Surgical treatments Research

09:39 EDT 14th August 2018 | BioPortfolio

Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients.

Early recognition of sepsis is a key factor to improve survival to this disease in surgical patients, since it allows prompt control of the infectious source. Combining pro-inflammatory and immunosupression biomarkers could represent a good strategy to improve sepsis detection. Here we evaluated the combination of procalcitonin (PCT) with gene expression levels of HLA-DRA to detect sepsis in a coh...

Anterior-posterior cricoid split combined with silastic T-tube stenting for subglottic stenosis in children: a single surgeon's experience.

Treatment strategies and clinical outcomes of subglottic stenosis (SGS) in children are varied due to the degree and range of stenotic lesions. The optimal surgical procedure for SGS in children is still under debate. The aim of this study was to evaluate the clinical outcomes of our anterior-posterior cricoid (APC) split technique combined with long-term T-tube stenting for grade II or III SGS in...

The S2k guideline: Indications for knee endoprosthesis : Evidence and consent-based indications for total knee arthroplasty.

Total knee arthroplasty (TKA) is one of the most frequent surgical procedures in orthopaedic surgery. Until now there have not been any standardized indication criteria, which might contribute to the large geographical differences in the frequency of TKA. This guideline aims to consent minimal requirements (main criteria), additional important aspects (minor criteria), as well as relative and abso...

Low prevalence of relevant associated articular lesions in patients with acute III-VI acromioclavicular joint injuries.

To define the prevalence of associated articular injuries in patients with severe (Rockwood's III-VI) acute acromioclavicular joint injuries and to find out how many of these were associated with the traumatic event and required surgical treatment.

Implementation of Current ENETS Guidelines for Surgery of Small (≤2 cm) Pancreatic Neuroendocrine Neoplasms in the German Surgical Community: An Analysis of the Prospective DGAV StuDoQ|Pancreas Registry.

ENETS guidelines recommend parenchyma-sparing procedures without formal lymphadenectomy, ideally with a minimally invasive laparoscopic approach for sporadic small pNENs (≤2 cm). Non-functioning (NF) small pNENs can also be observed. The aim of the study was to evaluate how these recommendations are implemented in the German surgical community.

Effects of Thoracic Epidural Anaesthesia on the Serosal Microcirculation of the Human Small Intestine.

The effect of thoracic epidural analgesia (TEA) on splanchnic blood flow during abdominal surgery remains unclear. The purpose of this study was to examine whether the hemodynamic effects of TEA resulted in microcirculatory alterations to the intestinal serosa, which was visualized using incident dark-field (IDF) videomicroscopy.

Trends in Retention and Decay of Basic Surgical Skills: Evidence from Addis Ababa University, Ethiopia: A Prospective Case-Control Cohort Study.

While prior studies have evaluated surgical skills simulation and retention in highly resourced environments, there is paucity of data on the retention of surgical skills taught in simulation laboratory to undergraduate students, and virtually none from low-resource settings. We aimed to evaluate the trends in retention/decay of surgical skills among medical students in Ethiopia and determine whet...

Reply to comment on "Are body mass index and performance status enough to assess the nutritional and functional status of elderly patients undergoing gastric cancer surgery?"

Safety of Blood Glucose Response Following Exercise Training After Bariatric Surgery.

Safety of exercise training in relationship with the risk of hypoglycemia post-bariatric surgery is unknown.

Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis.

Weight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate for biliary complications in patients followed after bariatric surgery. We compared the risks for mortality, complications, and in hospital stay a...

Effect of cabergoline monotherapy in Cushing's disease: an individual participant data meta-analysis.

The primary treatment of choice for Cushing's disease (CD) is the removal of the pituitary adenoma by transsphenoidal surgery (TSS). The surgical failure is seen in up to 75% of cases depending on the experience of the surgeon in different studies. Medical therapy is one of the options for the treatment of recurrent or persistent CD.

A patient-specific haptic drilling simulator based on virtual reality for dental implant surgery.

In the dental implant surgery, there are inevitable risks due to the anatomically complex operation in the cranio-maxillofacial region. Therefore, there is a trend to use computer-aided technology to simulate the process of the implant surgery. In this study, we present a haptic simulator for trainees to study and rehearse the drilling performance of dental implant surgery.

Laparoscopic lavage and drainage for Hinchey III diverticulitis: review of technical aspects.

The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there ...

The anatomy of transanal minimally invasive surgery: Perineal distances and transanal angles.

The recent interest in transanal, minimally invasive surgery has highlighted the importance of an in depth understanding of this complex region. We applied data from an anatomical study of the perineum to the concept of transanal minimally invasive surgery with the aim to describe more accurately anatomy relevant to this surgical technique.

Endoscopic approach in one hundred and seventy-nine patients of dacryocystorhinostomy.

Dacryocystorhinostomy surgery is currently performed using either several different intranasal approaches or an external approach. Using local anaesthesia, external dacryocystorhinostomy is more difficult for patients to tolerate compared with endoscopic dacryocystorhinostomy. For endoscopic dacryocystorhinostomy using the endoscopic approach, the ostium opens from the intended point. External and...

Reply by Bell et al.

We thank Sood and colleagues for their keen interest in our study. They make a valid point, and suggest that BMI is an imprecise predictor of surgical challenges (which we agree with), however the ratio of abdominal fat to extrapelvic fat (abdominal fat ratio), may in fact be a better predictor of surgical difficulty and hence completion. We welcome these comments and can see the merits of having ...

Utility of Optical Coherence Tomography for Guiding Laser Therapy Among Patients With Recurrent Respiratory Papillomatosis.

Recurrent respiratory papillomatosis (RRP) is a viral-induced disease caused by human papillomavirus and the second leading cause of dysphonia in children; however, neither a cure nor a definitive surgical treatment is currently available for RRP. Although laser therapy is often used in the treatment of RRP, the lack of real-time laser-tissue interaction feedback undermines the ability of physicia...

A personal series of 100 children operated for Cushing's disease (CD): optimizing minimally invasive diagnosis and transnasal surgery to achieve nearly 100% remission including reoperations.

Background Transnasal surgery (TNS) is the first choice in the treatment of pediatric Cushing's disease. The question is how can high remission rates be achieved with minimally invasive investigations and TNS whilst avoiding radiotherapy or bilateral adrenalectomy in children. Methods Data from a published series 1 (n=55) of surgeon DKL will be compared with his recent series 2 (n=45) until 2009. ...

Intraoperative fluorescence imaging in thoracic surgery.

Intraoperative fluorescence imaging (IFI) can improve real-time identification of cancer cells during an operation. Phase I clinical trials in thoracic surgery have demonstrated that IFI with second window indocyanine green (TumorGlow ) can identify subcentimeter pulmonary nodules, anterior mediastinal masses, and mesothelioma, while the use of a folate receptor-targeted near-infrared agent, OTL38...

Fluorescence-guided surgery for liver tumors.

In hepatobiliary surgery, fluorescence imaging enables identification of subcapsular liver tumors through accumulation of indocyanine green after preoperative intravenous injection in cancerous tissues of hepatocellular carcinoma and in noncancerous hepatic parenchyma around intrahepatic cholangiocarcinoma and liver metastases. Indocyanine green-fluorescence imaging can also be used for visualizin...

Lymphovenous bypass for the treatment of lymphedema.

Lymphovenous bypass (LVB) is a form of physiological lymphedema surgery, which was described decades ago, but recently it is gaining popularity with improved microsurgical technology available. Benefits of the procedure are its effectiveness in treating early stage lymphedema of either the upper or lower extremity and having low complication profile. In the following article, the history of the pr...

Appraising the Uptake and Use of the IDEAL Framework and Recommendations: A Review of the Literature.

Evaluation of new surgical innovations is complex and variably regulated, and historically the quality of surgical studies has been criticized. The IDEAL (Idea, Development, Exploration, Assessment, Long-term monitoring) Framework was established to provide a pathway for evaluating surgical innovations at each stage of their development in order to produce high quality surgical research. Since the...

Human Placenta Simulator For Intracranial - Intracranial Bypass: Vascular Anatomy And 5 Bypass Techniques.

Intracranial-intracranial (IC) bypass surgery involves the use of significant technical bimanual skills. Indications for this procedure are limited, so training in a simulator with brain vessels similarity could maintain micro-surgical dexterity. Our goal is to describe the human placenta vascular anatomy to guide IC-IC bypasses apprenticeship.

Partial hepatic resections for metastatic neuroendocrine tumors: perioperative outcomes.

Partial hepatic resection reduces tumor burden in patients with metastatic neuroendocrine tumors, thereby improving quality and length of life. These procedures can be challenging as well as life-threatening. Our aim was to evaluate our patients' perioperative outcomes and propose a definition for an intraoperative carcinoid crisis relevant to this surgery, given its unique surgical considerations...

Laparoscopic Surgical Algorithm to Triage the Timing of Tumor Reductive Surgery in Advanced Ovarian Cancer.

To estimate the effects of a laparoscopic scoring algorithm to triage patients with advanced ovarian cancer to immediate or delayed debulking to improve complete gross surgical resection rates and determine the resulting clinical outcomes.

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