Pub Date : 2021-09-07DOI: 10.9738/intsurg-d-21-00011.1
C. Sezer, Murat Gokten, A. Sezer, İ. Gezgin, Mehmet Onay, A. Binboğa
Background: Postoperative headache is a major complaint after RS surgery. PH affected the patient’s quality of life. The role of craniotomy in the prevention of such headaches. We aimed to evaluate the role of craniectomy versus craniotomy via the retrosigmoid approach in reducing the incidence of postoperative headaches. Materials and methods: Patients who underwent surgery between January 2012 and December 2018 were retrospectively assessed and were classified into the craniectomy and craniotomy groups. Clinical data, such as those on age, sex, type of surgery, surgical repair technique, development of infection, postoperative cerebrospinal fluid leak, postoperative meningitis, size of the bone flap, and wound infection, were collected. The severity of headache in all patients was clinically assessed using the Catalano grading system. Results: Overall, 95 patients underwent microsurgery via the retrosigmoid approach. Of these, 48 were men and 47 were women. In total, 34 patients underwent craniectomy, and 61 patients underwent craniotomy. On discharge, postoperative headache was observed in 47% (16/34) and 21% (13/61) of patients who underwent craniectomy and craniotomy, respectively ( P =.01). The incidence of headache decreased at follow-up. At 12 months after surgery, 15% of patients in the craniectomy group (5/34) and 2% of patients in the craniotomy group (2/61) experienced headache ( P =.01). Of the 61 patients in the craniotomy group, 2 (2%) had less severe headache at 12 months of follow-up. Conclusion: The severity of headache after surgery and upon discharge significantly decreased in patients who underwent craniotomy than in those who underwent craniectomy.
{"title":"Role of Craniectomy Versus Craniotomy via the Retrosigmoid Approach in Decreasing the Incidence of Postoperative Headache","authors":"C. Sezer, Murat Gokten, A. Sezer, İ. Gezgin, Mehmet Onay, A. Binboğa","doi":"10.9738/intsurg-d-21-00011.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00011.1","url":null,"abstract":"Background: Postoperative headache is a major complaint after RS surgery. PH affected the patient’s quality of life. The role of craniotomy in the prevention of such headaches. We aimed to evaluate the role of craniectomy versus craniotomy via the retrosigmoid approach in reducing the incidence of postoperative headaches. Materials and methods: Patients who underwent surgery between January 2012 and December 2018 were retrospectively assessed and were classified into the craniectomy and craniotomy groups. Clinical data, such as those on age, sex, type of surgery, surgical repair technique, development of infection, postoperative cerebrospinal fluid leak, postoperative meningitis, size of the bone flap, and wound infection, were collected. The severity of headache in all patients was clinically assessed using the Catalano grading system. Results: Overall, 95 patients underwent microsurgery via the retrosigmoid approach. Of these, 48 were men and 47 were women. In total, 34 patients underwent craniectomy, and 61 patients underwent craniotomy. On discharge, postoperative headache was observed in 47% (16/34) and 21% (13/61) of patients who underwent craniectomy and craniotomy, respectively ( P =.01). The incidence of headache decreased at follow-up. At 12 months after surgery, 15% of patients in the craniectomy group (5/34) and 2% of patients in the craniotomy group (2/61) experienced headache ( P =.01). Of the 61 patients in the craniotomy group, 2 (2%) had less severe headache at 12 months of follow-up. Conclusion: The severity of headache after surgery and upon discharge significantly decreased in patients who underwent craniotomy than in those who underwent craniectomy.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45631613","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 : 2021-08-12DOI: 10.9738/intsurg-d-21-00013.1
Otgontuya Altangerel, Yin-Hwa Shih, J. Wang, Wen-Yih Wu, T. Chan, A. Kwan
Abstract Introduction: PM 2.5 exposure impacts on prenatal health and birth outcomes including low birth weight and preterm delivery. Objective: To identify and explore PM 2.5 exposure on adverse obstetrical outcomes including preterm birth and low birth weight. Method: A total of 409 studies was identified by searching from PUBMED, EMBASE, SCOPUS, WEB OF SCIENCE, and SCIENCE DIRECT. Of the 409 articles from 1982 to 2020, 24 articles were identified qualitatively considered, and 7 articles were quantitively eligible included in this meta-analysis. The pooled effect of PM 2.5 exposure and LBW, PTD were calculated using a random effect model with significant heterogeneity.Totally, 7 studies conducted in meta-analysis, and the pooled effect of PM 2.5 exposure in LBW and entire pregnant were 1.033 (95%CI: 1.025, 1.041) with significant high heterogeneity (I 2 = 96.110, P=0.000). The pooled effect of PM 2.5 exposure PTD and entire pregnant were 1.024 (95%CI: 1.015, 1.033) with significant different low heterogeneity (I 2 = 60.036, P=0.082). Discussion: Although prenatal exposure of PM 2.5 during pregnancy is significantly associated with the risk of LBW, the risk of PTD is a significant differrent, but consistently associated with PM 2.5 . Conclusion: Globally, PM 2.5 exposure is significantly associated with serious outcomes of pregnancy and birth outcomes across the world. It appears in the prenatal health emerging risks that government is needed to influence the health policies to pursue on maternal and child health. Key words: “maternal”, “prenatal”, “air pollution”, “PM 2.5 ”, “Preterm Birth”, and ”Low Birth Weight.”
{"title":"Air pollutants-particular matter (PM)2.5 with antenatal exposure leading to Adverse Obstetrical Outcomes of Birth Weight and Preterm Birth: A Systematic Review and Meta-Analysis.","authors":"Otgontuya Altangerel, Yin-Hwa Shih, J. Wang, Wen-Yih Wu, T. Chan, A. Kwan","doi":"10.9738/intsurg-d-21-00013.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00013.1","url":null,"abstract":"Abstract Introduction: PM 2.5 exposure impacts on prenatal health and birth outcomes including low birth weight and preterm delivery. Objective: To identify and explore PM 2.5 exposure on adverse obstetrical outcomes including preterm birth and low birth weight. Method: A total of 409 studies was identified by searching from PUBMED, EMBASE, SCOPUS, WEB OF SCIENCE, and SCIENCE DIRECT. Of the 409 articles from 1982 to 2020, 24 articles were identified qualitatively considered, and 7 articles were quantitively eligible included in this meta-analysis. The pooled effect of PM 2.5 exposure and LBW, PTD were calculated using a random effect model with significant heterogeneity.Totally, 7 studies conducted in meta-analysis, and the pooled effect of PM 2.5 exposure in LBW and entire pregnant were 1.033 (95%CI: 1.025, 1.041) with significant high heterogeneity (I 2 = 96.110, P=0.000). The pooled effect of PM 2.5 exposure PTD and entire pregnant were 1.024 (95%CI: 1.015, 1.033) with significant different low heterogeneity (I 2 = 60.036, P=0.082). Discussion: Although prenatal exposure of PM 2.5 during pregnancy is significantly associated with the risk of LBW, the risk of PTD is a significant differrent, but consistently associated with PM 2.5 . Conclusion: Globally, PM 2.5 exposure is significantly associated with serious outcomes of pregnancy and birth outcomes across the world. It appears in the prenatal health emerging risks that government is needed to influence the health policies to pursue on maternal and child health. Key words: “maternal”, “prenatal”, “air pollution”, “PM 2.5 ”, “Preterm Birth”, and ”Low Birth Weight.”","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48522789","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 : 2021-08-01DOI: 10.9738/intsurg-d-21-00018.1
A. Parlakgumus, O. Erdoğan, Z. A. Taş, T. Toyran, U. Turan, B. Pekoz, O. Irkorucu
OBJECTIVE This study aimed to examine the rare locally aggressive intermediate tumours and malignant primary breast mesenchymal tumours in the patients receiving surgical treatment. SUMMARY OF BACKGROUND DATA Locally aggressive intermediate tumours were subdivided into non-metastasising and rarely metastasising, while malignant group was subdivided as a single subgroup called able to metastasise. A retrospective examination of surgical notes and clinical charts was carried out reviewing gender, age, symptoms, duration of symptoms, tumour size, clinical presentation, radiation history, kind of surgery undergone, adjuvant radiotherapy, adjuvant chemotherapy, local recurrences, systemic metastases and mortality. RESULTS Mitotic index and Ki-67 were statistically different between locally aggressive and malignant groups (p ˂ 0.001). One local recurrence occurred in only one patient diagnosed as dermatofibrosarcoma protuberans among all patients. None of the entities showed distant metastasis or mortality. In this result, clear margin of surgery in locally aggressive intermediate group and combination of surgery with radiation therapy in the malignant group was the most important determinant for the prospect of the patients with mean follow up 28 months. CONCLUSION The main treatment for localised mesenchymal breast tumours is surgery. When the disease is locally advanced or malignant with high mitotic index, radiotherapy with surgery is predominantly used.Targeted therapies are promising with the limited place of chemotherapy.
{"title":"EFFECTIVE TREATMENT FOR PRIMARY LOCALLY AGGRESSIVE INTERMEDIATE AND MALIGNANT SOFT TISSUE TUMOURS OF THE BREAST","authors":"A. Parlakgumus, O. Erdoğan, Z. A. Taş, T. Toyran, U. Turan, B. Pekoz, O. Irkorucu","doi":"10.9738/intsurg-d-21-00018.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00018.1","url":null,"abstract":"OBJECTIVE This study aimed to examine the rare locally aggressive intermediate tumours and malignant primary breast mesenchymal tumours in the patients receiving surgical treatment. SUMMARY OF BACKGROUND DATA Locally aggressive intermediate tumours were subdivided into non-metastasising and rarely metastasising, while malignant group was subdivided as a single subgroup called able to metastasise. A retrospective examination of surgical notes and clinical charts was carried out reviewing gender, age, symptoms, duration of symptoms, tumour size, clinical presentation, radiation history, kind of surgery undergone, adjuvant radiotherapy, adjuvant chemotherapy, local recurrences, systemic metastases and mortality. RESULTS Mitotic index and Ki-67 were statistically different between locally aggressive and malignant groups (p ˂ 0.001). One local recurrence occurred in only one patient diagnosed as dermatofibrosarcoma protuberans among all patients. None of the entities showed distant metastasis or mortality. In this result, clear margin of surgery in locally aggressive intermediate group and combination of surgery with radiation therapy in the malignant group was the most important determinant for the prospect of the patients with mean follow up 28 months. CONCLUSION The main treatment for localised mesenchymal breast tumours is surgery. When the disease is locally advanced or malignant with high mitotic index, radiotherapy with surgery is predominantly used.Targeted therapies are promising with the limited place of chemotherapy.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43936508","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 : 2021-07-22DOI: 10.9738/intsurg-d-20-00046.1
Mireia Amillo-Zaragueta, E. Nve, Daniel Casanova, P. Garro, J. M. Badia
Background. The incidence of biliary infections is rising worldwide and has become one of the main reasons for emergency admissions. Methods. Narrative review of the literature emphasizing news concepts related to the early management of biliary diseases. Results. The bacteriology is frequently polymicrobial, with a progressive increase of multidrug resistant bacteria. The form of presentation is variable, and the mortality rate may reach 20%. When cholecystitis or cholangitis is suspected, ultrasound is the gold standard imaging test. Depending on the severity of presentation, local resistances and risk factors for multi-resistant organisms, the most appropriate empirical antibiotic treatment must be initiated. In acute cholecystitis, cholecystectomy plays the main therapeutic role. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for source control. Treatment of severe cholangitis is based on the drainage of the bile duct and antibiotic therapy. Conclusions. Biliary infections are serious conditions which can lead to sepsis and death. The introduction of new internationally accepted guidelines, based on clinical presentation, laboratory tests and imaging, provides a platform for their timely diagnosis and management. Early severity assessment, initiation of intravenous antibiotics and source control are fundamental to improving morbidity and mortality.
{"title":"The importance of early management of severe biliary infection: current concepts","authors":"Mireia Amillo-Zaragueta, E. Nve, Daniel Casanova, P. Garro, J. M. Badia","doi":"10.9738/intsurg-d-20-00046.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00046.1","url":null,"abstract":"Background. The incidence of biliary infections is rising worldwide and has become one of the main reasons for emergency admissions. Methods. Narrative review of the literature emphasizing news concepts related to the early management of biliary diseases. Results. The bacteriology is frequently polymicrobial, with a progressive increase of multidrug resistant bacteria. The form of presentation is variable, and the mortality rate may reach 20%. When cholecystitis or cholangitis is suspected, ultrasound is the gold standard imaging test. Depending on the severity of presentation, local resistances and risk factors for multi-resistant organisms, the most appropriate empirical antibiotic treatment must be initiated. In acute cholecystitis, cholecystectomy plays the main therapeutic role. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for source control. Treatment of severe cholangitis is based on the drainage of the bile duct and antibiotic therapy. Conclusions. Biliary infections are serious conditions which can lead to sepsis and death. The introduction of new internationally accepted guidelines, based on clinical presentation, laboratory tests and imaging, provides a platform for their timely diagnosis and management. Early severity assessment, initiation of intravenous antibiotics and source control are fundamental to improving morbidity and mortality.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48335627","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 : 2021-07-19DOI: 10.9738/intsurg-d-21-00016.1
Emad Aljohani, Fahad Almadi, Yusuke Watanabe, A. Aldawsari, Mohammed Alsuwaigh, R. Alanazi, Salman T Alwadani, Talal Alfayez, Z. Alanazi
Objective: To assess General Surgery trainee’s knowledge about safe use of energy devices in two tertiary hospitals in Riyadh, Saudi Arabia Background: Electro surgery is the use of high-frequency electrical energy to achieve cutting, and coagulation. This method has become ubiquitous worldwide for the purpose of achieving rapid hemostasis and rapid dissection of tissues Methods: Participants completed a 35-item multiple choice question examination, testing critical knowledge of ES. The examination was developed according to the objectives and blueprints of SAGES’ Fundamental Use of Surgical Energy curriculum. Sections of the examination included: principles of ES, ES-related adverse events, monopolar and bipolar devices, and pediatric considerations and interference with implantable devices.’’ Scores were compared between juniors and seniors participants. Results: A total of 51 general surgical trainees from two academic hospitals completed the assessment. 15.69% of the participants correctly answered 30 questions out of 35 questions, 39.22% of the participants responded correctly to 20 questions out of 35 answers, and 45.09 who responded correctly to less than 20 questions. It was found that 52.2% of the individuals with a low level of understanding were junior residents as opposed to 87.5% of the participants with the highest level of understanding were senior residents with a significant P-value of 0.04. Conclusions: majority of general surgery residents enrolled in the Saudi Arabian board of surgery lack adequate knowledge about the safe and efficient use of surgical energy devices. The level of understanding is lower among the junior residents than seniors.
{"title":"Knowledge Assessment among Surgeons about Energy Devices safe use: A Multicenter Cross Sectional Study","authors":"Emad Aljohani, Fahad Almadi, Yusuke Watanabe, A. Aldawsari, Mohammed Alsuwaigh, R. Alanazi, Salman T Alwadani, Talal Alfayez, Z. Alanazi","doi":"10.9738/intsurg-d-21-00016.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00016.1","url":null,"abstract":"Objective: To assess General Surgery trainee’s knowledge about safe use of energy devices in two tertiary hospitals in Riyadh, Saudi Arabia Background: Electro surgery is the use of high-frequency electrical energy to achieve cutting, and coagulation. This method has become ubiquitous worldwide for the purpose of achieving rapid hemostasis and rapid dissection of tissues Methods: Participants completed a 35-item multiple choice question examination, testing critical knowledge of ES. The examination was developed according to the objectives and blueprints of SAGES’ Fundamental Use of Surgical Energy curriculum. Sections of the examination included: principles of ES, ES-related adverse events, monopolar and bipolar devices, and pediatric considerations and interference with implantable devices.’’ Scores were compared between juniors and seniors participants. Results: A total of 51 general surgical trainees from two academic hospitals completed the assessment. 15.69% of the participants correctly answered 30 questions out of 35 questions, 39.22% of the participants responded correctly to 20 questions out of 35 answers, and 45.09 who responded correctly to less than 20 questions. It was found that 52.2% of the individuals with a low level of understanding were junior residents as opposed to 87.5% of the participants with the highest level of understanding were senior residents with a significant P-value of 0.04. Conclusions: majority of general surgery residents enrolled in the Saudi Arabian board of surgery lack adequate knowledge about the safe and efficient use of surgical energy devices. The level of understanding is lower among the junior residents than seniors.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46650352","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 : 2021-07-08DOI: 10.9738/INTSURG-D-21-00010.1
Susumu Mochizuki, H. Nakayama, Y. Midorikawa, T. Higaki, M. Moriguchi, O. Aramaki, T. Takayama
Objective The effect of postoperative complications including red blood transfusion (BT) on long-term survival for hepatocellular carcinoma (HCC) is unknown. The purpose of this study was to define the relationship between postoperative complications and long-term survival in patients with HCC. Methods Postoperative complications of 1251 patients who underwent curative liver resection for HCC were classified, and their recurrence-free survival (RFS) and cumulative overall survival (OS) were investigated. Results Any complications occurred in 503 patients (40%). Five-year RFS and 5-year OS in the complication group were 21% and 56%, respectively, significantly lower than the respective values of 32% ( p < 0.001) and 68% ( p < 0.001) in the no-complication group (n=748). Complications related to RFS were postoperative BT [Hazard ratio (HR): 1.726, 95% confidence interval (CI): 1.338–2.228, p < 0.001], pleural effusion [HR: 1.434, 95% CI: 1.200–1.713, p < 0.001] using Cox-proportional hazard model. Complications related to OS were postoperative BT [HR: 1.843, 95%CI: 1.380-2.462, p < 0.001], ascites [HR: 1.562, 95% CI: 1.066–2.290 p = 0.022], and pleural effusion [HR: 1.421, 95% CI: 1.150–1.755, p = 0.001). Conclusions Postoperative complications were factors associated with poor long-term survival. Postoperative BT and pleural effusion, were noticeable complications that were prognostic factors for both recurrence-free survival and overall survival.
{"title":"Impact of postoperative complications on long-term survival of hepatocellular carcinoma patients after liver resection","authors":"Susumu Mochizuki, H. Nakayama, Y. Midorikawa, T. Higaki, M. Moriguchi, O. Aramaki, T. Takayama","doi":"10.9738/INTSURG-D-21-00010.1","DOIUrl":"https://doi.org/10.9738/INTSURG-D-21-00010.1","url":null,"abstract":"Objective The effect of postoperative complications including red blood transfusion (BT) on long-term survival for hepatocellular carcinoma (HCC) is unknown. The purpose of this study was to define the relationship between postoperative complications and long-term survival in patients with HCC. Methods Postoperative complications of 1251 patients who underwent curative liver resection for HCC were classified, and their recurrence-free survival (RFS) and cumulative overall survival (OS) were investigated. Results Any complications occurred in 503 patients (40%). Five-year RFS and 5-year OS in the complication group were 21% and 56%, respectively, significantly lower than the respective values of 32% ( p < 0.001) and 68% ( p < 0.001) in the no-complication group (n=748). Complications related to RFS were postoperative BT [Hazard ratio (HR): 1.726, 95% confidence interval (CI): 1.338–2.228, p < 0.001], pleural effusion [HR: 1.434, 95% CI: 1.200–1.713, p < 0.001] using Cox-proportional hazard model. Complications related to OS were postoperative BT [HR: 1.843, 95%CI: 1.380-2.462, p < 0.001], ascites [HR: 1.562, 95% CI: 1.066–2.290 p = 0.022], and pleural effusion [HR: 1.421, 95% CI: 1.150–1.755, p = 0.001). Conclusions Postoperative complications were factors associated with poor long-term survival. Postoperative BT and pleural effusion, were noticeable complications that were prognostic factors for both recurrence-free survival and overall survival.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44582898","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 : 2021-05-28DOI: 10.9738/INTSURG-D-20-00044.1
M. Takeda, Y. Onuki, K. Oishi, O. Kubota, T. Uchiyama, Y. Arai, H. Takeuchi
Introduction Appendiceal mucinous neoplasms can involve peritoneal pseudomyxoma or invasion of adjacent organs. This report describes a rare case in which a giant appendiceal mucinous carcinoma expansively developed in the retroperitoneum without perforating the abdominal cavity. Case presentation The patient was a 55-year-old woman with no relevant history who was admitted to our hospital after imaging examinations revealed a retroperitoneal tumor. The clinical diagnosis was a retroperitoneal tumor involving the hedge mucin. The patient underwent right hemicolectomy and partial resection of the duodenum and right abdominal wall to ensure complete tumor resection. Histopathological findings suggested that the tumor was a mucinous carcinoma arising from the appendix. The postoperative course was uneventful. Although adjuvant chemotherapy was performed for 6 months, peritoneal recurrence developed 7 years and 4 months postoperatively. Nine years have passed after surgery and the patient is alive under receiving chemotherapy. Conclusion Detailed pathological examinations revealed that the tumor originated from the appendix. The characteristics of mucinous carcinoma contributed to the extensive growth of the tumor.
{"title":"Giant mucinous carcinoma originating from the appendix: A case report","authors":"M. Takeda, Y. Onuki, K. Oishi, O. Kubota, T. Uchiyama, Y. Arai, H. Takeuchi","doi":"10.9738/INTSURG-D-20-00044.1","DOIUrl":"https://doi.org/10.9738/INTSURG-D-20-00044.1","url":null,"abstract":"Introduction Appendiceal mucinous neoplasms can involve peritoneal pseudomyxoma or invasion of adjacent organs. This report describes a rare case in which a giant appendiceal mucinous carcinoma expansively developed in the retroperitoneum without perforating the abdominal cavity. Case presentation The patient was a 55-year-old woman with no relevant history who was admitted to our hospital after imaging examinations revealed a retroperitoneal tumor. The clinical diagnosis was a retroperitoneal tumor involving the hedge mucin. The patient underwent right hemicolectomy and partial resection of the duodenum and right abdominal wall to ensure complete tumor resection. Histopathological findings suggested that the tumor was a mucinous carcinoma arising from the appendix. The postoperative course was uneventful. Although adjuvant chemotherapy was performed for 6 months, peritoneal recurrence developed 7 years and 4 months postoperatively. Nine years have passed after surgery and the patient is alive under receiving chemotherapy. Conclusion Detailed pathological examinations revealed that the tumor originated from the appendix. The characteristics of mucinous carcinoma contributed to the extensive growth of the tumor.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47171857","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}
We report a case of recurrent painful and disabling granulomatous flexor tenosynovitis of the right wrist in 50-year-old female patient. The proper diagnosis was made ex juvantibus after repeated cultivation of Mycobacteria yielded negative results and local disease control was surgically unsuccessful. It was then decided to start at first with oral Clarithromycin at 500mg 2x daily during 6-month period throughout which there was no sign of local recurrence. However, synovectomy had to be performed 3 times in total during the period of two years. While the noninfectious causes were excluded, and infectious agent was not to be determined, the decision was made to administer full anti-tuberculosis medication therapy. At about the same time, we were finally able to obtain a positive Mycobacterium tuberculosis culture after a sudden onset of right axillary lymphadenitis, but only two and half years from the occurrence of first symptoms related to right wrist tenosynovitis.
{"title":"Ex juvantibus diagnosis of recurrent granulomatous flexor tenosynovitis: insidious Mycobacterium tuberculosis.","authors":"Emir Halilbasic, Halilbasic Emir, Brkic Eldar, Merim Kasumović, Mehmedovic Zlatan, Sakic Almir","doi":"10.9738/INTSURG-D-21-00005.1","DOIUrl":"https://doi.org/10.9738/INTSURG-D-21-00005.1","url":null,"abstract":"We report a case of recurrent painful and disabling granulomatous flexor tenosynovitis of the right wrist in 50-year-old female patient. The proper diagnosis was made ex juvantibus after repeated cultivation of Mycobacteria yielded negative results and local disease control was surgically unsuccessful. It was then decided to start at first with oral Clarithromycin at 500mg 2x daily during 6-month period throughout which there was no sign of local recurrence. However, synovectomy had to be performed 3 times in total during the period of two years. While the noninfectious causes were excluded, and infectious agent was not to be determined, the decision was made to administer full anti-tuberculosis medication therapy. At about the same time, we were finally able to obtain a positive Mycobacterium tuberculosis culture after a sudden onset of right axillary lymphadenitis, but only two and half years from the occurrence of first symptoms related to right wrist tenosynovitis.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47780411","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 : 2021-05-03DOI: 10.9738/INTSURG-D-20-00013.1
C. Boeker, Frank Brose, M. Mall, J. Mall, C. Reetz, Kamil Yamac, Hinrich Koehler
Introduction Postoperative hemorrhage (POH) is the second most important acute complication following laparoscopic sleeve gastrectomy (LSG), with staple line leakage being the first. POH is reported in up to 5% of cases after LSG. Sufficient vessel sealing is crucial in avoiding later complications of POH during mobilization. This study investigated bleeding complications after LSG using the Advanced Bipolar Seal and Cut instrument Caiman 5 by Aesculap AG. Methods All LSG´s were performed using the Caiman 5 (Aesculap AG). Primary outcome was the incidence of POH, defined as the need for revisional surgery and/or blood transfusions. Secondary outcomes were hemoglobin levels preoperatively at the day of surgery (POD 0) and at postoperative days (POD) 1 and 2, volume and duration of drainage at POD 0-2, procedure time, and length of hospital stay. Results 100 patients who had undergone LSG from April 2016 to September 2017 were consecutively included in the study. Patients with contraindications to undergo LSG or were not able to give consent were excluded. Four patients needed treatment due to POH, in 3 of them surgery became necessary. Average operation time was 68.5 min, total volume of drainage was 186 ml. The drain stayed in situ for 2.2 days (mean). Average hospital stay was 3.6 days. Discussion/Conclusion In our study group of 100 LSG procedures POH was 4%. Operation time, volume and duration of drainage, length of hospital stay were not prolonged. LSG using Caiman is feasible and shows comparable results to other vessel sealing instruments at our center.
{"title":"A prospective observational study investigating postoperative hemorrhage after laparoscopic sleeve gastrectomy using Bipolar Seal and Cut Caiman® (Aesculap AG)","authors":"C. Boeker, Frank Brose, M. Mall, J. Mall, C. Reetz, Kamil Yamac, Hinrich Koehler","doi":"10.9738/INTSURG-D-20-00013.1","DOIUrl":"https://doi.org/10.9738/INTSURG-D-20-00013.1","url":null,"abstract":"Introduction Postoperative hemorrhage (POH) is the second most important acute complication following laparoscopic sleeve gastrectomy (LSG), with staple line leakage being the first. POH is reported in up to 5% of cases after LSG. Sufficient vessel sealing is crucial in avoiding later complications of POH during mobilization. This study investigated bleeding complications after LSG using the Advanced Bipolar Seal and Cut instrument Caiman 5 by Aesculap AG. Methods All LSG´s were performed using the Caiman 5 (Aesculap AG). Primary outcome was the incidence of POH, defined as the need for revisional surgery and/or blood transfusions. Secondary outcomes were hemoglobin levels preoperatively at the day of surgery (POD 0) and at postoperative days (POD) 1 and 2, volume and duration of drainage at POD 0-2, procedure time, and length of hospital stay. Results 100 patients who had undergone LSG from April 2016 to September 2017 were consecutively included in the study. Patients with contraindications to undergo LSG or were not able to give consent were excluded. Four patients needed treatment due to POH, in 3 of them surgery became necessary. Average operation time was 68.5 min, total volume of drainage was 186 ml. The drain stayed in situ for 2.2 days (mean). Average hospital stay was 3.6 days. Discussion/Conclusion In our study group of 100 LSG procedures POH was 4%. Operation time, volume and duration of drainage, length of hospital stay were not prolonged. LSG using Caiman is feasible and shows comparable results to other vessel sealing instruments at our center.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47930289","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 : 2021-04-13DOI: 10.9738/INTSURG-D-21-00007.1
Tung-Yen Wu, Yen-Ling Liu, Kuo-Hung Huang, W. Fang, S. Lo, A. Li, Chew‐Wun Wu, Y. Shyr
Objective: Minimally invasive surgery has become popular in the treatment of gastric cancer Background: Few reports have compared operative outcomes among laparoscopic, 3D-laparoscopic and robotic gastrectomy for distal gastric cancer. Methods: Between August 2011 and June 2020, a total of 245 patients underwent either laparoscopic (n=129), 3D-laparoscopic (n=55) or robotic (n=61) gastrectomy for distal gastric cancer; the clinicopathologic characteristics and operative outcomes were compared between groups. Results: Compared with the laparoscopic group, the 3D-laparoscopic and robotic groups were associated with more D2 lymphadenectomy, higher medical costs and a longer operative time, while the number of retrieved lymph nodes and surgical complications were similar among the three groups. For patients receiving D2 lymphadenectomy, the robotic group was associated with higher medical costs and longer operative time than the other two groups; high-body mass index (high-BMI) patients had a longer operative time than low-BMI patients in the laparoscopic group, which was not significantly different between low- and high-BMI patients in both the 3D-laparoscopic and robotic groups. For low-BMI patients, the medical costs were higher and the operative time was longer in the robotic group than the other two groups. For high-BMI patients, the robotic group was associated with higher medical costs, longer operative time and postoperative hospital stay than the other two groups. Conclusions: 3D-laparoscopic gastrectomy was associated with affordable medical costs, comparable lymphadenectomy, and similar surgical outcomes compared with robotic gastrectomy.
{"title":"Comparison of operative outcomes among laparoscopic, 3D-laparoscopic, and robotic gastrectomy for distal gastric cancer","authors":"Tung-Yen Wu, Yen-Ling Liu, Kuo-Hung Huang, W. Fang, S. Lo, A. Li, Chew‐Wun Wu, Y. Shyr","doi":"10.9738/INTSURG-D-21-00007.1","DOIUrl":"https://doi.org/10.9738/INTSURG-D-21-00007.1","url":null,"abstract":"Objective: Minimally invasive surgery has become popular in the treatment of gastric cancer Background: Few reports have compared operative outcomes among laparoscopic, 3D-laparoscopic and robotic gastrectomy for distal gastric cancer. Methods: Between August 2011 and June 2020, a total of 245 patients underwent either laparoscopic (n=129), 3D-laparoscopic (n=55) or robotic (n=61) gastrectomy for distal gastric cancer; the clinicopathologic characteristics and operative outcomes were compared between groups. Results: Compared with the laparoscopic group, the 3D-laparoscopic and robotic groups were associated with more D2 lymphadenectomy, higher medical costs and a longer operative time, while the number of retrieved lymph nodes and surgical complications were similar among the three groups. For patients receiving D2 lymphadenectomy, the robotic group was associated with higher medical costs and longer operative time than the other two groups; high-body mass index (high-BMI) patients had a longer operative time than low-BMI patients in the laparoscopic group, which was not significantly different between low- and high-BMI patients in both the 3D-laparoscopic and robotic groups. For low-BMI patients, the medical costs were higher and the operative time was longer in the robotic group than the other two groups. For high-BMI patients, the robotic group was associated with higher medical costs, longer operative time and postoperative hospital stay than the other two groups. Conclusions: 3D-laparoscopic gastrectomy was associated with affordable medical costs, comparable lymphadenectomy, and similar surgical outcomes compared with robotic gastrectomy.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43095588","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}
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