Pub Date : 2022-10-11DOI: 10.3390/surgeries3040032
Diana Parise, Federica Sartorato, Enrico Fabris, Andrea Scarpa, Tiziano Baesso, L. Sbricoli, Omnia Abdelwahab, M. Fedrigo, C. Bacci
Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery decreases surgical risks and is less invasive. The aim of this article is to present a case of guided osteotomy for bone biopsy and implant placement. Methods: CBCT was performed for the patient’s bone examination, an optical scanner was used for intra-oral images, and surgical certified software was applied for the osteotomy planning and the surgeon’s guide realization. Case report: The patient’s question is about left maxilla prosthetic rehabilitation. During the oral cavity and X-ray examination, a radiopacity with a feathered edge was found; in order to detect the finding, a CBCT was performed, and the surgery was planned. A bone biopsy was performed simultaneously with the implant’s placement through a drill guide. The specimen sent for histological exam showed osteosclerosis. Conclusions: It is the opinion of the authors that by involving and combining close collaboration and communication, several professional specializations (clinicians and radiologists) can improve the treatments for better patient care.
{"title":"Guided Biopsy of a Radiopaque Lesion Simultaneous with Dental Implants’ Placement: A Multidisciplinary Approach","authors":"Diana Parise, Federica Sartorato, Enrico Fabris, Andrea Scarpa, Tiziano Baesso, L. Sbricoli, Omnia Abdelwahab, M. Fedrigo, C. Bacci","doi":"10.3390/surgeries3040032","DOIUrl":"https://doi.org/10.3390/surgeries3040032","url":null,"abstract":"Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery decreases surgical risks and is less invasive. The aim of this article is to present a case of guided osteotomy for bone biopsy and implant placement. Methods: CBCT was performed for the patient’s bone examination, an optical scanner was used for intra-oral images, and surgical certified software was applied for the osteotomy planning and the surgeon’s guide realization. Case report: The patient’s question is about left maxilla prosthetic rehabilitation. During the oral cavity and X-ray examination, a radiopacity with a feathered edge was found; in order to detect the finding, a CBCT was performed, and the surgery was planned. A bone biopsy was performed simultaneously with the implant’s placement through a drill guide. The specimen sent for histological exam showed osteosclerosis. Conclusions: It is the opinion of the authors that by involving and combining close collaboration and communication, several professional specializations (clinicians and radiologists) can improve the treatments for better patient care.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46566312","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 : 2022-09-29DOI: 10.3390/surgeries3040030
M. D’Asta, F. Gulino, F. Cannone, C. Ettore, G. Bonanno, G. Ettore
Objective: Worldwide cervical cancer is the fourth most common cancer and is also the fourth leading cause of death among women, after breast cancer, colorectal cancer, and lung cancer. The aim of this study is to investigate the long-term oncological safety of laparoscopic treatment without the use of a uterine manipulator for patients with early stage cervical cancer. Materials and methods: A single-center retrospective study was conducted at the Department of Obstetrics and Gynecology of ARNAS Garibaldi Nesima on patients surgically treated for early cervical cancer from 2014 to 2017. Inclusion criteria included squamous or adenosquamous histotype, FIGO stage from Ia1 to Ib2, cancer size < 4 cm, ECOG status 0–1, and negative serum beta-HCG. The patients were divided into two groups: treatment with and without an intra-uterine manipulator. Results: Seventy patients were identified, but only thirty-one met the inclusion criteria and were enrolled. All patients underwent surgery: three patients with the uterine manipulator, twenty-eight without. Among the thirty-one patients enrolled, twelve women had cancer in situ (IA1), nineteen had an early stage cervical cancer, in particular two cases of cervical cancer stage IA2, ten cases of cervical cancer stage IB1, and seven cases of cervical cancer stage IB2, according to the FIGO classification. At follow-up, three cases of recurrence occurred, but the uterine manipulator was not used. Conclusion: After five years of follow-up, recurrence rates in patients treated with minimally invasive surgery are about 10%, but the use of a uterine manipulator is not related to a higher level of recurrence rates.
{"title":"Early Cervical Cancer and Recurrence after Minimally Invasive Surgery without Uterine Manipulator","authors":"M. D’Asta, F. Gulino, F. Cannone, C. Ettore, G. Bonanno, G. Ettore","doi":"10.3390/surgeries3040030","DOIUrl":"https://doi.org/10.3390/surgeries3040030","url":null,"abstract":"Objective: Worldwide cervical cancer is the fourth most common cancer and is also the fourth leading cause of death among women, after breast cancer, colorectal cancer, and lung cancer. The aim of this study is to investigate the long-term oncological safety of laparoscopic treatment without the use of a uterine manipulator for patients with early stage cervical cancer. Materials and methods: A single-center retrospective study was conducted at the Department of Obstetrics and Gynecology of ARNAS Garibaldi Nesima on patients surgically treated for early cervical cancer from 2014 to 2017. Inclusion criteria included squamous or adenosquamous histotype, FIGO stage from Ia1 to Ib2, cancer size < 4 cm, ECOG status 0–1, and negative serum beta-HCG. The patients were divided into two groups: treatment with and without an intra-uterine manipulator. Results: Seventy patients were identified, but only thirty-one met the inclusion criteria and were enrolled. All patients underwent surgery: three patients with the uterine manipulator, twenty-eight without. Among the thirty-one patients enrolled, twelve women had cancer in situ (IA1), nineteen had an early stage cervical cancer, in particular two cases of cervical cancer stage IA2, ten cases of cervical cancer stage IB1, and seven cases of cervical cancer stage IB2, according to the FIGO classification. At follow-up, three cases of recurrence occurred, but the uterine manipulator was not used. Conclusion: After five years of follow-up, recurrence rates in patients treated with minimally invasive surgery are about 10%, but the use of a uterine manipulator is not related to a higher level of recurrence rates.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47827846","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 : 2022-09-14DOI: 10.3390/surgeries3030029
M. G. Mastromarino, G. Cardillo, M. Jaus
Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. We reported a 67-year-old patient with middle tracheal squamous cell carcinoma treated by induction chemotherapy followed by a successful extended tracheal resection. The anastomosis was covered by a reversed thymic fat pad flap to prevent the erosion of adjacent brachiocephalic vessels. Postoperative concurrent chemoradiation did not threaten the integrity of the suture line. Careful tracheal dissection and accurate release manoeuvres are mandatory to achieve a tension-limited anastomosis. Extended tracheal resection may be safely performed after induction chemotherapy, with excellent long-term outcomes. A thymic fat flap seems to be beneficial to suture-line healing.
{"title":"A Reverse Thymic Fat Pad Flap to Cover the Anastomosis of an Extended Tracheal Resection Following Induction Chemotherapy: A Challenging Case Report","authors":"M. G. Mastromarino, G. Cardillo, M. Jaus","doi":"10.3390/surgeries3030029","DOIUrl":"https://doi.org/10.3390/surgeries3030029","url":null,"abstract":"Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. We reported a 67-year-old patient with middle tracheal squamous cell carcinoma treated by induction chemotherapy followed by a successful extended tracheal resection. The anastomosis was covered by a reversed thymic fat pad flap to prevent the erosion of adjacent brachiocephalic vessels. Postoperative concurrent chemoradiation did not threaten the integrity of the suture line. Careful tracheal dissection and accurate release manoeuvres are mandatory to achieve a tension-limited anastomosis. Extended tracheal resection may be safely performed after induction chemotherapy, with excellent long-term outcomes. A thymic fat flap seems to be beneficial to suture-line healing.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42534671","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 : 2022-09-14DOI: 10.3390/surgeries3030028
Jacqueline Chu Ruo Yang, Shih‐Ting Chiu, J. Oh, Arun-Kumar Kaliya-Perumal
Selective Nerve Root Block (SNRB) is a precise local injection technique that can be utilised to target a particular inflamed nerve root causing lumbar radiculopathy for both diagnostic and therapeutic purposes. Usually, for SNRB to be therapeutic, a combination of a local anaesthetic agent and a steroid is injected under imaging guidance, whereas for diagnostic purposes, just the local anaesthetic agent is injected. While the ideal treatment strategy is to relieve the nerve root from its compressing pathology, local injection of steroids targeted at the affected nerve root can also be attempted to reduce inflammation and thus achieve pain relief. Although the general principle for administering an SNRB remains largely the same across the field, there are differences in techniques depending on the region and level of the spine that is targeted. Moreover, drug combinations utilised by clinicians vary based on preference. The proven benefits of SNRBs largely outweigh their risks, and the procedure is deemed safe and well tolerated in a majority of patients. In this narrative, we explore the existing literature and seek to provide a comprehensive understanding of SNRB as a treatment for lumbar radiculopathy, its indications, techniques, outcomes, and complications.
{"title":"Selective Nerve Root Block in Treatment of Lumbar Radiculopathy: A Narrative Review","authors":"Jacqueline Chu Ruo Yang, Shih‐Ting Chiu, J. Oh, Arun-Kumar Kaliya-Perumal","doi":"10.3390/surgeries3030028","DOIUrl":"https://doi.org/10.3390/surgeries3030028","url":null,"abstract":"Selective Nerve Root Block (SNRB) is a precise local injection technique that can be utilised to target a particular inflamed nerve root causing lumbar radiculopathy for both diagnostic and therapeutic purposes. Usually, for SNRB to be therapeutic, a combination of a local anaesthetic agent and a steroid is injected under imaging guidance, whereas for diagnostic purposes, just the local anaesthetic agent is injected. While the ideal treatment strategy is to relieve the nerve root from its compressing pathology, local injection of steroids targeted at the affected nerve root can also be attempted to reduce inflammation and thus achieve pain relief. Although the general principle for administering an SNRB remains largely the same across the field, there are differences in techniques depending on the region and level of the spine that is targeted. Moreover, drug combinations utilised by clinicians vary based on preference. The proven benefits of SNRBs largely outweigh their risks, and the procedure is deemed safe and well tolerated in a majority of patients. In this narrative, we explore the existing literature and seek to provide a comprehensive understanding of SNRB as a treatment for lumbar radiculopathy, its indications, techniques, outcomes, and complications.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48146828","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 : 2022-09-13DOI: 10.3390/surgeries3030027
A. Schmedding, C. Assion, S. Mayer, Annika Brunner
The COVID-19 pandemic has been a great challenge, especially for families. We aimed to analyze the impact of the pandemic on childcare for and the work–family balance of pediatric surgeons in Germany. An anonymized questionnaire on the working and familial situation before and during the COVID-19 pandemic was sent to the members of the German Society of Pediatric Surgery and trainees in pediatric surgery (April–July 2021). One-hundred-fifty-three participants (59% female) completed the questionnaire. A total of 16% of the males and 62% of the females worked part-time. Most (68%) had underage children. During the COVID-19 pandemic, 36% reported a decrease in patients and interventions, and 55% reported an increase in the organizational work-related burden. Childcare for underage children during lockdown was organized mainly with the help of institutional emergency childcare (45%), staying home (34%), one parent working from a home office (33%), or staying home by themselves (34%). Before the lockdown, 54% reported a good work–family balance. During the lockdown, this worsened by 42%. Most of the families had to organize themselves. Different means such as a home office, flexible working hours, and different models for childcare can help to improve the situation.
{"title":"Challenges of the COVID-19 Pandemic for the Work–Family Balance of Pediatric Surgeons","authors":"A. Schmedding, C. Assion, S. Mayer, Annika Brunner","doi":"10.3390/surgeries3030027","DOIUrl":"https://doi.org/10.3390/surgeries3030027","url":null,"abstract":"The COVID-19 pandemic has been a great challenge, especially for families. We aimed to analyze the impact of the pandemic on childcare for and the work–family balance of pediatric surgeons in Germany. An anonymized questionnaire on the working and familial situation before and during the COVID-19 pandemic was sent to the members of the German Society of Pediatric Surgery and trainees in pediatric surgery (April–July 2021). One-hundred-fifty-three participants (59% female) completed the questionnaire. A total of 16% of the males and 62% of the females worked part-time. Most (68%) had underage children. During the COVID-19 pandemic, 36% reported a decrease in patients and interventions, and 55% reported an increase in the organizational work-related burden. Childcare for underage children during lockdown was organized mainly with the help of institutional emergency childcare (45%), staying home (34%), one parent working from a home office (33%), or staying home by themselves (34%). Before the lockdown, 54% reported a good work–family balance. During the lockdown, this worsened by 42%. Most of the families had to organize themselves. Different means such as a home office, flexible working hours, and different models for childcare can help to improve the situation.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48881078","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 : 2022-08-23DOI: 10.3390/surgeries3030026
Woojun Kim, B. Kim, J. Nho, Jun-Bum Kim, C. Hong, S. Kwon, Youngjin Choi, Tae-Gyun Kim, Chang-Ju Lee, K. Jung
Overgrowth syndromes generally present with inherent health concerns and, in some instances, an increased risk of malignant intra-abdominal tumors, such as Wilms tumor or hepatoblastoma. There are various types of hyperplasia, but the crossed type is reported to be the rarest. We present a rare, crossed type of congenital hemihyperplasia. A six-year-old girl was referred to our clinic for leg length discrepancy and was diagnosed with congenital hemihyperplasia of the right lower limb and left upper limb. The leg length discrepancy had begun to affect the patient’s gait and stair climbing. We regularly monitored her leg length and checked for functional and cosmetic problems for 24 months. However, the hyperplasia progressed and caused severe gait impairment. Leg length discrepancy at the last check-up was 30 mm. She underwent femoral lengthening surgery using a monolateral external fixator. At the 14th month follow-up, her gait and stair climbing had greatly improved, and a scanogram revealed that the leg length discrepancy had been successfully treated with a mild varus angulation of the femur. We present a rare, crossed congenital hemihyperplasia. We recommend limb lengthening surgery for treating patients with idiopathic hemihyperplasia.
{"title":"Crossed Congenital Hemihyperplasia: A Case Report","authors":"Woojun Kim, B. Kim, J. Nho, Jun-Bum Kim, C. Hong, S. Kwon, Youngjin Choi, Tae-Gyun Kim, Chang-Ju Lee, K. Jung","doi":"10.3390/surgeries3030026","DOIUrl":"https://doi.org/10.3390/surgeries3030026","url":null,"abstract":"Overgrowth syndromes generally present with inherent health concerns and, in some instances, an increased risk of malignant intra-abdominal tumors, such as Wilms tumor or hepatoblastoma. There are various types of hyperplasia, but the crossed type is reported to be the rarest. We present a rare, crossed type of congenital hemihyperplasia. A six-year-old girl was referred to our clinic for leg length discrepancy and was diagnosed with congenital hemihyperplasia of the right lower limb and left upper limb. The leg length discrepancy had begun to affect the patient’s gait and stair climbing. We regularly monitored her leg length and checked for functional and cosmetic problems for 24 months. However, the hyperplasia progressed and caused severe gait impairment. Leg length discrepancy at the last check-up was 30 mm. She underwent femoral lengthening surgery using a monolateral external fixator. At the 14th month follow-up, her gait and stair climbing had greatly improved, and a scanogram revealed that the leg length discrepancy had been successfully treated with a mild varus angulation of the femur. We present a rare, crossed congenital hemihyperplasia. We recommend limb lengthening surgery for treating patients with idiopathic hemihyperplasia.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45047403","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 : 2022-08-18DOI: 10.3390/surgeries3030024
Jan Bernal, Scott Adrian, Heather Burkart, M. Laffins
Purpose Vascular Access Ports (VAPs) consist of an indwelling catheter connected to an implanted port that provides direct access for sample collection or infusion. The use of VAPs in biomedical research reduces trauma on vessels from repeated venipuncture, decreases secondary infections, promotes social housing and animal welfare, and increases the accuracy and efficiency of study procedures. In addition to enabling comprehensive data collection, VAPs increase satisfaction, and well-being by minimizing interference with daily routines and fostering cooperation. The responsible use of VAPs includes approval by the institutional animal care and use committee (IACUC), verification of the surgeon′s skill and experience, and confirmation that research staff are trained on the proper maintenance and access techniques. This document aims to provide surgeons, researchers and research staff, veterinary staff, and IACUCs with guidelines for implanting, maintaining, accessing, and troubleshooting vascular access ports in large animal species. (Rabbit, Canine, Feline, Nonhuman Primate, Porcine).
{"title":"Guideline for Vascular Access Port Use and Maintenance in Large Animals for Biomedical Research","authors":"Jan Bernal, Scott Adrian, Heather Burkart, M. Laffins","doi":"10.3390/surgeries3030024","DOIUrl":"https://doi.org/10.3390/surgeries3030024","url":null,"abstract":"Purpose Vascular Access Ports (VAPs) consist of an indwelling catheter connected to an implanted port that provides direct access for sample collection or infusion. The use of VAPs in biomedical research reduces trauma on vessels from repeated venipuncture, decreases secondary infections, promotes social housing and animal welfare, and increases the accuracy and efficiency of study procedures. In addition to enabling comprehensive data collection, VAPs increase satisfaction, and well-being by minimizing interference with daily routines and fostering cooperation. The responsible use of VAPs includes approval by the institutional animal care and use committee (IACUC), verification of the surgeon′s skill and experience, and confirmation that research staff are trained on the proper maintenance and access techniques. This document aims to provide surgeons, researchers and research staff, veterinary staff, and IACUCs with guidelines for implanting, maintaining, accessing, and troubleshooting vascular access ports in large animal species. (Rabbit, Canine, Feline, Nonhuman Primate, Porcine).","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":"226 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41270926","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 : 2022-08-18DOI: 10.3390/surgeries3030025
M. Della Corte, D. Amparore, M. Sica, E. Clemente, D. Mazzuca, M. Manfredi, C. Fiori, F. Porpiglia
(1) Background: We report a very unusual presentation of pseudoaneurysm developed following a robot-assisted radical prostatectomy (RARP) with bilateral pelvic lymph node dissection. The patient was a 66-year-old male, admitted at the Emergency Department 20 days after discharge from RARP due to chest pain, lipothymia and occult bleeding, necessitating a blood transfusion and a moderate increase of serum troponin. Angiography showed a pseudo-aneurysm involving the inferior-epigastric artery pubic branch. The patient underwent percutaneous embolization with complete resolution. The aim of this study is to offer an overview on pseudoaneurysms developed as radical prostatectomy complications; (2) Methods: A literature search was conducted on Scopus and PubMed for pseudoaneurysms after RARP to analyze all the previously published cases. The search terms used were “pseudoaneurysm” and “prostatectomy” using the Boolean Operator “AND”. We used the default search strategy “all fields”; (3) Results: Herein, a narrative review is proposed to facilitate the approach to this emerging clinical challenge, due to both an implementing in diagnosis imaging techniques and a spread of robotic surgery in prostate cancer; (4) Conclusions: The management of radical prostatectomy complications still remains barely uniformed and needs to be precisely calibrated as the initial cure approach itself.
{"title":"Pseudoaneurysm after Radical Prostatectomy: A Case Report and Narrative Literature Review","authors":"M. Della Corte, D. Amparore, M. Sica, E. Clemente, D. Mazzuca, M. Manfredi, C. Fiori, F. Porpiglia","doi":"10.3390/surgeries3030025","DOIUrl":"https://doi.org/10.3390/surgeries3030025","url":null,"abstract":"(1) Background: We report a very unusual presentation of pseudoaneurysm developed following a robot-assisted radical prostatectomy (RARP) with bilateral pelvic lymph node dissection. The patient was a 66-year-old male, admitted at the Emergency Department 20 days after discharge from RARP due to chest pain, lipothymia and occult bleeding, necessitating a blood transfusion and a moderate increase of serum troponin. Angiography showed a pseudo-aneurysm involving the inferior-epigastric artery pubic branch. The patient underwent percutaneous embolization with complete resolution. The aim of this study is to offer an overview on pseudoaneurysms developed as radical prostatectomy complications; (2) Methods: A literature search was conducted on Scopus and PubMed for pseudoaneurysms after RARP to analyze all the previously published cases. The search terms used were “pseudoaneurysm” and “prostatectomy” using the Boolean Operator “AND”. We used the default search strategy “all fields”; (3) Results: Herein, a narrative review is proposed to facilitate the approach to this emerging clinical challenge, due to both an implementing in diagnosis imaging techniques and a spread of robotic surgery in prostate cancer; (4) Conclusions: The management of radical prostatectomy complications still remains barely uniformed and needs to be precisely calibrated as the initial cure approach itself.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47424976","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 : 2022-08-05DOI: 10.3390/surgeries3030023
Kirsten Wong, Alden Smith, J. Alonso, J. Long
Background: Airway stenosis is a known complication of prolonged intubation in hospitalized patients. With the high rate of intubations in patients with COVID-19 pneumonia, laryngotracheal stenosis (LTS) is a complication of COVID-19 that drastically reduces quality of life for patients who may remain tracheostomy-dependent. Methods: Patient medical history, laryngoscopy, and CT imaging were obtained from medical records. Results: We report four cases of complicated LTS following intubation after COVID-19 pneumonia and explore the current literature in a narrative review. Four patients developed LTS following intubation from COVID-19 pneumonia. Three patients remain tracheostomy-dependent, and the fourth required a heroic operative schedule to avoid tracheostomy. Conclusion: Intubation for COVID-19 pneumonia can result in severe LTS, which may persist despite endoscopic intervention.
{"title":"Complicated Laryngotracheal Stenosis Occurring Early after COVID-19 Intubation","authors":"Kirsten Wong, Alden Smith, J. Alonso, J. Long","doi":"10.3390/surgeries3030023","DOIUrl":"https://doi.org/10.3390/surgeries3030023","url":null,"abstract":"Background: Airway stenosis is a known complication of prolonged intubation in hospitalized patients. With the high rate of intubations in patients with COVID-19 pneumonia, laryngotracheal stenosis (LTS) is a complication of COVID-19 that drastically reduces quality of life for patients who may remain tracheostomy-dependent. Methods: Patient medical history, laryngoscopy, and CT imaging were obtained from medical records. Results: We report four cases of complicated LTS following intubation after COVID-19 pneumonia and explore the current literature in a narrative review. Four patients developed LTS following intubation from COVID-19 pneumonia. Three patients remain tracheostomy-dependent, and the fourth required a heroic operative schedule to avoid tracheostomy. Conclusion: Intubation for COVID-19 pneumonia can result in severe LTS, which may persist despite endoscopic intervention.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48152382","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 : 2022-07-20DOI: 10.3390/surgeries3030022
A. De Vito, Damiano Giardini, T. Perrone, S. Soon, G. Meccariello, G. Iannella, G. Ciammetti, Emanuele Checcoli, Chung-Yu Hao, Shengchen Hao
Objective: The objective of this article is to define a correct diagnostic pathway for oropharyngeal cancer of unknown primary (OPCUP) identification. Background: OPCUP represents one of the most frequent causes of neck metastases onset without the identification of the primary tumor. Therefore, there is a high percentage of late or missing diagnoses, resulting in treatment delay or in a wrong therapeutic process. The up-to-date diagnostic procedures can help us to begin therapies at the right time. Methods: This is a review of the latest articles about diagnostic pathways in the OPCUP. A selection of the references was carried out in PubMed, EMBASE, Cochrane, and CENTRAL electronic databases. Conclusion: The oropharynx represents the most common site of primary unknown head and neck cancer (HNCUP). Recent epidemiologic data reported an increasing incidence of HNCUP related to human papilloma virus positive squamous cell carcinoma. Positron emission tomography combined with computerized tomography scanning or magnetic resonance imaging allows for improving the detection of primary unknown tumors and distant and locoregional metastases. Finally, the introduction of the trans-oral robotic surgical approach has introduced a new role of surgery in the HNCUP diagnosis and treatment. Hence, the new technological improvement allows reaching in most HNCUP patients an early diagnosis, achieving targeted management and better treatment outcomes, as well as decreasing toxicity and the side effects of treatment options.
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