Cirugia y cirujanos最新文献

Objective: The aim of this study was to examine how the ABO blood type affects endometrioid-type, EC prognosis.

Method: A total of 522 patients diagnosed with EC between February 2010 and December 2021 were assessed, retrospectively. ABO blood types were used to divide the patients into four groups as A, B, O, and AB. Demographic data, menopause, prognostic variables, FIGO stage, and survival were evaluated. A in 217 patients, B in 84 patients, O in 181 patients, and AB blood type in 40 patients were analyzed.

Results: Age, gravida, parity, body mass index, menopause, comorbidity, prognostic variables, FIGO stage, and survival according to the groups were similar (p > 0.012). Group A differed from other groups statistically in peritoneal fluid cytology (p = 0.004). B blood type had the best chance of cumulative overall survival, followed by AB, A, and O blood types, in that order (p = 0.170).

Conclusion: In light of blood types sensitivity to endometrioid-type EC, O blood type has been identified as blood type with the highest risk of endometrioid EC.

Objective: The study aimed to explore the clinical efficacy of radiofrequency ablation (RFA) guided by high-density mapping on persistent atrial fibrillation (PsAF).

Method: A total of 190 patients with PsAF undergoing RFA were divided into a routine group (n = 105) and a high-density mapping group (n = 85). The indicators of therapeutic efficacy were collected and compared.

Results: A statistically significant difference was found in the overall rate of post-operative recurrence between the two groups (11.58% vs. 23.81%, χ2 = 5.055, p = 0.025). The effects of different treatment methods on SF-36 score varied (FSF-36 treatment = 43.142, p < 0.05), and SF-36 scores at 3, 6, and 12 months of both groups were in the same order: the high-density mapping group > the routine group. While surgery guided by high-density substrate mapping (odds ratio = 0.453, 95% confidence interval: [0.232-0.784], p < 0.001) was a protective factor for recurrence.

Conclusion: For patients with PsAF, more accurate mapping is conducted on the atrial substrate using a PentaRay electrode, which further verifies that the success rate of individualized ablation strategy is like mainstream procedures, and it significantly improves the subsequent health status of patients and reduces their incidence of adverse reactions.

Objective: The objective of the study is to evaluate the safety and efficacy of three different treatment methods for pediatric ulnar and radial double fractures.

Methods: 120 children with ulnar and radial double fractures were included in the study. According to the different treatment plans, children were divided into three groups: manual reduction, splint external fixation, double elastic intramedullary fixation, and double plate fixation. Surgical indicators, radiological results, clinical efficacy, and complications were evaluated and compared among the groups.

Results: The average hospital stay and operation time were significantly longer in the double plate internal fixation group compared to the other two groups. The double elastic intramedullary nailing group showed a higher fracture healing rate at 3 months compared to the other groups. There were no significant differences in clinical efficacy among the three groups. Complications were observed in all groups but did not show significant statistical differences.

Conclusion: Double elastic intramedullary nailing fixation demonstrated favorable outcomes in terms of surgical indicators and fracture healing rates for pediatric ulnar and radial double fractures.

Objective: Estrogen (E2) plays a significant role in postmenopausal osteoporosis, and its deficiency is related to chronic low-grade inflammation. Intravenous immunoglobulin (IVIG) is composed of immunoglobulins derived from the plasma of healthy donors. Numerous anti-inflammatory pathways are responsible for IVIG's anti-inflammatory action The aim of this study is to investigate the effects of IVIG on experimental-induced osteoporosis.

Materials and methods: Forty adult female Wistar rats were included in the study. Thirty rats underwent bilateral dorsal ovariectomy. Rats were grouped as Group 1 (n = 10, ovariectomy and saline); Group 2 (n = 10, ovariectomy and E2); Group 3 (n = 10, ovariectomy and IVIG), and Control group (n = 10, no oophorectomy). Histopathological examination of bone tissue, and biochemical analysis for beta-catenin, plasma Tumor Necrosis Factor-α, IL-6, receptor activator of nuclear-κB ligand (RANKL), and osteoprotegerin (OPG) levels were made.

Results: The IVIG group had increased trabecular number, area, and thickness with increased bone mineral density as well as decreased trabecular separation compared with the saline group. IVIG group had lower serum RANKL and higher serum OPG levels when compared with the saline group. The bone marrow beta-catenin level was significantly higher in the control and ovariectomy + IVIG groups.

Conclusion: IVIG has beneficial effects on experimentally induced osteoporosis with a possible action on inflammation and RANKL-β-catenin pathway.

Objective: The objective of this study was to compare the outcomes vertical and T-shaped pharyngoplasty closure techniques after total laryngectomy (TL) and to evaluate the factors associated with the development of pharyngocutaneous fistula.

Materials and methods: We performed a retrospective study that included patients with a histopathological diagnosis of laryngeal cancer that underwent TL between 2009 and 2021.

Results: Fifty-seven patients were included in the study. A total of 14 patients underwent a vertical closure of the neopharynx (24.6%), while 43 patients underwent a T-shaped closure (74.4%). Pharyngocutaneous fistula was the most common complication, observed in 40.4% of cases (n = 23). No difference in the rate of complications was observed between groups, with the exception of tracheal dehiscence which was reduced in patients with T-shaped closure (n = 2, 4.7% vs. n = 5, 35.7%, p = 0.002). Diabetes mellitus was more frequently observed in patients withthe development of pharyngocutaneous fistula (n = 7, 30.4% vs. n = 3, 8.8%, p = 0.03).

Conclusions: Although complicationswere lower in the T-shaped closure group, we could not establish the superiority of either technique.

Objective: Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.

Methods: This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/mL) referred for colonoscopy (2012-2015) at a tertiary center in Uruguay.

Results: Colorectal lesions were detected in 35.3% (516/1461) of cases, with a mean age of 62.8 ± 8.3 years. About 53.2% were men and 65.1% of the tumors were located in the left side of the colon. The size of the lesion and FIT values (p = 0.001) were positively correlated. Laterally spreading tumors predominated in the right colon (586 ng Hb/mL; 95% Confidence interval [CI] 443.4-760). One hundred and thirty-five (26%) lesions were advanced adenomas (15 ± 6.7 mm); 694.6 ng/mL; 95% CI 632.4-756.9). The highest diagnostic yield (0.5112) for advanced adenomas was at a FIT level of 400 ng Hb/mL (accuracy 88.6%). There were significant differences in FIT values early and advanced CRC (927 ng/mL; [95% CI: 637-1082] vs. 1453 [95% CI: 1352-1594; p = 0.001]).

Conclusion: A FIT value of 400 ng Hb/mL was the best diagnostic yield to detect advanced adenomas and CRC. This value is useful during the COVID-19 pandemic as it allows prioritization of colonoscopy to those most at risk of significant disease, thus reducing risks to both patients and healthcare workers.

Lipoblastoma is a very infrequent tumor, characteristic of early childhood. The thoracic location is infrequent, with isolated reports to date. We present the case of a 6-year-old male patient with a right thoracic tumor of months of evolution that was surgically removed by right anterolateral thoracotomy and in which the diagnosis of classic well-differentiated lipoblastoma was histologically confirmed. The patient evolved favorably and was discharged. He is currently under follow-up and without recurrence 1 year after surgery. This is, to our knowledge, the first thoracic lipoblastoma reported in an African pediatric patient. The importance of knowing the clinical, semiological, and intraoperative characteristics of this tumor becomes even more important, as in our case, in the context of international cooperation, where in many cases, there is no possibility of performing pre-operative imaging studies or subsequent genetic studies.

Objective: The objective of the study is to investigate the effect of pericapsular nerve group (PENG) block in early analgesia in elderly patients with hip fracture.

Methods: A total of 44 elderly patients with hip fracture admitted to our hospital from August 2021 to December 2022 were selected and divided into 2 groups according to different analgesia programs.

Results: At T1~T4, the resting and active visual analog scale (VAS) scores in group P were lower than group F (p < 0.05). The resting and active VAS scores at T5 in both groups were no visible differences (p > 0.05). After 30 min of block, systolic blood pressure, diastolic blood pressure, and heart rate were decreased in both groups (p < 0.05), but no obvious difference was found in the two groups (p > 0.05). Before surgery, Pittsburgh Sleep Quality Index (PSQI) and mini-mental state scale (MMSE) scores in both groups were reduced, and PSQI score in group P was lower than that in group F and MMSE score was higher than group F (p < 0.05).

Conclusion: PENG technology is safe and effective in the early analgesia of elderly hip fractures. It can effectively block physiological stress response caused by acute trauma, improve pre-operative sleep quality, and reduce the incidence of cognitive dysfunction.

Objective: To assess the construct validity and reliability of the Trabajo en Equipo en Cirugía (TECS) questionnaire.

Method: The questionnaire was administered to 401 undergraduate students who were doing surgery practices at three universities. An exploratory factor analysis was performed on the first 200 observations, and a confirmatory factor analysis on the remaining ones. The reliability of the instrument was established with Cronbach's alpha.

Results: The average age of the study population was 22 years (± 1.4) and 65.5% were women. The factors "Student's disposition towards teamwork", "Structure of the work environment" and "Leadership and collaboration in the work team" showed excellent internal consistency with a Cronbach's alpha of 0.94. The results in the exploratory factor analysis showed adequate goodness of fit with the empirical data.

Conclusions: The TECS is a valid (content and construct) and reliable instrument to assess the quality of teamwork in surgery in medical students.

Introducción: Mixed adenoneuroendocrine carcinoma is a rare tumor of the gastrointestinal tract with double differentiation into adenomatous and neuroendocrine carcinoma, each component with at least 30%.

Case report: A 60-year-old female with acute abdominal pain. Surgical treatment was decided, finding a tumor at the level of the cecum and ascending colon, a right hemicolectomy and ileostomy were performed.

Discussion: Mixed adenoneuroendocrine carcinoma can appear in various organs. They are highly malignant tumors, with a high risk of metastasis.

Conclusions: These tumors do not present symptoms or specific radiological or laboratory findings; diagnosis depends on postoperative histopathological and immunohistochemical studies.