Pub Date : 2024-08-09DOI: 10.5348/100059s05mm2024ra
Mohammed Matar, Klaus Ulrich Fetzner
Aims: This study conducts a comprehensive literature review on esophageal perforation during thyroidectomy for managing benign or neoplastic thyroidal diseases. This article encompasses published cases and studies and focuses on intraoperative esophageal perforation during total or subtotal thyroidectomy. Postoperative complications related to esophageal perforation are also included. Methods: A systematic literature search was performed using PubMed, Embase, and Cochrane databases with keywords including “thyroidectomy,” “esophageal perforation,” “postoperative complication,” “incidence,” “risk factors,” and “management.” Inclusion criteria were studies published in English with a sample size greater than 10 patients. Results: Thirty-eight studies were reviewed, mostly case reports or small case series. The incidence of iatrogenic esophageal perforation during thyroidectomy ranged from 0.1% to 1.5%, with higher rates in minimally invasive and robotic-assisted thyroidectomy compared to open thyroidectomy. Conservative management was successful in 62% of patients, while 38% required surgical repair. Mortality rates varied from 0% to 33% for those undergoing surgical repair. Conclusion: Esophageal perforation during thyroidectomy is rare, particularly with experienced surgeons or in high-volume centers. It is more common in malignant thyroid diseases. Symptoms range from mild to severe, and diagnosis typically involves endoscopy or computed tomography with contrast. Management depends on the perforation’s characteristics and the patient’s condition, with options including direct suturing, endoscopic stenting, and radical surgery with viable flaps. Complications can include prolonged hospitalization and feeding issues.
{"title":"Esophageal perforation during thyroidectomy: A literature review","authors":"Mohammed Matar, Klaus Ulrich Fetzner","doi":"10.5348/100059s05mm2024ra","DOIUrl":"https://doi.org/10.5348/100059s05mm2024ra","url":null,"abstract":"\u0000 Aims: This study conducts a comprehensive literature review on esophageal perforation during thyroidectomy for managing benign or neoplastic thyroidal diseases. This article encompasses published cases and studies and focuses on intraoperative esophageal perforation during total or subtotal thyroidectomy. Postoperative complications related to esophageal perforation are also included.\u0000\u0000 Methods: A systematic literature search was performed using PubMed, Embase, and Cochrane databases with keywords including “thyroidectomy,” “esophageal perforation,” “postoperative complication,” “incidence,” “risk factors,” and “management.” Inclusion criteria were studies published in English with a sample size greater than 10 patients.\u0000\u0000 Results: Thirty-eight studies were reviewed, mostly case reports or small case series. The incidence of iatrogenic esophageal perforation during thyroidectomy ranged from 0.1% to 1.5%, with higher rates in minimally invasive and robotic-assisted thyroidectomy compared to open thyroidectomy. Conservative management was successful in 62% of patients, while 38% required surgical repair. Mortality rates varied from 0% to 33% for those undergoing surgical repair.\u0000\u0000 Conclusion: Esophageal perforation during thyroidectomy is rare, particularly with experienced surgeons or in high-volume centers. It is more common in malignant thyroid diseases. Symptoms range from mild to severe, and diagnosis typically involves endoscopy or computed tomography with contrast. Management depends on the perforation’s characteristics and the patient’s condition, with options including direct suturing, endoscopic stenting, and radical surgery with viable flaps. Complications can include prolonged hospitalization and feeding issues.\u0000","PeriodicalId":91865,"journal":{"name":"Edorium journal of surgery","volume":"72 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922234","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 : 2022-11-16DOI: 10.5348/100058s05ao2022cr
Amir Camil Obeid, S. Sayida, Wisam Abboud
In common practice enlarged gallbladders are rarely encountered and there are a minimal number of cases reported worldwide. Most of these encounters have been associated with malignancy which is contrary to our finding. We describe a case of chronic cholecystitis which had the rare association of a giant gallbladder which was treated by surgical resection without any pathological associations. The review also describes the different grading of cholecystitis and various management approaches which are applied in common practice. Due to the fact that cases of giant gallbladders are a rare encounter, documenting this case will provide further analysis for future studies.
{"title":"A rare presentation of giant gallbladder","authors":"Amir Camil Obeid, S. Sayida, Wisam Abboud","doi":"10.5348/100058s05ao2022cr","DOIUrl":"https://doi.org/10.5348/100058s05ao2022cr","url":null,"abstract":"\u0000 In common practice enlarged gallbladders are rarely encountered and there are a minimal number of cases reported worldwide. Most of these encounters have been associated with malignancy which is contrary to our finding. We describe a case of chronic cholecystitis which had the rare association of a giant gallbladder which was treated by surgical resection without any pathological associations. The review also describes the different grading of cholecystitis and various management approaches which are applied in common practice. Due to the fact that cases of giant gallbladders are a rare encounter, documenting this case will provide further analysis for future studies.\u0000","PeriodicalId":91865,"journal":{"name":"Edorium journal of surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79541049","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 : 2022-05-17DOI: 10.5348/100057s05oa2022ra
O. Afuwape, Ikechukwu Bartholomew Ulasi
Aims: The aim of this study was to evaluate the ability of the surgical Apgar score (SAS) to predict post-operative complications at the University College Hospital (UCH), Ibadan, Nigeria. Methods: This was a retrospective study of adult patients undergoing emergency general surgery procedures. The main end-points were post-operative mortality and surgical site infection (SSI). The ability of the SAS to predict post-operative outcomes was determined using the receiver operating characteristics curve (ROC). Statistical significance was defined by a p value of less than 0.05. Results: The mean SAS was 5.6 ± 1.7 with majority of patients (61.4%, n = 70) being at medium risk (Apgar score 5–7) for post-operative complication. The most common post-operative complication was SSI (47.1%, n = 25) with a 30-day mortality of 9.6%. The ROC curve showed that the SAS is a poor predictor of post-operative complications (Area under the curve [AUC] = 0.408) and mortality (AUC = 0.394). However, there is a statistically significant association between mean SAS and occurrence of post-operative complications (p = 0.026). Conclusion: The SAS does not predict post-operative complications in adult patients undergoing emergency general surgery procedures.
{"title":"Evaluation of surgical Apgar score as a predictor of postoperative complications in emergency general surgical patients in a Nigerian teaching hospital","authors":"O. Afuwape, Ikechukwu Bartholomew Ulasi","doi":"10.5348/100057s05oa2022ra","DOIUrl":"https://doi.org/10.5348/100057s05oa2022ra","url":null,"abstract":"\u0000 Aims: The aim of this study was to evaluate the ability of the surgical Apgar score (SAS) to predict post-operative complications at the University College Hospital (UCH), Ibadan, Nigeria.\u0000\u0000 Methods: This was a retrospective study of adult patients undergoing emergency general surgery procedures. The main end-points were post-operative mortality and surgical site infection (SSI). The ability of the SAS to predict post-operative outcomes was determined using the receiver operating characteristics curve (ROC). Statistical significance was defined by a p value of less than 0.05.\u0000\u0000 Results: The mean SAS was 5.6 ± 1.7 with majority of patients (61.4%, n = 70) being at medium risk (Apgar score 5–7) for post-operative complication. The most common post-operative complication was SSI (47.1%, n = 25) with a 30-day mortality of 9.6%. The ROC curve showed that the SAS is a poor predictor of post-operative complications (Area under the curve [AUC] = 0.408) and mortality (AUC = 0.394). However, there is a statistically significant association between mean SAS and occurrence of post-operative complications (p = 0.026).\u0000\u0000 Conclusion: The SAS does not predict post-operative complications in adult patients undergoing emergency general surgery procedures.\u0000","PeriodicalId":91865,"journal":{"name":"Edorium journal of surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80301569","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 : 2016-12-15DOI: 10.5348/S05-2016-16-OA-6
S. DeMasi, Eriko Katsuta, K. Takabe
Aims The use of live animals for surgical training is a well-known, deliberated topic. However, medical students who use live animals rate the experience high not only in improving their surgical techniques, but also positively influencing their confidence levels in the operating room later in their careers. Therefore, we hypothesized that the use of live animal models is a unique and influential component of preclinical medical education. Materials and Methods Medical student performed the following surgical procedures using mice; surgical orthotopic implantation of cancer cells into fat pad and subsequently a radical mastectomy. The improvement of skill was then analyzed. Results All cancer cell inoculations were performed successfully. Improvement of surgical skills during the radical mastectomy procedure was documented in all parameters. All wounds healed without breakdown or dehiscence. The appropriate interval between interrupted sutures was ascertained after fifth wound closure. The speed of interrupted sutures was doubled by last wound closure. The time required to complete a radical mastectomy decreased by almost half. A single animal died immediately following the operation due to inappropriate anesthesia, which was attributed to the lack of understanding of the overall operative management. Conclusion Surgical training using live animals for preclinical medical students provides a unique learning experience, not only in improving surgical skills but also and arguably most importantly, to introduce the student to the complexities of the perioperative environment in a way that most closely resembles the stress and responsibility that the operating room demands.
{"title":"Live animals for preclinical medical student surgical training","authors":"S. DeMasi, Eriko Katsuta, K. Takabe","doi":"10.5348/S05-2016-16-OA-6","DOIUrl":"https://doi.org/10.5348/S05-2016-16-OA-6","url":null,"abstract":"Aims The use of live animals for surgical training is a well-known, deliberated topic. However, medical students who use live animals rate the experience high not only in improving their surgical techniques, but also positively influencing their confidence levels in the operating room later in their careers. Therefore, we hypothesized that the use of live animal models is a unique and influential component of preclinical medical education. Materials and Methods Medical student performed the following surgical procedures using mice; surgical orthotopic implantation of cancer cells into fat pad and subsequently a radical mastectomy. The improvement of skill was then analyzed. Results All cancer cell inoculations were performed successfully. Improvement of surgical skills during the radical mastectomy procedure was documented in all parameters. All wounds healed without breakdown or dehiscence. The appropriate interval between interrupted sutures was ascertained after fifth wound closure. The speed of interrupted sutures was doubled by last wound closure. The time required to complete a radical mastectomy decreased by almost half. A single animal died immediately following the operation due to inappropriate anesthesia, which was attributed to the lack of understanding of the overall operative management. Conclusion Surgical training using live animals for preclinical medical students provides a unique learning experience, not only in improving surgical skills but also and arguably most importantly, to introduce the student to the complexities of the perioperative environment in a way that most closely resembles the stress and responsibility that the operating room demands.","PeriodicalId":91865,"journal":{"name":"Edorium journal of surgery","volume":"2 1","pages":"24 - 31"},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90816959","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}
Aims: The use of live animals for surgical training is a well-known, deliberated topic. However, medical students who use live animals rate the experience high not only in improving their surgical techniques, but also positively influencing their confidence levels in the operating room later in their careers. Therefore, we hypothesized that the use of live animal models is a unique and influential component of preclinical medical education.
Materials and methods: Medical student performed the following surgical procedures using mice; surgical orthotopic implantation of cancer cells into fat pad and subsequently a radical mastectomy. The improvement of skill was then analyzed.
Results: All cancer cell inoculations were performed successfully. Improvement of surgical skills during the radical mastectomy procedure was documented in all parameters. All wounds healed without breakdown or dehiscence. The appropriate interval between interrupted sutures was ascertained after fifth wound closure. The speed of interrupted sutures was doubled by last wound closure. The time required to complete a radical mastectomy decreased by almost half. A single animal died immediately following the operation due to inappropriate anesthesia, which was attributed to the lack of understanding of the overall operative management.
Conclusion: Surgical training using live animals for preclinical medical students provides a unique learning experience, not only in improving surgical skills but also and arguably most importantly, to introduce the student to the complexities of the perioperative environment in a way that most closely resembles the stress and responsibility that the operating room demands.
{"title":"Live animals for preclinical medical student surgical training.","authors":"Stephanie C DeMasi, Eriko Katsuta, Kazuake Takabe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>The use of live animals for surgical training is a well-known, deliberated topic. However, medical students who use live animals rate the experience high not only in improving their surgical techniques, but also positively influencing their confidence levels in the operating room later in their careers. Therefore, we hypothesized that the use of live animal models is a unique and influential component of preclinical medical education.</p><p><strong>Materials and methods: </strong>Medical student performed the following surgical procedures using mice; surgical orthotopic implantation of cancer cells into fat pad and subsequently a radical mastectomy. The improvement of skill was then analyzed.</p><p><strong>Results: </strong>All cancer cell inoculations were performed successfully. Improvement of surgical skills during the radical mastectomy procedure was documented in all parameters. All wounds healed without breakdown or dehiscence. The appropriate interval between interrupted sutures was ascertained after fifth wound closure. The speed of interrupted sutures was doubled by last wound closure. The time required to complete a radical mastectomy decreased by almost half. A single animal died immediately following the operation due to inappropriate anesthesia, which was attributed to the lack of understanding of the overall operative management.</p><p><strong>Conclusion: </strong>Surgical training using live animals for preclinical medical students provides a unique learning experience, not only in improving surgical skills but also and arguably most importantly, to introduce the student to the complexities of the perioperative environment in a way that most closely resembles the stress and responsibility that the operating room demands.</p>","PeriodicalId":91865,"journal":{"name":"Edorium journal of surgery","volume":"3 2","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35175988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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