Pub Date : 2024-06-14eCollection Date: 2024-06-01DOI: 10.1097/IO9.0000000000000051
[This corrects the article DOI: 10.1097/IO9.0000000000000003.].
[此处更正了文章 DOI：10.1097/IO9.0000000000000003]。
{"title":"Erratum: Effect of dysnatremia and dysglycemia on outcomes among surgical intensive care unit patients: Erratum.","authors":"","doi":"10.1097/IO9.0000000000000051","DOIUrl":"https://doi.org/10.1097/IO9.0000000000000051","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/IO9.0000000000000003.].</p>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.1097/io9.0000000000000027
R. Mohapatra, Snehasish Mishra, V. Kandi, Sarvesh Rustagi, A. Gaidhane, P. Satapathy, L. S. Tuglo
{"title":"WHO officially recognises Noma as a NTD: suggested global scale countermeasures","authors":"R. Mohapatra, Snehasish Mishra, V. Kandi, Sarvesh Rustagi, A. Gaidhane, P. Satapathy, L. S. Tuglo","doi":"10.1097/io9.0000000000000027","DOIUrl":"https://doi.org/10.1097/io9.0000000000000027","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-15DOI: 10.1097/io9.0000000000000029
W. Lapisatepun, Tanyong Pipanmekaporn, Prangmalee Leurcharusamee, Jiraporn Khonara, J. Patumanond, W. Lapisatepun
Liver resection is the current treatment for hepatic neoplasms but may be associated with intraoperative hemorrhage and the need for blood transfusions. The aim of this study is to identify the risk factors for predicting the requirement of a perioperative blood transfusion in open liver resection. A total of 808 consecutive patients who had undergone elective open liver resection from 2006 to 2017 were retrospectively reviewed using the database. Baseline characteristics and intra-operative data were collected. Perioperative blood transfusion was defined as the transfusion of allogenic packed red cells during surgery and the 48 hours following surgery. An analysis of logistic regression was used to determine the independent risk factors for blood transfusion in open liver resection. Three hundred and seventy-seven patients (46.7%) received perioperative packed red cell transfusions. The independent risk factors associated with perioperative blood transfusion included ASA classification>2, preoperative anemia (Hb<12 g/dL for women, Hb<13 g/dL for men), thrombocytopenia (platelet count<100×103/mm3), albumin<3.5 g/dL, largest tumor size>4 cm., major liver resection, and surgeon experience performing<50 cases of major open liver resection. Preoperative risk factors may be utilized to assess and predict patients who require perioperative blood transfusions following liver resection. Modifiable risk factors may also be treated prior to surgery. Furthermore, patient blood management and methods to minimize blood loss and blood transfusions during surgery should be implemented in patients who require high-risk transfusions.
{"title":"The risk factors for perioperative blood transfusion in open liver resection, a retrospective cohort study","authors":"W. Lapisatepun, Tanyong Pipanmekaporn, Prangmalee Leurcharusamee, Jiraporn Khonara, J. Patumanond, W. Lapisatepun","doi":"10.1097/io9.0000000000000029","DOIUrl":"https://doi.org/10.1097/io9.0000000000000029","url":null,"abstract":"\u0000 \u0000 Liver resection is the current treatment for hepatic neoplasms but may be associated with intraoperative hemorrhage and the need for blood transfusions. The aim of this study is to identify the risk factors for predicting the requirement of a perioperative blood transfusion in open liver resection.\u0000 \u0000 \u0000 \u0000 A total of 808 consecutive patients who had undergone elective open liver resection from 2006 to 2017 were retrospectively reviewed using the database. Baseline characteristics and intra-operative data were collected. Perioperative blood transfusion was defined as the transfusion of allogenic packed red cells during surgery and the 48 hours following surgery. An analysis of logistic regression was used to determine the independent risk factors for blood transfusion in open liver resection.\u0000 \u0000 \u0000 \u0000 Three hundred and seventy-seven patients (46.7%) received perioperative packed red cell transfusions. The independent risk factors associated with perioperative blood transfusion included ASA classification>2, preoperative anemia (Hb<12 g/dL for women, Hb<13 g/dL for men), thrombocytopenia (platelet count<100×103/mm3), albumin<3.5 g/dL, largest tumor size>4 cm., major liver resection, and surgeon experience performing<50 cases of major open liver resection.\u0000 \u0000 \u0000 \u0000 Preoperative risk factors may be utilized to assess and predict patients who require perioperative blood transfusions following liver resection. Modifiable risk factors may also be treated prior to surgery. Furthermore, patient blood management and methods to minimize blood loss and blood transfusions during surgery should be implemented in patients who require high-risk transfusions.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-12DOI: 10.1097/io9.0000000000000003
Mahmoud Abu Abeeleh, Hanan Hamouri, A. Bani Hani, F. M. Ahmad, Sami Abu Halaweh, Wedad A. Al-Warafi, Leen B. Al Sahile, Zain M. Abu Amrieh, Farah Abu Abeeleh, Abdelkader H. Battah, Zuhair Bani Ismail, Saif Al Nassarwin, Tala Al Jaafreh, Mohammad Ribie, Mohammad Salameh, Anas H. A. Abu-Humaidan
The objectives of this study were to evaluate the relationships between serum sodium and glucose concentrations and outcomes among patients admitted to the surgical intensive care unit. Patient records admitted to the surgical intensive care unit (SICU) between July 2020 and December 2020 were used in the study. Data included in the analysis were patient age, gender, comorbidities, surgical intervention, diagnosis of sepsis, sequential organ system failure scores, serum sodium concentrations, serum glucose concentrations, and surgical intensive care unit outcomes (discharged vs. deceased). A univariate logistic regression analysis was used to determine significant risk factors for mortality during a surgical intensive care unit stay. A total of 194 patients with a mean age of 60±16 years were admitted to the SICU during the study period. Twenty-three percent of the patients were found to have sepsis with 18% mortality. Serum sodium and glucose concentrations were significantly higher (P-value ≤0.05) at all-time points in deceased patients compared to those who were discharged from the SICU. The results of the study indicate that serum sodium and glucose concentrations could be used as independent predictors of mortality in surgical intensive care unit patients with sepsis. However, further clinical trials are warranted before this application could be recommended in surgical intensive care units.
{"title":"Effect of dysnatremia and dysglycemia on outcomes among surgical intensive care unit patients","authors":"Mahmoud Abu Abeeleh, Hanan Hamouri, A. Bani Hani, F. M. Ahmad, Sami Abu Halaweh, Wedad A. Al-Warafi, Leen B. Al Sahile, Zain M. Abu Amrieh, Farah Abu Abeeleh, Abdelkader H. Battah, Zuhair Bani Ismail, Saif Al Nassarwin, Tala Al Jaafreh, Mohammad Ribie, Mohammad Salameh, Anas H. A. Abu-Humaidan","doi":"10.1097/io9.0000000000000003","DOIUrl":"https://doi.org/10.1097/io9.0000000000000003","url":null,"abstract":"\u0000 \u0000 The objectives of this study were to evaluate the relationships between serum sodium and glucose concentrations and outcomes among patients admitted to the surgical intensive care unit.\u0000 \u0000 \u0000 \u0000 Patient records admitted to the surgical intensive care unit (SICU) between July 2020 and December 2020 were used in the study. Data included in the analysis were patient age, gender, comorbidities, surgical intervention, diagnosis of sepsis, sequential organ system failure scores, serum sodium concentrations, serum glucose concentrations, and surgical intensive care unit outcomes (discharged vs. deceased). A univariate logistic regression analysis was used to determine significant risk factors for mortality during a surgical intensive care unit stay.\u0000 \u0000 \u0000 \u0000 A total of 194 patients with a mean age of 60±16 years were admitted to the SICU during the study period. Twenty-three percent of the patients were found to have sepsis with 18% mortality. Serum sodium and glucose concentrations were significantly higher (P-value ≤0.05) at all-time points in deceased patients compared to those who were discharged from the SICU.\u0000 \u0000 \u0000 \u0000 The results of the study indicate that serum sodium and glucose concentrations could be used as independent predictors of mortality in surgical intensive care unit patients with sepsis. However, further clinical trials are warranted before this application could be recommended in surgical intensive care units.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140457908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-07DOI: 10.1097/io9.0000000000000025
Yuhang Shen, Yuan Gao, Siyuan Wu, Le Ma, Chunfu Zhu
In 2016, the International Study Group of Pancreatic Fistula (ISGPF) improved the definition of postoperative pancreatic fistula (POPF) which defines one of diagnostic criteria for progression of biochemical leak (BL) to grade B fistula as drain for more than 3 weeks. However, we found patients with BL after pancreaticoduodenectomy (PD) or laparoscopic pancreatoduodenectomy (LPD) in our medical center usually progressed to grade B fistula within 3 weeks, which is inconsistent with diagnostic criteria (more than 3 weeks) described in the guidelines. The objective of this study was to investigate the time point at which patients with BL progressed to grade B fistula after PD or LPD. We selected patients from June 2013 to October 2022 as the research subjects. We used a receiver operating characteristic (ROC) curve to calculate the cutoff value of the time point when BL progressed to grade B fistula. The cutoff value of the time point at which BL progresses to grade B fistula was postoperative day (POD) 9.5. The sensitivity and specificity were 63.6% and 81.4%, respectively. The cutoff value of time point of BL progression to grade B fistula was 9.5, which indicated that we do not need to define grade B fistula as drain for more than 3 weeks. We considered that a too-late time point might delay the timely diagnosis and treatment of grade B fistula and further optimization of the definition of grade B fistula was necessary.
2016 年，国际胰瘘研究小组（ISGPF）改进了术后胰瘘（POPF）的定义，将生化漏（BL）进展为 B 级瘘的诊断标准之一定义为引流超过 3 周。然而，我们在本医疗中心发现，胰十二指肠切除术（PD）或腹腔镜胰十二指肠切除术（LPD）后出现生化漏的患者通常会在 3 周内发展为 B 级瘘，这与指南中描述的诊断标准（超过 3 周）不一致。本研究旨在探讨BL患者在PD或LPD术后进展为B级瘘管的时间点。 我们选择了2013年6月至2022年10月的患者作为研究对象。我们使用接收器操作特征曲线（ROC）计算了BL进展为B级瘘的时间点的临界值。 BL发展为B级瘘的时间点的临界值为术后第9.5天（POD）。灵敏度和特异度分别为 63.6% 和 81.4%。 BL进展为B级瘘管的时间点的临界值为9.5，这表明我们无需将B级瘘管定义为引流超过3周。我们认为过晚的时间点可能会延误对 B 级瘘管的及时诊断和治疗，因此有必要进一步优化 B 级瘘管的定义。
{"title":"Is 3 weeks a proper time point for the diagnosis of grade B POPF after pancreaticoduodenectomy?","authors":"Yuhang Shen, Yuan Gao, Siyuan Wu, Le Ma, Chunfu Zhu","doi":"10.1097/io9.0000000000000025","DOIUrl":"https://doi.org/10.1097/io9.0000000000000025","url":null,"abstract":"\u0000 \u0000 In 2016, the International Study Group of Pancreatic Fistula (ISGPF) improved the definition of postoperative pancreatic fistula (POPF) which defines one of diagnostic criteria for progression of biochemical leak (BL) to grade B fistula as drain for more than 3 weeks. However, we found patients with BL after pancreaticoduodenectomy (PD) or laparoscopic pancreatoduodenectomy (LPD) in our medical center usually progressed to grade B fistula within 3 weeks, which is inconsistent with diagnostic criteria (more than 3 weeks) described in the guidelines. The objective of this study was to investigate the time point at which patients with BL progressed to grade B fistula after PD or LPD.\u0000 \u0000 \u0000 \u0000 We selected patients from June 2013 to October 2022 as the research subjects. We used a receiver operating characteristic (ROC) curve to calculate the cutoff value of the time point when BL progressed to grade B fistula.\u0000 \u0000 \u0000 \u0000 The cutoff value of the time point at which BL progresses to grade B fistula was postoperative day (POD) 9.5. The sensitivity and specificity were 63.6% and 81.4%, respectively.\u0000 \u0000 \u0000 \u0000 The cutoff value of time point of BL progression to grade B fistula was 9.5, which indicated that we do not need to define grade B fistula as drain for more than 3 weeks. We considered that a too-late time point might delay the timely diagnosis and treatment of grade B fistula and further optimization of the definition of grade B fistula was necessary.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140460720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-07DOI: 10.1097/io9.0000000000000026
A. Boongird, Thitaporn Songkwamcharoen, Wipada Mongkolpech, Nutsiri Kittitirapong
Venous thromboembolism (VTE) is a common complication in neurosurgical procedures both before and after surgery. To examine the incidence of venous thromboembolism (VTE) in neurosurgical patients before surgery and in the postoperative period after implementing a VTE prophylaxis protocol. We also aimed to determine VTE risk factors. We conducted a retrospective cohort study examining 200 patients admitted to the hospital for cranial and spine neurosurgical procedures between January 2020 and October 2021. All patients were screened for VTE using a protocol combining measurement of D-dimer level and venous duplex ultrasonography. Patients who screened negative for VTE were evaluated for VTE risk using the Caprini risk assessment model; those with Caprini score ≥3 (indicating moderate-to-high risk) received VTE prophylaxis using intermittent pneumatic compression devices. Preoperative screening demonstrated DVT in seven of 200 patients (3.5%). All DVTs were asymptomatic and proximal in location. Univariate logistic regression showed that stroke, neurodegenerative disease, and confinement to bed for more than 72 hours were significant predictors of preoperative DVT. Among the patients without DVT on preoperative screening, 179 (93%) had a Caprini score ≥3; intermittent pneumatic compression was used for prophylaxis in 173 of these (96.6%). Incidence of postoperative VTE was 2.6% (5/193). Extended length of hospital stay, postoperative hydrocephalus, and infection were significant risk factors for VTE. Preoperative VTE screening using D-dimer level and V-DUS and implementation of VTE prophylaxis using IPC can reduce the incidence of VTE and VTE-related mortality in neurosurgical patients.
{"title":"Incidence and risk factors of venous thromboembolism in neurosurgical patients after implementing a screening protocol; a retrospective cohort study of a tertiary center","authors":"A. Boongird, Thitaporn Songkwamcharoen, Wipada Mongkolpech, Nutsiri Kittitirapong","doi":"10.1097/io9.0000000000000026","DOIUrl":"https://doi.org/10.1097/io9.0000000000000026","url":null,"abstract":"\u0000 \u0000 Venous thromboembolism (VTE) is a common complication in neurosurgical procedures both before and after surgery.\u0000 \u0000 \u0000 \u0000 To examine the incidence of venous thromboembolism (VTE) in neurosurgical patients before surgery and in the postoperative period after implementing a VTE prophylaxis protocol. We also aimed to determine VTE risk factors.\u0000 \u0000 \u0000 \u0000 We conducted a retrospective cohort study examining 200 patients admitted to the hospital for cranial and spine neurosurgical procedures between January 2020 and October 2021. All patients were screened for VTE using a protocol combining measurement of D-dimer level and venous duplex ultrasonography. Patients who screened negative for VTE were evaluated for VTE risk using the Caprini risk assessment model; those with Caprini score ≥3 (indicating moderate-to-high risk) received VTE prophylaxis using intermittent pneumatic compression devices.\u0000 \u0000 \u0000 \u0000 Preoperative screening demonstrated DVT in seven of 200 patients (3.5%). All DVTs were asymptomatic and proximal in location. Univariate logistic regression showed that stroke, neurodegenerative disease, and confinement to bed for more than 72 hours were significant predictors of preoperative DVT. Among the patients without DVT on preoperative screening, 179 (93%) had a Caprini score ≥3; intermittent pneumatic compression was used for prophylaxis in 173 of these (96.6%). Incidence of postoperative VTE was 2.6% (5/193). Extended length of hospital stay, postoperative hydrocephalus, and infection were significant risk factors for VTE.\u0000 \u0000 \u0000 \u0000 Preoperative VTE screening using D-dimer level and V-DUS and implementation of VTE prophylaxis using IPC can reduce the incidence of VTE and VTE-related mortality in neurosurgical patients.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140460770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1097/io9.0000000000000005
Ranjana Rohilla, A. Mohanty, Ranjit Sah
{"title":"Upsurge in acute respiratory infections in children from Northern China: WHO concerned","authors":"Ranjana Rohilla, A. Mohanty, Ranjit Sah","doi":"10.1097/io9.0000000000000005","DOIUrl":"https://doi.org/10.1097/io9.0000000000000005","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1097/io9.0000000000000018
Abdullah Al Noman, Nushaiba B. Hasan, Monty Datta, P. Satapathy, A. Mohanty, Ranjit Sah
{"title":"Disease X: a looming threat and a call for preparedness","authors":"Abdullah Al Noman, Nushaiba B. Hasan, Monty Datta, P. Satapathy, A. Mohanty, Ranjit Sah","doi":"10.1097/io9.0000000000000018","DOIUrl":"https://doi.org/10.1097/io9.0000000000000018","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1097/io9.0000000000000013
Simon Stoerzer, M. Winny, Oliver Beetz, Severin Jacobi, Juergen Klempnauer, D. Poehnert
Postoperative adhesions cause medical and socio-economic problems. 4DryField PH (4DF) is a starch-based medical product/agent with approved anti-adhesive and haemostatic effects. However, the influence on anastomotic healing has not yet been evaluated. The purpose of this study was, therefore, to characterize the effects of intraoperatively applied 4DF on the incidence of anastomotic leakage (AL) after rectal surgery. In this retrospective, monocentric cohort study, 157 patients after rectal surgery and primary anastomosis were divided into two groups. One group received 4DF (n=57), the other was treated without 4DF application (n=100). The groups were followed up for confirmed ALs. The rate of ALs (P=0.850) proved to be comparable. Other additional outcome parameters like postoperative hospital stay (P=0.801), wound infection rate (P=0.627), re-admission rate (P=1.000), re-operation rate (P=0.533) and the 30-day mortality (P=0.463) also showed no statistically significant differences. A multivariable regression model for the complete cohort could not identify 4DF application as prognostically relevant for the development of AL, whereas rectal cancer (OR=2.660 [1.184–5.974]; P=0.018), smoking (OR=3.555 [1.326–9.533]; P=0.012), an ASA (American Society of Anaesthesiologists) score ≥3 (OR=2.894 [1.300–6.442]; P=0.009) and male sex (OR=2.411 [1.040–5.591]; P=0.040) were determined as independent risk factors. The application of 4DF in proximity to the anastomotic region after rectal surgery did not increase the risk of AL and showed no impact on other investigated outcome parameters.
术后粘连会造成医疗和社会经济问题。4DryField PH（4DF）是一种以淀粉为基础的医疗产品/制剂，具有公认的抗粘连和止血效果。但其对吻合口愈合的影响尚未得到评估。因此，本研究的目的是描述术中使用 4DF 对直肠手术后吻合口漏（AL）发生率的影响。 在这项回顾性、单中心队列研究中，157 名接受过直肠手术和初次吻合术的患者被分为两组。一组接受4DF治疗（57人），另一组未接受4DF治疗（100人）。两组患者均接受了确诊 AL 的随访。 事实证明，两组的 AL 发生率（P=0.850）相当。其他结果参数，如术后住院时间（P=0.801）、伤口感染率（P=0.627）、再次入院率（P=1.000）、再次手术率（P=0.533）和 30 天死亡率（P=0.463）也没有统计学意义上的显著差异。完整队列的多变量回归模型无法确定 4DF 的应用与 AL 的发生预后相关，而直肠癌（OR=2.660 [1.184-5.974]; P=0.018）、吸烟（OR=3.555[1.326-9.533]；P=0.012）、ASA（美国麻醉医师协会）评分≥3（OR=2.894[1.300-6.442]；P=0.009）和男性（OR=2.411[1.040-5.591]；P=0.040）被确定为独立危险因素。 直肠手术后在吻合口附近使用 4DF 不会增加 AL 的风险，对其他研究结果参数也没有影响。
{"title":"Impact of the starch-based anti-adhesive agent 4DryField PH on anastomotic healing after rectal surgery","authors":"Simon Stoerzer, M. Winny, Oliver Beetz, Severin Jacobi, Juergen Klempnauer, D. Poehnert","doi":"10.1097/io9.0000000000000013","DOIUrl":"https://doi.org/10.1097/io9.0000000000000013","url":null,"abstract":"\u0000 \u0000 Postoperative adhesions cause medical and socio-economic problems. 4DryField PH (4DF) is a starch-based medical product/agent with approved anti-adhesive and haemostatic effects. However, the influence on anastomotic healing has not yet been evaluated. The purpose of this study was, therefore, to characterize the effects of intraoperatively applied 4DF on the incidence of anastomotic leakage (AL) after rectal surgery.\u0000 \u0000 \u0000 \u0000 In this retrospective, monocentric cohort study, 157 patients after rectal surgery and primary anastomosis were divided into two groups. One group received 4DF (n=57), the other was treated without 4DF application (n=100). The groups were followed up for confirmed ALs.\u0000 \u0000 \u0000 \u0000 The rate of ALs (P=0.850) proved to be comparable. Other additional outcome parameters like postoperative hospital stay (P=0.801), wound infection rate (P=0.627), re-admission rate (P=1.000), re-operation rate (P=0.533) and the 30-day mortality (P=0.463) also showed no statistically significant differences. A multivariable regression model for the complete cohort could not identify 4DF application as prognostically relevant for the development of AL, whereas rectal cancer (OR=2.660 [1.184–5.974]; P=0.018), smoking (OR=3.555 [1.326–9.533]; P=0.012), an ASA (American Society of Anaesthesiologists) score ≥3 (OR=2.894 [1.300–6.442]; P=0.009) and male sex (OR=2.411 [1.040–5.591]; P=0.040) were determined as independent risk factors.\u0000 \u0000 \u0000 \u0000 The application of 4DF in proximity to the anastomotic region after rectal surgery did not increase the risk of AL and showed no impact on other investigated outcome parameters.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1097/io9.0000000000000007
Hitesh Chopra, Kavita Munjal, V. Gauttam, T. Emran
{"title":"Application, scope, and limitations of grafting techniques and materials used in Nasal Augmentation","authors":"Hitesh Chopra, Kavita Munjal, V. Gauttam, T. Emran","doi":"10.1097/io9.0000000000000007","DOIUrl":"https://doi.org/10.1097/io9.0000000000000007","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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