MedWorm: Surgery

Numerical Analysis of Flow Field and Heat Transfer of 2D Wavy Ducts and Optimization by Entropy Generation Minimization Method

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

This article provided a research for the trend of heat transfer and flow field through a 2-dimensional wavy duct. To construct a grid mesh, the physical domain was transferred to the computational domain and finite volume scheme was used for discretizing the governing equations. Through the simulation, the flow regime stayed in laminar mode. Constant temperature boundary condition has been used for solid walls. Air was used as a working fluid. Existence of waves makes some phenomenon like flow separation. Effect of Reynolds number, wave width, and wave number has been analyzed and velocity distribution, heat transfer coefficient, and tangential stress were computed for different cases. The final results were compared with the same straight duct. The entropy generation minimization method h...

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Matricellular Proteins: A Sticky Affair with Cancers

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

The multistep process of metastasis is a major hallmark of cancer progression involving the cointeraction and coevolution of the tumor and its microenvironment. In the tumor microenvironment, tumor cells and the surrounding stromal cells aberrantly secrete matricellular proteins, which are a family of nonstructural proteins in the extracellular matrix (ECM) that exert regulatory roles via a variety of molecular mechanisms. Matricellular proteins provide signals that support tumorigenic activities characteristic of the metastastic cascade such as epithelial-to-mesenchymal (EMT) transition, angiogenesis, tumor cell motility, proliferation, invasion, evasion from immune surveillance, and survival of anoikis. Herein, we review the current understanding of the following matricellular proteins a...

Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

Conclusions: There is an excellent seizure outcome following disconnective epilepsy surgery for intractable hemispheric and subhemispheric pediatric epilepsy. An older age of seizure onset, RE, SWS and PES were good predictors of a Class I seizure outcome. (Source: Diagnostic and Therapeutic Endoscopy)

Fournier's Gangrene: Report of 2 Cases

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

In this study, we report 2 different cases of Fournier gangrene. Our first case was a young, nondiabetic, and without any multiorgan failure, who was managed successfully with good outcome. The second case was a 67-year-old man with diabetes and multiorgan dysfunction with extensive gangrene at presentation, who recovered well, but with a stormy postoperative period. (Source: Diagnostic and Therapeutic Endoscopy)

Methods of Developing User-Friendly Keys to Identify Green Sea Turtles (Chelonia mydas L.) from Photographs

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

Identifying individual animals is important in understanding their ecology and behaviour, as well as providing estimates of population sizes for conservation efforts. We produce identification keys from photographs of green sea turtles to identify them while foraging in Akumal Bay, Mexico. We create three keys, which (a) minimise the length of the key, (b) present the most obvious differential characteristics first, and (c) remove the strict dichotomy from key b. Keys were capable of identifying >99% of turtles in >2500 photographs during the six-month study period. The keys differed significantly in success rate for students to identify individual turtles, with key (c) being the best with >70% success and correctly being followed further than other keys before making ...

Research on the Human Dynamics in Mobile Communities Based on Social Identity

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

Through analyzing the data about the releases, comment, and forwarding of 120,000 microblog messages in a year, this paper finds out that the intervals between information releases and comment follow a power law; besides, the analysis of data in each 24 hours reveals obvious differences between microblogging and website visit, email, instant communication, and the use of mobile phone, reflecting how people use fragments of time via mobile internet technology. The paper points out the significant influence of the user's activity on the intervals of information releases and thus demonstrates a positive correlation between the activity and the power exponent. The paper also points out that user's activity is influenced by social identity in a positive way. The simulation results based...

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Weighted Hardy and Potential Operators in Morrey Spaces

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

We study the weighted p→q-boundedness of Hardy-type operators in Morrey spaces ℒp,λ(ℝn) (or ℒp,λ(ℝ+1) in the one-dimensional case) for a class of almost monotonic weights. The obtained results are applied to a similar weighted p→q-boundedness of the Riesz potential operator. The conditions on weights, both for the Hardy and potential operators, are necessary and sufficient in the case of power weights. In the case of more general weights, we provide separately necessary and sufficient conditions in terms of Matuszewska-Orlicz indices of weights. (Source: Diagnostic and Therapeutic Endoscopy)

Exfoliation Corrosion and Pitting Corrosion and Their Role in Fatigue Predictive Modeling: State-of-the-Art Review

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

Discussion of cases where IG attack and exfoliation caused issues in structural integrity in aircraft in operational fleets is presented herein along with a much more detailed presentation of the issues involved in dealing with corrosion of aircraft. Issues of corrosion and fatigue related to the structural integrity of aging aircraft are introduced herein. Mechanisms of pitting nucleation are discussed which include adsorption-induced, ion migration-penetration, and chemicomechanical film breakdown theories. In addition, pitting corrosion (PC) fatigue models are presented as well as a critical assessment of their application to aircraft structures and materials. Finally environmental effects on short crack behavior of materials are discussed, and a compilation of definitions related to co...

Incomplete Regulation, Asymmetric Information, and Collusion-Proofness

Diagnostic and Therapeutic Endoscopy — Thu, 09 Feb 2012 11:02:10 +0100

In an incomplete regulation framework, the regulator cannot replicate all the possible outcomes by himself since he has no influence over some firms in the market. Due to asymmetric information, it may be better for the regulator to allow the unregulated firms to extract a truthful report from the regulated firm through side-payments under collusion, and therefore the “collusion-proofness principle” may not hold. In fact, by introducing an exogenous number of unregulated firms, social welfare differences seem to favour a collusion-allowing equilibrium. However, such result will depend on the relative importance given by the regulator to the consumer surplus in the social welfare function. (Source: Diagnostic and Therapeutic Endoscopy)

Risk of anastomotic leakage with non‐steroidal anti‐inflammatory drugs in colorectal surgery

British Journal of Surgery — Thu, 09 Feb 2012 10:58:19 +0100

Conclusion:Non‐selective NSAIDs may be associated with anastomotic leakage. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Surgery Effective for Tough-to-Treat Epilepsy

Surgery News - Doctors Lounge — Thu, 09 Feb 2012 05:00:00 +0100

In 26-year study, procedure cut seizures and boosted quality of life long-term (Source: Surgery News - Doctors Lounge)

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Counting the cost of cancer surgery for advanced and metastatic disease

British Journal of Surgery — Thu, 09 Feb 2012 05:00:00 +0100

Putting cancer surgery into context is vital (Source: British Journal of Surgery)

Sex‐specific time trends in first admission to hospital for peripheral artery disease in Scotland 1991–2007

British Journal of Surgery — Thu, 09 Feb 2012 05:00:00 +0100

Conclusion:First hospital admission for PAD in Scotland declined steadily and substantially between 1991 and 2007, with an increase in the proportion that was unplanned. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Group A Streptococcus Causing Descending Necrotizing Mediastinitis: Report of a Case and Literature Review

Surgical Infections — Thu, 09 Feb 2012 04:04:10 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Pharmacokinetics of Beta-Lactam Antibiotics in Patients with Intra-Abdominal Disease: A Structured Review

Surgical Infections — Wed, 08 Feb 2012 17:23:14 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Treatment of Severe Hemolytic Anemia Caused by Clostridium perfringens Sepsis in a Liver Transplant Recipient

Surgical Infections — Wed, 08 Feb 2012 17:23:05 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

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Cefazolin Dosing for Surgical Prophylaxis in Morbidly Obese Patients

Surgical Infections — Wed, 08 Feb 2012 17:22:59 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Improving Emergency General Surgery Care And Outcomes

Health News from Medical News Today — Wed, 08 Feb 2012 09:00:00 +0100

Researchers at Wake Forest Baptist Medical Center in Winston-Salem, NC, have successfully created and implemented an emergency general surgery registry (EGSR) that will advance the science of acute surgical care by allowing surgeons to track and improve surgical patient outcomes, create performance metrics, conduct valid research and ensure quality care for all emergency general surgery (EGS) patients... (Source: Health News from Medical News Today)

To whom do the results of the multicenter, randomized, controlled INSECT trial (ISRCTN 24023541) apply? - Assessment of external validity

BMC Surgery — Wed, 08 Feb 2012 05:00:00 +0100

Conclusions: Results of the INSECT trial are applicable to a broad spectrum of patients treated at different hospital levels. (Source: BMC Surgery)

Mycobacterium szulgai Tenosynovitis: A Fishy Tale

Surgical Infections — Tue, 07 Feb 2012 16:37:37 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Effects of RS9939609 Gene Variant in FTO Gene on Weight Loss and Cardiovascular Risk Factors After Biliopancreatic Diversion Surgery

Journal of Gastrointestinal Surgery — Mon, 06 Feb 2012 19:36:51 +0100

Conclusion Our study showed a higher initial weight loss at 3 months after the TT variant of FTO gene (rs9939609). However, the weight loss at 9 and 12 months of BPD was similar in both genotypes with a significant improvement in biochemical parameters and cardiovascular comorbidities. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s11605-012-1829-2Authors Daniel Antonio de Luis, Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation. Hospital Rio Hortega, University of Valladolid, Valladolid, SpainRocío Aller, Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation. Hospital Rio Hortega, University of Valladolid, Valladolid, SpainRosa Conde, Institute of Endocrinology and ...

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What Is the Optimal Treatment for Peripancreatic Fluid Collections?

Journal of Gastrointestinal Surgery — Mon, 06 Feb 2012 19:36:50 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s11605-012-1832-7Authors Enver Zerem, Department of Gastroenterology, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and HerzegovinaAlma Sušić, Department of Gastroenterology, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and HerzegovinaNada Pavlović-Čalić, Department of Gastroenterology, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and HerzegovinaBahrija Haračić, Department of Gastroenterology, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and HerzegovinaPredrag Jovanović, Department of Gastroenterology, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and Herzegovina Journal Journal of Gastrointes...

Comparison of long-term prognosis of laparoscopy-assisted gastrectomy and conventional open gastrectomy with special reference to D2 lymph node dissection

Surgical Endoscopy — Mon, 06 Feb 2012 19:35:50 +0100

Conclusions LAG with D1, D1+ lymph node dissection for EGC is safe and equivalent to open gastrectomy in curability. Moreover, LAG with D2 lymph node dissection for AGC is comparable to OG with D2 lymph node dissection with regard to short- and long-term results. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2167-xAuthors Hirohiko Sato, Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503 JapanMitsuo Shimada, Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503 JapanNobuhiro Kurita, Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503 ...

Robotic liver resection: technique and results of 30 consecutive procedures

Surgical Endoscopy — Mon, 06 Feb 2012 19:35:49 +0100

Conclusions From our experience, robotic liver resection seems to be a feasible and safe procedure, even for major hepatectomy. Robotic surgery can be considered a new advanced option for minimally invasive liver surgery. Content Type Journal ArticlePages 1-12DOI 10.1007/s00464-012-2168-9Authors Gi Hong Choi, Department of Surgery, Yonsei University Health System, 250 Seongsanno, Seodaemoon-gu, Seoul, 120-752 KoreaSung Hoon Choi, Department of Surgery, Yonsei University Health System, 250 Seongsanno, Seodaemoon-gu, Seoul, 120-752 KoreaSung Hoon Kim, Department of Surgery, Yonsei University Health System, 250 Seongsanno, Seodaemoon-gu, Seoul, 120-752 KoreaHo Kyoung Hwang, Department of Surgery, Yonsei University Health System, 250 Seongsanno, Seodaemoon-gu, Seoul, 120...

Is Lightweight or Heavyweight Mesh Better for Hernia Repair?Is Lightweight or Heavyweight Mesh Better for Hernia Repair?

Medscape Today Headlines — Mon, 06 Feb 2012 16:21:12 +0100

Commentary on a study that compared lightweight mesh with heavyweight mesh in open inguinal hernia repair, published January 2012 in the British Journal of Surgery. Medscape General Surgery (Source: Medscape Today Headlines)

Atenção integral ao portador de pé diabético

Jornal Vascular Brasileiro — Mon, 06 Feb 2012 10:47:37 +0100

São apresentadas, nessa separata, as principais orientações sobre a atenção às complicações do pé diabético. A neuropatia, com suas diversas apresentações que acometem os membros inferiores dos diabéticos, as lesões da doença arterial obstrutiva periférica (DAOP), as múltiplas apresentações da infecção do pé diabético, e, principalmente, os cuidados preventivos que possam impedir o estabelecimento ou a evolução dessas complicações são tratados de forma sistemática e simplificada, visando a atenção integral desses doentes. Especial cuidado é dado às orientações diferenciadas para os diversos níveis de atenção nos serviços públicos de saúde, porta de entrada virtual de 80% dos infelizes portadores dessa complicação. São aqui apresentados modelos de...

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Laparoscopically Assisted Sacroperitoneal Pull-Through for High Imperforate Anus: A New Technique

European Journal of Pediatric Surgery — Mon, 06 Feb 2012 05:00:00 +0100

Eur J Pediatr SurgDOI: 10.1055/s-0031-1291286[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: European Journal of Pediatric Surgery)

Factors influencing the quality of total mesorectal excision

British Journal of Surgery — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion:TME quality was influenced by patient‐ and treatment‐related factors. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

New database aims to improve emergency general surgery care and outcomes

EurekAlert! - Medicine and Health — Mon, 06 Feb 2012 05:00:00 +0100

(Weber Shandwick Worldwide) Researchers at Wake Forest Baptist Medical Center in Winston-Salem, N.C., have successfully created and implemented an emergency general surgery registry that will advance the science of acute surgical care by allowing surgeons to track and improve surgical patient outcomes, create performance metrics, conduct valid research and ensure quality care for all emergency general surgery patients. (Source: EurekAlert! - Medicine and Health)

Allergan Stops Lap-Band Sales to '1-800-Get-Thin' SurgeonsAllergan Stops Lap-Band Sales to '1-800-Get-Thin' Surgeons

Medscape Today Headlines — Sat, 04 Feb 2012 19:18:43 +0100

The weight-loss surgery centers in Southern California are under intense scrutiny for their safety record, advertising, and billing practices. Medscape Medical News (Source: Medscape Today Headlines)

Comparison of Hybrid Natural Orifice Transluminal Endoscopic Surgery and Single-Port Laparoscopic Surgery for Sentinel Node Basin Dissection in a Porcine Model

Journal of Laparoendoscopic — Sat, 04 Feb 2012 04:09:56 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

MedWorm Sponsor Message: Have a look at these iconic medical scrubs which are handmade and come in a variety of colors to accommodate your surgical uniform.

Wernekink commissure syndrome: a rare midbrain syndrome

Neurological Sciences — Fri, 03 Feb 2012 17:52:59 +0100

We present two cases of the Wernekink commissure syndrome with acute onset of bilateral cerebellar dysfunction confirmed by magnetic resonance imaging. One patient presented internuclear ophthalmoplegia, but neither showed palatal tremor. It is notable that the bilateral cerebellar dysfunction may be ascribed to midbrain lesion involving the Wernekink commissure, and it may be the sole manifestation of the midbrain lesion. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s10072-012-0966-4Authors Huayan Liu, Department of Neurology, First Affiliated Hospital, China Medical University, No.155, North Nanjing Street, 110001 Shenyang, ChinaLei Qiao, Department of General Surgery, Shengjing Hospital, China Medical University, Shenyang, ChinaZhiyi He, Department of N...

Non-curative gastric resection for patients with stage 4 gastric cancer—a single center experience and current review of literature

Langenbeck's Archives of Surgery — Fri, 03 Feb 2012 17:52:53 +0100

Conclusions Primary non-curative gastric resection can reduce the incidence of severe tumor-related complications and can prolong overall survival in selected subgroups. In particular, younger patients with no more than two tumor locations should be considered for this procedure. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00423-012-0902-3Authors Yves Dittmar, Department of General, Visceral and Vascular Surgery, Jena University Hospital, Erlanger Allee 101, 07747 Jena, GermanyFalk Rauchfuss, Department of General, Visceral and Vascular Surgery, Jena University Hospital, Erlanger Allee 101, 07747 Jena, GermanyMax Goetz, Department of General, Visceral and Vascular Surgery, Jena University Hospital, Erlanger Allee 101, 07747 Jena, Germa...

Efficacy of zoledronic acid in postmenopausal Japanese women with early breast cancer receiving adjuvant letrozole: 12-month results

Breast Cancer Research and Treatment — Fri, 03 Feb 2012 17:52:05 +0100

Abstract Aromatase inhibitor-associated bone loss has not been proved in the Japanese or Asian women. The aim of this study was to evaluate an upfront or delayed strategy of bone protection therapy with zoledronic acid administered at 4 mg every 6 months in postmenopausal Japanese women with early breast cancer to compare with results of the Z-FAST and ZO-FAST studies in western countries. Postmenopausal women with hormone receptor positive early breast cancer receiving adjuvant letrozole were randomly assigned to receive either upfront or delayed-start zoledronic acid (4 mg intravenously every 6 months). The delayed group received zoledronic acid when lumbar spine (L2–L4) bone mineral density (BMD) decreased to less than young adult mean −2.0SD or w...

Gastrointestinal stromal tumor arising in an ileal duplication: report of a case

Surgery Today — Fri, 03 Feb 2012 17:11:08 +0100

This report presents the extremely rare case of an adult patient who presented with peritonitis caused by the perforation of an ileal duplication, associated with a gastrointestinal stromal tumor (GIST) arising within the duplication. A 70-year-old female was admitted to the hospital with lower abdominal pain. Abdominal computed tomography showed free air in the peritoneal cavity. An emergency laparotomy was performed, presuming diffuse peritonitis caused by a perforation of the gastrointestinal tract. The surgical findings showed that the peritonitis was caused by the perforation of an ileal duplication, 90 cm proximal to the ileocecal valve, with an extrinsic tumor protruding from the duplication. A segmental resection of the ileum—including the tumor and ileal duplication�...

Spontaneous pneumothorax in a patient with dendriform pulmonary ossification: report of a case

Surgery Today — Fri, 03 Feb 2012 17:11:08 +0100

We report herein the rare case of a patient with dendriform pulmonary ossification (DPO) who developed spontaneous pneumothorax. A 33-year-old male with a history of bronchial asthma presented with pneumothorax of the left lung. An intraoperative inspection revealed no findings of bullae in the entire left lung, but inflammatory pleural changes were identified on the interlobular surface of the left lower lobe. In addition, hard, twig-like configurations were clearly palpable in the subpleural parenchyma and were resected. A histological examination showed acicular bone formations containing myeloid tissue and marrow fat in the lung. DPO was thus diagnosed, and the bony spines were considered to have caused a rupture of the elastic fiber layer of the visceral pleura. DPO may thus hav...

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Intestinal obstruction caused by colonic metastasis from intrahepatic cholangiocarcinoma 6 years after removal of the primary tumor: report of a case

Surgery Today — Fri, 03 Feb 2012 17:11:08 +0100

We report a case of intestinal obstruction caused by metastasis that manifested 6 years after surgery for intrahepatic cholangiocarcinoma (ICC). The patient, a 57-year-old man, had undergone resection of the hepatic left lobe, Spiegel lobe, and extrahepatic bile duct, following which histopathological examination had confirmed the diagnosis of ICC and that the resection margins were free from disease. There had been no signs of recurrence until an increase in the CA19-9 level was detected 6 years later. Colonoscopy revealed an ulcer-like lesion and stenosis at the level of the hepatic flexure. The patient was subsequently admitted to our hospital with abdominal pain and underwent right hemicolectomy with partial resection of hepatic segment V. Based on the immunohistologica...

Totally Laparoscopic Management of Gallstone Ileus—Technical Report and Review of the Literature

Journal of Laparoendoscopic — Fri, 03 Feb 2012 14:56:47 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Intraoperative, postoperative and reoperative problems with ileoanal pouches

British Journal of Surgery — Fri, 03 Feb 2012 11:07:28 +0100

Conclusion:A structured management plan will minimize the adverse consequences of the problems associated with pouches. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Enhancing Braden pressure ulcer risk assessment in acutely ill adult veterans

Wound Repair and Regeneration — Fri, 03 Feb 2012 05:00:00 +0100

This study sought to determine if a parsimonious pressure ulcer (PU) predictive model could be identified specific to acute care to enhance the current PU risk assessment tool (Braden Scale) utilized within veteran facilities. Factors investigated include: diagnosis of gangrene, anemia, diabetes, malnutrition, osteomyelitis, pneumonia/pneumonitis, septicemia, candidiasis, bacterial skin infection, device/implant/graft complications, urinary tract infection, paralysis, senility, respiratory failure, acute renal failure, cerebrovascular accident, or congestive heart failure during hospitalization; patient's age, race, smoking status, history of previous PU, surgery, hours in surgery; length of hospitalization, and intensive care unit days. Retrospective chart review and logistic regression a...

Study Finds Low Risk for LVAD Exchange (CME/CE)

MedPage Today Surgery — Fri, 03 Feb 2012 03:13:12 +0100

FT. LAUDERDALE (MedPage Today) -- Clinicians can be "aggressive" when deciding whether to replace a left ventricular assist device (LVAD) because the reoperation poses low risk, a small study showed. (Source: MedPage Today Surgery)

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Stents, Surgery Both Maintain Open Carotids (CME/CE)

MedPage Today Surgery — Thu, 02 Feb 2012 23:47:52 +0100

NEW ORLEANS (MedPage Today) -- For patients with carotid stenosis, both stenting and endarterectomy provided durable revascularization through two years, an analysis of the CREST trial showed. (Source: MedPage Today Surgery)

Legal Problems Pile Up for '1-800-Get-Thin' SurgeonsLegal Problems Pile Up for '1-800-Get-Thin' Surgeons

Medscape Today Headlines — Thu, 02 Feb 2012 23:18:29 +0100

The California surgeons, who market gastric-banding surgery for weight loss through 1-800-Get-Thin ads, face FDA scrutiny, a state investigation into alleged billing fraud, a whistleblower suit, and more. Medscape Medical News (Source: Medscape Today Headlines)

Lodox/Statscan facilitates the early detection of commonly overlooked extracranial injuries in patients with traumatic brain injury

European Journal of Trauma and Emergency Surgery — Thu, 02 Feb 2012 18:16:54 +0100

Conclusion The Lodox/Statscan can provide benefits for surveying extracranial injuries in patients with diminished level of consciousness. The Lodox/Statscan also emits a notably low dose of radiation and appears to be a relatively inexpensive adjunct to screen torso or extremity injuries in TBI patients. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00068-012-0176-zAuthors H.-C. Huang, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCC.-Y. Fu, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCC.-H. Hsieh, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCY.-...

Correlation of LAPTM4B polymorphisms with gallbladder carcinoma susceptibility in Chinese patients

Medical Oncology — Thu, 02 Feb 2012 18:16:09 +0100

This study aimed to investigate the relationship of LAPTM4B allelic variation and GBC susceptibility. LAPTM4B genotype was analyzed in 155 healthy individuals and 91 GBC patients by PCR, and the genotypic distribution of LAPTM4B was analyzed with the chi-squared test. The frequency of allele *2 was 37.9 and 24.8% in the GBC and the control groups, respectively, representing a significant difference between these two groups (P < 0.001). LAPTM4B allele *2 may be a risk factor associated with genetic susceptibility to GBC. Content Type Journal ArticleCategory Original PaperPages 1-5DOI 10.1007/s12032-012-0173-4Authors Hua Yang, Department of Cell Biology, School of Basic Medical Sciences, Peking University, Beijing, 100191 ChinaGuojun Zhai, Department of Interventional R...

Clinicopathological Profile, Airway Management, and Outcome in Huge Multinodular Goiters: An Institutional Experience from an Endemic Goiter Region

World Journal of Surgery — Thu, 02 Feb 2012 18:12:35 +0100

Conclusions Long-standing huge goiters are common in iodine-deficient endemic areas. The majority of patients have symptomatic or clinicoradiological evidence of airway involvement. The incidence of RSE, airway deformity, intubation difficulty, and tracheomalacia is high with huge goiters. The surgery is technically demanding with greater associated chances of injury to native structures. Malignancy influences the presentation and outcome in smaller goiters. In centers with experienced endocrine surgeons and dedicated anesthetists, huge goiters can be successfully managed with minimal short-term and long-term morbidity. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1447-xAuthors Amit Agarwal, Department of Endocrine Surgery, Sanjay Gandhi Post Gradua...

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Video-Assisted Versus Conventional Total Thyroidectomy and Central Compartment Neck Dissection for Papillary Thyroid Carcinoma

World Journal of Surgery — Thu, 02 Feb 2012 18:12:34 +0100

Conclusions The results of VA-TT and CCD in selected cases of PTC appear to be comparable to those of conventional surgery. A longer follow-up and larger series are necessary to draw definitive conclusions concerning long-term outcomes. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1439-xAuthors Celestino P. Lombardi, Division of General and Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli,” L.go A. Gemelli 8, 00168 Rome, ItalyMarco Raffaelli, Division of General and Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli,” L.go A. Gemelli 8, 00168 Rome, ItalyCarmela De Crea, Division of General and Endocrine Surgery, Department of Surgery, U...

Outcome Following Management of Dysphagia after Laparoscopic Anti-reflux Surgery

World Journal of Surgery — Thu, 02 Feb 2012 18:12:34 +0100

Conclusions Approximately two thirds of patients with troublesome post-fundoplication dysphagia have a satisfactory outcome following either endoscopic dilatation or revisional surgery. However, approximately one third continue to be troubled by symptoms, despite further intervention. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1416-9Authors Huiqi Yang, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaCindy Meun, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaXiangyu Sun, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaDavid I. Watson, Flinders University Depart...

The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:54 +0100

Conclusion One-third to one-half of patients experience pain and discomfort during and immediately after ERCP when it is performed with conscious sedation for the patient. Other sedation strategies, such as the use of general anesthesia or propofol, may well reduce the burden of ERCP, particularly for patients with a higher EQ-5D score, younger age, or therapeutic ERCP treatment. However, randomized trials are warranted. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2162-2Authors S. M. Jeurnink, Department of Gastroenterology and Hepatology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The NetherlandsE. W. Steyerberg, Department of Public Health, Erasmus MC/University Medical Center, Rotterdam, The NetherlandsE. J. Kuipers, Department o...

Endoscopic laser fragmentation and removal of a nonremovable metal esophageal stent for persistent dysphagia: a technical note

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:53 +0100

Conclusions We describe a successful technique for the removal of a nonretrievable stent using laser fracture and endoscopic retrieval. This method of stent removal has not been previously reported. Content Type Journal ArticleCategory TechniquePages 1-3DOI 10.1007/s00464-011-2111-5Authors Ross S. Coomber, Department of Upper GI Surgery, West Herts NHS Trust, Watford General Hospital, Vicarage Road, Watford, WD18 0HB UKPranav H. Patel, Department of Upper GI Surgery, West Herts NHS Trust, Watford General Hospital, Vicarage Road, Watford, WD18 0HB UKAnubhav Dhir, Department of Healths Clinical Advisor Scheme, Bupa Health Dialog, London, UKJeremy I. Livingstone, Department of Upper GI Surgery, West Herts NHS Trust, Watford General Hospital, Vicarage Road, Watford, WD18...

Randomized controlled trial of laparoscopic gastric ischemic conditioning prior to minimally invasive esophagectomy, the LOGIC trial

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:53 +0100

Conclusions LIC does not translate into an improved perfusion of the gastric conduit tip. The benefits reported from published clinical series suggest that the resistance of the conduit to ischemia occurs through alternative possibly microcellular mechanisms. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-011-2123-1Authors Darmarajah Veeramootoo, Department of Upper Gastro-Intestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, EX2 5DW UKAngela C. Shore, Institute of Biomedical and Clinical Science, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UKShahjehan A. Wajed, Department of Upper Gastro-Intestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, EX2 5DW UK Journal Surgical EndoscopyOnlin...

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The use of novel hemostatic sealant (Tisseel®) in laparoscopic myomectomy: a case–control study

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:53 +0100

Conclusions The use of Tisseel® during LM may represent a valid alternative solution for obtaining hemostasis, reducing intra- and postoperative bleeding. Furthermore, it may help the surgeon to obtain a rapid healing of the injured surfaces, probably reducing the use of electrocoagulation and traumatisms. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2154-2Authors Roberto Angioli, Department of Obstetrics and Gynecology, “Campus Bio Medico” University of Rome, Via Álvaro del Portillo, 200-00128 Rome, ItalyFrancesco Plotti, Department of Obstetrics and Gynecology, “Campus Bio Medico” University of Rome, Via Álvaro del Portillo, 200-00128 Rome, ItalyRoberto Ricciardi, Department of Obstetrics and Gynecology, “Campus Bio Medico” University...

The optimal strategy for proximal mesh fixation during laparoscopic ventral rectopexy for rectal prolapse: an ex vivo study

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:51 +0100

Conclusion The new screw for proximal mesh fixation during LVR procedures offers similar fixation strength when compared to tacks. The use of one screw for proximal mesh fixation is therefore a reasonable alternative to the use of several tacks or sutures. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-012-2161-3Authors Hendrik A. Formijne Jonkers, Department of Surgery, Meander Medical Centre, Amersfoort, The NetherlandsHarm J. van de Haar, Department of Surgery, Meander Medical Centre, Amersfoort, The NetherlandsWerner A. Draaisma, Department of Surgery, Meander Medical Centre, Amersfoort, The NetherlandsBen G. F. Heggelman, Department of Radiology, Meander Medical Centre, Amersfoort, The NetherlandsEsther C. J. Consten, Department of Surgery, Meander Medi...

Comparable early changes in gastrointestinal hormones after sleeve gastrectomy and Roux-En-Y gastric bypass surgery for morbidly obese type 2 diabetic subjects

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:50 +0100

Conclusions The data show that in a cohort of morbidly obese T2DM subjects, SG and RYGBP are associated with an early improvement in glucose tolerance, similar changes in insulin and glucagon secretion, and a similar GLP-1, GIP, and GLP-2 response to a standardized mixed liquid meal. Content Type Journal ArticlePages 1-9DOI 10.1007/s00464-012-2166-yAuthors Fabiola Romero, Endocrinology and Diabetes Department, Obesity Unit, Hospital Clinic Universitari, Villarroel 170, 08036 Barcelona, SpainJoana Nicolau, Endocrinology and Diabetes Department, Obesity Unit, Hospital Clinic Universitari, Villarroel 170, 08036 Barcelona, SpainLílliam Flores, Endocrinology and Diabetes Department, Obesity Unit, Hospital Clinic Universitari, Villarroel 170, 08036 Barcelona, SpainRoser ...

Anti-Xa Levels 4 h After Subcutaneous Administration of 5,700 IU Nadroparin Strongly Correlate with Lean Body Weight in Morbidly Obese Patients

Obesity Surgery — Thu, 02 Feb 2012 17:58:24 +0100

Abstract Background Morbidly obese patients (BMI > 40 kg/m2) are at increased risk for venous thromboembolism, especially after surgery. Despite limited evidence, morbidly obese patients are often administered a double dose of nadroparin for thromboprophylaxis compared to non-obese patients. The aim of this study was to evaluate the influence of different body size descriptors on anti-Xa levels after a double dose of nadroparin (5,700 IU) in morbidly obese patients. Methods In 27 morbidly obese patients with a mean total body weight of 148 kg (range 107–260 kg), anti-Xa levels were determined peri-operatively until 24 h after administration of a subcutaneous dose of 5,700 IU of nadroparin. Results &nbs...

A systematic review of peer review for scientific manuscripts

Hand — Thu, 02 Feb 2012 06:56:00 +0100

Conclusions The criteria for submission will vary, but our systematic review provides a comprehensive overview of what reviewers expect from authors. Our systematic review also highlighted ethical considerations for both authors and reviewers during the peer-review process. Although the topic of peer review is expansive and its process may vary from journal to journal, the understanding of the themes outlined in this paper will help authors recognize how to write a more successful paper. Also, more research must be carried out to establish the efficacy of the different styles of peer review, and it would be presumptuous to draw conclusions until further research is established. Content Type Journal ArticleCategory Review Articles of topicsPages 1-8DOI 10.1007/s1155...

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Current Strategies and Future Perspectives for Intraperitoneal Adhesion Prevention

Journal of Gastrointestinal Surgery — Thu, 02 Feb 2012 06:55:38 +0100

Discussion Mesothelial cells play a crucial physiological role in frictionless gliding of the serosa and the maintenance of an antiadhesive surface. The formation of postoperative adhesions results from a cascade of events and is regulated by various cellular and humoral factors. Therefore, optimization or functionalization of barrier materials by developments interacting with this cascade on a structural or pharmacological level could give an innovative input for future strategies in peritoneal adhesion prevention. For this purpose, the proper understanding of the formal pathogenesis of adhesion formation is essential. Based on the physiology of the serosa and the pathophysiology of adhesion formation, the available barriers in current clinical practice as well as new inn...

Short- and Long-Term Changes in Gastric Morphology and Histopathology Following Sleeve Gastrectomy in Diet-Induced Obese Rats

Obesity Surgery — Thu, 02 Feb 2012 06:54:07 +0100

Conclusion After SG gastric macro- and microscopic changes with functional implications in both the short and long term take place. Content Type Journal ArticleCategory Animal ResearchPages 1-7DOI 10.1007/s11695-012-0606-3Authors Marina Martín, Department of Histology & Pathology, University of Navarra, Pamplona, SpainMaría A. Burrell, Department of Histology & Pathology, University of Navarra, Pamplona, SpainJavier Gómez-Ambrosi, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, SpainVíctor Valentí, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, SpainÁlvaro Bueno, Department of Surgery, University of Navarra, Pamplona, SpainBeatriz Ramírez, CIBER Fisiopat...

Visualization versus Neuromonitoring of Recurrent Laryngeal Nerves during Thyroidectomy: What About the Costs?

World Journal of Surgery — Thu, 02 Feb 2012 06:53:59 +0100

Conclusions The regional DRG tariff for thyroid surgery is barely sufficient to cover conventional surgery costs. Intraoperative neural monitoring accounts for 5–7% of the hospitalization costs for a thyroidectomy. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1452-0Authors Gianlorenzo Dionigi, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyAlessandro Bacuzzi, Department of Anesthesia, University of Insubria, 21100 Varese, ItalyLuigi Boni, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyStefano Rausei, Department of Surgical Sciences, Endocrine Surgery Research Center...

A Mathematical Model for Predicting Malignancy of Solitary Pulmonary Nodules

World Journal of Surgery — Thu, 02 Feb 2012 06:53:58 +0100

Conclusions Age, diameter, border, calcification, spiculation, and family history of tumor were independent predictors of malignancy in patients with SPN. Our prediction model was sufficient to estimate malignancy in patients with SPN and proved to be more accurate than the two existing models. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1449-8Authors Yun Li, Department of Thoracic Surgery, People’s Hospital of Peking University, No. 11 Xizhimen South Street, Xicheng District, 100044 Beijing, People’s Republic of ChinaJun Wang, Department of Thoracic Surgery, People’s Hospital of Peking University, No. 11 Xizhimen South Street, Xicheng District, 100044 Beijing, People’s Republic of China Journal World Journal of SurgeryOnline ISSN 1432...

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient-Controlled Analgesia-Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

World Journal of Surgery — Thu, 02 Feb 2012 06:53:57 +0100

Conclusions Dexamethasone 5 mg with either haloperidol 2 mg or ondansetron 4 mg provides a better antiemetic effect than dexamethasone 5 mg alone in patients receiving postoperative morphine PCA. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1446-yAuthors Po-Kai Wang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CPei-Jiuan Tsay, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CChia-Chun Huang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CHsien-Yong Lai, Department of Medical Education and Research, M...

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Solitary rectal diverticulum. A case presentation.

Cirugia eEspanola — Thu, 02 Feb 2012 05:00:00 +0100

Authors: Abrisqueta J, Frutos MD, Luján J, Abellán I, Parrilla P PMID: 22305179 [PubMed - as supplied by publisher] (Source: Cirugia eEspanola)

Effect of Roux‐en‐Y gastric bypass on testosterone and prostate‐specific antigen

British Journal of Surgery — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion:RYGB normalizes the serum testosterone level. PSA levels increase with weight loss and may be inversely correlated with changes in plasma volume, indicating that PSA levels may be artificially low in obese men owing to haemodilution. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Development of an evidence‐based protocol for care of pilonidal sinus wounds healing by secondary intent using a modified Reactive Delphi procedure. Part 2: methodology, analysis and results

International Wound Journal — Thu, 02 Feb 2012 05:00:00 +0100

This is the second part of the article based on the thesis work for a Masters of Science in Wound Healing and Tissue Repair, Cardiff University, to develop an evidence‐based protocol for the care of pilonidal sinus wounds (PSWs) healing by secondary intent, using a modified Reactive Delphi process. The sample included surgeons, clinic physicians, nurses and enterostomal therapy nurses experienced in the care of these wounds. Item generation involved an extensive review of the literature to identify key aspects of evidence‐based wound care essential to wound healing, infected wounds and pilonidal wounds healing by secondary intent and drawing on clinical experience. The participants responded via an electronic Delphi website, using a 4‐point Likert rating scale and a ranking system. C...

Effect of Normal Saline Irrigation on Attenuation of Shoulder Tip Pain and on β-Endorphin Levels After Laparoscopic Cholecystectomy

Journal of Laparoendoscopic — Thu, 02 Feb 2012 04:11:02 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Minimally invasive intrathoracic anastomosis after Ivor Lewis esophagectomy for cancer: a review of transoral or transthoracic use of staplers

Surgical Endoscopy — Wed, 01 Feb 2012 18:26:14 +0100

Conclusions This review has found no important differences between the two most frequently used stapled anastomoses: the transoral introduction of the anvil and the transthoracic. Clinical trials are needed to compare different methods to improve the quality of the intrathoracic anastomosis after esophagectomy. Content Type Journal ArticleCategory ReviewPages 1-8DOI 10.1007/s00464-012-2149-zAuthors K. W. Maas, Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsS. S. A. Y. Biere, Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsJ. J. G. Scheepers, Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsS. S....

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Toluidine blue for the intraoperative staining of the ureters. Studies on the safe administration in rats

Langenbeck's Archives of Surgery — Wed, 01 Feb 2012 17:11:57 +0100

Conclusions In rats, intravenous injection of 0.4 mg TB/kg was sufficient for the intraoperative staining of the urinary tract without the risk of severe cardiovascular and hemodynamic side effects. Provided our results are transferable to humans, the administration of low TB doses could allow its safer clinical use for the intraoperative visualization of the ureters. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00423-012-0907-yAuthors Frank Petrat, Institut für Physiologische Chemie, Universitätsklinikum, Universität Duisburg-Essen, Hufelandstr. 55, 45122 Essen, GermanyMatthias Hartmann, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, GermanyErnst Schmidt, Dr. F...

A review of patch options in the repair of congenital diaphragm defects

Pediatric Surgery International — Wed, 01 Feb 2012 17:10:05 +0100

Abstract Repair of congenital diaphragmatic hernia (CDH) continues to pose a dilemma for the pediatric surgeon. While the management of CDH has evolved from surgical urgency to delayed repair after medical optimization with substantial improvements in mortality, morbidity continues to perplex clinicians. Significant morbidity occurs with recurrence, re-recurrence and complications such as obstructions, principally with mesh repair. When primary closure is not possible, mesh repair is indicated. While there are several non-absorbable prosthetic, absorbable biosynthetic and composite mesh types available, the ideal mesh remains elusive. In this article, we reviewed the current materials, reported advantages, and animal and clinical studies of non-absorbable prosthetic, absor...

Pediatric surgical site infection in the developing world: a Kenyan experience

Pediatric Surgery International — Wed, 01 Feb 2012 17:10:04 +0100

Conclusions Our rate of SSI among pediatric patients in sub-Saharan Africa is the lowest reported in the literature to date. More work is needed to identify modifiable risk factors for pediatric SSI in low- and middle-income countries. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00383-012-3058-xAuthors James H. Wood, Department of Surgery, University of Colorado Denver School of Medicine, 12631 East 17th Avenue, Box C302, Aurora, CO 80045, USAPeter M. Nthumba, BethanyKids at Kijabe Hospital, Kijabe, KenyaEdita Stepita-Poenaru, BethanyKids at Kijabe Hospital, Kijabe, KenyaDan Poenaru, BethanyKids at Kijabe Hospital, Kijabe, Kenya Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358 (Source: Pediatric Su...

The calcitonin levels can sometimes mislead parathyroid surgeons in patients with chronic kidney disease and renal hyperparathyroidism: report of a case

Surgery Today — Wed, 01 Feb 2012 17:09:40 +0100

This report presents a case of a patient with CKD and mild rHPT scheduled for thyroidectomy for a suspected medullary thyroid carcinoma (MTC) within a mononodular goiter. A hemithyroidectomy with resection of both adjacent parathyroid glands and unilateral central lymph node dissection was performed. Histopathology revealed no evidence of MTC. The rHPT, calcitonin and pentagastrin test subsequently normalized and follow-up revealed no evidence for MTC within the remaining right thyroid lobe. Elevated calcitonin levels in patients with CKD may reflect a physiological response to rHPT than rather represent MTC. The thresholds for calcitonin levels need to be better defined in affected patients to determine the optimal extent of surgical resection. Content Type Journal ArticleCateg...

Commentary on “Are Natural Orifice Transluminal Endoscopic Surgery and Single-Incision Surgery Viable Techniques for Cholecystectomy?”

Journal of Laparoendoscopic — Wed, 01 Feb 2012 16:20:18 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Jan 2012, Vol. 22, No. 1: 15-16. (Source: Journal of Laparoendoscopic)

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Laparoscopic Choledochoduodenostomy for Biliary Stone Disease: A Single-Center 10-Year Experience

Journal of Laparoendoscopic — Wed, 01 Feb 2012 16:20:08 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Jan 2012, Vol. 22, No. 1: 81-84. (Source: Journal of Laparoendoscopic)

Single-Center Experience with Pediatric Laparoscopic Extravesical Reimplantation: Safe and Effective in Simple and Complex Anatomy

Journal of Laparoendoscopic — Wed, 01 Feb 2012 16:19:58 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Jan 2012, Vol. 22, No. 1: 102-106. (Source: Journal of Laparoendoscopic)

EJVES vol. 43, issue 2 (February 2012) - Spanish Translated Abstracts

European Journal of Vascular and Endovascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

(Source: European Journal of Vascular and Endovascular Surgery)

EJVES vol. 43, issue 2 (February 2012) - Chinese Translated Abstracts

European Journal of Vascular and Endovascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

(Source: European Journal of Vascular and Endovascular Surgery)

Primary Malignant melanoma of the esophagus: a case report and literature review.

Surgical Practice — Wed, 01 Feb 2012 05:00:00 +0100

We report a case of primary malignant malenoma of esophagus (PMME) followed by review of recent literatures. Surgical resection for operable tumor remains the current practice. In general, prognosis of PMME is poor, with a median survival of 10 months. Recent advance including Chemoendocrine and chemoimmunotherapy may help to improve overall survival. Combined endoscopic and systemic therapy is an alternative in patients unfit for surgery, or in metastatic disease.© 2012 The Authors. Surgical Practice © 2012 College of Surgeons of Hong Kong (Source: Surgical Practice)

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Healing process of venous ulcers: the role of microcirculation

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

In order to describe adequately the process of healing in the intermediate degrees, we investigated microcirculatory changes in the venous ulcers at well‐defined stages of wound repair. We investigated dynamic changes in microcirculation during the healing process of venous ulcers. Ten venous ulcers were investigated in three consecutive clinical stages of wound healing: non granulation tissue (NGTA), GTA and scar. Subpapillary microcirculation was measured by laser Doppler perfusion (LDP) imaging and expressed using LDP values in arbitrary units. Nutritive perfusion by capillary microscopy and expressed as capillary density (CD) – the number of capillaries per square millimetre. Before the development of GTA the LDP was low (median 1·35; lower–upper quartiles 0·71–1·83) accompa...

Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: point prevalence and reasons.

Hong Kong Med J — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS. Case cancellations were mainly due to facility factors, such as no operating room time being available. The odds of having no operating room time available varied between surgical specialties. PMID: 22302904 [PubMed - in process] (Source: Hong Kong Med J)

A Case with Unilateral Hypoglossal nerve injury in Branchial cyst surgery.

Journal of Brachial Plexus and Peripheral Nerve Injury — Wed, 01 Feb 2012 05:00:00 +0100

An 11 years old boy came, with complain of mild dysarthria. Examination revealed marked hemiatrophy of left side of the tongue. Five months back he underwent ipsilateral branchial cyst operation. To our knowledge, no case was reported. After branchial cyst operation if there is any residual remnant chance of recurrence is very high. (Source: Journal of Brachial Plexus and Peripheral Nerve Injury)

Real‐time deformation of colon and endoscope for colonoscopy simulation

The International Journal of Medical Robotics and Computer Assisted Surgery — Wed, 01 Feb 2012 05:00:00 +0100

ConclusionsThe proposed method allows real‐time simulation of colon and endoscope deformation while maintaining a visually plausible result and realistic haptic sensation. Copyright © 2012 John Wiley & Sons, Ltd. (Source: The International Journal of Medical Robotics and Computer Assisted Surgery)

Successful Treatment for Infected Aortic Aneurysm Using Endovascular Aneurysm Repairs as a Bridge to Delayed Open Surgery

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Management of infected aortic aneurysms, which can be life-threatening, remains challenging. Open surgical treatments, including debridement of the infected aorta and the surrounding tissue and either in situ reconstruction or extra-anatomic bypass covering with omentum or muscle flap, are the mainstay of therapy. However, increasing advances in technology have made endovascular treatment of infected aneurysms feasible. The present study describes the first clinical report of successful treatment of an infected aneurysm using endovascular techniques in the acute phase, followed by delayed open surgery. (Source: Annals of Vascular Surgery)

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Clostridium septicum Aortitis With Associated Sigmoid Colon Adenocarcinoma

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

We report an unusual case of Clostridium septicum aortitis with associated adenocarcinoma of the sigmoid colon. An 87-year-old man with multiple medical comorbidities presented with a 1-week history of severe abdominal pain in the left lower quadrant of his abdomen. Abdominal computed tomography showed, in addition to a mass in the sigmoid colon, a gas density within the wall of the abdominal aorta with extensive periaortic fat stranding and some additional gas densities in the proximal left common iliac artery. The patient refused surgery, and was treated with intravenous antibiotics. He died 5 weeks later. The development of Clostridium septicum aortitis, an extremely rare but life-threatening infection, is highly associated with an underlying colonic malignancy and demands immediate sur...

Giant, Metachronous Bilateral Dorsalis Pedis Artery True Aneurysms

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

This report is the first to describe the clinical, radiographic, operative, and pathologic findings associated with large, bilateral dorsalis pedis artery true aneurysms in a single patient. A 61-year-old African American woman complained of difficulty in wearing shoes. She had a moderately firm, nontender, pulsatile mass on the dorsum of her right foot. Computed tomography and angiography confirmed dorsalis pedis artery aneurysm with sufficient collateralization. She underwent resection without reconstruction. Pathologic analysis revealed a true aneurysm (8 × 5.3 × 4.1 cm3) containing intralumenal thrombus. Treatment for small symptomatic and large dorsalis pedis artery aneurysms remains resection with or without reconstruction. (Source: Annals of Vascular Surgery)

Delayed Axillary Artery Pseudoaneurysm as an Isolated Consequence to Anterior Dislocation of the Shoulder

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

We describe a case of delayed axillary artery pseudoaneurysm, presenting as single complication after anterior shoulder dislocation reduction, which was successfully managed by surgical intervention—resection–anastomosis. Although uncommon, pseudoaneurysms should not be forgotten after trivial trauma. The early diagnosis of upper-limb pseudoaneurysms should prevent the risk of vascular and neurological compromises with potential serious long-term sequelae. (Source: Annals of Vascular Surgery)

Infected Abdominal Aneurysm due to Salmonella Sepsis: Report of a Unique Case Treated Using the Superficial Femoral Vein

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

We describe a 61-year-old patient with an infected aneurysm of the abdominal aorta due to Salmonella sepsis. Treatment was successful and included aneurysm resection, extensive debridement, and reconstruction of the abdominal aorta using the superficial femoral vein, combined with long-term antibiotic therapy. (Source: Annals of Vascular Surgery)

Bilateral Femoral Artery Aneurysm Mimicking Soft Tissue Sarcoma

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Despite the rarity of femoral aneurysm and the plethora of other causes of swelling in and around its anatomic location, the possibility of its existence must always be borne in mind. A rare case of metachronously bilateral femoral aneurysms mimicking soft tissue sarcoma in a young Nigerian man is presented. Caution in the diagnosis of groin masses is hereby re-emphasized. (Source: Annals of Vascular Surgery)

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Anatomic Bifurcated Reconstruction of Chronic Bilateral Innominate–Superior Vena Cava Occlusion Using the Y-Stenting Technique

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

This article presents the case of a 42-year-old man who presented with superior vena cava (SVC) syndrome due to fibrosing mediastinitis with multiple failed attempts at recanalization. We initially treated him with unilateral sharp needle recanalization of the right innominate vein into the SVC stump followed by stenting. Although his symptoms improved immediately, they did not completely resolve. Six months later, he returned with worsening symptoms, and venography revealed in-stent restenosis. The patient requested simultaneous treatment on the left side. The right stent was dilated, and a 3-cm-long occlusion of the left innominate vein was recanalized, again using sharp needle technique, homing into the struts of the right-sided stent. Following fenestration of the stent, a second stent...

Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in (Source: Annals of Vascular Surgery)

Matrine Inhibits Disturbed Flow–Enhanced Migration via Downregulation of ERK1/2–MLCK Signaling Vascular Smooth Muscle Cells

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Matrine inhibits VSMC migration under disturbed flow, in part, by downregulation of ERK1/2–MLCK signaling pathway. (Source: Annals of Vascular Surgery)

Pedicled Flaps in Association With Distal Bypass for Lower-Limb Salvage

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our results suggest that pedicle flaps are feasible after distal bypass in patients with lower-extremity occlusive artery disease. This technique expands the indication for limb salvage with low morbidity. (Source: Annals of Vascular Surgery)

The Results of a Needs Assessment to Guide a Vascular Surgery Skills Simulation Curriculum

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our needs assessment identified vascular procedures where simulation may be beneficial to improve the skill level of vascular trainees in Southern California. With economic and logistical constraints for simulation at each individual training facility, a potential approach to this educational challenge is a regional Southern California vascular surgery skills simulation center. (Source: Annals of Vascular Surgery)

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Preoperative Cardiac Evaluation and Perioperative Cardiac Therapy in Patients Undergoing Open Surgery for Abdominal Aortic Aneurysms: Effects on Cardiovascular Outcome

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: These data suggest a significant benefit of an intensive cardiac preoperative evaluation in reducing the incidence of perioperative and postoperative cardiac morbidity and mortality. (Source: Annals of Vascular Surgery)

On The Cover

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Annals of Vascular Surgery)

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Annals of Vascular Surgery)

Follicular thyroid cancer: minimally invasive tumours can give rise to metastases

ANZ Journal of Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Currently accepted histological classification of FTC is inadequate and fails to accurately predict patients with distant metastatic disease and a more aggressive clinical course. It is thus the policy of our unit to recommend total thyroidectomy and radioactive iodine ablation for all patients with FTC. (Source: ANZ Journal of Surgery)

A prospective pilot study of ultrasound therapy effectiveness in refractory venous leg ulcers

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

In conclusion, we found that patients treated with ultrasound therapy and compression therapy show clinical improvement over the course of 4 weeks and had a decrease in inflammatory cytokines, bacterial counts and pain. (Source: International Wound Journal)

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Wound‐healing potential of an ethanol extract of Carica papaya (Caricaceae) seeds

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

This study evaluated the wound‐healing and antimicrobial activity of C. papaya seed extract. Ethanol extract of C. papaya seed (50 mg/kg/day) was evaluated for its wound‐healing activity in Sprague‐Dawley rats using excision wound model. Animals were randomly divided into four groups of six each (group 1 served as control, group 2 treated with papaya seed extract, group 3 treated with a standard drug mupirocin and papaya seed extract (1:1 ratio) and group 4 treated with a mupirocin ointment. Rate of wound contraction and hydroxyproline content were determined to assess the wound‐healing activity of the seed extract. The group 2 animals showed a significant decrease in wound area of 89% over 13 days when compared with groups 1 (82%), 3 (86%) and 4 (84%) respectively. The hydroxyprol...

The utility of Gram stains and culture in the management of limb ulcers in persons with diabetes

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

In Tanzania, limited laboratory services often preclude routine identification of microorganisms that cause infections in persons with diabetes. Thus, we carried out this study to determine the utility of a Gram stain alone versus culture in guiding appropriate antimicrobial therapy. During February 2006 to December 2007 (study period), deep tissue biopsies were obtained from persons with diabetes presenting to the Muhimbili National Hospital (MNH) with infected limb ulcers. Specimens were Gram‐stained then cultured for bacteria and fungi. Biopsies were obtained from 128 patients. Of 128 cultures, 118 (92%) yielded bacterial or fungal growth; 59 (50%) of these 118 cultures yielded mixed growth (80% included Gram‐negative organisms); 38 (32%) and 20 (17%) yielded Gram‐negative and Gra...

Wound outcomes in patients with advanced illness

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

A prospective case series was studied to assess the potential for complete healing of wounds among patients with advanced illness referred to a regional palliative care program in Toronto, Canada. Two hundred and eighty‐two patients, of which 148 were primarily diagnosed with cancer and 134 with non cancer advanced illness, were assessed and followed until their deaths. On the baseline initial referral date, 823 wounds were documented. The wound classes assessed included pressure ulcers, malignant wounds, skin tears, venous leg ulcers, diabetic foot ulcers and arterial leg/foot ulcers. Proportions of patients showing complete healing of at least one wound were calculated, stratified by patient's survival time post‐baseline (1 week, 1 month, 3 months and 6 months). Proportions of patien...

High Reliability Organizations and Surgical Microsystems: Re-engineering Surgical Care.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article introduces basic concepts of complexity and systems theory that are useful in redesigning the surgical work environment to create safety, quality, and reliability in surgical care. PMID: 22269256 [PubMed - in process] (Source: The Surgical Clinics of North America)

Building high-performance teams in the operating room.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Sax HC Abstract Building effective teams requires the delineation of clear goals, an understanding of each member's role in reaching that goal, and continuous feedback as issues are identified. The solo mentality required to become a health care provider needs to be modified to see a bigger picture. Finally, consistent buy-in and support from senior administration to deal with disruptive personalities is vital for long-term success. PMID: 22269257 [PubMed - in process] (Source: The Surgical Clinics of North America)

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Human factors and operating room safety.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Elbardissi AW, Sundt TM Abstract A human factors model is used to highlight the nature of many systems factors that affect surgical performance, including the OR environment, teamwork and communication, technology and equipment, tasks and workload factors, and organizational variables. If further improvements in the success rate and reliability of cardiac surgery are to be realized, interventions need to be developed to reduce the negative impact that work system failures can have on surgical performance. Some recommendations are proposed here; however, several challenges remain. PMID: 22269258 [PubMed - in process] (Source: The Surgical Clinics of North America)

Surgeons' Non-technical Skills.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article discusses the core cognitive and social skills categories thought to underpin medical knowledge and surgical expertise, and describes the rise of non-technical skill models of assessment in surgery. Behavior rating systems such as NOTSS (Non-Technical Skills for Surgeons) have been developed to support education and assessment in this regard. We now understand more about these critical skills and how they impact surgery. The challenge in the future is to incorporate them into undergraduate teaching, postgraduate training, workplace assessment, and perhaps even selection. PMID: 22269259 [PubMed - in process] (Source: The Surgical Clinics of North America)

A Comprehensive Unit-Based Safety Program (CUSP) in Surgery: Improving Quality Through Transparency.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Cooper M, Makary MA Abstract Many medical errors can be attributed to large and complex health care systems in which care is increasingly fragmented. Hospitals with good safety cultures have lower complication rates, and improved patient and staff satisfaction. Transparency in health care is an increasingly recognized means to improve outcomes by allowing the free market to reward hospitals with a strong safety culture, good outcomes, and compliance with evidence-based medicine. As more data become available regarding strategies that work to improve patient safety and such strategies are more widely implemented, significant improvements in the quality of care that is delivered nationwide should become apparent. PMID: 22269260 [PubMed - in process] (Source: The Surgical...

Hospital-acquired infections.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article focuses on HAIs that are well studied, common, and costly (direct, indirect, and intangible). The HAIs reviewed are catheter-related bloodstream infection, ventilator-associated pneumonia, surgical site infection, and catheter-associated urinary tract infection. This article excludes discussion of Clostridium difficile infections and vancomycin-resistant Enterococcus. PMID: 22269261 [PubMed - in process] (Source: The Surgical Clinics of North America)

Information technologies and patient safety.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Ellner SJ, Joyner PW Abstract Advances in health information technology provide significant opportunities for improvements in surgical patient safety. The adoption and use of electronic health records can enhance communication along the surgical spectrum of care. Bar coding and radiofrequency identification technology are strategies to prevent retained surgical sponges and for tracking the operating room supply chain. Computerized intraoperative monitoring systems can improve the performance of the operating room team. Automated data registries collect patient information to be analyzed and used for surgical quality improvement. PMID: 22269262 [PubMed - in process] (Source: The Surgical Clinics of North America)

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Adverse events: root causes and latent factors.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article describes the process of root cause analysis (RCA), the theories of error that underlie the concept of systemic or latent factors that allow errors to occur or to be propagated without correction; the difference between the process in health care and those found in high-reliability organizations; and suggests some ways to augment the standard health care RCA into a more robust and helpful process. PMID: 22269263 [PubMed - in process] (Source: The Surgical Clinics of North America)

Making sense of root cause analysis investigations of surgery-related adverse events.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article discusses the limitations of root cause analysis (RCA) for surgical adverse events. Making sense of adverse events involves an appreciation of the unique features in a problematic situation, which resist generalization to other contexts. The top priority of adverse event investigations must be to inform the design of systems that help clinicians to adapt and respond effectively in real time to undesirable combinations of design, performance, and circumstance. RCAs can create opportunities in the clinical workplace for clinicians to reflect on local barriers and identify enablers of safe and reliable outcomes. PMID: 22269264 [PubMed - in process] (Source: The Surgical Clinics of North America)

Residency Training Oversight(s) in Surgery: The History and Legacy of the Accreditation Council for Graduate Medical Education Reforms.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Nauta RJ Abstract Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. PMID: 22269265 [PubMed - in process] (Source: The Surgical Clini...

Teaching the Slowing-down Moments of Operative Judgment.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: St-Martin L, Patel P, Gallinger J, Moulton CA Abstract Surgical judgment has been an elusive construct to define, let alone teach or assess. A recent study has characterized a phenomenon called slowing down when you should, and suggests it is a hallmark for operative judgment. This research highlights areas where surgical judgment can be identified and therefore taught more explicitly in the operating room. Through the identification of these slowing-down moments and an understanding of how control is negotiated between surgeon and trainee during these moments, this article uses several theoretic frameworks to understand how teaching judgment in the operating room can be optimized. PMID: 22269266 [PubMed - in process] (Source: The Surgical Clinics of North America)

The role of unconscious bias in surgical safety and outcomes.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article reviews the evidence in support of unconscious bias and resultant disparate health outcomes. Although unconscious bias cannot be entirely eliminated, acknowledging it, encouraging empathy, and understanding patients' sociocultural context promotes just, equitable, and compassionate care to all patients. PMID: 22269267 [PubMed - in process] (Source: The Surgical Clinics of North America)

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When bad things happen to good surgeons: reactions to adverse events.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article presents a framework to understand surgeons' reactions to adverse events that was derived from a more recent study as well as a review of relevant psychology literatures. This framework is then situated within the broader picture of mindful practice to explore how the psychological and social dimensions of the surgeon can affect judgment and cognition. PMID: 22269268 [PubMed - in process] (Source: The Surgical Clinics of North America)

Open disclosure of adverse events: transparency and safety in health care.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

This article explores our experience of managing and implementing an open disclosure program in an acute and chronic tertiary care facility with university affiliation in the Veterans Health Administration. PMID: 22269269 [PubMed - in process] (Source: The Surgical Clinics of North America)

Patient safety.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Martin RF PMID: 22269270 [PubMed - in process] (Source: The Surgical Clinics of North America)

[Pathological anatomical characteristics of Klatskin tumors : Classification, current molecular biological aspects, prognosis factors.]

Der Chirurg — Wed, 01 Feb 2012 05:00:00 +0100

[Pathological anatomical characteristics of Klatskin tumors : Classification, current molecular biological aspects, prognosis factors.] Chirurg. 2012 Feb 1; Authors: Munding J, Tannapfel A Abstract Klatskin tumors are a distinct subgroup of cholangiocarcinomas which are a surgical challenge due to their special localization. Different localizations do not show great differences concerning histomorphology and precursor lesions. With respect to molecular alterations there are only small differences. Accurate clinical and histomorphological diagnosis is important for therapy and especially the prediction of prognosis as well as standardized processing of the resection specimen if the carcinoma is resectable. Additionally, accurate lymph node dissection is necessary. Concerning...

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[Research as attractiveness parameter for young surgeons.]

Der Chirurg — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Vollmar B Abstract Increasing concern has been expressed about the significant shortage of new trainees in surgery. As research in the context of surgical education and training is an essential element of attraction for the field of surgery, there is an urgent priority to implement clear room for research in the concepts of education and training. In this article the relevance of both the thesis accompanying the study and research training during surgical residency for the clinical self-image, personal satisfaction and academic development of young surgeons will be presented. PMID: 22290223 [PubMed - as supplied by publisher] (Source: Der Chirurg)

[Management abilities of the head surgeon: essential for survival!]

Der Chirurg — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Jähne J Abstract Due to increased economic challenges in the management of hospitals head surgeons do not only need excellent surgical expertise but also significant management qualities. The personality of head surgeons should include authenticity, sincerity, fairness and the ability to cooperate. Visionary leadership, strategic thinking and strategic management of the personnel are further prerequisites for success. Besides good abilities in communication head surgeons need knowledge of the operating figures for interpretation. To keep up with the own capabilities time and self-management is essential. A survival as head surgeon is likely if these qualities and abilities exist. PMID: 22290224 [PubMed - as supplied by publisher] (Source: Der Chirurg)

[Hospital cooperation models : Safeguarding optimized patient care, medical training and resource utilization.]

Der Chirurg — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: The long-term results indicate that the cooperation model functions to achieve an optimized treatment of patients and an economical win-win situation for all cooperation partners by differential utilization of the available resources in the hospital network. PMID: 22290225 [PubMed - as supplied by publisher] (Source: Der Chirurg)

[Multilocular pyoderma gangrenosum after uterus resection.]

Der Chirurg — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Al Ghazal P, Dissemond J Abstract A 71-year-old patient presented with very painful ulcers after uterus-resection with the da Vinci® Surgical System 3 months before. The anamnesis revealed that in the past 10 months similar wounds had appeared after osteosynthesis of a humerus fracture and after breast biopsy. The patient had been unsuccessfully treated with different antibiotics and wound dressings for several months for a suspected superinfected, postoperative disturbed wound healing. None of the wounds became smaller or healed completely. After exclusion of relevant differential diagnoses pyoderma gangrenosum (PG) could be diagnosed and systemic immunosuppressive therapy was initiated. The pain improved rapidly and complete wound healing was achieved. Pyoderma gangreno...

Contemporary body armor: technical data, injuries, and limits

European Journal of Trauma and Emergency Surgery — Tue, 31 Jan 2012 16:48:13 +0100

Abstract The introduction of firearms in the fifteenth century led to the continuous development of bulletproof personal protection. Due to recent industrial progress and the emergence of a new generation of ballistic fibers in the 1960s, the ability of individual ballistic protections to stop projectiles greatly increased. While protective equipment is able to stop increasingly powerful missiles, deformation during the impact can cause potentially lethal nonpenetrating injuries that are grouped under the generic term of behind armor blunt trauma, and the scope and consequences of these are still unclear. This review first summarizes current technical data for modern bulletproof vests, the materials used in them, and the stopping mechanisms they employ. Then it describes r...

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A Review of the Relationships Between Extreme Obesity, Quality of Life, and Sexual Function

Obesity Surgery — Tue, 31 Jan 2012 16:47:32 +0100

Abstract Extreme obesity is associated with significant health issues as well as substantial psychosocial burden for many individuals. Numerous studies have documented the impairments in quality of life associated with extreme obesity. Sexual behavior and functioning is an important aspect of quality of life but is frequently overlooked in research studies as well as clinical care. This paper focuses on the quality of life and sexual functioning of obese individuals with specific focus on the changes in these domains following the substantial weight losses seen after bariatric surgery. Content Type Journal ArticleCategory ReviewPages 1-9DOI 10.1007/s11695-012-0588-1Authors David B. Sarwer, Department of Psychiatry, Center for Weight and Eating Disorders, Perelman Scho...

Incidence and location of positive surgical margins following open, pure laparoscopic, and robotic-assisted radical prostatectomy and its relation with neurovascular preservation: a single-institution experience

Journal of Robotic Surgery — Tue, 31 Jan 2012 16:47:06 +0100

Abstract To evaluate whether robotic-assisted radical prostatectomy (dvRP) provides adequate local control of the disease, incidence of positive surgical margins (PSMs) obtained with dvRP was compared with that of laparoscopic radical prostatectomy (LRP) and with that of open radical retropubic prostatectomy (RRP) performed in a single institution by the same surgeons. We also studied whether neurovascular bundle preservation modified PSM rates. The records were retrospectively reviewed from electronic medical data, and three groups of 100 patients were organized. Group 1 included 100 patients who underwent RRP prior to the incorporation of minimally invasive techniques. Group 2 included the first 100 patients who underwent LRP, and group 3 was made up of th...

The parachute design as a new extraperitoneal method of closing a recalcitrant high-output enterocutaneous fistula: report of a case

Surgery Today — Tue, 31 Jan 2012 16:46:47 +0100

Abstract We introduce a new method for closure of a recalcitrant high-output jejunal enterocutaneous fistula. First, a transposed rectus abdominis muscle is sutured into the fistula opening using a parachuting technique, then the muscle is covered with a skin graft and temporarily immobilized to the fistula wall and abdominal wall with a negative pressure device. This extraperitoneal method provides tension-free closure of the fistula with well-vascularized tissue, without compromising the intestinal lumen. No bowel is resected. This new technique allows for early mobilization and recommencement of enteral nutrition. Content Type Journal ArticleCategory Case ReportPages 1-5DOI 10.1007/s00595-012-0128-6Authors Louis de Weerd, Department of Plastic Surgery and Hand Surg...

Laparoscopic resection of a gastrointestinal stromal tumor of the rectum after treatment with imatinib mesylate: report of a case

Surgery Today — Tue, 31 Jan 2012 16:46:47 +0100

This report describes the laparoscopic resection of a rectal GIST after treatment with imatinib mesylate. A 56-year-old male presented with a submucosal tumor (longest diameter, 8 cm) arising in the lower rectum. A core needle biopsy revealed that the tumor contained bundles of spindle-like cells. Immunostaining revealed that the tumor was positive for c-kit and CD34. Analysis of the c-kit gene revealed a substitution of ACA (threonine) by GCA (alanine) at codon 574 of exon 11. Imatinib mesylate (400 mg/day) was given as preoperative adjuvant therapy for 3 months, and the tumor shrank to 5 cm in diameter. Proctectomy with transanal anastomosis could be performed laparoscopically, while preserving the anus. There was no evidence of recurrence 2 years 6 mo...

The incremental value of magnetic resonance imaging for breast surgery planning

Surgery Today — Tue, 31 Jan 2012 16:46:47 +0100

Conclusions Assessment of the tumor size, multifocality, multicentricity, and presence of ductal carcinoma in situ by MRI may lead to misinterpretations in the majority of patients. The surgical approach should not be changed based solely on MRI findings. An accurately interpreted MMG combined with USG may be sufficient in most cases. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00595-012-0137-5Authors Sibel Ozkan Gurdal, Department of Surgery, School of Medicine, Namık Kemal University, 100. yıl mahallesi, Tunca caddesi, No: 32, Tekirdağ, Istanbul, TurkeyBeyza Ozcinar, Departments of Surgery, Istanbul University, Istanbul, TurkeyMunire Kayahan, Departments of Surgery, Bezmialem Vakif University Medical Faculty, Istanbul, TurkeyAbdul...

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The evaluation of surgical treatment for gastric cancer patients with noncurative resection

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 16:44:38 +0100

Conclusions TG is considered to be inappropriate for the treatment of noncurative gastric cancer because of the poor prognosis, high morbidity rates, and poor compliance for chemotherapy associated with the procedure. However, noncurative DG was acceptable and postoperative chemotherapy should be used in selected patients. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00423-012-0906-zAuthors Teiji Naka, Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510 JapanMakoto Iwahashi, Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510 JapanMikihito Nakamori, Second Department of Surgery, School of Medicine, Wakayama Medic...

Lexicon for standardized interpretation of gamma camera molecular breast imaging: observer agreement and diagnostic accuracy

European Journal of Nuclear Medicine and Molecular Imaging — Tue, 31 Jan 2012 07:10:53 +0100

Conclusion Dedicated breast imaging radiologists, newly trained to interpret MBI with the proposed lexicon, achieved high agreement and diagnostic accuracy. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00259-011-2054-zAuthors Amy Lynn Conners, Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USACarrie B. Hruska, Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USACindy L. Tortorelli, Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USARobert W. Maxwell, Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USADeborah J. Rhodes, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USAJudy C. Boughey, Department of General Surg...

Outcomes Following Laparoscopic Choledochoduodenostomy in the Management of Benign Biliary Obstruction

Journal of Gastrointestinal Surgery — Tue, 31 Jan 2012 07:06:42 +0100

Conclusion Laparoscopic choledochoduodenostomy is a useful technique in patients with benign, refractory common bile duct obstruction. This technically demanding procedure is feasible; however, the associated comorbidities in this complex group of patients result in a relatively high complication rate. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s11605-011-1768-3Authors Yashodhan S. Khajanchee, Hepatobiliary and Pancreatic Surgery Program, Providence Portland Medical Center, Portland, OR, USAMaria A. Cassera, Hepatobiliary and Pancreatic Surgery Program, Providence Portland Medical Center, Portland, OR, USAChet W. Hammill, Hepatobiliary and Pancreatic Surgery Program, Providence Portland Medical Center, Portland, OR, USALee L. Swanströ...

Autologous dendritic cell vaccine for estrogen receptor (ER)/progestin receptor (PR) double-negative breast cancer

Cancer Immunology, Immunotherapy — Tue, 31 Jan 2012 07:06:06 +0100

Conclusion Our findings strongly suggest that tumor lysate-pulsed DCs provide a standardized and widely applicable source of breast cancer antigens that are very effective in evoking anti-breast cancer immune responses. Content Type Journal ArticleCategory Original articlePages 1-10DOI 10.1007/s00262-011-1192-2Authors Chun-Jian Qi, Department of Oncology, The Affiliated Hospital of Nanjing Medical University, Changzhou No. 2 People’s Hospital, Changzhou, 213003 People’s Republic of ChinaYong-Ling Ning, Department of Oncology, The Affiliated Hospital of Nanjing Medical University, Changzhou No. 2 People’s Hospital, Changzhou, 213003 People’s Republic of ChinaYe-Shan Han, Central Laboratory, The Affiliated Hospital of Nanjing Medical University, Changzhou No. 2...

Single trocar retroperitoneoscopic nephrectomy for unilateral multicystic dysplastic kidney in children

Pediatric Surgery International — Tue, 31 Jan 2012 07:05:59 +0100

Abstract The author presents the first report in performing single trocar nephrectomy for five patients with multicystic dysplastic kidney (MCDK). The mean operative time was 66 min and mean postoperative hospital stay was 36 h. There were no perioperative complications. The one-trocar nephrectomy is a feasible and safe procedure for patients with MCDK. Content Type Journal ArticleCategory Technical InnovationPages 1-3DOI 10.1007/s00383-012-3056-zAuthors N. T. Liem, Department of Surgery, National Hospital of Pediatrics, 18/879 La Thanh Road, Dong Da District, Hanoi, VietnamL. A. Dung, Department of Surgery, National Hospital of Pediatrics, 18/879 La Thanh Road, Dong Da District, Hanoi, VietnamN. D. Viet, Department of Surgery, National Hospital of Pediatrics,...

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Slit Versus Non-Slit Mesh Placement in Total Extraperitoneal Inguinal Hernia Repair

World Journal of Surgery — Tue, 31 Jan 2012 07:05:21 +0100

Content Type Journal ArticlePages 1-2DOI 10.1007/s00268-012-1436-0Authors Ferdinand Koeckerling, Department of Surgery, Center of Minimally Invasive Surgery, Vivantes Hospital Spandau, Neue Bergstrasse 6, 13585 Berlin, GermanyDietmar A. Jacob, Department of Surgery, Center of Minimally Invasive Surgery, Vivantes Hospital Spandau, Neue Bergstrasse 6, 13585 Berlin, GermanyDavide Lomanto, Minimally Invasive Surgical Center, National University Hospital, Singapore, SingaporePradeep Chowbey, Department of Minimal Access, Metabolic and Bariatric Surgery, Max Healthcare Institute Ltd, 2 Press Enclave Road, Saket, New Delhi, 110 017 IndiaR. Bittner, Department of General, Visceral, and Vascular Surgery, Euromed Clinic, Hernia Center, Europaaliee 1, 90763 Fürth, Germany Journal World Jo...

Accuracy of BRCA1/2 Mutation Prediction Models for Different Ethnicities and Genders: Experience in a Southern Chinese Cohort

World Journal of Surgery — Tue, 31 Jan 2012 07:05:20 +0100

Conclusions The variation in model performance underscores the need for research on larger Asian cohorts as prediction models, and the possible need for customizing these models for different ethnic groups and genders. Content Type Journal ArticlePages 1-12DOI 10.1007/s00268-011-1406-yAuthors Ava Kwong, Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, ChinaConnie H. N. Wong, Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, ChinaDacita T. K. Suen, Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, ChinaMichael Co, Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, ChinaAllison W. Kurian, Department of Healt...

HCC: current surgical treatment concepts

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 07:04:17 +0100

Conclusions The improvement of survival in HCC patients after surgical treatment results from refinements in surgical technique and better identification of adverse prognostic factors. Content Type Journal ArticleCategory Review ArticlePages 1-15DOI 10.1007/s00423-012-0911-2Authors F. Cauchy, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, FranceD. Fuks, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, FranceJ. Belghiti, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, France Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source:...

Severe gastro-oesophageal reflux necessitating fundoplication after percutaneous endoscopic and open gastrostomy in children

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 07:04:16 +0100

Conclusion The results of this study indicated a higher incidence for severe GER leading to fundoplication in children with OG, while no difference with complications and clinical outcome between the two techniques, OG and PEG, were observed. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00423-012-0909-9Authors Hannu Lintula, Department of Paediatric Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, FinlandHannu Kokki, Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, FinlandPetri Juvonen, Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, F...

Complications after end-to-end vs. side-to-side anastomosis in ileocecal Crohn’s disease—early postoperative results from a randomized controlled multi-center trial (ISRCTN-45665492)

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 07:04:16 +0100

Conclusions Because of the early discontinuation of the study, it is not possible to provide a statement about the perianastomotic recurrence rates regarding the primary endpoint. With regard to the early postoperative outcome, we observed no difference between the two types of anastomosis. Content Type Journal ArticleCategory Controlled Clinical TrialPages 1-8DOI 10.1007/s00423-012-0904-1Authors Urte Zurbuchen, Department of General, Vascular and Thoracic Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, GermanyAnton J. Kroesen, Department of General, Visceral and Trauma Surgery, Hospital Porz am Rhein, Cologne, GermanyPhilipp Knebel, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Ge...

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Ethyl Pyruvate Improves Healing of Colonic Anastomosis in a Rat Model of Peritonitis.

Surgical Innovation — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. EP administration prevented intraperitoneal sepsis-induced impaired anastomotic healing of colon. PMID: 22298750 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Effect of Basic Laparoscopic Skills Courses on Essential Knowledge of Equipment.

Surgical Innovation — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. The laparoscopic skills courses evaluated in this study had a modest positive effect on the acquisition of knowledge about laparoscopic equipment. Variance exists among their contents. PMID: 22298751 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Laparoscopic Radical Nephrectomy Under Near Real-Time Three- Dimensional Surgical Navigation With C-Arm Cone Beam Computed Tomography.

Surgical Innovation — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion. This novel technology has great potential for application in LRN because it enables accurate depiction of the renal vessels and increases surgeon confidence. PMID: 22298752 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Laparoscopic Surgery in the Management of Hypersplenism and Esophagogastric Varices: Our Initial Experiences.

Surgical Innovation — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. Although the data are still preliminary, laparoscopic surgery for patients with portal hypertension may prove to be a successful strategy. PMID: 22298753 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

The "AMID" Hernia and Skin Stapler for Lichtenstein Hernia Repair: A Pilot Study.

Surgical Innovation — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion. The Lichtenstein hernia repair using the AMID Stapler is simple and safe and resulted in lower acute postoperative pain and lower analgesic consumption as compared with the sutured Lichtenstein hernia repair. A multicenter clinical trial with a large sample size is needed to more accurately study pain reduction. PMID: 22298754 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

MedWorm Sponsor Message: Have a look at these iconic medical scrubs which are handmade and come in a variety of colors to accommodate your surgical uniform.

Arsenic and Basal Cell Carcinoma in Areas of Hungary, Romania, and Slovakia: A Case-Control Study

EHP-in-Press — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion: We found a positive association between BCC and exposure to As through drinking water with concentrations below 100 µg/L. (Source: EHP-in-Press)

Risk stratification for metastasis from cutaneous squamous cell carcinoma of the head and neck

ANZ Journal of Surgery — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion: Ongoing management of patients with histo‐pathologically proven invasive SCC of the head and neck should be based upon risk stratification for metastasis. (Source: ANZ Journal of Surgery)

Non healing leg ulcer infected with Stenotrophomonas maltophilia: first reported case from India

International Wound Journal — Tue, 31 Jan 2012 05:00:00 +0100

Stenotrophomonas maltophilia is a recently described organism which was mainly reported either in nosocomial setup, or in immunosuppresed individuals. This was rarely reported as cutaneous pathogenic organism causing cellulitis‐like lesion, paronychia, mucocutaneous ulcers and ecthyma gangrenosum in immunocompromised individuals. Here we describe a case of leg ulcer caused by S. maltophilia in an immuno‐competent patient. The infection was possibly community acquired as the patient had no exposure to hospital environment. The bacillus was sensitive to cotrimoxazole and levofloxacin, and the patient was successfully treated with cotrimoxazole. Our case is unique not only because it is probably the first ever case of leg ulcer caused by S. maltophilia, but also because of its unusual occ...

Effects of non contact low‐frequency ultrasound on healing of suspected deep tissue injury: a retrospective analysis

International Wound Journal — Tue, 31 Jan 2012 05:00:00 +0100

The purpose of this study was to assess the effectiveness of non contact low‐frequency ultrasound on the healing of suspected deep tissue injury (SDTI). Participants were adults ranging in age from 28 to 93 years old, with multiple diagnoses including anaemia, diabetes mellitus and hypertension. Data were examined retrospectively on 85 patients (intervention group = 43 and non intervention group = 42) with 127 SDTI (intervention group = 64 and non intervention group = 63). Participants in both groups received standard of care for treating pressure ulcers. A severity score was used to assess SDTI severity before treatment and healing/progression after treatment. This scale measures surface area, wound colour/tissue assessment, and skin integrity with potential scores of 3 to 18 (higher sc...

Cost Comparison Between Hand-Assisted Laparoscopic Colectomy and Open Colectomy

Journal of Laparoendoscopic — Mon, 30 Jan 2012 20:22:44 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

MedWorm Sponsor Message: Have a look at these iconic medical scrubs which are handmade and come in a variety of colors to accommodate your surgical uniform.

Pneumatosis Intestinalis and Laparosopic Exploration: Beware of Gas Explosion

Journal of Laparoendoscopic — Mon, 30 Jan 2012 20:22:43 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Laparoscopic Distal Pancreatectomy: Feasibility Study of Radiofrequency-Assisted Transection in a Porcine Model

Journal of Laparoendoscopic — Mon, 30 Jan 2012 20:22:42 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Surgical Outcome of Patients with Perforation After Endoscopic Retrograde Cholangiopancreatography

Journal of Laparoendoscopic — Mon, 30 Jan 2012 20:22:37 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Live Liver Donation Safer Than Previously Thought

Surgery News - Doctors Lounge — Mon, 30 Jan 2012 18:00:00 +0100

Risk of death is 1.7 per thousand donors, new study finds (Source: Surgery News - Doctors Lounge)