Annali italiani di chirurgia最新文献

{"title":"Analysis of Risk Factors for Surgical Treatment of Acute Female Pelvic Inflammatory Disease.","authors":"Xu-Wei Chen, Ye-Qin Zhu, Ping Yu, Jun-Qiang Du, Hua-Qing Li","doi":"10.62713/aic.3364","DOIUrl":"10.62713/aic.3364","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the incidence and high-risk factors associated with the surgical treatment of acute female pelvic inflammatory disease (PID).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all inpatients diagnosed with acute female PID, encompassing conditions such as endometritis, salpingitis, tubo-ovarian abscess, ovarian abscess, and pelvic peritonitis, at Dongyang Hospital of Wenzhou Medical University from January 2013 to December 2021. Patients were categorized into two groups: the surgery group (n = 58) and the non-surgery group (n = 399), based on the necessity of surgical intervention (refer to Materials and Methods for surgical indications). Collected data included patient demographics (age, body mass index (BMI)), comorbidities (hypertension, diabetes mellitus), initial laboratory findings upon admission (white blood cell count, absolute neutrophil count, hemoglobin, platelet count, blood urea nitrogen/creatinine, prothrombin time (PT), international normalized ratio (INR), fibrinogen, albumin), surgical records, and postoperative pathology. Univariate and multivariate logistic regression analyses were conducted to ascertain the risk factors associated with the surgical treatment of acute female PID.</p><p><strong>Results: </strong>Out of 457 hospitalized patients with acute female PID, 58 cases (12.7%) required surgical intervention. Univariate and multivariate logistic regression analyses indicated that advancing age correlated with an increased likelihood of surgical intervention in women with acute PID (odds ratio (OR) = 1.052, 95% Confidence Interval (CI) 1.022-1.082, p = 0.001). Additionally, lower serum albumin levels upon admission were associated with a heightened risk of surgery (OR = 0.913, 95% CI 0.859-0.970, p = 0.003), while elevated fibrinogen levels amplified the risk of surgical intervention in these patients (OR = 1.193, 95% CI 1.008-1.411, p = 0.04).</p><p><strong>Conclusions: </strong>Elderly women diagnosed with acute PID, especially those presenting with abscess formation, should undergo prompt surgical intervention if they display high-risk factors such as low albumin levels and elevated fibrinogen levels upon admission.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"724-728"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054764","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":"Clinical Effects of Enhanced Recovery after Surgery in Perioperative Period Patients with Video-Assisted Thoracoscopic Lobectomy.","authors":"Yinhui Xu, Guanghui Liang, Wei Wang, Wenqun Xing, Junxiao Liu","doi":"10.62713/aic.3386","DOIUrl":"10.62713/aic.3386","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Enhanced recovery after surgery (ERAS) guidelines provide significant benefits for patients after surgery. Care bundles combine various evidence-based treatments and care measures for managing refractory clinical diseases. Therefore, we aimed to evaluate the ERAS measures and care bundles to reduce post-operative complications associated with video-assisted thoracic surgery (VATS) lobectomy and promote patients' recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;As a retrospective study, this study included 120 non-small cell lung carcinoma patients, who were divided into a control group and an observation group according to the post-operative care methods of the patients in the medical record system. Among them, sixty patients, admitted from January 2018 to January 2019, were included in the control group, and 60 patients, admitted from January 2022 to January 2023, were included in the observation group. The control group received routine care (non-ERAS group), and the observation group followed the bundles of care strategy based on ERAS guidelines (ERAS group). Data collected included baseline characteristics, clinical parameters, and post-operative parameters of patients in the ERAS and non-ERAS groups. The clinical data of all patients came from the hospital medical record system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were no significant differences in gender, age, tumor node metastasis (TNM) stages, smoking, and drinking between the ERAS and non-ERAS groups (p &gt; 0.05). Similarly, no significant differences were observed in Cardiac Ejection fraction (≥50%), forced expiratory volume in 1 sec % (FEV1%) forced vital capacity (FVC), Lymphocyte, Neutrophils (%), and Tumor diameter between the ERAS and non-ERAS groups (p &gt; 0.05). In contrast, significant differences were found in FVC, FEV1%, diffusing capacity of the lungs for carbon monoxide single breath (DLCO SB), Albumin, C-reactive protein, Leukocyte, Monocytes, Lymphocyte (%), Hemoglobin, and Neutrophils between the ERAS and non-ERAS groups (p &lt; 0.05). Furthermore, Receiver Operating Characteristic (ROC) analysis indicated that Leukocytes, DLCO, C-reactive protein (CRP), FEV1%, Monocytes, Lymphocytes (%), Neutrophils (%), and Body Mass Index (BMI) were essential predictors of ERAS. Using cutoff values of Leukocytes &gt;12.5, FEV1% &gt;112.9, Monocytes &gt;16.8 (109/L), and Neutrophils &gt;11.6, patients undergoing VATS lobectomy were more likely to experience a quick recover. When ERAS measures integrated bundles of care, the extubation time can reduced to less than 5.5 days, the visual analogue scale (VAS) score to less than 3.5, and the post-operative hospital stay to less than 10.5 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;ERAS management measures based on bundles of care can significantly improve the prognosis of patients undergoing VATS lobectomy, reduce post-operative complications, and accelerate safe rehabilitation. Furthermore, they can greatly shorten hospital stays, lower over","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"583-592"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054777","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":"Diagnostic Efficacy of Type B Vessels in the Japan Esophageal Society Classification for the Depth of Invasion of Superficial Esophageal Squamous Cell Carcinoma.","authors":"Siyue Zhang, Hanchao Pan, Haoran Liu, Yongda Lu, Zhibin Han, Rui Li","doi":"10.62713/aic.3528","DOIUrl":"10.62713/aic.3528","url":null,"abstract":"<p><strong>Aim: </strong>The preoperative diagnostic method for superficial esophageal squamous cell carcinoma (SESCC) invasion depth based on the Japan Esophageal Society (JES) classification has been promoted. However, there have been a few investigations into its diagnostic performance in clinical settings. Therefore, we aimed to elucidate the actual diagnostic performance of the JES classification using a single-center retrospective study design.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 315 newly diagnosed SESCC patients who underwent narrow-band imaging magnifying endoscopy (NBI-ME) examination and received endoscopic submucosal dissection (ESD) or esophagectomy in our center during the past 5 years. To evaluate the diagnostic performance of JES classification in assessing the depth of invasion of SESCC, clinical data of these patients were collected, and the concordance between NBI-ME findings and postoperative pathology reports was analyzed.</p><p><strong>Results: </strong>This study included a total of 338 lesions. The diagnostic accuracy of vascular morphology was 76.0%. The sensitivity (87.0%) and positive predictive value (PPV, 85.4%) of B1 vessels were high, but the specificity (42.0%) and negative predictive value (NPV, 45.3%) were low. The specificity (86.9% and 98.8%) and NPVs (87.5% and 96.8%) of B2 and B3 vessels were high, but the sensitivity (36.4% and 21.4%) and PPVs (35.1% and 42.9%) ware low. Furthermore, only a few lesions (n = 57) described avascular area, but the overall diagnostic accuracy was not ideal (21.1%). However, if lesions invading the superficial submucosa or shallower were included in the category of \"suitable for ESD\", the overall accuracy of the JES classification was found to be 95.6%.</p><p><strong>Conclusions: </strong>In actual clinical settings, the overall accuracy of the JES classification system decreases, but the diagnostic performance of each subtype retains its original characteristics. Additionally, this classification is appropriate for determining whether type 0-II SESCC lesions are suitable for ESD.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"621-627"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054780","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":"Effect of a Percutaneous Screw Guide on Screw Placement for Posterior Talar Fractures.","authors":"Hua Wang, Jichong Ying, Jianlei Liu, Tianming Yu, Dichao Huang","doi":"10.62713/aic.3382","DOIUrl":"10.62713/aic.3382","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to evaluate the hypothesis that the utilization of percutaneous screw guides enhances the precision of screw placement in the surgical fixation of talar fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Computed tomography (CT) scans of ankle joints were obtained from 40 healthy adults and 10 cadaveric specimens between April 2019 and August 2020 at Ningbo No. 6 Hospital. The acquired CT data were imported into Materialise Interactive Medical Image Control System (MIMICS) software for processing. Three-dimensional (3D) digital models of the ankle joints were reconstructed, and relevant anatomical parameters were measured. A percutaneous screw guide (PSG) was designed and fabricated to facilitate accurate screw placement in the posterior talar process. Ten eligible cadaveric ankle joints were selected for further analysis and their 3D models were reconstructed using the MIMICS software. Screw trajectory parameters were then measured and analyzed based on these cadaveric models, forming the model group for comparative analyses. Ten cadaveric specimens were utilized in this study, equally divided into two groups: a guider group (n = 5) and a free-hand group (n = 5). In the guider group, talar posterior process screws were inserted using percutaneous screw guidance. In the free-hand group, screws were inserted into the talar posterior process without guidance. Post-operative CT scans were performed on all specimens. The following parameters were quantitatively compared between the two groups: screw trajectories, entry point distances in specimens with preselected screws, entry point distance trajectories in the 3D model, operation time, frequency of fluoroscopic imaging, and number of drilling attempts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following the generation of the 3D models from 10 cadavers, a virtual screw was digitally inserted into each model. In the model group, the preselected screw trajectory was oriented towards the medial aspect of the talar neck base, with a cephalad inclination angle (CIA) of 3.1° ± 1.5° in the transverse~plane and a medial diverge angle (MDA) of 12.0° ± 1.4° in the coronal plane. The CIA and MDA of the screw trajectory in the guider group were 2.1° ± 1.7° and 11.2° ± 1.6°, respectively, whereas the CIA and MDA in the free-hand group were 6.0° ± 2.2° and 18.8° ± 1.6°, respectively. Statistical analysis revealed significant differences in both CIA and MDA between the two groups (p &lt; 0.05). Furthermore, the guider group yielded superior outcomes in terms of entry point distance, operation time, fluoroscopic exposure time, and number of drilling attempts compared to the free-hand group (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Percutaneous screw guidance can improve the accuracy and safety of the posterior process of the talar screws, which can be feasible for percutaneous fixation. Further studies are required to confirm the efficacy and clinical outcomes of percutaneous screw guidan","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"648-656"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054782","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":"Effect of Modified Miccoli's Thyroidectomy on Post-Operative Stress Responses and Quality of Life in Patients with Differentiated Thyroid Cancer.","authors":"Liang Huang, Xueyun Zhao, Yanmei Lai","doi":"10.62713/aic.3477","DOIUrl":"10.62713/aic.3477","url":null,"abstract":"<p><strong>Aim: </strong>Differentiated thyroid cancer (DTC) is a type of thyroid cancer with rapid progression and poor prognosis, and effective clinical treatment is of great significance in safeguarding the prognostic health of patients. Therefore, we assessed the effect of modified Miccoli's thyroidectomy on stress responses and quality of life in DTC patients, aiming to provide a more comprehensive reference for future DTC treatment.</p><p><strong>Methods: </strong>This study retrospectively analyzed 100 DTC patients admitted to our hospital from January 2023 to December 2023. Study participants were divided into two groups: The research group (n = 57) receiving modified Miccoli's thyroidectomy and the control group (n = 43) receiving routine open thyroidectomy. Surgical indexes (incision length, operative time, intraoperative bleeding, and the number of lymph nodes dissected) and post-operative indexes (post-operative pain, drainage volume, and hospitalization time) were comparatively assessed between the two experimental groups. Furthermore, stress response-associated indexes and immune function were evaluated before and after surgery. Additionally, the post-operative quality of life was investigated in both experimental groups.</p><p><strong>Results: </strong>The research group showed higher operative time but smaller incision length, less intraoperative bleeding, lower post-operative pain scores, less drainage volume, and shorter hospitalization time than the control group (p < 0.05). Furthermore, we observed reduced post-operative stress responses, better immune function, and higher quality of life scores in the research group compared to the control group (p < 0.05).</p><p><strong>Conclusions: </strong>Modified Miccoli's thyroidectomy can effectively alleviate post-operative stress responses in DTC patients and promote their post-operative rehabilitation and quality of life.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"561-567"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054798","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":"Endograft Collapse after Standard Endovascular Aneurysm Repair Implantation: A Report of Two Cases.","authors":"Martina Palughi, Nazzareno Stella, Giulia Colonna, Annalisa Schioppa, Luigi Rizzo, Maurizio Taurino, Pasqualino Sirignano","doi":"10.62713/aic.3373","DOIUrl":"10.62713/aic.3373","url":null,"abstract":"<p><p>Endovascular aneurysm repair (EVAR) has emerged as the preferred treatment for abdominal aortic aneurysm (AAA), offering advantages such as reduced mortality, faster recovery, and fewer complications compared to open repair (OR). However, concerns persist regarding long-term durability, and the need for reinterventions. Among all reported EVAR complications, endograft collapse poses a significant challenge, particularly when presenting with acute lower limb ischemia (ALI). The aim of this report is to describe two cases of non-dissection-related abdominal endograft collapse manifesting as ALI, requiring urgent intervention, emergent conversion to OR and complete endograft removal.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"470-476"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054802","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":"Drive Pressure-Guided Individualized Positive End-Expiratory Pressure in Traumatic Brain Injury Surgery: A Randomized Controlled Trial.","authors":"Xiaoping Chen, Zi Wang, Yali Ge, Ju Gao, Liuqing Yang","doi":"10.62713/aic.3513","DOIUrl":"https://doi.org/10.62713/aic.3513","url":null,"abstract":"<p><strong>Aim: </strong>Intraoperative lung-protective ventilation strategies (LPVS) have been shown to improve lung oxygenation and prevent postoperative pulmonary problems in surgical patients. However, the application of positive end-expiratory pressure (PEEP)-based LPVS in emergency traumatic brain injury (TBI) has not been thoroughly explored. The purpose of this study is to evaluate the effects of drive pressure-guided individualized PEEP on perioperative pulmonary oxygenation, postoperative pulmonary complications, and recovery from neurological injury in patients with TBI.</p><p><strong>Methods: </strong>A total of 111 TBI patients who met the inclusion criteria at Northern Jiangsu People's Hospital were randomized into three groups: group A (0 PEEP, 50% inhaled oxygen concentration, and 6 mL/kg tidal volume), group B (5 cmH2O PEEP, 50% inhaled oxygen concentration, and 6 mL/kg tidal volume), and group C (individualized PEEP guided by driving pressure, 50% inhaled oxygen concentration, and 6 mL/kg tidal volume). The primary endpoints were lung ultrasound score (LUS), optic nerve sheath diameter (ONSD), and serum levels of neuron-specific enolase (NSE) and High mobility group box 1 protein (HMGB1). Secondary endpoints included intraoperative hemodynamic and respiratory mechanics parameters, postoperative pulmonary complications, and clinical lung infection scores.</p><p><strong>Results: </strong>Eighty-nine patients completed the final analysis. LUS was significantly lower in group C compared to group A at T4 (least square mean [95% confidence interval (CI)]: 2.50 [1.35, 3.65] vs. 5.25 [4.10, 6.40], p < 0.05). Although ONSD increased gradually in group C, it did not differ substantially from group A postoperatively (least square mean [95% CI]: 5.09 [4.90, 5.27] vs 5.16 [4.97, 5.34] mm, p > 0.05). Serum NSE levels in group C were significantly lower on postoperative days 1 (4.40 [3.89, 4.41] vs. 10.95 [10.44, 11.46], p < 0.05) and 3 (2.79 [2.28, 3.30] vs. 10.95 [10.44, 11.46], p < 0.05). Additionally, serum HMGB1 levels in group C were significantly reduced on postoperative days 1 (229 [200, 258] vs. 662 [633, 691], p < 0.05) and 3 (166 [137, 195] vs. 662 [633, 691], p < 0.05).</p><p><strong>Conclusions: </strong>Individualized PEEP guided by driving pressure can improve perioperative pulmonary oxygenation and reduce the incidence of postoperative pulmonary complications. Furthermore, this strategy did not significantly elevate intraoperative intracranial pressure (ICP) and promoted recovery from postoperative neurological injury, likely by reducing the inflammatory response.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/ (clinical trial no. ChiCTR2200066795).</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1249-1260"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891477","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":"Efficacy Analysis of Modified Single-Incision Surgery for Repair of Pediatric Chest Wall Defects: A Retrospective Cohort Study.","authors":"Jinlong Liu, Xiaoying Liu, Yong Wu, Rufang Zhang, Qilin Tao, Qiang Wang","doi":"10.62713/aic.3695","DOIUrl":"https://doi.org/10.62713/aic.3695","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to compare the efficacy of modified single-incision surgery with that of traditional modified Ravitch surgery for the repair of pectus excavatum in pediatric patients.</p><p><strong>Methods: </strong>In this retrospective study, we included patients who underwent surgical correction for sternal depression from January 2015 to December 2020 across four major medical centers. Patients were categorized into two specific groups on the basis of the surgical technique employed: the modified single-incision surgery group, which comprised patients treated using the novel single-incision approach, and the traditional modified Ravitch surgery group, which included patients who received the conventional Ravitch surgery with multiple incisions. This study only included patients in the age range of 10 to 18 years, diagnosed with moderate to severe pectus excavatum, and lacked remarkable comorbid conditions that could influence surgical outcomes. Comprehensive data on preoperative characteristics, intraoperative variables, and postoperative results were collected for analysis.</p><p><strong>Results: </strong>The modified single-incision surgery group showed significantly lower mean blood loss, mean operating time, mean hospital stay, postoperative drainage rate, postoperative mean Haller index and mean Haller index after bar removal compared to the traditional modified Ravitch surgery group (p < 0.05). Furthermore, the surgical outcomes were significantly better in the modified single-incision surgery group (p = 0.010) than in the traditional modified Ravitch surgery group. The modified single-incision surgery group also had a significantly lower incidence of postoperative complications, including pneumothorax, pleural effusion, pulmonary infection, bar rejection, and bar flipping and displacement (p < 0.05), than the traditional modified Ravitch surgery group. The modified single-incision surgery group showed significantly greater improvement in sternal depression depth compared to the traditional modified Ravitch surgery group (p = 0.031). Corrected symmetry was significantly better in the modified single-incision surgery group (p = 0.037). The overall satisfaction of patients in the modified single-incision surgery group was significantly higher than that in the traditional modified Ravitch surgery group (p = 0.011).</p><p><strong>Conclusions: </strong>The modified single-incision procedure for the treatment of pectus excavatum offers considerable advantages over the traditional modified Ravitch surgery. The findings of this study suggest that the modified single-incision procedure is a safe and effective alternative for the correction of pectus excavatum.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1085-1094"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891479","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":"A Case Report Describing the Surgical Removal of Venous and Intracardiac Cement Leakage after Percutaneous Vertebroplasty in a Hybrid Operating Room.","authors":"Giorgio Mastroiacovo, Edona Leka, Francesca Marchetti, Riccardo Maragna, Ermes Carulli, Marco Agrifoglio","doi":"10.62713/aic.3515","DOIUrl":"https://doi.org/10.62713/aic.3515","url":null,"abstract":"<p><strong>Aim: </strong>Percutaneous vertebroplasty is generally considered a safe procedure, however, cases of cardioembolism and cardiac perforation have been reported.</p><p><strong>Case presentation: </strong>A 69-year-old woman was referred to our emergency department after an outpatient echocardiogram revealed a \"thrombus-like\" formation involving the right heart. Two weeks before she had undergone percutaneous vertebroplasty of the third to fifth lumbar vertebrae due to osteoporotic fractures. She presented with palpitations. Further investigations revealed polymethyl methacrylate leakage involving the inferior vena cava, the right atrium, and the right ventricle in the total.</p><p><strong>Results: </strong>Although the patient was clinically and hemodynamically stable, decisions about the timing and the specific technique for surgical removal of the foreign body were challenging. Considerable multidisciplinary teamwork involving cardiologists, cardiac surgeons, anesthetists, and bioengineer specialists of the bone cement was necessary due to the extension of the consolidated leakage.</p><p><strong>Conclusions: </strong>Through a combined approach with sternotomy and fluoroscopic guidance, it was possible to remove the foreign body without intraoperative complications. The patient recovered and returned to her normal life, following cardiac and physical rehabilitation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1072-1075"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891528","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":"Systematic Review and Meta-Analysis of Application of Ultrasound-Guided Thoracic Paravertebral Block in Clinical Surgical Treatment.","authors":"Yanchun Fang, Haiyan Lu, Jinxia Yang, Hailing He, Suhuan Rao","doi":"10.62713/aic.3495","DOIUrl":"https://doi.org/10.62713/aic.3495","url":null,"abstract":"<p><strong>Aim: </strong>There is a lack of consensus regarding the efficacy of thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) for postoperative pain in randomized controlled trials (RCTs). The comparison of TPVB and ESPB was explored through a systematic review and meta-analysis (MA) of relevant RCTs.</p><p><strong>Methods: </strong>A comprehensive search of relevant literature was conducted using databases such as PubMed, Embase, and MEDLINE, from 2019 to June 2024. The search utilized keywords such as \"TPVB\", \"ESPB\", and \"postoperative analogy\". Following the search, quality evaluation and extraction of outcome indicators were implemented. The software RevMan5.3 was employed for data analysis and evaluation.</p><p><strong>Results: </strong>The analysis included 18 articles. In patients at rest, a significant difference in pain scores was observed between the TPVB group and the ESPB group at 1 h postoperatively, with a standardized mean difference (SMD) of -0.52 [95% confidence interval (CI): -0.88 to -0.16, p = 0.005]. In non-resting patients, there were significant differences in pain scores between TPVB and ESPB at 24 and 48 h postoperatively. At 24 h postoperatively, the SMD was -0.37 (95% CI: -0.69 to -0.05, p = 0.02), and at 48 h postoperatively, in the visual analog scale (VAS) subgroup, the SMD was -0.38 (95% CI: -0.65 to -0.11, p = 0.006). Furthermore, notable statistical variations were identified in the frequency of rescue analgesia required following surgery between TPVB and ESPB.</p><p><strong>Conclusions: </strong>The meta-analysis indicated that lower clinical pain scores in non-resting states at 24 and 48 h post-surgery were associated with TPVB rather than ESPB. This finding was accompanied by a more discernible and accurate analgesic effect, as well as a significant reduction in the need for rescue analgesia following surgical procedures.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1026-1047"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891578","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}