ISRN surgery最新文献_第7页

Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil). 肝胆胰手术中的止血剂:一种新型载体结合纤维蛋白密封剂(TachoSil)的文献综述和关键评价。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-09-13 DOI: 10.5402/2012/729086

K A Simo, E M Hanna, D K Imagawa, D A Iannitti

{"title":"Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil).","authors":"K A Simo, E M Hanna, D K Imagawa, D A Iannitti","doi":"10.5402/2012/729086","DOIUrl":"https://doi.org/10.5402/2012/729086","url":null,"abstract":"Background. Despite progress in surgical techniques applied during hepatobiliary and pancreas (HPB) surgery, bleeding and bile leak remain significant contributors to postoperative mortality and morbidity. Topical hemostatics have been developed and utilized across surgical specialties, but data regarding effectiveness remains inconsistent and sparse in HPB surgery. Methods. A comprehensive search for studies and reviews on hemostatics in HPB surgery was performed via an October 2011 query of Medline, EMBASE, and Cochrane Library. In-depth evaluation of a novel carrier-bound fibrin sealant (TachoSil) was also performed. Results. The literature review illustrates multiple attempts have been made at developing different topical hemostatics and sealants to aid in surgical procedures. In HPB surgery, efforts have been directed at decreasing bleeding, biliary leakage, and pancreatic fistula. Conflicting scientific evidence exists regarding the effectiveness of these agents. Critical evaluation of the literature demonstrates TachoSil is a valuable tool in achieving hemostasis, and possibly biliostasis and pancreatic fistula prevention. Conclusion. While progress has been made in topical hemostatics for HPB surgery, an ideal agent has not yet been identified. TachoSil is promising, but larger randomized, controlled clinical trials are required to more fully evaluate its efficacy in reducing bleeding, biliary leakage, and pancreatic fistulas in HPB surgery.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"729086"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/729086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30947522","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}

引用次数: 37

Recent advances in biomarkers and potential targeted therapies in head and neck squamous cell carcinoma. 头颈部鳞状细胞癌生物标志物及潜在靶向治疗的最新进展。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-02-15 DOI: 10.5402/2012/715743

Eric J Yavrouian, Uttam K Sinha

引用次数: 7

Does number of ports affect outcomes in patients undergoing laparoscopic pyloromyotomy? Retrospective chart-review study. 腹腔镜幽门切开术患者的门静脉数量是否影响预后?回顾性图表回顾研究。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-02-01 DOI: 10.5402/2012/745964

Tariq O Abbas, Adel Ismail

{"title":"Does number of ports affect outcomes in patients undergoing laparoscopic pyloromyotomy? Retrospective chart-review study.","authors":"Tariq O Abbas, Adel Ismail","doi":"10.5402/2012/745964","DOIUrl":"https://doi.org/10.5402/2012/745964","url":null,"abstract":"Background. Although open Ramstedt's pyloromyotomy is the gold standard for the surgical management of infantile hypertrophic pyloric stenosis, laparoscopic pyloromyotomy has been found highly successful. Various factors, however, can affect the outcomes of surgical interventions in these patients. We observed a relationship between the number of ports used and outcome in patients undergoing laparoscopic pyloromyotomies. Methods. We retrospectively assessed the medical records of selected group of patients who underwent laparoscopic pyloromyotomy in our institution. Factors analyzed included operation time, length of hospital stay, postoperative complications, and time to postoperative full feeding. Results. We observed failure of myotomy in both two patients who underwent laparoscopic pyloromyotomy using only two working ports compared to successful myotomies in the remaining patients. Conclusion. Laparoscopy provides good results in terms of intraoperative exposure and cosmesis. However, standardized surgical technique with two working ports is advisable, and this can trigger further research to be ascertained.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":" ","pages":"745964"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/745964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40173547","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}

引用次数: 0

Comparison between Tube Ileostomy and Loop Ileostomy as a Diversion Procedure. 管式回肠造口术与环形回肠造口术分流术的比较。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-12-18 DOI: 10.5402/2012/547523

Vijayraj Patil, Abhishek Vijayakumar, M B Ajitha, Sharath Kumar L

{"title":"Comparison between Tube Ileostomy and Loop Ileostomy as a Diversion Procedure.","authors":"Vijayraj Patil, Abhishek Vijayakumar, M B Ajitha, Sharath Kumar L","doi":"10.5402/2012/547523","DOIUrl":"https://doi.org/10.5402/2012/547523","url":null,"abstract":"Aim. Loop ileostomy has high complication rates and causes much patient inconvenience. This study was performed to compare the outcome of tube versus loop ileostomy in management of ileal perforations. Patients and Methods. From July 2008 to July 2011, all patients with ileal perforation on laparotomy where a defunctioning proximal protective loop ileostomy was considered advisable were chosen for study. Patients were randomly assigned to undergo either tube ileostomy or classical loop ileostomy as the diversion procedure. Tube ileostomy was constructed in the fashion of feeding jejunostomy, with postoperative saline irrigation. Results. A total of 60 diversion procedures were performed over the period with 30 for each of tube and loop ileostomy. Typhoid and tuberculosis formed the most common etiology for ileal perforation. The complication rate of tube ileostomy was 33%. Main complications related to tube ileostomy were peritubal leak, tube blockage. In patients with loop, overall complications in 53% majority were peristomal skin irritation and wound infection following ileostomy closure. Two patients developed obstruction following ileostomy closure which needed reoperation. Conclusions. Tube ileostomy is effective and feasible as a diversion procedure and has reduced morbidity. It can be used as an alternative to loop ileostomy.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"547523"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/547523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31162204","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}

引用次数: 27

Outcomes of open subacromial decompression after failed arthroscopic acromioplasty. 关节镜下肩峰成形术失败后开放性肩峰下减压的疗效。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-05-09 DOI: 10.5402/2012/806843

Anand Pillai, Vivek Eranki, Joby Malal, Gavin Nimon

引用次数: 2

Appropriate patient selection in the management of common bile duct stones: when not to do ERCP. 胆总管结石的适当患者选择:何时不做ERCP。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-06-13 DOI: 10.5402/2012/286365

Palak Jitendrakumar Trivedi, Donald Tse, Ibrahim Al-Bakir, Horace D'Costa

{"title":"Appropriate patient selection in the management of common bile duct stones: when not to do ERCP.","authors":"Palak Jitendrakumar Trivedi, Donald Tse, Ibrahim Al-Bakir, Horace D'Costa","doi":"10.5402/2012/286365","DOIUrl":"10.5402/2012/286365","url":null,"abstract":"Background. Magnetic resonance cholangiopancreatography (MRCP) is noninvasive and accurate for diagnosing intra common bile duct stones (ICSs). However, given limited access, routine utilisation for investigating all patients with gallstone disease is neither practical nor cost-effective. Conversely, many individuals proceed directly to endoscopic retrograde cholangiopancreatography (ERCP), an invasive test with appreciable complications. Aim. Identify factors associated with ICS in order to improve risk-stratification for MRCP/ERCP. Methods. All patients having undergone cholecystectomy between November 2007 and October 2008 were reviewed. High-risk features for ICS were predefined, and their true presence confirmed by ERCP or intraoperative cholangiogram. Multivariate logistic regression was performed on candidate risk features. Results. Of 231 patients, 10.4% had ICS. Defining a high-risk group with \"both\" biochemical and ultrasound risk factors predicted ICS with 92% specificity and also bore strong association (OR 8.88). However, isolated hyperbilirubinaemia, ultrasound impression of CBD stones, and clinical risk factors did not (OR 1.10, 0.97, and 1.26). Normal liver biochemistry and normal ultrasound had a NPV of 99.5% for ICS. Conclusions. Ultrasound impression of CBD calculi without ductal dilatation is not predictive of ICS. Patients with normal liver biochemistry and normal CBD diameter on ultrasound are unlikely to have ICS and should not proceed to ERCP.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"286365"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/286365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30750342","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}

引用次数: 8

Correlates of morbidity and mortality in severe necrotizing pancreatitis. 严重坏死性胰腺炎发病率和死亡率的相关因素。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-07-09 DOI: 10.5402/2012/215193

K M Pal, Pashtoon Murtaza Kasi, Mohammad Tayyeb, S M Faisal Mosharraf, Zafar Fatmi

{"title":"Correlates of morbidity and mortality in severe necrotizing pancreatitis.","authors":"K M Pal, Pashtoon Murtaza Kasi, Mohammad Tayyeb, S M Faisal Mosharraf, Zafar Fatmi","doi":"10.5402/2012/215193","DOIUrl":"https://doi.org/10.5402/2012/215193","url":null,"abstract":"Acute severe pancreatitis is associated with a high morbidity and mortality and frequently is accompanied by underlying pancreatic parenchymal necrosis. Patients with pancreatic necrosis must be identified, because the morbidity and mortality rate in this subgroup is much higher. Our objective was to compare the clinical outcomes of these patients based on the degree of pancreatic necrosis. A total of 35 patients were noted to have pancreatic necrosis. These were divided into 2 groups based on extent of necrosis: group A had less than 50% necrosis and group B had more than 50% necrosis. The rate of mortality (5% versus 40%) was significantly higher in group B. The rate of organ dysfunction also rose along with the rates of other morbidities and variables that were related to a patient's hospital stay. Only APACHE II significantly correlated with the degree of necrosis, wherein the chances of substantial necrosis rose by 20% with each unit increase of APACHE II score. APACHE II Score could be employed and studied further prospectively to help identify patients with pancreatic necrosis.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"215193"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/215193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30798913","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}

引用次数: 18

Incidence and Surgical Importance of Zuckerkandl's Tubercle of the Thyroid and Its Relations with Recurrent Laryngeal Nerve. 甲状腺Zuckerkandl结节的发病率、手术重要性及其与喉返神经的关系。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-08-16 DOI: 10.5402/2012/450589

Emin Gurleyik, Gunay Gurleyik

{"title":"Incidence and Surgical Importance of Zuckerkandl's Tubercle of the Thyroid and Its Relations with Recurrent Laryngeal Nerve.","authors":"Emin Gurleyik, Gunay Gurleyik","doi":"10.5402/2012/450589","DOIUrl":"https://doi.org/10.5402/2012/450589","url":null,"abstract":"Background. Variations of recurrent laryngeal nerve (RLN) and Zuckerkandl's tubercle (ZT), which is posterior extension of lateral lobes, may affect safety of thyroidectomy. Methods. Total and hemithyroidectomy were surgical procedures in 60 and 40 patients, respectively. Surgical anatomy was studied in 87 right and 73 left lobes. Presence of ZT was noted and its incidence was determined. RLNs were identified and fully isolated. Relationship between ZT and RLN was established. Results. ZTs were identified in 66 (66%) patients and in 81 (51%) lobes. ZT was present in 53 (61%) right and in 28 (38%) left lobes. ZTs were bilateral in 15 (25%) of 60 total thyroidectomy cases. Smaller tubercles show the neurovascular crossing point. RLN was posterior (medial) to ZT in 76 (94%) occurrences. RLN was laying on anterior surface of ZT only in 5 (6%) instances. Conclusions. RLN is unusually laying lateral to ZT which is common structure in the thyroid. Lateral RLN may be more vulnerable to injury. Total thyroidectomy requires dissection of ZT adjacent to RLN. Based on unusual relations and variations, RLN should be fully isolated before excision of adjacent structures.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"450589"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/450589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30887861","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}

引用次数: 28

Biliary atresia: 50 years after the first kasai. 胆道闭锁:第一次开斋后50年。

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-12-06 DOI: 10.5402/2012/132089

Barbara E Wildhaber

{"title":"Biliary atresia: 50 years after the first kasai.","authors":"Barbara E Wildhaber","doi":"10.5402/2012/132089","DOIUrl":"https://doi.org/10.5402/2012/132089","url":null,"abstract":"Biliary atresia is a rare neonatal disease of unknown etiology, where obstruction of the biliary tree causes severe cholestasis, leading to biliary cirrhosis and death in the first years of life, if the condition is left untreated. Biliary atresia is the most frequent surgical cause of cholestatic jaundice in neonates and should be evoked whenever this clinical sign is associated with pale stools and hepatomegaly. The treatment of biliary atresia is surgical and currently recommended as a sequence of, eventually, two interventions. During the first months of life a hepatoportoenterostomy (a \"Kasai,\" modifications of which are discussed in this paper) should be performed, in order to restore the biliary flow to the intestine and lessen further damage to the liver. If this fails and/or the disease progresses towards biliary cirrhosis and life-threatening complications, then liver transplantation is indicated, for which biliary atresia represents the most frequent pediatric indication. Of importance, the earlier the Kasai is performed, the later a liver transplantation is usually needed. This warrants a great degree of awareness of biliary atresia, and the implementation of systematic screening for this life-threatening pathology.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"132089"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/132089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31151131","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}

引用次数: 101

Locally advanced pancreatic head cancer: margin-positive resection or bypass? 局部晚期胰头癌:边缘阳性切除还是旁路手术?

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-06-18 DOI: 10.5402/2012/513241

Ulrich Friedrich Wellner, Frank Makowiec, Dirk Bausch, Jens Höppner, Olivia Sick, Ulrich Theodor Hopt, Tobias Keck

{"title":"Locally advanced pancreatic head cancer: margin-positive resection or bypass?","authors":"Ulrich Friedrich Wellner, Frank Makowiec, Dirk Bausch, Jens Höppner, Olivia Sick, Ulrich Theodor Hopt, Tobias Keck","doi":"10.5402/2012/513241","DOIUrl":"https://doi.org/10.5402/2012/513241","url":null,"abstract":"Pancreatic cancer is a highly aggressive disease with poor survival. The only effective therapy offering long-term survival is complete surgical resection. In the setting of nonmetastatic disease, locally advanced tumors constitute a technical challenge to the surgeon and may result in margin-positive resection margins. Few studies have evaluated the implications of the latter in depth. The aim of this study was to compare the margin-positive situation to palliative bypass procedures and margin-negative resections in terms of perioperative and long-term outcome. By retrospective analysis of prospectively maintained data from 360 patients operated for pancreatic cancer at our institution, we provide evidence that margin-positive resection still yields a significant survival benefit over palliative bypass procedures. At the same time, perioperative severe morbidity and mortality are not significantly increased. Our observations suggest that pancreatic cancer should be resected whenever technically feasible, including, cases of locally advanced disease.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2012 ","pages":"513241"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/513241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30750343","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}

引用次数: 10