Journal of surgery and research最新文献

{"title":"Research Protocol: Prehabilitation for Holmium Laser Enucleation of the Prostate (HoLEP)","authors":"Mubariz Mahmood, D. Cottam, Momen Sid Ahmed, N. Nkwam, T. Rampal","doi":"10.26502/jsr.10020219","DOIUrl":"https://doi.org/10.26502/jsr.10020219","url":null,"abstract":"Surgery causes a physiological and psychological stress response which can lead to a decline in functional capacity (1). The adoption of prehabilitation into existing pathways can improve postoperative outcomes. HoLEP (Holmium laser enucleation of the prostate) is a minimally invasive surgical treatment for men with benign prostatic hyperplasia. We aim to assess the feasibility of providing multimodal prehabilitation to patients with an ASA score of 2 or more. The prehabilitation interventions include supervised cardiopulmonary exercise, muscle conditioning, dietary/lifestyle advice and exploration of psychosocial needs. Patients will also receive a medication review by a specialist pharmacist. Compliance is to be assessed with a phonecall 2 weeks into the program and 6 weeks post procedure. Viability of the project will be determined by the ability of the organisation to deliver and sustain the program. The data to be collected will include project costs, time spent, patient satisfaction, length of stay, early and later surgical complications and daycase rate. This project will assess feasibility of perioperative optimisation programmes for non-oncology surgical pathways for maximal patient benefit.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75127364","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":"Metabolic Impact of Immune-Suppressor Cells in Cancer Patients","authors":"M. Shibata, A. Inukai, Daigo Yoshimori, M. Ashizawa, T. Nakajima, Makoto Takada, T. Yazawa, K. Mimura, N. Inoue, Takafumi Watanabe, Kazunos .","doi":"10.26502/jsr.10020207","DOIUrl":"https://doi.org/10.26502/jsr.10020207","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) are not equally effective for all patients, regardless type of cancer. Immune-suppressor cells, including regulatory T tumor and their metabolic microenvironment (TME) play important roles in resistance to ICIs. Although Treg cells, TAMs and MDSCs play significant roles in immunosuppression in the TME, these cells are very important in the orchestration of metabolism such as angiogenesis and production of indoleamine 2,3-dioxygenase (IDO) and nitric oxide (NO) towards tumor escape, progression and expansion. Cancer immunotherapies tailored with metabolic characterizations such as parameters of angiogenesis, inflammation or obesity may be needed for the establishment of a successful treatment modality in the immunotherapy era.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77965607","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":"Hepatocellular Carcinoma in Transposition of Great Arteries (TGA) with Atrial Switch Procedure: A Case Report and Review of the Literature","authors":"P. Fontanges, O. Domanski, F. Godart","doi":"10.26502/jsr.10020262","DOIUrl":"https://doi.org/10.26502/jsr.10020262","url":null,"abstract":"","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88859221","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":"Procedures Never Explained in Textbooks: How to Correctly Convert a Closed-Suction Drain to a Closed-Gravity Drain, and How to Correctly Remove a Closed-Suction Drain Off Suction.","authors":"J. Stelmar, Shannon M Smith, Andrew Chen, J. Masterson, Vivian Hu, Maurice M. Garcia","doi":"10.26502/jsr.10020236","DOIUrl":"https://doi.org/10.26502/jsr.10020236","url":null,"abstract":"Objective To describe a novel method to convert a closed-system suction drain to a highly efficient closed-system gravity-dependent drain and demonstrate its efficacy in an ex-vivo model. Methods We reviewed the 5 top-selling urology and surgery text/reference books for information on drainage systems. An ex-vivo model was designed with a reservoir of fluid connected to a Jackson-Pratt bulb drain. We measured the volume of fluid drained from the reservoir into the bulb while on-suction and off-suction. This was repeated using a novel modified bulb, where the bulb's outflow stopper was replaced with a one-way valve oriented to allow release of pressure from the bulb. Results With the bulb on-suction, drainage was maintained regardless of the height of the drain relative to the reservoir. With the bulb off-suction, closed passive gravity-dependent drainage occurred only when the drain was below the fluid reservoir; drainage ceased at minimal volumes. With addition of a one-way valve and maintenance of the bulb below the level of the reservoir, drainage proceeded to completion. Conclusion How surgical drains work is not described in the leading urology and general surgery textbooks/reference books. Closed-system suction drains cannot be used to achieve passive gravity-dependent drainage without allowing release of displaced air from the bulb-lumen. The novel modified drain we describe affords reversible closed-system suction and passive drainage.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 1","pages":"419-422"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89284277","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":"<i>IBM WATSON Trauma Pathway Explorer©</i> as a Predictor for Sepsis after Polytrauma - Is Procalcitonin Useful for Identifying Septic Polytrauma Patients?","authors":"Cédric Niggli,&nbsp;Philipp Vetter,&nbsp;Jan Hambrecht,&nbsp;Philipp Niggli,&nbsp;Jindřich Vomela,&nbsp;Richard Chaloupka,&nbsp;Hans-Christoph Pape,&nbsp;Ladislav Mica","doi":"10.26502/jsr.10020272","DOIUrl":"https://doi.org/10.26502/jsr.10020272","url":null,"abstract":"<p><p>IBM and the University Hospital Zurich have developed an online tool for predicting outcomes of a patient with polytrauma, the <i>IBM WATSON Trauma Pathway Explorer^®</i> . The three predicted outcomes are Systemic Inflammatory Response Syndrome (SIRS) and sepsis within 21 days as well as early death within 72 hours since the admission of the patient. The validated <i>Trauma Pathway Explorer^®</i> offers insights into the most common laboratory parameters, such as procalcitonin (PCT). Sepsis is one of the most important complications after polytrauma, which is why it is crucial to detect it early. This study aimed to examine the time-dependent relationship between PCT values and sepsis, based on the WATSON technology. A total of 3653 patients were included, and ongoing admissions are incorporated continuously. Patients were split into two groups (sepsis and non-sepsis), and the PCT value was assessed for 21 days (1, 2, 3, 4, 6, 8, 12, 24, 48 hours, and 3, 4, 5, 7, 10, 14 and 21 days). The Mann-Whitney U-Test was used to evaluate the difference between the two groups. Binary logistic regression was utilized to examine the dependency of prediction. The Closest Top-left Threshold Method provided time-specific thresholds at which the PCT level is predictive for sepsis. At p <0.05, the data were declared significant. R was used to conduct all statistical analyses. The Mann-Whitney U-test showed a significant difference in PCT values in sepsis and non-sepsis patients between 12 and 24 hours, including post-hoc analysis (p <0.05). Likewise, the p-value started to be significant between 12 and 24 hours in the binary logistic regression (p <0.05). The threshold value of PCT to predict sepsis at 24 hours is 0.7μg/l, and at 48 hours 0.5μg/l. The presented time course of PCT levels in polytrauma patients shows the PCT as a separate predictor for sepsis relatively early. Even later, during the 21-day observation period, time-dependent PCT values may be utilized as a benchmark for the early and preemptive detection of sepsis, which may reduce death from septic shock and other deadly infectious episodes.</p>","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 4","pages":"637-644"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10856917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Lactate for Sepsis in Polytrauma Patients, a Time related Analysis using the IBM Watson Trauma Pathway Explorer^®.","authors":"Philipp Vetter,&nbsp;Cédric Niggli,&nbsp;Jan Hambrecht,&nbsp;Philipp Niggli,&nbsp;Jindrich Vomela,&nbsp;Richard Chaloupka,&nbsp;Hans-Christoph Pape,&nbsp;Ladislav Mica","doi":"10.26502/jsr.10020268","DOIUrl":"https://doi.org/10.26502/jsr.10020268","url":null,"abstract":"<p><p>The <i>Watson Trauma Pathway Explorer</i> ^® is an outcome prediction tool invented by the University Hospital of Zurich in collaboration with IBM^®, representing an artificial intelligence application to predict the most adverse outcome scenarios in polytrauma patients: Systemic Inflammatory Respiratory Syndrome (SIRS), sepsis within 21 days and death within 72 h. The hypothesis was how lactate values woud be associated with the incidence of sepsis. Data from 3653 patients in an internal database, with ongoing implementation, served for analysis. Patients were split in two groups according to sepsis presence, and lactate values were measured at formerly defined time points from admission until 21 days after admission for both groups. Differences between groups were analyzed; time points with lactate as independent predictor for sepsis were identified. The predictive quality of lactate at 2 and 12 h after admission was evaluated. Threshold values between groups at all timepoints were calculated. Lactate levels differed from less than 2 h after admission until the end of the observation period (21 d). Lactate represented an independent predictor for sepsis from 12 to 48 h and 14 d to 21 d after admission relative to ISS levels. AUROC was poor at 2 and 12 h after admission with a slight improvement at the 12 h mark. Lactate levels decreased over time at a range of 2 [mmol/L] for 6-8 h after admission. These insights may allow for time-dependent referencing of lactate levels and anticipation of subsequent sepsis, although further parameters must be considered for a higher predictability.</p>","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 4","pages":"618-624"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenteric Pseudocyst Following Blunt Abdominal Trauma: Report of a Case and Review of Literature","authors":"Klaudia Gjinoska, O. Kostovski, A. Nikolovski, Daniela Bajdevska Dukoska, Agron Alimi, S. Antović","doi":"10.26502/jsr.10020258","DOIUrl":"https://doi.org/10.26502/jsr.10020258","url":null,"abstract":"Mesenteric pseudocysts are rare intraabdominal lesions. A total of 29 similar case reports were retrieved via the Medline/PubMed search engine. They represent a subtype of mesenteric cysts displaying histological similarity to pancreatic pseudocysts which are usually surrounded by a thick fibrous wall without an inner epithelial lining. Mesenteric pseudocysts may present as any other expanding intraabdominal lesion. Accurate preoperative characterization of mesenteric cystic lesions remains challenging. Imaging diagnostics for most of the cases involve both ultrasound and computerized tomography. It is unclear whether routine MRI use would increase preoperative diagnostic accuracy and aid in preoperative planning. Total surgical excision of the pseudocyst has been the treatment of choice. Surgical removal has been achieved by means of open surgery, laparoscopy and the robotic system. It remains unclear to this date whether other treatment approaches are feasible. Other options such as debridement, marsupialization or partial excision have been considered inadequate due to concerns such as the possibility of malignant cell seeding, septic complications and risk of recurrence. We present the case of a posttraumatic mesenteric pseudocyst following blunt abdominal trauma in a 27 year old female, treated by surgical excision.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87470506","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":"Closure Techniques and Suture Materials for Upper Blepharoplasty: An Extensive Narrative Literature Review","authors":"Ibrahim H Alawadh, Waleed M Alshehri, Nouf A Alshehri, Ahmed S Alsaleh, Ibrahim AlQuniabut, Sami A Alharethy","doi":"10.26502/jsr.10020213","DOIUrl":"https://doi.org/10.26502/jsr.10020213","url":null,"abstract":"Closure Techniques and Suture Materials Upper Abstract Purpose Blepharoplasty is an operation performed for the correction of functional abnormalities and for esthetic appearance. Differences in various techniques include the wound closure technique and the suture materials used. In this review, we Few studies have been conducted on this subject; however, there are various suturing and non-suturing techniques available for upper blepharoplasty wound closure, and several materials are used for these suturing and non-suturing closure techniques. These techniques include suturing with different materials, such as an adhesive made of a polymer called cyanoacrylate and wound adhesive strips. The selection of the wound closure technique and material should be performed depending on the surgeon’s preference and experience.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77212922","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":"An In-Depth Examination of Surgeon-Scientists' NIH-Funded Areas of Research.","authors":"Lindsay A Demblowski, Andrew M Blakely, Martha A Zeiger","doi":"10.26502/jsr.10020254","DOIUrl":"10.26502/jsr.10020254","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined which National Institutes of Health (NIH) Institutes or Centers (ICs) provide most of the funding to surgeons, nor examined the specifics of their research focus areas. A better understanding of both the goals of ICs and research focus areas for surgeons may facilitate further alignment of the two.</p><p><strong>Methods: </strong>A previously created database of NIH-funded surgeons was queried. To understand trends in funding, total grant cost was calculated for each IC in 2010 and 2020, and distribution of IC funds to each principal investigator (PI) category (surgeons, other physicians, and PhDs without a medical degree) was compared. Finally, total cost for Research Condition and Disease Categorization (RCDC) areas funded to surgeons compared to all of NIH was calculated. Statistical analyses were performed; a two-tailed <i>p</i> value of < 0.05 was considered significant.</p><p><strong>Results: </strong>The National Cancer Institute (NCI) awarded the largest percentage of all 2020 surgeon funding, 34.3% ($298.9M). Compared to the other ICs, surgeons held the largest percentage of the National Eye Institute's (NEI) total funding in 2010 and 2020 at 8.7% and 9.0%, respectively. The RCDC super category comprising the most funding for surgeons was health disparities with 14.5% of all surgeon funding, followed by neurology (13.8%) and cancer (11.4%). Surgeons were awarded 10.8% of NIH's transplant-related research, 7.0% of ophthalmology-related research, and 3.4% of cancer-related research in 2020.</p><p><strong>Conclusions: </strong>Our study shows surgeons have positioned themselves to examine new and myriad research topics while maintaining a focus on health disparities and cancer-related research.</p>","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 3","pages":"541-548"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10532454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Injury Clusters in Polytrauma Patients.","authors":"Tanja Birri,&nbsp;Hans-Christoph Pape,&nbsp;Cyrill Dennler,&nbsp;Hans-Peter Simmen,&nbsp;Jindrich Vomela,&nbsp;Richard Chaloupka,&nbsp;Ladislav Mica","doi":"10.26502/jsr.10020270","DOIUrl":"https://doi.org/10.26502/jsr.10020270","url":null,"abstract":"<p><p>Polytrauma is a major cause of death in young adults. The trial was to identify clusters of interlinked anatomical regions to improve strategical operational planning in the acute situation. A total of 2219 polytrauma patients with an ISS (Injury Severity Score) ≥ 16 and an age ≥ 16 years was included into this retrospective cohort study. Pearson's correlation was performed amongst the AIS (Abbreviated Injury Scale) groups. The predictive quality was tested by ROC (Receiver Operating Curve) and their area under the curve. Independency was tested by the binary logistic regression, AIS ≥3 was taken as a significant injury. The analysis was conducted using IBM SPSS^® 24.0. The highest predictive value was reached in the combination of thorax, abdomen, pelvis and spine injuries (ROC: abdomen for thorax 0.647, thorax for abdomen 0.621, pelvis for thorax 0.608, pelvis for abdomen 0.651, spine for thorax 0.617). The binary logistic regression revealed the anatomical regions thorax, abdomen pelvis and spine as per-mutative independent predictors for each other when a particular injury exceeded the AIS ≥3. The documented clusters of injuries in truncal trauma are crucial to define priorities in the polytrauma management.</p>","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 4","pages":"626-631"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}