Pub Date : 2024-10-04DOI: 10.1016/j.surge.2024.09.007
Amir Farah
{"title":"A Letter to the editor: Parastomal hernia repairs: A nationwide cohort study in the Republic of Ireland","authors":"Amir Farah","doi":"10.1016/j.surge.2024.09.007","DOIUrl":"10.1016/j.surge.2024.09.007","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages e230-e231"},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376236","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 : 2024-10-02DOI: 10.1016/j.surge.2024.09.006
Amir Farah
{"title":"A Letter to the Editor: Sick-leave duration after elective day case surgery in ENT: Is it affected by the type of employment?","authors":"Amir Farah","doi":"10.1016/j.surge.2024.09.006","DOIUrl":"10.1016/j.surge.2024.09.006","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Page e234"},"PeriodicalIF":2.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367189","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 : 2024-09-30DOI: 10.1016/j.surge.2024.09.001
David J. O'Regan , John Rudd
{"title":"Situational awareness - The surgeon and the advanced motorist","authors":"David J. O'Regan , John Rudd","doi":"10.1016/j.surge.2024.09.001","DOIUrl":"10.1016/j.surge.2024.09.001","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages e235-e236"},"PeriodicalIF":2.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367190","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 : 2024-09-23DOI: 10.1016/j.surge.2024.09.002
Karthikeyan Kandaswamy, Ajay Guru
{"title":"Comment on “Comparative surgical outcomes of navigated vs non-navigated posterior spinal fusions in ankylosing spondylitis patients”","authors":"Karthikeyan Kandaswamy, Ajay Guru","doi":"10.1016/j.surge.2024.09.002","DOIUrl":"10.1016/j.surge.2024.09.002","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages e232-e233"},"PeriodicalIF":2.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331018","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 : 2024-09-23DOI: 10.1016/j.surge.2024.08.016
Harin B. Parikh, Stuart H. Kuschner
{"title":"Letter to the Editors Re: Frailty and the incidence of surgical site infection after total hip or knee arthroplasty: A meta-analysis","authors":"Harin B. Parikh, Stuart H. Kuschner","doi":"10.1016/j.surge.2024.08.016","DOIUrl":"10.1016/j.surge.2024.08.016","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Page e237"},"PeriodicalIF":2.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331019","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 : 2024-09-21DOI: 10.1016/j.surge.2024.09.004
Hethesh Chellapandian, Sivakamavalli Jeyachandran
This study investigates the potential of 2-methoxyestradiol (2-ME) to overcome tamoxifen (TAM) resistance in MCF-7 breast cancer cells by downregulating hypoxia-inducible factor 1 alpha (HIF-1α). Through a series of in vitro experiments, the authors demonstrate that combining 2-ME with TAM enhances the cytotoxic effects on resistant cells, increases apoptosis markers, and reduces cholesterol and triglyceride levels. While the findings highlight a promising therapeutic approach, the lack of in vivo or clinical data limits direct clinical application. Future research should focus on validating these results in animal models and exploring long-term efficacy and molecular mechanisms.
{"title":"Comment on, “2-methoxyestradiol sensitizes tamoxifen-resistant MCF-7 breast cancer cells via downregulating HIF-1α”","authors":"Hethesh Chellapandian, Sivakamavalli Jeyachandran","doi":"10.1016/j.surge.2024.09.004","DOIUrl":"10.1016/j.surge.2024.09.004","url":null,"abstract":"<div><div>This study investigates the potential of 2-methoxyestradiol (2-ME) to overcome tamoxifen (TAM) resistance in MCF-7 breast cancer cells by downregulating hypoxia-inducible factor 1 alpha (HIF-1α). Through a series of in vitro experiments, the authors demonstrate that combining 2-ME with TAM enhances the cytotoxic effects on resistant cells, increases apoptosis markers, and reduces cholesterol and triglyceride levels. While the findings highlight a promising therapeutic approach, the lack of in vivo or clinical data limits direct clinical application. Future research should focus on validating these results in animal models and exploring long-term efficacy and molecular mechanisms.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages e240-e241"},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299481","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}
The use of body-warming systems is recommended by international anaesthesia societies for patients undergoing surgery. Limited research is however available on the influence of positioning of forced-air warming blankets for patients undergoing spinal surgery. This study aimed to investigate how patients’ intra-operative body temperature was affected by the position of forced-air warming blankets while undergoing spinal surgery on a spinal table.
Design
A randomized comparative experimental study was conducted with 60 adult patients undergoing posterior spinal surgery.
Methods
Patients were randomized into full underbody (n = 30) or surgical access (n = 30) forced-air warming blanket groups. Intra-operative body temperature was recorded at regular time intervals. The student's T-test, Chi-square, and MANOVA tests were performed to determine the differences between the two groups.
Results
Intraoperative hypothermia was significantly lower in the full underbody group than in the surgical access group (p = 0.020). The change in body temperature differed significantly between the two groups from 15 min until 240 min, with a mean difference of 0.5 °C.
Conclusion
The full underbody position of the forced-air warming blanket was effective for maintaining normal range core body temperature. The use of full underbody forced-air warming blanket for spinal surgery when patients are positioned on a spinal table in a prone position is recommended.
{"title":"The effect of forced-air warming blanket position during spinal surgery on patients’ intra-operative body temperature","authors":"Natasha Joubert, Celia Filmalter, Zelda White, Andries Masenge","doi":"10.1016/j.surge.2024.09.003","DOIUrl":"10.1016/j.surge.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>The use of body-warming systems is recommended by international anaesthesia societies for patients undergoing surgery. Limited research is however available on the influence of positioning of forced-air warming blankets for patients undergoing spinal surgery. This study aimed to investigate how patients’ intra-operative body temperature was affected by the position of forced-air warming blankets while undergoing spinal surgery on a spinal table.</div></div><div><h3>Design</h3><div>A randomized comparative experimental study was conducted with 60 adult patients undergoing posterior spinal surgery.</div></div><div><h3>Methods</h3><div>Patients were randomized into full underbody (n = 30) or surgical access (n = 30) forced-air warming blanket groups. Intra-operative body temperature was recorded at regular time intervals. The student's T-test, Chi-square, and MANOVA tests were performed to determine the differences between the two groups.</div></div><div><h3>Results</h3><div>Intraoperative hypothermia was significantly lower in the full underbody group than in the surgical access group (p = 0.020). The change in body temperature differed significantly between the two groups from 15 min until 240 min, with a mean difference of 0.5 °C.</div></div><div><h3>Conclusion</h3><div>The full underbody position of the forced-air warming blanket was effective for maintaining normal range core body temperature. The use of full underbody forced-air warming blanket for spinal surgery when patients are positioned on a spinal table in a prone position is recommended.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages 373-376"},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1016/S1479-666X(24)00106-9
{"title":"List of editors","authors":"","doi":"10.1016/S1479-666X(24)00106-9","DOIUrl":"10.1016/S1479-666X(24)00106-9","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 5","pages":"Page i"},"PeriodicalIF":2.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1479666X24001069/pdfft?md5=020bb01cd0dd5810a05e98820408f7d1&pid=1-s2.0-S1479666X24001069-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.1016/j.surge.2024.08.015
Ross Condell, Dhruv Kapoor, Alexander Price, David O'Briain
Background: Tourniquets are commonly used in extremity surgery to help provide a bloodless operative field to improve visibility and reduce length of procedures. With the development of WALANT (wide awake, local anaesthetic, no tourniquet) techniques, many surgeons undertake surgery without tourniquet inflation. The correct technique of pneumatic tourniquet application is poorly understood by healthcare staff. The application of a tight tourniquet when applied for optional use or use for only a portion of a procedure, rather than for inflation throughout can cause venous engorgement of an extremity leading to increased blood loss and reduced operative field visualisation thereby discouraging surgeons from persevering with WALANT strategies.
Aim: To determine the effect of tourniquet application tension on limb volume prior to skin incision.
Methods: 30 volunteers had the volume of their non-dominant forearm measured post-inflation of a surgical tourniquet using two different application techniques. Tight application was defined as the tourniquet fastened using a dynamometer to a tension of 100 N. Loose application was defined as the tourniquet fastened using a dynamometer to a tension of 50 N. The tourniquet was then inflated to 200 mmHg after both application techniques. Exsanguination was performed by elevation of the arm for 1 min prior to tourniquet inflation. At 5 min the forearm volume was measured using a volume displacement technique.
Results: 93 % of participants (28/30) had a higher volume of water displaced when the tourniquet was applied tightly. The mean difference between the loose and tight applications was 30.06 mls.
Conclusion: The increase in volume in tightly applied tourniquets is believed to result from increased intravascular volume. This increase in blood volume can lead to increased intra-operative blood loss and poor intra-operative visualisation when operating without tourniquet inflation. Loose application of the tourniquet pre-inflation appears to prevent sequestration of venous blood in the limb, therefore decreasing operative blood loss and improving view for operating.
Level of evidence: Level 1; Symptom Prevalence Study.
{"title":"Tight application of a surgical tourniquet prior to inflation increases venous pressure in the upper limb; Potentially resulting in increased blood loss and poorer visibility.","authors":"Ross Condell, Dhruv Kapoor, Alexander Price, David O'Briain","doi":"10.1016/j.surge.2024.08.015","DOIUrl":"https://doi.org/10.1016/j.surge.2024.08.015","url":null,"abstract":"<p><strong>Background: </strong>Tourniquets are commonly used in extremity surgery to help provide a bloodless operative field to improve visibility and reduce length of procedures. With the development of WALANT (wide awake, local anaesthetic, no tourniquet) techniques, many surgeons undertake surgery without tourniquet inflation. The correct technique of pneumatic tourniquet application is poorly understood by healthcare staff. The application of a tight tourniquet when applied for optional use or use for only a portion of a procedure, rather than for inflation throughout can cause venous engorgement of an extremity leading to increased blood loss and reduced operative field visualisation thereby discouraging surgeons from persevering with WALANT strategies.</p><p><strong>Aim: </strong>To determine the effect of tourniquet application tension on limb volume prior to skin incision.</p><p><strong>Methods: </strong>30 volunteers had the volume of their non-dominant forearm measured post-inflation of a surgical tourniquet using two different application techniques. Tight application was defined as the tourniquet fastened using a dynamometer to a tension of 100 N. Loose application was defined as the tourniquet fastened using a dynamometer to a tension of 50 N. The tourniquet was then inflated to 200 mmHg after both application techniques. Exsanguination was performed by elevation of the arm for 1 min prior to tourniquet inflation. At 5 min the forearm volume was measured using a volume displacement technique.</p><p><strong>Results: </strong>93 % of participants (28/30) had a higher volume of water displaced when the tourniquet was applied tightly. The mean difference between the loose and tight applications was 30.06 mls.</p><p><strong>Conclusion: </strong>The increase in volume in tightly applied tourniquets is believed to result from increased intravascular volume. This increase in blood volume can lead to increased intra-operative blood loss and poor intra-operative visualisation when operating without tourniquet inflation. Loose application of the tourniquet pre-inflation appears to prevent sequestration of venous blood in the limb, therefore decreasing operative blood loss and improving view for operating.</p><p><strong>Level of evidence: </strong>Level 1; Symptom Prevalence Study.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127156","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 : 2024-08-26DOI: 10.1016/j.surge.2024.08.011
Michael El Boghdady
{"title":"Surgical procedures performed by non-medical practitioners, reviewing the era of the barber-surgeon","authors":"Michael El Boghdady","doi":"10.1016/j.surge.2024.08.011","DOIUrl":"10.1016/j.surge.2024.08.011","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 6","pages":"Pages e238-e239"},"PeriodicalIF":2.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074345","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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