Pub Date : 2021-02-09DOI: 10.26420/AUSTINJSURG.2021.1260
Gomes Lcl, Dutra Jc
The purpose of this review was to give the reader an update about the postoperative period and healing outcome after surgical endodontic retreatment. Endodontic surgery has become a standard of care for dental maintenance if conventional endodontic retreatment is not able to eliminate the infection, it is important to know how to manage the post-surgical care; due it might directly interfere in the healing outcome after the surgical procedure. Based on the results of the present review, the postoperative period after the surgery treatment is very mild, without any complications, being similar to any dental surgical discomfort, as swelling, bleeding and pain, which could be easily controlled with simple medicine. Regarding the repair after endodontic surgery, the length of follow-up time and the healing evaluation criteria affect the outcome, and 1-year follow-up periods might be insufficient to predict a long-term healing.
{"title":"Endodontic Surgery: A Review of Postoperative and Healing Outcome","authors":"Gomes Lcl, Dutra Jc","doi":"10.26420/AUSTINJSURG.2021.1260","DOIUrl":"https://doi.org/10.26420/AUSTINJSURG.2021.1260","url":null,"abstract":"The purpose of this review was to give the reader an update about the postoperative period and healing outcome after surgical endodontic retreatment. Endodontic surgery has become a standard of care for dental maintenance if conventional endodontic retreatment is not able to eliminate the infection, it is important to know how to manage the post-surgical care; due it might directly interfere in the healing outcome after the surgical procedure. Based on the results of the present review, the postoperative period after the surgery treatment is very mild, without any complications, being similar to any dental surgical discomfort, as swelling, bleeding and pain, which could be easily controlled with simple medicine. Regarding the repair after endodontic surgery, the length of follow-up time and the healing evaluation criteria affect the outcome, and 1-year follow-up periods might be insufficient to predict a long-term healing.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75193659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-13DOI: 10.26420/AUSTINJSURG.2021.1259
A. Jamry
Objective: To analyze the risk factors for post-endoscopic pancreatitis (PEP). Background: PEP occurs in 4%-42% of patients, depending on their risk factors. Over 56 risk factors were analyzed, but only 4were found to be repeated in most studies. Study: A single-center retrospective study analyzing 402 consecutive patients with naïve papillae who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) was conducted. The significance of 14 potentially new risk factors was evaluated, and it was found that they were associated with the level of bile duct stenosis, papilla anatomy, bleeding during sphincterotomy, endoscopic bleeding control, and pathological examination. Furthermore, 13 of the most frequently published risk factors were re-analyzed. Results: Five risk factors (containing two new ones) were significant with the following univariate and multivariate regression values: flat papilla (odds ratio [OR] 5.1, p=0.0049; OR 4.59, p=0.0244) and bleeding during endoscopic sphincterotomy (OR 3.58, p=0.148; OR 4.07, p=0.0257), and significance of the three already known risk factors was confirmed: age <40 years (OR 6.89, p=0.0139; OR 4.96, p=0.0139), common bile duct (CBD) diameter < 9 mm (OR 5.35, p=0.0007; OR 3.98, p=0.0203), and difficulty in cannulation (OR 3.2, p=0.0298; OR 7.72, p=0.004). Conclusion: This study reaffirms the risk of PEP associated with age, difficulty in cannulation, and CBD diameter. It also identifies two new risk factors: flat papilla and bleeding during sphincterotomy. These results suggest the need for a change in ERCP methodology in patients with these risk factors, but this finding requires confirmation in subsequent studies.
{"title":"Flat Papilla of Vater and Bleeding during Endoscopic Sphincterotomy: Two New Risk Factors for Post-Endoscopic Pancreatitis","authors":"A. Jamry","doi":"10.26420/AUSTINJSURG.2021.1259","DOIUrl":"https://doi.org/10.26420/AUSTINJSURG.2021.1259","url":null,"abstract":"Objective: To analyze the risk factors for post-endoscopic pancreatitis (PEP). Background: PEP occurs in 4%-42% of patients, depending on their risk factors. Over 56 risk factors were analyzed, but only 4were found to be repeated in most studies. Study: A single-center retrospective study analyzing 402 consecutive patients with naïve papillae who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) was conducted. The significance of 14 potentially new risk factors was evaluated, and it was found that they were associated with the level of bile duct stenosis, papilla anatomy, bleeding during sphincterotomy, endoscopic bleeding control, and pathological examination. Furthermore, 13 of the most frequently published risk factors were re-analyzed. Results: Five risk factors (containing two new ones) were significant with the following univariate and multivariate regression values: flat papilla (odds ratio [OR] 5.1, p=0.0049; OR 4.59, p=0.0244) and bleeding during endoscopic sphincterotomy (OR 3.58, p=0.148; OR 4.07, p=0.0257), and significance of the three already known risk factors was confirmed: age <40 years (OR 6.89, p=0.0139; OR 4.96, p=0.0139), common bile duct (CBD) diameter < 9 mm (OR 5.35, p=0.0007; OR 3.98, p=0.0203), and difficulty in cannulation (OR 3.2, p=0.0298; OR 7.72, p=0.004). Conclusion: This study reaffirms the risk of PEP associated with age, difficulty in cannulation, and CBD diameter. It also identifies two new risk factors: flat papilla and bleeding during sphincterotomy. These results suggest the need for a change in ERCP methodology in patients with these risk factors, but this finding requires confirmation in subsequent studies.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78235152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-21DOI: 10.26420/austinjsurg.2019.1218
Khurana Cs
Synovial sarcoma (SS) is a tumour of the soft tissues with a unique chromosomal translocation t(X;18)(p11.2;q11.2) detected by polymerase chain reaction in tissue homogenates. A 36 years old woman, with complaints of pain and lump in left flank was found to have a large lump occupying the left flank, left hypochondrium and the umbilical region, which was bimanually palpable and did not cross the midline. Investigations were suggestive of left RCC for which patient was operated. Intraoperatively, a tumour mass was seen replacing the whole kidney with involvement of left adrenal gland. Histopathology of the specimen revealed primary synovial sarcoma of left kidney.
{"title":"Renal Synovial Sarcoma- A Rare Primary Malignancy","authors":"Khurana Cs","doi":"10.26420/austinjsurg.2019.1218","DOIUrl":"https://doi.org/10.26420/austinjsurg.2019.1218","url":null,"abstract":"Synovial sarcoma (SS) is a tumour of the soft tissues with a unique chromosomal translocation t(X;18)(p11.2;q11.2) detected by polymerase chain reaction in tissue homogenates. A 36 years old woman, with complaints of pain and lump in left flank was found to have a large lump occupying the left flank, left hypochondrium and the umbilical region, which was bimanually palpable and did not cross the midline. Investigations were suggestive of left RCC for which patient was operated. Intraoperatively, a tumour mass was seen replacing the whole kidney with involvement of left adrenal gland. Histopathology of the specimen revealed primary synovial sarcoma of left kidney.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"171 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79412658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-13DOI: 10.26420/AUSTINJRADIOL.2019.1173
A. Elsaady
Laparoscopic cholecystectomy is one of the most common abdominal surgical procedures all over the world. It carries a lot of advantages over the open procedure. One of these advantages is the marked decrease in the incidence of surgical site infection. However, no wound is immune and SSI is still present and may be troublesome. The role of antibiotic prophylaxis in preventing or reducing SSI is still a matter of controversy in laparoscopic cholecystectomy. This study is a prospective one that conducted over two years to assess the role of antibiotic prophylaxis and best regimen. Four hundreds and fifty six patients were included which were divided into two large groups; group of simple cholecystectomy and group of risky cholecystectomy .Each group were further subdivided into three groups ; one received no antibiotic at all, the second received single dose of antibiotic, and a third one received antibiotic for at least five days. Sixteen cases developed SSI in the whole study (approximately 3.5%). Group of simple cholecystectomy reported three cases (~1%) suffered from SSI with insignificant value between the three groups. On the other hand in group B (risky group) , thirteen patients developed surgical site infections (~7%) with high statistical significance between the group where patient did not received antibiotics at all and other two groups received antibiotics. Also significant value was found between the group used single dose antibiotic (group 5) and those with at least five days administration of antibiotics, the latter reported less incidence of SSI. The study concluded that; no role of antibiotic prophylaxis in simple cholecystectomy. On the other hand prophylactic antibiotic is strongly recommended in risky cholecystectomy. It is better to give the antibiotic for at least five days in such risky groups. The presence of immune-comprised state,
{"title":"Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy","authors":"A. Elsaady","doi":"10.26420/AUSTINJRADIOL.2019.1173","DOIUrl":"https://doi.org/10.26420/AUSTINJRADIOL.2019.1173","url":null,"abstract":"Laparoscopic cholecystectomy is one of the most common abdominal surgical procedures all over the world. It carries a lot of advantages over the open procedure. One of these advantages is the marked decrease in the incidence of surgical site infection. However, no wound is immune and SSI is still present and may be troublesome. The role of antibiotic prophylaxis in preventing or reducing SSI is still a matter of controversy in laparoscopic cholecystectomy. This study is a prospective one that conducted over two years to assess the role of antibiotic prophylaxis and best regimen. Four hundreds and fifty six patients were included which were divided into two large groups; group of simple cholecystectomy and group of risky cholecystectomy .Each group were further subdivided into three groups ; one received no antibiotic at all, the second received single dose of antibiotic, and a third one received antibiotic for at least five days. Sixteen cases developed SSI in the whole study (approximately 3.5%). Group of simple cholecystectomy reported three cases (~1%) suffered from SSI with insignificant value between the three groups. On the other hand in group B (risky group) , thirteen patients developed surgical site infections (~7%) with high statistical significance between the group where patient did not received antibiotics at all and other two groups received antibiotics. Also significant value was found between the group used single dose antibiotic (group 5) and those with at least five days administration of antibiotics, the latter reported less incidence of SSI. The study concluded that; no role of antibiotic prophylaxis in simple cholecystectomy. On the other hand prophylactic antibiotic is strongly recommended in risky cholecystectomy. It is better to give the antibiotic for at least five days in such risky groups. The presence of immune-comprised state,","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87889423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-06DOI: 10.26420/AUSTINJRADIOL.2019.1171
R. Beelen
Background: When conservative measures fail in the treatment of thoracic outlet syndrome (TOS), a first rib resection (FRR) is in order. Nowadays, a transaxillary or supraclavicular approach is most commonly used. However, both techniques have technical limitations. Objective: In this paper a minimal invasive, robot-assisted thoracoscopic technique tackling those shortcomings is proposed. Methods: A single-center retrospective study including 11 patients with 12 FRR’s from January 2017 until August 2018 was performed. The main focus was the feasibility of this new technique by looking at mean hospital stay, postoperative pain and complication rate. Clinical outcome was evaluated at 6 weeks.
{"title":"Robot-Assisted First Fib Resection for Neurogenic Thoracic Outlet Syndrome","authors":"R. Beelen","doi":"10.26420/AUSTINJRADIOL.2019.1171","DOIUrl":"https://doi.org/10.26420/AUSTINJRADIOL.2019.1171","url":null,"abstract":"Background: When conservative measures fail in the treatment of thoracic outlet syndrome (TOS), a first rib resection (FRR) is in order. Nowadays, a transaxillary or supraclavicular approach is most commonly used. However, both techniques have technical limitations. \u0000Objective: In this paper a minimal invasive, robot-assisted thoracoscopic technique tackling those shortcomings is proposed. \u0000Methods: A single-center retrospective study including 11 patients with 12 FRR’s from January 2017 until August 2018 was performed. The main focus was the feasibility of this new technique by looking at mean hospital stay, postoperative pain and complication rate. Clinical outcome was evaluated at 6 weeks.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90342933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-06DOI: 10.26420/AUSTINJRADIOL.2019.1170
M. Garg
Oral squamous cell carcinoma (OSCC) has a variable incidence of contralateral neck (CLN) metastases which affects long-term survival and prognosis. Therefore, due consideration should be given to the management of the CLN in OSCC for certain cases. Neck dissection is often indicated in the N0 cases where the primary OSCC obviously crosses the midline. However, there is much variability in the management of the CLN when considering two other clinical events encountered in multidisciplinary meetings. These were interrogated by conducting an online survey in the UK. The first scenario included a tumour close to but not crossing the midline and the second included an ipsilateral metachronous or recurrent tumour when the ipsilateral neck (ILN) had been previously treated. The respondents included head and neck (H&N) consultant clinicians in the UK. Our findings suggest wide inconsistencies in the management of the CLN in these particular situations. The variability in practice is also reflected in the literature review. There is a need to address the CLN. There may be a role for sentinel lymph node biopsy (SLNB) in staging the neck for tumours close to the midline or in ipsilateral metachronous tumour or recurrence in a patient with a previously treated ILN.
{"title":"Management of the Contralateral Neck in Oral Squamous Cell Carcinoma in the UK and a Review of Literature","authors":"M. Garg","doi":"10.26420/AUSTINJRADIOL.2019.1170","DOIUrl":"https://doi.org/10.26420/AUSTINJRADIOL.2019.1170","url":null,"abstract":"Oral squamous cell carcinoma (OSCC) has a variable incidence of contralateral neck (CLN) metastases which affects long-term survival and prognosis. Therefore, due consideration should be given to the management of the CLN in OSCC for certain cases. Neck dissection is often indicated in the N0 cases where the primary OSCC obviously crosses the midline. However, there is much variability in the management of the CLN when considering two other clinical events encountered in multidisciplinary meetings. These were interrogated by conducting an online survey in the UK. The first scenario included a tumour close to but not crossing the midline and the second included an ipsilateral metachronous or recurrent tumour when the ipsilateral neck (ILN) had been previously treated. The respondents included head and neck (H&N) consultant clinicians in the UK. Our findings suggest wide inconsistencies in the management of the CLN in these particular situations. The variability in practice is also reflected in the literature review. There is a need to address the CLN. There may be a role for sentinel lymph node biopsy (SLNB) in staging the neck for tumours close to the midline or in ipsilateral metachronous tumour or recurrence in a patient with a previously treated ILN.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86441903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.26420/austinjradiol.2019.1168
Choi Gh
{"title":"Prognostic Significance and Predictive Factors of Lymph Node Metastasis in Resectable Intrahepatic Cholangiocarcinoma","authors":"Choi Gh","doi":"10.26420/austinjradiol.2019.1168","DOIUrl":"https://doi.org/10.26420/austinjradiol.2019.1168","url":null,"abstract":"","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"224 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86686201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.26420/AUSTINJRADIOL.2019.1166
S. Takagi
Congenital depression of the fetal skull unassociated with any acute trauma, typically involving the temporal or parietal areas, is rare. The need for surgical intervention for the deformity remains controversial, particularly with respect to an indentation located in the forehead area. Herein, we report a case of a congenital frontal-vault depression in a neonate that was managed conservatively for nearly 18 months. The shape of the infant’s skull resolved spontaneously with no active intervention. When congenital vault depression is diagnosed, watchful waiting for a year or more may be advisable because spontaneous resolution can be expected.
{"title":"Congenital Frontal-Vault Depression in a Neonate","authors":"S. Takagi","doi":"10.26420/AUSTINJRADIOL.2019.1166","DOIUrl":"https://doi.org/10.26420/AUSTINJRADIOL.2019.1166","url":null,"abstract":"Congenital depression of the fetal skull unassociated with any acute trauma, typically involving the temporal or parietal areas, is rare. The need for surgical intervention for the deformity remains controversial, particularly with respect to an indentation located in the forehead area. Herein, we report a case of a congenital frontal-vault depression in a neonate that was managed conservatively for nearly 18 months. The shape of the infant’s skull resolved spontaneously with no active intervention. When congenital vault depression is diagnosed, watchful waiting for a year or more may be advisable because spontaneous resolution can be expected.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79591270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.26420/austinjradiol.2019.1167
J. Maurel
{"title":"EGFR Blockade as Effective Therapy in BRAF and EGFR Mutated Metastatic Colorectal Cancer: Learning from a Clinical Case","authors":"J. Maurel","doi":"10.26420/austinjradiol.2019.1167","DOIUrl":"https://doi.org/10.26420/austinjradiol.2019.1167","url":null,"abstract":"","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75532656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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