Pub Date : 2023-05-03DOI: 10.3390/surgeries4020021
Jean-Gabriel Lacombe, M. Cooke, Hyeree Park, Suliman Mohammed Alshammari, R. Gawri, S. Nazhat, P. Martineau, D. Rosenzweig
The current gold standard technique for the treatment of anterior cruciate ligament (ACL) injury is reconstruction with a tendon autograft. These treatments have a relatively high failure and re-rupture rate and are associated with early-onset osteoarthritis, developing within two decades of injury. Furthermore, both autografting and allografting come with several drawbacks. Tissue engineering and additive manufacturing present exciting new opportunities to explore 3D scaffolds as graft substitutes. We previously showed that 3D-printed scaffolds using low-cost equipment are suitable for tissue engineering approaches to regenerative medicine. Here, we hypothesize that Lay-Fomm 60, a commercially available nanoporous elastomer, may be a viable tissue engineering candidate for an ACL graft substitute. We first printed nanoporous thermoplastic elastomer scaffolds using low-cost desktop 3D printers and determined the mechanical and morphological properties. We then tested the impact of different surface coatings on primary human ACL fibroblast adhesion, growth, and ligamentous matrix deposition in vitro. Our data suggest that poly-L-lysine-coated Lay-Fomm 60 scaffolds increased ligament fibroblast activity and matrix formation when compared to uncoated scaffolds but did not have a significant effect on cell attachment and proliferation. Therefore, uncoated 3D printed Lay-Fomm 60 scaffolds may be viable standalone scaffolds and warrant further research as ligament tissue engineering and reconstruction grafts.
{"title":"Primary Human Ligament Fibroblast Adhesion and Growth on 3D-Printed Scaffolds for Tissue Engineering Applications","authors":"Jean-Gabriel Lacombe, M. Cooke, Hyeree Park, Suliman Mohammed Alshammari, R. Gawri, S. Nazhat, P. Martineau, D. Rosenzweig","doi":"10.3390/surgeries4020021","DOIUrl":"https://doi.org/10.3390/surgeries4020021","url":null,"abstract":"The current gold standard technique for the treatment of anterior cruciate ligament (ACL) injury is reconstruction with a tendon autograft. These treatments have a relatively high failure and re-rupture rate and are associated with early-onset osteoarthritis, developing within two decades of injury. Furthermore, both autografting and allografting come with several drawbacks. Tissue engineering and additive manufacturing present exciting new opportunities to explore 3D scaffolds as graft substitutes. We previously showed that 3D-printed scaffolds using low-cost equipment are suitable for tissue engineering approaches to regenerative medicine. Here, we hypothesize that Lay-Fomm 60, a commercially available nanoporous elastomer, may be a viable tissue engineering candidate for an ACL graft substitute. We first printed nanoporous thermoplastic elastomer scaffolds using low-cost desktop 3D printers and determined the mechanical and morphological properties. We then tested the impact of different surface coatings on primary human ACL fibroblast adhesion, growth, and ligamentous matrix deposition in vitro. Our data suggest that poly-L-lysine-coated Lay-Fomm 60 scaffolds increased ligament fibroblast activity and matrix formation when compared to uncoated scaffolds but did not have a significant effect on cell attachment and proliferation. Therefore, uncoated 3D printed Lay-Fomm 60 scaffolds may be viable standalone scaffolds and warrant further research as ligament tissue engineering and reconstruction grafts.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43674833","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 : 2023-04-27DOI: 10.3390/surgeries4020020
A. Elgalad, Ahmed E. Hanafy, Angel Moctezuma-Ramirez, A. Post, M. John, Yutao Xi, M. Razavi
Complete atrioventricular block (AVB) is an abnormal heart rhythm resulting from a defect in the cardiac conduction system. Patients with complete AVB are at risk of symptoms ranging from syncope or hypotension to cardiovascular collapse or sudden cardiac death. A reliable animal model of complete AVB is essential for understanding the mechanisms underlying the fatal hemodynamic effects and alterations in electrical conductivity associated with this arrhythmia. We evaluated the use of ethanol injections in a systematic surgical approach to create a complete AVB model in rats. We used eight Sprague Dawley rats (8 weeks old, 220 ± 30 g): four received a 70% ethanol injection in the AV node, and four received a similar injection of 0.9% sodium chloride. Our surgical approach involved performing a partial sternotomy, using the epicardial fat as a landmark for ethanol injections. Animals were followed for 7 and 14 days. Complete AVB was successfully induced in all four rats that received ethanol injections. Rats in the control group experienced a transient AVB with a return to sinus rhythm. Our study found that using 70% ethanol injections in a systematic surgical approach is a reliable, safe, and reproducible way of creating a complete AVB model in rats.
{"title":"Use of Ethanol Injections to Create a Complete Atrioventricular Block in a Rat Model","authors":"A. Elgalad, Ahmed E. Hanafy, Angel Moctezuma-Ramirez, A. Post, M. John, Yutao Xi, M. Razavi","doi":"10.3390/surgeries4020020","DOIUrl":"https://doi.org/10.3390/surgeries4020020","url":null,"abstract":"Complete atrioventricular block (AVB) is an abnormal heart rhythm resulting from a defect in the cardiac conduction system. Patients with complete AVB are at risk of symptoms ranging from syncope or hypotension to cardiovascular collapse or sudden cardiac death. A reliable animal model of complete AVB is essential for understanding the mechanisms underlying the fatal hemodynamic effects and alterations in electrical conductivity associated with this arrhythmia. We evaluated the use of ethanol injections in a systematic surgical approach to create a complete AVB model in rats. We used eight Sprague Dawley rats (8 weeks old, 220 ± 30 g): four received a 70% ethanol injection in the AV node, and four received a similar injection of 0.9% sodium chloride. Our surgical approach involved performing a partial sternotomy, using the epicardial fat as a landmark for ethanol injections. Animals were followed for 7 and 14 days. Complete AVB was successfully induced in all four rats that received ethanol injections. Rats in the control group experienced a transient AVB with a return to sinus rhythm. Our study found that using 70% ethanol injections in a systematic surgical approach is a reliable, safe, and reproducible way of creating a complete AVB model in rats.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45671357","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}
M. Salehi, Irena Zivkovic, S. Mayronne, J. Letoquart, Shahrzad Joharifard, É. Joos
Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, p = 0.0541) and morbidity (17% vs. 12%, p = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.
{"title":"The Evaluation of a Surgical Task-Sharing Program in South Sudan","authors":"M. Salehi, Irena Zivkovic, S. Mayronne, J. Letoquart, Shahrzad Joharifard, É. Joos","doi":"10.14288/1.0397102","DOIUrl":"https://doi.org/10.14288/1.0397102","url":null,"abstract":"Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, p = 0.0541) and morbidity (17% vs. 12%, p = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46505461","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 : 2023-04-19DOI: 10.3390/surgeries4020019
Mina Salehi, Irena Zivkovic, Stephanie Mayronne, Jean-Pierre Letoquart, Shahrzad Joharifard, Emilie Joos
Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, p = 0.0541) and morbidity (17% vs. 12%, p = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.
50亿人无法获得手术，撒哈拉以南非洲负担最重。由于外科工作人员对缩小这一差距至关重要，不列颠哥伦比亚大学与无国界医生组织合作创建并启动了基本外科技能(ESS)任务共享计划，该计划由在线学习模块和实际手术培训组成。我们的研究旨在评估这一试点项目。这是一项混合方法前瞻性队列研究，旨在评估南苏丹ESS项目的有效性。定量数据包括患者结果(并发症、再手术和死亡率)、受术者的手术熟练程度(测验、可信赖的专业活动(EPA)和日志数据)和电子调查。我们使用半结构化访谈来收集定性数据。2019年7月至2021年2月，3名学员共实施手术385例。最常见的手术是植皮(14.8%)和脓肿引流(9.6%)。共完成了172份环境评估报告，其中136份(79%)证明了学员的独立性。在训练期间，手术死亡率(0.56% vs. 0.13%， p = 0.0541)和发病率(17% vs. 12%， p = 0.1767)与训练前相比保持不变。访谈和调查显示，在整个培训过程中，外科知识和跨专业团队合作得到了提高。该项目使受训人员能够发展外科职业道路，并提高了当地患者和其他医疗保健提供者对他们的接受程度。这项研究证实了在南苏丹实施外科手术任务分担计划的可行性。这一规划评价有望为卫生部及其合作伙伴在撒哈拉以南非洲地区制定国家外科、产科和麻醉计划的培训支柱提供信息。
{"title":"The Evaluation of a Surgical Task-Sharing Program in South Sudan","authors":"Mina Salehi, Irena Zivkovic, Stephanie Mayronne, Jean-Pierre Letoquart, Shahrzad Joharifard, Emilie Joos","doi":"10.3390/surgeries4020019","DOIUrl":"https://doi.org/10.3390/surgeries4020019","url":null,"abstract":"Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, p = 0.0541) and morbidity (17% vs. 12%, p = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807868","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 : 2023-04-18DOI: 10.3390/surgeries4020018
C. Zirafa, Alessandra Lenzini, P. Spontoni, C. Cariello, L. Doroni, Adrea Pieroni, A. Petronio, F. Melfi
Platypnea-orthodeoxia syndrome (POS) is an uncommon clinical condition characterized by orthostatic dyspnea and hypoxemia. The case of a female patient who manifested postoperative episodes of sudden oxygen desaturation, dyspnea, and systemic arterial hypotension following lower bilobectomy for lung adenocarcinoma was reported. After meticulous clinical investigations, the patient proved to be affected by a rare form of postural dyspnea: platypnea-orthodeoxia syndrome, a clinical disorder described in the middle of the last century. The pathophysiology was found in an intracardiac mechanism of right-to-left blood shunt, combined with lung and chest wall modification. Atrial septal defect, such as patent foramen ovale (PFO), is a common cause of platypnea-orthodeoxia syndrome; the rescue closure of PFO usually allows for an immediate and consistent improvement of the symptoms.
{"title":"Platypnea-Orthodeoxia Syndrome Manifesting as an Early Complication after Lower Bilobectomy","authors":"C. Zirafa, Alessandra Lenzini, P. Spontoni, C. Cariello, L. Doroni, Adrea Pieroni, A. Petronio, F. Melfi","doi":"10.3390/surgeries4020018","DOIUrl":"https://doi.org/10.3390/surgeries4020018","url":null,"abstract":"Platypnea-orthodeoxia syndrome (POS) is an uncommon clinical condition characterized by orthostatic dyspnea and hypoxemia. The case of a female patient who manifested postoperative episodes of sudden oxygen desaturation, dyspnea, and systemic arterial hypotension following lower bilobectomy for lung adenocarcinoma was reported. After meticulous clinical investigations, the patient proved to be affected by a rare form of postural dyspnea: platypnea-orthodeoxia syndrome, a clinical disorder described in the middle of the last century. The pathophysiology was found in an intracardiac mechanism of right-to-left blood shunt, combined with lung and chest wall modification. Atrial septal defect, such as patent foramen ovale (PFO), is a common cause of platypnea-orthodeoxia syndrome; the rescue closure of PFO usually allows for an immediate and consistent improvement of the symptoms.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46864978","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 : 2023-04-04DOI: 10.3390/surgeries4020017
V. Chatziravdeli, Evdokia Psaroulaki, Grigoriοs Rodiftsis, G. Katsaras
Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder in children 9–15 years old with an incidence that ranges from 0.33:100,000 to 24.58:100,000. Idiopathic SCFE is strongly associated with obesity, while atypical SCFE is associated with endocrinopathies, metabolic and renal disease, radiation therapy, and chemotherapy. In this review, we summarized the current data regarding the pathogenesis of SCFE and its association to obesity. In the last years, there have been increasing evidence regarding the implication of obesity in the pathogenesis of SCFE, but no definitive mechanism has been proven. The etiology is probably multifactorial, with both mechanical and metabolic factors contributing to the disease, with the later gaining more ground, especially in obese patients. Understanding what causes the disease will help paediatricians and orthopaedists develop more efficient strategies for treating patients and diminishing complication rates.
{"title":"Slipped Capital Femoral Epiphysis Pathogenesis and Its Relation to Obesity—Where Do We Stand? A Narrative Review","authors":"V. Chatziravdeli, Evdokia Psaroulaki, Grigoriοs Rodiftsis, G. Katsaras","doi":"10.3390/surgeries4020017","DOIUrl":"https://doi.org/10.3390/surgeries4020017","url":null,"abstract":"Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder in children 9–15 years old with an incidence that ranges from 0.33:100,000 to 24.58:100,000. Idiopathic SCFE is strongly associated with obesity, while atypical SCFE is associated with endocrinopathies, metabolic and renal disease, radiation therapy, and chemotherapy. In this review, we summarized the current data regarding the pathogenesis of SCFE and its association to obesity. In the last years, there have been increasing evidence regarding the implication of obesity in the pathogenesis of SCFE, but no definitive mechanism has been proven. The etiology is probably multifactorial, with both mechanical and metabolic factors contributing to the disease, with the later gaining more ground, especially in obese patients. Understanding what causes the disease will help paediatricians and orthopaedists develop more efficient strategies for treating patients and diminishing complication rates.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49479924","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 : 2023-04-03DOI: 10.3390/surgeries4020016
J. Ehrmann, Wendy Johnson, Arlene de Castro, Marcie Donnelly
Rabbits are commonly used for pharmacokinetic (PK) and toxicokinetic (TK) studies in the research setting, requiring repetitive venipuncture, which can be challenging in this species. The auricular vessels are commonly used for venipuncture in rabbits. The repetitive access of these delicate vessels can lead to trauma such as hematomas causing venipuncture to become more challenging as the study progresses. In turn, this leads to missed time points or insufficient blood samples. Surgical models for chronic vascular access in rabbits are common throughout the industry. Common models include exteriorized vascular catheters and implanted vascular access ports. However, these implants come with their own complications and restrictions when used in rabbits. Therefore, the authors evaluated the use of a vascular access button (VAB), an implant commonly used in small rodents, as a refinement to the current chronic models in use in the industry. Seventeen rabbits were implanted with either single or dual channel VABs. The catheters were implanted in the femoral artery and/or vein and then tunneled subcutaneously to the button on the dorsal thoracic area. Overall, the results were outstanding, and an established model was created. The average patency rate was 316 days with several implants still patent after 2 years. The authors feel the implantation and use of a vascular access button in rabbits for routine PK studies is an excellent refinement. The rabbits tolerate the buttons extremely well with minimal issues. The patency rate is equal to or better than vascular access ports and when used with the tethering system, provides a hands-off method for blood collection and intravenous administration in rabbits during PK studies.
{"title":"Implantation of a Vascular Access Button for Chronic Blood Sampling and Drug Administration in the Rabbit","authors":"J. Ehrmann, Wendy Johnson, Arlene de Castro, Marcie Donnelly","doi":"10.3390/surgeries4020016","DOIUrl":"https://doi.org/10.3390/surgeries4020016","url":null,"abstract":"Rabbits are commonly used for pharmacokinetic (PK) and toxicokinetic (TK) studies in the research setting, requiring repetitive venipuncture, which can be challenging in this species. The auricular vessels are commonly used for venipuncture in rabbits. The repetitive access of these delicate vessels can lead to trauma such as hematomas causing venipuncture to become more challenging as the study progresses. In turn, this leads to missed time points or insufficient blood samples. Surgical models for chronic vascular access in rabbits are common throughout the industry. Common models include exteriorized vascular catheters and implanted vascular access ports. However, these implants come with their own complications and restrictions when used in rabbits. Therefore, the authors evaluated the use of a vascular access button (VAB), an implant commonly used in small rodents, as a refinement to the current chronic models in use in the industry. Seventeen rabbits were implanted with either single or dual channel VABs. The catheters were implanted in the femoral artery and/or vein and then tunneled subcutaneously to the button on the dorsal thoracic area. Overall, the results were outstanding, and an established model was created. The average patency rate was 316 days with several implants still patent after 2 years. The authors feel the implantation and use of a vascular access button in rabbits for routine PK studies is an excellent refinement. The rabbits tolerate the buttons extremely well with minimal issues. The patency rate is equal to or better than vascular access ports and when used with the tethering system, provides a hands-off method for blood collection and intravenous administration in rabbits during PK studies.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42670369","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 : 2023-03-20DOI: 10.3390/surgeries4010014
G. Romano, F. Davini, Alessandra Lenzini, C. Zirafa, F. Melfi
Primary focal hyperhidrosis is an idiopathic condition characterized by excessive sweating, predominantly localized in the hands and armpits. This condition affects about 1% of the general population and it is often associated with a deterioration of the Quality of Life (QoL), especially in younger patients. Medical therapy, usually prescribed as a first approach, is associated with good results, but only in the short term. Surgery, on the other hand, is associated with a definitive resolution of the disease in most patients. Currently, there is no consensus on the timing of treatment and the final decision is often at the discretion of the physician and the patient. The aim of this study is to analyze the post-operative, age-related QoL in patients affected by primary hyperhidrosis treated by surgery by analyzing data of 56 patients who underwent biportal thoracoscopic sympathectomy between January 2016 and October 2019, dividing the patients into two groups: under and over the age of 25. The QoL was studied by administering the IIRS questionnaire pre-operatively and then six months after surgery. Data analysis demonstrated a lower complication rate in younger patients and equal post-operative outcomes in the two age groups.
{"title":"Thoracic Sympathectomy for Primary Hyperhidrosis: Focus on Post-Operative Age-Related Quality of Life","authors":"G. Romano, F. Davini, Alessandra Lenzini, C. Zirafa, F. Melfi","doi":"10.3390/surgeries4010014","DOIUrl":"https://doi.org/10.3390/surgeries4010014","url":null,"abstract":"Primary focal hyperhidrosis is an idiopathic condition characterized by excessive sweating, predominantly localized in the hands and armpits. This condition affects about 1% of the general population and it is often associated with a deterioration of the Quality of Life (QoL), especially in younger patients. Medical therapy, usually prescribed as a first approach, is associated with good results, but only in the short term. Surgery, on the other hand, is associated with a definitive resolution of the disease in most patients. Currently, there is no consensus on the timing of treatment and the final decision is often at the discretion of the physician and the patient. The aim of this study is to analyze the post-operative, age-related QoL in patients affected by primary hyperhidrosis treated by surgery by analyzing data of 56 patients who underwent biportal thoracoscopic sympathectomy between January 2016 and October 2019, dividing the patients into two groups: under and over the age of 25. The QoL was studied by administering the IIRS questionnaire pre-operatively and then six months after surgery. Data analysis demonstrated a lower complication rate in younger patients and equal post-operative outcomes in the two age groups.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49502510","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 : 2023-03-20DOI: 10.3390/surgeries4010015
F. Frattini, A. Pino, G. Cordaro, G. Lianos, Simona Bertoli, G. Dionigi
Gastric diverticula are uncommon anatomic abnormalities that are usually asymptomatic or found incidentally in upper gastrointestinal radiographs with contrast or endoscopy. Gastric diverticula usually arise from the wall of the gastric fundus. Their preoperative study or intraoperative finding is of great importance in patients with obesity who are scheduled for bariatric surgery. In bariatric surgery, and especially in sleeve gastrectomy, it is of utmost importance to know the exact location of the diverticulum in order to position the stapler correctly and to perform appropriate gastric resection including the diverticulum. Sleeve gastrectomy has gained popularity worldwide and currently accounts for the most performed bariatric procedure according to more recent international surveys. It is considered to be a technically easy procedure. Nonetheless, some steps of the procedure, such as gastric fundus mobilization and the gastric resection with the use of the stapler, may be challenging in patients with a high BMI and in the presence of abnormalities of the gastric wall. This can represent a risk for the occurrence of complications such as a gastric leak or bleeding. We propose some considerations about technical tips to adopt for safely performing sleeve gastrectomy in the presence of a subcardial diverticulum.
{"title":"Management of Large Subcardial Diverticula in Sleeve Gastrectomy: Technical Tips","authors":"F. Frattini, A. Pino, G. Cordaro, G. Lianos, Simona Bertoli, G. Dionigi","doi":"10.3390/surgeries4010015","DOIUrl":"https://doi.org/10.3390/surgeries4010015","url":null,"abstract":"Gastric diverticula are uncommon anatomic abnormalities that are usually asymptomatic or found incidentally in upper gastrointestinal radiographs with contrast or endoscopy. Gastric diverticula usually arise from the wall of the gastric fundus. Their preoperative study or intraoperative finding is of great importance in patients with obesity who are scheduled for bariatric surgery. In bariatric surgery, and especially in sleeve gastrectomy, it is of utmost importance to know the exact location of the diverticulum in order to position the stapler correctly and to perform appropriate gastric resection including the diverticulum. Sleeve gastrectomy has gained popularity worldwide and currently accounts for the most performed bariatric procedure according to more recent international surveys. It is considered to be a technically easy procedure. Nonetheless, some steps of the procedure, such as gastric fundus mobilization and the gastric resection with the use of the stapler, may be challenging in patients with a high BMI and in the presence of abnormalities of the gastric wall. This can represent a risk for the occurrence of complications such as a gastric leak or bleeding. We propose some considerations about technical tips to adopt for safely performing sleeve gastrectomy in the presence of a subcardial diverticulum.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41511759","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 : 2023-03-15DOI: 10.3390/surgeries4010013
Joshua Song, Brjan Kaiji Betzler, Arun-Kumar Kaliya-Perumal, J. Oh
Lumbosacral transition vertebra (LSTV) is a common occurrence and its prevalence ranges from 2.6% to 35.6%. Our aim is to study this phenomenon in the adult Singaporean population and assess the level of degeneration of the suprajacent disc in those with LSTV. Retrospectively, 545 patients (Age = 57.6 ± 18.3 years; Male = 277; Female = 268) who underwent radiographic evaluation of the lumbar spine for lower back pain or radicular symptoms were shortlisted. LSTV was found to be present in 106 patients (19.4%) with sacralization of L5 and lumbarization of S1 occurring in 96 patients (17.6%) and 10 patients (1.8%), respectively. The most common form of LSTV was Castellvi type IIA (46 patients; 43.4%). Based on Pfirrmann grading, Grade IV disc degeneration was most common in both the LSTV level (63%) and the unfused suprajacent level (77%) in those with LSTV. There was a significantly higher number of patients with grade IV and above degeneration in the suprajacent disc level among those with LSTV when compared to the last unfused (L5-S1) disc level in those without LSTV (84% vs. 65%; p = 0.0001). This suprajacent disc degeneration seen in patients with LSTV may contribute to low back pain and related problems in these patients.
{"title":"Prevalence of Lumbosacral Transition Vertebrae in Symptomatic Adults and the Levels of Degeneration in the Suprajacent Disc","authors":"Joshua Song, Brjan Kaiji Betzler, Arun-Kumar Kaliya-Perumal, J. Oh","doi":"10.3390/surgeries4010013","DOIUrl":"https://doi.org/10.3390/surgeries4010013","url":null,"abstract":"Lumbosacral transition vertebra (LSTV) is a common occurrence and its prevalence ranges from 2.6% to 35.6%. Our aim is to study this phenomenon in the adult Singaporean population and assess the level of degeneration of the suprajacent disc in those with LSTV. Retrospectively, 545 patients (Age = 57.6 ± 18.3 years; Male = 277; Female = 268) who underwent radiographic evaluation of the lumbar spine for lower back pain or radicular symptoms were shortlisted. LSTV was found to be present in 106 patients (19.4%) with sacralization of L5 and lumbarization of S1 occurring in 96 patients (17.6%) and 10 patients (1.8%), respectively. The most common form of LSTV was Castellvi type IIA (46 patients; 43.4%). Based on Pfirrmann grading, Grade IV disc degeneration was most common in both the LSTV level (63%) and the unfused suprajacent level (77%) in those with LSTV. There was a significantly higher number of patients with grade IV and above degeneration in the suprajacent disc level among those with LSTV when compared to the last unfused (L5-S1) disc level in those without LSTV (84% vs. 65%; p = 0.0001). This suprajacent disc degeneration seen in patients with LSTV may contribute to low back pain and related problems in these patients.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46050009","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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