Pub Date : 2024-08-01Epub Date: 2024-01-17DOI: 10.1080/00015458.2024.2304386
Van Zande Jaro, Krick Marc, Willaert Bart, Van Den Heede Klaas
Objective: Robot-assisted ventral hernia repair (RVHR) has become a feasible alternative for open ventral hernia repair showing fewer postoperative complications and satisfying short-term results. However, long-term results are scarce in current literature.
Methods: All consecutive patients who underwent robot-assisted surgery for ventral hernias from June 2018 until February 2023 were included. Patient records were retrospectively reviewed for indication, need for conversion, length of stay (LOS), postoperative complications, and postoperative pain.In addition, long-term (>24 months) results (recurrence, chronic pain, and esthetic satisfaction) were assessed by phone questionnaire.
Results: In total, 177 patients underwent a robot-assisted ventral hernia repair. Indication for surgery was incisional hernia (N = 109) and primary hernia (N = 68), including 124 cases with abdominal rectus diastasis. A TransAbdominal Retromuscular Umbilical Prosthesis (TARUP) was performed in 138 patients. Robotic Transversus Abdominis Release (TAR) and Extended Totally Extraperitoneal Repair (eTEP) were performed in 20 (11%) and 9 (5%) cases, respectively.Median LOS was 2 days for TARUP and 3.5 days for TAR. Minor complications occurred in 22 patients (16 TARUP, 5 TAR, 1 eTEP). The average pain score on the first postoperative day was 1.8/10. No risk factors for morbidity could be identified by uni- and multivariable analysis.Hernia recurrence developed in four (2%) patients. Chronic pain was reported in two (1%) cases. Seven (4%) patients had esthetic complaints.
Conclusion: Robot-assisted ventral hernia repair is a safe procedure with low postoperative pain and short LOS. Long-term results including recurrence and chronic pain are satisfying.
{"title":"Five years of robot-assisted ventral hernia repair: initial experience and surgical outcome.","authors":"Van Zande Jaro, Krick Marc, Willaert Bart, Van Den Heede Klaas","doi":"10.1080/00015458.2024.2304386","DOIUrl":"10.1080/00015458.2024.2304386","url":null,"abstract":"<p><strong>Objective: </strong>Robot-assisted ventral hernia repair (RVHR) has become a feasible alternative for open ventral hernia repair showing fewer postoperative complications and satisfying short-term results. However, long-term results are scarce in current literature.</p><p><strong>Methods: </strong>All consecutive patients who underwent robot-assisted surgery for ventral hernias from June 2018 until February 2023 were included. Patient records were retrospectively reviewed for indication, need for conversion, length of stay (LOS), postoperative complications, and postoperative pain.In addition, long-term (>24 months) results (recurrence, chronic pain, and esthetic satisfaction) were assessed by phone questionnaire.</p><p><strong>Results: </strong>In total, 177 patients underwent a robot-assisted ventral hernia repair. Indication for surgery was incisional hernia (<i>N</i> = 109) and primary hernia (<i>N</i> = 68), including 124 cases with abdominal rectus diastasis. A TransAbdominal Retromuscular Umbilical Prosthesis (TARUP) was performed in 138 patients. Robotic Transversus Abdominis Release (TAR) and Extended Totally Extraperitoneal Repair (eTEP) were performed in 20 (11%) and 9 (5%) cases, respectively.Median LOS was 2 days for TARUP and 3.5 days for TAR. Minor complications occurred in 22 patients (16 TARUP, 5 TAR, 1 eTEP). The average pain score on the first postoperative day was 1.8/10. No risk factors for morbidity could be identified by uni- and multivariable analysis.Hernia recurrence developed in four (2%) patients. Chronic pain was reported in two (1%) cases. Seven (4%) patients had esthetic complaints.</p><p><strong>Conclusion: </strong>Robot-assisted ventral hernia repair is a safe procedure with low postoperative pain and short LOS. Long-term results including recurrence and chronic pain are satisfying.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139401376","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 : 2024-08-01Epub Date: 2023-07-26DOI: 10.1080/00015458.2023.2239550
Muhammet Ali Beyoglu, Mehmet Furkan Sahin, Muhammet Fethi Saglam, Huseyin Unsal Ercelik, Servet Guresci, Erdal Yekeler
Introduction: Myxofibrosarcoma usually occurs in the extremities of middle-aged to older adults. Metastatic myxofibrosarcomas generally emerge in the lung. In this case report, we aim to present a case of primary pulmonary myxofibrosarcoma with tumor thrombus extending into the left atrium without pulmonary vein or atrial invasion.
Case presentation: A 55-year-old male who was being followed up due to a pulmonary nodule presented with a mass extending from the left lower lobe to the left atrium. No extrathoracic malignancy was detected in the pre-operative examination. The mass extending into the left atrium without invasion was excised with the lower lobe of the left lung. A post-operative histopathological examination revealed myxofibrosarcoma.
Conclusion: Very few cases of cervical, thoracic wall, mediastinum and cardiac primary myxofibrosarcoma have been documented, and to the best of our knowledge, only one primary pulmonary myxofibrosarcoma case has previously been reported in the English literature. Here, we present a case of primary pulmonary myxofibrosarcoma that extended to the left atrium through the pulmonary vein. In such rare clinical presentations, intracardiac tumor resection should precede pulmonary resection due to the possibility of catastrophic tumor embolisms.
{"title":"A pulmonary mass extending into the left atrium through the pulmonary vein: a rare diagnosis with an unusual origin.","authors":"Muhammet Ali Beyoglu, Mehmet Furkan Sahin, Muhammet Fethi Saglam, Huseyin Unsal Ercelik, Servet Guresci, Erdal Yekeler","doi":"10.1080/00015458.2023.2239550","DOIUrl":"10.1080/00015458.2023.2239550","url":null,"abstract":"<p><strong>Introduction: </strong>Myxofibrosarcoma usually occurs in the extremities of middle-aged to older adults. Metastatic myxofibrosarcomas generally emerge in the lung. In this case report, we aim to present a case of primary pulmonary myxofibrosarcoma with tumor thrombus extending into the left atrium without pulmonary vein or atrial invasion.</p><p><strong>Case presentation: </strong>A 55-year-old male who was being followed up due to a pulmonary nodule presented with a mass extending from the left lower lobe to the left atrium. No extrathoracic malignancy was detected in the pre-operative examination. The mass extending into the left atrium without invasion was excised with the lower lobe of the left lung. A post-operative histopathological examination revealed myxofibrosarcoma.</p><p><strong>Conclusion: </strong>Very few cases of cervical, thoracic wall, mediastinum and cardiac primary myxofibrosarcoma have been documented, and to the best of our knowledge, only one primary pulmonary myxofibrosarcoma case has previously been reported in the English literature. Here, we present a case of primary pulmonary myxofibrosarcoma that extended to the left atrium through the pulmonary vein. In such rare clinical presentations, intracardiac tumor resection should precede pulmonary resection due to the possibility of catastrophic tumor embolisms.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228123","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 : 2024-08-01Epub Date: 2023-12-26DOI: 10.1080/00015458.2023.2298097
Alan M Houben, Margaux Crepy, Marc Senard, Vincent Bonhomme, Vincent Tchana-Sato, Gregory Hans
Background: The risks and benefits of preoperative aspirin continuation in patients undergoing isolated heart valve replacement surgery are unclear. We investigated the effect of aspirin continuation on the risk of bleeding and transfusion in these patients.
Methods: In this single center, retrospective study, among 474 adult patients who underwent isolated heart valve surgery between April 2013 and June 2018, 269 continued aspirin within 5 days before surgery (aspirin group) and 205 patients did not take or stopped aspirin no later than 5 days before surgery (non-aspirin group). The chi-square test, the Mann-Whitney U-test, and the Student's T-test were used to compare data between the groups. Univariate and Multivariate logistic regressions were used to assess crude and adjusted relationships between outcome and exposure.
Results: The primary outcome, red blood cell (RBC) transfusion, occurred in 59 patients (22%) of the aspirin group and in 24 patients (12%) of the non-aspirin group (p = 0.004). After adjustment for confounding factors, continuation of aspirin was no longer associated with RBC transfusion (aOR1.8;95%CI,0.98-3.2;p = 0.06). The amount of allogenic blood products, the incidence of surgical re-exploration for bleeding, the volume of re-transfused cell-saved blood, and the cumulative chest tube drainage during the first 24 postoperative hours were similar between groups.
Conclusion: Preoperative continuation of aspirin in patients undergoing isolated heart valve surgery is neither associated with a higher incidence of RBC transfusion, nor with larger perioperative blood loss, or more frequent surgical revision for bleeding.
背景:接受孤立心脏瓣膜置换手术的患者术前继续服用阿司匹林的风险和益处尚不明确。我们研究了继续服用阿司匹林对这些患者出血和输血风险的影响:在这项单中心回顾性研究中,2013年4月至2018年6月期间接受孤立心脏瓣膜手术的474名成年患者中,269名患者在术前5天内继续服用阿司匹林(阿司匹林组),205名患者在术前5天内未服用或停止服用阿司匹林(非阿司匹林组)。组间数据比较采用卡方检验、曼-惠特尼 U 检验和学生 T 检验。采用单变量和多变量逻辑回归评估结果与暴露之间的粗略关系和调整关系:主要结果是阿司匹林组的 59 名患者(22%)和非阿司匹林组的 24 名患者(12%)输注了红细胞(RBC)(P = 0.004)。调整混杂因素后,继续服用阿司匹林与输注红细胞不再相关(aOR1.8;95%CI,0.98-3.2;p = 0.06)。两组患者的异体血制品用量、因出血而再次手术的发生率、再次输注的细胞保存血量以及术后 24 小时内累计胸管引流量相似:结论:接受孤立心脏瓣膜手术的患者术前继续服用阿司匹林既不会导致输注红细胞的发生率升高,也不会导致围手术期失血量增加或因出血而更频繁地进行手术翻修:试验注册:Clinicaltrials.gov (NCT05151796)。
{"title":"Preoperative continuation of aspirin before isolated heart valve surgery and postoperative bleeding and transfusion: a single-center retrospective study.","authors":"Alan M Houben, Margaux Crepy, Marc Senard, Vincent Bonhomme, Vincent Tchana-Sato, Gregory Hans","doi":"10.1080/00015458.2023.2298097","DOIUrl":"10.1080/00015458.2023.2298097","url":null,"abstract":"<p><strong>Background: </strong>The risks and benefits of preoperative aspirin continuation in patients undergoing isolated heart valve replacement surgery are unclear. We investigated the effect of aspirin continuation on the risk of bleeding and transfusion in these patients.</p><p><strong>Methods: </strong>In this single center, retrospective study, among 474 adult patients who underwent isolated heart valve surgery between April 2013 and June 2018, 269 continued aspirin within 5 days before surgery (aspirin group) and 205 patients did not take or stopped aspirin no later than 5 days before surgery (non-aspirin group). The chi-square test, the Mann-Whitney <i>U</i>-test, and the Student's <i>T</i>-test were used to compare data between the groups. Univariate and Multivariate logistic regressions were used to assess crude and adjusted relationships between outcome and exposure.</p><p><strong>Results: </strong>The primary outcome, red blood cell (RBC) transfusion, occurred in 59 patients (22%) of the aspirin group and in 24 patients (12%) of the non-aspirin group (<i>p</i> = 0.004). After adjustment for confounding factors, continuation of aspirin was no longer associated with RBC transfusion (aOR1.8;95%CI,0.98-3.2;<i>p</i> = 0.06). The amount of allogenic blood products, the incidence of surgical re-exploration for bleeding, the volume of re-transfused cell-saved blood, and the cumulative chest tube drainage during the first 24 postoperative hours were similar between groups.</p><p><strong>Conclusion: </strong>Preoperative continuation of aspirin in patients undergoing isolated heart valve surgery is neither associated with a higher incidence of RBC transfusion, nor with larger perioperative blood loss, or more frequent surgical revision for bleeding.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT05151796).</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037299","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}
Background: We conducted a systematic review to assess the safety and efficacy of Aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for the treatment of hemorrhoidal disease.
Methods: Our study was conducted in accordance with the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020. Primary endpoints included overall recurrence and type of recurrence while secondary endpoints included postoperative complications, reintervention, presence of rectal ulcer, rectal stricture, defecation abnormalities and perianal abscess. Α regression analysis, where the percentage of patients with grade II, III and IV hemorrhoidal disease was used as a covariate, was also performed.
Results: Twelve studies with 4249 patients met all the inclusion criteria and were eventually included. The crude and pooled estimates of the overall recurrence and complications by the end of follow-up were 10% (95% CI, 6.52%-14.08%) and 5.20% (95% CI, 2.59%-8.52%), respectively. Regression analysis displayed no correlation between recurrence and the grade of hemorrhoid disease II, β= -0.0012 (95% CI, -0.0074 to 0.0049) (p = .64), grade III β= -0.0006 (95% CI, -0.0056 to 0.0045) (p = .79) and grade IV β = 0.0025 (95% CI, -0.0075 to 0.0124). However, a trend suggestive of increased recurrence was observed in patient populations with a higher proportion of grade IV disease.
Conclusion: ALTA sclerotherapy may be a safe and viable alternative for patients with hemorrhoidal disease. Long-term follow-up and high-quality randomized controlled trials will help define the place of ALTA sclerotherapy in the armamentarium of treatment of hemorrhoids.
背景:我们对硫酸铝钾和鞣酸(ALTA)硬化剂疗法治疗痔疮的安全性和有效性进行了系统回顾:我们进行了一项系统综述,以评估硫酸铝钾和鞣酸(ALTA)硬化疗法治疗痔疮疾病的安全性和有效性:我们的研究是根据2020年PRISMA声明(系统综述和元分析首选报告项目)进行的。主要终点包括总复发率和复发类型,次要终点包括术后并发症、再次干预、直肠溃疡、直肠狭窄、排便异常和肛周脓肿。此外,还进行了Α回归分析,将II级、III级和IV级痔疮患者的百分比作为协变量:共有 12 项研究、4249 名患者符合所有纳入标准,最终被纳入研究。随访结束时的总复发率和并发症的粗略估计值和汇总估计值分别为 10%(95% CI,6.52% - 14.08%)和 5.20%(95% CI,2.59% - 8.52%)。回归分析表明,复发与痔疮疾病等级之间没有相关性,II级β= -0.0012 (95% CI, -0.0074 to 0.0049) (p = 0.64),III级β= -0.0006 (95% CI, -0.0056 to 0.0045) (p = 0.79),IV级β= 0.0025 (95% CI, -0.0075 to 0.0124)。然而,在IV级疾病比例较高的患者群体中观察到复发率增加的趋势:结论:对于痔疮患者来说,ALTA硬化疗法可能是一种安全可行的替代疗法。长期随访和高质量的随机对照试验将有助于确定 ALTA 硬化剂注射疗法在痔疮治疗中的地位。
{"title":"Aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for hemorrhoidal disease: a systematic review and meta-analysis.","authors":"Vasiliki Manaki, Vangelis Bontinis, Alkis Bontinis, Argirios Giannopoulos, Ioannis Kontes, Angeliki Chorti, Kiriakos Ktenidis","doi":"10.1080/00015458.2024.2326273","DOIUrl":"10.1080/00015458.2024.2326273","url":null,"abstract":"<p><strong>Background: </strong>We conducted a systematic review to assess the safety and efficacy of Aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for the treatment of hemorrhoidal disease.</p><p><strong>Methods: </strong>Our study was conducted in accordance with the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020. Primary endpoints included overall recurrence and type of recurrence while secondary endpoints included postoperative complications, reintervention, presence of rectal ulcer, rectal stricture, defecation abnormalities and perianal abscess. Α regression analysis, where the percentage of patients with grade II, III and IV hemorrhoidal disease was used as a covariate, was also performed.</p><p><strong>Results: </strong>Twelve studies with 4249 patients met all the inclusion criteria and were eventually included. The crude and pooled estimates of the overall recurrence and complications by the end of follow-up were 10% (95% CI, 6.52%-14.08%) and 5.20% (95% CI, 2.59%-8.52%), respectively. Regression analysis displayed no correlation between recurrence and the grade of hemorrhoid disease II, β= -0.0012 (95% CI, -0.0074 to 0.0049) (<i>p</i> = .64), grade III β= -0.0006 (95% CI, -0.0056 to 0.0045) (<i>p</i> = .79) and grade IV β = 0.0025 (95% CI, -0.0075 to 0.0124). However, a trend suggestive of increased recurrence was observed in patient populations with a higher proportion of grade IV disease.</p><p><strong>Conclusion: </strong>ALTA sclerotherapy may be a safe and viable alternative for patients with hemorrhoidal disease. Long-term follow-up and high-quality randomized controlled trials will help define the place of ALTA sclerotherapy in the armamentarium of treatment of hemorrhoids.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140011902","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 : 2024-08-01Epub Date: 2024-02-29DOI: 10.1080/00015458.2024.2321557
Jian Liu, Bicheng Zhan, Zhiping Chen, Jian Chen
Background: Displaced posterior segmental bronchus (B2) accompanied by anomalous pulmonary vessels is a very rare condition. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer, especially thoracoscopic surgery.
Methods: We reported a case of thoracoscopic right upper lobectomy in a patient with a displaced B2 and pulmonary vascular variation.
Results: A 74-year-old woman was admitted to our hospital with a 2.2 cm × 2.1 cm nodule in the right lung. Three-dimensional computed tomography (3D-CT) revealed the combined apical/anterior segmental branch (B1 + 3) taken off the beginning of the right main bronchus (RMB), at the level of the carina. The displaced B2 taken off the end of the RMB. The anomalous central vein (CV), which passed between B2 and B1 + 3, ran dorsal to the main pulmonary artery (MPA) and directly into the left atrium. The patient consequently underwent uniportal thoracoscopic right upper lobectomy and mediastinal lymph node dissection. The intraoperative findings were completely consistent with 3D-CT.
Conclusions: This paper reports a case of a displaced B2 combined with right upper pulmonary vessels malformation. Under the guidance of 3D-CT, the right upper lobectomy was successfully completed by single hole thoracoscopic surgery.
{"title":"Thoracoscopic right upper lobectomy in a patient with displaced posterior segmental bronchus and vascular abnormalities: a case report.","authors":"Jian Liu, Bicheng Zhan, Zhiping Chen, Jian Chen","doi":"10.1080/00015458.2024.2321557","DOIUrl":"10.1080/00015458.2024.2321557","url":null,"abstract":"<p><strong>Background: </strong>Displaced posterior segmental bronchus (B<sup>2</sup>) accompanied by anomalous pulmonary vessels is a very rare condition. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer, especially thoracoscopic surgery.</p><p><strong>Methods: </strong>We reported a case of thoracoscopic right upper lobectomy in a patient with a displaced B<sup>2</sup> and pulmonary vascular variation.</p><p><strong>Results: </strong>A 74-year-old woman was admitted to our hospital with a 2.2 cm × 2.1 cm nodule in the right lung. Three-dimensional computed tomography (3D-CT) revealed the combined apical/anterior segmental branch (B<sup>1 + 3</sup>) taken off the beginning of the right main bronchus (RMB), at the level of the carina. The displaced B<sup>2</sup> taken off the end of the RMB. The anomalous central vein (CV), which passed between B<sup>2</sup> and B<sup>1 + 3</sup>, ran dorsal to the main pulmonary artery (MPA) and directly into the left atrium. The patient consequently underwent uniportal thoracoscopic right upper lobectomy and mediastinal lymph node dissection. The intraoperative findings were completely consistent with 3D-CT.</p><p><strong>Conclusions: </strong>This paper reports a case of a displaced B<sup>2</sup> combined with right upper pulmonary vessels malformation. Under the guidance of 3D-CT, the right upper lobectomy was successfully completed by single hole thoracoscopic surgery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929470","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 : 2024-08-01Epub Date: 2023-07-10DOI: 10.1080/00015458.2023.2234146
Sebastien Michiels, Jean-Luc Engelholm
Background: Laparoscopic adjustable gastric banding (LAGB) has been widely performed in the past, however, given its limited weight loss compared to some other procedures, this technique is less often used. Furthermore, a number of complications leading to band removal have been reported in the past few years.
Methods: We present a late acute bowel obstruction by sigmoid strangulation in a female patient with the LAGB performed 15 years ago.
Results: The laparoscopic exploration displayed a post-LAGB intestinal strangulation of the sigmoid loop which was caused by the connecting tube. Since the bowel was still viable, the tube was cut and the obstruction has been successfully resolved. The patient was discharged three days after the surgery.
Conclusion: Although less often performed, knowledge of LAGB complications can be of importance. We believe that, the present strangulation of the sigmoid by the LAGB tubing is the world's first ever case reported. Nevertheless, when it is still proposed to selected patients, an adequate length of the intra-abdominal tubing could reduce the risk of loop formation and prevent this kind of obstruction by internal hernia.
{"title":"Bowel obstruction by sigmoid strangulation as complication after laparoscopic adjustable gastric banding.","authors":"Sebastien Michiels, Jean-Luc Engelholm","doi":"10.1080/00015458.2023.2234146","DOIUrl":"10.1080/00015458.2023.2234146","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic adjustable gastric banding (LAGB) has been widely performed in the past, however, given its limited weight loss compared to some other procedures, this technique is less often used. Furthermore, a number of complications leading to band removal have been reported in the past few years.</p><p><strong>Methods: </strong>We present a late acute bowel obstruction by sigmoid strangulation in a female patient with the LAGB performed 15 years ago.</p><p><strong>Results: </strong>The laparoscopic exploration displayed a post-LAGB intestinal strangulation of the sigmoid loop which was caused by the connecting tube. Since the bowel was still viable, the tube was cut and the obstruction has been successfully resolved. The patient was discharged three days after the surgery.</p><p><strong>Conclusion: </strong>Although less often performed, knowledge of LAGB complications can be of importance. We believe that, the present strangulation of the sigmoid by the LAGB tubing is the world's first ever case reported. Nevertheless, when it is still proposed to selected patients, an adequate length of the intra-abdominal tubing could reduce the risk of loop formation and prevent this kind of obstruction by internal hernia.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761049","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}
Background: Surgical injury induces a stress response to surgery that induces tissue repair with the activation of endocrine, metabolic, and immunological mediators aimed at restoring hemostasis.
Objective: In our study to determine the effect of analgesic method on postoperative respiratory function tests, stress hormone and proinflammatory response in patients undergoing elective thoracotomy surgery.
Methods: Seventy-two patients aged between 18 and 75 years with scheduled for elective thoracotomy surgery were included in the study. Thirty-six patients who underwent Erector Spinae Plane block were included in the block group, and 36 patients were included in the control group. IL 6, TNF alpha, cortisol, CRP, insulin and blood glucose levels were measured preoperatively, at the 3rd hour after postoperative extubation and at the 24th postoperative hour.
Results: We observed that while IL6 and TNF alpha levels decreased in the ESPB group compared to the preoperative period, they increased insignificantly in the control group.
Conclusion: ESPB has a positive effect on stress hormones and proinflammatory cytokines, reduces the use of opioids and analgesics in the intraoperative and postoperative period compared to patients without block, and lower VAS scores are obtained in patients with block.
{"title":"The effects of erector spinae plane block (ESPB) on surgery-related stress response in thoracic surgery.","authors":"Ercan Albayrak, Emel Gündüz, Tülin Titiz, Ikbal Özen Küçükçetin","doi":"10.1080/00015458.2023.2297532","DOIUrl":"10.1080/00015458.2023.2297532","url":null,"abstract":"<p><strong>Background: </strong>Surgical injury induces a stress response to surgery that induces tissue repair with the activation of endocrine, metabolic, and immunological mediators aimed at restoring hemostasis.</p><p><strong>Objective: </strong>In our study to determine the effect of analgesic method on postoperative respiratory function tests, stress hormone and proinflammatory response in patients undergoing elective thoracotomy surgery.</p><p><strong>Methods: </strong>Seventy-two patients aged between 18 and 75 years with scheduled for elective thoracotomy surgery were included in the study. Thirty-six patients who underwent Erector Spinae Plane block were included in the block group, and 36 patients were included in the control group. IL 6, TNF alpha, cortisol, CRP, insulin and blood glucose levels were measured preoperatively, at the 3rd hour after postoperative extubation and at the 24th postoperative hour.</p><p><strong>Results: </strong>We observed that while IL6 and TNF alpha levels decreased in the ESPB group compared to the preoperative period, they increased insignificantly in the control group.</p><p><strong>Conclusion: </strong>ESPB has a positive effect on stress hormones and proinflammatory cytokines, reduces the use of opioids and analgesics in the intraoperative and postoperative period compared to patients without block, and lower VAS scores are obtained in patients with block.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138796830","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 : 2024-08-01Epub Date: 2024-02-14DOI: 10.1080/00015458.2024.2301806
Murat Can Mollaoğlu, Ufuk Karabacak, Meriç Emre Bostancı, Turan Eray Seven, Kürşat Karadayı
Introduction: Malign peritoneal mesothelioma (MPM) is an uncommon disease that is difficult to treat. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are the gold standards for treating MPM. Sometimes extreme cytoreductive surgery (eCRS) is required to achieve complete cytoreduction, which is one of the most important prognostic factors. There is limited information in the literature about the contribution of eCRS in patients with MPM. In this study, we aimed to investigate the impact of eCRS on survival and perioperative outcomes.
Methods: The Department of Surgical Oncology at Cumhuriyet University database was retrospectively reviewed for MPM patients who underwent CRS-HIPEC between January 2004 and December 2018. Patients who underwent CRS-HIPEC were divided into eCRS and less extensive CRS (leCRS) groups. A resection of ≥5 organs or ≥3 small bowel anastomoses were defined as eCRS. Both groups were compared regarding survival, demographic information, and perioperative outcomes.
Results: A total of 31 patients were included. eCRS-HIPEC was used in 15 patients. Complete cytoreduction (CC score 0/1) was achieved in all 31 patients. Compared to leCRS, the eCRS group had a longer median length of stay, longer intensive care unit stay, a higher median peritoneal cancer index (PCI), higher intraoperative blood loss, more frequent occurrence of any complication, and a longer operative time (all p values < 0.001). Clavien Dindo 3-4 complications, ASA, and gender were similar in both groups of patients (p > 0.05). It was found that there was no significant difference between the OS of the eCRS and leCRS groups (37.5 vs. 42.8 months, p = 0.895).
Conclusions: Rates of serious complications and morbidity are similar in patients undergoing eCRS compared to leCRS. In patients with high PCI and multiorgan involvement, complete cytoreduction can be achieved by performing eCRS, and survival results equivalent to those with low PCI can be achieved.
{"title":"Is extereme cytoreductive surgery beneficial to survival ın malignant peritoneal mesothelioma?","authors":"Murat Can Mollaoğlu, Ufuk Karabacak, Meriç Emre Bostancı, Turan Eray Seven, Kürşat Karadayı","doi":"10.1080/00015458.2024.2301806","DOIUrl":"10.1080/00015458.2024.2301806","url":null,"abstract":"<p><strong>Introduction: </strong>Malign peritoneal mesothelioma (MPM) is an uncommon disease that is difficult to treat. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are the gold standards for treating MPM. Sometimes extreme cytoreductive surgery (eCRS) is required to achieve complete cytoreduction, which is one of the most important prognostic factors. There is limited information in the literature about the contribution of eCRS in patients with MPM. In this study, we aimed to investigate the impact of eCRS on survival and perioperative outcomes.</p><p><strong>Methods: </strong>The Department of Surgical Oncology at Cumhuriyet University database was retrospectively reviewed for MPM patients who underwent CRS-HIPEC between January 2004 and December 2018. Patients who underwent CRS-HIPEC were divided into eCRS and less extensive CRS (leCRS) groups. A resection of <b>≥</b>5 organs or <b>≥</b>3 small bowel anastomoses were defined as eCRS. Both groups were compared regarding survival, demographic information, and perioperative outcomes.</p><p><strong>Results: </strong>A total of 31 patients were included. eCRS-HIPEC was used in 15 patients. Complete cytoreduction (CC score 0/1) was achieved in all 31 patients. Compared to leCRS, the eCRS group had a longer median length of stay, longer intensive care unit stay, a higher median peritoneal cancer index (PCI), higher intraoperative blood loss, more frequent occurrence of any complication, and a longer operative time (all p values < 0.001). Clavien Dindo 3-4 complications, ASA, and gender were similar in both groups of patients (<i>p</i> > 0.05). It was found that there was no significant difference between the OS of the eCRS and leCRS groups (37.5 vs. 42.8 months, <i>p</i> = 0.895).</p><p><strong>Conclusions: </strong>Rates of serious complications and morbidity are similar in patients undergoing eCRS compared to leCRS. In patients with high PCI and multiorgan involvement, complete cytoreduction can be achieved by performing eCRS, and survival results equivalent to those with low PCI can be achieved.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641414","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 : 2024-08-01Epub Date: 2024-04-02DOI: 10.1080/00015458.2024.2313263
Haentjens Louis, Lerut Philip
Introduction: Cystic adventitial disease (CAD) is an uncommon condition that affects arteries and veins. It can cause a rare type of non-atherosclerotic peripheral vessel disease. The most common vessel affected is the popliteal artery. The number of case reports on CAD of the femoral artery is growing. We present a case of a 62-year-old female presented with claudication of the left leg diagnosed with CAD of the left common femoral artery. The patient was treated surgically with cyst excision and vessel reconstruction with saphenous vein autograft patch plasty. After 8-months the cyste relapsed and she had new claudication complains. We decided to perform new surgery. Surgical treatment consisted of cyst resection by excision of the femoral bifurcation and saphenous vein autograft interposition reconstruction of the bifurcation. We also provide an update on the latest literature of surgical treatment of CAD of the ilio-femoral artery region.
Methods: Medline and EMBASE were used to collect articles on CAD of ilio-femoral artery. We included English written or translated case reports or series between 1987 and 2023.
Results: Twenty-nine patients out of 28 case reports were included. Most patients were male (59%). Claudication is the most common symptom (76%). Treatment consisted of cyst resection, cyst decompression, Endarterectomy, patch angioplasty and interposition graft using PTFE, Dacron, Great saphenous vein (GSV) or femoral vein autograft. Recurrence appeared in 4 cases (14%).
Conclusion: In accordance to the literature and our experience we recommend complete vessel excision and saphenous vein (or PTFE) interposition bypass as treatment.
{"title":"Cystic adventitial disease of the common femoral artery: a case report and overview of the literature.","authors":"Haentjens Louis, Lerut Philip","doi":"10.1080/00015458.2024.2313263","DOIUrl":"10.1080/00015458.2024.2313263","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic adventitial disease (CAD) is an uncommon condition that affects arteries and veins. It can cause a rare type of non-atherosclerotic peripheral vessel disease. The most common vessel affected is the popliteal artery. The number of case reports on CAD of the femoral artery is growing. We present a case of a 62-year-old female presented with claudication of the left leg diagnosed with CAD of the left common femoral artery. The patient was treated surgically with cyst excision and vessel reconstruction with saphenous vein autograft patch plasty. After 8-months the cyste relapsed and she had new claudication complains. We decided to perform new surgery. Surgical treatment consisted of cyst resection by excision of the femoral bifurcation and saphenous vein autograft interposition reconstruction of the bifurcation. We also provide an update on the latest literature of surgical treatment of CAD of the ilio-femoral artery region.</p><p><strong>Methods: </strong>Medline and EMBASE were used to collect articles on CAD of ilio-femoral artery. We included English written or translated case reports or series between 1987 and 2023.</p><p><strong>Results: </strong>Twenty-nine patients out of 28 case reports were included. Most patients were male (59%). Claudication is the most common symptom (76%). Treatment consisted of cyst resection, cyst decompression, Endarterectomy, patch angioplasty and interposition graft using PTFE, Dacron, Great saphenous vein (GSV) or femoral vein autograft. Recurrence appeared in 4 cases (14%).</p><p><strong>Conclusion: </strong>In accordance to the literature and our experience we recommend complete vessel excision and saphenous vein (or PTFE) interposition bypass as treatment.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334292","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 : 2024-08-01Epub Date: 2024-05-08DOI: 10.1080/00015458.2024.2350112
Fabiola Zurlini, Silvia Iorio, Vera Nigrisoli Wärnhjelm
Background: Queen Christina of Sweden, a prominent Early Modern European character, died in Rome on April 19th, 1689. The scarce literature published about her illness and death agrees about the cause of the death in the diagnosis of erysipelas, that did not appear externally with an ulcer, but became manifest in her blood, causing an inflammation of heart and lungs. The article underlines the essential contribution of the learned surgeons to the development of practical anatomy in the late Seventeenth century as illustrated by the specific case of the Queen's autopsy report by the court surgeon Alessio Spalla.
Methods: The study is based on the analysis of the published literature and the comparison of archival sources as the anonymous report of the Queen's autopsy, preserved in Vienna and the unknown autopsy by Spalla, discovered in a private archive.
Results: The comparison of Spalla's autopsy with the Viennese report of an anonymous practical doctor -suspected to be Marcello Malpighi-, who also participated in the Queen's dissection highlights how the two perspectives of investigation - the surgical-morphological and the medical-practical ones - are integrated in the theoretical and practical dimension of practical anatomy.
Conclusions: The unpublished report of the surgeon Spalla integrates the knowledge of the queen's illness and death, stands as an example of a private autopsy performed by a court surgeon in the late Seventeenth-century Rome and as a case study on the development of new hybrid areas of knowledge, such as practical anatomy.
{"title":"Alessio Spalla, court surgeon of Christina of Sweden and his unknown Queen's autopsy report.","authors":"Fabiola Zurlini, Silvia Iorio, Vera Nigrisoli Wärnhjelm","doi":"10.1080/00015458.2024.2350112","DOIUrl":"10.1080/00015458.2024.2350112","url":null,"abstract":"<p><strong>Background: </strong>Queen Christina of Sweden, a prominent Early Modern European character, died in Rome on April 19th, 1689. The scarce literature published about her illness and death agrees about the cause of the death in the diagnosis of erysipelas, that did not appear externally with an ulcer, but became manifest in her blood, causing an inflammation of heart and lungs. The article underlines the essential contribution of the learned surgeons to the development of practical anatomy in the late Seventeenth century as illustrated by the specific case of the Queen's autopsy report by the court surgeon Alessio Spalla.</p><p><strong>Methods: </strong>The study is based on the analysis of the published literature and the comparison of archival sources as the anonymous report of the Queen's autopsy, preserved in Vienna and the unknown autopsy by Spalla, discovered in a private archive.</p><p><strong>Results: </strong>The comparison of Spalla's autopsy with the Viennese report of an anonymous practical doctor -suspected to be Marcello Malpighi-, who also participated in the Queen's dissection highlights how the two perspectives of investigation - the surgical-morphological and the medical-practical ones - are integrated in the theoretical and practical dimension of practical anatomy.</p><p><strong>Conclusions: </strong>The unpublished report of the surgeon Spalla integrates the knowledge of the queen's illness and death, stands as an example of a private autopsy performed by a court surgeon in the late Seventeenth-century Rome and as a case study on the development of new hybrid areas of knowledge, such as practical anatomy.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846875","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}