Journal of current surgery最新文献

{"title":"Surgical Management of Coexisting Primary Splenic Abscess and Lymphoma: Case Report and Review of Literature","authors":"Sundus Abbasi, Emma Punni, E. Fakhoury, P. Michael, H. Bui","doi":"10.14740/JCS304W","DOIUrl":"https://doi.org/10.14740/JCS304W","url":null,"abstract":"We present an extremely rare case of combined splenic abscess and B-cell lymphoma in a patient who was initially admitted for congestive heart failure. Due to its non-specific clinical picture, the final diagnosis was challenging. The patient was initially conservatively managed with antibiotics and percutaneous drainage of the abscess and then definitively managed with a splenectomy. This is the first case described with both pathological processes present simultaneously. J Curr Surg. 2016;6(3-4):73-74 doi: https://doi.org/10.14740/jcs304w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"14 1","pages":"73-74"},"PeriodicalIF":0.0,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89548981","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":"Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review","authors":"S. Biswas, L. Richards","doi":"10.14740/JCS308W","DOIUrl":"https://doi.org/10.14740/JCS308W","url":null,"abstract":"Splenic rupture due to trauma is relatively common. However, spontaneous non-traumatic ruptures do occur. Causes include infection, neoplasia and infiltrative process. We present an unique case of a 59-year-old patient who presented with dyspnea and left upper abdominal discomfort following bouts of coughing, and was provisionally diagnosed as pulmonary embolism. CT scan revealed splenic rupture. Only a few case reports are published documenting spontaneous splenic rupture following coughing. The therapy of choice can vary between patients depending on the grade of splenic rupture, hemodynamic instability, availability of endovascular treatment and physician preference. Treatment should be focused on preserving splenic tissue if feasible. Non-traumatic rupture of the spleen must be considered in patients presenting with left-sided upper abdominal pain even without evident history of trauma, since early recognition and treatment can prevent serious morbidity and mortality. J Curr Surg. 2016;6(3-4):81-85 doi: https://doi.org/10.14740/jcs308w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"1 1","pages":"81-85"},"PeriodicalIF":0.0,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79913421","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":"A Comparative Study of Polydioxanone and Nylon for Abdominal Wall Closure With Interrupted Figure of Eight in Peritonitis Cases","authors":"R. Singal, Mohinder Kumar, Nitin Kaushik, Siddhartha Dhar, Bir Singh","doi":"10.14740/JCS306E","DOIUrl":"https://doi.org/10.14740/JCS306E","url":null,"abstract":"Background: In emergency and elective settings, some surgeons prefer continuous or interrupted closure of abdominal fascia, because in a continuous suturing, cutting out of even a single bite of tissue leads to opening of the entire wound and high risk of burst abdomen, whereas in interrupted method, they found much lower risk of burst abdomen. The aim is to assess the complication rate with the same closure technique between two different sutures. The best suture is one that maintains tensile strength throughout the healing process with good tissue approximation and less wound infection, is well tolerated by patient and is technically simple and expedient. The aim was to compare the non-absorbable sutures (nylon) and delayed absorbable sutures (polydioxanone (PDS)) for abdominal wall closure in cases of peritonitis. We used a different technique to close the abdominal wall fascia and study the postoperative complications. Methods: This was a prospective study carried out in the Department of Surgery, MMIMSR, Mullana, Ambala from March 2014 to April 2015, a single unit by a single surgeon. A total of 60 patients underwent interrupted closure of abdominal fascia by figure of eight techniques with polyamide (nylon No. 1) suture in group A and polydiaxanone (PDS No. 1) suture in group B. The incidence rates of wound infection, dehiscence, suture sinus formation and incisional hernia were recorded. Patients were followed up for a period of 1 year. Results: Out of the 60 patients, the rates of wound pain, discharge and dehiscence in group A were 30%, 23.3% and 26.7% and in group B were 6.7%, 16.6% and 23.3%. There was 0 burst abdomen in group A compared to one burst abdomen in group B. Suture sinus formation, chronic wound infection and stitch granuloma was one each in group A and was 0 in group B. Incisional hernia was not found in any of the group. We have concluded that condition of the wound depends on the comorbidity of the patient like smoking, malnutrition, and old peritonitis. It also mainly depends on the technique used for closure of the wound and also on the material used. Conclusion: Though wound complications were found more in non-absorbable suture but the rate of wound complications between the two sutures was found insignificant. The purpose of the study is to assess the presence of differences in abdominal wall closure in patients with risk criteria, with the same closure technique between slowly absorbable sutures and non-absorbable sutures. Sutures were placed and tied such that fascial edges were well approximated but not compressed tightly together. J Curr Surg. 2016;6(3-4):65-72 doi: https://doi.org/10.14740/jcs306e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"15 1","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80017098","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":"Midfacial Degloving Approach for Bilateral Giant Cell Reparative Granuloma","authors":"G. Ahluwalia, K. Morwani","doi":"10.14740/JCS304E","DOIUrl":"https://doi.org/10.14740/JCS304E","url":null,"abstract":"Reparative giant cell granuloma is a rare benign tumor. Mandible is the most common site. The case is reported for its rarity in maxilla and difficulty in differentiating it from other giant cell lesions. Differentiation is only based on the clinical test and histopathological examination. Midfacial degloving approach popularized by Caisson et al and Conley in 1974 is best suited for bilateral facial lesions. This approach gives a wide exposure with no facial scar or deformity. The advantages of the degloving technique in exposure of the midface, maxilla, mandible, nasal cavities, and paranasal sinuses, have led to its increasing importance in the otorhinolaryngology. J Curr Surg. 2016;6(3-4):78-80 doi: https://doi.org/10.14740/jcs304e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"7 1","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81973641","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":"The Pigtail Catheter for Pleural Drainage: A Less Invasive Alternative to Tube Thoracostomy","authors":"Asmita A. Mehta, A. Gupta, Aziz Kallikunnel Sayed Mohamed","doi":"10.14740/JCS300E","DOIUrl":"https://doi.org/10.14740/JCS300E","url":null,"abstract":"Background: Thoracostomy tubes are a mainstay of treatment for removing fluid or air from the pleural space. Placement of a chest tube is, however, an invasive procedure with potential morbidity. In an effort to reduce these complications, the use of percutaneous pigtail catheters in place of traditional large-bore tubes for thoracostomy and pleural drainage has been described. The aim of the study was to determine the role of pigtail catheters in adult population for drainage of pleural effusion. Methods: It was an observational study. All consecutive patients with pleural effusion requiring drainage were subjected to either tube thoracostomy or pig tail drainage. A standardized questionnaire was prepared for retrieving data. Outcomes of interest were time to drain and total duration of hospital stay. Results: A total of 92 patients (71 men and 21 women; age range, 17 - 86 years; mean age, 54 ± 15 years) were enrolled into the study. Thirty-five patients were treated with traditional chest tubes, whereas 57 patients were treated with pigtail catheters. There were no significant differences in either drainage days or hospitalization days between the chest tube group and pigtail catheter group (9.81 ± 6 vs. 9 ± 5.6 and 13.8 ± 6 vs. 13 ± 5.7, respectively). Conclusions: The pigtail catheter offers reliable treatment of effusions and is a safe and less invasive alternative to tube thoracostomy. There was no significant difference in time to drain and duration of hospital stay in both the groups. J Curr Surg. 2016;6(2):52-56 doi: http://dx.doi.org/10.14740/jcs300e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"46 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77853170","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":"Assessing Outcomes After Breast Surgery: Patient and Clinician Reported Outcomes","authors":"J. Kilkenny, Douglas C. Brown, Avril Gunning, M. Reis, E. Macaskill","doi":"10.14740/JCS.303W","DOIUrl":"https://doi.org/10.14740/JCS.303W","url":null,"abstract":"Background: Survival has significantly improved in women diagnosed with breast cancer, and as a result, it has become increasingly important to assess the psychological outcomes from the patient’s perspective. Interpreting the outcome based on the opinion of the operating surgeons may not reflect the opinions of the patient. The aim of this study was to assess clinician and patient reported outcomes of breast surgery at routine follow-up. Methods: Consecutive patients previously treated for breast cancer attending routine follow-up breast clinic over a period of 5 weeks were invited to participate. Patients were first seen by a clinician for review (four breast surgeons and one clinical nurse specialist), and cosmetic outcome was assessed using the Harris Harvard scale. Patient reported outcomes were measured using the Hopwood body image scale 10-item questionnaire. Results: Of 105 patients, complete data were available for 84 patients. All patients were female with a median age of 65 years (range 32 - 83 years). Wide local excisions accounted for 54% of all surgeries (n = 45), mastectomies 26% (n = 22) and mastectomy with reconstruction 20% (n = 17). Patients’ scores ranged from 0 to 30 with a median score of 1; 9% of patients had a score of > 10. Clinician rating was “excellent” for 37%, 34% as “very good”, 22% as “good” and 5.9% as “poor”. There was a weak correlation of patient scores to clinician score (Spearman rho: 0.219; 95% CI: 0.005 - 0.414; P = 0.045). Conclusions: With standard breast surgery, the majority of patients seen at follow-up clinics were satisfied with their cosmetic outcome, with the most favorable outcomes in patients who had undergone breast conservation, with mastectomy and reconstruction yielding the poorest results. Patient reported outcomes are not reflected in the clinician assessment of cosmesis. J Curr Surg. 2016;6(2):46-51 doi: http://dx.doi.org/10.14740/jcs303w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"26 1","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83062247","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":"Surgical Versus Non-Surgical Treatment for Traumatic Esophageal Perforation in Children: A Systematic Review","authors":"Abdulwahhab Al Jubab, I. Jafarli, Tariq Al Tokhais","doi":"10.14740/JCS296W","DOIUrl":"https://doi.org/10.14740/JCS296W","url":null,"abstract":"The study design of this paper is a systematic review of literature published in the recent 10 years. Esophageal perforations in children have long been a topic of debate. The management protocols are chiefly governed by symptom severity, perforation site, time elapsed since perforation and cause of perforation. Esophageal perforations in pediatric group of patients can be iatrogenic or traumatic. The aim to conduct the study was to assess the benefits and timely management of surgical versus non-surgical treatment for pediatric patients with traumatic esophageal perforation. The two research questions below were determined. We systematically reviewed retrospective serial studies assessing the medical treatment compared to the surgical interventions for the traumatic esophageal perforation in children. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects, as well as foreign literature with English translations. No randomized controlled trial studies had been conducted in children with esophageal perforation. Information on patients’ age, comorbidities, methods of treatment, and effects on mortality, morbidity were extracted. Three independent reviewers selected the articles for analysis after screening the titles, abstracts, and full texts, then extracted data and graded the quality of each paper according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Specific clinical questions were as follows. 1) In patients with early diagnosis of esophageal perforation, what are the indications for treatment (surgery versus conservative management) and its impact on prognosis? 2) In patients with delayed diagnosis, what are the indications for treatment (surgery versus conservative management) and its impact on mortality and morbidity rate? A total of 66 abstracts were identified using various keywords. Nine retrospective articles (level III) were eligible for inclusion, involving a total of 77 cases of esophageal perforation in pediatric patients. Non-operative management is recommended for perforations diagnosed within 24 - 48 hours in a stable patient with contained leakage, but hemodynamically unstable patients with a contained perforation, ongoing leakage and early diagnosed have a higher chance of successful primary repair, whereas delayed ones require conservative treatment. J Curr Surg. 2016;6(2):41-45 doi: http://dx.doi.org/10.14740/jcs296w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"3 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86960400","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":"Fronto-Temporo-Zygomatic Approach for Orbital Apex and Infratemporal Fossa","authors":"K. Morwani, G. Ahluwalia","doi":"10.14740/JCS298E","DOIUrl":"https://doi.org/10.14740/JCS298E","url":null,"abstract":"Modified fronto-temporo-zygomatic approach is a relatively direct and less time-consuming approach to infratemporal fossa and orbital apex. This approach has a smaller learning curve and sutures are hidden in hairs, hence beneficial to both the patient and the surgeon. J Curr Surg. 2016;6(2):60-64 doi: http://dx.doi.org/10.14740/jcs298e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"4291 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74990505","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":"Dermatofibrosarcoma Protuberans: A Case Report and Review of Surgical Management","authors":"S. Trinh, P. Hanna, K. Petersen, Osama A Elsawy","doi":"10.14740/JCS302W","DOIUrl":"https://doi.org/10.14740/JCS302W","url":null,"abstract":"Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous neoplasm with low to intermediate grade malignancy. While it rarely metastasizes, it is characterized by aggressive local infiltration and high recurrence. The etiology of DFSP remains unknown, but current research has shown that DFSP has specific histologic, immunohistochemical, and cytogenetic findings. We report a unique case of a 29-year-old female who presented with a dry, shallow ulcerated right posterior shoulder mass diagnosed as DFSP, and describe our surgical management. J Curr Surg. 2016;6(2):57-59 doi: http://dx.doi.org/10.14740/jcs302w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"7 4","pages":"57-59"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72604087","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":"Length of Hospitalization: A Protective Factor in a Prospective Observational Cohort Study in Brazilian ASA III and IV Hip Fracture Elderly Patients","authors":"T. Ribeiro, Ricardo Issler Unfried, Luiz Giulian Brito, K. Stein, João Alberto Larangeira, O. Monticielo","doi":"10.14740/JCS296E","DOIUrl":"https://doi.org/10.14740/JCS296E","url":null,"abstract":"Background: Hip fracture is a devastating injury in elderly and the vast majorities are usually treated surgically. However, this treatment can also be non-operative, principally for patients classified at ASA III-IV. Several risk factors are associated with 1-year mortality for operated patients but a small number of studies provide the risk factors for non-operated patients. The aim of this study was to investigate the influence of hospitalization time and other risk factors on non-operated patients. Methods: A prospective observational cohort study from April 2005 to April 2012 was conducted on 286 patients aged 65 years or more with hip fracture classified at ASA III-IV for 1 year to investigate the influence of hospitalization time and the 1-year mortality risk factors. Survival time was analyzed by Kaplan-Meier curves and Cox’s regression models were used to evaluate risk factors to all subjects, operated and non-operated subjects. Results: The mortality was 73.5% for non-operated subjects. Final Cox’s regression for all subjects demonstrated that for patients that do not undergo surgery, mortality increased by six times. To operated patients, for each day of hospitalization, 1-year survival decreased 12.6 days, and ASA IV increased the mortality rate three times. To non-operated subjects, hospitalization time was a protective factor; for each day of hospitalization, 1-year survival increased 10.44 days. Conclusion: When conservative treatment is chosen for a complicated elderly, extended hospitalization should be considered. Hospitalization time has proved to be a protective factor in these cases and discharge with improved survival rates with good clinical status should be advocated. However, surgery should always be employed even for patients with poor clinical conditions. J Curr Surg. 2016;6(1):21-29 doi: http://dx.doi.org/10.14740/jcs296e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"4 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2016-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89737731","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}