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Surgery (General)

Yong Ahn, Han Joong Keum, Sang-Gu Lee, Sheen-Woo Lee
OBJECTIVE: The clinical application of endoscopic technique for lumbar lateral recess stenosis (LRS) is still challenging. This study aimed to describe a transforaminal endoscopic decompression (TED) technique for LRS and to demonstrate its clinical results. METHODS: Two-year follow-up data were collected from 45 consecutive patients who underwent TED for LRS. Full-scale endoscopic decompression can be performed in the dorsal and ventral aspects of the lateral recess with combined partial pediculectomy using an articulating bone burr and endoscopic instruments...
February 11, 2019: World Neurosurgery
Perica Mutavdzic, Marko Dragas, Biljana Kukic, Ksenija Stevanovic, Igor Končar, Nikola Ilić, Ivan Tomic, Milos Sladojevic, Lazar Davidovic
We present a case of successfully treated abdominal aortic aneurysm in a 24-year old patient with Marfan's syndrome. Following initial physical and ultrasound examination, the multislice computed tomography scan revealed infrarenal aortic aneurysm of 6 cm in diameter, 10 cm long, along with slightly dilated iliac arteries. However, dimensions of aortic root, aortic arch and descending suprarenal aorta were within normal limits. Further on, since the patient presented with signs of impending rupture, an urgent surgical intervention was performed...
February 11, 2019: Annals of Vascular Surgery
Lucien Chassin-Trubert, Giorgio Prousse, Baris Ata Ozdemir, Youcef Lounes, William Alonso, Myriam Clapiès, Pierre Alric, Ludovic Canaud
OBJECTIF: The aim of this paper is to report a case of filter associated inferior vena cava (IVC) thrombosis with perforation of the duodenum and penetration of a vertebral body by the filter struts. CASE REPORT: A 37 year old woman with a medical history of Behcet`s disease treated with corticosteroids, underwent placement of a retrievable IVC filter because of recurrent ileofemoral venous thrombosis regardless of therapeutic levels of anticoagulation. Despite a correct positioning of the filter, the second follow-up CT-scan, performed at 1 year, showed a complete thrombosis of the infra-renal IVC segment, with perforation of the vessel wall by the filter struts and penetration in the duodenum...
February 11, 2019: Annals of Vascular Surgery
Alejandro Quiroga-Garza, Rodrigo Teran-Garza, Rodrigo Enrique Elizondo-Omana, Santos Guzman-Lopez
Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge, and to develop the skill of applying that knowledge in clinical scenarios...
February 14, 2019: Anatomical Sciences Education
Eva Huysmans, Karen Pien, Lieselot Callens, Lesley Van Loon, Kelly Ickmans, Jo Nijs, Ronald Buyl, Maarten Moens, Lisa Goudman, Griet Van Belleghem, Koen Putman
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to determine hospital costs related to surgery for lumbar radiculopathy and identify determinants of intramural costs based on minimal hospital and claims data. SUMMARY OF BACKGROUND DATA: Costs related to the initial hospitalization of patients undergoing surgery for lumbar radiculopathy make up the major part of direct health care expenditure in this population. Identifying factors influencing intramural costs can be beneficial for health care policy makers, and clinicians working with patients with lumbar radiculopathy...
March 1, 2019: Spine
Ya Zhang, Ao Li, Jie He, Minghui Wang
Glioblastoma Multiforme (GBM) is one of the most malignant brain tumors with very short prognosis expectation. To improve patients' clinical treatment and their life quality after surgery. Researches have developed tremendous in silico models and tools for predicting GBM prognosis based on molecular datasets and have earned great success. However, pathology still plays the most critical role in cancer diagnosis and prognosis in the clinic at present. Recent advancement of storing and processing histopathological images have drawn attention from researches...
February 11, 2019: IEEE Journal of Biomedical and Health Informatics
Genwen Mao, Chuang Wang, Qian Li, Tonghe Zhu, Jianhai Yang, Tao Fu, Xing Ma
This study aimed to evaluate the safety and efficacy of strontium-substituted nanohydroxyapatite (Sr-nHA) coatings in decreasing aseptic loosening of the femoral prosthetic stem after hip replacement surgery in a rat model. Sr-nHAs (atomic ratio of Sr/(Ca + Sr) of 0%, 5%, 10% and 20%) were prepared by homogeneous phase coprecipitation. Plasma spraying was employed to prepare the Sr-nHA coatings on titanium rod substrate. After microstructure analyses, we investigated the safety and efficacy of Sr-nHA coatings both in vitro and in vivo...
February 14, 2019: ACS Applied Materials & Interfaces
Jin Ma, Wenyao Li, Qing Chai, Xiaohong Tan, Kexian Zhang
The aim of this study was to investigate the association between purinergic receptor P2X7 (P2RX7) gene rs1718125 polymorphism and analgesic effect of fentanyl after surgery among patients with lung cancer in a Chinese Han population.A total of 238 patients with lung cancer who received resection were enrolled in our study. The genotype distributions of P2RX7 rs1718125 polymorphism were detected by polymerase chain reaction and direct sequencing. Postoperative analgesia was performed by patient-controlled intravenous analgesia, and the consumption of fentanyl was recorded...
February 2019: Medicine (Baltimore)
Yan Li, Hongquan Dong, Shanbai Tan, Yanning Qian, Wenjie Jin
BACKGROUND: Appropriate postoperative pain management can improve outcomes in patients with esophageal cancer (EC). OBJECTIVE: To compare different combinations of anesthesia and analgesia techniques in patients with EC undergoing open thoracotomy. METHODS: This randomized, controlled, open-label trial enrolled 100 patients with EC (aged 40-65 years; American Society of Anesthesiologists [ASA] grade I/II) receiving elective surgery at Jiangsu Province Hospital (China) between July 2016 and December 2017...
February 2019: Medicine (Baltimore)
Hyun Jung Kim, Seung Ho Choi, Darhae Eum, Seung Hyun Kim
BACKGROUND: Adequate intravenous fluid replacement is recommended as an effective nonpharmacologic strategy for reducing postoperative nausea and vomiting (PONV), one of the most common and stressful complications of general anesthesia. We aimed to evaluate the effect of hydration, according to the type of fluid, on PONV as previous studies have reported inconsistent results. METHODS: We performed a systemic review and meta-analysis of randomized controlled trials (RCTs) comparing infusion of colloid with that of crystalloid in terms of PONV incidence and the need for rescue antiemetic therapies for 24 hours after surgery under general anesthesia...
February 2019: Medicine (Baltimore)
Aaron Alokozai, Sara L Eppler, Laura Y Lu, Nicole Sheikholeslami, Robin N Kamal
BACKGROUND: Forecasting is a construct in which experiences and beliefs inform a projection of future outcomes. Current efforts to predict postoperative patient-reported outcome measures such as risk-stratifying models, focus on studying patient, surgeon, or facility variables without considering the mindset of the patient. There is no evidence assessing the association of a patient's forecasted postoperative disability with realized postoperative disability. Patient-forecasted disability could potentially be used as a tool to predict postoperative disability...
March 2019: Clinical Orthopaedics and related Research
Kai Lee, Hao-Hsuan Tsai, Jiandong Sun, Arun Chandu
PURPOSE: Alcohol screening and a brief intervention (SBI) can be effective in changing harmful drinking behaviour and reducing the chance of future alcohol-related traumas. However, there is no standardised method in its application. This study aims to deliver a novel method of SBI to patients with alcohol-related facial fractures and to assess changes in their alcohol intake and attitudes to drinking following this intervention. METHODS: Twenty consecutive patients at two Victorian Hospitals were consented to undergo a novel SBI program...
February 14, 2019: Oral and Maxillofacial Surgery
Tokuro Baba, Motoi Mukai, Ryuta Masuya, Masato Kawano, Keisuke Yano, Masakazu Murakami, Shun Onishi, Koji Yamada, Waka Yamada, Takafumi Kawano, Seiro Machigashira, Kazuhiko Nakame, Tatsuru Kaji, Satoshi Ieiri
PURPOSE: Late postoperative complications in choledochal cyst (CC) patients are severe problems that affect the quality of life (QOL). We evaluated the postoperative complications and health-related QOL (HRQOL) of CC patients ≥ 18 years of age. METHODS: From April 1984 to January 2018, 114 CC patients underwent definitive surgery at our institution. Seventy-nine patients reached ≥ 18 years of age. The HRQOL was assessed using the Japanese version of the SF-36v2...
February 14, 2019: Pediatric Surgery International
Stefan Greiner, Matthias Koch, Maximilian Kerschbaum, Pushkar P Bhide
PURPOSE: Most elbow dislocations can be treated conservatively, with surgery indicated in special circumstances. Surgical options, apart from fracture fixation, range from repair or reconstruction of the damaged ligaments to static external fixation, usually entailing either a long period of immobilization followed by carefully monitored initiation of movement or dynamic external fixation. In general, no consensus regarding surgical treatment has been reached. A new method of open ligament repair and augmentation of the lateral ulnar collateral ligament using a non-absorbable suture tape in cases of acute and subacute elbow instability following dislocations has been described here, which allows an early, brace-free initiation of the full range of motion...
February 14, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Gabriele Bellio, Marina Troian, Arianna Pasquali, Nicolò De Manzini
BACKGROUND: Laparoscopy for locally advanced colorectal cancer is not standardized yet and its potential risks and benefits in elderly patients are still under debate. The aim of this study was to evaluate clinical and oncologic results of laparoscopic surgery for pT3/pT4 lesions in both old and young people. METHODS: Between 2006 and 2015, 115 patients aged <70 years and 112 patients aged ≥70 years underwent elective laparoscopic surgery for pT3/pT4 colorectal cancer presenting without distant metastasis at the Department of General Surgery, Trieste...
February 13, 2019: Minerva Chirurgica
Roberto Fariña-Castro, Cristina Roque-Castellano, Manuel Artiles-Armas, Joaquín Marchena-Gómez
AIM: The number of nonagenarians undergoing surgery has increased considerably in recent decades as a result of population aging. Greater knowledge of the most influential factors affecting perioperative morbidity and mortality would improve the quality of care and provision of health resources for these patients. The objective of the present study was to analyze the perioperative mortality, and its most determinant factors, among nonagenarian patients who underwent a surgical procedure in the Department of General and Digestive Surgery...
February 13, 2019: Geriatrics & Gerontology International
Doralina L Anghelescu, Jessica Michala Tesney
Neuropathic pain in pediatric oncology can be caused by distinct lesions or disease processes affecting the somatosensory system, including chemotherapy-related neuronal injury, solid tumor-related involvement of neural structures, post-surgical neuropathic pain-including phantom limb pain and pain after limb-sparing surgery-and the complex circumstances of neuropathic pain at the end of life. Treatment algorithms reflect the general treatment principles applied for adult neuropathic pain, but the dose regimens applied in children are modest and rarely escalated to the maximum doses to optimize analgesic efficacy...
February 14, 2019: Paediatric Drugs
Muhammad Shaheryar Ahmed Rajput, Ahmad Nawaz Ahmad, Asif Ali Arain, Mohammad Adeel, Saeed Akram, Muhammad Sohail Awan, Muhammad Ehsan Bari
Introduction Vestibular schwannomas (VS) are the most common benign neoplasms of a cerebellopontine angle (CPA), which arise from the Schwann cells of the vestibulocochlear nerve. Eighty percent of CPA tumors are VS followed by meningioma as the second common mass lesion in this critical potential space. Treatment options range from watchful waiting with serial imaging studies to radiosurgery or a microsurgical excision or a combination of surgery and radiation therapy. The primary objective of the study was to assess hearing and facial nerve status before and after the surgery via the retrosigmoid approach...
December 4, 2018: Curēus
Stephan Polterauer, Richard Schwameis, Christoph Grimm, Peter Hillemanns, Julia Jückstock, Felix Hilpert, Nikolaus de Gregorio, Annette Hasenburg, Jalid Sehouli, Sophie Theresa Fürst, Hans Georg Strauß, Klaus Baumann, Falk Thiel, Alexander Mustea, Philipp Harter, Pauline Wimberger, Heinz Kölbl, Alexander Reinthaller, Linn Woelber, Sven Mahner
OBJECTIVE: Lymph node ratio (LNR) can predict treatment outcome and prognosis in patients with solid tumors. Aim of the present analysis was to confirm the concept of using LNR for assessing outcome in patients with vulvar cancer after surgery with inguinal lymphadenectomy in a large multicenter project. METHODS: The AGO-CaRE-1 study multicenter database was used for analysis. LNR was defined as ratio of number of positive lymph nodes (LN) to the number of resected...
February 11, 2019: Gynecologic Oncology
Tim Gutierrez, Greg Hambright, Tahir Mustafa, Anthony Cahill, Vaidehi Agrawal, Michael S Truitt
No abstract text is available yet for this article.
January 1, 2019: American Surgeon
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