Pub Date : 2021-01-01DOI: 10.9738/intsurg-d-20-00001.1
M. Almayouf, T. Alsabahi, Ahmad Alburakan, T. Nouh
This case emphasizes the safety of laparoscopy in patients with ventriculoperitoneal shunts. Previously published reports have suggested possible risks associated with laparoscopy in patients with ventriculoperitoneal shunt. We report a case of a 17-year-old male with a ventriculoperitoneal shunt inserted 6 years ago to manage hydrocephalus that developed after surgery for medulloblastoma. The patient presented with a 5-day history of abdominal pain. He was diagnosed as having acute biliary pancreatitis. We performed laparoscopic cholecystectomy with the ventriculoperitoneal shunt in place. The patient had an uneventful recovery with no shunt-related complications.
{"title":"Laparoscopy in a Patient With a Ventriculoperitoneal Shunt: A Case Report and Literature Review","authors":"M. Almayouf, T. Alsabahi, Ahmad Alburakan, T. Nouh","doi":"10.9738/intsurg-d-20-00001.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00001.1","url":null,"abstract":"\u0000 \u0000 This case emphasizes the safety of laparoscopy in patients with ventriculoperitoneal shunts.\u0000 \u0000 \u0000 \u0000 Previously published reports have suggested possible risks associated with laparoscopy in patients with ventriculoperitoneal shunt.\u0000 \u0000 \u0000 \u0000 We report a case of a 17-year-old male with a ventriculoperitoneal shunt inserted 6 years ago to manage hydrocephalus that developed after surgery for medulloblastoma. The patient presented with a 5-day history of abdominal pain. He was diagnosed as having acute biliary pancreatitis. We performed laparoscopic cholecystectomy with the ventriculoperitoneal shunt in place.\u0000 \u0000 \u0000 \u0000 The patient had an uneventful recovery with no shunt-related complications.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49452275","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 : 2021-01-01DOI: 10.9738/intsurg-d-17-00015.1
N. Miyoshi, M. Ohue, M. Yasui, Y. Takahashi, S. Fujino, Y. Wada, K. Sugimura, A. Tomokuni, H. Akita, Shogo Kobayashi, Hidenori Takahashi, T. Omori, H. Miyata, M. Yano
The objective of this study was to develop novel prediction models for liver metastasis-free survival (LMFS) and overall survival (OS) in colorectal cancer (CRC) patients following surgically curative resections. We developed novel prediction models for LMFS and OS in CRC patients following surgically curative resections. Using clinicopathologic factors, such models were constructed with concordance indices of 0.811 and 0.776 for LMFS and OS, respectively. Seven hundred seventy-six CRC patients presenting to the Osaka Medical Center for Cancer and Cardiovascular Diseases between January 2004 and December 2010 were retrospectively studied. The exclusion criteria were patients with preoperative treatment, synchronous distant metastasis, noncurative resection, and incomplete postoperative follow-up. Based on the analysis of clinicopathologic factors, the following factors had significant correlation with LMFS: preoperative serum carcinoembryonic antigen (pre-CEA), tumor invasion, lymph node metastasis, lymphatic invasion, and venous invasion. Using these variables, a novel prediction model was constructed by the Cox regression model with a concordance index (c-index) of 0.811 for LMFS. The following factors had a significant correlation with OS: age, pre-CEA, preoperative serum carbohydrate antigen 19-9, tumor location, pathologically defined tumor invasion, lymph node metastasis, and venous invasion. Using these variables, a prediction model was constructed with a c-index of 0.776 for OS. These models were validated by external datasets in an independent patient group. We demonstrated the utility of a novel personalized prognostic model for liver metastasis, integrating tumor node metastasis factors, pre-CEA, and histologic lymphovascular invasion to predict the prognosis. Such models can help clinicians in treating CRC patients postoperatively.
{"title":"Prognostic Prediction Models for Liver Metastasis and Overall Survival in Colorectal Cancer Patients","authors":"N. Miyoshi, M. Ohue, M. Yasui, Y. Takahashi, S. Fujino, Y. Wada, K. Sugimura, A. Tomokuni, H. Akita, Shogo Kobayashi, Hidenori Takahashi, T. Omori, H. Miyata, M. Yano","doi":"10.9738/intsurg-d-17-00015.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00015.1","url":null,"abstract":"\u0000 \u0000 The objective of this study was to develop novel prediction models for liver metastasis-free survival (LMFS) and overall survival (OS) in colorectal cancer (CRC) patients following surgically curative resections. We developed novel prediction models for LMFS and OS in CRC patients following surgically curative resections. Using clinicopathologic factors, such models were constructed with concordance indices of 0.811 and 0.776 for LMFS and OS, respectively.\u0000 \u0000 \u0000 \u0000 Seven hundred seventy-six CRC patients presenting to the Osaka Medical Center for Cancer and Cardiovascular Diseases between January 2004 and December 2010 were retrospectively studied. The exclusion criteria were patients with preoperative treatment, synchronous distant metastasis, noncurative resection, and incomplete postoperative follow-up.\u0000 \u0000 \u0000 \u0000 Based on the analysis of clinicopathologic factors, the following factors had significant correlation with LMFS: preoperative serum carcinoembryonic antigen (pre-CEA), tumor invasion, lymph node metastasis, lymphatic invasion, and venous invasion. Using these variables, a novel prediction model was constructed by the Cox regression model with a concordance index (c-index) of 0.811 for LMFS. The following factors had a significant correlation with OS: age, pre-CEA, preoperative serum carbohydrate antigen 19-9, tumor location, pathologically defined tumor invasion, lymph node metastasis, and venous invasion. Using these variables, a prediction model was constructed with a c-index of 0.776 for OS. These models were validated by external datasets in an independent patient group.\u0000 \u0000 \u0000 \u0000 We demonstrated the utility of a novel personalized prognostic model for liver metastasis, integrating tumor node metastasis factors, pre-CEA, and histologic lymphovascular invasion to predict the prognosis. Such models can help clinicians in treating CRC patients postoperatively.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47273795","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 : 2021-01-01DOI: 10.9738/intsurg-d-20-00024.1
Junpei Takashima, K. Taniguchi, T. Yasui, Masahiro Yamane, Yutaka Hattori, Ayaka Ito, Takumi Hikawa, Fumi Shigehara, Sachiyo Kawamura, Kenji Yamazaki, F. Miura, H. Kobayashi
We investigated the validity of our intraperitoneal onlay mesh (IPOM) Plus technique with barbed sutures. Laparoscopic intraperitoneal onlay mesh repair has become a proven method for treating abdominal incisional hernias in recent years. There have been a few reports on the utility of IPOM Plus, which is IPOM + celiorrhaphy, although this method has not been widely discussed. We adopted the IPOM Plus technique with barbed sutures at our hospital and investigated the validity of this technique. We included 7 patients who underwent IPOM Plus repair from 2015 to 2017 at our hospital. We excluded patients with a hernia hilum <2 cm or ≥10 cm, age < 20 years old, PS3 or more, and uncontrolled comorbidity. The hernial orifice was closed laparoscopically using barbed sutures and subsequently secured by tacking on an onlay mesh. The median hernial orifice size of the 7 patients was 45 mm (25 to 55 mm). Hernia onset occurred after laparotomy in all cases. In one case, an abdominal incisional hernia recurred after IPOM used to treat the condition 15 years earlier. The mean duration of surgery was 80.5 minutes (53 to 126 minutes), and the median pain scale score was 3 points (0 to 3 points), indicating little pain. None of the patients reported persistent postoperative pain. The mean duration of the postoperative hospital stay was a median of 3.5 days (2 to 5 days). Both short- and long-term outcomes indicated that no recurrence or complications, such as bulging or seroma, occurred. IPOM Plus with intracavitary abdominal suturing using barbed suture for abdominal scar hernia repair may be a valid surgical procedure.
{"title":"A Study of Intraperitoneal Onlay Mesh Repair Using Barbed Sutures for Abdominal Incisional Hernia","authors":"Junpei Takashima, K. Taniguchi, T. Yasui, Masahiro Yamane, Yutaka Hattori, Ayaka Ito, Takumi Hikawa, Fumi Shigehara, Sachiyo Kawamura, Kenji Yamazaki, F. Miura, H. Kobayashi","doi":"10.9738/intsurg-d-20-00024.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00024.1","url":null,"abstract":"\u0000 \u0000 We investigated the validity of our intraperitoneal onlay mesh (IPOM) Plus technique with barbed sutures.\u0000 \u0000 \u0000 \u0000 Laparoscopic intraperitoneal onlay mesh repair has become a proven method for treating abdominal incisional hernias in recent years. There have been a few reports on the utility of IPOM Plus, which is IPOM + celiorrhaphy, although this method has not been widely discussed. We adopted the IPOM Plus technique with barbed sutures at our hospital and investigated the validity of this technique.\u0000 \u0000 \u0000 \u0000 We included 7 patients who underwent IPOM Plus repair from 2015 to 2017 at our hospital. We excluded patients with a hernia hilum <2 cm or ≥10 cm, age < 20 years old, PS3 or more, and uncontrolled comorbidity. The hernial orifice was closed laparoscopically using barbed sutures and subsequently secured by tacking on an onlay mesh.\u0000 \u0000 \u0000 \u0000 The median hernial orifice size of the 7 patients was 45 mm (25 to 55 mm). Hernia onset occurred after laparotomy in all cases. In one case, an abdominal incisional hernia recurred after IPOM used to treat the condition 15 years earlier. The mean duration of surgery was 80.5 minutes (53 to 126 minutes), and the median pain scale score was 3 points (0 to 3 points), indicating little pain. None of the patients reported persistent postoperative pain. The mean duration of the postoperative hospital stay was a median of 3.5 days (2 to 5 days). Both short- and long-term outcomes indicated that no recurrence or complications, such as bulging or seroma, occurred.\u0000 \u0000 \u0000 \u0000 IPOM Plus with intracavitary abdominal suturing using barbed suture for abdominal scar hernia repair may be a valid surgical procedure.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49411297","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 : 2021-01-01DOI: 10.9738/intsurg-d-21-00001.1
Yeon Wook Ju, W. Ji, Jung Sik Kim, K. Hong, J. Um
This study aimed to compare the surgical site infection (SSI) rates between intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA). Laparoscopic surgery is recommended for colonic malignancies because of its superior clinical outcomes and comparable oncologic results. Laparoscopic colectomy with ICA has the advantages of incision length and free extraction site choice. However, ICA may be associated with a risk of SSI due to enterotomy inside the abdominal cavity. We retrospectively analyzed patients with colon cancer who underwent radical surgery at Korea University Ansan Hospital between January 2017 and June 2020. We compared the SSI rates and other clinical variables between the ICA and ECA groups. Of the 502 patients who underwent radical surgery for colorectal cancer during the study period, 234 were eligible for inclusion. ECA and ICA were performed in 62.4% and 37.6% of patients, respectively. There were no statistically significant intergroup differences in clinicopathologic variables. The overall SSI rate did not differ between the groups (P = 0.801), but organ/space SSIs were more common in the ICA group than in the ECA group (P = 0.048). There was no significant difference in overall SSI or anastomotic leakage (AL) rates between the ICA and ECA groups, but the organ/space SSI rate was higher in the ICA group when AL cases were excluded. Further high-quality studies are needed to assess the risk of organ/space SSIs in the ICA after colon cancer surgery.
{"title":"Does Intracorporeal Anastomosis Decrease the Rate of Surgical Site Infection in Laparoscopic Colon Cancer Surgery?","authors":"Yeon Wook Ju, W. Ji, Jung Sik Kim, K. Hong, J. Um","doi":"10.9738/intsurg-d-21-00001.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-21-00001.1","url":null,"abstract":"\u0000 \u0000 This study aimed to compare the surgical site infection (SSI) rates between intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA).\u0000 \u0000 \u0000 \u0000 Laparoscopic surgery is recommended for colonic malignancies because of its superior clinical outcomes and comparable oncologic results. Laparoscopic colectomy with ICA has the advantages of incision length and free extraction site choice. However, ICA may be associated with a risk of SSI due to enterotomy inside the abdominal cavity.\u0000 \u0000 \u0000 \u0000 We retrospectively analyzed patients with colon cancer who underwent radical surgery at Korea University Ansan Hospital between January 2017 and June 2020. We compared the SSI rates and other clinical variables between the ICA and ECA groups.\u0000 \u0000 \u0000 \u0000 Of the 502 patients who underwent radical surgery for colorectal cancer during the study period, 234 were eligible for inclusion. ECA and ICA were performed in 62.4% and 37.6% of patients, respectively. There were no statistically significant intergroup differences in clinicopathologic variables. The overall SSI rate did not differ between the groups (P = 0.801), but organ/space SSIs were more common in the ICA group than in the ECA group (P = 0.048).\u0000 \u0000 \u0000 \u0000 There was no significant difference in overall SSI or anastomotic leakage (AL) rates between the ICA and ECA groups, but the organ/space SSI rate was higher in the ICA group when AL cases were excluded. Further high-quality studies are needed to assess the risk of organ/space SSIs in the ICA after colon cancer surgery.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43123906","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 : 2021-01-01DOI: 10.9738/intsurg-d-15-00151.1
Meghan Aabo, Sarah Walcott-Sapp, H. Standage, B. Standage
We report the first case of a clinically diagnosed incidental appendiceal carcinoid tumor contained in an incarcerated inguinal hernia without inflammation of the appendix. A 67-year-old white man underwent elective open repair of an incarcerated right inguinal hernia containing small bowel, cecum, appendix, and ascending colon. He was found to have a grossly abnormal mass at the tip of his appendix. Appendectomy was performed, and histopathologic analysis confirmed the presence and adequate resection of a neuroendocrine tumor. It is important for general surgeons to be aware that unusual presentations of appendiceal tumors may not be associated with appendiceal inflammation or related symptoms.
{"title":"Appendiceal Carcinoid Tumor Contained in a Large Inguinal Hernia: A Case Report","authors":"Meghan Aabo, Sarah Walcott-Sapp, H. Standage, B. Standage","doi":"10.9738/intsurg-d-15-00151.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-15-00151.1","url":null,"abstract":"We report the first case of a clinically diagnosed incidental appendiceal carcinoid tumor contained in an incarcerated inguinal hernia without inflammation of the appendix. A 67-year-old white man underwent elective open repair of an incarcerated right inguinal hernia containing small bowel, cecum, appendix, and ascending colon. He was found to have a grossly abnormal mass at the tip of his appendix. Appendectomy was performed, and histopathologic analysis confirmed the presence and adequate resection of a neuroendocrine tumor. It is important for general surgeons to be aware that unusual presentations of appendiceal tumors may not be associated with appendiceal inflammation or related symptoms.","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49640939","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 : 2021-01-01DOI: 10.9738/intsurg-d-20-00043.1
Jun Higashijima, T. Yoshimoto, Shohei Eto, H. Kashihara, C. Takasu, M. Nishi, T. Tokunaga, K. Yoshikawa, M. Shimada
Anastomotic leakage (AL) in colorectal resections is often caused by insufficient blood flow to the stump. Injecting indocyanine green can help detect blood flow intraoperatively. In this study, we evaluated our original strategy using an indocyanine green fluorescence system to avoid AL. We retrospectively evaluated 79 patients who underwent laparoscopic colorectal resection for colon cancer using a double-stapling technique. Blood flow in oral stumps was evaluated by measuring indocyanine green fluorescence time (FT). We investigated AL cases in detail and analyzed correlations between FT and risk factors for AL. Of the 79 patients, 7 (8.9%) developed AL. We divided patients by FTs: >60 seconds, 50 to 60 seconds, and <50 seconds. The AL rates were FT >60 seconds, 60%; FT 50 to 60 seconds, 10.3%; and FT <50 seconds, 2.2%. The AL rate of high-risk cases (with more than 2 risk factors) were calculated and we made our original strategy to avoid AL as the following. Further resection or diverting stomas were needed by the FT >60 seconds group, and by members of the FT 50 to 60 seconds group with ≥3 risk factors. The FT <60 seconds group needed no additional management. Patients with delayed FT (>60 seconds, or 50–60 seconds with ≥3 risk factors) may need revision of the anastomosis (diverting stoma or additional resection) to avoid AL. Our original strategy may contribute to reduce AL in colorectal operations.
{"title":"Strategy to Avoid Anastomotic Leakage in Laparoscopic Colorectal Resection Using the Indocyanine Green Fluorescence System","authors":"Jun Higashijima, T. Yoshimoto, Shohei Eto, H. Kashihara, C. Takasu, M. Nishi, T. Tokunaga, K. Yoshikawa, M. Shimada","doi":"10.9738/intsurg-d-20-00043.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00043.1","url":null,"abstract":"\u0000 \u0000 Anastomotic leakage (AL) in colorectal resections is often caused by insufficient blood flow to the stump. Injecting indocyanine green can help detect blood flow intraoperatively. In this study, we evaluated our original strategy using an indocyanine green fluorescence system to avoid AL.\u0000 \u0000 \u0000 \u0000 We retrospectively evaluated 79 patients who underwent laparoscopic colorectal resection for colon cancer using a double-stapling technique. Blood flow in oral stumps was evaluated by measuring indocyanine green fluorescence time (FT). We investigated AL cases in detail and analyzed correlations between FT and risk factors for AL.\u0000 \u0000 \u0000 \u0000 Of the 79 patients, 7 (8.9%) developed AL. We divided patients by FTs: >60 seconds, 50 to 60 seconds, and <50 seconds. The AL rates were FT >60 seconds, 60%; FT 50 to 60 seconds, 10.3%; and FT <50 seconds, 2.2%. The AL rate of high-risk cases (with more than 2 risk factors) were calculated and we made our original strategy to avoid AL as the following. Further resection or diverting stomas were needed by the FT >60 seconds group, and by members of the FT 50 to 60 seconds group with ≥3 risk factors. The FT <60 seconds group needed no additional management.\u0000 \u0000 \u0000 \u0000 Patients with delayed FT (>60 seconds, or 50–60 seconds with ≥3 risk factors) may need revision of the anastomosis (diverting stoma or additional resection) to avoid AL. Our original strategy may contribute to reduce AL in colorectal operations.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47961700","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 : 2021-01-01DOI: 10.9738/intsurg-d-16-00187.1
Masaaki Shida, Masayuki Tanaka, Toshiya Tanaka, Y. Kitajima, Seiji Sato
A retrocecal hernia is a rare type of internal hernia that occasionally causes small bowel obstruction and strangulation ileus. We report a case of retrocecal hernia that was preoperatively diagnosed using multidetector raw computed tomography and successfully treated by emergency surgery. A 97-year-old woman presented at another hospital with abdominal distension and nausea. She was diagnosed with ileus and was conservatively treated with long intestinal tube placement. However, the symptoms had not improved after 7 days in the hospital. The patient was then referred to our hospital, where a pericecal hernia was diagnosed using multidetector raw computed tomography. We performed emergency surgery and intraoperatively confirmed the presence of a retrocecal hernia. A 30-cm nonviable section of small intestine was resected, and the hernia orifice was closed routinely. Postoperative recovery was uneventful. Patients with pericecal hernia usually require surgical treatment. Multidetector raw computed tomography is useful for precise diagnosis of this type of hernia. Precise diagnosis is necessary to select prompt operative intervention for internal hernia.
{"title":"Successful Retrocecal Hernia Diagnosis and Treatment: A Case Report","authors":"Masaaki Shida, Masayuki Tanaka, Toshiya Tanaka, Y. Kitajima, Seiji Sato","doi":"10.9738/intsurg-d-16-00187.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-16-00187.1","url":null,"abstract":"\u0000 \u0000 A retrocecal hernia is a rare type of internal hernia that occasionally causes small bowel obstruction and strangulation ileus. We report a case of retrocecal hernia that was preoperatively diagnosed using multidetector raw computed tomography and successfully treated by emergency surgery.\u0000 \u0000 \u0000 \u0000 A 97-year-old woman presented at another hospital with abdominal distension and nausea. She was diagnosed with ileus and was conservatively treated with long intestinal tube placement. However, the symptoms had not improved after 7 days in the hospital. The patient was then referred to our hospital, where a pericecal hernia was diagnosed using multidetector raw computed tomography. We performed emergency surgery and intraoperatively confirmed the presence of a retrocecal hernia. A 30-cm nonviable section of small intestine was resected, and the hernia orifice was closed routinely. Postoperative recovery was uneventful.\u0000 \u0000 \u0000 \u0000 Patients with pericecal hernia usually require surgical treatment. Multidetector raw computed tomography is useful for precise diagnosis of this type of hernia. Precise diagnosis is necessary to select prompt operative intervention for internal hernia.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914027","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 : 2021-01-01DOI: 10.9738/intsurg-d-20-00033.1
Seungmin Lee, K. Paik
The aim of this study is to examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better reconstructive method to reduce postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the fistula risk. An institutional database was reviewed for patients undergoing PD between January 2008 and August 2019. A total of 159 patients were stratified into 4 groups according to the Clinical Risk Score-Pancreatic Fistula. POPF according to 4 risk groups was compared between PJ and PG. Of the 159 patients, 82 underwent PG (51.6%) and 77 underwent PJ (48.4%) reconstruction. POPF rate was 17.1% (n = 14) in the PG group and 12.9% (n = 10) in the PJ group (P = 0.51). POPF rates were not different in intermediate, low, and negligible risks between 2 reconstructive methods. In the high-risk group (n = 47), there were 4 POPFs (22.2%) in PJ group and 9 (31.0%) in the PG group, respectively (P = 0.74). In PD, there was no superior method of reconstruction with regard to POPF, even in high-risk glands.
{"title":"Retrospective Comparative Analysis of POPF Using Fistula Risk Score According to Pancreaticoenterostomy Method","authors":"Seungmin Lee, K. Paik","doi":"10.9738/intsurg-d-20-00033.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00033.1","url":null,"abstract":"\u0000 \u0000 The aim of this study is to examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better reconstructive method to reduce postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the fistula risk.\u0000 \u0000 \u0000 \u0000 An institutional database was reviewed for patients undergoing PD between January 2008 and August 2019. A total of 159 patients were stratified into 4 groups according to the Clinical Risk Score-Pancreatic Fistula. POPF according to 4 risk groups was compared between PJ and PG.\u0000 \u0000 \u0000 \u0000 Of the 159 patients, 82 underwent PG (51.6%) and 77 underwent PJ (48.4%) reconstruction. POPF rate was 17.1% (n = 14) in the PG group and 12.9% (n = 10) in the PJ group (P = 0.51). POPF rates were not different in intermediate, low, and negligible risks between 2 reconstructive methods. In the high-risk group (n = 47), there were 4 POPFs (22.2%) in PJ group and 9 (31.0%) in the PG group, respectively (P = 0.74).\u0000 \u0000 \u0000 \u0000 In PD, there was no superior method of reconstruction with regard to POPF, even in high-risk glands.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45277117","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 : 2021-01-01DOI: 10.9738/intsurg-d-17-00097.1
Jian Wang, Jie Chu, Lihua Zhang, Juan Chen, Yi Zheng, Shi Sheng, Bi Jin, C. Ouyang, Yiqing Li
Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian artery occlusion and may not benefit from less-invasive angioplasty/stenting. This study described 4 cases in which carotid-vertebral transposition (CVT) or carotid-subclavian transposition (CST) was adapted when endovascular treatment was unfeasible or unsuccessful. Case 1: A 65-year-old woman presented with severe stenosis of the right vertebral artery ostium, dysplastic left vertebral artery, and aneurysmal dilatation of proximal right subclavian artery and brachiocephalic trunk. Case 2: A 23-year-woman had severe stenosis at the first portion of left vertebral artery caused by Takayasu's arteritis. Because endovascular intervention was unfeasible, CVTs were performed in cases 1 and 2. Case 3: A 73-year-old man presented with total occlusion of the proximal right subclavian artery and severe stenosis of the right internal carotid artery. Case 4: A 58-year-old man experienced complete occlusion of the left subclavian artery and severe stenosis of the left common carotid artery. Duplex ultrasonography showed reverse flow in the vertebral artery in keeping with vertebral steal syndrome. Endovascular treatment was unsuccessful because the wire did not cross the occlusion of the subclavian artery. CSTs were performed with concurrent ipsilateral carotid endarterectomy in cases 3 and 4. The present case series demonstrated that CST and CVT were effective treatment modalities for subclavian or vertebral artery lesions. Although endovascular stenting and angioplasty have been advocated as first-line management, CST and CVT should be considered as the remedy when endovascular intervention is unsuccessful or unfeasible.
{"title":"Carotid-Vertebral or Carotid-Subclavian Transpositions in Supra-Aortic Steno-Occlusive Diseases When Endovascular Therapy Is Unfeasible or Unsuccessful","authors":"Jian Wang, Jie Chu, Lihua Zhang, Juan Chen, Yi Zheng, Shi Sheng, Bi Jin, C. Ouyang, Yiqing Li","doi":"10.9738/intsurg-d-17-00097.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-17-00097.1","url":null,"abstract":"\u0000 \u0000 Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian artery occlusion and may not benefit from less-invasive angioplasty/stenting. This study described 4 cases in which carotid-vertebral transposition (CVT) or carotid-subclavian transposition (CST) was adapted when endovascular treatment was unfeasible or unsuccessful.\u0000 \u0000 \u0000 \u0000 Case 1: A 65-year-old woman presented with severe stenosis of the right vertebral artery ostium, dysplastic left vertebral artery, and aneurysmal dilatation of proximal right subclavian artery and brachiocephalic trunk. Case 2: A 23-year-woman had severe stenosis at the first portion of left vertebral artery caused by Takayasu's arteritis. Because endovascular intervention was unfeasible, CVTs were performed in cases 1 and 2. Case 3: A 73-year-old man presented with total occlusion of the proximal right subclavian artery and severe stenosis of the right internal carotid artery. Case 4: A 58-year-old man experienced complete occlusion of the left subclavian artery and severe stenosis of the left common carotid artery. Duplex ultrasonography showed reverse flow in the vertebral artery in keeping with vertebral steal syndrome. Endovascular treatment was unsuccessful because the wire did not cross the occlusion of the subclavian artery. CSTs were performed with concurrent ipsilateral carotid endarterectomy in cases 3 and 4.\u0000 \u0000 \u0000 \u0000 The present case series demonstrated that CST and CVT were effective treatment modalities for subclavian or vertebral artery lesions. Although endovascular stenting and angioplasty have been advocated as first-line management, CST and CVT should be considered as the remedy when endovascular intervention is unsuccessful or unfeasible.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46461114","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 : 2021-01-01DOI: 10.9738/intsurg-d-20-00012.1
Hyun Jeong Lee, W. Kim, Jae Bok Lee, K. Ha, Young Woo Chang, H. Lee, S. Jung, Y. Lee, O. Woo, S. Woo, G. Son
The aim of this study was to identify the effectiveness and selective applications of preoperative magnetic resonance imaging (MRI) by investigating clinicopathologic factors of the index tumor with or without false lesions on MRI. Preoperative MRI is commonly performed in patients with newly diagnosed breast cancer, but its clinical significance is unclear. A total of 103 breast cancer patients who had undergone MRI or ultrasound followed by mastectomy were included in this retrospective investigation of pathologic, clinical, and imaging findings. MRI showed 29 false-positive lesions in 57 patients, 5 false-negative lesions in 5 patients, and 69 true-positive lesions in 103 patients. More false lesions on MRI were found in patients with more lesions on ultrasound, small-sized index tumors on ultrasound, or early-stage cancer. The sensitivity of MRI and ultrasound were 96.5% and 92.3% (P = 0.119), respectively, and the positive predictive value of them were 71.5% and 72.5% (P = 0.828), respectively. Preoperative MRI is more useful in patients with newly diagnosed breast cancer who have large-sized or more advanced cancers or fewer lesions on ultrasound.
{"title":"Which Patients With Newly Diagnosed Breast Cancer Benefit From Preoperative Magnetic Resonance Imaging?","authors":"Hyun Jeong Lee, W. Kim, Jae Bok Lee, K. Ha, Young Woo Chang, H. Lee, S. Jung, Y. Lee, O. Woo, S. Woo, G. Son","doi":"10.9738/intsurg-d-20-00012.1","DOIUrl":"https://doi.org/10.9738/intsurg-d-20-00012.1","url":null,"abstract":"\u0000 \u0000 The aim of this study was to identify the effectiveness and selective applications of preoperative magnetic resonance imaging (MRI) by investigating clinicopathologic factors of the index tumor with or without false lesions on MRI.\u0000 \u0000 \u0000 \u0000 Preoperative MRI is commonly performed in patients with newly diagnosed breast cancer, but its clinical significance is unclear.\u0000 \u0000 \u0000 \u0000 A total of 103 breast cancer patients who had undergone MRI or ultrasound followed by mastectomy were included in this retrospective investigation of pathologic, clinical, and imaging findings.\u0000 \u0000 \u0000 \u0000 MRI showed 29 false-positive lesions in 57 patients, 5 false-negative lesions in 5 patients, and 69 true-positive lesions in 103 patients. More false lesions on MRI were found in patients with more lesions on ultrasound, small-sized index tumors on ultrasound, or early-stage cancer. The sensitivity of MRI and ultrasound were 96.5% and 92.3% (P = 0.119), respectively, and the positive predictive value of them were 71.5% and 72.5% (P = 0.828), respectively.\u0000 \u0000 \u0000 \u0000 Preoperative MRI is more useful in patients with newly diagnosed breast cancer who have large-sized or more advanced cancers or fewer lesions on ultrasound.\u0000","PeriodicalId":14474,"journal":{"name":"International surgery","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43574726","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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