Open Access Surgery最新文献

{"title":"Diagnostic difficulties and therapeutic choices in intrapancreatic accessory spleen: case reports","authors":"M. Massani, P. Maccatrozzo, G. Morana, L. Fabris, C. Ruffolo, L. Bonariol, B. Pauletti, N. Bassi","doi":"10.2147/OAS.S86394","DOIUrl":"https://doi.org/10.2147/OAS.S86394","url":null,"abstract":"because of a mass of the pancreatic tail misdiagnosed as a pancreatic neuroendocrine tumor due to its radiologic features on computed tomography and magnetic resonance imaging (MRI) (small, ovoidal, and well defined). Misdiagnosis also occurred in the second case, in which an 82-year-old woman was referred to our hospital because of a pancreatic mass of uncertain diagnosis. She also underwent an operation, and pathologic examination showed splenic parenchyma. A correct diagnosis was achieved in the remaining three cases that are still under radiologic monitoring. Discussion: IPAS is a benign entity and therefore does not require surgical treatment. We discuss the best diagnostic options that have recently been experienced, focusing on diffusion-weighted and superparamagnetic iron oxide MRI, which in our experience seem to be the safest and most easily accessible diagnostic tools. Conclusion: We suggest that a multidisciplinary approach should guide the diagnosis. When a pancreatic mass with specific features (round, ovoid, and well defined) is detected by computed tomography or MRI, an IPAS should be suspected.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"9 1","pages":"15-20"},"PeriodicalIF":1.0,"publicationDate":"2016-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S86394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions","authors":"Benjamin Phillips","doi":"10.2147/OAS.S54936","DOIUrl":"https://doi.org/10.2147/OAS.S54936","url":null,"abstract":"Various techniques and interventions have been developed in an effort to obviate gas- trointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and sur - gical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. Buttressing of anastomoses with omentum has proven utility for esophageal surgery. Further recommendations include 5-7 days of immune-modifying nutritional supplementation for malnourished patients, discontinuation of smoking in the perioperative period, limiting steroid use, utilization of oral antibiotic preparation for colorectal surgery, avoidance of early operations (,4 weeks) following","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"95 1","pages":"5-14"},"PeriodicalIF":1.0,"publicationDate":"2016-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S54936","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullet to the femoral head","authors":"Krishna Akella, Nupur Murthy, Phoenix D Bell, A. Chendrasekhar","doi":"10.2147/OAS.S96097","DOIUrl":"https://doi.org/10.2147/OAS.S96097","url":null,"abstract":"A bullet being lodged in the femoral head is a unique trauma situation, which can be managed either operatively or non-operatively. We present two different scenarios of a bullet being lodged in the femoral head with a discussion of both operative and non-operative manage- ment as well as diagnostic considerations.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"9 1","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2016-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S96097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal wound closure: current perspectives","authors":"Z. Williams, W. Hope","doi":"10.2147/OAS.S60958","DOIUrl":"https://doi.org/10.2147/OAS.S60958","url":null,"abstract":": This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"89-94"},"PeriodicalIF":1.0,"publicationDate":"2015-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S60958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative management of facial bipartition surgery","authors":"M. Caruselli, M. Tsapis, F. Ughetto, G. Pech-gourg, D. Galante, O. Paut","doi":"10.2147/OAS.S80036","DOIUrl":"https://doi.org/10.2147/OAS.S80036","url":null,"abstract":": Severe craniofacial malformations, such as Crouzon, Apert, Saethre-Chotzen, and Pfeiffer syndromes, are very rare conditions (one in 50,000/100,000 live births) that often require corrective surgery. Facial bipartition is the more radical corrective surgery. It is a high-risk intervention and needs complex perioperative management and a multidisciplinary covered. including and major","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"85-87"},"PeriodicalIF":1.0,"publicationDate":"2015-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S80036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decompressive craniectomy in the management of traumatic brain injury: a review of current practice","authors":"W. Mezue, C. Ndubuisi","doi":"10.2147/OAS.S52742","DOIUrl":"https://doi.org/10.2147/OAS.S52742","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Open Access Surgery 2015:8 73–83 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"73-83"},"PeriodicalIF":1.0,"publicationDate":"2015-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S52742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilonidal sinus - challenges and solutions","authors":"A. Guner, A. Çekiç","doi":"10.2147/OAS.S54939","DOIUrl":"https://doi.org/10.2147/OAS.S54939","url":null,"abstract":"Although it is clinically asymptomatic in some cases, pilonidal sinus disease may also present as a complicated disease, characterized by multiple sinus tracts, leading to severe impairment of patient quality of life. Although clinical studies of pilonidal sinus have been conducted for approximately a century, the gold standard for treatment is undefined. The ideal treatment requires a shorter hospital stay, requires less wound care, results in rapid recovery, maintains quality of life, and has low recurrence rates. In this review, we aim to discuss the challenges and possible solutions for the management of pilonidal sinus disease.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"89 1","pages":"67-71"},"PeriodicalIF":1.0,"publicationDate":"2015-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S54939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrared parietal colorectal flowmetry: a new application of the pulse oximeter. is this method useful for general surgeons in preventing anastomotic leakage after colorectal resections?","authors":"R. Delfrate, Massimo Bricchi, P. Forti, C. Franceschi","doi":"10.2147/OAS.S81138","DOIUrl":"https://doi.org/10.2147/OAS.S81138","url":null,"abstract":"Background: Anastomotic leak is a major complication of colorectal surgery. Among the causes of dehiscence, anastomotic ischemia seems to be fundamental and consequently so is the evaluation of the parietal flow. We proposed a new application of infrared flowmeter for the evaluation of the parietal flow at the stumps after colon resection. Objective: The aim of this study is to assess the feasibility of using an intraoperative intestinal wall flowmeter to assess arterial capillary flow in order to avoid the execution of anastomoses in poorly vascularized segments of bowel, and consequently to reduce the risk of anastomotic leakage. Methods: Retrospective analysis of two groups of patients with different methods of evaluation of colon resection stump vascularization. Ninety-two consecutive patients (Group A) underwent surgical colorectal resection for cancer. In this group, we used a pulse-oximetry sensor to assess the parietal flow: once the magnitude of the colon resection was established according to surgi cal and oncological criteria, the exact location of the resection was adjusted according to the parietal flowmetry curve. This method was compared with 139 consecutive colorectal resections (Group B) in which vascularization was assessed by checking the pulsatility of the mesenteric arteries, macroscopic wall resection stump appearance, and bleeding of the wall stump. The main outcome measure was the reduction in anastomotic dehiscence. Results: In Group A no anastomotic leakage occurred (0/92). Conversely, in Group B six anastomotic leaks occurred (6/139). The statistical analysis of the two groups thanks to the Fisher’s exact test shows that P,0.05, which is statistically significant. Conclusion: We tested a new application of the pulse oximeter: the evaluation of the colon parietal flow (infrared parietal flowmeter). The infrared parietal flowmetry appears to be a fea sible, simple, and low-cost method, able to detect the vascularization of the large bowel stump; for this reason this procedure appears to be useful in order to avoid a colon anastomosis of two poorly vascularized bowel stumps, thus reducing the risk of anastomotic leakage. Despite the positive results of our experience in the assessment of the intestine vascularization with the intraoperative infrared stump flowmeter, the possibility of reducing the number of anastomotic","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"61-65"},"PeriodicalIF":1.0,"publicationDate":"2015-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S81138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of excess skin after massive weight loss: challenges and solutions","authors":"S. Giordano","doi":"10.2147/OAS.S62235","DOIUrl":"https://doi.org/10.2147/OAS.S62235","url":null,"abstract":": The advent of bariatric surgery has led to a subspecialty in plastic surgery for skin and fat contouring which remain after massive weight loss. The author discusses the preoperative assessment, surgical treatment plan, postoperative management, possible complications, and benefits of postbariatric surgery. Preoperative planning includes medical history and patient assessment. Surgical procedures for brachioplasty, upper back lift, breast reshaping, abdominoplasty, panniculectomy, lower back lift, and thigh lift are discussed. Indications, postoperative complications, and benefits are also discussed. The best candidates for postbariatric plastic surgery are those who have achieved weight loss stability with a BMI of 32 or less and who have adequate nutrition in order to heal the surgical excisions. Abdominal and truncal deformity are the most common presenting complaints in massive weight loss patients, and the procedure of choice to address this region is a body lift. Postoperative care focuses on patient safety, pri-oritizing in deep venous thrombosis (DVT) prophylaxis and seroma prevention. Postbariatric body contouring aims to correct the deformity due to the excess of skin after massive weight loss and to restore a sense of normalcy.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"60 1","pages":"51-60"},"PeriodicalIF":1.0,"publicationDate":"2015-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S62235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of surgeon fatigue by surgical simulators","authors":"Khaled Tuwairqi, J. Selter, S. Sikder","doi":"10.2147/OAS.S77711","DOIUrl":"https://doi.org/10.2147/OAS.S77711","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Open Access Surgery 2015:8 43–50 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"43-50"},"PeriodicalIF":1.0,"publicationDate":"2015-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S77711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}