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Incisional Hernia Repair: Laparoscopy versus Open Surgery - A Prospective Study 切口疝修补:腹腔镜与开放手术-一项前瞻性研究
4区 医学 Q2 SURGERY Pub Date : 2023-06-30 DOI: 10.33425/2689-1093.1056
LAMARA Abdelhak, BENYARABAH Saliha, GUADDA Mounir, BELHATEM Mohamed Salah, NINI Badereddine, BOUKHENE Mohamed, MEDJAHDI Sid Ahmed, NIBOUCHA Mohamed Lamine, Meriem Rayen LAMARA
Objective: To assess the feasibility of laparoscopic incisional hernia repairs and to examine possible differences in operative time, morbidity, recurrence rates and length of hospital stay compared to repairs performed by open surgery. Patients: Between January 2016 and June 2019, sixty patients who underwent parietal repair were enrolled in this study. Patients were divided into two non-randomised groups. Data were collected prospectively and recorded in a database. The statistical analysis was performed using SPSS24 biomedical statistics software and Microsoft Excel. The statistical analysis was performed using the chi-two test, with calculation of the P value (Pearson test). Results: Thirty patients who underwent parietal repair by laparoscopic preperitoneal prosthesis placement (first group), and 30 patients who underwent open repair (2nd group). The two groups were comparable in terms of gender distribution and body mass index. No significant differences were observed in age and comorbidities between the two groups. In the first group, implantation of an intraperitoneal bifacial prosthesis was possible in 93.3% of patients. In the second group, the prosthesis was placed retromuscularly in 56.6% of patients and perifascial in 41% of patients. The conversion rate to open surgery was 6.6%. The average operating time was (81mn vs 92min). The complication rate was (26.6% vs 43.3%). The average length of hospital stay was 2 days 5.6 days. The recurrence rate at 3 years is (3.3% 6.6%; P< 0.05). Conclusion: The results of this study suggest that parietal repair by laparoscopic intraperitoneal prosthesis placement has some advantages over open surgery.
目的:评价腹腔镜切口疝修补术的可行性,探讨与开放手术修补术相比在手术时间、发病率、复发率和住院时间等方面可能存在的差异。患者:在2016年1月至2019年6月期间,60名接受顶骨修复的患者参加了这项研究。患者被分为两个非随机组。前瞻性地收集数据并记录在数据库中。采用SPSS24生物医学统计软件和Microsoft Excel进行统计分析。统计学分析采用chi-two检验,计算P值(Pearson检验)。结果:30例患者行腹腔镜腹膜前假体置入顶骨修复术(第一组),30例患者行开放式修复术(第二组)。两组在性别分布和体重指数方面具有可比性。两组在年龄和合并症方面无显著差异。在第一组中,93.3%的患者可以植入腹膜内双面假体。在第二组中,56.6%的患者将假体放置在肌肉后,41%的患者将假体放置在筋膜周围。转换率为6.6%。平均手术时间为(81mn vs 92min)。并发症发生率分别为26.6%和43.3%。平均住院时间2天5.6天。3年复发率为(3.3% 6.6%;术中;0.05)。结论:本研究结果提示腹腔镜腹膜内假体置入顶骨修复术较开放手术有一定优势。
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引用次数: 0
Non-Traumatic Abdominal Surgical Emergencies in the Field of HIV: A Series of 22 Cases in the Visceral and Digestive Surgery Department of the Siguiri Prefectural Hospital 艾滋病毒领域的非创伤性腹部外科急诊:锡吉里县医院内脏和消化外科22例
4区 医学 Q2 SURGERY Pub Date : 2023-06-30 DOI: 10.33425/2689-1093.1055
Mariama II Guirassy, Keita Doubany Mariame, Moussa Diakité, Nouhan Keita, Fofana Naby, Camara Naby Soriba
Introduction: This study aimed to describe the epidemiological-clinical and therapeutic aspects of abdominal surgical emergencies on the ground of HIV in the department of visceral and digestive surgery of the prefectural hospital of Siguiri. Method: This was a descriptive prospective study which concerned patients operated on for abdominal surgical emergencies in the field of HIV, carried out in the visceral and digestive surgery department of the Siguiri prefectural hospital. Results: Out of a total of 88 cases of abdominal surgical emergencies operated on during our study, we collected 22 cases on HIV ground, i.e. 25%. The female sex dominated, including 14 women against 8 men, i.e. a sex ratio of 0.6 with an average age of 35 years. Miners were the most affected socio-professional layer, i.e. 31.80%, followed by traders and housewives, i.e. 27.30% each. HIV type I affected 77.27% against 22.73%. There were 41% of our patients who knew their serological status among which 66.66% were on ARV treatment and 33.33% were not on ARV treatment. The symptomatology was dominated by abdominal pain in 100% followed by fever in 77.27%. Appendicitis accounted for 40.09% followed by generalized acute peritonitis in 31.82%. The management was medico-surgical with pre-operative, intra-operative and post-operative resuscitation. The average length of hospitalization was 7 days. The postoperative course was favorable in 45.45%, we recorded 36.36% parietal suppuration and the mortality rate was 13.64%. Conclusion: Abdominal surgical emergencies in the field of HIV remain a major health problem in terms of care. The clinical pictures are dominated by acute appendicitis and generalized acute peritonitis.
前言:本研究旨在描述锡吉里州医院内脏和消化外科以HIV为基础的腹部外科急诊的流行病学、临床和治疗方面的情况。方法:本研究是一项描述性前瞻性研究,涉及在锡吉里县医院内脏和消化外科进行的艾滋病毒领域腹部外科急诊患者。结果:本研究共收治腹部急诊手术88例,其中以HIV为理由的病例22例,占25%。以女性为主,14名女性对8名男性,即性别比例为0.6,平均年龄为35岁。矿工是受影响最大的社会专业阶层,占31.80%,其次是商人和家庭主妇,各占27.30%。1型艾滋病病毒感染率为77.27%对22.73%。有41%的患者知道自己的血清学状况,其中66.66%的患者接受抗逆转录病毒治疗,33.33%的患者未接受抗逆转录病毒治疗。症状以腹痛为主(100%),其次为发热(77.27%)。阑尾炎占40.09%,其次是全身性急性腹膜炎,占31.82%。术前、术中、术后均采用内科手术治疗。平均住院时间为7天。术后病程良好的占45.45%,顶骨化脓率36.36%,病死率13.64%。结论:腹部外科急诊在艾滋病领域仍然是一个主要的卫生问题。临床表现以急性阑尾炎和全身性急性腹膜炎为主。
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引用次数: 0
PN HPT™ and Striae Albae-Exploratory Interim Analysis of a Randomised Prospective Study PN HPT™和白纹:一项随机前瞻性研究的探索性中期分析
4区 医学 Q2 SURGERY Pub Date : 2023-06-30 DOI: 10.33425/2689-1093.1057
Emanuele Bartoletti, Carmen De Luca, Laura Maioli, Leda Moro, Isabella Pia Palmieri, Simona Piscopo, Carolina Prussia, Ting Song Lim, Gloria Trocchi
Introduction: The outcomes of striae albae remodelling are currently disappointing. Replenishing the fibroblast pool of nucleotide precursors through passive exposure to Polynucleotides Highly Purified Technology (PN HPT™) facilitates the dermal production of new fibres. The manuscript reports on the outcomes of a prospective study with an intradermal PN HPT™-based medical device. Methods: Intra-subject-controlled randomised real-world study to evaluate the efficacy and safety of a medical device containing 20 mg/mL of PN HPT™ (functional ingredient) intradermal gel as therapy for moderate-to-severe striae albae. Based on a preliminary sample size assessment, the study estimated the need to enrol at least 65 mature albae from 18-to-55-year-old male and female subjects seeking ambulatory treatment (mean age: 34.1 ± 10.65). Up to eight symmetrical striae albae in the target areas (breast, abdomen, buttocks, thighs) per enrolled subject underwent randomisation into the two parallel “PN HPT™ intradermal infiltration” active group and “no-treatment striae albae” intra-subject control group. Actively treated striae albae underwent a four-session intradermal therapy cycle with the PN HPT™ device. Comparative efficacy assessments, performed at the two final evaluation visits by independent evaluators: Width of actively treated and untreated control striae albae (digital calliper). Global Aesthetic Improvement Scale (GAIS) outcomes (by investigators and subjects, respectively; assessments on digital photographic documentation). Width and wrinkling of actively treated and control striae albae (quantitative Antera 3D CS skin imaging technology). Results: The digital-calliper-assessed width for the exploratory sample of the 44 actively treated striae albae (29 control striae) decreased, on average, from 4.6 ± 2.31 at the V1 baseline visit to 2.7 ± 1.42 at V5 (first follow-up visit) one month after the last PN HPT™ intradermal infiltration at V4 (–40.8% vs. baseline, p <0.01). In a subset of 17 striae (7 subjects), the mean digital-calliper-assessed width was still a significant 2.0 ± 0.94 at the final V6 follow-up visit, six months after V1 and three months after V4 (–54.5% vs control striae albae at V6, p <0.05). At the V5 assessment, three months after V1 and one month and a half after V4, investigators and treated subjects reported average GAIS scores of 3.8 ± 0.51 (median, 4.0) and 4.0 ± 0.66 (median, 4.0) out of 5.0 as GAIS maximum score for both. The occasional mild local pain and irritation at the injection site, expected and known in the previous PN HPT™ literature, were of no clinical significance and rapidly transitory. Discussion: PN HPT™ are an innovative option with a solid rationale for treating mature striae albae. The efficacy outcomes of PN HPT™ dermal infiltrations appear noteworthy, with excellent safety and ease of use, confirming the previous results. However, waiting for complete results and confirmation by other controlled studies is p
目前,白纹重塑的结果令人失望。通过被动暴露于多核苷酸高纯化技术(PN HPT™)来补充核苷酸前体的成纤维细胞库,有助于皮肤产生新纤维。该手稿报告了一项基于皮内PN HPT™医疗设备的前瞻性研究的结果。方法:受试者内对照随机现实世界研究,以评估含有20mg /mL PN HPT™(功能成分)皮内凝胶的医疗器械治疗中重度白纹的疗效和安全性。根据初步样本量评估,该研究估计需要招募至少65名年龄在18- 55岁之间寻求门诊治疗的成熟白疮患者(平均年龄:34.1±10.65)。每位入组受试者在目标区域(乳房、腹部、臀部、大腿)最多8个对称白纹被随机分为两个平行的“PN HPT™皮内浸润”活跃组和“无治疗白纹”受试者对照组。积极治疗的白纹用PN HPT™装置进行了4次皮内治疗周期。比较疗效评估,由独立评估人员在两次最终评估访问中进行:积极治疗和未治疗的对照白纹宽度(数字卡尺)。全球审美改善量表(GAIS)结果(分别由研究者和受试者;评估数码摄影文件)。积极处理和控制白纹的宽度和皱纹(定量Antera 3D CS皮肤成像技术)。结果:44个积极治疗的白纹(29个对照纹)的探索性样本的数字卡尺评估宽度平均从V1基线访问时的4.6±2.31下降到V4最后一次PN HPT™皮内浸润一个月后V5(首次随访)时的2.7±1.42(与基线相比-40.8%,p <0.01)。在17条纹(7名受试者)中,在最后一次V6随访时,V1后6个月和V4后3个月,数字卡尺评估的平均宽度仍为2.0±0.94(与V6时对照白纹相比-54.5%,p <0.05)。在V5评估时,即V1后3个月和V4后1个半月,研究者和治疗对象的GAIS平均得分分别为3.8±0.51(中位数,4.0)和4.0±0.66(中位数,4.0),满分为5.0。在以前的PN HPT™文献中预期和已知的注射部位偶尔出现的轻度局部疼痛和刺激,没有临床意义,而且是短暂的。讨论:PN HPT™是一种创新的选择,具有治疗成熟白斑的坚实基础。PN HPT™真皮浸润的疗效结果值得注意,具有良好的安全性和易用性,证实了先前的结果。然而,等待完整的结果和其他对照研究的确认是谨慎的。
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引用次数: 0
Diagnostic Support for the Surgical Patient: The Experiences and Challenges, As Seen by Practitioners in Resource-Poor Setting 对外科病人的诊断支持:经验和挑战,在资源贫乏的环境下从业人员的看法
4区 医学 Q2 SURGERY Pub Date : 2023-04-30 DOI: 10.33425/2689-1093.1053
Rex Friday Ogoronte Alderton Ijah, Nkemsinachi M Onodingene, Linda U Iroegbu-Emeruem, Friday E Aaron, Michael Ogamba, Akpevweoghene D Maduka, Ibinabo Oboro
Background: The input of laboratory medicine has no doubt improved surgical practice and will continue to impact positively on patient care. The aim of this study was to explore the experiences of practitioners and diagnostic challenges if any, encountered in the care of surgical patients in Port Harcourt in the last quarter of year 2022. Materials and Methods: A descriptive observational study was carried out among total population of consenting health workers (medical doctors, laboratory scientists / technologists, and technicians) in the Surgery and Diagnostic Services Departments in two teaching hospitals in Port Harcourt, using self-administered questionnaires. Data on experiences and challenges was analysed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The respondents had a male to female ratio of 1.3:1, mean age of 35.47 ± 8.44 years, mean years in practice of 7.58 ± 6.97 years, and 171 (98.3%) were Christians. One hundred and sixteen (66.7%) respondents were aware of delay in diagnostic services, in varying degrees. Lack of reagents (49 = 28.2%), inadequate personnel (18 = 10.3%), long processing time (15 = 8.6%) and poor electric power supply (9 = 5.2%) were the most common reasons for delay in diagnostic test results. Diagnostic challenges were highlighted, occurrence of medico-legal issues was reported, and solutions proffered. Conclusion: The professionals practicing in the diagnostic / surgical departments were aware and do experience delays in diagnostic test results and errors (reported by a few) that affects surgical services in our environment. Their experiences and challenges were highlighted and recommendations were made.
背景:检验医学的投入无疑改善了外科实践,并将继续对患者护理产生积极影响。本研究的目的是探讨2022年最后一个季度在哈科特港的外科病人护理中遇到的从业人员的经验和诊断挑战。材料和方法:在哈科特港两所教学医院的外科和诊断服务部门的全体同意的卫生工作者(医生、实验室科学家/技术人员和技术人员)中进行了一项描述性观察研究,采用自我管理的问卷调查。有关经验和挑战的数据使用社会科学统计软件包(SPSS) 20.0版进行分析。结果:被调查者男女比例为1.3:1,平均年龄为35.47±8.44岁,平均执业年龄为7.58±6.97岁,其中基督徒171人(98.3%)。116名(66.7%)受访者在不同程度上意识到诊断服务的延误。缺少试剂(49例= 28.2%)、人员不足(18例= 10.3%)、处理时间长(15例= 8.6%)和电力供应差(9例= 5.2%)是导致诊断检测结果延误的最常见原因。强调了诊断方面的挑战,报告了发生的医疗法律问题,并提出了解决办法。结论:在诊断/外科执业的专业人员意识到并确实经历了诊断测试结果的延迟和错误(少数报告),影响了我们环境中的外科服务。强调了他们的经验和挑战,并提出了建议。
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引用次数: 0
Acne Scars, Stretch Marks, and Similar Skin Defects Qualify as Medical Problems. A Real-World Survey on a Hyaluronic Acid Medical Device 痤疮疤痕、妊娠纹和类似的皮肤缺陷都属于医学问题。透明质酸医疗器械的实际情况调查
4区 医学 Q2 SURGERY Pub Date : 2023-04-30 DOI: 10.33425/2689-1093.1052
Lucia Cimarra
Introduction: Beyond impacting the quality of life, unpleasant stretch marks, skin aging, the dermal scars secondary to acne and chickenpox, and wrinkles expose those harboring these skin defects to psychiatric problems like anxiety, depression, ADHD, and insomnia more often than one might suspect. Remodeling skin scarring and supporting the deteriorated networks of dermal elastic fibers also have medical value. The moisturizing properties and skin-protective scavenger action against free radicals rapidly developed by non-cross-linked hyaluronic acid offer a powerful rationale to help with those problems. Methods: The study focused on a survey questionnaire administered by the investigators to a prospective cohort of 45 subjects of both genders with stretch marks, dermal scars, and skin aging. Before the survey, all individuals had undergone a three-session treatment cycle with a Class-III CE-marked medical device containing 40 mg of non-cross-linked HA in 2-mL prefilled disposable syringes with 30G½ needles (IALEST®, Mastelli Srl, Sanremo, Italy). The primary observational efficacy assessment tool was the six-score Wrinkle Severity Rating Scale (WSRS); the secondary efficacy assessment tool was the five-score Global Aesthetic Improvement Scale (GAIS). Timing of WSRS and GAIS assessments: at baseline (T0), before the first intradermal treatment session, and three to four weeks after T2 (end of the treatment cycle). Results: The mean WSRS scores for skin quality significantly improved between the T0 baseline visit (2.8 ± 1.17) and the T2 final follow-up visit (1.6 ± 1.09; –42.9%, p <0.001). The cohort distribution of the GAIS skin quality descriptors assessed by the investigators improved by one severity level in 66.7% of surveyed subjects, two severity levels in 20.0%, and four levels in 2.2%. Only a tiny cohort minority (2 individuals out of 45, 4.4%) reported no subjective improvement in skin quality. Among surveyed participants, 95.6% reported a clinically meaningful skin quality improvement. The device safety was high. Conclusions: The real-world survey, performed within the framework of a long-term program to monitor the device’s clinical performance and safety over time, demonstrated that the HA-based medical device retains its long-standing record of efficient performance and excellent safety with no variations over time.
导读:除了影响生活质量外,令人不快的妊娠纹、皮肤老化、痤疮和水痘引发的皮肤疤痕以及皱纹还会让那些有这些皮肤缺陷的人更容易出现精神问题,比如焦虑、抑郁、注意力缺陷多动症和失眠,这种情况比人们想象的要频繁得多。重塑皮肤瘢痕和支持老化的真皮弹性纤维网络也具有医学价值。非交联透明质酸迅速发展的保湿特性和皮肤保护清除自由基的作用为帮助解决这些问题提供了强有力的理论依据。方法:研究人员对45名有妊娠纹、皮肤疤痕和皮肤老化的男女受试者进行问卷调查。在调查之前,所有患者都接受了三个疗程的治疗周期,使用带有iii类ce标志的医疗器械,其中含有40mg非交联HA,用2ml预填充一次性注射器使用30G½针头(IALEST®,Mastelli Srl,圣雷莫,意大利)。主要观察性疗效评估工具为六分皱纹严重性评定量表(WSRS);二级疗效评估工具为五分制全球审美改善量表(GAIS)。WSRS和GAIS评估的时间:基线(T0),第一次皮内治疗前,T2(治疗周期结束)后3至4周。结果:在T0基线随访(2.8±1.17)和T2最终随访(1.6±1.09)之间,wrs皮肤质量平均评分显著提高;-42.9%, p <0.001)。研究人员评估的GAIS皮肤质量描述符的队列分布在66.7%的调查对象中改善了一个严重级别,20.0%的调查对象改善了两个严重级别,2.2%的调查对象改善了四个严重级别。只有一小部分人(45人中2人,4.4%)报告皮肤质量没有主观改善。在接受调查的参与者中,95.6%的人报告有临床意义的皮肤质量改善。设备安全性高。结论:在长期监测设备临床性能和安全性的计划框架内进行的真实世界调查表明,基于ha的医疗设备保持了其高效性能和出色安全性的长期记录,没有随时间变化。
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引用次数: 0
The Surgical Patient and Nursing Care in a Low-Income Setting: Challenges and Way Forward 低收入环境下的外科病人和护理:挑战和前进的道路
4区 医学 Q2 SURGERY Pub Date : 2023-04-30 DOI: 10.33425/2689-1093.1054
Rex Friday Ogoronte Alderton Ijah, Linda U Iroegbu-Emeruem, Mary Obidiya Okuku, Nwizor Monday Nkadam, Victoria Amagboruju
Background: The newly developed Nigerian addition to the universal health coverage has surgery, obstetrics, anesthesia, and nursing as components of the plan. This study evaluated the challenges in the nursing care of the surgical patient in two public Teaching Hospitals in Port Harcourt, Nigeria. Materials and Methods: A cross sectional descriptive study was conducted among total population of consenting Nurses and Medical Doctors at the Surgery Departments two public Teaching Hospitals, using semi-structured selfadministered questionnaire. Data obtained was entered into Microsoft Excel Spreadsheet / Statistical Package for the Social Sciences, and formed into tables. Results: There were 67(26.1%) male and 190 (73.9%) female respondents. The mean age of respondents was 37.63 ± 10.22 years. The mean years in practice was 11.05 ± 9.26 years. One hundred and forty-nine (58.0%) of the respondents were nurses. Most challenging nursing issues were giving intravenous fluids according to schedule (75 = 29.2%), wound dressing (73 = 28.4%), inadequate equipment and manpower (51 = 19.8%), administration and charting of intravenous fluids (26 = 10.1%), and drug administration (26 = 10.1%). The most challenging surgeon / doctor-related issues was poor staff interpersonal relationship (103 = 40.1%) followed by poor supervision of the surgical team (97 = 37.7%). Conclusion: The challenges of nursing the surgical patient in our setting are of multiple origin. Administrative issues of inadequate employment of manpower and its multiplier effects are reported along with patient-related and health professional issues.
背景:尼日利亚新制定的全民健康保险补充计划将外科、产科、麻醉和护理作为该计划的组成部分。本研究评估了尼日利亚哈科特港两所公立教学医院外科病人护理方面的挑战。材料与方法:采用半结构化的自填问卷,对两所公立教学医院的外科护士和医生进行了横断面描述性研究。将得到的数据输入到Microsoft Excel Spreadsheet / Statistical Package for Social Sciences中,并形成表格。结果:男性67例(26.1%),女性190例(73.9%)。受访者平均年龄37.63±10.22岁。平均执业年数为11.05±9.26年。149人(58.0%)为护士。最具挑战性的护理问题是按计划给予静脉输液(75 = 29.2%),伤口敷料(73 = 28.4%),设备和人力不足(51 = 19.8%),静脉输液的给药和图表(26 = 10.1%)和药物给药(26 = 10.1%)。与外科医生/医生相关的最具挑战性的问题是员工人际关系差(103 = 40.1%),其次是对手术团队的监管差(97 = 37.7%)。结论:本院外科病人护理面临的挑战是多方面的。报告了人力就业不足的行政问题及其乘数效应,以及与病人有关的问题和保健专业问题。
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引用次数: 0
Preliminary Pages 初步的页面
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-23 DOI: 10.1159/000529176

Eur Surg Res 2023;64:1–4
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引用次数: 0
Subject Index Vol. 64, No. 1, 2023 主题索引第64卷,第1期,2023年
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000529175
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引用次数: 0
Front & Back Matter 正面和背面事项
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000530321
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引用次数: 0
Author Index Vol. 64, No. 1, 2023 作者索引第64卷,第1期,2023
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000529174
{"title":"Author Index Vol. 64, No. 1, 2023","authors":"","doi":"10.1159/000529174","DOIUrl":"https://doi.org/10.1159/000529174","url":null,"abstract":"","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":"64 1","pages":"139 - 139"},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47509534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
European Surgical Research
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