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Langenbeck's Archives of Surgery

Giovanni Marchegiani, Marco Ramera, Elena Viviani, Fabio Lombardo, Adam Cybulski, Marco Chincarini, Giuseppe Malleo, Claudio Bassi, Giulia A Zamboni, Roberto Salvia
PURPOSE: The use of intra-abdominal drains after major surgical procedures represents a well-established but controversial practice. No data are available regarding both the occurrence and the potential impact of their postoperative accidental dislocation. The aim of this study is to assess the actual rate of dislocation of intra-abdominal drains postoperatively and to evaluate its clinical impact. METHODS: This is a prospective observational study using major pancreatic surgery as a model...
February 15, 2019: Langenbeck's Archives of Surgery
Dominik Taterra, Linda M Wong, Jens Vikse, Beatrice Sanna, Przemysław Pękala, Jerzy Walocha, Roberto Cirocchi, Krzysztof Tomaszewski, Brandon Michael Henry
PURPOSE: The anatomy of parathyroid glands (PTG) is highly variable in the population. The aim of this study was to conduct a systematic analysis on the prevalence and location of PTG in healthy and hyperparathyroidism (HPT) patients. METHODS: An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the number of PTG per patient and location of PTG. The data was extracted from the eligible studies and pooled into a meta-analysis...
February 14, 2019: Langenbeck's Archives of Surgery
Gurkirat Singh, Christopher B Nahm, Nigel B Jamieson, Terence C Chua, Shen Wong, Cathy Thoo, Anubhav Mittal, Anthony J Gill, Jaswinder S Samra
BACKGROUND: Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. However, re-operative surgery in the post-pancreatectomy setting is technically challenging. METHODS: A novel strategy of incorporating the resuscitative endovascular balloon occlusion of the aorta (REBOA) is described...
February 13, 2019: Langenbeck's Archives of Surgery
A Chudner, M Gachabayov, A Dyatlov, H Lee, R Essani, Roberto Bergamaschi
BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate the morbidity of loop ileostomy (LI) and loop colostomy (LC) creation in restorative anterior resection for rectal cancer as well as the morbidity of their reversal. METHODS: PubMed, EMBASE, MEDLINE via Ovid, and Cochrane Library were systematically searched for records published from 1980 to 2017 by three independent researchers. The primary endpoint was overall morbidity after stoma creation and reversal...
February 12, 2019: Langenbeck's Archives of Surgery
Safi Dokmak, Fadhel Samir Ftériche, Roberto Luca Meniconi, Béatrice Aussilhou, Igor Duquesne, Genaro Perrone, Chihebeddine Romdhani, Jacques Belghiti, Philippe Lévy, Olivier Soubrane, Alain Sauvanet
INTRODUCTION: Risk factors of postoperative pancreatic fistula (POPF) after laparoscopic distal pancreatectomy (LDP) are not well known and were studied, including the stapler cartridge size and drainage modality. METHODS: Between January 2008 and December 2016, 181 LDP were performed and the pancreas was sectioned by stapler in 130 patients (72%). Patients received white (2.5 mm), blue (3.5 mm), or green (4.1 mm) staplers and the size was not based on any pre or peroperative randomization...
February 9, 2019: Langenbeck's Archives of Surgery
R R Dulfer, E Y Koh, W Y van der Plas, A F Engelsman, E J M Nieveen van Dijkum, R A Pol, L Vogt, M H de Borst, S Kruijff, A Schepers, N M Appelman-Dijkstra, J I Rotmans, D A Hesselink, C H J van Eijck, E J Hoorn, T M van Ginhoven
INTRODUCTION: Tertiary hyperparathyroidism (tHPT), i.e., persistent HPT after kidney transplantation, affects 17-50% of transplant recipients. Treatment of tHPT is mandatory since persistently elevated PTH concentrations after KTx increase the risk of renal allograft dysfunction and osteoporosis. The introduction of cinacalcet in 2004 seemed to offer a medical treatment alternative to parathyroidectomy (PTx). However, the optimal management of tHPT remains unclear. METHODS: A retrospective analysis was performed on patients receiving a kidney transplantation (KT) in two academic centers in the Netherlands...
February 7, 2019: Langenbeck's Archives of Surgery
Samuel A Käser, P Brosi, P A Clavien, R Vonlanthen
PURPOSE: Therapeutic approaches for septic open abdomen treatment remain a major challenge with many uncertainties. The most convincing method is vacuum-assisted wound closure with mesh-mediated fascia traction with a protective plastic sheet placed on the viscera. As this plastic sheet and the mesh must be removed before final fascial closure, such a technique only allows temporary abdominal closure. This retrospective study analyzes the results of a modification of this technique allowing final abdominal closure using an anti-adhesive permeable polyvinylidene fluoride (PVDF) mesh...
February 7, 2019: Langenbeck's Archives of Surgery
A Hecker, M Reichert, C J Reuß, T Schmoch, J G Riedel, E Schneck, W Padberg, M A Weigand, M Hecker
PURPOSE: The abdomen is the second most common source of sepsis and is associated with unacceptably high morbidity and mortality. Recently, the essential definitions of sepsis and septic shock were updated (Third International Consensus Definitions for Sepsis and Septic Shock, Sepsis-3) and modified. The purpose of this review is to provide an overview of the changes introduced by Sepsis-3 and the current state of the art regarding the treatment of abdominal sepsis. RESULTS: While Sepsis-1/2 focused on detecting systemic inflammation as a response to infection, Sepsis-3 defines sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection...
January 26, 2019: Langenbeck's Archives of Surgery
Petra Ganschow, Irmgard Treiber, Ulf Hinz, Martina Kadmon
INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal reconstruction is the surgical standard for the majority of patients with familial adenomatous polyposis (FAP). The pouch-anal anastomosis may be performed handsewn after primary mucosectomy or by double stapling. Better functional results favour the latter; however, higher rates of remaining rectal mucosa with adenomas often necessitate secondary mucosectomy. Data on functional outcome after secondary mucosectomy is scarce...
January 24, 2019: Langenbeck's Archives of Surgery
Raouef Ahmed Bichoo, Anjali Mishra, Niraj Kumari, Narendra Krishnani, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Saroj Kanta Mishra
PURPOSE: Poorly differentiated thyroid carcinoma (PDTC) patients have worse outcomes than patients with differentiated thyroid carcinoma (DTC), but the implication of poorly differentiated areas (PDAs) noted in DTC is not very well understood. The aim of the present study was to compare the clinicopathologic profiles and outcomes of PDTC and DTC with PDA. METHODS: A total of 142 patients, managed at out center between September 1989 and June 2016, were enrolled in this retrospective study...
January 23, 2019: Langenbeck's Archives of Surgery
Hiroshi Kurahara, Hiroyuki Shinchi, Takao Ohtsuka, Yoshihiro Miyasaka, Taketo Matsunaga, Hirokazu Noshiro, Tomohiko Adachi, Susumu Eguchi, Naoya Imamura, Atsushi Nanashima, Kazuhiko Sakamoto, Hiroaki Nagano, Masayuki Ohta, Masafumi Inomata, Akira Chikamoto, Hideo Baba, Yusuke Watanabe, Kazuyoshi Nishihara, Masafumi Yasunaga, Koji Okuda, Shoji Natsugoe, Masafumi Nakamura
PURPOSE: Neoadjuvant therapy (NAT) is increasingly used to improve the prognosis of patients with borderline resectable pancreatic cancer (BRPC) albeit with little evidence of its advantage over upfront surgical resection. We analyzed the prognostic impact of NAT on patients with BRPC in a multicenter retrospective study. METHODS: Medical data of 165 consecutive patients who underwent treatment for BRPC between January 2010 and December 2014 were collected from ten institutions...
January 16, 2019: Langenbeck's Archives of Surgery
Bernhard Morell, Fritz Murray, Diana Vetter, Marco Bueter, Christoph Gubler
PURPOSE: Anastomotic leakages or staple line defects after Roux-en-Y gastric bypass (RYGB) and primary laparoscopic sleeve gastrectomy (LSG), respectively, with consecutive bariatric revisional surgery are associated with relevant morbidity and mortality rates. Endoscopic vacuum therapy (EVT) with or without stent-over-sponge (SOS) has been shown to be a promising therapy in foregut wall defects of various etiologies and may therefore be applied in the treatment of postbariatric leaks...
January 15, 2019: Langenbeck's Archives of Surgery
Giulia Manzini, Florian Malhofer, Theresia Weber
IMPORTANCE: Postoperative hypoparathyroidism remains a relevant problem after thyroid surgery. Although the roles of vitamin D deficiency and other risk factors have been discussed in previous studies, variable results have been reported. OBJECTIVE: Predicting the risk of postoperative hypocalcemia could be helpful for individual prognoses and medical treatment. PATIENTS AND METHODS: Documentation and analysis of bilateral thyroid operations performed between July 2011 and May 2014 were studied...
January 14, 2019: Langenbeck's Archives of Surgery
Fumihiro Terasaki, Yasuyuki Fukami, Atsuyuki Maeda, Yuichi Takayama, Takamasa Takahashi, Masahito Uji, Yuji Kaneoka
PURPOSE: Many studies report that pancreatoduodenectomy (PD) with portal-superior mesenteric vein resection and reconstruction (PVR) is not a contraindication to extended tumor resection for pancreatic ductal adenocarcinoma. However, the clinical benefit of an interposition graft for PVR still remains controversial. METHODS: Between January 2001 and December 2017, 199 patients with pancreatic cancer underwent PD either with or without PVR, and their medical records were reviewed retrospectively, paying specific attention to the PVR methods and the long-term outcome...
January 10, 2019: Langenbeck's Archives of Surgery
Zeeshan Ateeb, Roberto Valente, Raffaella M Pozzi-Mucelli, Linnéa Malgerud, Yasmine Schlieper, Elena Rangelova, Carlos Fernandez-Moro, Johannes Matthias Löhr, Urban Arnelo, Marco Del Chiaro
INTRODUCTION: IPMNs, considered precursor lesions of pancreatic adenocarcinoma (PDAC), might display histological alteration varying from low-grade dysplasia (LGD) to cancer. Nevertheless, the prevalence of PDAC is far below the prevalence of IPMN; therefore, not all of these precursor lesions finally progress to cancer. Preoperative features consistent with and finding at final histology of high-grade dysplasia (HGD) or cancer are currently lacking. The aim of this study is to correlate the presence of preoperative clinical features with the finding of advance lesions at final histology...
January 5, 2019: Langenbeck's Archives of Surgery
Kei Hosoda, Marie Washio, Hiroaki Mieno, Hiromitsu Moriya, Akira Ema, Hideki Ushiku, Masahiko Watanabe, Keishi Yamashita
BACKGROUND: Laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using the double-flap technique has been reported to rarely cause gastroesophageal reflux. However, quantitative evaluation of the reflux has hardly been performed. The aim of this study was to clarify the superiority of the double-flap technique of LAPG with esophagogastrostomy compared with the OrVil technique in terms of preventing gastroesophageal reflux. METHODS: A total of 40 and 51 patients who underwent LAPG with esophagogastrostomy using the double-flap and OrVil techniques, respectively, for upper one-third gastric cancer were included in this study...
January 5, 2019: Langenbeck's Archives of Surgery
Patrick Heger, Susanne Blank, Käthe Gooßen, Henrik Nienhüser, Markus K Diener, Alexis Ulrich, André L Mihaljevic, Thomas Schmidt
PURPOSE: The aim of this systematic review and meta-analysis was to compare the oncological and perioperative outcomes of transhiatally extended gastrectomy (TEG) and thoracoabdominal esophagectomy (TAE) for therapy of adenocarcinomas of the esophagogastric junction (AEG) with focus on AEG type II, as the optimal approach for these tumors is still unclear. METHODS: MEDLINE, EMBASE, and the Cochrane Library (CENTRAL) were searched until July 24, 2018. Studies comparing TAE and TEG for surgical treatment of AEG type tumors have been included...
January 3, 2019: Langenbeck's Archives of Surgery
Nicholas Latchana, Dhruvin H Hirpara, Julie Hallet, Paul J Karanicolas
BACKGROUND: Several modalities exist for the management of hepatic neoplasms. Resection, the most effective approach, carries significant risk of hemorrhage. Blood loss may be corrected with red blood cell transfusion (RBCT) in the short term, but may ultimately contribute to negative outcomes. PURPOSE: Using available literature, we seek to define the frequency and risk factors of blood loss and transfusion following hepatectomy. The impact of blood loss and RBCT on short- and long-term outcomes is explored with an emphasis on peri-operative methods to reduce hemorrhage and transfusion...
January 3, 2019: Langenbeck's Archives of Surgery
Fabian Grass, Basile Pache, Fabio Butti, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
PURPOSE: The present study aimed to analyze the impact of perioperative fluid management on postoperative ileus (POI) after loop ileostomy closure. METHODS: Consecutive loop ileostomy closures over a 6-year period (May 2011-May 2017) were included. Main outcomes were POI, defined as time to first stool beyond POD 3, and postoperative complications of any grade. Critical fluid management-related thresholds including postoperative weight gain were identified through receiver operator characteristics (ROC) analysis and tested in a multivariable analysis...
January 3, 2019: Langenbeck's Archives of Surgery
Roxane D Staiger, Milo A Puhan, Pierre-Alain Clavien
No abstract text is available yet for this article.
January 3, 2019: Langenbeck's Archives of Surgery
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