plus screw) and postoperative outcomes.Material and methods. The MEDLINE, Cochrane, Web of Science, Scopus and Elibrary online databases were searched using the keywords ‘distal biceps tendon’, ‘elbow’, ‘intramedullary’, ‘partial’. ‘complete’, ‘review’ and ‘rupture’. Sixty publications on distal biceps tendon rupture treatment were identified that appeared over 60 years, between 1951 and October 2021.Results and discussion. The review has demonstrated that complete deltoid ligament (DBT) tears are predominantly diagnosed clinically, while medical imaging has proven to be a valuable adjunct for diagnosing partial tears. Advances in clinical and medical imaging of partial tears have the potential to expedite the diagnostic process and guide treatment strategies. Primary repair is commonly employed for complete tears, utilizing either a single-incision or double-incision approach, resulting in favorable clinical outcomes. However, the double-incision technique carries a higher risk of heterotopic ossification, whereas the single-incision approach presents a greater risk of nerve-related complications. To mitigate the risk of posterior interosseous nerve lesions in single-incision repairs, intramedullary fixation may serve as a viable solution. Additionally, DBT endoscopy holds promise for the treatment of low-grade partial tears and tendinosis.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"68 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81456479","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":"A prediction model for after postoperative outcome in SARS-CоV-2 patients: a retrospective observation study","authors":"L. K. Orbelyan, V. M. Durleshter, N. Trembach, S. V. Sinkov, M. M. Rogal, O. V. Vysotskii, E. S. Babenko, D. S. Murashko","doi":"10.38181/2223-2427-2023-2-4","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-4","url":null,"abstract":"Introduction. Coronavirus infection can complicate the perioperative course of any surgical intervention, posing an acute problem in surgical patients with COVID-19. At the same time, the risk factors and their contribution to the adverse outcome remain obscure.Objectives. This study aims to identify risk factors for postoperative death in patients diagnosed with SARS-CoV-2.Materials and methods. The study offers a retrospective analysis of data from 1029 patients at the Krasnodar Regional Clinical Hospital № 2, which had been converted into a COVID-19 treatment facility.Results. A total of 421 (41 %) patients underwent high-risk surgery. Mortality in the study cohort reached 21.2 %. Factors such as the ASA baseline physical status, age, surgery duration and the degree of lung damage seen on CT scans (CT-3 and CT-4) serve as independent predictors of death. Using these parameters makes it possible to predict perioperative mortality with high accuracy (AUROC = 0.814).Conclusion. The study examined risk factors for poor outcomes in surgery patients with COVID-19 and developed a model to predict death in this group of patients. The frequency of adverse outcomes after surgical treatment of patients with SARS-CоV-2 was relatively high, the predictors of death being advanced age, baseline physical status, surgery severity and duration, as well as the volume of lung damage seen on CT scans. The developed model allows accurate prediction of an unfavourable outcome.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"32 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78762818","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":"Results of preoperative application of micronised purified flavonoid fraction as part of a multimodal analgesic regimen in anorectal surgery: a prospective, randomised, placebo-controlled, double-blind study","authors":"T. Garmanova, D. Markaryan, E. Kazachenko, R. Ishchenko, A. Lukyanov, D. A. Krivonosova, M. Agapov","doi":"10.38181/2223-2427-2023-2-2","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-2","url":null,"abstract":"This study aims to assess the efficiency of micronised purified flavonoid fraction (MPFF) administration prior to open haemorrhoidectomy on postoperative pain severity reduction.Methods. The prospective clinical study involved patients with haemorrhoidal disease. Participants were randomly divided into two groups: the first one received 1000 mg of MPFF (Detralex®) 15 days before surgery, seven days after surgery, according to the acute haemorrhoid treatment scheme, and 1000 mg per day until 30 days after surgery; the second one received a placebo. The primary endpoint was the frequency of opioid intake.Results. The study included 182 participants (102 and 82 in the experimental and control group, respectively). Postoperative pain at rest and during defecation was significantly lower in the experimental group on days 6—9 postoperatively (p < 0.05). The use of opioids and other NSAIDs after surgery did not differ between groups. There was no significant difference between groups in side effects frequency and time to return to the usual lifestyle. As for the quality of life, the control group had significantly higher levels of self-care difficulty, anxiety and lingering pain/discomfort, being more likely to suffer from other persistent complaints.Conclusion. The preoperative administration of MPFF as analgesia has demonstrated safety and efficacy, effectively reducing postoperative pain in anorectal surgery while avoiding an increase in side effects. Hence, it is recommended for routine implementation in patient care as an essential component of multimodal analgesia during anorectal surgery.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"3 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90119751","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":"Recent advances in the surgical treatment of malignant liver tumours: a review","authors":"V. Pelts, V. Pavlenko, V. E. Tropin, A. O. Krasnov, E. V. Rudaeva","doi":"10.38181/2223-2427-2023-2-7","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-7","url":null,"abstract":"This article reviews unresolved problems in the surgical treatment of primary and metastatic liver cancer and ways to overcome them. The state of affairs in liver surgery calls for new patient-oriented rational surgical tactics, the use of patient-oriented methods of diagnosis and surgical treatment of malignant liver tumours, as well as multidisciplinary therapeutic and diagnostic approaches.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"7 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77367527","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":"Organ-sparing resection techniques in the treatment of liver echinococcosis","authors":"A. O. Krasnov, V. V. Anishchenko, I. V. Pachgin, K. A. Krasnov, V. Pelts, O. A. Krasnov, V. Pavlenko","doi":"10.38181/2223-2427-2023-2-1","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-1","url":null,"abstract":"This study aims to present and evaluate the results of treating surgery patients using organsparing resection interventions for liver echinococcosis.Material and methods. The study presents the results of treating 103 patients (51/49.6 % males, 52/50.6 % females) who have undergone total radical pericystectomy/atypical liver resection for liver echinococcosis. Patients were divided into two groups: Group 1, with interventions performed through laparotomic access (n = 84), and Group 2, with interventions using laparoscopic techniques (n = 19).Results. In the abdominal intervention group, there was no statistically significant advantage in the rate of parenchyma dissection between different methods (p > 0.05). The average time of haemostasis without the Tachocomb haemostatic substance applied showed a lower value (p = 0.17). The average blood loss during the Pringle manoeuvre was significantly lower (p = 0.043).There was no statistically significant advantage in the laparoscopic intervention group as regards the rate of parenchyma dissection (p = 0.74). The average haemostasis time was significantly shorter in patients using the Floseal haemostatic matrix than those treated otherwise (p = 0.001). In patients with the improved laparoscopic Pringle manoeuvre, blood loss was significantly less than in those who had not undergone the technique (p = 0.00008).No statistically significant differences were observed (p = 0.76) when comparing the percentages of nonspecific complications in the two groups. The average value of postoperative bed-day was significantly lower in the laparoscopic surgical treatment group (p = 0.00001).Conclusion. Using the Pringle maneuver when performing abdominal and laparoscopic interventions statistically proved its effectiveness. The use of the Floseal haemostatic matrix during laparoscopic operations allowed a statistically significant reduction in the time of haemostasis and intraoperative bleeding. The duration of the operation and the time of dissection of the parenchyma in the laparoscopic surgery were significantly higher (p < 0.05). The immediate results of the laparoscopic and abdominal interventions proved comparable.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"44 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77614371","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":"Reliability of self-assessment of quality of life in patients with hiatal hernia associated with gastroesophageal reflux disease after videolaparoscopic anti-reflux surgery","authors":"В. И. Оскретков, Е. А. Цеймах, А. Р. Андреасян, М. А. Григорян, С. А. Масликова, I. Prof.Vladimir, Osretkov, A. Prof.Evgeniy, Tseymach, Armen R. Andreasyan, M. Grigoryan, S. Maslikova","doi":"10.38181/2223-2427-2023-2-3","DOIUrl":"https://doi.org/10.38181/2223-2427-2023-2-3","url":null,"abstract":"This article aims to investigate the reliability of self-assessment of the quality of life in patients with hiatal hernia after undergoing videolaparoscopic anti-reflux intervention. To achieve this, the responses to a questionnaire were compared with the results of a study on the failure of the cardia anti-reflux mechanism.Materials and methods. A total of 213 patients who underwent videolaparoscopic oesophagus fundoplication were included in this study. The participants completed three questionnaires: GORD-HRQL, GIQLI, and SF-36. The responses obtained from the questionnaires were then compared with the results of a cardia anti-reflux mechanism study, which involved X-ray endoscopy of the oesophagus and stomach, daily oesophageal pH-metry, and oesophagogastric junction manometry. Based on the responses to the three questionnaires, the quality of life index was calculated for all patients. Additionally, a composite index of cardia anti-reflux mechanism failure was computed to assess the severity of pathological gastro-oesophageal reflux and describe the effectiveness of the cardia anti-reflux mechanism in preventing it.Results. The comparison of the components forming the integral quality of life index with the composite index of cardia anti-reflux mechanism failure before and after the operation revealed an inverse relationship: as the values of the integral quality of life index decreased, the values of the composite index of cardia anti-reflux mechanism failure increased.Conclusion. The self-assessment of the quality of life by patients with GORD-associated hiatal hernia after anti-reflux intervention, as assessed through GORD-HRQL, GIQLI, and SF-36 questionnaires, is accurate and can be effectively utilized for screening and diagnosing disease recurrence.","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81729056","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}