{"title":"Comments on ‘Extraperitoneal sigmoidopexy versus sigmoidectomy for sigmoid volvulus: A prospective comparative study’","authors":"Sabri Selcuk Atamanalp, Esra Disci, Rifat Peksoz","doi":"10.1111/1744-1633.12717","DOIUrl":"https://doi.org/10.1111/1744-1633.12717","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"227-228"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116082","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}
{"title":"Surgical Practice August 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12731","DOIUrl":"https://doi.org/10.1111/1744-1633.12731","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"244-245"},"PeriodicalIF":0.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116623","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 diced cartilage has become increasingly popular in rhinoplasty; however, the viability of the graft can vary. This study aimed to investigate the use of fillers for diced cartilage, evaluate their morphology and viability, and provide a foundation for their clinical use. Six rabbits were used in this experiment. Ear cartilage was excised and diced into pieces and mixed with different fillers, including collagen (COLD), hyaluronic acid (HAD), and normal saline (NSD), or used alone (COND) as a control. They were embedded in the backs of rabbits. After 3 months, the weight and volume of grafts were measured. The cellular viability and morphology were assessed. The HAD group showed the most significant volume change, followed by the NSD group. There was no significant weight change between the COLD and COND groups. Grossly, the COLD group appeared as a smooth block, while the COND and NSD groups appeared rough. Microscopically, fibrous tissue and collagen were arranged regularly in the COLD and HAD groups, and chondrocytes were arranged neatly. By contrast, collagen was less and arranged messily in the NSD and COND groups. There was better cell viability and angiogenesis around cartilage in the COLD group than in the HAD and NSD groups. When mixed with collagen, diced cartilage can maintain its basic shape and smooth appearance, and there is better cell viability and angiogenesis than when mixed with hyaluronic acid or normal saline, or used alone. These findings may provide implications for the clinical use of diced cartilage as injectable implants.
{"title":"Collagen enhances stability and viability of diced cartilage as an injectable implant: An experimental study in rabbits","authors":"Yanghonghong Fei, Shengxian Shen, Zhao Chen, Wenjia Lv, Haishan Lu, Lina Shi, Xudong Hong, Jian Jin","doi":"10.1111/1744-1633.12732","DOIUrl":"https://doi.org/10.1111/1744-1633.12732","url":null,"abstract":"<p>The use of diced cartilage has become increasingly popular in rhinoplasty; however, the viability of the graft can vary. This study aimed to investigate the use of fillers for diced cartilage, evaluate their morphology and viability, and provide a foundation for their clinical use. Six rabbits were used in this experiment. Ear cartilage was excised and diced into pieces and mixed with different fillers, including collagen (COLD), hyaluronic acid (HAD), and normal saline (NSD), or used alone (COND) as a control. They were embedded in the backs of rabbits. After 3 months, the weight and volume of grafts were measured. The cellular viability and morphology were assessed. The HAD group showed the most significant volume change, followed by the NSD group. There was no significant weight change between the COLD and COND groups. Grossly, the COLD group appeared as a smooth block, while the COND and NSD groups appeared rough. Microscopically, fibrous tissue and collagen were arranged regularly in the COLD and HAD groups, and chondrocytes were arranged neatly. By contrast, collagen was less and arranged messily in the NSD and COND groups. There was better cell viability and angiogenesis around cartilage in the COLD group than in the HAD and NSD groups. When mixed with collagen, diced cartilage can maintain its basic shape and smooth appearance, and there is better cell viability and angiogenesis than when mixed with hyaluronic acid or normal saline, or used alone. These findings may provide implications for the clinical use of diced cartilage as injectable implants.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"79-85"},"PeriodicalIF":0.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308798","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}
To explore the potential and accuracy of the generative dialogue artificial intelligence tool GPT-4.0 in answering questions related to paediatric emergency appendicitis.
Methods
A cross-sectional observational study design was used. We collected 134 appendicitis-related questions from authoritative websites, such as Mayo Medical and APSA, covering all aspects of appendicitis, including simple and complex questions. These questions were answered by GPT-4.0, and then evaluated by three paediatric surgical experts using a quality score ranging from 0 to 5. The answers were generated by GPT-4.0 and then similarly evaluated by three experts for accuracy.
Results
We found that GPT-4.0 could achieve a high accuracy rate on simple questions with a quality score of 4.65 (standard deviation 0.51). For complex questions, the average score was 3.77 (standard deviation 0.68), and there was a significant difference between the two (P < .05). On clinical questions, the accuracy score of GPT-4.0 was 4.00 (standard deviation 0.21). When answering actual questions from families of children with appendicitis, the accuracy score was 4.12 (standard deviation 0.59). Its accuracy lies between simple questions and complex questions, and it can basically meet the accuracy requirements of clinical questions. It's worth noting that GPT-4.0 demonstrated empathy in answering some questions, which might further enhance patient satisfaction.
Conclusion
GPT-4.0 showed its potential and accuracy in handling paediatric appendicitis questions, especially in simple and clinical questions. However, improvements are still needed in handling complex questions and updating information. Despite the limitations, this model is expected to improve the quality of medical services and enhance patient satisfaction.
{"title":"Exploring GPT-4.0's efficiency in handling paediatric appendicitis questions","authors":"Defeng Zeng, Guoqiang Chen, Guoyong Wang, Hai Zhou MD, PhD, Chunbao Guo MD, PhD","doi":"10.1111/1744-1633.12733","DOIUrl":"https://doi.org/10.1111/1744-1633.12733","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the potential and accuracy of the generative dialogue artificial intelligence tool GPT-4.0 in answering questions related to paediatric emergency appendicitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional observational study design was used. We collected 134 appendicitis-related questions from authoritative websites, such as Mayo Medical and APSA, covering all aspects of appendicitis, including simple and complex questions. These questions were answered by GPT-4.0, and then evaluated by three paediatric surgical experts using a quality score ranging from 0 to 5. The answers were generated by GPT-4.0 and then similarly evaluated by three experts for accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that GPT-4.0 could achieve a high accuracy rate on simple questions with a quality score of 4.65 (standard deviation 0.51). For complex questions, the average score was 3.77 (standard deviation 0.68), and there was a significant difference between the two (<i>P</i> < .05). On clinical questions, the accuracy score of GPT-4.0 was 4.00 (standard deviation 0.21). When answering actual questions from families of children with appendicitis, the accuracy score was 4.12 (standard deviation 0.59). Its accuracy lies between simple questions and complex questions, and it can basically meet the accuracy requirements of clinical questions. It's worth noting that GPT-4.0 demonstrated empathy in answering some questions, which might further enhance patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GPT-4.0 showed its potential and accuracy in handling paediatric appendicitis questions, especially in simple and clinical questions. However, improvements are still needed in handling complex questions and updating information. Despite the limitations, this model is expected to improve the quality of medical services and enhance patient satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"13-18"},"PeriodicalIF":0.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707491","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}
Paul Munguakonkwa Budema, Jean de Dieu Tumusifu Manegabe, Victoire Urbain Hatu'm, Fabrice Cikomola Gulimwentuga, Georges Kuyigwa Toha, Olivier Mukuku, Zacharie Kibendelwa Tsongo, Theophile Barhwamire Kabesha, Stanislas Okitotsho Wembonyama
Background
Survivors of gunshot injuries are at high risk of developing infections at the injury site. However, data on gunshot wound infections and their associated burdens are limited. This study aims to determine the prevalence of gunshot wound infections and identify the risk factors associated with them in a tertiary hospital located in the eastern part of the Democratic Republic of the Congo.
Materials and Methods
This retrospective observational study was conducted at the Provincial General Reference Hospital of Bukavu in the Democratic Republic of the Congo, reviewing data from patients hospitalised between January 1, 2019, and December 31, 2020.
Results
A total of 549 patients were included in the study, with wound infections occurring in 26.6% of cases. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [CI] 1.12–2.92; P = .0146), nerve damage (aOR = 2.65; 95% CI 1.70–4.14; P < .0001), trunk injuries (aOR = 5.64; 95% CI 2.61–12.16; P < .0001), lower extremity injuries (aOR = 2.71; 95% CI 1.39–5.28; P = .0034), and multiple injuries (>2; aOR = 2.35; 95% CI 1.05–5.25; P = .0378) as independent predictors of gunshot wound infection.
Conclusion
The main factors predisposing gunshot wounds to infection, identified in this study, require thorough evaluation and urgent management. In cases of abdominal gunshot trauma, fractures, and vascular or nerve lesions, management procedures are aimed at reducing the infection burden.
枪伤幸存者在受伤部位发生感染的风险很高。然而，枪伤感染及其相关负担的数据有限。本研究旨在确定位于刚果民主共和国东部的一家三级医院枪伤感染的流行情况，并确定与之相关的危险因素。本回顾性观察性研究在刚果民主共和国布卡武省综合参考医院进行，回顾了2019年1月1日至2020年12月31日住院患者的数据。结果共纳入549例患者，伤口感染发生率为26.6%。多因素logistic回归分析发现骨折(校正优势比[aOR] = 1.81；95%置信区间[CI] 1.12-2.92；P = 0.0146)，神经损伤(aOR = 2.65；95% ci 1.70-4.14；P < .0001)，躯干损伤(aOR = 5.64；95% ci 2.61-12.16；P < .0001)，下肢损伤(aOR = 2.71；95% ci 1.39-5.28；P = 0.0034)，多发损伤(>2；aOR = 2.35；95% ci 1.05-5.25；P = .0378)作为枪伤感染的独立预测因子。结论本研究确定的枪伤感染的主要易感因素需要深入评估和紧急处理。在腹部枪伤、骨折和血管或神经损伤的病例中，管理程序旨在减少感染负担。
{"title":"Prevalence and risk factors of gunshot wound infection in the eastern Democratic Republic of the Congo: A hospital-based cross-sectional study","authors":"Paul Munguakonkwa Budema, Jean de Dieu Tumusifu Manegabe, Victoire Urbain Hatu'm, Fabrice Cikomola Gulimwentuga, Georges Kuyigwa Toha, Olivier Mukuku, Zacharie Kibendelwa Tsongo, Theophile Barhwamire Kabesha, Stanislas Okitotsho Wembonyama","doi":"10.1111/1744-1633.12735","DOIUrl":"https://doi.org/10.1111/1744-1633.12735","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Survivors of gunshot injuries are at high risk of developing infections at the injury site. However, data on gunshot wound infections and their associated burdens are limited. This study aims to determine the prevalence of gunshot wound infections and identify the risk factors associated with them in a tertiary hospital located in the eastern part of the Democratic Republic of the Congo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective observational study was conducted at the Provincial General Reference Hospital of Bukavu in the Democratic Republic of the Congo, reviewing data from patients hospitalised between January 1, 2019, and December 31, 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 549 patients were included in the study, with wound infections occurring in 26.6% of cases. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [CI] 1.12–2.92; <i>P</i> = .0146), nerve damage (aOR = 2.65; 95% CI 1.70–4.14; <i>P</i> < .0001), trunk injuries (aOR = 5.64; 95% CI 2.61–12.16; <i>P</i> < .0001), lower extremity injuries (aOR = 2.71; 95% CI 1.39–5.28; <i>P</i> = .0034), and multiple injuries (>2; aOR = 2.35; 95% CI 1.05–5.25; <i>P</i> = .0378) as independent predictors of gunshot wound infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The main factors predisposing gunshot wounds to infection, identified in this study, require thorough evaluation and urgent management. In cases of abdominal gunshot trauma, fractures, and vascular or nerve lesions, management procedures are aimed at reducing the infection burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"19-25"},"PeriodicalIF":0.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707194","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}
Wang-Lin Ng MBBS, MRCSEd, Man-Hin Chan FRCSEd (ORL), FHKCORL, FHKAM (Otorhinolaryngology), Ka-Chun Wong FRCSEd (ORL), FHKCORL, FHKAM (Otorhinolaryngology)
We herein report a rare case of benign lateral neck ectopic thyroid tissue that presentation micmicked cerivcal lymph node metastasis of follicular thyroid cancer and discuss its management pearl.
Christos K. Stefanou, Stefanos K. Stefanou, Kostas Tepelenis, Theocharis Chatzoglou, Thomas Iraklis Smyris, Marini Aikaterini, Alexandra Barbouti, Dimitrios N. Varvarousis, Panagiotis Kanavaros, Panagiotis Kitsoulis
Transanal total mesorectal excision (TaTME) has emerged as a surgical method for treating rectal malignancies in the middle and lower third of the rectum over the past 15 years. This approach was adopted because of the challenges encountered in secure total mesorectal excision (TME). Patient selection criteria and the rationale for TaTME have evolved, leading to improved oncological outcomes and patient quality of life. The procedure includes inserting a unique platform through the anus, forming a purse-string closure, and endoscopically sealing the lower rectum. The mesorectum is then removed laparoscopically following a ‘down-to-up’ approach, finalised with a transabdominal laparoscopic phase and anastomosis. Pelvic anatomy complexity poses challenges, including potential injuries to the urinary tract, surgical site leakage, sinus damage, sagittal vein harm, nerve injury, carbon dioxide embolism, bowel function disturbance, sphincter mechanism issues, and rectal abscess formation. Proficient anatomy knowledge, precise surgical techniques, and advanced technologies contribute to their prevention. In conclusion, TaTME offers a promising approach to rectal surgery with satisfactory oncological outcomes. However, vigilance is required to eliminate potential complications.
{"title":"Transanal total mesorectal excision: Understanding indications, managing complications, and effective prevention methods","authors":"Christos K. Stefanou, Stefanos K. Stefanou, Kostas Tepelenis, Theocharis Chatzoglou, Thomas Iraklis Smyris, Marini Aikaterini, Alexandra Barbouti, Dimitrios N. Varvarousis, Panagiotis Kanavaros, Panagiotis Kitsoulis","doi":"10.1111/1744-1633.12730","DOIUrl":"https://doi.org/10.1111/1744-1633.12730","url":null,"abstract":"<p>Transanal total mesorectal excision (TaTME) has emerged as a surgical method for treating rectal malignancies in the middle and lower third of the rectum over the past 15 years. This approach was adopted because of the challenges encountered in secure total mesorectal excision (TME). Patient selection criteria and the rationale for TaTME have evolved, leading to improved oncological outcomes and patient quality of life. The procedure includes inserting a unique platform through the anus, forming a purse-string closure, and endoscopically sealing the lower rectum. The mesorectum is then removed laparoscopically following a ‘down-to-up’ approach, finalised with a transabdominal laparoscopic phase and anastomosis. Pelvic anatomy complexity poses challenges, including potential injuries to the urinary tract, surgical site leakage, sinus damage, sagittal vein harm, nerve injury, carbon dioxide embolism, bowel function disturbance, sphincter mechanism issues, and rectal abscess formation. Proficient anatomy knowledge, precise surgical techniques, and advanced technologies contribute to their prevention. In conclusion, TaTME offers a promising approach to rectal surgery with satisfactory oncological outcomes. However, vigilance is required to eliminate potential complications.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 4","pages":"219-226"},"PeriodicalIF":0.3,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120140","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}
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