Annals of Medicine and Surgery最新文献

Single-incision robotic surgery (SIRS) has emerged as a progression in minimally invasive practice, enabling complex operations through a single entry point. Modern systems such as the da Vinci SP (Intuitive Surgical, USA) and Versius (CMR Surgical, UK) allow multi-instrument articulation and high-definition visualization through a single port, overcoming the ergonomic and triangulation challenges of traditional laparoscopy. Recent evidence from South Korea, China, the USA, and Turkey demonstrates SIRS's feasibility, safety, and promising clinical outcomes across specialties including urology, gynecology, and general surgery. Studies report lower conversion rates, minimal postoperative pain, and enhanced cosmesis, though cost and learning curve remain limiting factors. As robotic technologies evolve, SIRS is poised to redefine minimally invasive standards through precision, reduced invasiveness, and improved recovery profiles. Rigorous multicenter trials and cost-effectiveness analyses are essential to confirm its broader clinical value.

The concept behind 4D morphing biopolymers represents a further improvement in reconstructive plastic surgery, as it can now create scaffolds that are stimulus-responsive, allowing them to exhibit flexibility in shape and functionality once implanted. Such materials have the potential to address the shortcomings of conventional autologous reconstruction through enhanced integration, vascularization, and minimally invasive implantation. Nevertheless, significant issues of translation, regulation, and ethics remain, underscoring the need for in vivo research, surgeon-engineer partnerships, and fair clinical practice.

Introduction and importance: Kounis syndrome is a rare condition described by acute coronary syndrome following an allergic reaction. This case report highlights a unique presentation of Kounis syndrome following moxifloxacin ingestion in a patient with vasculitis and a history of smoking.

Case presentation: A 55-year-old male smoker with a history of vasculitis presented with acute chest pain 1 hour after moxifloxacin ingestion. The patient developed epigastric pain, dizziness, and sweating. ECG showed ST-segment elevation in leads II, III, and aVF. Initial lab work revealed elevated eosinophil and basophil counts consistent with an allergic reaction. Cardiac catheterization identified significant stenosis in the left anterior descending artery, which was managed with a stent and a balloon. The patient was treated with corticosteroids, antihistamines, and dual antiplatelet therapy. Eosinophil and basophil counts became normal, and the patient was discharged in a stable condition.

Clinical discussion: This case showcases the intersection between allergic reactions and coronary events. Moxifloxacin is a known trigger for Kounis syndrome. The patient's vasculitis and smoking history likely predisposed him to coronary inflammation, making him susceptible to Kounis syndrome. While Kounis syndrome remains underdiagnosed due to the overlapping symptoms, timely recognition and management addressing both the allergic and cardiac components are crucial.

Conclusion: This article highlights the importance of considering Kounis syndrome in patients presenting with ACS following an allergic reaction, particularly in those with predisposing factors. Prompt diagnosis and intervention are essential to improve outcomes.