Pub Date : 2020-02-26DOI: 10.11648/J.JS.20200801.16
Wuji Li, Wenrui Wu, Xiaofei Zheng, Simin Luo
Background: Dislocation of acromioclavicular joint is a relatively common injury, accounting for about 9% to 10% of all shoulder injuries. There are many surgical methods to treat dislocation of acromioclavicular joint, including fixation through acromioclavicular joint, intercoracoid fixation and ligament reconstruction. However, at present, more and more attention has been paid to biological reconstruction technology, and related technologies have also been greatly developed. Methods: The semitendinosus tendon from the body is used as the material for the reconstruction of the ligament. The reconstruction holes were made at the original attachment of the clavicular conical ligament and the trapezium ligament, and 10 absorbable lines were taken to pass through the lower part of the coracoid process through the two reconstruction holes respectively. The semitendinosus tendon was pruned, and the two ends were inserted through the reconstruction holes respectively to reach the lower part of the coracoid process. While pressing down on the clavicle, 10 absorbable lines were knotted on the surface of the clavicle, and the semitendinosus tendon was knotted below the coracoid process. Finally, two u-shaped loops were formed to complete the reconstruction of the coracoid ligaments. Results: The intraoperative and post-operative imaging examination indicated that acromioclavicular joint dislocation was well treated. Conclusions: This kind of surgery has many advantages over traditional plate fixation, such as reducing postoperative complications, shortening the length of hospital stay and so on.
{"title":"Surgical Reatment of Acromioclavicular Dislocation-reconstruction of Coracoclavicular Ligament","authors":"Wuji Li, Wenrui Wu, Xiaofei Zheng, Simin Luo","doi":"10.11648/J.JS.20200801.16","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.16","url":null,"abstract":"Background: Dislocation of acromioclavicular joint is a relatively common injury, accounting for about 9% to 10% of all shoulder injuries. There are many surgical methods to treat dislocation of acromioclavicular joint, including fixation through acromioclavicular joint, intercoracoid fixation and ligament reconstruction. However, at present, more and more attention has been paid to biological reconstruction technology, and related technologies have also been greatly developed. Methods: The semitendinosus tendon from the body is used as the material for the reconstruction of the ligament. The reconstruction holes were made at the original attachment of the clavicular conical ligament and the trapezium ligament, and 10 absorbable lines were taken to pass through the lower part of the coracoid process through the two reconstruction holes respectively. The semitendinosus tendon was pruned, and the two ends were inserted through the reconstruction holes respectively to reach the lower part of the coracoid process. While pressing down on the clavicle, 10 absorbable lines were knotted on the surface of the clavicle, and the semitendinosus tendon was knotted below the coracoid process. Finally, two u-shaped loops were formed to complete the reconstruction of the coracoid ligaments. Results: The intraoperative and post-operative imaging examination indicated that acromioclavicular joint dislocation was well treated. Conclusions: This kind of surgery has many advantages over traditional plate fixation, such as reducing postoperative complications, shortening the length of hospital stay and so on.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84450058","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}
Pub Date : 2020-02-10DOI: 10.11648/J.JS.20200801.15
I. Zaderenko, A. Mudunov, S. Ivanov, S. Alieva, V. Tsiklauri, A. Kazimov, D. Safarov, A. Eremina, Alena Hromushina, Bulat Bektimirov, A. Dymnikov
Through-and-through defect of soft tissues of the cheek, mouth angles, upper and lower lip originate from surgical intervention of tumors of the oral cavity involving external skin, soft tissue and oral lining. The article describes an original method of one-stage reconstruction in N. N. Blokhin National Medical and Research Center of Oncology. Russian Federation’s patent № 2489096 was granted for this method. We propose to use 3 different flaps from different anatomic areas, which have varying histological structures and independent blood supply. The first flap - muscle, is formed from the biggest part of the muscles masseter from the affected side and serves to restore the functions of the lips and cheek due to the fact that after the formation of the flap two its parts fixed to the remnants of the muscles of the upper and lower lips and part of the buccal muscle. The flap is perfusion by a. maxillaris and a. facialis. The second flap - musculocutaneous, formed from the skin of areas adjacent to the defect, nasolabial or submandibular. The flap serves to replace a skin defect, defect of the cheek, upper and lower lips. The flap is perfusion by a. facialis. The third flap - fascial, formed from the temporal fascia on the affected side. The temporal fascial flap is used to replace the defect of the mucous membrane of the cheek, upper and lower lips, in addition, the red border of the lips and the corner of the mouth. The flap is perfusion by aa. temporalis profunda et superficialis. All three flaps perfectly carry out hermetic sealing of the oral cavity, independent perfusion of each flap, even in the case of necrosis of one of the flaps, allows preservation of hermeticism. The use of three flaps with different histological structure allows to achieve a good functional and aesthetic result. Flaps perform various functions, ensuring the functional and anatomical usefulness of the resected tissues. By improving the blood suppling of flaps, we reduce time for patient’s rehabilitation and postoperative damage.
{"title":"013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect","authors":"I. Zaderenko, A. Mudunov, S. Ivanov, S. Alieva, V. Tsiklauri, A. Kazimov, D. Safarov, A. Eremina, Alena Hromushina, Bulat Bektimirov, A. Dymnikov","doi":"10.11648/J.JS.20200801.15","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.15","url":null,"abstract":"Through-and-through defect of soft tissues of the cheek, mouth angles, upper and lower lip originate from surgical intervention of tumors of the oral cavity involving external skin, soft tissue and oral lining. The article describes an original method of one-stage reconstruction in N. N. Blokhin National Medical and Research Center of Oncology. Russian Federation’s patent № 2489096 was granted for this method. We propose to use 3 different flaps from different anatomic areas, which have varying histological structures and independent blood supply. The first flap - muscle, is formed from the biggest part of the muscles masseter from the affected side and serves to restore the functions of the lips and cheek due to the fact that after the formation of the flap two its parts fixed to the remnants of the muscles of the upper and lower lips and part of the buccal muscle. The flap is perfusion by a. maxillaris and a. facialis. The second flap - musculocutaneous, formed from the skin of areas adjacent to the defect, nasolabial or submandibular. The flap serves to replace a skin defect, defect of the cheek, upper and lower lips. The flap is perfusion by a. facialis. The third flap - fascial, formed from the temporal fascia on the affected side. The temporal fascial flap is used to replace the defect of the mucous membrane of the cheek, upper and lower lips, in addition, the red border of the lips and the corner of the mouth. The flap is perfusion by aa. temporalis profunda et superficialis. All three flaps perfectly carry out hermetic sealing of the oral cavity, independent perfusion of each flap, even in the case of necrosis of one of the flaps, allows preservation of hermeticism. The use of three flaps with different histological structure allows to achieve a good functional and aesthetic result. Flaps perform various functions, ensuring the functional and anatomical usefulness of the resected tissues. By improving the blood suppling of flaps, we reduce time for patient’s rehabilitation and postoperative damage.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89550954","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}
Pub Date : 2020-02-07DOI: 10.11648/J.JS.20200801.14
M. Hiraki, Toshiya Tanaka, Kohei Yamada, E. Sadashima, T. Manabe, K. Kitahara, H. Noshiro
Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.
{"title":"A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess","authors":"M. Hiraki, Toshiya Tanaka, Kohei Yamada, E. Sadashima, T. Manabe, K. Kitahara, H. Noshiro","doi":"10.11648/J.JS.20200801.14","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.14","url":null,"abstract":"Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86946017","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}
Pub Date : 2020-02-04DOI: 10.11648/J.JS.20200801.13
Saho Wada, R. Sadahiro, Y. Matsuoka, Y. Uchitomi, K. Shimizu
Surgery is one of the main treatments component against cancer. Although the basic principle of surgical treatment of cancer is curability, safety, and functionality, early recovery after surgery is also important. While some previous studies focus on physical recovery, there are few studies regarding the perioperative period of cancer patients and their impact on postoperative recovery. This study is aim to clarify psychosocial factors that affect postoperative recovery in cancer patients. The study design is a secondary data analysis of a prospective observational cohort study whose primary purpose was to investigate whether preoperative anxiety predicted onset of postoperative delirium in cancer patients at the National Cancer Center Hospital in Japan. The primary outcome of this study was the length of postoperative hospital stay, and the secondary outcome was postoperative complications. We conducted multivariable regression analysis to determine psychosocial predictors of primary and secondary outcomes. The final analysis included 109 patients. The mean length of postoperative hospital stay was 23.4 (SD = 12.4) days and the incidence rate of postoperative complications was 32.1%. In multivariable regression, preoperative anxiety was positively associated with the length of postoperative hospital stay, while sex (female) and alcohol dependence showed a negative association. Cognitive function was marginally associated with postoperative complications. In conclusion, Appropriate management of preoperative anxiety contributes to early discharge after surgery in cancer patients.
{"title":"The Association Between Postoperative Recovery and Psychosocial Factors in Cancer Patients","authors":"Saho Wada, R. Sadahiro, Y. Matsuoka, Y. Uchitomi, K. Shimizu","doi":"10.11648/J.JS.20200801.13","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.13","url":null,"abstract":"Surgery is one of the main treatments component against cancer. Although the basic principle of surgical treatment of cancer is curability, safety, and functionality, early recovery after surgery is also important. While some previous studies focus on physical recovery, there are few studies regarding the perioperative period of cancer patients and their impact on postoperative recovery. This study is aim to clarify psychosocial factors that affect postoperative recovery in cancer patients. The study design is a secondary data analysis of a prospective observational cohort study whose primary purpose was to investigate whether preoperative anxiety predicted onset of postoperative delirium in cancer patients at the National Cancer Center Hospital in Japan. The primary outcome of this study was the length of postoperative hospital stay, and the secondary outcome was postoperative complications. We conducted multivariable regression analysis to determine psychosocial predictors of primary and secondary outcomes. The final analysis included 109 patients. The mean length of postoperative hospital stay was 23.4 (SD = 12.4) days and the incidence rate of postoperative complications was 32.1%. In multivariable regression, preoperative anxiety was positively associated with the length of postoperative hospital stay, while sex (female) and alcohol dependence showed a negative association. Cognitive function was marginally associated with postoperative complications. In conclusion, Appropriate management of preoperative anxiety contributes to early discharge after surgery in cancer patients.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86604124","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}
Pub Date : 2020-01-17DOI: 10.11648/J.JS.20200801.12
S. Balzan, V. Gava, Érika Luiza Maschio, Victoria Lucateli Bernardi, G. Lima, Graziela de Gasperi, M. P. Marins, Vanessa Batistella Kunzler, Bruna Aparecida Fontana Costa
Pancreatoduodenectomy for cancer is a complex surgical procedure with significant morbidity and mortality. Technical aspects of this procedure typically comprise dissection of celiac trunk, the common and the proper hepatic arteries. The presence of hepatic arterial anomalies is not uncommon and influences surgical technique. An aberrant right hepatic artery (replaced or accessory) or a common hepatic artery originating from the superior mesenteric artery are present in nearly 13% of cases and usually run in contact with the posterior aspect of the head of the pancreas. These anomalous arteries are at risk of iatrogenic injury and tumor involvement. Iatrogenic vascular lesions can lead to bleeding and/or ischemic complications, such as anastomotic stenosis, hepatic abscess and liver failure. Also, vascular tumor involvement might require arterial resection and reconstruction. The presence of arterial variations should not affect the radicalness of pancreatic resection as the involvement of aberrant arteries does not seem to affect postoperative outcomes or overall survival. These vascular variations should be, preferably, recognized pre-operatively in order to define possible surgical strategies. Preoperative contrast enhanced computed tomography provides accurate arterial anatomy evaluation. Lastly, aberrant hepatic arteries require proper dissection and/or occasionally resection and reconstruction during pancreatoduodenectomy to achieve a safe resection with proper radicalness. Knowledge of arterial variations is crucial for pancreatic cancer surgery.
{"title":"Implications of Arterial Variations in Pancreatoduodenectomy for Cancer","authors":"S. Balzan, V. Gava, Érika Luiza Maschio, Victoria Lucateli Bernardi, G. Lima, Graziela de Gasperi, M. P. Marins, Vanessa Batistella Kunzler, Bruna Aparecida Fontana Costa","doi":"10.11648/J.JS.20200801.12","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.12","url":null,"abstract":"Pancreatoduodenectomy for cancer is a complex surgical procedure with significant morbidity and mortality. Technical aspects of this procedure typically comprise dissection of celiac trunk, the common and the proper hepatic arteries. The presence of hepatic arterial anomalies is not uncommon and influences surgical technique. An aberrant right hepatic artery (replaced or accessory) or a common hepatic artery originating from the superior mesenteric artery are present in nearly 13% of cases and usually run in contact with the posterior aspect of the head of the pancreas. These anomalous arteries are at risk of iatrogenic injury and tumor involvement. Iatrogenic vascular lesions can lead to bleeding and/or ischemic complications, such as anastomotic stenosis, hepatic abscess and liver failure. Also, vascular tumor involvement might require arterial resection and reconstruction. The presence of arterial variations should not affect the radicalness of pancreatic resection as the involvement of aberrant arteries does not seem to affect postoperative outcomes or overall survival. These vascular variations should be, preferably, recognized pre-operatively in order to define possible surgical strategies. Preoperative contrast enhanced computed tomography provides accurate arterial anatomy evaluation. Lastly, aberrant hepatic arteries require proper dissection and/or occasionally resection and reconstruction during pancreatoduodenectomy to achieve a safe resection with proper radicalness. Knowledge of arterial variations is crucial for pancreatic cancer surgery.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82979500","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}
Pub Date : 2020-01-13DOI: 10.11648/J.JS.20200801.11
John A Geha, M. Goss, Joseph D. Geha, C. O'Mahony, N. T. Galván, A. Rana, R. Cotton, M. Kueht, John A. Goss
The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.
{"title":"Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient","authors":"John A Geha, M. Goss, Joseph D. Geha, C. O'Mahony, N. T. Galván, A. Rana, R. Cotton, M. Kueht, John A. Goss","doi":"10.11648/J.JS.20200801.11","DOIUrl":"https://doi.org/10.11648/J.JS.20200801.11","url":null,"abstract":"The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79523809","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}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001300
Huijuan Cheng, Xiaoming Chen, Guodong Sun, Z. Shao
Hepatitis B is among the most important infectious diseases in China. The prevalence of hepatitis B virus (HBV) infection is high in Northwest China, particularly in Wuwei City, Gansu Province. To investigate genetic diversity and genotype distribution in this region, HBV genomes were completely sequenced from 78 HBV-infected individuals from the Physical Examination Center of Wuwei City and analyzed with MEGA (version 5.05) and SimPlot program (version 3.5.1). The results indicated that genotype C (47.44%, 37/78) was the most frequently observed. The nearly half of the individuals were infected by five phylogenetically distinct B/C or C/D inter-genotype recombinant variations of HBV. Our studies indicate that highly diversified HBV viruses are epidemic in this local population. In my study may provide an important reference for further HBV clinical studies, which presents the HBV genomic background will contribute to the establishment of a reliable virus evolution history and provide vital genomic baseline references.
{"title":"Prevalence of Inter-Genotype Recombinant Hepatitis B Viruses in a Highly Epidemic Region of Northwest China","authors":"Huijuan Cheng, Xiaoming Chen, Guodong Sun, Z. Shao","doi":"10.29011/2575-9760.001300","DOIUrl":"https://doi.org/10.29011/2575-9760.001300","url":null,"abstract":"Hepatitis B is among the most important infectious diseases in China. The prevalence of hepatitis B virus (HBV) infection is high in Northwest China, particularly in Wuwei City, Gansu Province. To investigate genetic diversity and genotype distribution in this region, HBV genomes were completely sequenced from 78 HBV-infected individuals from the Physical Examination Center of Wuwei City and analyzed with MEGA (version 5.05) and SimPlot program (version 3.5.1). The results indicated that genotype C (47.44%, 37/78) was the most frequently observed. The nearly half of the individuals were infected by five phylogenetically distinct B/C or C/D inter-genotype recombinant variations of HBV. Our studies indicate that highly diversified HBV viruses are epidemic in this local population. In my study may provide an important reference for further HBV clinical studies, which presents the HBV genomic background will contribute to the establishment of a reliable virus evolution history and provide vital genomic baseline references.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77166955","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}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001314
H. Miura, J. Miura, Keisei Tachimbana, S. Goto
We report a rare case of pericardial defect detected during lung cancer resection. A 60-year-old male patient presented with a mixed ground-glass nodule about 17 mm in diameter at the left S6b area. During a left lower lobectomy, naked atrium was observed. The operation was completed without any reconstruction, and the patient survived without recurrence or complications two year after surgery. Pathologically, the tumor was lepidic adenocarcinoma of surgical stage IA2 with pT1bN0M0. To date, 13 lung cancers with pericardial deficiency have been reported in Japan. Reconstruction should be considered in the following cases: in pneumonectomy cases after detaching adhesion between the lung and heart, cases in which poor expansion of the remaining lobes after lobectomy is insufficient to sustain the heart, or cases with a defect around the apex. Because pericardial defect is not detected preoperatively, thoracic surgeons should be aware of this congenital disease and indications for the reconstruction.
{"title":"Detection of Pericardial Defect During Lung Cancer Surgery with Proposal for Reconstruction","authors":"H. Miura, J. Miura, Keisei Tachimbana, S. Goto","doi":"10.29011/2575-9760.001314","DOIUrl":"https://doi.org/10.29011/2575-9760.001314","url":null,"abstract":"We report a rare case of pericardial defect detected during lung cancer resection. A 60-year-old male patient presented with a mixed ground-glass nodule about 17 mm in diameter at the left S6b area. During a left lower lobectomy, naked atrium was observed. The operation was completed without any reconstruction, and the patient survived without recurrence or complications two year after surgery. Pathologically, the tumor was lepidic adenocarcinoma of surgical stage IA2 with pT1bN0M0. To date, 13 lung cancers with pericardial deficiency have been reported in Japan. Reconstruction should be considered in the following cases: in pneumonectomy cases after detaching adhesion between the lung and heart, cases in which poor expansion of the remaining lobes after lobectomy is insufficient to sustain the heart, or cases with a defect around the apex. Because pericardial defect is not detected preoperatively, thoracic surgeons should be aware of this congenital disease and indications for the reconstruction.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78573169","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}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001325
Dossouvi Tamegnon, Boumé Missoki Azanlédji, Kanassoua Kokou, Amouzou Efoé-Ga Olivier, Amavi Ayi, Adabra Komlan, Kassegne Iroukora, Tchangaï Boyodi, A. Fousseni, Wiyao Rebecca, D. David
Objective: To report our experience as general surgeon in the management of pathologies of Peritoneo-Vaginal Duct Persistences (PVDP) in the general surgery department of Kara teaching hospital (Togo). Material and Method: This is a retrospective and descriptive study that was carried out for 5 years, from January 1, 2014 to December 31, 2018 in the general surgery department of Kara teaching hospital. It is a study which concerned children or adults managed for pathologies of the persistence of the peritoneo-vaginal duct. Results: During our study period, 82 patients were operated for PVDP. The average age was 5 years of extremes ranging from one month to 56 years. Persistence of peritoneo-vaginal duct sat on the right in 69 cases and on the left in 13 cases. It was bilateral in three cases. We operated on a recurrence of a right inguinoscrotal hernia. Among hernias, 6 (7.3%) of inguoscrotal hernias were strangulated. All patients underwent ligation of the peritoneal-vaginal canal. This gesture was associated with an evacuation of the hydrocele in 29 cases; a cystectomy in 3 cases and a course of treatment according to Bassini in 3 cases (patients aged 15 years and over). The six cases of strangulated inguino-scrotal hernias were operated on urgently. There was no bowel resection. The postoperative course was marked by a bursa hematoma in two children which regressed under after one week of monitoring. The average length of hospital stay was 24 hours. No deaths have been reported. No recurrence was observed after one year of follow-up. Conclusion: Pathologies of the persistence of peritoneo-vaginal duct are frequent. They include several pathologies dominated by hernias which are often found in children under 5 years of age. The postoperative operations are often fraught with complications, the most serious of which is testicular atropia. Reducing complications requires early management, improvement of the technical platform and surgical management by a well-trained team.
{"title":"Pathologies of Peritoneo-Vaginal Duct Persistence in the General Surgery Department of Kara Teaching Hospital (Togo)","authors":"Dossouvi Tamegnon, Boumé Missoki Azanlédji, Kanassoua Kokou, Amouzou Efoé-Ga Olivier, Amavi Ayi, Adabra Komlan, Kassegne Iroukora, Tchangaï Boyodi, A. Fousseni, Wiyao Rebecca, D. David","doi":"10.29011/2575-9760.001325","DOIUrl":"https://doi.org/10.29011/2575-9760.001325","url":null,"abstract":"Objective: To report our experience as general surgeon in the management of pathologies of Peritoneo-Vaginal Duct Persistences (PVDP) in the general surgery department of Kara teaching hospital (Togo). Material and Method: This is a retrospective and descriptive study that was carried out for 5 years, from January 1, 2014 to December 31, 2018 in the general surgery department of Kara teaching hospital. It is a study which concerned children or adults managed for pathologies of the persistence of the peritoneo-vaginal duct. Results: During our study period, 82 patients were operated for PVDP. The average age was 5 years of extremes ranging from one month to 56 years. Persistence of peritoneo-vaginal duct sat on the right in 69 cases and on the left in 13 cases. It was bilateral in three cases. We operated on a recurrence of a right inguinoscrotal hernia. Among hernias, 6 (7.3%) of inguoscrotal hernias were strangulated. All patients underwent ligation of the peritoneal-vaginal canal. This gesture was associated with an evacuation of the hydrocele in 29 cases; a cystectomy in 3 cases and a course of treatment according to Bassini in 3 cases (patients aged 15 years and over). The six cases of strangulated inguino-scrotal hernias were operated on urgently. There was no bowel resection. The postoperative course was marked by a bursa hematoma in two children which regressed under after one week of monitoring. The average length of hospital stay was 24 hours. No deaths have been reported. No recurrence was observed after one year of follow-up. Conclusion: Pathologies of the persistence of peritoneo-vaginal duct are frequent. They include several pathologies dominated by hernias which are often found in children under 5 years of age. The postoperative operations are often fraught with complications, the most serious of which is testicular atropia. Reducing complications requires early management, improvement of the technical platform and surgical management by a well-trained team.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75911459","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}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001316
P. Vostrel, F. Kolo, J. Aaken
Scaphoid nonunion is an infrequent finding in children. In the absence of treatment guidelines, both surgical and nonsurgical treatments are valid options. We present the case of a 13-year-old boy with an established nonunion of the scaphoid that healed after six months of immobilisation. Subtle bone bridging was detected on a Computed Tomography (CT) scan after 3.5 months, requiring further casting. CT is a valuable tool to detect early callus formation; we advocate its use before abandoning nonsurgical treatment in cases of scaphoid nonunion in children.
{"title":"Conservative Treatment of Scaphoid Nonunion in Children - A Case Report and Review of the Literature","authors":"P. Vostrel, F. Kolo, J. Aaken","doi":"10.29011/2575-9760.001316","DOIUrl":"https://doi.org/10.29011/2575-9760.001316","url":null,"abstract":"Scaphoid nonunion is an infrequent finding in children. In the absence of treatment guidelines, both surgical and nonsurgical treatments are valid options. We present the case of a 13-year-old boy with an established nonunion of the scaphoid that healed after six months of immobilisation. Subtle bone bridging was detected on a Computed Tomography (CT) scan after 3.5 months, requiring further casting. CT is a valuable tool to detect early callus formation; we advocate its use before abandoning nonsurgical treatment in cases of scaphoid nonunion in children.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83999791","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}
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