Surgical Practice最新文献

Patients with long-segment tracheal defects, deemed technically inoperable, constitute a population in critical need of airway replacement. Regardless of the underlying cause—be it benign or malignant processes—this patient category requires either a tracheal transplant or admission to a palliative care facility. Despite over 50 years of exploration in thoracic surgery and regenerative medicine, airway transplantation remains a significant challenge. Various tracheobronchial substitutes, such as synthetic prostheses, bioprostheses, allografts, autografts, and bioengineered conduits, have been experimentally tested, yet none have provided a standardized method for airway replacement. Aortic grafts were suggested by Aortic grafts have been suggested as a biological matrix for extensive airway reconstruction as a biological matrix for extensive airway reconstruction. Cryopreserved aortic allografts, because of their availability in tissue banks and the lack of need for immunosuppressive therapy, were first used in clinical applications. The TRITON-01 study (NCT04263129) focuses on patients who received airway replacement to determine the routine applicability of this novel approach. The primary objective of this review is to provide information on advancements in the use of aortic allografts as tracheal replacements.

Liver transplantation (LT) remains the most effective treatment for end-stage liver disease. However, there continues to be a severe shortage of liver donors worldwide, resulting in a significant disparity between the number of patients on the liver transplant waiting list and the available donor organs. Split liver transplantation (SLT) enables a single whole liver graft to be divided into two partial grafts, which can then be transplanted into two recipients. This approach expands the pool of available liver donors and reduces the waiting time for LT. Since its inception, SLT has undergone continuous development and research. As a complex variant of LT, SLT requires a high level of surgical expertise, and many aspects of SLT have not yet reached a consensus or clear definition within the transplantation community. In addition, it represents a smaller proportion among all LT techniques, which hampers the further development of SLT technology. This review concludes recent developments in SLT, offering a comprehensive summary of current practices regarding donor selection criteria, surgical techniques, and clinical outcomes. Its purpose is to serve as a reference for real clinical scenarios and explore potential future trends in SLT.

Phyllodes tumours (PTs) of the breasts are rare fibroepithelial tumours accounting for less than 1% of all breast tumours. They have a wide range of presentations, ranging from benign-natured tumours that behave similarly to fibroadenomas, to aggressive malignant tumours that can rapidly advance both locally and distally. Histologically, PTs are classified into benign, borderline, or malignant based on a combination of the following five features: degree of stromal cellularity, stromal cell atypia, mitotic activity, infiltrative or circumscribed margins, and presence or absence of stromal overgrowth. Malignant tumours demonstrate high levels of stromal cellularity and atypia, infiltrative margins, high mitotic rate (>10 mitoses per 10 high-power fields), and the presence of stromal overgrowth. Treatment predominantly relies on complete excision of the lesion, although treatment regimens for malignant PTs with adjuvant chemoradiation lack standardization as a result of its rarity. Malignant tumours are also often associated with paraneoplastic syndromes such as recurrent hypoglycaemia and hypertrophic osteoarthropathy. Here, we report a case of recurrent malignant PT with serum beta-human chorionic gonadotrophin secretion.