Otto B van Leeuwen, Marjolein van Reeven, Danny van der Helm, Jan N M IJzermans, Vincent E de Meijer, Aad P van den Berg, Sarwa Darwish Murad, Bart van Hoek, Ian P J Alwayn, Robert J Porte, Wojciech G Polak
BACKGROUND: Donor hepatectomy time is associated with graft survival after liver transplantation. The aim of this study was to identify the impact of donor hepatectomy time on biliary injury during donation after circulatory death liver transplantation. METHODS: First, bile duct biopsies of livers included in (pre)clinical machine perfusion research were analyzed. Secondly, of the same livers, bile samples were collected during normothermic machine perfusion. Lastly, a nationwide retrospective cohort study was performed including 273 adult patients undergoing donation after circulatory death liver transplantation between January 1, 2002 and January 1, 2017...
March 26, 2020: Surgery
Manuel Barberio, Eric Felli, Emilie Seyller, Fabio Longo, Manish Chand, Ines Gockel, Bernard Geny, Lee Swanström, Jacques Marescaux, Vincent Agnus, Michele Diana
BACKGROUND: Fluorescence-based enhanced reality is a software that provides quantitative fluorescence angiography by computing the fluorescence intensity time-to-peak after intravenous indocyanine green. Hyperspectral imaging is a contrast-free, optical imaging modality which measures tissue oxygenation. METHODS: In 8 pigs, an ischemic bowel segment created by dividing the arcade branches was imaged using hyperspectral imaging and fluorescence-based enhanced reality...
March 26, 2020: Surgery
Yang-Xun Pan, Jun-Cheng Wang, Xiao-Yun Lu, Jin-Bin Chen, Wei He, Jian-Cong Chen, Xiao-Hui Wang, Yi-Zhen Fu, Li Xu, Yao-Jun Zhang, Min-Shan Chen, Ren-Chun Lai, Zhong-Guo Zhou
BACKGROUND: Excessive intraoperative hemorrhage is a critical factor of poor prognoses after hepatectomy. Low central venous pressure during parenchymal transection is recognized to effectively reduce intraoperative hemorrhage in open procedures. However, the role of controlled low central venous pressure in laparoscopic hepatectomy is still controversial. METHODS: In the present randomized clinical trial, we set up a standard boundary of low central venous pressure according to our Pilot Study, then enrolled patients scheduled for elective laparoscopic hepatectomy and allocated them randomly to a group undergoing central venous pressure reduction by anesthesiologic interventions or a control group...
March 23, 2020: Surgery
Ramiro Fernández-Placencia, Nicolas Golse, Luis Cano, Marc-Antoine Allard, Gabriella Pittau, Oriana Ciacio, Antonio Sa Cunha, Denis Castaing, Chady Salloum, Daniel Azoulay, Daniel Cherqui, Didier Samuel, René Adam, Eric Vibert
BACKGROUND: Posthepatectomy decompensation remains a frequent and poor outcome after hepatectomy, but its prediction is still inaccurate. Liver stiffness measurement can predict posthepatectomy decompensation, but there is a so-called "gray zone" that requires another predictor. Because splenomegaly is an objective sign of portal hypertension, we hypothesized that spleen volumetry could improve the identification of patients at risk. METHODS: Patients with hepatocellular carcinoma who underwent hepatectomy in our tertiary center between August 2014 and December 2017 were reviewed...
March 20, 2020: Surgery
Derrick C Wan, George P Yang
No abstract text is available yet for this article.
March 19, 2020: Surgery
Christopher J LaRocca, Arthur Li, Kelly Lafaro, Karen Clark, Matthew Loscalzo, Laleh G Melstrom, Susanne G Warner
BACKGROUND: Biopsychosocial distress screening is a critical component of comprehensive cancer care. Financial issues are a common source of distress in this patient population. This study uses a biopsychosocial distress screening tool to determine the factors associated with financial toxicity and the impact of these stressors on gastrointestinal cancer patients. METHODS: A 48-question, proprietary distress screening tool was administered to patients with gastrointestinal malignancies from 2009 to 2015...
March 17, 2020: Surgery
James M Halle-Smith, James Hodson, Lewis G Stevens, Bobby Dasari, Ravi Marudanayagam, Thamara Perera, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius F Mirza, Keith J Roberts
BACKGROUND: Outcomes after Strasberg grade E bile duct injury have been widely reported. However, there are comparatively few reports of outcomes after Strasberg A to D bile duct injury. Therefore, the aim of this study was to comprehensively evaluate the long-term clinical and economic impact of Strasberg A to D bile duct injury. METHODS: Patients with Strasberg A to D bile duct injury were identified from a prospectively collected and maintained database. Long-term biliary complication rates, as well as treatment costs were then estimated, and compared across Strasberg injury grades...
March 14, 2020: Surgery
Ajith K Siriwardena, John Windsor, Nicholas Zyromski, Giovanni Marchegiani, Dejan Radenkovic, Catherine Morgan, Ioannis Passas, Attila Olah, Kevin C Conlon, Martin Smith, Olivier Busch, Minas Baltatzis, Marc G Besselink, Charles Vollmer, Carlos Fernandez-Del Castillo, Helmut Friess, Giuseppe Garcea, Sean Burmeister, Thilo Hackert, Keith D Lillemoe, Richard Schulick, Shailesh V Shrikhande, Andrew Smith, Luca Gianotti, Massimo Falconi, David Adams, Mustapha Adham, Roland Andersson, Marco Del Chiaro, John Devar, Santhalingam Jegatheeswaran, Hjalmar van Santvoort, Igor Khatkov, Jakob Izbicki, Markus Büchler, John P Neoptolemos, Claudio Bassi, Christos Dervenis
BACKGROUND: The International Study Group for Pancreatic Surgery provides globally accepted definitions for reporting of complications after pancreatic surgery. This International Study Group for Pancreatic Surgery project aims to provide a standardized framework for reporting of the results of operative treatment for chronic pancreatitis. METHODS: An International Study Group for Pancreatic Surgery project circulation list was created with pre-existing and new members and including gastroenterologists in addition to surgeons...
March 14, 2020: Surgery
Anastassia Y Gorvitovskaia, Laura A Scrimgeour, Brittany A Potz, Nicholas C Sellke, Afshin Ehsan, Neel R Sodha, Frank W Sellke
BACKGROUND: Cardiopulmonary bypass may be associated with postoperative neurocognitive dysfunction; however, risk factors have not been clearly identified. We hypothesize that lower hematocrit levels are correlated with postoperative neurocognitive dysfunction. METHODS: A total of 30 patients underwent cardiac operations utilizing cardiopulmonary bypass and screening for neurocognitive dysfunction preoperatively and on postoperative day 4. Patients were analyzed according to hematocrit preoperatively, 6 hours postoperatively, and on postoperative day 4, and whether they received intra or postoperative transfusions of packed red blood cells...
March 13, 2020: Surgery
Zheng Liu, Yang Liu, Yuxia Fan, Xiaoming Wang, Xiubo Lu
BACKGROUND: The aim of the present study was to examine the frequency, characteristics, and risk factors of level IIb lymph node metastases in papillary thyroid carcinoma. METHODS: We reviewed and collected clinical and pathological records for 954 papillary thyroid carcinoma patients with clinically positive lateral neck node metastasis. Univariate and multivariate analyses were performed to detect risk factors for level IIb lymph node metastasis; a predictive model was built based on multivariate analysis and tested in a validation group...
March 13, 2020: Surgery
Kathryn A Schlosser, Sean R Maloney, Korene Gbozah, Tanushree Prasad, Paul D Colavita, Vedra A Augenstein, B Todd Heniford
BACKGROUND: Weight loss is often encouraged or required before open ventral hernia repair. This study evaluates the impact of weight change on total, intra-abdominal, subcutaneous, and hernia volume. METHODS: Patients who underwent open ventral hernia repair from 2007 to 2018 with two preoperative computed tomography scans were identified. Scans were reviewed using 3D volumetric software. Demographics, operative characteristics, and outcomes were evaluated. The impact of weight change on intra-abdominal, subcutaneous, and hernia volume was assessed using Spearman's correlation coefficients and linear regression models...
March 6, 2020: Surgery
Hou-Ju Lee, Chi-Tung Cheng, Chih-Chi Chen, Chien-An Liao, Shao-Wei Chen, Shang-Yu Wang, Yu-Tung Wu, Chi-Hsun Hsieh, Chun-Nan Yeh, Chien-Hung Liao
BACKGROUND: Splenectomy is the life-saving treatment for high-grade spleen trauma. Splenectomized patients are at a significant infection risk. However, the trauma-induced splenectomy results in less incidence of postsplenectomy infection than the hematologic disorder. We conducted a large-scale study to identify the infection rate and management strategy in trauma-related splenic injuries. METHODS: We included patients with the diagnosis of spleen injury in Taiwan from January 2003 to December 2013 by using the National Health Insurance Database and divided them into spleen preserved and splenectomized groups...
March 3, 2020: Surgery
Jonah Shiroky, Erin Lillie, Hala Muaddi, Marika Sevigny, Woo Jin Choi, Paul J Karanicolas
BACKGROUND: Surgical site infections cause substantial morbidity and mortality. Negative pressure wound therapy may reduce the risk of surgical site infections, but current evidence is unclear. The objective of this study was to examine whether negative pressure wound therapy reduces the risk of surgical site infections and other wound complications when compared with conventional dressings in all patients with primarily closed surgical wounds. METHODS: A comprehensive systematic review of randomized controlled trials was conducted...
March 3, 2020: Surgery
R J Cruz, J McGurgan, L Butera, K Poloyac, M Roberts, W Stein, M Minervini, D R Jorgensen, A Humar
BACKGROUND: Historically, adults with ultra short bowel syndrome (USBS) have been considered candidates for lifetime parenteral nutrition (PN) or are referred for visceral transplantation. We examined the surgical and nutritional outcomes of adult patients with USBS managed at a single intestinal rehabilitation center. METHODS: We retrospectively reviewed data on 588 adult patients referred to our center between January 2013 and December 2018. USBS was defined as residual small bowel (SB) length ≤ 50 cm...
March 2, 2020: Surgery
Wataru Izumo, Ryota Higuchi, Toru Furukawa, Takehisa Yazawa, Shuichiro Uemura, Masahiro Shiihara, Masakazu Yamamoto
BACKGROUNDS: Upfront surgery is the standard treatment for resectable invasive intraductal papillary mucinous carcinoma; however, recurrence is common. Therefore, we investigated the recurrence, surgical outcome, and preoperative prognostic factors for recurrence in patients with resectable invasive intraductal papillary mucinous carcinoma. METHODS: We analyzed 111 patients who underwent upfront surgery for resectable invasive intraductal papillary mucinous carcinoma between 2000 and 2017 and evaluated the relationship among clinicopathologic factors, recurrence, and outcomes...
March 2, 2020: Surgery
Shirley Liu, Danielle R Heller, Raymond A Jean, Alexander S Chiu, Sajid A Khan, Alan Dardik
No abstract text is available yet for this article.
March 2, 2020: Surgery
Joseph A Caprini, Thomas W Wakefield
No abstract text is available yet for this article.
March 2, 2020: Surgery
Francesco Tonelli, Giacomo Batignani
Leonardo da Vinci's analysis and artistic representation of the hepatic vascular anatomy, performed more than 500 years ago, has not yet been fully recognized nor appreciated. Leonardo modified the anatomic concepts of Galen, up until then in vogue, and described for the first time the intrahepatic distribution of the proper hepatic artery, the portal vein, and the hepatic veins. The depiction of these structures is surprising for its clarity and perspective and reproduces the anatomic situation almost exactly...
March 2, 2020: Surgery
Jean-Nicolas Vauthey
No abstract text is available yet for this article.
February 29, 2020: Surgery
Vardan Papoian, Kevin G Handy, Anthony M Villano, Rafael A Tolentino, Mohamed T Hassanein, Lauren S Nosanov, Erin A Felger
BACKGROUND: Opioid-based analgesia is the most common method for pain control in the postoperative period. Limited data exist to compare the adequacy of pain control in the post thyroidectomy period with nonopioid-based analgesia. We aimed to evaluate the efficacy of nonopioid-based, postoperative analgesia. METHODS: After institutional review board approval, patients were randomized to 1 of 2 pain control regimens. Sample size was calculated to assess for a pain score difference of 1 based on a visual analog scale...
February 29, 2020: Surgery
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