Journal of current surgery最新文献

{"title":"Surgical Management of Lower Gastrointestinal Hemorrhage: An Analysis of the ACS NSQIP Database","authors":"L. Greco, Sarah E Koller, M. Philp, H. Ross","doi":"10.14740/JCS307W","DOIUrl":"https://doi.org/10.14740/JCS307W","url":null,"abstract":"Background: Despite advances in diagnostics for lower gastrointestinal bleeding, colorectal resection remains the only option when non-surgical management fails. This study examines a cohort of patients who underwent surgery for this indication to determine the effect of procedure type on postoperative outcomes. Methods: We identified all patients who underwent colorectal resection for bleeding in the ACS NSQIP Participant Use Data File and the Procedure Targeted PUF for colectomy from 2012 to 2013. We compared patients who underwent partial versus total colectomy using univariate analyses and multivariable logistic regression. Results: Of 38,486 colorectal resections performed for bleeding, 85.3% underwent a partial colectomy and 14.7% underwent total colectomy. Patients who had total colectomy were more likely to receive more than four units of blood prior to surgery and have operative times longer than 180 min. Patients who had partial colectomy were more likely to have laparoscopic procedures and to have a stoma created during surgery. On univariate analysis, total colectomy was associated with increased risk of postoperative ileus, cardiac and renal complications, and mortality. On multivariate analysis, total colectomy was associated with increased risk of cardiac and renal complications. Conclusion: The most common procedure performed for lower gastrointestinal hemorrhage was partial colectomy. J Curr Surg. 2017;7(1-2):4-6 doi: https://doi.org/10.14740/jcs307w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"22 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72726963","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":"Treatment of Appendicitis With Iliopsoas Abscess by Laparoscopic One-Step Surgery","authors":"K. W. Choi, W. Lee","doi":"10.14740/jcs313w","DOIUrl":"https://doi.org/10.14740/jcs313w","url":null,"abstract":"Acute appendicitis is the most common cause of acute abdomen and on rare occasions can present atypically with a retroperitoneal abscess. In this report, we present a rare case of acute appendicitis combined with iliopsoas muscle abscess. A laparoscopic appendectomy and iliopsoas abscess drainage were performed by a one-step laparoscopic procedure that did not incur any intraoperative or postoperative complications. The results of this case demonstrate that the laparoscopic approach is feasible and effective for the treatment of appendicitis complicated by retroperitoneal abscess. J Curr Surg. 2017;7(1-2):23-25 doi: https://doi.org/10.14740/jcs313w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"1 1","pages":"23-25"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90291838","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":"Erectile Dysfunction Secondary to Pudendal Nerve Injury Complicating Orthopedic Surgery: Practical Recommandations","authors":"S. Naouar, S. Braiek, R. E. Kamel","doi":"10.14740/JCS322E","DOIUrl":"https://doi.org/10.14740/JCS322E","url":null,"abstract":"Erectile dysfunction (ED) resulting from direct damage of pudendal nerve injury during orthopedic surgery is common and closely associated to the use of traction tables. Prolonged countertraction on the fracture table and the inappropriate placement of the perineal post are the two main contributing factors. Clinical signs are essentially sensitive, such as hypoesthesia of the perineum. Urinary incontinence, ED and hypoesthesia or complete anesthesia of scrotum and glans penis are the main clinical manifestations. Electrophysiological examinations should be considered when symptoms are not regressive and in cases of vesico-sphincter dysfunction and immediate severe ED. No medical treatment has demonstrated its effectiveness. Pudendal nerve decompression was reported to be useful in some cases. Preventive measures should be considered by surgeons to avoid perineal traction injuries. Patients must be clearly informed about this possible neurological complication before an operation on the orthopedic table. J Curr Surg. 2017;7(1-2):1-3 doi: https://doi.org/10.14740/jcs322e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"74 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74656008","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":"Tubercular Perforation of the Small Bowel: Should All Patients Have an End Ileostomy?","authors":"M. Aslam, M. O. Karim, S. Abbas, O. Abdalla, H. Shakir","doi":"10.14740/JCS322W","DOIUrl":"https://doi.org/10.14740/JCS322W","url":null,"abstract":"Background: Spontaneous ileal perforation is a common surgical emergency in developing countries due to high incidence of tuberculosis in these countries. Patients diagnosed to have intestinal perforation are universally treated surgically. The aim of this study was to compare the outcome and complication of two procedures usually performed for intestinal perforation i.e., primary repair and ileostomy. Methods: The study is based on interventional quasi-experimental design with non-probability purposive sampling and was conducted for 6 months between April and October 2010 at a teaching hospital. Sixty patients with intestinal tubercular perforation participated in this study and were divided into two groups. Group A consisted of 30 patients who underwent primary repair and group B consisted of 30 patients who underwent ileostomy. Using Chi-square test, two groups were compared with respect to four outcome variables including duration of hospital stay, complications (peritonitis, wound infection, fever, and obstruction fistula formation) during hospital stay, and complications observed in second week and fourth week follow-ups. Results: The mean age of presentation was 39.13 ± 18.917 years (range 13 - 75). Sixty percent of patients were male and 40% were female. Size of perforation dictated operative decision; in group A, 100% of patients had a perforation less than 1 cm and in group B, 100% of patients had a perforation greater than 1 cm (P ≤ 0.05). In both groups, 73.4% of patients had an admission of less than 7 days and 26.6% of patients stayed beyond this period (P ≥ 0.05). The complication rate in group A during admission was 40%, compared to 30% in group B (P ≥ 0.05). In the second postoperative week, complication rate was 16.6% in group A and 6.6% in group B (P ≥ 0.05). Similarly in the fourth postoperative week, the complication rate was 13.4% in group A and 6.6% in group B (P ≥ 0.05). Conclusion: End ileostomy had fewer complications compared to primary closure in management of tubercular small bowel perforation. The choice of surgery was dependent on intra-operative judgement following assessment of the size of perforation and surrounding intra-abdominal contamination. Primary repair may still be a feasible option for perforations less than 1 cm without gross contamination given similar outcomes. J Curr Surg. 2017;7(1-2):11-14 doi: https://doi.org/10.14740/jcs322w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"66 1","pages":"11-14"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82849008","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":"Effect of Duration of Surgery on Liver Enzymes After Cholecystectomy: Safety or Duration","authors":"Abhishek Sharma, R. Singal, A. Mittal, A. Grover, Muzzafar Zaman","doi":"10.14740/JCS334W","DOIUrl":"https://doi.org/10.14740/JCS334W","url":null,"abstract":"Background: An elevation of serum liver enzymes after laparoscopic cholecystectomy (LC) occurs due to transient decrease in splanchnic blood flow. The changes are attributed to CO 2 gas inside the abdominal cavity for a prolonged period as compared to open surgeries. Methods: This study was conducted in the Department of Surgery at M. M. Institute of Medical Sciences and Research, Mullana, Haryana, India. A total number of 300 patients diagnosed as cholelithiasis were included from January 2014 for a period of 2 years. These patients were randomly divided into three groups: LC was done in groups A and B (intraabdominal pressures of 10 and 14 mm Hg, respectively) and in group C, open cholecystectomy was performed. In all the patients, liver function tests (LFTs) were done pre- and postoperatively and the levels changed in LFTs were noted. Results: In LC, changes were seen in serum bilirubin, aspartate transaminase (AST) and alanine transaminase (ALT) after 24 h of surgery. But there was not much difference observed between pre- and post-surgery in LFTs (P > 0.05). In LC, with low pressure (short and long duration), LFTs were changed to less extent than in high pressure (short). In prolonged surgery under high pressure, LFT significantly changed postoperatively (P < 0.05). Conclusion: Duration of surgery has definitively impact on the liver enzymes but it does not remain for prolonged period. Not only the prolonged time but also pneumoperitoneum pressure affects liver enzymes in laparoscopic surgery especially in high pressure CO 2 . J Curr Surg. 2017;7(4):53-57 doi: https://doi.org/10.14740/jcs334w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"23 1","pages":"53-57"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75070574","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":"Approach of the Bile Duct by Gastrostomy in Patients With Bypass in Roux-en-Y Proved to Be Safe and Effective","authors":"L. Périssé, Paulo Cézar Marques Perissé, Trajano Salvador de Oliveira Filho, I. J. Filho","doi":"10.14740/JCS336E","DOIUrl":"https://doi.org/10.14740/JCS336E","url":null,"abstract":"Background: The prevalence and increase of obesity in the world are that 2.3 billion adults were overweight and 700 million adults were obese in 2015. In the context of the morbid obesity pandemic, bariatric surgery was presented as a gold standard treatment. It is known that the prevalence of cholelithiasis is 3 to 4 times higher in morbidly obese patients when compared to the general population. Literature reports that the first attempts to approach the biliary tract in patients with gastric bypass in Roux-en-Y, were performed transorally and had resulted in low success rates. The aim of this study was to analyze the results of the use of the endoscopic transgastrostomy technique for the treatment of biliary tract diseases in patients submitted to Y-de-Roux bypass. Methods: Between August 2010 and December 2014, procedures of transgastrostomy endoscopic retrograde cholangiopancreatography (TG-ERCP) were performed in six patients, previously submitted to Roux-en-Y gastric bypass for treatment of morbid obesity. Results: All patients were successfully submitted to procedures for duodenal papilla catheterization, cholangiography, and endoscopic papillotomy. No complications related to the surgical or endoscopic procedure were observed in the cases described, despite the small sample studied and also the variation of age and body mass index (BMI). Conclusions: The technique described in the current study has been shown to be safe and effective. The possibility of performing it in single surgical time, as well as the use of conventional duodenoscopes and their accessories, make it a choice in patients undergoing Roux-en-Y gastric bypass. J Curr Surg. 2017;7(4):58-63 doi: https://doi.org/10.14740/jcs336e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"29 1","pages":"58-63"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81174122","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":"Intimal Angiosarcoma of the Aorta: Single Case Report and Effective Surgical Management","authors":"Merveesh L Auchoybur, C. Su, Xin Chen, F. Huang","doi":"10.14740/JCS332W","DOIUrl":"https://doi.org/10.14740/JCS332W","url":null,"abstract":"Primary malignant tumors of the aorta (PMTAs) are not only extremely rare, but also exhibit enormous histological heterogeneity. We present the first recorded case of a female patient with intimal angiosarcoma of the aortic arch and descending thoracic aorta in China, along with the clinical presentation, histopathologic diagnosis, and surgical excision of the lesion. We propose surgery as a viable curative approach to angiosarcomas of intimal origin. J Curr Surg. 2017;7(4):64-68 doi: https://doi.org/10.14740/jcs332w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"253 1","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75095825","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":"Patient Satisfaction Following Laparoscopic Umbilical Hernia Repair Using a “Two-Port” Technique","authors":"Ghassan Almaimani","doi":"10.14740/JCS333W","DOIUrl":"https://doi.org/10.14740/JCS333W","url":null,"abstract":"NOTICE: THIS ARTICLE HAS BEEN RETRACTED. Background: Measuring patient satisfaction is important to help improve health service delivery and improve outcomes. The aim of this study is to evaluate patient satisfaction with laparoscopic umbilical hernia repair and determine overall satisfaction with referral, outpatient consultation, pre-assessment clinic attendance, and post-operative care. Methods: This was a retrospective study of 52 patients undergoing laparoscopic umbilical hernia repair. Each patient completed an extensive self-administered questionnaire distributed at a scheduled follow-up appointment 3 months following the operation. Results: The response rate was 86.5%. Most patients (77.8%) were referred from their general practitioner. Patient satisfaction with surgical outcome was very high at > 98%, and the overall patient satisfaction from being listed for surgery to discharge was > 95%. Patient satisfaction was significantly associated with the patient being referred to the hospital by a general practitioner (GP). Conclusions: Patient satisfaction is an important health outcome, and understanding the domains of satisfaction, as well as their relative importance to patients, is necessary to improve overall quality of patient care. Laparoscopic umbilical hernia repair using a “two-port” technique is an effective procedure with excellent results and an extremely high rate of patient satisfaction. J Curr Surg. 2017;7(4):49-52 doi: https://doi.org/10.14740/jcs333w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"39 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81807446","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":"Cocoon Syndrome: A Rare Entity","authors":"S. Díaz, M. Chacon, R. Vílchez","doi":"10.14740/JCS334E","DOIUrl":"https://doi.org/10.14740/JCS334E","url":null,"abstract":"Sclerosing encapsulating peritonitis (SEP) is an uncommon condition characterized by the encasement of small bowel due to a thick fibrotic coverage. This entity is usually related to several diseases, highlighting among them the peritoneal dialysis, and less frequent is the primary or idiopathic peritoneal sclerosis or cocoon syndrome. SEP is clinically variable, depending on the severity and duration of the disease, the underlying causes and the patient’s immune status. The most common presentation is intestinal obstruction. It is rarely presented as a complication such as enterocutaneous fistulas, intestinal necrosis and malnutrition. Intestinal perforation is quite uncommon in patients with SEP. We present a case of cocoon syndrome in a 67-year-old man and describe his clinical onset, radiology and anatomical pathology findings. J Curr Surg. 2017;7(4):69-71 doi: https://doi.org/10.14740/jcs334e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"26 1","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83274245","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":"Laparoscopic Repair of Vesicouterine Fistula: A Case Report and Mini-Review of the Literature","authors":"S. Naouar, S. Braiek, R. E. Kamel","doi":"10.14740/JCS309W","DOIUrl":"https://doi.org/10.14740/JCS309W","url":null,"abstract":"Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas. Despite the advantages of laparoscopy, there are few case reports showing its feasibility in the management of this rare entity. A 40-year-old woman presented to our department with urinary incontinence associated to cyclic hematuria and amenorrhea. After diagnosis of cervicovesical fistula, the laparoscopic approach was chosen. Catheterization of the fistula tract during cystoscopy at the time of laparoscopy was beneficial to localize the fistula tract and allowed meticulous dissection in the retrovesical space between the bladder and the uterus. Operating time was approximately 165 min. The woman had no signs of recurrence after 12 months of follow-up. Laparoscopic VUF repair is an effective and safe technique with successful outcome. J Curr Surg. 2016;6(3-4):75-77 doi: https://doi.org/10.14740/jcs309w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"25 9-10 1","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85949980","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}