Acta Chirurgica BelgicaPub Date : 2025-02-01Epub Date: 2024-09-25DOI: 10.1080/00015458.2024.2406603
Francesco Maria Crafa, Serafino Vanella, Emanuele Caruso, Enrico Coppola Bottazzi, Adele Noviello, Alfonso Amendola
{"title":"Robotic subtotal D2-gastrectomy for gastric cancer after right hemiliver transplantation: case report and literature review.","authors":"Francesco Maria Crafa, Serafino Vanella, Emanuele Caruso, Enrico Coppola Bottazzi, Adele Noviello, Alfonso Amendola","doi":"10.1080/00015458.2024.2406603","DOIUrl":"10.1080/00015458.2024.2406603","url":null,"abstract":"<p><strong>Background: </strong>With the progress achieved in transplant surgeries an improved long-term survival of patients is obtained due to more effective immunosuppressant therapy. <i>De novo</i> malignancy (DNM) has gained interest in this group of patients. DNM is a major cause of late mortality after liver transplantation.</p><p><strong>Methods: </strong>We report the case of a patient who underwent orthotopic liver transplantation with right hemiliver (right split) 18 years ago who came to our attention for gastric cancer. We performed a robotic subtotal gastrectomy D2 lymphadenectomy with manual latero lateral trans mesocolic BII gastro jejunal anastomosis using da Vinci robotic surgery system at our hospital.</p><p><strong>Results: </strong>The operation was successful, the operative time was 230 min, the intraoperative blood loss was 100 ml. The patient was discharged on day 8 after surgery, and no complications occurred. Postoperative pathological stages were pT2 N0 (0/25). During the follow-up period, the patient was in good health without long-term complications.</p><p><strong>Conclusion: </strong>Robotic approach is feasible in patients after liver transplantation.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"33-39"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339032","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":"The Hellenic surgical School for treatment of neuralgias and dystonias as presented in 19th-20th centuries in Greece.","authors":"Konstantinos Laios, Pavlos Lytsikas-Sarlis, Evangelia Mourellou, Constantinos G Zografos, Gregory Tsoucalas, Marianna Karamanou, Georgios Androutsos","doi":"10.1080/00015458.2024.2424038","DOIUrl":"10.1080/00015458.2024.2424038","url":null,"abstract":"<p><strong>Background: </strong>This article examines the surgical techniques used for the treatment of neuralgia and dystonia in Greece during the late 19th to the middle of the twentieth century. It emphasizes on the Greek contribution to neurosurgery.</p><p><strong>Methods: </strong>The aim of this study is achieved by examining unpublished archives as well as historical documents collected from both the National Library of Greece and the Library of the Hellenic Parliament.</p><p><strong>Results: </strong>Greek medicine of the nineteenth century emerged through the practice of Greek physicians who have studied abroad. Many important figures on surgery, like Theodoros Aretaios, Nikolaos Taptas and Konstantinos Mermigas attempted myotomies, neurectomies, trasoraphies, and injections according the European protocols, though introducing some variants on well established procedures. This article also refers to the early stereotactic neurosurgery in Greece, especially in the treatment of Parkinson's Disease and extrapyramidal syndromes by Aggelos Karakalos, ultimately contributing toward a better understanding of the evolution of Greek surgery, highlighting its pivotal role in the international development of neurosurgical techniques. Greek school of surgery avoided brutal operations like trephination and proved worthy among most advanced school of the 19<sup>th</sup> and 20<sup>th</sup> centuries.</p><p><strong>Conclusion: </strong>Neuralgias and dystonias constituted for the physicians of the past a riddle connected with the mystery of the central and peripheral neural system. Surgical procedures were proposed, finding ways of implication mainly in the cases of neuralgias. Gradually drug administration of simple substances like alcohol demonstrated some results. The study of Greek medical archives dated back to 19<sup>th</sup> and early twentieth century allow us to have a comprehensive idea about the therapeutical approaches and especially the operative ones used by the Greek physicians of the time to fight dystonias and neuralgias unveiling their capabilities and theoretical medical knowledge.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"69-75"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543031","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":"Congenital diaphragmatic hernia with intrathoracic kidney: case report, review of the literature, and strategy for treatment in neonates and infants.","authors":"Yannick Vancampenhout, Stijn Heyman, Daphne Arnold, Stefanie Devriendt, Dirk Vervloessem","doi":"10.1080/00015458.2024.2419705","DOIUrl":"10.1080/00015458.2024.2419705","url":null,"abstract":"<p><strong>Background: </strong>Congenital diaphragmatic hernia (CDH) is a rare developmental defect in the diaphragm, occurring in 2 in 10,000 births. Herniation of intraperitoneal organs through the diaphragmatic opening is always present, however few cases mention the herniation of retroperitoneal organs, such as a kidney. Due to the rarity of this condition, the optimal treatment strategy remains unclear.</p><p><strong>Methods: </strong>A PubMed search was conducted, gathering all published reports of CDH with intrathoracic herniation of the kidney. Cases of isolated intrathoracic kidney without CDH and cases of traumatic hernia were excluded. Patients who underwent surgical repair before the age of 5 years were included for further analysis.</p><p><strong>Results: </strong>Thirty-seven cases were found from 1970 to 2022. The approach used for surgical repair was not mentioned in 55.6% of cases. 52.9% of the remaining patients were treated through laparotomy, whereas in 23.5% a thoracoscopy was performed. A primary repair of the hernia was performed in 88.6%. A hernia sac was noted in 70%. Most patients had a normal origin of the renal vessels and reduction of the intrathoracic kidney was achieved in 78.8%. Moreover, we report a case of CDH with intrathoracic kidney treated through thoracoscopic repair.</p><p><strong>Conclusion: </strong>A thoracoscopic approach is effective for the treatment of CDH with an intrathoracic kidney case with an associated intrathoracic kidney. A therapeutic strategy for CDH with intrathoracic kidney is suggested based on data from published cases.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"44-52"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455425","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}
Acta Chirurgica BelgicaPub Date : 2025-02-01Epub Date: 2024-07-02DOI: 10.1080/00015458.2024.2371697
Filipa Jácome, Mariana Basílio Martins, Alexandre Sarmento, Andreia Coelho, Marina Dias-Neto, Ahmed Khairy, Eduardo Ocke-Reis, José Andrade, João Rocha-Neves
{"title":"Blood group is a long-term cardiovascular risk factor after carotid endarterectomy.","authors":"Filipa Jácome, Mariana Basílio Martins, Alexandre Sarmento, Andreia Coelho, Marina Dias-Neto, Ahmed Khairy, Eduardo Ocke-Reis, José Andrade, João Rocha-Neves","doi":"10.1080/00015458.2024.2371697","DOIUrl":"10.1080/00015458.2024.2371697","url":null,"abstract":"<p><strong>Background: </strong>ABO blood group system has been clinically related to an increased incidence of cardiovascular diseases. Preliminary data relating Rhesus (Rh) factor and these outcomes also have been published. Our aim was to analyse the impact of blood group on the short and long-term outcomes after carotid endarterectomy (CEA).</p><p><strong>Materials and methods: </strong>From 2012 to 2019, patients from a referral centre who underwent CEA for atherosclerotic carotid stenosis were prospectively followed. Our primary outcomes were long-term major adverse cardiovascular events (MACEs) and all-cause mortality. Secondary outcomes were perioperative complications and myocardial injury after non-cardiac surgery (MINS). Median follow-up was 50 months (interquartile range 21-69). Time-to-event analysis was used to determine the effect of ABO and Rh groups in long-term outcomes.</p><p><strong>Results: </strong>One hundred and eighty-four patients were included, with a mean age of 70.1 ± 9.1 years. Eighteen (25.7%) patients with O type and 48 (42.1%) patients with non-O type presented coronary artery disease (odds ratio [OR]: 2.313, 5-95% confidence interval (CI) 1.245-4.297, <i>p</i> = .008). Patients Rh<sup>+</sup> presented significantly more congestive heart failure, 23 (14.7%), <i>p</i> = .03. The incidence of MACE in the long-term was higher in non-O patients (adjusted hazard ratio: 2.034; CI: 1.032-4.010, <i>p</i> = .040). Rh<sup>-</sup> patients, presented a higher incidence of perioperative MINS. However, there was no statistically significant association with long-term risk of MACE.</p><p><strong>Conclusion: </strong>The incidence of MACE in long-term analysis was higher in non-O blood type and 30-day MINS was significantly more common amongst Rh<sup>-</sup> patients. The benefit from a more complete preoperative cardiac study in these patients should be performed.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"14-21"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431077","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}
Acta Chirurgica BelgicaPub Date : 2025-02-01Epub Date: 2024-07-31DOI: 10.1080/00015458.2024.2384687
Kartik Sharma, Yashwant Raj Sakaray, Satish S N, Cherring Tandup, Siddhant Khare, Ajay Savlania, Ashish Gupta, Harish Bhujade, Sant Ram, Lileswar Kaman
{"title":"Effect of laparoscopic cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in post menopausal women.","authors":"Kartik Sharma, Yashwant Raj Sakaray, Satish S N, Cherring Tandup, Siddhant Khare, Ajay Savlania, Ashish Gupta, Harish Bhujade, Sant Ram, Lileswar Kaman","doi":"10.1080/00015458.2024.2384687","DOIUrl":"10.1080/00015458.2024.2384687","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the gold standard management for benign gallbladder diseases. It has been observed that there is alteration in vitamin D levels and bone mineral density after cholecystectomy due to altered enterohepatic circulation. With increase in average age expectancy of the population, low levels of vitamin D levels and osteoporosis after cholecystectomies might cause increased health care burden.</p><p><strong>Methods: </strong>A prospective observational study was planned between 1 January 2022 and 30 June 2023 in the Department of General Surgery at PGIMER Chandigarh, a tertiary care hospital in north India. One hundred and three post-menopausal women who underwent LC and met the inclusion and exclusion criteria were included in the study. All participants underwent estimation of vitamin D and bone mineral density preoperatively and third-post operative month (POM).</p><p><strong>Results: </strong>The mean age of the patients was 58.46 ± 7.44. Pain abdomen was present in 68(66%) patients, 18 had epigastric discomfort and 17 had dyspepsia. The mean levels of vitamin D decreased from 21.92 at the baseline to 20.12 at third POM (<i>p</i> < .001). There was a significant change in <i>t</i> score Femoral Neck (-1.12 vs -1.15, <i>p</i> < .001) and Lumbar spine L1-L4 - 1.98 vs -1.98 (<i>p</i> = .033). <i>z</i>-scores of the femoral neck were -0.34 vs -0.54 (<i>p</i> < .001) and of lumbar spine L1-L4 were -0.95 vs 1.02 (<i>p</i> < .001). The decrease in fracture risk for the femoral neck (<i>p</i> = .344) and the lumbar spine (<i>p</i> = .223) was not statistically significant.</p><p><strong>Conclusion: </strong>There is a significant decrease in vitamin D and BMD levels after LC in post-menopausal females.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"29-32"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750761","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}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-04-04DOI: 10.1080/00015458.2024.2336676
Paolo Ossola, Andrea Borasi, Andrea Barberis, Silvia Marola, Francesco Ghiglione, Giuseppe Pentassuglia, Barbara Puligheddu, Paolo Riccardo Brustio, Ilaria Messuti, Marco Bononi, Renzo Leli, Fabio Lanfranco
{"title":"Early parathyroid hormone (PTH) level as a predictor of post-surgical hypoparathyroidism.","authors":"Paolo Ossola, Andrea Borasi, Andrea Barberis, Silvia Marola, Francesco Ghiglione, Giuseppe Pentassuglia, Barbara Puligheddu, Paolo Riccardo Brustio, Ilaria Messuti, Marco Bononi, Renzo Leli, Fabio Lanfranco","doi":"10.1080/00015458.2024.2336676","DOIUrl":"10.1080/00015458.2024.2336676","url":null,"abstract":"<p><strong>Introduction: </strong>Post-operative hypocalcemia and postoperative persistent hypoparathyroidism remain the most common complications after thyroidectomy. Many approaches have been developed to prevent them, but actually, a common protocol is not yet individuated.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the results of a prospectively collected database. We dosed PTH preoperatively and 4 h after surgery (PTH_4); calcium was evaluated preoperatively, on the first (I_POD) and on the second postoperative day (II_POD). Hypocalcemia was defined when calcium <8 mg/dl. PTH_4 and I_POD calcium serum levels are identified to predict postoperative hypocalcemia.</p><p><strong>Results: </strong>Three hundred and forty-eight patients were enrolled, 37 patients resulted as hypocalcemic on I_POD and 41 on the II_POD. PTH_4 is related to I_POD (<i>p</i> < 0.001, <i>r</i> = 0.45) and II_POD (<i>p</i> < 0.001, <i>r</i> = 0.44) calcemia. PTH_4-cut-off predicting I_POD hypocalcemia was 10.50 pg/ml (sensitivity: 78.7%, specificity: 72.7%). A PTH_4 value of 11.5 pg/ml is able to predict hypocalcemia during II_POD (sensitivity: 76.5%, specificity: 69.2%). We set up a combined test to predict II_POD hypocalcemia, using PTH_4 and I_POD calcium (sensitivity: 77.8%, specificity: 89.9%).</p><p><strong>Conclusion: </strong>This research shows the association between PTH_4 and postoperative hypocalcemia. The PTH_4 cut-off to predict I_POD-hypocalcemia was 10.5 pg/ml. We analyzed the calcemia trend during the postoperative period and we realized a combined test using PTH_4 and I_POD-calcemia. This test improves the accuracy of the previous test. Further studies, in particular multicentric, with a larger sample are necessary to validate the combined model.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"455-465"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317597","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}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-07-29DOI: 10.1080/00015458.2024.2384796
Maud A S Schoenmakers, Anke H C Gielen, Kevin P Wevers, Jarno Melenhorst
{"title":"Sigmoidorectal intussusception caused by colon carcinoma.","authors":"Maud A S Schoenmakers, Anke H C Gielen, Kevin P Wevers, Jarno Melenhorst","doi":"10.1080/00015458.2024.2384796","DOIUrl":"10.1080/00015458.2024.2384796","url":null,"abstract":"<p><p>Intussusception, the invagination of a bowel segment into an adjacent segment, occurs in 5% of adult patients with an obstruction of the bowel. It is often seen as a result of obstructive defecation syndrome or malignancy. However, a sigmoidal malignancy as lead point is rare. Symptoms in adults are less specific than in children, which makes preoperative diagnosis challenging. An 85-year-old female presented with bright red anal blood loss. A large palpable mass was found during rectal examination. A computed tomography was performed during workup, which showed a 'target-sign' on the location of the lesion. An intussusception of the sigmoid into the rectum was seen over the length of 15 cm. This particular type of intussusception is extremely rare. When a neoplasm is suspected to be the lead point, an oncological resection is recommended. We performed a total mesorectal excision, after which the patient had an uneventful recovery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"504-507"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756498","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}