Manabu Kakizoe, Jun Watanabe, Koki Goto, Yusuke Suwa, Kazuya Nakagawa, Hirokazu Suwa, Mayumi Ozawa, Atsushi Ishibe, Mitsuyoshi Ota, Chikara Kunisaki, Itaru Endo
Objectives: The present study aimed to identify patients with locally advanced rectal cancer in whom preoperative radiotherapy (RT) can be omitted. Methods: This study was a retrospective multi-institutional study for patients with pathological stage II and III rectal cancer who underwent surgery without preoperative therapy between January 2008 and December 2012. Clinicopathological factors were examined by univariate and multivariate analyses to clarify independent risk factors of local recurrence (LR)...
2021: Journal of the Anus, Rectum and Colon
Lukas H Kohler, Hannes Köhler, Simon Kohler, Stefan Langer, Rima Nuwayhid, Ines Gockel, Nick Spindler, Georg Osterhoff
OBJECTIVES: Free flap surgery is an essential procedure in soft tissue reconstruction. Complications due to vascular compromise often require revision surgery or flap removal. We present hyperspectral imaging (HSI) as a new tool in flap monitoring to improve sensitivity compared to established monitoring tools. METHODS: We performed a prospective observational cohort study including 22 patients. Flap perfusion was assessed by standard clinical parameters, Doppler ultrasound, and HSI on t0 (0 h), t1 (16-28 h postoperatively), and t2 (39-77 h postoperatively)...
April 30, 2021: BMC Surgery
Sara L Zettervall, Kirsten Dansey, Brenda Kline, Niten Singh, Benjamin W Starnes
OBJECTIVES: Aortic neck dilation is a reported mode of failure and can be associated with aneurysm sac expansion following standard endovascular repair of aortic aneurysms. Fenestrated repairs of the juxtarenal segment increase the seal zone length and are often utilized to treat this disease progression. However, the frequency and risk factors for neck dilation following fenestrated repairs is unknown. METHODS: We evaluated 124 consecutive fenestrated EVARs (FEVARs) performed under an investigational device exemption clinical trial for juxtarenal aneurysms (#NCT01538056)...
April 27, 2021: Journal of Vascular Surgery
Karim M Al-Azizi, Amr Idris, Jared Christensen, Mohanad Hamandi, Sarah Hale, Katalin Martits-Chalangari, Johanna S Van Zyl, Preethi Ravindranathan, Jasjit K Banwait, Julie Mckracken, Adm Smith, Ginika Apakama, Jennifer Swim, Penni Dolton, Kristen Chionh, Michael Dimaio, Sibi Thomas, Molly Szerlip, Sameh Sayfo, Chadi Dib, Michael Mack, Srinivasa Potluri
BACKGROUND: Radial artery (RA) catheterization is the access of choice over femoral artery access for most interventional vascular procedures given its safety and faster patient recovery. There has been growing interest in distal radial artery (dRA) access as an alternative to the conventional proximal radial artery (pRA) access. Preserving the RA is important which serves as a potential conduit for future coronary artery bypass surgery, dialysis conduit or preserve the artery for future cardiovascular procedures...
April 15, 2021: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Yuichi Matsuzaki, Matthew G Wiet, Brian A Boe, Toshiharu Shinoka
Bioabsorbable materials made from polymeric compounds have been used in many fields of regenerative medicine to promote tissue regeneration. These materials replace autologous tissue and, due to their growth potential, make excellent substitutes for cardiovascular applications in the treatment of congenital heart disease. However, there remains a sizable gap between their theoretical advantages and actual clinical application within pediatric cardiovascular surgery. This review will focus on four areas of regenerative medicine in which bioabsorbable materials have the potential to alleviate the burden where current treatment options have been unable to within the field of pediatric cardiovascular surgery...
April 27, 2021: Biomedicines
Maria M Rubinstein, Kristy A Brown, Neil M Iyengar
Obesity is a risk factor for at least 13 different types of cancer, many of which are hormonally driven, and is associated with increased cancer incidence and morbidity. Adult obesity rates are steadily increasing and a subsequent increase in cancer burden is anticipated. Obesity-related dysfunction can contribute to cancer pathogenesis and treatment resistance through various mechanisms, including those mediated by insulin, leptin, adipokine, and aromatase signalling pathways, particularly in women. Furthermore, adiposity-related changes can influence tumour vascularity and inflammation in the tumour microenvironment, which can support tumour development and growth...
April 28, 2021: British Journal of Cancer
Francesco E Botelho, Daniel G Cacione, Jose Oyama Leite, Jose Cc Baptista-Silva
BACKGROUND: Bypass surgery using a large saphenous vein graft, or another autologous venous graft, is a well-recognised treatment option for managing peripheral arterial disease of the lower limb, including chronic limb-threatening ischaemia (CLTI) and intermittent claudication, peripheral limb aneurysms, and major limb arterial trauma. Bypass surgery has good results in terms of limb preservation rates and long-term graft patency but is limited by the possibility of vein graft failure due to stenoses of the graft...
April 28, 2021: Cochrane Database of Systematic Reviews
Yonggang Fan, Mandi Cai, Jie Wang, Lei Xia
BACKGROUND: Superior mesenteric artery (SMA) syndrome is a well-recognized, rare complication of undergoing surgical correction of a spinal deformity. The objective of this study was to summarize the best available evidence on SMA syndrome treatment after scoliosis surgery. To identify differences, special attention was paid to scoliosis pathology, intervention and SMA syndrome presentation. METHODS: A systematic review of the literature was performed on SMA syndrome following scoliosis surgery...
April 24, 2021: Annals of Vascular Surgery
Yifei Gu, Hongyang Ma, Sohaib Shujaat, Kaan Orhan, Wim Coucke, Mehdi Salar Amoli, Michel Bila, Constantinus Politis, Reinhilde Jacobs
The aim of this article is to evaluate the early and late morbidities of the donor- and recipient-site in patients undergoing mandibular reconstruction using either vascularized fibular flap (VFF) or vascularized iliac flap (VIF). Electronic databases, including PubMed, Web of Science, Cochrane Central and Embase, were explored for literature published until October 2020. A total of twenty-four articles reporting complications following mandibular reconstruction surgery with follow-up periods ranging from six to 63 months were selected based on the exclusion criteria...
March 30, 2021: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Soheyla Nazarnia, Kathirvel Subramaniam
Opioid analgesia is still considered the standard of practice for cardiac surgery. In recent years, combinations of several nonnarcotic analgesics and regional analgesia have shown promise in restricting opioid use during and after cardiac surgery. Ketamine infusion, dexmedetomidine infusion, acetaminophen, ketorolac, and gabapentin are useful adjuvants in cardiac anesthesia practice and have opioid-sparing properties. The beneficial effects of nonnarcotic multimodal analgesia on intraoperative stress response, recovery profile, postoperative pain, and persistent opioid use after cardiac surgery are yet to be established, and further randomized clinical trials are required...
April 25, 2021: Seminars in Cardiothoracic and Vascular Anesthesia
Johannes Christian Lauscher, Christian H W Schineis, Benjamin Weixler, Martin E Kreis
BACKGROUND: Neoadjuvant chemoradiotherapy was implemented in the treatment of rectal cancer for UICC stages II and III in 2004. Recent studies have provided new insights with respect to the indications and sequence of radiotherapy in the concept of multimodal treatment. OBJECTIVE: The aim of the study was to review the status of radiotherapy in the context of current developments in the treatment of rectal cancer, such as magnetic resonance imaging (MRI)-based surgery, total neoadjuvant therapy and the watch and wait strategy for complete clinical remission...
April 23, 2021: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Fabio Verzini, Enrico Cieri, Andrea Kahlberg, Yaron Sternbach, Robin Heijmen, Kenneth Ouriel, Sam Robaina, Ali Azizzadeh
OBJECTIVES: Patients in the Valiant EVO US and International Clinical Trials had positive short-term outcomes, but late structural failures including Type IIIB endoleaks have been recently discovered. Type IIIB endoleaks are serious adverse events as the re-pressurization of the aneurysm sac increases the risk for rupture. The purpose of this report is to detail the imaging patterns associated with the structural failures with the aim of increasing awareness on failing graft presentation, early recognition, and prompt treatment...
April 19, 2021: Journal of Vascular Surgery
Mohamed Shukri Abdelgawad, Amr M El-Shafei, Hesham A Sharaf El-Din, Ehab M Saad, Tamer A Khafagy, Amr Sameer, Nshaat A Elsaadany, Mohamed A Abdelmaksoud
BACKGROUND: Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. PATIENTS AND METHODS: In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients)...
April 22, 2021: Vascular
Nicolai Seiffert, Peter Tang, Eriselda Keshi, Anja Reutzel-Selke, Simon Moosburner, Hannah Everwien, Dag Wulsten, Hendrik Napierala, Johann Pratschke, Igor M Sauer, Karl H Hillebrandt, Benjamin Struecker
BACKGROUND: Many patients suffering from peripheral arterial disease (PAD) are dependent on bypass surgery. However, in some patients no suitable replacements (i.e. autologous or prosthetic bypass grafts) are available. Advances have been made to develop autologous tissue engineered vascular grafts (TEVG) using endothelial colony forming cells (ECFC) obtained by peripheral blood draw in large animal trials. Clinical translation of this technique, however, still requires additional data for usability of isolated ECFC from high cardiovascular risk patients...
April 21, 2021: Journal of Biological Engineering
Lewis Meecham, Mathew A Popplewell, Gareth R Bate, Smitaa Patel, Andrew W Bradbury
INTRODUCTION: Despite the BASIL-1 trial concluding that bypass surgery (BS) was superior to plain balloon angioplasty (PBA) in terms of longer-term amputation free (AFS) and overall survival (OS), CLTI patients are increasingly offered an endovascular-first revascularization strategy. This study investigates whether the results of BASIL-1 are still relevant to current practice by comparing femoro-popliteal (FP) BS with PBA in a series of CLTI patients treated in our unit 10 years after BASIL-1 (1999-2004)...
April 22, 2021: Vascular and Endovascular Surgery
Michael T Kemp, Andrea T Obi, Peter K Henke, Thomas W Wakefield
BACKGROUND: Chronic venous disease (CVD) describes a spectrum of conditions associated with venous hypertension. The association between various CVD etiologies and subsequent risk of venous thromboembolic (VTE) events, such as deep vein thrombosis or pulmonary embolism, is a topic of considerable clinical interest. The aims of this review are to characterize the risk of VTE according to CVD etiology and to determine the optimal anticoagulation strategy for treatment or prevention of VTE in patients with CVD...
April 15, 2021: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Selma Oguzhan, Stefan Sponholz, Moritz Schirren, Mesut Mese, Joachim Schirren
BACKGROUND:  Due to its very aggressive nature and low survival chances, the metastasized urothelium carcinoma poses a challenge in regard to therapy. The gold-standard chemotherapy is platinum based. The therapy options are considered controversial, including new systemic therapies. In this respect, surgical therapies, as already established for pulmonary metastases of other tumor entities play an increasingly important role. The consumption of nicotine is a risk factor not only for urothelium carcinoma but also for a pulmonary carcinoma...
April 16, 2021: Thoracic and Cardiovascular Surgeon
Poh-Ching Tan, Pei-Chuan Chao, Chen Cheng, Chu-Hsin Chen, Ru-Lin Huang, Shuang-Bai Zhou, Yun Xie, Qing-Feng Li
BACKGROUND: The regeneration response of the skin to mechanical stretching in vivo has been explored in reconstructive surgery to repair large-scale deformities. The ability of the skin to regenerate limits the reconstructive outcome. Here, we propose an approach in which autologous stromal vascular fraction (SVF) cells and mechanical stretching are combined to overcome this limitation and promote skin regeneration. METHODS: This randomized, blinded, placebo-controlled clinical trial screened 22 participants undergoing tissue expansion with exhausted regeneration...
April 15, 2021: Stem Cell Research & Therapy
Todd Robinson, Randolph L Geary, Ross P Davis, Justin B Hurie, Timothy K Williams, Gabriella Velazquez-Ramirez, Shahriar Moossavi, Haiying Chen, Mariana Murea
Background: It is unclear whether surgical placement of an arteriovenous (AV) fistula (AVF) confers substantial clinical benefits over an AV graft (AVG) in older adults with end-stage kidney disease (ESKD). We report vascular access outcomes of a pilot clinical trial. Study Design: Pilot randomized parallel-group open-label trial. Setting & Participants: Patients 65 years and older with ESKD and no prior AV access receiving maintenance hemodialysis through a tunneled central venous catheter referred for AV access placement by their treating nephrologist...
March 2021: Kidney medicine
Joel Berends, Ajith Dupati, John Dibianco, Arvin K George
Focal therapy (FT) is a promising alternative to definitive therapy for localized prostate cancer (PCa). Rather than simply monitoring cancer through active surveillance (AS) or risking the side effects of robotic radical prostatectomy (RP) it offers an intermediate solution. Azzouzi et al. examined vascular-targeted photodynamic therapy (PDT) for PCa. In this randomized, controlled clinical trial, patients with low-risk and localized PCa with no prior treatment were either assigned to a group undergoing vascular-targeted photodynamic therapy or to another group undergoing AS...
April 13, 2021: Journal of Endourology
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