Pub Date : 2023-12-23DOI: 10.9738/intsurg-d-23-00001.1
Alexandra Close, Tyler J Kingma, Maaria Chaudhry, B. Chaudhry, K. Alekseyev
Pulmonary herniation is an uncommon but potentially dangerous complication of chest wall trauma. We present a 60-year-old female who presented to the hospital after blunt chest wall trauma resulting in thoracic pulmonary herniation. A majority of cases have historically been treated surgically, though this patient achieved spontaneous reduction of lung tissue after chest tube placement without recurrence. This report evaluates the elements of pulmonary herniation and highlights the need for defined guidelines in treatment of this condition.
{"title":"Traumatic Pulmonary Herniation: A Conservative Approach","authors":"Alexandra Close, Tyler J Kingma, Maaria Chaudhry, B. Chaudhry, K. Alekseyev","doi":"10.9738/intsurg-d-23-00001.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-23-00001.1","url":null,"abstract":"Pulmonary herniation is an uncommon but potentially dangerous complication of chest wall trauma. We present a 60-year-old female who presented to the hospital after blunt chest wall trauma resulting in thoracic pulmonary herniation. A majority of cases have historically been treated surgically, though this patient achieved spontaneous reduction of lung tissue after chest tube placement without recurrence. This report evaluates the elements of pulmonary herniation and highlights the need for defined guidelines in treatment of this condition.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"96 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139162978","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}
Pub Date : 2023-12-15DOI: 10.9738/intsurg-d-22-00003.1
Shuo Dong, Guanghua Pei
Morganella morganii infection mainly occurred in elderly people and immunocompromised patients.However, the abdominal wall abscess due to Morganella morganii infection in prepubertal children hasn't been documented.Our presented case is a 4-year-old male patient with a 1 month history of left lower quadrant abdominal mass. Preoperative ultrasonography showed a hypoechoic, heterogeneous mass and the mass wasn't just confined to the abdominal wall, mimicking lymphoma. On CDFI, an image of highly vascularized mass was demonstrated. The patient underwent lump resection of abdominal wall.Postoperative process was uneventful except intermittent haematuria, and bladder sludge and urethral calculus on ultrasonography.By symptomatic treatment, haematuria disappeared and urethral calculus and bladder sludge decreased. Then the patient discharged home. Postoperative histopathology and immunohistochemistry were suggestive of abscess formation and Morganella morganii was isolated finally from the aspirated pus. Therefore, although the abdominal wall abscess due to Morganella morganii infection is rare, it should not be absent in the differential diagnosis of abdominal wall masses in children. Imaging features of abdominal wall masses should closely integrate the pertinent clinical history.
{"title":"Abscess formation of abdominal wall mimicking lymphoma due to Morganella morganii infection in a prepubescent children","authors":"Shuo Dong, Guanghua Pei","doi":"10.9738/intsurg-d-22-00003.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-22-00003.1","url":null,"abstract":"\u0000 \u0000 Morganella morganii infection mainly occurred in elderly people and immunocompromised patients.However, the abdominal wall abscess due to Morganella morganii infection in prepubertal children hasn't been documented.Our presented case is a 4-year-old male patient with a 1 month history of left lower quadrant abdominal mass. Preoperative ultrasonography showed a hypoechoic, heterogeneous mass and the mass wasn't just confined to the abdominal wall, mimicking lymphoma. On CDFI, an image of highly vascularized mass was demonstrated. The patient underwent lump resection of abdominal wall.Postoperative process was uneventful except intermittent haematuria, and bladder sludge and urethral calculus on ultrasonography.By symptomatic treatment, haematuria disappeared and urethral calculus and bladder sludge decreased. Then the patient discharged home. Postoperative histopathology and immunohistochemistry were suggestive of abscess formation and Morganella morganii was isolated finally from the aspirated pus.\u0000 \u0000 \u0000 \u0000 Therefore, although the abdominal wall abscess due to Morganella morganii infection is rare, it should not be absent in the differential diagnosis of abdominal wall masses in children. Imaging features of abdominal wall masses should closely integrate the pertinent clinical history.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"4 8","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999817","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}
Pub Date : 2023-12-15DOI: 10.9738/intsurg-d-23-00016.1
Kayla Krause, Ahsan Zil-E-Ali, Kristine L. So, Faisal Aziz, Aditya Safaya
Iliac vein injuries are associated with high morbidity and mortality, with a feared complication of hemorrhage. We discuss management and the thought process behind mitigating such emergencies. An 81-year-old Caucasian male was seen intraoperatively by Vascular Surgery for hemorrhage from an injured left external iliac vein (LEIV) in the setting of left radical nephrectomy and ureterectomy. Despite initial temporizing efforts by Urology, Vascular Surgical intervention proved necessary in hemostasis, venous reconstruction and thus, establishing continuity of lower extremity venous drainage.
{"title":"Considerations for Iliac Vein Repair in the Setting of Urologic Procedures","authors":"Kayla Krause, Ahsan Zil-E-Ali, Kristine L. So, Faisal Aziz, Aditya Safaya","doi":"10.9738/intsurg-d-23-00016.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-23-00016.1","url":null,"abstract":"\u0000 \u0000 Iliac vein injuries are associated with high morbidity and mortality, with a feared complication of hemorrhage. We discuss management and the thought process behind mitigating such emergencies.\u0000 \u0000 \u0000 \u0000 An 81-year-old Caucasian male was seen intraoperatively by Vascular Surgery for hemorrhage from an injured left external iliac vein (LEIV) in the setting of left radical nephrectomy and ureterectomy.\u0000 \u0000 \u0000 \u0000 Despite initial temporizing efforts by Urology, Vascular Surgical intervention proved necessary in hemostasis, venous reconstruction and thus, establishing continuity of lower extremity venous drainage.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"49 3","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998615","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}
To study the effect of Kegel exercise combined with Baliao warming acupuncture in the treatment of urinary incontinence after radical prostatectomy. A single-center, retrospective cohort study was conducted on clinically localized prostate cancer patients. This study involved 200 patients through a specific exclusion criterion admitted to the Department of Urology of our hospital, including 100 cases in the control group (single Kegel Motion) and 100 cases in the experimental group (Kegel Motion combined with acupuncture) from July 2017 to November 2020. Time from catheter removal to full recovery of urinary continence was recorded by 1 month, 3 months and 6 months after surgery. The International Consultation on Incontinence Questionnaire-short Form (ICIQ), the “one-hour diaper test” and the Quality-of-Life Incontinence Questionnaire (I-QOL) were used to evaluate the frequency and severity of urinary incontinence, the efficacy of urinary incontinence and the patients’ qualities of life, respectively. An independent sample t-test, rank sum test and Chi-square test were adopted for comparison between groups. None of the frequency, severity and efficacy of urinary incontinence nor the patients’ qualities of life showed difference between the experimental group and the control group at one month after surgery (P > 0.05) but showed significant differences at three months and six months postoperatively (P < 0.05). The Kegel Motion combined with warming acupuncture at the eight acupuncture points can reduce the incidence of urinary incontinence, improve urinary control ability and improve the quality of life of patients with urinary incontinence after radical prostatectomy.
{"title":"Application of Kegel Motion Combined with Warming Acupuncture at the Eight Acupuncture Points in Patients with Urinary Incontinence after Radical Prostatectomy","authors":"Hui Chen, Chenchen Wang, Zhongqing Zhang, Lingling Hao, Xuefeng Qiu, Linfeng Xu, J. Zhuang, Hongqian Guo","doi":"10.9738/intsurg-d-22-00013.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-22-00013.1","url":null,"abstract":"\u0000 \u0000 To study the effect of Kegel exercise combined with Baliao warming acupuncture in the treatment of urinary incontinence after radical prostatectomy.\u0000 \u0000 \u0000 \u0000 A single-center, retrospective cohort study was conducted on clinically localized prostate cancer patients. This study involved 200 patients through a specific exclusion criterion admitted to the Department of Urology of our hospital, including 100 cases in the control group (single Kegel Motion) and 100 cases in the experimental group (Kegel Motion combined with acupuncture) from July 2017 to November 2020. Time from catheter removal to full recovery of urinary continence was recorded by 1 month, 3 months and 6 months after surgery. The International Consultation on Incontinence Questionnaire-short Form (ICIQ), the “one-hour diaper test” and the Quality-of-Life Incontinence Questionnaire (I-QOL) were used to evaluate the frequency and severity of urinary incontinence, the efficacy of urinary incontinence and the patients’ qualities of life, respectively. An independent sample t-test, rank sum test and Chi-square test were adopted for comparison between groups.\u0000 \u0000 \u0000 \u0000 None of the frequency, severity and efficacy of urinary incontinence nor the patients’ qualities of life showed difference between the experimental group and the control group at one month after surgery (P > 0.05) but showed significant differences at three months and six months postoperatively (P < 0.05).\u0000 \u0000 \u0000 \u0000 The Kegel Motion combined with warming acupuncture at the eight acupuncture points can reduce the incidence of urinary incontinence, improve urinary control ability and improve the quality of life of patients with urinary incontinence after radical prostatectomy.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"25 2","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597026","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}
Pub Date : 2023-10-01DOI: 10.9738/intsurg-d-17-00060.1
Wujun Miao, Tong Meng, Jian Yang, Qi Jia, Tianqi Fan, Lei Zhou, Lianshun Jia, Dianwen Song
Objective The necessity of radical debridement in the treatment of thoracic and lumbar tuberculosis is increasingly challenged. We introduce the 1-stage surgical treatment with 270° retention of the spinal structure via a posterior-only approach and investigate the clinical efficacy and feasibility of this method in treating thoracic and lumbar spinal tuberculosis. Summary of Background Data In former research articles, many potential disadvantages are found in the treatment of thoracic and lumbar tuberculosis after radical debridement, such as prolonged operative time, increased the surgical trauma, unsatisfactory bony fusion, instability of the spine, and too much blood loss. Methods Twenty-one patients who had thoracic and lumbar tuberculosis were admitted to our hospital between January 2013 and September 2014. All of them were treated with 1-stage surgical treatment by internal fixation, focal debridement, and fusion via the posterior-only approach. Then, the clinical efficacy was evaluated, with the Cobb angle reflecting spinal kyphotic angles, erythrocyte sedimentation rate (ESR), Frankel Grade scores, and imaging examination preoperatively and postoperatively. Results Patients were followed up for 24 to 40 months (mean, 29.95 months), Fusion occurred at 4 to 9 months (mean, 5.86 months). There were significant differences between groups regarding the Cobb angle, ESR, and Frankel Grade scores. Delayed wound healing affected 1 patient because of diabetes. No complications regarding the internal fixation and no tuberculosis recurrence were observed during follow-up. Conclusions Combined with anti-tuberculosis chemotherapy, the method, characterized by 270° retention of the spinal structure, can be an effective and feasible method in treating thoracic and lumbar spinal tuberculosis.
{"title":"A 270° Retention of Spinal Structure in the Treatment of Thoracic and Lumbar Tuberculosis via Posterior-Only Approach","authors":"Wujun Miao, Tong Meng, Jian Yang, Qi Jia, Tianqi Fan, Lei Zhou, Lianshun Jia, Dianwen Song","doi":"10.9738/intsurg-d-17-00060.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00060.1","url":null,"abstract":"Objective The necessity of radical debridement in the treatment of thoracic and lumbar tuberculosis is increasingly challenged. We introduce the 1-stage surgical treatment with 270° retention of the spinal structure via a posterior-only approach and investigate the clinical efficacy and feasibility of this method in treating thoracic and lumbar spinal tuberculosis. Summary of Background Data In former research articles, many potential disadvantages are found in the treatment of thoracic and lumbar tuberculosis after radical debridement, such as prolonged operative time, increased the surgical trauma, unsatisfactory bony fusion, instability of the spine, and too much blood loss. Methods Twenty-one patients who had thoracic and lumbar tuberculosis were admitted to our hospital between January 2013 and September 2014. All of them were treated with 1-stage surgical treatment by internal fixation, focal debridement, and fusion via the posterior-only approach. Then, the clinical efficacy was evaluated, with the Cobb angle reflecting spinal kyphotic angles, erythrocyte sedimentation rate (ESR), Frankel Grade scores, and imaging examination preoperatively and postoperatively. Results Patients were followed up for 24 to 40 months (mean, 29.95 months), Fusion occurred at 4 to 9 months (mean, 5.86 months). There were significant differences between groups regarding the Cobb angle, ESR, and Frankel Grade scores. Delayed wound healing affected 1 patient because of diabetes. No complications regarding the internal fixation and no tuberculosis recurrence were observed during follow-up. Conclusions Combined with anti-tuberculosis chemotherapy, the method, characterized by 270° retention of the spinal structure, can be an effective and feasible method in treating thoracic and lumbar spinal tuberculosis.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761219","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}
Pub Date : 2023-10-01DOI: 10.9738/0020-8868-107.2.i
{"title":"The 43rd International College of Surgeons World Scientific Congress","authors":"","doi":"10.9738/0020-8868-107.2.i","DOIUrl":"https://doi.org/10.9738/0020-8868-107.2.i","url":null,"abstract":"","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761220","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}
Pub Date : 2023-03-20DOI: 10.9738/intsurg-d-23-00003.1
Emad Aljohani, S. Alshieban, Saud Albuthi, Sarah Breakeit, Ikram Hassain, A. Alanazi, Abdullah Alotaibi, Eyad Hijan
Abstract Objective: To assess whether routine histopathological examination of the pilonidal sinus is necessary. Background: Pilonidal sinus disease (PSD) is an acquired condition of the hair follicles and is thought to be an obstruction of the infundibulum of a hair follicle. The follicle enlarges and ruptures, causing secondary infection, the development of fistulae and abscesses, and other complications. Methods: This is a retrospective study including all patients who had pilonidal sinus excision from January 2015 to December 2021 at King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. A review of pathological slides took place in the Department of Pathology, and the chart review was conducted in the Department of Surgery through electronic patient’s medical records. Results: All of the excised sinuses (100%) were benign, and none of the patients in the study population had any cancerous lesions. Around 90% of the patients had no history of recurrence, and 84.8% had no history of surgical abscess drainage. With respect to the histopathological subtype of a benign sinus, the most common type was chronic inflammation, followed by granulation and fibrosis. Conclusions: This study’s findings reveal that none of the patients were diagnosed as having malignancy after excision of the pilonidal sinus. However, the findings reveal no need for performing an unnecessary histopathological examination unless someone is at risk of developing cancer based on whether they have palpable lymph nodes and a history of recurrence.
{"title":"Is routine histological examination of the pilonidal sinus required? A Retrospective analysis","authors":"Emad Aljohani, S. Alshieban, Saud Albuthi, Sarah Breakeit, Ikram Hassain, A. Alanazi, Abdullah Alotaibi, Eyad Hijan","doi":"10.9738/intsurg-d-23-00003.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-23-00003.1","url":null,"abstract":"Abstract Objective: To assess whether routine histopathological examination of the pilonidal sinus is necessary. Background: Pilonidal sinus disease (PSD) is an acquired condition of the hair follicles and is thought to be an obstruction of the infundibulum of a hair follicle. The follicle enlarges and ruptures, causing secondary infection, the development of fistulae and abscesses, and other complications. Methods: This is a retrospective study including all patients who had pilonidal sinus excision from January 2015 to December 2021 at King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. A review of pathological slides took place in the Department of Pathology, and the chart review was conducted in the Department of Surgery through electronic patient’s medical records. Results: All of the excised sinuses (100%) were benign, and none of the patients in the study population had any cancerous lesions. Around 90% of the patients had no history of recurrence, and 84.8% had no history of surgical abscess drainage. With respect to the histopathological subtype of a benign sinus, the most common type was chronic inflammation, followed by granulation and fibrosis. Conclusions: This study’s findings reveal that none of the patients were diagnosed as having malignancy after excision of the pilonidal sinus. However, the findings reveal no need for performing an unnecessary histopathological examination unless someone is at risk of developing cancer based on whether they have palpable lymph nodes and a history of recurrence.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43574937","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}
Pub Date : 2023-01-01DOI: 10.9738/intsurg-d-17-00013.1
J. Cheong, S. Faraj
Fungal infection is a serious complication seen in immunosuppressed patients. Fungal dissemination and infection of the intestine is a rare complication noted in the literature. We report an extremely rare case of colonic perforation from dissemination fungal infection in an immunocompetent patient. A 76-year-old man presented with a 1-week history of pneumonia-like symptoms of fever, lethargy, productive cough, and night sweats. On examination he was hypotensive and hypoxic. Chest X-ray showed bilateral diffuse consolidation. Peripheral blood showed raised white cell count and inflammatory markers. His background history included chronic lymphocytic leukemia for which he has been in remission for over 7 years. Preliminary diagnosis of pneumonia was made and the patient was started on intravenous antibiotics. His condition deteriorated over the course of 3 weeks, culminating in multi-organ failure, including acute renal failure requiring dialysis, respiratory failure requiring intubation, and hypotension requiring inotropic support. Culture of bronchial washing revealed growth of Pseudomonas aeruginosa and Candida glabrata. On the 19th day of admission, the patient's condition further deteriorated with colonic perforation and feculent peritonitis. Emergency laparotomy with removal of involved colon and end colostomies were performed. Histopathology of the involved colon showed 1.5 cm perforation with inflammatory infiltration. Histopathologic staining showed angioinvasive fungal infection with Aspergillus. Aspergillus usually spreads hematogenously from the lungs. Gastrointestinal involvement is difficult to diagnose as the symptoms are often vague and masked by other systemic symptoms. Computed tomography scan can show bowel wall thickening. However, often the diagnosis is only made postoperatively.
{"title":"Rare Case of Colonic Perforation From Disseminated Fungal Infection in Immunocompetent Patient","authors":"J. Cheong, S. Faraj","doi":"10.9738/intsurg-d-17-00013.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00013.1","url":null,"abstract":"\u0000 \u0000 Fungal infection is a serious complication seen in immunosuppressed patients. Fungal dissemination and infection of the intestine is a rare complication noted in the literature. We report an extremely rare case of colonic perforation from dissemination fungal infection in an immunocompetent patient.\u0000 \u0000 \u0000 \u0000 A 76-year-old man presented with a 1-week history of pneumonia-like symptoms of fever, lethargy, productive cough, and night sweats. On examination he was hypotensive and hypoxic. Chest X-ray showed bilateral diffuse consolidation. Peripheral blood showed raised white cell count and inflammatory markers. His background history included chronic lymphocytic leukemia for which he has been in remission for over 7 years. Preliminary diagnosis of pneumonia was made and the patient was started on intravenous antibiotics. His condition deteriorated over the course of 3 weeks, culminating in multi-organ failure, including acute renal failure requiring dialysis, respiratory failure requiring intubation, and hypotension requiring inotropic support. Culture of bronchial washing revealed growth of Pseudomonas aeruginosa and Candida glabrata. On the 19th day of admission, the patient's condition further deteriorated with colonic perforation and feculent peritonitis. Emergency laparotomy with removal of involved colon and end colostomies were performed. Histopathology of the involved colon showed 1.5 cm perforation with inflammatory infiltration. Histopathologic staining showed angioinvasive fungal infection with Aspergillus.\u0000 \u0000 \u0000 \u0000 Aspergillus usually spreads hematogenously from the lungs. Gastrointestinal involvement is difficult to diagnose as the symptoms are often vague and masked by other systemic symptoms. Computed tomography scan can show bowel wall thickening. However, often the diagnosis is only made postoperatively.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45844318","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}
Pub Date : 2023-01-01DOI: 10.9738/intsurg-d-21-00023.1
E. Park, Rukhsora D. Sultonova, S. Song, H. Kim, Y. Hur, C. Cho, Y. Koh
To evaluate the efficacy and safety of laparoscopic major hepatectomy for hepatocellular carcinoma patients. Despite the popularity of laparoscopic hepatectomy, it is still in need of further evidence to assess its safety and efficacy for the treatment of hepatocellular carcinoma. From 2008 to 2017, 149 patients (laparoscopic right hepatectomy [LRH], 28 patients; open right hepatectomy [ORH], 121 patients) were included. Baseline characteristics, including tumor characteristics, perioperative outcomes, and survival outcomes, were compared between the 2 groups. For group comparisons, one-to-one propensity score matching was used to minimize selection biases. After one-to-one propensity score matching, 25 LRHs were compared to 25 ORHs. Operative time was significantly shorter for the ORH group than for the LRH group (mean, 322.5 versus 379.5 minutes; P = 0.015), whereas the LRH group showed less intraoperative blood loss (P = 0.02) and lower intraoperative transfusion (P = 0.02). Postoperative hospital stays were significantly shorter for the LRH group (mean, 14.5 days versus 20.2 days; P = 0.004). Overall morbidities were significantly lower in the LRH group (1:13, P = 0.00). The cumulative 1-, 3-, and 5-year overall survival rates were 100%, 92.0%, and 92.0%, respectively, for the LRH group, and 84.0%, 80.0%, and 64.0%, respectively, for the ORH group. Furthermore, the cumulative 1-, 3-, and 5-year disease-free survival rates were 96.0%, 80.0%, and 75.3%, respectively, for the LRH group, and 72.0%, 48.0%, and 40.0%, respectively, for the ORH group. The LRH group showed significantly longer disease-free survival (P = 0.009) and overall survival (P = 0.028) than the ORH group. LRH can be safely performed for hepatocellular carcinoma. LRH was associated with more favorable oncologic outcomes.
{"title":"Perioperative and Long-Term Oncologic Outcomes of Laparoscopic Right Hepatectomy Versus Open Right Hepatectomy for Hepatocellular Carcinoma: A Propensity Score–Matching Analysis","authors":"E. Park, Rukhsora D. Sultonova, S. Song, H. Kim, Y. Hur, C. Cho, Y. Koh","doi":"10.9738/intsurg-d-21-00023.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00023.1","url":null,"abstract":"\u0000 \u0000 To evaluate the efficacy and safety of laparoscopic major hepatectomy for hepatocellular carcinoma patients.\u0000 \u0000 \u0000 \u0000 Despite the popularity of laparoscopic hepatectomy, it is still in need of further evidence to assess its safety and efficacy for the treatment of hepatocellular carcinoma.\u0000 \u0000 \u0000 \u0000 From 2008 to 2017, 149 patients (laparoscopic right hepatectomy [LRH], 28 patients; open right hepatectomy [ORH], 121 patients) were included. Baseline characteristics, including tumor characteristics, perioperative outcomes, and survival outcomes, were compared between the 2 groups. For group comparisons, one-to-one propensity score matching was used to minimize selection biases.\u0000 \u0000 \u0000 \u0000 After one-to-one propensity score matching, 25 LRHs were compared to 25 ORHs. Operative time was significantly shorter for the ORH group than for the LRH group (mean, 322.5 versus 379.5 minutes; P = 0.015), whereas the LRH group showed less intraoperative blood loss (P = 0.02) and lower intraoperative transfusion (P = 0.02). Postoperative hospital stays were significantly shorter for the LRH group (mean, 14.5 days versus 20.2 days; P = 0.004). Overall morbidities were significantly lower in the LRH group (1:13, P = 0.00). The cumulative 1-, 3-, and 5-year overall survival rates were 100%, 92.0%, and 92.0%, respectively, for the LRH group, and 84.0%, 80.0%, and 64.0%, respectively, for the ORH group. Furthermore, the cumulative 1-, 3-, and 5-year disease-free survival rates were 96.0%, 80.0%, and 75.3%, respectively, for the LRH group, and 72.0%, 48.0%, and 40.0%, respectively, for the ORH group. The LRH group showed significantly longer disease-free survival (P = 0.009) and overall survival (P = 0.028) than the ORH group.\u0000 \u0000 \u0000 \u0000 LRH can be safely performed for hepatocellular carcinoma. LRH was associated with more favorable oncologic outcomes.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":"25 4","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41244013","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}
Pub Date : 2023-01-01DOI: 10.9738/intsurg-d-17-00034.1
H. Iida, T. Aihara, S. Ikuta, N. Yamanaka
To determine the usefulness of the enhanced rate of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid–enhanced magnetic resonance imaging (EOB-MRI) during the hepatobiliary phase as a new parameter for hepatic functional reserve. We retrospectively analyzed 153 patients who underwent EOB-MRI before radiofrequency ablation or hepatic resection between January 2008 and December 2012. The enhanced rate during the hepatobiliary phase was estimated using the ratio of regions of interest in the liver parenchyma to that in the paraspinal muscles. The enhanced rate was examined along with liver function tests and fibrosis levels for any correlations. A high correlation was found between the enhanced rate and indocyanine green retention rate at 15 minutes (r = −0.66, P < 0.0001). Additionally, a moderate correlation was discovered between the enhanced rate and serum albumin (r = 0.57, P < 0.0001), and fibrosis level (r = −0.48, P < 0.0001). The enhanced rate also weakly correlated with platelet count (r = 0.28, P = 0.0005), aspartate aminotransferase (r = −0.37, P < 0.0001), total bilirubin (r = −0.26, P = 0.0014), and prothrombin activity (r = 0.27, P = 0.0014). The EOB-MRI–enhanced rate during the hepatobiliary phase strongly correlates with hepatic functional reserve.
目的探讨钆乙氧基苄基二乙烯三胺五乙酸增强磁共振成像(EOB-MRI)在肝胆期的增强率作为肝功能储备的新参数的实用性。我们回顾性分析了2008年1月至2012年12月153例在射频消融或肝切除术前接受EOB-MRI检查的患者。利用肝实质感兴趣区域与棘旁肌肉感兴趣区域的比值来估计肝胆期的增强率。提高的比率与肝功能测试和纤维化水平一起检查是否存在相关性。增强率与15 min时吲哚菁绿保留率呈高度相关(r = - 0.66, P < 0.0001)。此外，发现增强率与血清白蛋白(r = 0.57, P < 0.0001)和纤维化水平(r = - 0.48, P < 0.0001)之间存在中度相关性。增强率与血小板计数(r = 0.28, P = 0.0005)、天冬氨酸转氨酶(r = - 0.37, P < 0.0001)、总胆红素(r = - 0.26, P = 0.0014)和凝血酶原活性(r = 0.27, P = 0.0014)呈弱相关。肝胆期eob - mri增强率与肝功能储备密切相关。
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