Acta Chirurgica BelgicaPub Date : 2024-10-01Epub Date: 2024-02-29DOI: 10.1080/00015458.2024.2323286
Isik Cetinoglu, Mehmet Taner Unlu, Hatice Yasemin Sit, Nurcihan Aygun, Semra Tiryaki Demir, Mehmet Uludag
{"title":"A unique complication of thyroidectomy for Hashimoto's thyroiditis: central retinal artery thrombosis.","authors":"Isik Cetinoglu, Mehmet Taner Unlu, Hatice Yasemin Sit, Nurcihan Aygun, Semra Tiryaki Demir, Mehmet Uludag","doi":"10.1080/00015458.2024.2323286","DOIUrl":"10.1080/00015458.2024.2323286","url":null,"abstract":"<p><strong>Background: </strong>Central retinal artery occlusion (CRAO) is a rare ophthalmological emergency and also a unique complication after thyroid surgery.</p><p><strong>Methods: </strong>We present the first case of CRAO following thyroid surgery in a patient with Hashimoto's thyroiditis, along with a variety of interventions to overcome this complication.</p><p><strong>Results: </strong>A 42-year-old female patient suffering from sudden vision loss following total thyroidectomy was diagnosed with CRAO. Hyperbaric oxygen therapy was started within the postoperative first 6 hours.</p><p><strong>Conclusion: </strong>Although it is extremely rare, it should be noted that patients may experience retinal artery occlusion following the thyroid surgery. Immediate evaluation of patients with visual impairment in the early postoperative period, and planning of emergent hyperbaric oxygen therapy for the management are critical.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"409-414"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929469","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 : 2024-10-01Epub Date: 2024-07-04DOI: 10.1080/00015458.2024.2369745
Michael El Boghdady, Béatrice Marianne Ewalds-Kvist
{"title":"Surgeons with disabilities, they do exist.","authors":"Michael El Boghdady, Béatrice Marianne Ewalds-Kvist","doi":"10.1080/00015458.2024.2369745","DOIUrl":"10.1080/00015458.2024.2369745","url":null,"abstract":"<p><strong>Introduction: </strong>Doctors with disability are likely to face major life crises, challenges and distressing emotions from unforeseen circumstances that threaten their physical well-being. We aimed to identify the existence of work-related pain and discomfort that may cause surgeon's disability. Surgeons who were struck with unpredictable disasters leading to disabilities were also reviewed.</p><p><strong>Methods: </strong>We conducted a 10-year literature review. In addition, citations about surgeons' physical disabilities were complemented with commentaries about disabled surgeons from gray literature. The quantitative citations were quality assessed by MERSQI scores and evidence graded according to GRADE. For the qualitative study part, the severely traumatized surgeons were analysed by means of Cullberg's crisis phases (CCP) and analysed from Tedeschi and Calhoun's post-traumatic growth perspective (PTG).</p><p><strong>Results: </strong>Altogether 3593 citations from PubMed were studied, and 10 citations met inclusion criteria with a total of 11591 participants. We included 6 surgeons subjected to highly traumatic events complicating their medical career. Our quantitative citations' mean MERSQI score was 11.73 (SD .79) and the citations' evidence value completed grade II (moderate quality: 11.26 to 12.00 scores). Work-related musculoskeletal pain and occupational injuries may lead to physical disabilities. The accidentally traumatized surgeons fought through the four CCP phases and reached successfully the PTG stage.</p><p><strong>Conclusions: </strong>The surgical workforce is at high risk of work-related musculoskeletal morbidity which can progress to chronic pain and disruption of surgeon's career. Surgeons with disabilities faced serious barriers in their career. Institutions and healthcare systems must urgently develop support strategies for surgeons with disabilities.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"339-348"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465381","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 : 2024-10-01Epub Date: 2024-02-06DOI: 10.1080/00015458.2024.2312493
Harald De Cauwer, Dennis Barten, Fredrik Granholm, Luc Mortelmans, Patrick Cras, Francis Somville
{"title":"Comparing the top 100 attacks in the Global Terrorism Database: high injury rate versus high fatality rate attacks.","authors":"Harald De Cauwer, Dennis Barten, Fredrik Granholm, Luc Mortelmans, Patrick Cras, Francis Somville","doi":"10.1080/00015458.2024.2312493","DOIUrl":"10.1080/00015458.2024.2312493","url":null,"abstract":"<p><strong>Background: </strong>Terrorist attacks have the potential to be mass casualty events, causing multiple injuries and deaths. High injury rate attacks will particularly place a high burden on emergency medical systems. This study aimed to assess if there is a difference between attacks with high injury rates and high fatality rates.</p><p><strong>Methods: </strong>The top 100 terrorist events causing the highest number of fatalities versus the highest number of injuries were selected from the Global Terrorism Database. Analyses were performed on temporal factors, location, target type, attack and weapon type, and perpetrator type.</p><p><strong>Results: </strong>The 9/11 attacks caused the highest number of both fatalities and injuries. With regards to injury rates, the sarin attacks in Tokyo, Japan ranked second. Events with high fatality rates were overrepresented in Sub-Saharan Africa, whereas events with high injury rates were predominant in the Middle East & North Africa. High fatality rates were most often associated with armed assaults and hostage takings. Bombings were responsible for the highest number of injuries. CBRN attacks were overrepresented in the top 100 injuries, and accounted for 11% of the incidents.</p><p><strong>Conclusion: </strong>High injury rate incidents place a heavy burden on the health care system as the number of injuries is nearly ten times as high as the number of injuries in high fatality rate incidents. Epidemiological analysis of high impact terrorist events may contribute to counter-terrorism preparedness, to an increased focus on dealing with CBRN-events, and thus to a proper medical response to future terrorist events.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"356-364"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569427","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":"Laparoscopic Toupet-Sleeve gastrectomy in morbid obese patients with preoperative gastro-esophageal reflux: a 4-year follow-up cohort study.","authors":"Hauters Philippe, Granjean Steven, Stefanescu Iulia, Jacqmin Geoffrey, Gerard Mickaël, van Vyve Etienne","doi":"10.1080/00015458.2024.2320504","DOIUrl":"10.1080/00015458.2024.2320504","url":null,"abstract":"<p><strong>Aim: </strong>To assess the 4-year outcomes after Toupet-Sleeve (TS) gastrectomy in morbid obese patients with concomitant preoperative gastro-esophageal reflux disease (GERD).</p><p><strong>Material and methods: </strong>The study group consisted of 19 consecutive patients operated on between August 2017 and February 2019. There were 5 men and 14 women with a mean body mass index (BMI) of 43 ± 5 kg/m<sup>2</sup> and a mean age of 42 ± 15 years. A retrospective analysis of database and telephone interview of patients who defaulted clinic follow-up was conducted. The main study end-points were weight loss and success of surgery, defined as no need for conversion and %EWL > 50%. Resolution of GERD was a secondary end-point.</p><p><strong>Results: </strong>No patient was lost for follow-up. Nadir weight loss was reached after a follow-up of one year: mean BMI was 32 ± 5 kg/m<sup>2</sup>, %EWL 61 ± 21% and %TWL 24 ± 7%. Thereafter, we observed a progressive weight regain over time. With a mean follow-up of 51 ± 6 months, mean BMI was 36 ± 8 kg/m<sup>2</sup>, %EWL 43 ± 35% and %TWL 16 ± 12%. Two patients were converted to another bariatric procedure because of dysphagia and fundus dilatation or because of insufficient weight loss. The overall surgical success rate was 32% (6/19). Resolution of GERD without any PPI treatment was noted in 88% (15/17) of the non-converted patients.</p><p><strong>Conclusion: </strong>In our experience, with a 4-year follow-up, TS is associated with a significant risk of conversion, a moderate weight loss and a poor surgical success rate.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"372-379"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139745806","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 : 2024-10-01Epub Date: 2024-02-01DOI: 10.1080/00015458.2024.2308400
Harald De Cauwer, Luc J Mortelmans, Francis Somville, Patrick Cras
{"title":"50 Years of terrorism in Belgium: a review of 121 incidents in the global terrorism database.","authors":"Harald De Cauwer, Luc J Mortelmans, Francis Somville, Patrick Cras","doi":"10.1080/00015458.2024.2308400","DOIUrl":"10.1080/00015458.2024.2308400","url":null,"abstract":"<p><strong>Objectives: </strong>Belgium is not only prone to inland terrorism but also attracts terrorist factions aiming at various political, diplomatic, military, and/or religious targets. This study aimed to identify and characterize all documented terrorist attacks in Belgium reported to the Global Terrorism Database (GTD) over a period of 50 years.</p><p><strong>Methods: </strong>The GTD was searched for all terrorist attacks in Belgium between 1970 and 2019. Analyses were performed on temporal factors, location, target type, attack and weapon type, attacker type, and number of casualties or hostages.</p><p><strong>Results: </strong>In 50 years, 121 incidents accounted for 80 confirmed fatalities and 498 injured people. Bombings and explosions were the most frequently identified attack type (46.3%), followed by assassination (16.5%), infrastructure damage (15.7%) and armed or unarmed assaults (14.0%). Governmental and diplomatic institutions were the most frequent target (24.0%). For those perpetrators the GTD did have enough information we saw a timely change from far left and separatist dominating the early decades to Jihadi groups in the last decade, while anti-semitic factions were active in every decade.</p><p><strong>Conclusion: </strong>In contrast to other studies, this study did not show an increase over time. Left-wing perpetrators dominated the eighties. In 50 years of terrorist activity in Belgium, the health care system was spared. Devastating mass casualty attacks challenging the health care system are rare in Belgium.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"349-355"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541047","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 : 2024-10-01Epub Date: 2024-08-02DOI: 10.1080/00015458.2021.1928877
Laura Boutin, Mihane Nayeri, Julien Frandon, Frédéric Borie
{"title":"Pancreatic tuberculosis in an 18-year-old patient.","authors":"Laura Boutin, Mihane Nayeri, Julien Frandon, Frédéric Borie","doi":"10.1080/00015458.2021.1928877","DOIUrl":"10.1080/00015458.2021.1928877","url":null,"abstract":"<p><p>An 18-year-old male patient presented with abdominal pain, nausea, and diarrhea. Subsequent laboratory investigations involving the patient's blood samples revealed an inflammatory syndrome. Subsequent radiographic investigations (CT scan, MRI, and endoscopic ultrasound with biopsies) led to the discovery of a heterogenic cystic lesion in the tail of the pancreas. Although the investigations orientated the diagnosis towards a pseudopapillary tumor, no certain pathological diagnosis could be obtained. After a multidisciplinary meeting, surgery was chosen as the designated therapeutic option. The patient underwent left pancreatectomy and no complications were encountered. The pathological examination revealed isolated pancreatic tuberculosis. Currently, the patient is under treatment and no longer presents any digestive symptoms.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"406-408"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38996002","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 : 2024-10-01Epub Date: 2024-02-27DOI: 10.1080/00015458.2024.2320510
Murat Akkuş, Yunus Seyrek
{"title":"Completely portal robotic lobectomy in lung cancer: is subcostal specimen removal necessary?","authors":"Murat Akkuş, Yunus Seyrek","doi":"10.1080/00015458.2024.2320510","DOIUrl":"10.1080/00015458.2024.2320510","url":null,"abstract":"<p><strong>Background: </strong>The best place for specimen extraction is a relevant question since either after robotic or video-thoracoscopic lobectomy, both intercostal and subcostal routes can be potential extraction routes. In this study, we studied completely portal robotic lobectomies (CPRL-4) for pulmonary neoplasms to investigate the efficacy and feasibility of subcostal specimen removal by comparing the two techniques.</p><p><strong>Material and methods: </strong>Between January 2014 and July 2021, data from 90 patients who underwent robotic thoracic surgery with a Da Vinci Surgical System SI (Intuitive Surgical Inc., Mountain View, California, USA) were collected and retrospectively analyzed. Out of 90 patients, we analyzed 36 CPRL-4 cases. We removed specimens traditionally <i>via</i> intercostal utility thoracotomy in the first 22 patients (group A) and <i>via</i> subcostal incision in the next consecutive 14 patients (group B). Operative parameters, postoperative parameters, the visual analog scale (VAS) and SF36 life quality scoring were comparatively analyzed.</p><p><strong>Results: </strong>The mean docking time was significantly higher in group B than in group A (26.2 ± 5.3 vs 17.8 ± 4.1) (<i>p</i> = .001). In terms of early-stage postoperative pain, group B had significantly lower pain scores compared to group A (<i>p</i> < .05). There was no significant difference between the groups in terms of SF36 life quality scoring.</p><p><strong>Conclusion: </strong>We can conclude that performing a subcostal incision is not a sophisticated process, though it significantly prolongs the docking time. Although our study is based on a small group, we noticed that removing the specimen through the subcostal incision after CPRL-4 is potentially useful, has several advantages and it is a practical, feasible, and safe method.</p><p><strong>Clinical registration number: </strong>2018/57.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"380-386"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139904721","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}
Roza S. Makarian, Oana Mirea, Peter Verhamme, Karel M. Smeyers, Evelien Berkmans, Victor Raicea, Mihaela Berceanu, Dirk Van Raemdonck, Laurens J. Ceulemans
{"title":"Pericardial fenestration and thoracic duct ligation for treatment of chylopericardium as first symptom of underlying generalized lymphatic anomaly: a case report","authors":"Roza S. Makarian, Oana Mirea, Peter Verhamme, Karel M. Smeyers, Evelien Berkmans, Victor Raicea, Mihaela Berceanu, Dirk Van Raemdonck, Laurens J. Ceulemans","doi":"10.1080/00015458.2024.2406606","DOIUrl":"https://doi.org/10.1080/00015458.2024.2406606","url":null,"abstract":"Chylopericardium represents a rare condition of chyle accumulation within the pericardial sac, caused by abnormal thoracic duct anatomy or prolonged increased pressure. Nothing by mouth (NPO) polic...","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"27 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257160","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}
Zohal Fazli, Alexander Croo, Karen Van Langenhove, Gilles Uijtterhaegen, Nathalie Moreels, Frank Vermassen, Isabelle Van Herzeele, Caren Randon
{"title":"Literature review on management of prosthetic graft infections after supra-aortic bypass surgery, based on a case report","authors":"Zohal Fazli, Alexander Croo, Karen Van Langenhove, Gilles Uijtterhaegen, Nathalie Moreels, Frank Vermassen, Isabelle Van Herzeele, Caren Randon","doi":"10.1080/00015458.2024.2398849","DOIUrl":"https://doi.org/10.1080/00015458.2024.2398849","url":null,"abstract":"Graft infections of supra-aortic bypasses are rare, but often life-threatening. Guidelines for treatment of graft infections recommend systemic antibiotics and complete graft removal, followed by i...","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"5 1","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201652","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 : 2024-08-01Epub Date: 2024-01-17DOI: 10.1080/00015458.2024.2305501
Yalin Iscan, Berke Sengun, Irem Karatas, Hasan Berke Atalay, Ismail Cem Sormaz, Semen Onder, Gulcin Yegen, Hulya Hacisahinogullari, Fatih Tunca, Yasemin Giles Senyurek
{"title":"The impact of intraoperative neural monitoring during papillary thyroid cancer surgery on completeness of thyroidectomy and thyroglobulin response: a propensity-score matched study.","authors":"Yalin Iscan, Berke Sengun, Irem Karatas, Hasan Berke Atalay, Ismail Cem Sormaz, Semen Onder, Gulcin Yegen, Hulya Hacisahinogullari, Fatih Tunca, Yasemin Giles Senyurek","doi":"10.1080/00015458.2024.2305501","DOIUrl":"10.1080/00015458.2024.2305501","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative neural monitoring (IONM) has been utilized for a variety of thyroid pathologies, including papillary thyroid carcinoma (PTC). Remnant thyroid tissue following total thyroidectomy (TT) in patients with PTC is associated with increased recurrence. The aim of this study is to investigate whether the use of IONM in PTC surgery has an impact on the completeness of thyroidectomy.</p><p><strong>Methods: </strong>Retrospectively, patients with preoperative diagnosis of PTC, who underwent TT in a tertiary center were reviewed. They were grouped based on the IONM usage, and 1:1 propensity-score match was performed. Primary outcome was the completeness of thyroidectomy, determined by measuring postoperative stimulated thyroglobulin levels (sTg).</p><p><strong>Results: </strong>Among 274 clinically node-negative PTC patients who underwent TT and ipsilateral prophylactic central lymph-node dissection, a total of 170 patients (85:85) were matched. Postoperative sTg levels were significantly lower in the IONM group (1 ng/dL vs. 0.4 ng/dL; <i>p</i> < 0.01) with higher percentage of the patients with sTg levels <1 ng/ml (50.6% vs. 69.4%; <i>p</i> = 0.01). More patients in the no-IONM group received RAI ablation with significantly higher doses (mean mci: 120 vs. 102; <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>The use of IONM during thyroidectomy provides improvement in the completeness of thyroidectomy and reduction in postoperative sTg levels which can be used as a guide by clinicians to avoid RAI ablation in selected PTC patients and to adjust low ablative doses in patients who are scheduled for remnant ablation.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"298-306"},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416066","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}