Global journal of surgery最新文献

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Cyanoacrylate Mesh Fixation in Lichtenstein Inguinal Hernia Repair. Does It Have Advantages? 氰基丙烯酸酯补片固定在腹股沟利希滕斯坦疝修补中的应用。它有优势吗?

Global journal of surgery Pub Date : 2019-01-03 DOI: 10.12691/JS-7-1-1

L. Vega, Kevin Oh-Uiginn, D. Carmona, D. Salazar, R. Rodríguez, Hasan Janafse, M. Molinete, J. Camps

{"title":"Cyanoacrylate Mesh Fixation in Lichtenstein Inguinal Hernia Repair. Does It Have Advantages?","authors":"L. Vega, Kevin Oh-Uiginn, D. Carmona, D. Salazar, R. Rodríguez, Hasan Janafse, M. Molinete, J. Camps","doi":"10.12691/JS-7-1-1","DOIUrl":"https://doi.org/10.12691/JS-7-1-1","url":null,"abstract":"Objectives: To compare the short-term effects of mesh fixation in Lichtenstein inguinal hernia repair. Materials and methods: Prospective, randomized and unicentric study of patients undergoing primary, unilateral inguinal hernia, operated under the Lichtenstein technique; comparing the mesh fixation with n-butyl-2-cyanoacrylate (group I) versus non-reabsorbable suture (group II). The study variables in the postoperative period focused on the incidence of pain, complications and hernia recurrence. Results: 120 patients have been included, from 26/11/2013 to 09/02/2015. 60 patients in each treatment arm. In group I pain was recorded (EVA ≥3) at 24h in 19 patients, at 30 days in 9 patients and at 90 days in 1 patient, against 22, 15 and 6 patients in group II (p= 0, 56; p= 0.17, p= 0.048, specifically). The incidence of morbidity at 90 days was 15% in the cyanoacrylate group and 13.33% in the suture fixation group, p= 0.79. Repairs were 4.8 minutes faster in the glue group (p= 0.02). There were no early recurrences in either group. Discussion: There were no differences in the incidence of acute pain evaluated at 24 hours after the intervention or at 30 days, but there was a lower incidence in favor of the glue at the 90-day assessment p= 0.048. There were no statistically significant differences in complications at 90 days, we objective reduction in surgical time of 4.8 minutes in favor of the cyanoacrylate. There were not early recurrence. ANZCTR registration with reference number ACTRN12616000242426.","PeriodicalId":89556,"journal":{"name":"Global journal of surgery","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91186242","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}

引用次数: 0

Serum Bilirubin Levels Can Predict Pancreatic and Biliary Malignancies in Patients with Obstructive Jaundice and Non-conclusive Cytology 血清胆红素水平可预测梗阻性黄疸和非结论性细胞学患者的胰腺和胆道恶性肿瘤

Global journal of surgery Pub Date : 2018-11-06 DOI: 10.12691/JS-6-1-3

Assad Khan, S. Lapsia, M. Aslam, V. Kaushik, Y. Reddy, D. Subar

{"title":"Serum Bilirubin Levels Can Predict Pancreatic and Biliary Malignancies in Patients with Obstructive Jaundice and Non-conclusive Cytology","authors":"Assad Khan, S. Lapsia, M. Aslam, V. Kaushik, Y. Reddy, D. Subar","doi":"10.12691/JS-6-1-3","DOIUrl":"https://doi.org/10.12691/JS-6-1-3","url":null,"abstract":"Background: Elevated serum bilirubin has been shown to be a reliable predictor of pancreatic and biliary malignancy but the relationship between serum bilirubin and inadequate (C1), benign (C2) and indeterminate (C3) cellular samples has not been explored. The aim of this study is to determine the relationship between serum bilirubin and pancreatic, biliary or ampullary malignancy in the context of non-confirmatory cytology. Methods: This is a retrospective analysis of patients with obstructive jaundice undergoing investigation for possible pancreatic, peri-ampullary or biliary malignancy between 2009 and 2013. Results: 135 patients were included; 84 had a malignant diagnosis and 51 benign. All patients with C4 or C5 cytology (n=49) had confirmed malignancy. 35 out of 86 C1 – C3 samples were falsely negative. ROC curve analysis demonstrated a strong association (AUC 0.912) between elevated serum bilirubin and malignancy; serum bilirubin ≥ 100 µmol/L had a sensitivity of 86% and a specificity of 88%. In the C1-C3 subgroup, this association was maintained (AUC 0.905). Serum bilirubin ≥ 100 µmol/L had a sensitivity of 80% and specificity of 88%. Using this cut-off highlighted 28 out of 35 of the malignancies missed by cytology (p = 0.003). Conclusion: Our study demonstrates that a serum bilirubin ≥ 100 µmol/L is associated with malignancy and this relationship is maintained in C1-C3 cytology. When faced with non-confirmatory cytology in the absence of a benign aetiology and an elevated serum bilirubin ≥ 100 µmol/L, we advocate more aggressive investigation to avoid missing an occult malignancy.","PeriodicalId":89556,"journal":{"name":"Global journal of surgery","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89425145","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}

引用次数: 2

Re-examining treatment strategies for sigmoid volvulus: An analysis of treatment and outcomes in Lilongwe, Malawi. 重新检查乙状结肠扭转的治疗策略:马拉维利隆圭的治疗和结果分析。

Global journal of surgery Pub Date : 2010-10-01

Jonathan C Samuel, Adesola Akinkuotu, Nelson Msiska, Bruce A Cairns, Arturo P Muyco, Anthony G Charles

{"title":"Re-examining treatment strategies for sigmoid volvulus: An analysis of treatment and outcomes in Lilongwe, Malawi.","authors":"Jonathan C Samuel, Adesola Akinkuotu, Nelson Msiska, Bruce A Cairns, Arturo P Muyco, Anthony G Charles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>INTRODUCTION: Sigmoid volvulus is a common surgical emergency in many regions of the world, with significant morbidity and mortality. The aims of this study were to (a) summarize outcomes and (b) define a treatment algorithm for sigmoid volvulus in our setting. EXPERIMENTAL: Five year (2003-2008) retrospective review of sigmoid volvulus cases at Kamuzu Central Hospital, in Lilongwe, Malawi. RESULTS AND DISCUSSION: There were 239 cases of sigmoid volvulus identified. Cases were mostly seen in males (91.7%), with a median age of 50 (range 18-86). Gangrene was noted in 36.7% of cases. Mesosigmoidopexy (36%), Hartmann's procedure (33%), and resection and anastomosis (23%) were the most common procedures. There was seasonal variation with more cases seen in the harvest months of March and April. The major complications noted were recurrence (5 of 6 recurrences after mesosigmoidopexy / plasty) and anastomotic leakage after resection and anastomosis (2 in gangrenous, and 2 in non-gangrenous sigmoid volvulus). CONCLUSIONS: Gangrenous sigmoid volvulus is best managed with Hartmann's procedure. Non-gangrenous sigmoid volvulus is best managed with resection and anastomosis, unless there are risk factors for anastomotic leakage, in which case the surgeon should consider mesosigmoidopexy with non-absorbable suture.</p>","PeriodicalId":89556,"journal":{"name":"Global journal of surgery","volume":"1 2","pages":"149-153"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345201/pdf/nihms355556.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30603868","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

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