Pub Date : 2023-12-20DOI: 10.3390/surgeries5010001
V. Q. Sier, A. Schepers, Ž. Dambrauskas, J. R. van der Vorst, Roderick F. Schmitz
Surgeons are known for their steady hands, decision-making skills, and, according to some, their self-admiration [...]
外科医生以其稳健的双手和决策技能而闻名，有些人还说他们自视甚高 [...] 。
{"title":"The Christmas Procedure: A Surgical Approach to Holiday Cooking","authors":"V. Q. Sier, A. Schepers, Ž. Dambrauskas, J. R. van der Vorst, Roderick F. Schmitz","doi":"10.3390/surgeries5010001","DOIUrl":"https://doi.org/10.3390/surgeries5010001","url":null,"abstract":"Surgeons are known for their steady hands, decision-making skills, and, according to some, their self-admiration [...]","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955872","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 : 2023-12-15DOI: 10.3390/surgeries4040066
Jule Reitz, Simon Lindner, Stefan Benz, Guido Schwarzer, S. Hetjens, Maurizio Grilli, Christoph Reissfelder, Steffen Seyfried, Florian Herrle
Despite the development of new technologies and multimodal therapies, improving the prognosis of patients with UICC stage III right colon adenocarcinoma remains challenging. Several randomized controlled trials have shown the oncological non-inferiority of minimally invasive surgery compared to open surgery for colon cancer patients. However, for UICC stage III patients, carrying the highest risk for local recurrence and the worst survival, the evidence remains inconclusive. The aim of this systematic review and individual patient data meta-analysis is to improve the scarce evidence regarding minimally invasive surgery for this subgroup of patients. Data from adult patients with pathologically UICC stage III right adenocarcinoma of the colon will be included. The intervention to be assessed is the minimally invasive right hemicolectomy in comparison with the open procedure. The primary outcome will be the 5-year overall survival. Secondary outcomes will include further long-term outcomes, such as disease-free survival, short term, and histological outcomes. Only randomized controlled trials and quasi-randomized controlled clinical trials will be included. The literature search will be conducted in the following databases: PubMed, CINAHL, Cochrane Trials, ClinicalTrials.gov, and Web of Science. The review will be performed using the Cochrane methodology including GRADE tools. The findings of this meta-analysis will be important for choosing optimal treatment pathways and tailoring of surgical therapy in patients with locally advanced UICC stage III right colon cancer.
尽管新技术和多模式疗法不断发展，但改善 UICC III 期右侧结肠腺癌患者的预后仍是一项挑战。多项随机对照试验表明，与开腹手术相比，微创手术在结肠癌患者的肿瘤治疗中并无劣势。然而，对于局部复发风险最高、生存率最差的 UICC III 期患者，相关证据仍不明确。本系统综述和单个患者数据荟萃分析的目的是改善有关该亚组患者微创手术的稀缺证据。本研究将纳入病理诊断为 UICC III 期右侧结肠腺癌的成年患者的数据。评估的干预措施是微创右半结肠切除术与开放手术的比较。主要结果是 5 年总生存率。次要结果将包括进一步的长期结果，如无疾病生存期、短期结果和组织学结果。研究对象只包括随机对照试验和准随机对照临床试验。文献检索将在以下数据库中进行：PubMed、CINAHL、Cochrane Trials、ClinicalTrials.gov 和 Web of Science。将采用包括 GRADE 工具在内的 Cochrane 方法进行综述。这项荟萃分析的结果将对局部晚期 UICC III 期右侧结肠癌患者选择最佳治疗路径和手术治疗的定制非常重要。
{"title":"A Comparison between Open and Minimally Invasive Right Hemicolectomies in Patients with Locally Advanced UICC Stage III Colon Cancer: A Protocol for a Systematic Review and an Individual Patient Data Meta-Analysis","authors":"Jule Reitz, Simon Lindner, Stefan Benz, Guido Schwarzer, S. Hetjens, Maurizio Grilli, Christoph Reissfelder, Steffen Seyfried, Florian Herrle","doi":"10.3390/surgeries4040066","DOIUrl":"https://doi.org/10.3390/surgeries4040066","url":null,"abstract":"Despite the development of new technologies and multimodal therapies, improving the prognosis of patients with UICC stage III right colon adenocarcinoma remains challenging. Several randomized controlled trials have shown the oncological non-inferiority of minimally invasive surgery compared to open surgery for colon cancer patients. However, for UICC stage III patients, carrying the highest risk for local recurrence and the worst survival, the evidence remains inconclusive. The aim of this systematic review and individual patient data meta-analysis is to improve the scarce evidence regarding minimally invasive surgery for this subgroup of patients. Data from adult patients with pathologically UICC stage III right adenocarcinoma of the colon will be included. The intervention to be assessed is the minimally invasive right hemicolectomy in comparison with the open procedure. The primary outcome will be the 5-year overall survival. Secondary outcomes will include further long-term outcomes, such as disease-free survival, short term, and histological outcomes. Only randomized controlled trials and quasi-randomized controlled clinical trials will be included. The literature search will be conducted in the following databases: PubMed, CINAHL, Cochrane Trials, ClinicalTrials.gov, and Web of Science. The review will be performed using the Cochrane methodology including GRADE tools. The findings of this meta-analysis will be important for choosing optimal treatment pathways and tailoring of surgical therapy in patients with locally advanced UICC stage III right colon cancer.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000924","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 : 2023-12-14DOI: 10.3390/surgeries4040065
S. Morgan, N. Amzallag, O. Shaked, N. Snir, A. Gold, I. Ashkenazi, S. Factor, Y. Warschawski
One of the main objectives of total hip arthroplasty (THA) is to recreate the center of rotation (COR). Accurate reconstruction of the COR is suggested to be within 5 mm of its anatomical location. The goal of our study was to assess whether accurate reconstruction of the COR, based on preoperative planning, is associated with improved clinical outcomes. The study population consisted of patients who underwent THA at our institution between August 2018 and May 2020. All patients underwent preoperative digital templating. The position of the predicted COR was compared to its actual postoperative position. Patients were subsequently stratified into two subgroups based on the difference between the distance of the predicted COR and the reconstructed COR, over or under 5 mm. A 12-Item Short Form Health Survey (SF-12) and visual analogue scale (VAS) were taken for each patient. 90 patients were included in this study. 60 patients (66%) had their COR reconstructed within 5 mm of preoperative planning, whereas for 30 patients (33%), reconstruction was outside of 5 mm of preoperative planning. Between the two cohorts, no significant difference existed in the physical component summary (PCS) (p = 0.33), the mental component summary (MCS = 0.16), or the visual analogue scale (VAS) (p = 0.12). The accurate restoration of COR based on preoperative planning is not associated with improved clinical outcomes. During postoperative evaluation, surgeons should feel confident if the COR is slightly greater than 5 mm of preoperative limitations.
{"title":"Accurate Restoration of the Center of Rotation of the Hip Joint Based on Preoperative Planning Is Not Associated with Improved Clinical Outcomes","authors":"S. Morgan, N. Amzallag, O. Shaked, N. Snir, A. Gold, I. Ashkenazi, S. Factor, Y. Warschawski","doi":"10.3390/surgeries4040065","DOIUrl":"https://doi.org/10.3390/surgeries4040065","url":null,"abstract":"One of the main objectives of total hip arthroplasty (THA) is to recreate the center of rotation (COR). Accurate reconstruction of the COR is suggested to be within 5 mm of its anatomical location. The goal of our study was to assess whether accurate reconstruction of the COR, based on preoperative planning, is associated with improved clinical outcomes. The study population consisted of patients who underwent THA at our institution between August 2018 and May 2020. All patients underwent preoperative digital templating. The position of the predicted COR was compared to its actual postoperative position. Patients were subsequently stratified into two subgroups based on the difference between the distance of the predicted COR and the reconstructed COR, over or under 5 mm. A 12-Item Short Form Health Survey (SF-12) and visual analogue scale (VAS) were taken for each patient. 90 patients were included in this study. 60 patients (66%) had their COR reconstructed within 5 mm of preoperative planning, whereas for 30 patients (33%), reconstruction was outside of 5 mm of preoperative planning. Between the two cohorts, no significant difference existed in the physical component summary (PCS) (p = 0.33), the mental component summary (MCS = 0.16), or the visual analogue scale (VAS) (p = 0.12). The accurate restoration of COR based on preoperative planning is not associated with improved clinical outcomes. During postoperative evaluation, surgeons should feel confident if the COR is slightly greater than 5 mm of preoperative limitations.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139002111","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 : 2023-12-08DOI: 10.3390/surgeries4040064
Giulio Perrotta, Daniele Castellani
Background: Wilms tumor (or nephroblastoma) is a malignant and solid neoplasm that derives from the primitive renal bud. It represents the most frequent primary tumor of the urogenital tract in childhood, and treatment consists of surgery and chemo-radiotherapy. However, concerning quality of life, the new therapeutic frontier is exploring other safer and potentially more effective options, such as minimally invasive surgery and biological drugs. Method: Literature (PubMed) from January 2013 to July 2023 was reviewed, checking for innovations in diagnosis and treatment. Results: A total of 130 articles was included in the review. Conclusion: In addition to the therapeutic strategies already identified, such as classic surgery and pharmacological therapies, recent studies focus attention on the new frontiers of minimally invasive surgery, such as diagnostics using biomarkers and immunotherapy, which could represent a new therapeutic option and is possibly less risky than in the past, contributing in fact to the current knowledge of the scientific panorama in terms of “tumor microenvironment” and systemic implications deriving from oncological disease.
{"title":"Wilms Tumor: Updates about Pathogenesis and New Possible Clinical Treatments of the Most Frequent Pediatric Urogenital Cancer: A Narrative Review","authors":"Giulio Perrotta, Daniele Castellani","doi":"10.3390/surgeries4040064","DOIUrl":"https://doi.org/10.3390/surgeries4040064","url":null,"abstract":"Background: Wilms tumor (or nephroblastoma) is a malignant and solid neoplasm that derives from the primitive renal bud. It represents the most frequent primary tumor of the urogenital tract in childhood, and treatment consists of surgery and chemo-radiotherapy. However, concerning quality of life, the new therapeutic frontier is exploring other safer and potentially more effective options, such as minimally invasive surgery and biological drugs. Method: Literature (PubMed) from January 2013 to July 2023 was reviewed, checking for innovations in diagnosis and treatment. Results: A total of 130 articles was included in the review. Conclusion: In addition to the therapeutic strategies already identified, such as classic surgery and pharmacological therapies, recent studies focus attention on the new frontiers of minimally invasive surgery, such as diagnostics using biomarkers and immunotherapy, which could represent a new therapeutic option and is possibly less risky than in the past, contributing in fact to the current knowledge of the scientific panorama in terms of “tumor microenvironment” and systemic implications deriving from oncological disease.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138588807","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 : 2023-12-06DOI: 10.3390/surgeries4040063
Eike Wilbers, Samer Zawy Alsofy, S. Schipmann, Christian Ewelt, T. Fortmann, Marc Lewitz, M. Schwake
Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a 25-year-old male admitted with headache, vertigo, and nystagmus. The MRI scan showed a tetraventricular hydrocephalus with a patent aqueduct. After endoscopic third ventriculostomy (ETV), symptoms resolved. We performed a systematic review of the literature, covering 26 years, with the aim to investigate the symptoms, therapy, and outcome of primary FVOO, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We found 9 case reports and 2 case series and could extract a total of 34 cases. After ETV all symptoms resolved in 10 of 23 cases (43.5%), and in 13 of 23 cases (56.5%) symptoms improved partially. Seven cases (30.4%) required additional surgery. A decrease in ventricular volume occurred in most cases. In the 10 patients who were operated via fenestration, all symptoms resolved in 6 cases. ETV seems to be an effective treatment option for patients with idiopathic FVOO in a majority of cases. In special cases, fenestration of the foramen of Magendie may be suitable.
{"title":"Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature","authors":"Eike Wilbers, Samer Zawy Alsofy, S. Schipmann, Christian Ewelt, T. Fortmann, Marc Lewitz, M. Schwake","doi":"10.3390/surgeries4040063","DOIUrl":"https://doi.org/10.3390/surgeries4040063","url":null,"abstract":"Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a 25-year-old male admitted with headache, vertigo, and nystagmus. The MRI scan showed a tetraventricular hydrocephalus with a patent aqueduct. After endoscopic third ventriculostomy (ETV), symptoms resolved. We performed a systematic review of the literature, covering 26 years, with the aim to investigate the symptoms, therapy, and outcome of primary FVOO, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We found 9 case reports and 2 case series and could extract a total of 34 cases. After ETV all symptoms resolved in 10 of 23 cases (43.5%), and in 13 of 23 cases (56.5%) symptoms improved partially. Seven cases (30.4%) required additional surgery. A decrease in ventricular volume occurred in most cases. In the 10 patients who were operated via fenestration, all symptoms resolved in 6 cases. ETV seems to be an effective treatment option for patients with idiopathic FVOO in a majority of cases. In special cases, fenestration of the foramen of Magendie may be suitable.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596322","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 : 2023-11-06DOI: 10.3390/surgeries4040056
Katherine Aw, Aziza Al Rawahi, Rebecca Lau, Sami Aftab Abdul, Caitlin Anstee, Sebastien Gilbert, Daniel Jones, Andrew J. E. Seely, Ramanadhan Sudhir Sundaresan, Patrick James Villeneuve, Donna Elizabeth Maziak
Background: In this study, we investigate indocyanine green (ICG) dye visualization of the thoracic duct (TD) and conduit perfusion during esophagectomy to reduce anastomotic leak (AL) and chylothorax adverse events (AEs). Methods: Retrospective data of adult patients who underwent esophagectomy for esophageal carcinoma between July 2019 and 2022 were included (n = 105). ICG was delivered intravenously (2 mL, 2.5 mg/mL) to assess conduit perfusion into the small bowel mesentery, inguinal lymph nodes, or foot web spaces for TD visualization using fluorescence imaging. Incidence of TD injury, chylothorax, AL, and AEs were collected. Results: A total of 23 patients received ICG (ICG for TD and perfusion (n = 12) and perfusion only (n = 11)), while 82 patients were controls. TD was visualized in 6 of 12 patients who received ICG for TD. No intraoperative TD injuries or postoperative chylothoraces occurred in these patients. Non-ICG patients had 1 (1.22%) intraoperative TD injury and 10 (12.2%) postoperative chylothoraces (grade I–IIIb). While 10 non-ICG patients (12.2%) developed AL (grade I–IVb), only 2 (8.7%) ICG patients developed AL (grade IIIa). Conclusions: This study demonstrates the utility of ICG fluorescence in intraoperative TD and conduit perfusion assessment for limiting AEs. Standard incorporation of ICG in esophagectomy may help surgeons improve the quality of care in this patient population.
{"title":"The Use of Indocyanine Green to Visualize the Thoracic Duct and Evaluate Gastric Conduit Perfusion in Esophagectomy","authors":"Katherine Aw, Aziza Al Rawahi, Rebecca Lau, Sami Aftab Abdul, Caitlin Anstee, Sebastien Gilbert, Daniel Jones, Andrew J. E. Seely, Ramanadhan Sudhir Sundaresan, Patrick James Villeneuve, Donna Elizabeth Maziak","doi":"10.3390/surgeries4040056","DOIUrl":"https://doi.org/10.3390/surgeries4040056","url":null,"abstract":"Background: In this study, we investigate indocyanine green (ICG) dye visualization of the thoracic duct (TD) and conduit perfusion during esophagectomy to reduce anastomotic leak (AL) and chylothorax adverse events (AEs). Methods: Retrospective data of adult patients who underwent esophagectomy for esophageal carcinoma between July 2019 and 2022 were included (n = 105). ICG was delivered intravenously (2 mL, 2.5 mg/mL) to assess conduit perfusion into the small bowel mesentery, inguinal lymph nodes, or foot web spaces for TD visualization using fluorescence imaging. Incidence of TD injury, chylothorax, AL, and AEs were collected. Results: A total of 23 patients received ICG (ICG for TD and perfusion (n = 12) and perfusion only (n = 11)), while 82 patients were controls. TD was visualized in 6 of 12 patients who received ICG for TD. No intraoperative TD injuries or postoperative chylothoraces occurred in these patients. Non-ICG patients had 1 (1.22%) intraoperative TD injury and 10 (12.2%) postoperative chylothoraces (grade I–IIIb). While 10 non-ICG patients (12.2%) developed AL (grade I–IVb), only 2 (8.7%) ICG patients developed AL (grade IIIa). Conclusions: This study demonstrates the utility of ICG fluorescence in intraoperative TD and conduit perfusion assessment for limiting AEs. Standard incorporation of ICG in esophagectomy may help surgeons improve the quality of care in this patient population.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135590011","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 : 2023-11-02DOI: 10.3390/surgeries4040055
Maria Tereza A. Scalzo, Mauro Henrique N. G. Abreu, Juliana V. M. Mambrini, Letícia C. Pinheiro, Antônio Thomaz G. Matta-Machado, Renata C. Martins
Access to quality healthcare is an essential component of health policy. This cross-sectional study describes the actions performed by Brazilian Oral Health Teams (OHTs) analyzed in the National Program for Improving Access and Quality of Primary Care and the relationship of contextual aspects. A total of 22,993 OHTs that participated in the third cycle of the referred program were evaluated using a structured questionnaire. Thirteen procedures (items) related to spontaneous dental care and preventive, surgical, restorative, prosthetic, and oral cancer prevention or diagnosis were assessed. Item response theory was used to estimate the performance scores of OHTs, based on 13 items. The relationship between performance scores and contextual variables in Brazilian regions was analyzed by thematic maps and Spearman correlation (p < 0.05). The highest difficulty parameters were for questions related to prosthetics (b = 0.879) and actions for oral cancer (b = 2.922). The 13 items were more appropriate to discriminate the teams with lower performance and relatively ineffective in differentiating those with better performance. A direct relationship with the Human Development Index (rs = 0.249; p = 0.004) and an indirect relationship with the Gini Index (rs = −0.482; p < 0.001) were found. Contextual aspects presented a relationship with the performance of the Brazilian OHTs. The evaluated items showed some potential to discriminate the performance of OHTs since many of the evaluated dental procedures are performed by most of the teams.
{"title":"Performance Evaluation of Oral Health Teams in Brazil: An Item Response Theory Approach","authors":"Maria Tereza A. Scalzo, Mauro Henrique N. G. Abreu, Juliana V. M. Mambrini, Letícia C. Pinheiro, Antônio Thomaz G. Matta-Machado, Renata C. Martins","doi":"10.3390/surgeries4040055","DOIUrl":"https://doi.org/10.3390/surgeries4040055","url":null,"abstract":"Access to quality healthcare is an essential component of health policy. This cross-sectional study describes the actions performed by Brazilian Oral Health Teams (OHTs) analyzed in the National Program for Improving Access and Quality of Primary Care and the relationship of contextual aspects. A total of 22,993 OHTs that participated in the third cycle of the referred program were evaluated using a structured questionnaire. Thirteen procedures (items) related to spontaneous dental care and preventive, surgical, restorative, prosthetic, and oral cancer prevention or diagnosis were assessed. Item response theory was used to estimate the performance scores of OHTs, based on 13 items. The relationship between performance scores and contextual variables in Brazilian regions was analyzed by thematic maps and Spearman correlation (p < 0.05). The highest difficulty parameters were for questions related to prosthetics (b = 0.879) and actions for oral cancer (b = 2.922). The 13 items were more appropriate to discriminate the teams with lower performance and relatively ineffective in differentiating those with better performance. A direct relationship with the Human Development Index (rs = 0.249; p = 0.004) and an indirect relationship with the Gini Index (rs = −0.482; p < 0.001) were found. Contextual aspects presented a relationship with the performance of the Brazilian OHTs. The evaluated items showed some potential to discriminate the performance of OHTs since many of the evaluated dental procedures are performed by most of the teams.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135973736","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 : 2023-10-27DOI: 10.3390/surgeries4040054
Michele Mercurio, Olimpio Galasso, Renato de Filippis, Filippo Familiari, Giorgio Gasparini
Thermal comfort is a significant factor in maintaining a satisfactory perception of the body temperature and influences behavioral thermoregulation. This pilot study aimed to investigate regional differences in thermal comfort in the head and neck areas by applying a surgical helmet equipped with cooling pads containing octadecane (CAS 593-45-3) as a phase change material (PCM) in healthy volunteers. Forty-three surgeons and nurses were enrolled. Octadecane is an odorless alkane hydrocarbon with an appearance of white crystal and a melting point of 28 °C. The PCM pads, each with a diameter of 5 cm and containing 7 g of octadecane, were placed between the helmet and the wearer’s head directly in contact with the skin. To identify the areas of the head and neck investigated, the surface was sampled and numbered, with the identification of a total of 38 different locations. A climate chamber maintained at 23–26 °C was used for the experiment. Thermal comfort of the stimulated area was reported by the subjects in an evaluation questionnaire at the end of the local stimulation conducted for 1 h. The sensations were reported as 1 (maximum uncomfortable) to 7 (maximum cold comfort), with 4 indicating a neutral sensation. The duration of the thermal comfort effect was also recorded. The highest mean value reported was 6 in five areas. The frontal region, the frontotemporal region, and the neck region were the areas sensitive to thermal comfort. A neutral sensation was reported in 13 areas. No uncomfortable sensation was reported in any area. This pilot study provides preliminary evidence of the feasibility and potential benefits of integrating PCM cooling pads into surgical helmets to enhance thermal comfort.
{"title":"Head Regional Differences in Thermal Comfort: Evaluating a Novel Surgical Helmet Cooling Method with Phase Change Material","authors":"Michele Mercurio, Olimpio Galasso, Renato de Filippis, Filippo Familiari, Giorgio Gasparini","doi":"10.3390/surgeries4040054","DOIUrl":"https://doi.org/10.3390/surgeries4040054","url":null,"abstract":"Thermal comfort is a significant factor in maintaining a satisfactory perception of the body temperature and influences behavioral thermoregulation. This pilot study aimed to investigate regional differences in thermal comfort in the head and neck areas by applying a surgical helmet equipped with cooling pads containing octadecane (CAS 593-45-3) as a phase change material (PCM) in healthy volunteers. Forty-three surgeons and nurses were enrolled. Octadecane is an odorless alkane hydrocarbon with an appearance of white crystal and a melting point of 28 °C. The PCM pads, each with a diameter of 5 cm and containing 7 g of octadecane, were placed between the helmet and the wearer’s head directly in contact with the skin. To identify the areas of the head and neck investigated, the surface was sampled and numbered, with the identification of a total of 38 different locations. A climate chamber maintained at 23–26 °C was used for the experiment. Thermal comfort of the stimulated area was reported by the subjects in an evaluation questionnaire at the end of the local stimulation conducted for 1 h. The sensations were reported as 1 (maximum uncomfortable) to 7 (maximum cold comfort), with 4 indicating a neutral sensation. The duration of the thermal comfort effect was also recorded. The highest mean value reported was 6 in five areas. The frontal region, the frontotemporal region, and the neck region were the areas sensitive to thermal comfort. A neutral sensation was reported in 13 areas. No uncomfortable sensation was reported in any area. This pilot study provides preliminary evidence of the feasibility and potential benefits of integrating PCM cooling pads into surgical helmets to enhance thermal comfort.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136262930","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 : 2023-10-25DOI: 10.3390/surgeries4040053
Angel Moctezuma-Ramirez, David Dworaczyk, Julia Whitehorn, Ke Li, Cristiano de Oliveira Cardoso, Abdelmotagaly Elgalad
During the preclinical research process, multiple factors can be difficult to implement without the careful consideration and planning of each step. As research has become more advanced with the use of increasingly complex technology, animal models have also become essential for understanding the potential impact of devices, drug therapies, and surgical techniques on humans before clinical trials are conducted. The use of an in vivo animal model is a key and necessary step in the progression of preclinical research studies that will lead to future medical inventions and innovation. Here, we describe the three phases of effectively designing a preclinical research protocol: the research, preprocedural planning, and experimental phases. Furthermore, we provide researchers with guidance through these phases and discuss important considerations.
{"title":"Designing an In Vivo Preclinical Research Study","authors":"Angel Moctezuma-Ramirez, David Dworaczyk, Julia Whitehorn, Ke Li, Cristiano de Oliveira Cardoso, Abdelmotagaly Elgalad","doi":"10.3390/surgeries4040053","DOIUrl":"https://doi.org/10.3390/surgeries4040053","url":null,"abstract":"During the preclinical research process, multiple factors can be difficult to implement without the careful consideration and planning of each step. As research has become more advanced with the use of increasingly complex technology, animal models have also become essential for understanding the potential impact of devices, drug therapies, and surgical techniques on humans before clinical trials are conducted. The use of an in vivo animal model is a key and necessary step in the progression of preclinical research studies that will lead to future medical inventions and innovation. Here, we describe the three phases of effectively designing a preclinical research protocol: the research, preprocedural planning, and experimental phases. Furthermore, we provide researchers with guidance through these phases and discuss important considerations.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217159","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 : 2023-10-17DOI: 10.3390/surgeries4040052
Ludovico Lucenti, Claudia de Cristo, Luciano Costarella, Alessia Caldaci, Marco Sapienza, Gianluca Testa, Vito Pavone
Non-prosthetic peri-implant fractures (NPPIFs) are often reported mixed with periprosthetic fractures (PPFs), but they are different entities. Due to the increase in the age of the world’s population and to the intensification of surgeries for fractures, nowadays, peri-implant fractures are a very frequent entity in clinical practice, with an increasing trend expected in the future. A clear exclusive classification of NPPIFs is not reported in the literature. The aim of this study is to provide a valid comprehensive classification for all the NPPIFs. X-rays of all the peri-implant cases treated in our unit in a 3-year period were retrospectively collected. Five orthopedic surgeons reviewed 30 X-rays of NPPIFs, providing a code according to the classification proposed. After a 3-month interval, they reviewed the same X-rays. Eighteen femoral, eight humeral, and four forearm peri-implant fractures were collected and showed to the raters. Inter- and intra-observer reliability was calculated using a k-statistic, showing a moderate agreement between observers (κ = 0.73) and a substantial agreement between the observations of the same viewer (κ = 0.82). The literature lacks a comprehensive classification for peri-implant fractures that considers all the bones and all the types of implants. The proposed classification is meant to be an instrument for orthopedic surgeons to categorize these types of fractures and seems to be simple, easy to comprehend, and reproducible. This new classification can provide the orthopedic surgeon a reliable method to clearly catalogue different fractures according to the site and the implants; the physicians can use it, through a code, in clinical practice to describe an NPPIF without the need of images. Further studies may be necessary to confirm the validity and eventually to improve the suggested classification.
{"title":"A Novel Comprehensive Classification for Non-Prosthetic Peri-Implant Fractures","authors":"Ludovico Lucenti, Claudia de Cristo, Luciano Costarella, Alessia Caldaci, Marco Sapienza, Gianluca Testa, Vito Pavone","doi":"10.3390/surgeries4040052","DOIUrl":"https://doi.org/10.3390/surgeries4040052","url":null,"abstract":"Non-prosthetic peri-implant fractures (NPPIFs) are often reported mixed with periprosthetic fractures (PPFs), but they are different entities. Due to the increase in the age of the world’s population and to the intensification of surgeries for fractures, nowadays, peri-implant fractures are a very frequent entity in clinical practice, with an increasing trend expected in the future. A clear exclusive classification of NPPIFs is not reported in the literature. The aim of this study is to provide a valid comprehensive classification for all the NPPIFs. X-rays of all the peri-implant cases treated in our unit in a 3-year period were retrospectively collected. Five orthopedic surgeons reviewed 30 X-rays of NPPIFs, providing a code according to the classification proposed. After a 3-month interval, they reviewed the same X-rays. Eighteen femoral, eight humeral, and four forearm peri-implant fractures were collected and showed to the raters. Inter- and intra-observer reliability was calculated using a k-statistic, showing a moderate agreement between observers (κ = 0.73) and a substantial agreement between the observations of the same viewer (κ = 0.82). The literature lacks a comprehensive classification for peri-implant fractures that considers all the bones and all the types of implants. The proposed classification is meant to be an instrument for orthopedic surgeons to categorize these types of fractures and seems to be simple, easy to comprehend, and reproducible. This new classification can provide the orthopedic surgeon a reliable method to clearly catalogue different fractures according to the site and the implants; the physicians can use it, through a code, in clinical practice to describe an NPPIF without the need of images. Further studies may be necessary to confirm the validity and eventually to improve the suggested classification.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135994834","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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