Open Access Surgery最新文献

{"title":"Glycemic control in critically ill surgical patients: risks and benefits","authors":"K. Mukherjee, Vance L. Albaugh, J. Richards, Kelli A. Rumbaugh, A. May","doi":"10.2147/OAS.S50416","DOIUrl":"https://doi.org/10.2147/OAS.S50416","url":null,"abstract":"Glucose metabolism in humans is exceedingly complex. At baseline, it is controlled by elaborate signaling mechanisms, and these mechanisms are profoundly altered by the surge of catecholamines and cytokines associated with acute postsurgical and post-traumatic stress. These alterations in signaling mechanisms result in hyperglycemia; although this hyperglycemia can start very rapidly after the traumatic or surgical insult, it can persist during the entire period of critical illness and even afterward. Numerous randomized clinical trials have been conducted to determine if hyperglycemia is associated with increased mortality in surgical patients. These studies have had different conclusions that are difficult to interpret in light of differences in study methodology, but there is certainly ample evidence that inadequately controlled hyperglycemia causes harm due to increased infectious morbidity, and possibly increased mortality. As we have become more proficient in controlling hyperglycemia, the concept of insulin resistance, determined as the amount of insulin required to achieve hyperglycemia, has come to the fore. Insulin resistance is not a static concept, and may change before significant events such as infection. Patients with elevated and persistent insulin resistance have been demonstrated to suffer increased infectious morbidity and mortality, albeit in nonrandomized studies. Along with insulin resistance, the concept of glycemic variability, the amount of variation in serum blood glucose over time, has also become relevant; increased variability has been associated with hypoglycemia and mortality. Both of these risks can result from aggressive insulin therapy, and glycemic control protocols must be appropriately planned and implemented to avoid hypo- glycemia and excessive externally induced variability. Computer-assisted protocols may be of significant benefit in optimizing glycemic control. The most recent recommendations available are to keep serum blood glucose levels below 150 mg/dL and to avoid hypoglycemia.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"27-42"},"PeriodicalIF":1.0,"publicationDate":"2015-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S50416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424655","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":"Early abdominal closure using component separation in patients with an open abdomen after trauma: a pilot study","authors":"K. Chopra, K. Tadisina, Jamil A. Matthews, J. Sabino, Devinder Singh, W. Habre","doi":"10.2147/OAS.S47805","DOIUrl":"https://doi.org/10.2147/OAS.S47805","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 21–26 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"21-26"},"PeriodicalIF":1.0,"publicationDate":"2015-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S47805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424215","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":"How many meals should you skip before undergoing a colonoscopy? A randomized controlled trial: association between duration of abstinence from solid food to cleanliness of the bowel in patients undergoing elective colonoscopy","authors":"D. Aziz, Loh H Peow, Jasiah Zakaria, Mahmud Mohd Nor, Z. Latiff","doi":"10.2147/OAS.S74996","DOIUrl":"https://doi.org/10.2147/OAS.S74996","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 9–20 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"9-20"},"PeriodicalIF":1.0,"publicationDate":"2015-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S74996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425406","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":"Ex vivo and in vivo evaluation of an ultrasonic device for precise dissection, coagulation, and transection","authors":"Brian D. Bertke, P. Scoggins, Alissa L. Welling, Tamara V. Widenhouse, Chaoyang Chen, S. Kallakuri, J. Cavanaugh, J. Clymer, Joseph F. Amaral","doi":"10.2147/OAS.S73851","DOIUrl":"https://doi.org/10.2147/OAS.S73851","url":null,"abstract":"Background: A new ultrasonic device, Harmonic Focus ® + , has been developed that is smaller and delivers energy more efficiently than its predecessor via the inclusion of Adaptive Tissue Technology. This study was undertaken to compare its dissection capabilities to an advanced bipolar electrosurgery device in benchtop and preclinical evaluations. Methods: In ex vivo testing, Focus + and LigaSure™ Small Jaw were evaluated for physical dimensions, device and tissue temperature after repeated applications to porcine jejunum, and burst pressure of vessel seals, transection time, and tissue sticking in 3–5 mm porcine carotid arteries. In in vivo testing, the devices were tested on intact porcine carotid arteries for thermal damage via collagen denaturation and in muscle incisions near rat sciatic nerve for acute inflammation via hematoxylin and eosin and for impaired axonal transport via β -APP. Results: Focus + was smaller than the Small Jaw in width and height, yet it had a longer active blade and larger jaw aperture. Device temperatures were not different after application, but thermal spread (tissue temperature above 50 ° C) was 78% greater for Small Jaw (9.6 mm) than for Focus + (5.4 mm). Burst pressures of sealed vessels were not significantly different between the devices: 900 ( ± 466) mmHg for Focus + versus 974 ( ± 500) mmHg for Small Jaw. Small Jaw had a shorter individual transection time (5.0 seconds compared to 6.3 seconds for Focus + ), whereas Focus + had 70% less tissue sticking. Thermal damage, neural inflammation, and impaired axonal transport were all significantly lower for Focus + compared to Small Jaw, by 19%, 57%, and 50%, respectively. Conclusion: With the addition of Adaptive Tissue Technology, Harmonic Focus + builds upon the manifold advantages of ultrasonic devices in procedures requiring meticulous dissecting capability. Improvements in energy sensing and controlled delivery produce lower tissue temperatures and less thermal damage, especially critical when working near nerves. Focus + produces vessel seal strengths equivalent to advanced bipolar devices and, although individual device activations are longer, the reduction in tissue sticking is expected to materially lessen operative time in clinical practice.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"8 1","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2014-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S73851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68425323","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":"Advances in abdominal access for laparoscopic surgery: a review","authors":"M. Ogaick, G. Martel","doi":"10.2147/OAS.S47328","DOIUrl":"https://doi.org/10.2147/OAS.S47328","url":null,"abstract":"There are several laparoscopic surgery abdominal wall access techniques. The most useful and well-established is the open Hasson technique. The Veress needle closed technique is another alternative, but its use is controversial owing to possibly higher rates of rare insertion complications. Optical trocars have been developed in an attempt to decrease complication rates even further, although the evidence base supporting their use is limited. Single-incision laparo- scopic surgery (SILS) is used in certain centers to carry out various abdominal surgeries, but most commonly appendectomy and cholecystectomy. To date, SILS appears safe and feasible, with possibly greater costs and operative time. Natural orifice translumenal endoscopic surgery (NOTES) is an evolving area of incisionless surgery. While some progress has been made in achieving transgastric or transvaginal peritoneal endoscopic access, this technique remains","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"7 1","pages":"81-88"},"PeriodicalIF":1.0,"publicationDate":"2014-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S47328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424150","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":"Fibrin sealant patches: powerful and easy-to-use hemostats","authors":"W. Spotnitz","doi":"10.2147/OAS.S41516","DOIUrl":"https://doi.org/10.2147/OAS.S41516","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 2014:7 71–79 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"7 1","pages":"71-79"},"PeriodicalIF":1.0,"publicationDate":"2014-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S41516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424177","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":"Laparoscopic partial nephrectomy: state of the art review","authors":"I. Faiena, C. Han, E. Olweny","doi":"10.2147/OAS.S40275","DOIUrl":"https://doi.org/10.2147/OAS.S40275","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 2014:7 59–69 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"99 1","pages":"59-69"},"PeriodicalIF":1.0,"publicationDate":"2014-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S40275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68423938","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":"Robotic radical cystectomy in bladder cancer: is it the future?","authors":"A. Canda, A. Atmaca, M. Arslan, M. Keske, O. U. Cakici, S. Çakmak, D. Kamaci, Emre Urer","doi":"10.2147/OAS.S42290","DOIUrl":"https://doi.org/10.2147/OAS.S42290","url":null,"abstract":"Open radical cystectomy (RC) is the gold standard surgical approach in the management of muscle invasive bladder cancer in addition to high-grade, recurrent, noninvasive tumors. With the development of surgical robotic technology, robotic-assisted laparoscopic radical cystectomy (RARC) is increasingly being performed as a minimally invasive surgical approach. A learning curve exists with a recommended case number of at least 20 RARC procedures in order to achieve satisfying outcomes in terms of operation time, complication rate, and onco- logical outcomes, including positive surgical margins (SMs) and lymph node (LN) yield. In the current literature, long-term outcomes of RARC are not yet available. Due to the outcomes of the published literature, RARC seems to have satisfactory oncologic and functional outcomes in addition to acceptable complication rates. Intraoperative blood loss and transfusion rates seem to be decreased in RARC series when compared to open approaches. On the other hand, a number of authors have reported decreased complication rates but increased operation time in the robotic approach. Similar oncologic results including positive SM rates and LN yields were detected in most comparative publications. Totally intracorporeal RARC with urinary diversion is a complex procedure and the number of centers performing this type of surgery is currently very limited. Although, it is still too early to make strict conclusions about RARC, RARC with intracorporeal urinary diversion has the potential to be the future of robotic bladder cancer surgery. Therefore, further prospective and randomized studies with increased numbers of patients and with longer follow-up are needed. Lastly, RARC may be related to increased cost when compared to open surgery, although controversial reports exist about this issue.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"7 1","pages":"47-57"},"PeriodicalIF":1.0,"publicationDate":"2014-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S42290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424277","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":"Longitudinal sleeve gastrectomy: current perspectives","authors":"E. Soricelli, G. Casella, G. Rocco, A. Redler, N. Basso","doi":"10.2147/OAS.S41497","DOIUrl":"https://doi.org/10.2147/OAS.S41497","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 2014:7 35–46 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"7 1","pages":"35-46"},"PeriodicalIF":1.0,"publicationDate":"2014-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S41497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68424101","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":"Transcatheter closure of secundum atrial septal defect in adults: report of our first experience in a developing country","authors":"A. Animasahun, Yele Aluko, Adeyemi Johnson, K. Ogunyankin, S. Maheshwari","doi":"10.2147/OAS.S38204","DOIUrl":"https://doi.org/10.2147/OAS.S38204","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 2014:7 29–33 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"12372 1","pages":"29-33"},"PeriodicalIF":1.0,"publicationDate":"2014-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S38204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68423915","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}