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Surgical Techniques Development
Volume 10
Issue 1
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Surgical Techniques Development is published by MDPI from Volume 11 Issue 1 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.

Surg. Tech. Dev., Volume 10, Issue 1 (June 2021) – 2 articles

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2 pages, 328 KiB  
Article
Successful Surgical Treatment of Intractable Post-Radiation Rectal Bleeding
by Rezvan Mirzaei, Bahar Mahjoubi, Jalil Shoa, Roozbeh Cheraghali and Zahra Omrani
Surg. Tech. Dev. 2021, 10(1), 9125; https://doi.org/10.4081/std.2021.9125 - 13 Jan 2022
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Abstract
Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8–12 months after finishing their treatment. Endoscopic methods play the main role the treatment of bleeding caused by post-radiation colitis and proctitis. Surgical treatment is required for remained approximately 10% of patients. [...] Read more.
Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8–12 months after finishing their treatment. Endoscopic methods play the main role the treatment of bleeding caused by post-radiation colitis and proctitis. Surgical treatment is required for remained approximately 10% of patients. Here we present a 64 year old female with metastatic breast cancer, who was referred to us for intractable rectal bleeding. Total colonoscopy and rigid rectosigmoidoscopy revealed proctitis, rectal and sigmoidal telangiectasis, multiple necrotic ulcers between 15 to 30 cm from the anal verge, and also huge ishemic ulcer with patchy necrotic areas about 10 cm from the anal verge. This abnormal irradiated part was resected and then mucosectomy of the remnant rectum, both transabdominally and transanally was done. We performed pull-through technique of normal proximal colon to anal region through the remnant rectal wall and finally did coloanal anastomosis. Diverting stoma was not made because of anastomosis in anal region. With this technique we can achieve benefits such as avoidance of harsh dissection in a frozen pelvis and its consequences, we can avoid intra-abdominal anastomosis, there is no need to a diverting stoma and, most important of all, definite bleeding control. Full article
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Article
How to Treat Proximal and Middle One-Third Humeral Shaft Fractures: The Role of Helical Plates
by Giulia Nicolaci and Nicola Lollino
Surg. Tech. Dev. 2021, 10(1), 9175; https://doi.org/10.4081/std.2021.9175 - 23 Jun 2021
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Abstract
Complex proximal third diaphyseal humeral fractures are uncommon patterns of injury mainly caused by high energy trauma. The anatomical shape of the humerus, the presence of the deltoid tuberosity and the close proximity of the radial nerve into the radial groove represent challenge [...] Read more.
Complex proximal third diaphyseal humeral fractures are uncommon patterns of injury mainly caused by high energy trauma. The anatomical shape of the humerus, the presence of the deltoid tuberosity and the close proximity of the radial nerve into the radial groove represent challenge elements to deal with. Historically, straight plates were manually twisted; subsequently, helical plates created for other anatomical sites (as distal tibia) were used in humeral fractures. In both these experiences surgeons observed several disadvantages. More recently, dedicated helical plates have been created. In this study, we expose our surgical technique for using helical humeral plates (A.L.P.S.® Proximal Humeral Plating System, Zimmer Biomet), with its advantages and operative recommendation. From 2019 to 2021, nine patients who were admitted to our institution for humeral fractures involving the proximal third diaphysis have been treated with humeral helical plates. At one and six months after surgery, standard antero-posterior and lateral radiographs were obtained, and at last follow-up (fourteen months on average) clinical evaluation was performed through range of motion assessment, Constant score and DASH score questionnaires. At six months, all fractures have healed. At last follow-up (fourteen months on average, 6–22) the average range of motion were flexion 135° (90–180°); abduction 124° (85–180°); external rotation 52° (20–80°), internal rotation at L3 (between scapulae-trochanter). Average Constant Shoulder Score was 70 (33–96), average Dash score was 21 (range 1,7–63). Three patients experienced temporary radial nerve palsy from injury, with subsequently improvement at EMG analysis within eight months from surgery. In our opinion this strategy avoids the deltoid tuberosity and reduces the risk of radial nerve injury, increasing the possibility of a rapid functional recovery after surgery. Full article
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