Acta Chirurgica Belgica最新文献

{"title":"Teaching humanitarian surgery: filling the gap between NGO needs and subspecialized surgery through a novel inter-university certificate.","authors":"Maximilien Thoma, Lynette Dominguez, Martial Ledecq, Jean-Paul Goolaerts, Réginald Moreels, Innocent Nyaruhirira, Jean-François Brichant, Thierry Roumeguere, Raymond Reding","doi":"10.1080/00015458.2020.1846943","DOIUrl":"10.1080/00015458.2020.1846943","url":null,"abstract":"<p><strong>Background: </strong>Access to surgical care is a global health burden. A broad spectrum of surgical competences is required in the humanitarian context whereas current occidental surgical training is oriented towards subspecialties. We proposed to design a course addressing the specificities of surgery in the humanitarian setting and austere environment.</p><p><strong>Method: </strong>The novelty of the course lies in the implication of academic medical doctors alongside surgeons working for humanitarian non-governmental organizations (NGO). The medical component of the National Defense participated regarding particular topics of war surgery. The course is aimed at trained surgeons and senior residents interested in participating in humanitarian missions.</p><p><strong>Results: </strong>The program includes theoretical teaching on surgical knowledge and skills applied to the austere context. The course also covers non-medical aspects of humanitarian action such as international humanitarian law, logistics, disaster management and psychological support. It comprises a large-scale mass casualty exercise and a practical skills lab on surgical techniques, ultrasonography and resuscitation. Attendance to the four teaching modules, ATLS certification and succeeding final examinations provide an interuniversity certificate. Thirty participants originating from 11 different countries joined the course. Various surgical backgrounds, training levels as well as humanitarian experience were represented. Feedback from the participants was solicited after each teaching module and remarks were applied to the following session. Overall participant evaluations of the first-course session are presented.</p><p><strong>Conclusion: </strong>Teaching humanitarian surgery joining academic and field actors seem to allow filling the gap between high-income country surgical practice and the needs of the humanitarian context.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38726741","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":"An early report of using protecting gloves by Ḥakim Mohammad, a Persian surgeon (16th century CE).","authors":"Narges Tajik, Zahra Ghahremani, Sobhan Ghezloo, Shahrzad Irannejad, Arman Zargaran","doi":"10.1080/00015458.2025.2489802","DOIUrl":"10.1080/00015458.2025.2489802","url":null,"abstract":"<p><strong>Background: </strong>Although using gloves in surgery dates back to the nineteenth century in modern medicine, it seems that the earliest evidence can be found in the Middle Ages.</p><p><strong>Methods: </strong>It is a library research-based study on the book of <i>Ḏaḫīre-ye Kāmele</i>, written by Ḥakim Mohammad (Ḥakīm Muhammad), a Persian surgeon in the sixteenth century.</p><p><strong>Results: </strong>Ḥakim Mohammad advises the surgeons to use a sheath made of sheep testicle skin for their fingers when examining a wound and putting ointment and bandage on it to protect oneself from diseases that are transmitted through the skin and blood, such as people with wounds whose wounds are caused by smallpox, anthrax, leprosy and infectious wounds.</p><p><strong>Conclusion: </strong>The words of Ḥakim Mohammad suggest a preliminary concept of using surgical gloves to prevent transmitted diseases, dating back to sixteenth century, 3 centuries before its use in modern era.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771001","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":"Incidental finding of giant dedifferentiated liposarcoma of the spermatic cord: case report and review of the literature.","authors":"Andreas Bouckaert, Bruno Bamelis, Lieven Dedrye, Stefan Sohier, Anneleen Verbrugghe, Johan Fierens","doi":"10.1080/00015458.2025.2481696","DOIUrl":"https://doi.org/10.1080/00015458.2025.2481696","url":null,"abstract":"<p><strong>Introduction: </strong>Giant dedifferentiated liposarcomas of the spermatic cord are a rare and aggressive entity. Both large size and dedifferentiated liposarcoma histology implicate a poorer prognosis with a high risk of recurrence and metastasis.</p><p><strong>Methods: </strong>This is a retrospective case report. We describe a 58-year-old patient who presented with a hemodynamic collapse, caused by a high gastro-intestinal bleeding. A giant inguinoscrotal mass challenged the diagnostic path.</p><p><strong>Results: </strong>A combined abdominal and scrotal approach was used to remove the giant mass (26x15x11cm, 1.617kg) en bloc with the right testicle and spermatic cord. Pathological examination showed a giant dedifferentiated liposarcoma (FNCLCC grade 2), with a microscopically complete resection. Follow-up at 24 months showed no locoregional recurrence or distant metastasis.</p><p><strong>Conclusion: </strong>Radical surgery remains the cornerstone of treatment for retroperitoneal liposarcoma. Microscopically complete resection is an important positive prognostic indicator for risk of recurrence. Rigorous follow up is necessary, considering the high risk for recurrence. This patient illustrates the challenge of not allowing the giant inguinoscrotal mass to draw away all attention from a life-threatening high gastro-intestinal bleeding.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794337","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":"Let us ask the patient: psychological well-being from a patients'-perspective due to postponed care of cardiac surgery during the COVID-19 lockdown.","authors":"Ashley Welch, Jan Nijs, Ines Van Loo, Marina Mallefroy, Mark La Meir","doi":"10.1080/00015458.2021.1917749","DOIUrl":"10.1080/00015458.2021.1917749","url":null,"abstract":"<p><strong>Introduction: </strong>The onset of the COVID-19 pandemic has forced a rapid and extensive change in the need of intensive care beds. Therefore, we decided early in the pandemic to suspend all elective cases of cardiac surgery and closed the ambulatory clinic. The effect of this strategy on the mental well-being of the non-COVID-19 patients is unknown. The aim of this study is to assess whether planned or operated patients suffered from either anxiety or depression by their altered medical care trajectory and if their score influenced decision-making. The findings intend to anticipate individual needs during subsequent waves of the COVID-19 pandemic.</p><p><strong>Methods: </strong>The patient population consisted of two groups. The first group included planned patients whose operation date was delayed; in the second group, the postoperative control visit was postponed. Both groups received a twofold questionnaire. Part one was the Hospital Anxiety and Depression scale, part two a series of questions on the influence of the COVID-19 pandemic on cardiac surgical care from a patient's perspective.</p><p><strong>Results: </strong>The study population was composed of 46 patients (63% men). Most of them (82.6%) would like the surgery to be performed as fast as possible, even before the end of the first wave of COVID-19-related hospitalizations. Of all patients 30.4% have avoided to consult a physician because of fear and 34.8% consulted a physician by phone call. When they physically consulted a physician, there was a prominent role for the general practitioner (41.3% went to the GP vs 19.6% to the specialist). Most (58.7%) of the patients would have liked a (tele)consultation with the cardiac surgeon.</p><p><strong>Conclusions: </strong>Regardless of the HADS, one can state that a closer follow-up using telemedicine during the pandemic is expected by all patients. All patients prefer their surgery to take place even during a pandemic.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"90-94"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39052945","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":"Image of the month: wooden branch ingestion crossing the mediastinum.","authors":"Mahaudens M, Gumus A, Brunée L, Poncelet P-A, Dasnoy D, Schraverus P","doi":"10.1080/00015458.2025.2484885","DOIUrl":"10.1080/00015458.2025.2484885","url":null,"abstract":"<p><p>A 33-year-old patient was managed in the emergency room. After right thoracic drainage for a pneumothorax, intubation for hypoxemia, and extraction of wooden foreign bodies from his mouth, a full-body scan identified a 6 mm diameter tubular-shaped structure extending from the nasopharynx to the retroperitoneum, passing through the mediastinum, in between major cardiovascular structures and organs. Cardiothoracic surgeons performed a sternotomy to remove the foreign body, which was identified as a long tree branch, without finding any major collateral anatomical damage. The cause of this ingestion was attributed to psychiatric delirium. Post-operative care included prolonged antibiotic therapy, one drainage surgery, and intensive rehabilitation, ultimately leading to a slow and progressive recovery. This unique case of tree branch ingestion crossing the mediastinum in an adult is astounding as the patient survived remarkably this life-threatening self-inflicted trauma. Furthermore, this case highlights the critical role of multidisciplinary management, the importance of imaging, and the emphasis on coordinated medical efforts to achieve positive outcomes in similar self-inflicted multiple site injuries cases.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"120-123"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762631","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":"Potential source of Al-Zahrawi's knowledge of surgical instruments in the book of Al-Tasrif (10^th A.D.).","authors":"Mahsima Abdoli, Kamran Mahlooji","doi":"10.1080/00015458.2024.2437271","DOIUrl":"10.1080/00015458.2024.2437271","url":null,"abstract":"<p><strong>Background: </strong>Surgery is one of the most important branches of medical science. The importance of using surgical tools in applying various surgical methods is clear. With the development of surgical instruments, the science of surgery made significant progress. At the beginning of the era of Islamic civilization (tenth century A.D.), The book entitled Al-Tasrif Leman Ujza an Al-Talif was written by Zahrawi, an Andalusian physician, which became world famous due to its section on surgery and surgical instruments. The original of this book was in Arabic and was translated into Latin by Gerald of Cremona. After that, he made his way to Europe and taught in European medical universities for many years. In this study, the possible source used by Zahrawi in writing this part of his book is discussed.</p><p><strong>Methods: </strong>This study was done by library and Internet research method. Reference books and relevant articles from reliable databases such as ISI, Scopus, PubMed and search engines such as Google Scholar, and also some archeological websites were used for gathering data. The date was analyzed.</p><p><strong>Results: </strong>Zahrawi has introduced more than 200 surgical tools in an illustrated form and described their use in the 30th chapter of the 3rd part of Al-Tasrif book. Also, there are some images of surgical instruments carved on a stone inscription on the wall of the Kom Ombo temple in Egypt, dating back to 305-30 BC, which are very similar to Al-Tasrif's.</p><p><strong>Discussion: </strong>The similarity between the images of these two mentioned documents, releaves a potential of Zahrawi's exposure to the Egyptian Kom Ombo and the use of that source in the compilation of al-Tasrif.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"113-119"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765372","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":"Reconstruction of elbow flexion after sarcoma excision by a unipolar pedicled latissimus dorsi flap.","authors":"Matthieu Garcia, Yohan Legallois, Eberhard Stoeckle, Audrey Michot","doi":"10.1080/00015458.2021.1883392","DOIUrl":"10.1080/00015458.2021.1883392","url":null,"abstract":"<p><strong>Introduction: </strong>The latissimus dorsi flap is widely used in plastic surgery for covering the upper limb but also for reconstruction the function of the elbow or shoulder. We describe a case of a sarcoma of the anterior compartment of the arm, the surgical removal then the covering and reconstruction of the elbow flexion. This case was carried out by a unipolar pedicled flap of the latissimus dorsi.</p><p><strong>Material and methods: </strong>Three steps were performed (excision, flap preparation and flap fixation). The functional results (muscle strength, MRC scale) and range of motion (ROM) were analyzed. We performed a small literature review to compare the results.</p><p><strong>Results: </strong>A complete excision (R0) was carried out with a good vitality of the latissimus dorsi flap. A rapid scarring was obtained, allowing an early start of adjuvant radiotherapy. Muscular strength was 33% less compared to preoperative, MRC scale was classified 4. ROM of the elbow was rated at -10/0/130. One year after the operation, the patient is still in remission.</p><p><strong>Conclusion: </strong>Our functional results are comparable to those found in the literature. The muscle strength in our case appears to be superior, probably linked to a brachio-radialis muscle still functional. No difference in function has been found in the literature between a unipolar or a bipolar transfer of the latissimus dorsi. This case report confirms the reliable and effective nature of the latissimus dorsi flap. The use of this flap for reconstruction after sarcoma surgery has only few reports in the literature.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"95-99"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25327091","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":"Primary percutaneous metal stenting above the ampulla in resectable perihilar cholangiocarcinoma.","authors":"J A Luyten, S W M Olde Damink, C van der Leij, B Groot Koerkamp, O Detry, U P Neumann, M J L Dewulf","doi":"10.1080/00015458.2024.2432739","DOIUrl":"10.1080/00015458.2024.2432739","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case of a patient with resectable perihilar cholangiocarcinoma (pCCA) who underwent primary metal stenting above the ampulla, followed by a successful surgical resection. Biliary drainage is a crucial step in the preoperative management of pCCA, yet there is no consensus on the optimal approach. Traditional drainage methods involve passing through the ampulla and/or the skin barrier, thereby increasing the risk of bacterial contamination of the biliary tree and secondary cholangitis.</p><p><strong>Method: </strong>A novel drainage technique was utilised in this case. A metal stent was percutaneously placed across the malignant hilar stenosis without external biliary drainage. During the procedure, both guidewires and stents were meticulously prevented from passing through the ampulla. Additionally, percutaneous access to the biliary tree was removed during the index procedure to minimise the risk of biliary colonisation and cholangitis.</p><p><strong>Results: </strong>Following the drainage, bilirubin levels rapidly normalised, and no clinical or biochemical signs of cholangitis were observed. This allowed for rapid and uncomplicated surgical resection.</p><p><strong>Conclusion: </strong>This case illustrates the potential of a novel biliary drainage technique in patients with pCCA. By minimising the risk of biliary colonisation and cholangitis, this approach could potentially improve surgical outcomes.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"103-107"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680182","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":"In memoriam: Emeritus Professor Dr. Jacques Aimé Gruwez 24 March 1927-9 July 2024.","authors":"Paul De Leyn, André D'Hoore, Toni Lerut","doi":"10.1080/00015458.2025.2460284","DOIUrl":"https://doi.org/10.1080/00015458.2025.2460284","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"125 2","pages":"79-81"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951682","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":"Spontaneous splenic rupture two days after laparoscopic sleeve gastrectomy.","authors":"M Mertens, L Verheyen, J Ceulemans","doi":"10.1080/00015458.2024.2424047","DOIUrl":"10.1080/00015458.2024.2424047","url":null,"abstract":"<p><strong>Introduction: </strong>Sleeve gastrectomy is a common bariatric procedure to manage morbid obesity. Splenic injury such as splenic rupture after sleeve gastrectomy is a rare complication which can be treated both with a splenectomy or conservative approach, called spleen-preserving surgery.</p><p><strong>Patients and methods: </strong>A 42-year old male, in whom we performed a sleeve gastrectomy, presented with splenic rupture, within 48 h postoperative, for which spleen-preserving surgery was performed. As splenic rupture is a very rare complication, we performed an extensive literature search in the PubMed database. After obtaining patient informed consent, we aim to describe a sixth presentation of this rare surgical complication.</p><p><strong>Result: </strong>To the best of our knowledge, only five cases of splenic rupture after laparoscopic sleeve gastrectomy have been described before, all treated with a splenectomy. Furthermore, we are the first to describe spleen-preserving surgery.</p><p><strong>Conclusion: </strong>We present the sixth case of spontaneous splenic rupture after laparoscopic sleeve gastrectomy, and the first to treat it with spleen-preserving surgery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"100-102"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543030","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}