The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard in autologous breast reconstruction. One of the existing challenges of the procedure is maintaining a pedicle of suitable length and diameter for flap survival. In this study, we analyzed the vascular anatomy of bi-pedicle DIEP flap cases in terms of the vessel diameter, the rate of secondary venae comitantes, and pedicle length to determine the efficacy of microvascular anastomosis and venous drainage. We retrospectively evaluated 108 patients who underwent immediate breast reconstruction using free bi-pedicle DIEP flaps between 2012 and 2019. The patient characteristics, diameters of the deep inferior epigastric artery (DIEA) and accompanying veins (DIEVs), DIEA pedicle length, vessel re-anastomosis rate, flap failure rate, and fat necrosis were recorded. Comparison of the right side and left side diameters and pedicle lengths obtained showed no significant differences (p > 0.05). A total of 148 sides (68.52%) of flaps had double venous drainage, whereas 68 sides (31.48%) of flaps had one. Vein congestion occurred in 5 cases, and all involved with just one DIEV anastomosis. No arterial occlusions were observed. This is an analysis of extensive clinical data in terms of DIEA, DIEV, and pedicle length. The low vein congestion rate observed reveals adequate venous drainage was achieved in the DIEV system for DIEP reconstruction. Adequate deep inferior epigastric vessel pedicle length and vessel size, as well as greater than 60% of flaps with secondary DIEV, may allow comfortable microsurgery with reduced complications.
{"title":"Analysis of Vascular Anatomy in Deep Inferior Epigastric Perforator Flap","authors":"Hsu-Yun Tsai, Chien-Liang Fang, Chin-Hao Hsu, Chin-Wen Tu, Yueh-Lin Wu, Hsin-Yi Yang","doi":"10.1097/fs9.0000000000000128","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000128","url":null,"abstract":"\u0000 \u0000 \u0000 The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard in autologous breast reconstruction. One of the existing challenges of the procedure is maintaining a pedicle of suitable length and diameter for flap survival. In this study, we analyzed the vascular anatomy of bi-pedicle DIEP flap cases in terms of the vessel diameter, the rate of secondary venae comitantes, and pedicle length to determine the efficacy of microvascular anastomosis and venous drainage.\u0000 \u0000 \u0000 \u0000 We retrospectively evaluated 108 patients who underwent immediate breast reconstruction using free bi-pedicle DIEP flaps between 2012 and 2019. The patient characteristics, diameters of the deep inferior epigastric artery (DIEA) and accompanying veins (DIEVs), DIEA pedicle length, vessel re-anastomosis rate, flap failure rate, and fat necrosis were recorded.\u0000 \u0000 \u0000 \u0000 Comparison of the right side and left side diameters and pedicle lengths obtained showed no significant differences (p > 0.05). A total of 148 sides (68.52%) of flaps had double venous drainage, whereas 68 sides (31.48%) of flaps had one. Vein congestion occurred in 5 cases, and all involved with just one DIEV anastomosis. No arterial occlusions were observed.\u0000 \u0000 \u0000 \u0000 This is an analysis of extensive clinical data in terms of DIEA, DIEV, and pedicle length. The low vein congestion rate observed reveals adequate venous drainage was achieved in the DIEV system for DIEP reconstruction. Adequate deep inferior epigastric vessel pedicle length and vessel size, as well as greater than 60% of flaps with secondary DIEV, may allow comfortable microsurgery with reduced complications.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006150","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 : 2024-04-10DOI: 10.1097/fs9.0000000000000126
Kai-Chun Lin, Cheng-Ta Hsieh, Shiu-Jau Chen, Cheng-Chia Tsai, Sheng-Yu Cheng, J. Lin, Chih-Chuan Yang, C. Hu, Yun-Kai Chan, Hsin-Yao Lin
Mitigating residual cerebral aneurysm and parent artery trauma during the microsurgical treatment of aneurysms, specifically clipping, is of paramount importance to enhance patient outcomes. This study examines the effectiveness of intraoperative indocyanine green-videoangiography as a strategic tool to attenuate these surgical complications. We conducted a retrospective analysis of patient medical records who underwent cerebral aneurysm surgery in our institution from January 2012 to July 2018. The characteristic variables were juxtaposed between cohorts who had undergone intraoperative ICG-VA and those who had not, employing the independent-samples Student’s t-test and Chi-square test for statistical comparison. The Sindou grading system was utilized to categorize aneurysm remnants, while injury to the parent artery was determined jointly by a neurosurgeon and a neuroradiologist. Logistic regression models were utilized to investigate the correlation between intraoperative ICG-VA usage and the presence of aneurysm remnants and parent artery injury. A total of 127 patients, harboring 131 aneurysms, underwent surgical treatment. Among these patients, 55 had intraoperative ICG-VA utilized. The occurrence rates of residual aneurysm and parent artery injury were documented at 30.5% and 6.9%, respectively. With regards to the Sindou grade I–III aneurysm remnants, interpreted as favorable outcomes, such results were observed in 14 (82.4%) patients in the non-ICG-VA group and 21 (91.3%) patients in the ICG-VA group, with no significant difference discerned between the two groups (p = 0.406; odds ratio [OR], 2.250; 95% confidence interval [CI], 0.332–15.236). Without parent artery injury, there were 64 (88.9%) patients in the non-ICG-VA group and 58 (98.3%) patients in the ICG-VA group, presenting a significant difference (p = 0.038; OR, 10.793; 95% CI, 1.134–102.691). The utilization of intraoperative ICG-VA during microsurgical aneurysm clipping could notably decrease the incidence of parent artery injury. Nonetheless, when considering the presence of aneurysm remnants, the expertise of the neurosurgeon may play a more influential role compared to the use of ICG-VA.
{"title":"The Correlation Between the Intraoperative Employment of Indocyanine Green Videoangiography and Incidences of Residual Aneurysm and Parent Vessel Trauma: A Retrospective Analysis from a Single Centre","authors":"Kai-Chun Lin, Cheng-Ta Hsieh, Shiu-Jau Chen, Cheng-Chia Tsai, Sheng-Yu Cheng, J. Lin, Chih-Chuan Yang, C. Hu, Yun-Kai Chan, Hsin-Yao Lin","doi":"10.1097/fs9.0000000000000126","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000126","url":null,"abstract":"\u0000 \u0000 \u0000 Mitigating residual cerebral aneurysm and parent artery trauma during the microsurgical treatment of aneurysms, specifically clipping, is of paramount importance to enhance patient outcomes. This study examines the effectiveness of intraoperative indocyanine green-videoangiography as a strategic tool to attenuate these surgical complications.\u0000 \u0000 \u0000 \u0000 We conducted a retrospective analysis of patient medical records who underwent cerebral aneurysm surgery in our institution from January 2012 to July 2018. The characteristic variables were juxtaposed between cohorts who had undergone intraoperative ICG-VA and those who had not, employing the independent-samples Student’s t-test and Chi-square test for statistical comparison. The Sindou grading system was utilized to categorize aneurysm remnants, while injury to the parent artery was determined jointly by a neurosurgeon and a neuroradiologist. Logistic regression models were utilized to investigate the correlation between intraoperative ICG-VA usage and the presence of aneurysm remnants and parent artery injury.\u0000 \u0000 \u0000 \u0000 A total of 127 patients, harboring 131 aneurysms, underwent surgical treatment. Among these patients, 55 had intraoperative ICG-VA utilized. The occurrence rates of residual aneurysm and parent artery injury were documented at 30.5% and 6.9%, respectively. With regards to the Sindou grade I–III aneurysm remnants, interpreted as favorable outcomes, such results were observed in 14 (82.4%) patients in the non-ICG-VA group and 21 (91.3%) patients in the ICG-VA group, with no significant difference discerned between the two groups (p = 0.406; odds ratio [OR], 2.250; 95% confidence interval [CI], 0.332–15.236). Without parent artery injury, there were 64 (88.9%) patients in the non-ICG-VA group and 58 (98.3%) patients in the ICG-VA group, presenting a significant difference (p = 0.038; OR, 10.793; 95% CI, 1.134–102.691).\u0000 \u0000 \u0000 \u0000 The utilization of intraoperative ICG-VA during microsurgical aneurysm clipping could notably decrease the incidence of parent artery injury. Nonetheless, when considering the presence of aneurysm remnants, the expertise of the neurosurgeon may play a more influential role compared to the use of ICG-VA.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718287","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 : 2024-04-09DOI: 10.1097/fs9.0000000000000124
Jiří Kotek, Ivo Žvák, Tomáš Dušek, Jaroslav Růžička, Jana Šatanková, Zuzana Burešová, Petr Lochman
Penetrating neck injury is quite a rare entity, all the more if it is caused by a shotgun. Due to lots of vital important structures it may immediately be life threatening and an organized and systematic approach is highly recommended. We present a case of a young man who was accidentaly hit by a crossbow arrow to the neck. An overview of diagnostic and treatment management of such an injury is also provided.
{"title":"Prelaryngeal soft tissue injury of the neck caused by an accidental crossbow shot","authors":"Jiří Kotek, Ivo Žvák, Tomáš Dušek, Jaroslav Růžička, Jana Šatanková, Zuzana Burešová, Petr Lochman","doi":"10.1097/fs9.0000000000000124","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000124","url":null,"abstract":"\u0000 Penetrating neck injury is quite a rare entity, all the more if it is caused by a shotgun. Due to lots of vital important structures it may immediately be life threatening and an organized and systematic approach is highly recommended. We present a case of a young man who was accidentaly hit by a crossbow arrow to the neck. An overview of diagnostic and treatment management of such an injury is also provided.","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721744","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 : 2024-03-06DOI: 10.1097/fs9.0000000000000120
Thuong Pham Van, Ngoc Son Vu, Minh-Tung Do
Only a few studies on single-incision laparoscopic surgery for transabdominal preperitoneal (SILS-TAPP) inguinal hernia (IH) repair have been conducted. Thus, we aimed to verify whether SILS-TAPP IH repair in elderly patients (≥ 65 years old) is safe and effective for non-elderly patients (< 65 years old). A retrospective study of 91 patients who underwent SILS-TAPP for IH between November 2011 and April 2014 and were followed up until June 2018 was conducted. The inclusion criterion was SILS-TAPP for unilateral inguinal hernia, regardless of primary or recurrent. The main variables of interest were age, body mass index (BMI), comorbidities, inguinal hernia classification, operation time, perioperative and postoperative complications, postoperative visual analog scale (VAS) pain score, long-term complications, and recurrence. Elderly patients had a higher prevalence of comorbidities and higher ASA of Anesthesiologists scores than non-elderly patients. Intraoperative characteristics, including IH classification and size of the internal hernia ring, were similar. Operation time did not differ between the two groups (44.1 ± 14.7 minutes in the elderly versus 49.8 ± 19.7 minutes in the nonelderly). The postoperative pain score, short- and long-term complications, and recurrence rates were similar between the groups. SILS-TAPP is safe, feasible, and an alternative treatment for IH in the elderly.
{"title":"Single-incision laparoscopic surgery transabdominal preperitoneal approach for hernia in elderly: a cross-sectional study","authors":"Thuong Pham Van, Ngoc Son Vu, Minh-Tung Do","doi":"10.1097/fs9.0000000000000120","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000120","url":null,"abstract":"\u0000 \u0000 \u0000 Only a few studies on single-incision laparoscopic surgery for transabdominal preperitoneal (SILS-TAPP) inguinal hernia (IH) repair have been conducted. Thus, we aimed to verify whether SILS-TAPP IH repair in elderly patients (≥ 65 years old) is safe and effective for non-elderly patients (< 65 years old).\u0000 \u0000 \u0000 \u0000 A retrospective study of 91 patients who underwent SILS-TAPP for IH between November 2011 and April 2014 and were followed up until June 2018 was conducted. The inclusion criterion was SILS-TAPP for unilateral inguinal hernia, regardless of primary or recurrent. The main variables of interest were age, body mass index (BMI), comorbidities, inguinal hernia classification, operation time, perioperative and postoperative complications, postoperative visual analog scale (VAS) pain score, long-term complications, and recurrence.\u0000 \u0000 \u0000 \u0000 Elderly patients had a higher prevalence of comorbidities and higher ASA of Anesthesiologists scores than non-elderly patients. Intraoperative characteristics, including IH classification and size of the internal hernia ring, were similar. Operation time did not differ between the two groups (44.1 ± 14.7 minutes in the elderly versus 49.8 ± 19.7 minutes in the nonelderly). The postoperative pain score, short- and long-term complications, and recurrence rates were similar between the groups.\u0000 \u0000 \u0000 \u0000 SILS-TAPP is safe, feasible, and an alternative treatment for IH in the elderly.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078235","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 : 2024-03-06DOI: 10.1097/fs9.0000000000000121
Yu-Pin Su, Wen-Chung Liu, Cheng-Ta Lin, Hsin-I Chien, Kuo‐Chung Yang
Osteonecrosis of the jaw (ONJ) is a serious adverse effect of therapy with bisphosphonates (BP) and other antiresorptive agents. The aim of the study was to report thirteen bisphosphonates related osteonecrosis of the jaw (BRONJ) patient cases at Kaohsiung Veterans General Hospital (VGHKS), Taiwan and their medical history and disease outcomes. Thirteen symptomatic patients with BRONJ were reviewed between 1985 and 2021 at VGHKS. We included symptomatic patients who were in advanced BRONJ stage two and three. Four multiple myeloma, three bone metastatic breast cancer and six advanced osteoporosis patients. Seven patients were AAOMS MRONJ stage three and six were stage two. The average anti-resorptive medication duration was 25.83 ± 31.45 months in BRONJ stage two patients and 53.71 ± 31.25 months in BRONJ stage three patients respectively. No correlation was found between the anti-resorptive agent duration and BRONJ stage (p value = 0.098; Mann-Whitney U test) among cancer (p value = 0.157; Mann-Whitney U test) and osteoporosis patients (p value = 0.184; Mann-Whitney U test). Most of them died of terminal stage cancer disease or complications of being bedridden. The correlation between the duration of anti-resorptive agents and BRONJ stage needs larger patient data to confirm the result.
颌骨骨坏死（ONJ）是使用双膦酸盐（BP）和其他抗骨吸收剂治疗的一种严重不良反应。本研究旨在报告台湾高雄荣民总医院（VGHKS）13例与双膦酸盐相关的颚骨骨坏死（BRONJ）患者的病史和疾病结果。 我们回顾了1985年至2021年间高雄荣民总医院13例有症状的颚骨骨坏死患者。我们纳入了BRONJ二期和三期晚期的无症状患者。其中包括四名多发性骨髓瘤患者、三名骨转移乳腺癌患者和六名晚期骨质疏松症患者。 七名患者为 AAOMS MRONJ 三期，六名为二期。BRONJ二期患者的平均抗骨质吸收药物治疗时间分别为（25.83 ± 31.45）个月，BRONJ三期患者的平均抗骨质吸收药物治疗时间分别为（53.71 ± 31.25）个月。在癌症患者（P 值 = 0.157；Mann-Whitney U 检验）和骨质疏松症患者（P 值 = 0.184；Mann-Whitney U 检验）中，抗骨质吸收药物持续时间与 BRONJ 分期（P 值 = 0.098；Mann-Whitney U 检验）无相关性。 这些患者大多死于癌症晚期或卧床不起的并发症。抗骨质吸收剂的使用时间与 BRONJ 分期之间的相关性需要更多的患者数据来证实。
{"title":"Bisphosphonate-related Osteonecrosis of The Jaw : Is the Medication Duration Related to Advanced Disease Stage?","authors":"Yu-Pin Su, Wen-Chung Liu, Cheng-Ta Lin, Hsin-I Chien, Kuo‐Chung Yang","doi":"10.1097/fs9.0000000000000121","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000121","url":null,"abstract":"\u0000 \u0000 \u0000 Osteonecrosis of the jaw (ONJ) is a serious adverse effect of therapy with bisphosphonates (BP) and other antiresorptive agents. The aim of the study was to report thirteen bisphosphonates related osteonecrosis of the jaw (BRONJ) patient cases at Kaohsiung Veterans General Hospital (VGHKS), Taiwan and their medical history and disease outcomes.\u0000 \u0000 \u0000 \u0000 Thirteen symptomatic patients with BRONJ were reviewed between 1985 and 2021 at VGHKS. We included symptomatic patients who were in advanced BRONJ stage two and three. Four multiple myeloma, three bone metastatic breast cancer and six advanced osteoporosis patients.\u0000 \u0000 \u0000 \u0000 Seven patients were AAOMS MRONJ stage three and six were stage two. The average anti-resorptive medication duration was 25.83 ± 31.45 months in BRONJ stage two patients and 53.71 ± 31.25 months in BRONJ stage three patients respectively. No correlation was found between the anti-resorptive agent duration and BRONJ stage (p value = 0.098; Mann-Whitney U test) among cancer (p value = 0.157; Mann-Whitney U test) and osteoporosis patients (p value = 0.184; Mann-Whitney U test).\u0000 \u0000 \u0000 \u0000 Most of them died of terminal stage cancer disease or complications of being bedridden. The correlation between the duration of anti-resorptive agents and BRONJ stage needs larger patient data to confirm the result.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261144","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 : 2024-03-06DOI: 10.1097/fs9.0000000000000122
Shih-Chen Tsai, Yin Cheng, Chi-Tai Fang, Hao-Chih Tai, Nai-Chen Cheng
Necrotizing fasciitis (NF) is a life-threatening soft tissue infection requiring urgent interventions. This study aimed to investigate the effect of implementation of a standardized management protocol on the outcome of NF patients admitted to the intensive care unit. We initiated a management protocol for NF patients in 2012 at our institution. The protocol consisted of early surgical intervention, initial board-spectrum antibiotic regimen, daily wound inspection, repeated debridement, and inter-professional collaboration. Herein, we reviewed the NF cases admitted between 2005 and 2018 and compared their clinical features and outcome before and after the protocol implementation. All of the NF cases underwent were confirmed by intraoperative findings. We included 134 NF patients before (2005 to 2011, n = 62) and after (2013 to 2018, n = 72) the protocol implementation. The baseline patient profile from these two periods were largely similar, except that after protocol implementation, more patients presented with erythema (64.5% vs 84.7%) and a higher C-reactive protein level (65.5% vs 85.5%) on admission. Notably, the day 28-censored mortality was significantly lower after protocol implementation (40.3% vs 13.9%). By analyzing the 28-day mortality with univariate and multivariate model, initial presentation with neutropenia was identified as a risk factor [hazard ratio (HR) = 8.45, 95% confidence interval (CI) = 1.76-40.6], while protocol implementation (HR = 0.27, 95% CI = 0.11-0.71) was a protective factor. A multidisciplinary bundle care protocol for NF including board-spectrum empirical antibiotic regimen and inter-professional collaboration was feasible, which was associated with improved overall and 28-day survival.
{"title":"Implementation of a Standardized Management Protocol Improved the Survival of Patients with Necrotizing Fasciitis","authors":"Shih-Chen Tsai, Yin Cheng, Chi-Tai Fang, Hao-Chih Tai, Nai-Chen Cheng","doi":"10.1097/fs9.0000000000000122","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000122","url":null,"abstract":"\u0000 \u0000 \u0000 Necrotizing fasciitis (NF) is a life-threatening soft tissue infection requiring urgent interventions. This study aimed to investigate the effect of implementation of a standardized management protocol on the outcome of NF patients admitted to the intensive care unit.\u0000 \u0000 \u0000 \u0000 We initiated a management protocol for NF patients in 2012 at our institution. The protocol consisted of early surgical intervention, initial board-spectrum antibiotic regimen, daily wound inspection, repeated debridement, and inter-professional collaboration. Herein, we reviewed the NF cases admitted between 2005 and 2018 and compared their clinical features and outcome before and after the protocol implementation. All of the NF cases underwent were confirmed by intraoperative findings.\u0000 \u0000 \u0000 \u0000 We included 134 NF patients before (2005 to 2011, n = 62) and after (2013 to 2018, n = 72) the protocol implementation. The baseline patient profile from these two periods were largely similar, except that after protocol implementation, more patients presented with erythema (64.5% vs 84.7%) and a higher C-reactive protein level (65.5% vs 85.5%) on admission. Notably, the day 28-censored mortality was significantly lower after protocol implementation (40.3% vs 13.9%). By analyzing the 28-day mortality with univariate and multivariate model, initial presentation with neutropenia was identified as a risk factor [hazard ratio (HR) = 8.45, 95% confidence interval (CI) = 1.76-40.6], while protocol implementation (HR = 0.27, 95% CI = 0.11-0.71) was a protective factor.\u0000 \u0000 \u0000 \u0000 A multidisciplinary bundle care protocol for NF including board-spectrum empirical antibiotic regimen and inter-professional collaboration was feasible, which was associated with improved overall and 28-day survival.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262928","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 : 2024-02-27DOI: 10.1097/fs9.0000000000000104
Yu-Ning Lin, Chung-Yi Tsai, Ta-Sen Yeh
Laparoscopic partial splenectomy has become the preferred method for benign disease or low-graded malignancy with advantages of organ-preservation and avoidance of potential post-splenectomy fulminant infection. We herein presented a presumed diagnosis of sclerosing angiomatoid nodular transformation (SANT) subjected to laparoscopic partial splenectomy. The patient underwent the surgical procedure uneventfully and was discharged at day 4 postoperatively. The diagnosis was confirmed by the pathological examination.
{"title":"Laparoscopic partial splenectomy for sclerosing angiomatoid nodular transformation: a case report and literature review","authors":"Yu-Ning Lin, Chung-Yi Tsai, Ta-Sen Yeh","doi":"10.1097/fs9.0000000000000104","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000104","url":null,"abstract":"\u0000 Laparoscopic partial splenectomy has become the preferred method for benign disease or low-graded malignancy with advantages of organ-preservation and avoidance of potential post-splenectomy fulminant infection. We herein presented a presumed diagnosis of sclerosing angiomatoid nodular transformation (SANT) subjected to laparoscopic partial splenectomy. The patient underwent the surgical procedure uneventfully and was discharged at day 4 postoperatively. The diagnosis was confirmed by the pathological examination.","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425831","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 : 2024-01-11DOI: 10.1097/fs9.0000000000000115
Dai Nga Mai, Quoc Vinh Nguyen, Minh Tri Phan, Tien My Doan
Over half of the patients who underwent the Partington procedure for painful chronic pancreatitis developed recurrent pain attacks. This occurs because the proximal ducts at the head of the pancreas, often containing stones, are left undrained. To overcome this pitfall, an extended Partington procedure is recommended. To assess our one-year follow-up results of the extended Partington procedure in patients with painful chronic pancreatitis. This prospective study comprises patients undergoing extended Partington procedures who were followed for at least one year. Data were collected preoperatively and postoperatively in a fixed-interval fashion at three months, six months, and one year. Thirty-one patients underwent assessment. At one-year follow-up, effective and complete pain relief was achieved in 81% and 55% of patients, respectively. The Izbicki pain score decreased significantly; the median dropped from 47.5 to 4.4. The quality of life using SF-12 physical and mental component summary improved significantly; the medians increased from 41.7 to 93.8, and 47.5 to 86.7, respectively. Endocrine function remained stable. Exocrine insufficiency developed in most patients as a natural progression of chronic pancreatitis. Two patients had complications directly related to surgical procedures (6%). No early postoperative deaths occurred. Extended Partington procedure for chronic pancreatitis results in excellent pain relief and quality of life improvement, with a low morbidity rate, and does not worsen pancreatic function. It should replace the original Partington procedure in treating painful chronic pancreatitis.
{"title":"Extended Partington procedure for chronic pancreatitis: one-year follow-up results","authors":"Dai Nga Mai, Quoc Vinh Nguyen, Minh Tri Phan, Tien My Doan","doi":"10.1097/fs9.0000000000000115","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000115","url":null,"abstract":"\u0000 \u0000 \u0000 Over half of the patients who underwent the Partington procedure for painful chronic pancreatitis developed recurrent pain attacks. This occurs because the proximal ducts at the head of the pancreas, often containing stones, are left undrained. To overcome this pitfall, an extended Partington procedure is recommended.\u0000 \u0000 \u0000 \u0000 To assess our one-year follow-up results of the extended Partington procedure in patients with painful chronic pancreatitis.\u0000 \u0000 \u0000 \u0000 This prospective study comprises patients undergoing extended Partington procedures who were followed for at least one year. Data were collected preoperatively and postoperatively in a fixed-interval fashion at three months, six months, and one year.\u0000 \u0000 \u0000 \u0000 Thirty-one patients underwent assessment. At one-year follow-up, effective and complete pain relief was achieved in 81% and 55% of patients, respectively. The Izbicki pain score decreased significantly; the median dropped from 47.5 to 4.4. The quality of life using SF-12 physical and mental component summary improved significantly; the medians increased from 41.7 to 93.8, and 47.5 to 86.7, respectively. Endocrine function remained stable. Exocrine insufficiency developed in most patients as a natural progression of chronic pancreatitis. Two patients had complications directly related to surgical procedures (6%). No early postoperative deaths occurred.\u0000 \u0000 \u0000 \u0000 Extended Partington procedure for chronic pancreatitis results in excellent pain relief and quality of life improvement, with a low morbidity rate, and does not worsen pancreatic function. It should replace the original Partington procedure in treating painful chronic pancreatitis.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139627004","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}
Endoscopic sleeve gastroplasty (ESG) is emerging as an innovative approach to treating obesity. It provides a bridge between surgical and medical treatments for obesity. Nevertheless, the majority of reports on ESG originate from Western countries, and there is a lack of data from Asian nations. This study aims to share our pioneering experience with this novel technique in Asia. We enrolled obese patients with a BMI greater than 27 kg/m2 who were at least 20 years old. Endoscopic sleeve gastroplasty (ESG) was conducted following a comprehensive pre-operative assessment. Following the procedure, patients were scheduled for regular outpatient department (OPD) follow-up appointments at 7 days, 1 month, 2 months, 3 months, and then every 3 months up to 18 months post-operation. Body weight and any adverse events were documented during each follow-up visit. A total of 49 obese patients were enrolled in this study. Our findings demonstrate that ESG can be safely integrated into a conventional bariatric surgery center, with a learning curve observed after 10 cases in this study. In our series, the results showed that total body weight loss (TBWL) reached 7% at one month, 9% at three months, 14% at six months, 16% at 12 months, and 18.6% at 18 months. No adverse events or complications were reported in the study; however, five patients experienced procedure failures. Four of these patients underwent a repeat ESG, while one patient opted for surgical intervention. Endoscopic sleeve gastroplasty can be utilized in Asian countries, and the effectiveness of weight loss has proven to be satisfactory.
{"title":"Preliminary experience with eighteen months result of endoscopic sleeve gastroplasty from Asian: Learning curve of one bariatric surgeon","authors":"Sheng-Shih Chen, Wei-Jei Lee, Lung-Yun Kang, Chu-Kung Chou","doi":"10.1097/fs9.0000000000000113","DOIUrl":"https://doi.org/10.1097/fs9.0000000000000113","url":null,"abstract":"\u0000 \u0000 \u0000 Endoscopic sleeve gastroplasty (ESG) is emerging as an innovative approach to treating obesity. It provides a bridge between surgical and medical treatments for obesity. Nevertheless, the majority of reports on ESG originate from Western countries, and there is a lack of data from Asian nations. This study aims to share our pioneering experience with this novel technique in Asia.\u0000 \u0000 \u0000 \u0000 We enrolled obese patients with a BMI greater than 27 kg/m2 who were at least 20 years old. Endoscopic sleeve gastroplasty (ESG) was conducted following a comprehensive pre-operative assessment. Following the procedure, patients were scheduled for regular outpatient department (OPD) follow-up appointments at 7 days, 1 month, 2 months, 3 months, and then every 3 months up to 18 months post-operation. Body weight and any adverse events were documented during each follow-up visit.\u0000 \u0000 \u0000 \u0000 A total of 49 obese patients were enrolled in this study. Our findings demonstrate that ESG can be safely integrated into a conventional bariatric surgery center, with a learning curve observed after 10 cases in this study. In our series, the results showed that total body weight loss (TBWL) reached 7% at one month, 9% at three months, 14% at six months, 16% at 12 months, and 18.6% at 18 months. No adverse events or complications were reported in the study; however, five patients experienced procedure failures. Four of these patients underwent a repeat ESG, while one patient opted for surgical intervention.\u0000 \u0000 \u0000 \u0000 Endoscopic sleeve gastroplasty can be utilized in Asian countries, and the effectiveness of weight loss has proven to be satisfactory.\u0000","PeriodicalId":12390,"journal":{"name":"Formosan Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626645","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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