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Frontiers in Surgery

Zlatan Zvizdic, Asmir Jonuzi, Aleksandra Djuran, Semir Vranic
Gastric necrosis with perforation is a rare and potentially life-threatening condition in childhood beyond the neonatal period. We report a case of gastric necrosis and perforation of a portion of the great curvature due to a massive gastric dilatation caused by pathological aerophagia in a 13-years-old, mentally impaired adolescent girl. Despite the successful surgical treatment, the patient's condition rapidly deteriorated post-operatively and she died due to the multisystem organ failure and multiple infections...
2019: Frontiers in Surgery
Wolfgang Reinpold, Ferdinand Köckerling, Reinhard Bittner, Joachim Conze, René Fortelny, Andreas Koch, Jan Kukleta, Andreas Kuthe, Ralph Lorenz, Bernd Stechemesser
Introduction: Recently, the promising results of new procedures for the treatment of rectus diastasis with concomitant hernias using extraperitoneal mesh placement and anatomical restoration of the linea alba were published. To date, there is no recognized classification of rectus diastasis (RD) with concomitant hernias. This is urgently needed for comparative assessment of new surgical techniques. A working group of the German Hernia Society (DHG) and the International Endohernia Society (IEHS) set itself the task of devising such a classification...
2019: Frontiers in Surgery
Marc N Gallay, David Moser, Christian Federau, Daniel Jeanmonod
Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery. Objective: To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS. Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed...
2019: Frontiers in Surgery
Dimitrios Symeonidis, Konstantinos Tepetes
Gastric cancer patients represent a rather divergent patient group and in certain carefully selected cases of early forms of gastric cancer the D2 gastrectomy could be considered a more radical procedure than the biological and oncological characteristics of the primary tumor on the gastric wall would require. As any unnecessary dissection increases morbidity without always respective survival benefits, an approach that could accurately predict and actually dictate the exact extent of lymph node dissection would be ideal...
2018: Frontiers in Surgery
Andreas Hiester, Alessandro Nini, Anna Fingerhut, Robert Große Siemer, Christian Winter, Peter Albers, Achim Lusch
Background: Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) plays a crucial role in treatment of metastatic non-seminomatous germ cell cancer. Objective: To evaluate the functional outcome regarding the preservation of ejaculatory function comparing a bilateral vs. unilateral template resection in PC-RPLND patients. In addition, oncological safety and perioperative complications of the unilateral template resection was compared to the full bilateral one. Design/Setting/Participants: Between 2003 and 2018, 504 RPLNDs have been performed in 434 patients...
2018: Frontiers in Surgery
Pierre Arnaud Godin, Konstantinos Syrios, Gwennaelle Rege, Sami Demir, Efstratia Charitidou, Olivier Wery
Objectives: To evaluate the pregnancy and delivery rates of laparoscopic tubal reanastomosis. Study Design: From 2003 to 2013, 135 laparoscopic tubal reversals were performed according to the four stitch technique. The parameters studied, included positive pregnancy test, miscarriage, ectopic pregnancy, termination of pregnancy, term delivery, post-operative time to conception, post-operative hysterosalpingography, and spermogram. Results: From the 135 patients operated, 93 fulfilled the inclusion criteria...
2018: Frontiers in Surgery
Haralampos Gouveris, Danny J Eckert
No abstract text is available yet for this article.
2018: Frontiers in Surgery
Riccardo Campi, Francesco Sessa, Fabrizio Di Maida, Isabella Greco, Andrea Mari, Tána Takáčová, Andrea Cocci, Riccardo Fantechi, Alberto Lapini, Sergio Serni, Marco Carini, Andrea Minervini
Background: The role of lymph node dissection (LND) for renal cell carcinoma (RCC) is controversial. Notably, the conflicting evidence on the benefits and harms of LND is inherently linked to the lack of consensus on both anatomic templates and extent of lymphadenectomy. Herein, we provide a detailed overview of the most commonly dissected templates of LND for RCC, focusing on key anatomic landmarks and patterns of lymphatic drainage. Methods: A systematic review of the English-language literature was performed without time filters in July 2018 in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement recommendations...
2018: Frontiers in Surgery
Patrick R G Eriksen, Gitte B Hvilsom, Preben Homøe
Introduction: Infected "mycotic" Aneurysm (IA) of the extracranial carotid artery is a rare condition that can be fatal if mistaken for other pathology. An 83-year-old man presented with a mass on the neck initially suspected malignant. Weeks later it grew rapidly and was found to be an IA, thus requiring acute surgery. Via this case report, we discuss diagnostics and approach when diagnosing masses in relation to vessels of the neck not readily explained. Case Report: After diagnostic imaging and clinical assessment an unknown primary tumor of the neck was suspected...
2018: Frontiers in Surgery
Raoul Muteganya, Serge Goldman, Fouad Aoun, Thierry Roumeguère, Simone Albisinni
Introduction: Lymph node metastases (LNM) represent a proven prognostic factor for biochemical recurrence (BCR)-free survival, metastatic free survival and overall survival in prostate cancer (PCa). Although pelvic node dissection remains the gold standard for the detection of LNM, novel imaging techniques are entering clinical practice, in the effort to improve LNM detection and spare unnecessary surgeries. Aim of the current review is to describe such imaging techniques and explore their advantages and limitations...
2018: Frontiers in Surgery
Nicole S Klee, Cameron G McCarthy, Steven Lewis, Jaine L McKenzie, Julie E Vincent, R Clinton Webb
Diabetic bladder dysfunction (DBD) is a well-recognized and common symptom affecting up to 50% of all diabetic patients. DBD has a broad range of clinical presentations ranging from overactive to underactive bladder symptoms that develops in middle-aged to elderly patients with long standing and poorly controlled diabetes. Low efficacy of current therapeutics and lifestyle interventions combined with high national healthcare costs highlight the need for more research into bladder dysfunction pathophysiology and novel treatment options...
2018: Frontiers in Surgery
Dirk Weyhe, Verena Uslar, Felix Weyhe, Maximilian Kaluschke, Gabriel Zachmann
We developed a prototype of a virtual, immersive, and interactive anatomy atlas for surgical anatomical training. The aim of this study was to test the usability of the VR anatomy atlas and to measure differences in knowledge acquirement between an immersive content delivery medium and conventional learning (OB). Twenty-eight students of the 11th grade of two german high schools randomly divided into two groups. One group used conventional anatomy books and charts whereas the other group used the VR Anatomy Atlas to answer nine anatomy questions...
2018: Frontiers in Surgery
Sam L Francis, Claudia Di Bella, Gordon G Wallace, Peter F M Choong
There is no long-term treatment strategy for young and active patients with cartilage defects. Early and effective joint preserving treatments in these patients are crucial in preventing the development of osteoarthritis. Tissue engineering over the past few decades has presented hope in overcoming the issues involved with current treatment strategies. Novel advances in 3D bioprinting technology have promoted more focus on efficient delivery of engineered tissue constructs. There have been promising in-vitro studies and several animal studies looking at 3D bioprinting of engineered cartilage tissue...
2018: Frontiers in Surgery
Ferdinand Köckerling
Introduction: A meta-analysis that compared the onlay vs. sublay technique in open incisional hernia repair identified better outcomes for the sublay operation. Nonetheless, an Expert Consensus Guided by Systematic Review found the onlay mesh location useful in certain settings. Therefore, all studies on the onlay technique were once again collated and analyzed. Materials and Methods: A systematic search of the available literature was performed in August 2018 using Medline, PubMed, Scopus, Embase, Springer Link, and the Cochrane Library...
2018: Frontiers in Surgery
Wiebke Ackermann, Qianqian Fan, Akarsh J Parekh, Nicoleta Stoicea, John Ryan, Sergio D Bergese
Introduction: Perioperative hypothermia is one of the most common phenomena seen among surgical patients, leading to numerous adverse outcomes such as intraoperative blood loss, cardiac events, coagulopathy, increased hospital stay and associated costs. Forced air warming (FAW) and resistive heating (RH) are the two most commonly used and widely studied devices to prevent perioperative hypothermia. The effect of FAW on operating room laminar flow and surgical site infection is unclear and we initiated an extensive literature search in order to get a scientific insight of this aspect...
2018: Frontiers in Surgery
Alejandra Vilanova-Sánchez, Carlos Albert Reck, Richard J Wood, Cristina Garcia Mauriño, Alessandra C Gasior, Robert E Dyckes, Katherine McCracken, Laura Weaver, Devin R Halleran, Karen Diefenbach, Dennis Minzler, Rebecca M Rentea, Christina B Ching, Venkata Rama Jayanthi, Molly Fuchs, Daniel Dajusta, Geri D Hewitt, Marc A Levitt
Aim of the study: Many patients with an anorectal malformation (ARM) or pelvic anomaly have associated urologic or gynecologic problems. We hypothesized that our multidisciplinary center, which integrates pediatric colorectal, urologic, gynecologic and GI motility services, could impact a patient's anesthetic exposures and hospital visits. Methods: We tabulated during 2015 anesthetic/surgical events, endotracheal intubations, and clinic/hospital visits for all patients having a combined procedure. Main results: Eighty two patients underwent 132 combined procedures (Table 1)...
2018: Frontiers in Surgery
Jean Bouquet de Jolinière, A Major, F Khomsi, N Ben Ali, L Guillou, A Feki
The presence of tumor cells can be identified in the lymph node when metastasis has occurred from the primary cancer site into the lymph node (1) If the sentinel lymph node ganglion is negative for the presence of tumor cells at the time of histological examination, the other lymph nodes are also negative in 99% of cases. If no tumor cells are identified in the sentinel lymph node ganglion by histological examination, the other lymph nodes are also negative for the presence of tumor cells in 99% of cases. The sentinel lymph node advantageously replaces axillary dissection as a staging method in breast cancer T1 and T2 (2)...
2018: Frontiers in Surgery
Carlos A Reck-Burneo, Alexander J M Dingemans, Victoria A Lane, Jennifer Cooper, Marc A Levitt, Richard J Wood
Introduction: Operative surgical videos are a popular educational resource, not commonly a part of a peer-reviewed article. We wanted to evaluate the impact of either reading a peer-reviewed manuscript or watching an operative video on a surgeon's confidence in performing a complex case. Methods: Pediatric surgeons and fellows were asked to complete an initial questionnaire to assess their confidence (formulated as a score) in the diagnosis and operative repair of anal stenosis and rectal atresia. Results: Of 101 pediatric surgeons and fellows, 52 (51%) were randomized into a "manuscript" group and 49 (49%) into a "video" group...
2018: Frontiers in Surgery
Ganeshwaran Shivapathasundram, Agadha C Wickremesekera, Helen D Brasch, Reginald Marsh, Swee T Tan, Tinte Itinteang
Aim: The presence of cells within meningioma (MG) that express embryonic stem cell (ESC) markers has been previously reported. However, the precise location of these cells has yet to be determined. Methods: 3,3-Diaminobenzidine (DAB) immunohistochemical (IHC) staining was performed on 11 WHO grade I MG tissue samples for the expression of the ESC markers OCT4, NANOG, SOX2, KLF4 and c-MYC. Immunofluorescence (IF) IHC staining was performed to investigate the localization of each of these ESC markers. NanoString and colorimetric in situ hybridization (CISH) mRNA expression analyses were performed on six snap-frozen MG tissue samples to confirm transcriptional activation of these proteins, respectively...
2018: Frontiers in Surgery
Ferdinand Köckerling, Bernhard Lammers
In an Expert Consensus Guided by Systematic Review the panel agreed that for open elective incisional hernia repair sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. Accordingly, the available literature on the open IPOM technique was searched and evaluated. Material and Methods: A systematic search of the available literature was performed in July 2018 using Medline, PubMed, and the Cochrane Library. Forty-five publications were identified as relevant for the key question...
2018: Frontiers in Surgery
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