Journal Description
Surgeries
Surgeries
is an international, peer-reviewed, open access journal on findings and developments in surgery published quarterly online by MDPI. The Academy of Surgical Research is affiliated with Surgeries and its members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), Scopus, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.9 days after submission; acceptance to publication is undertaken in 2.7 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Latest Articles
Styletubation versus Laryngoscopy: A New Paradigm for Routine Tracheal Intubation
Surgeries 2024, 5(2), 135-161; https://doi.org/10.3390/surgeries5020015 - 26 Mar 2024
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Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VLs) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VLs have been repeatedly studied in both normal and difficult airways. The
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Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VLs) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VLs have been repeatedly studied in both normal and difficult airways. The superiority of VLs then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) was noticed two decades ago. Since then, sporadic clinical experiences of use have appeared in the literature. In this review article, we presented our vast use experiences of the styletubation (more than 55,000 patients since 2016). We found this technique to be swift (the time to intubate from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satisfaction and fast learning curve for the novice trainees) in both normal and difficult airway scenarios. We, therefore, propose that the styletubation technique can be feasibly applied as universal routine use for tracheal intubation.
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Open AccessReview
Dual-Mobility Cups in Patients Undergoing Primary Total Hip Arthroplasty with Prior Lumbar Spine Fusion: A Systematic Review
by
Tariq Ziad Issa, Adam Pearl, Emelia Moore, Hannan Ahmad Maqsood and Khaled J. Saleh
Surgeries 2024, 5(2), 125-134; https://doi.org/10.3390/surgeries5020014 - 25 Mar 2024
Abstract
Spine and hip abnormalities frequently occur together in most of the orthopedic population; therefore, both of these abnormalities impact the outcomes of the modalities that are being used. Few studies have reported reduced dislocation and revision rates with the use of dual-mobility cups
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Spine and hip abnormalities frequently occur together in most of the orthopedic population; therefore, both of these abnormalities impact the outcomes of the modalities that are being used. Few studies have reported reduced dislocation and revision rates with the use of dual-mobility cups (DMCs) in high-risk lumbar spine fusion (LSF) patients undergoing primary total hip arthroplasty (THA). This study aims to clarify the relationship between pre-existing lumbar spinal fusion and the outcomes of THA with dual-mobility constructs. We systematically reviewed the current literature through several online databases following PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Interventions. We used the methodological index for non-randomized studies (MINORS) to evaluate the methodological quality of the included trials. Four studies examined the feasibility and effectiveness of dual-mobility cups in patients undergoing primary THA with prior LSF. Two studies were conducted in the United States, while the other two originated in Finland and France, respectively. The included studies enrolled 284 patients. Most of these patients had instrumented fusions. Seventy-eight percent of patients received one- or two-level fusions. The average age across the studies was 68.22 and the mean body mass index was 28. No cases of postoperative DMC implant dislocations were identified. The incidence of postoperative complications was 6% (10/173), including deep venous thrombosis, periprosthetic loosening, infection, and fracture, greater trochanteric fracture, and superficial wound infections. Most included studies had some methodological limitations, with an average MINORS score of 10.5 ± 5.8. The use of dual-mobility cups in these high-risk patients undergoing total hip arthroplasty may lead to reduced dislocation rates and postoperative complications. Further long-term follow-up studies are warranted to support these findings.
Full article
(This article belongs to the Topic Orthopaedic Diseases and Innovative Intervention Strategies, 2nd Volume)
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Open AccessArticle
Elderly Patients’ Outcomes following Emergency Laparotomy—Early Surgical Consultations Are Crucial
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Rachel Gefen, Samer Abu Salem, Asaf Kedar, Joshua Zev Gottesman, Gad Marom, Alon J. Pikarsky and Miklosh Bala
Surgeries 2024, 5(2), 115-124; https://doi.org/10.3390/surgeries5020013 - 23 Mar 2024
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We aimed to study the relationship between mortality following emergency laparotomy (EL) in elderly patients and admission to a hospital facility, hypothesizing that patients initially admitted to a general surgery service have a better outcome. A retrospective review of the medical records of
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We aimed to study the relationship between mortality following emergency laparotomy (EL) in elderly patients and admission to a hospital facility, hypothesizing that patients initially admitted to a general surgery service have a better outcome. A retrospective review of the medical records of all the elderly patients (≥65 years) who underwent EL over three years was conducted in a single tertiary medical center. The outcomes evaluated include postoperative morbidity, mortality, discharge destination, and readmission. A total of 200 patients were eligible for this study; 106 (53%) were male, with a mean age of 77 ± 8.3 years. The mortality rate was 29.5% (59 patients), and 55% of all patients were discharged home after initial admission. Bowel obstruction was the most common indication for surgery (91, 45.5%). Patients undergoing an operation from non-general surgical services had higher readmission, unfavorable discharge and mortality rates, a greater incidence of stoma formation, and required a tracheostomy or were TPN-dependent (all p < 0.001). The mortality rate is higher in elderly patients needing an EL when initially admitted through a non-general surgery service. A correct and rapid initial diagnosis and decision are crucial when treating elderly individuals; initial admission to a general surgery service increases the probability of discharge home.
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Open AccessSystematic Review
The Influence of Root Prominence on the Onset of Gingival Recession: A Systematic Review
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Girolamo Raso, Nuno Bernardo Malta dos Santos, Leonardo M. Nassani, Anna Carolina Volpi Mello-Moura, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes
Surgeries 2024, 5(1), 103-114; https://doi.org/10.3390/surgeries5010012 - 12 Mar 2024
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This systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was
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This systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was “In teeth with vestibular site-specific root or alveolar bone prominence, what are the chances that this will lead to gingival recession or difficulty in root coverage procedures, compared to teeth correctly positioned in the alveolar bone or without anatomical root prominence?”. A search was carried out on three databases: Embase, PubMed/MedLine, and Wiley Library. This initial search was complemented with manual research. It included any clinical study, such as a randomized clinical trial, controlled clinical trial, prospective/retrospective clinical study, case series, or case report, published in English from January 2012 to December 2023, which reported any involvement of the root/bone prominence approach. The exclusion criteria were clinical studies without report results/details of the case(s), studies based on questionnaires, editorial letters, any review, in vitro/in silica and animal studies, and interviews. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was applied for quality assessment. A total of 163 articles were found, but only three articles were included (k = 0.98). The included studies observed negative correlations when comparing the variables root prominence with linear root coverage, root surface area covered, and linear tissue thickness gain. It suggested a significant reduction in root coverage for prominences greater than 1 mm; therefore, relevant keratinized tissue gains can be achieved in gingival recession treatment after the application of the odontoplasty. The STROBE checklist evaluated 22 items, and all the included studies had a high-quality assessment (greater than 75%) with values greater than 85%. Then, it was not possible to draw conclusions due to the number of articles included, even though they had high-quality assessments. Otherwise, it is possible to suggest that the root prominence may impact gingival recession. Therefore, new and well-designed studies must be developed to establish a significant conclusion about this condition.
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Open AccessArticle
Ostomy Belt Use Improves Quality of Life in Patients with a Stoma
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Elisa K. Karhu, Alexandra E. Hernandez, Ana M. Restrepo and Vanessa W. Hui
Surgeries 2024, 5(1), 92-102; https://doi.org/10.3390/surgeries5010011 - 08 Mar 2024
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Ostomy formation is a vital component in the treatment of advanced gastrointestinal diseases, including colorectal cancer and inflammatory bowel disease. It usually involves externalizing a part of the colon or small bowel to the skin surface. Thus, the creation of an ostomy can
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Ostomy formation is a vital component in the treatment of advanced gastrointestinal diseases, including colorectal cancer and inflammatory bowel disease. It usually involves externalizing a part of the colon or small bowel to the skin surface. Thus, the creation of an ostomy can often have a major negative impact on quality of life. This study aimed to evaluate whether the use of an ostomy belt could improve quality of life measures in stoma patients through a prospective interventional open-label study of 17–80-year-old English- and Spanish-speaking patients with stomas who were using an ostomy belt for 8 weeks. Changes in quality of life were assessed using the Stoma Quality of Life Scale questionnaire at baseline, at 4 weeks, and at 8 weeks post ostomy belt use. A total of 45 patients enrolled (20 female, mean age 48) in the study. The ostomy belt significantly improved quality of life scores from baseline to 4 weeks regarding overall life satisfaction (F(2, 76) = 14.77, p < 0.001) and in the domains of work/social function (F(2, 72) = 30.32, p < 0.001), sexuality/body image (F(2, 68) = 3.34, p = 0.04), and stoma function (F(2, 72) = 8.72, p < 0.001). These improvements were sustained at the 8-week follow-up. No significant differences were observed in the domains of financial impact and skin irritation. This study represents the first prospective interventional study that provides evidence for the simple low-cost intervention of ostomy support belt use in improving quality of life in patients with a stoma.
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Open AccessCase Report
An Incidental Discovery of the Intrathoracic Accessory Liver Lobe in a 72-Year-Old Man: Case Report and Literature Review
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Aleksandra Polikarpova, Harinder K. Bains, Samuel Thomson, Yijun Gao and David L. Morris
Surgeries 2024, 5(1), 84-91; https://doi.org/10.3390/surgeries5010010 - 07 Mar 2024
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Accessory liver lobe is a rare finding, with the most common cases being accessory liver tissue on the gallbladder wall separate from the orthotopic liver. As the incidence of the ectopic liver is low there are only several case reports in published literature
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Accessory liver lobe is a rare finding, with the most common cases being accessory liver tissue on the gallbladder wall separate from the orthotopic liver. As the incidence of the ectopic liver is low there are only several case reports in published literature that describe similar presentations. We report a case of intrathoracic liver lobe that was connected to the main liver by a thick pedicle. Due to benign presentation, the patient was discharged without any surgical intervention. This case highlights the importance of understanding anatomical variability of internal organs, understanding the risks of torsion and malignant transformation of the accessory liver tissue. The literature review provides an excellent overview of published case series and reports, and outlines current recommendations on imaging, diagnosis, and management.
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Open AccessArticle
The Influence of Insurance Status on Extensor Tendon Repair Outcomes
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Stewart S. Dalton, Laura M. Maharjan, Hayyan Yousuf and William F. Pientka II
Surgeries 2024, 5(1), 73-83; https://doi.org/10.3390/surgeries5010009 - 29 Feb 2024
Abstract
Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior
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Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior outcomes due to more facile access to postoperative hand therapy and fewer barriers to appropriate postoperative care. Methods: A retrospective chart review was conducted of patients who underwent primary extensor tendon repair in any zone, excluding the thumb, at a single large safety-net hospital. Inclusion criteria included a minimum of eight weeks of follow-up, complete data available for review, and an extensor tendon injury requiring primary surgical repair. Four cohorts were examined: patients with commercial insurance, patients with Medicare/Medicaid, patients with county hospital-sponsored insurance, and uninsured patients. Statistical analysis was performed using Chi-Square and ANOVA analyses, with significance defined as p ≤ 0.05. Results: Of the 62 patients (100 digits) included, 20 had commercial insurance, 12 had Medicare/Medicaid, 13 had hospital-sponsored insurance, and 17 were uninsured. Except for mean age, there were no significant differences between groups in terms of demographic data, medical comorbidities, or digit characteristics. There were also no significant differences in mean follow-up, time to return to full activity, or surgical complications among groups. Procedure duration differed significantly between groups, with procedures lasting longer in uninsured patients. Postoperative final flexion total arc of motion (TAM) and extension measurements were similar across all groups. Additionally, hand therapy visits did not differ significantly between groups. Conclusions: Following extensor tendon repair, patient insurance status did not affect outcomes in terms of final range of motion, return to full activity, or postoperative complications.
Full article
Open AccessSystematic Review
Biliary Leak from Ducts of Luschka: Systematic Review of the Literature
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Antonio Vitiello, Maria Spagnuolo, Marcello Persico, Roberto Peltrini, Giovanna Berardi, Pietro Calabrese, Carlo De Werra, Carmela Rescigno, Roberto Troisi and Vincenzo Pilone
Surgeries 2024, 5(1), 63-72; https://doi.org/10.3390/surgeries5010008 - 26 Feb 2024
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Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a
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Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a bile leak from an LD. A total of 136 articles were retrieved from the searched databases. After the removal of duplicates and non-eligible papers, 48 studies reporting 231 leaks were included: 20 (41.6%) case reports, 2 (4.3%) comparative studies, 7 (14.9%) meeting abstracts and 19 (40.4%) retrospective cohort articles. The rate of LD leak ranges from 0.05% to 1.9%, but injury to a duct of Luschka was the second most common cause of biliary leakage in all the cohort studies (5.5% to 41%). In 21 (43.7%) cases, the leak was successfully treated with a sphincterotomy through Endoscopic Retrograde Cholangiopancreatography (ERCP) plus or minus stenting, and in 12 (25%), re-laparoscopy was necessary.
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Open AccessReview
Modulation of the Tumor Stroma and Associated Novel Nanoparticle Strategies to Enhance Tumor Targeting
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Hessel Haze, Cornelis F. M. Sier, Alexander L. Vahrmeijer and Floris A. Vuijk
Surgeries 2024, 5(1), 49-62; https://doi.org/10.3390/surgeries5010007 - 12 Feb 2024
Abstract
Growth of malignant cells in solid tumors induces changes to the tumor microenvironment (TME). These changes result in promotion of tumor growth, invasion, and metastasis, but also in tumor resistance to drugs and radiotherapy. The enhanced permeability and retention (EPR) effect in neo-angiogenic
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Growth of malignant cells in solid tumors induces changes to the tumor microenvironment (TME). These changes result in promotion of tumor growth, invasion, and metastasis, but also in tumor resistance to drugs and radiotherapy. The enhanced permeability and retention (EPR) effect in neo-angiogenic tumor tissue enables the transport of therapeutic molecules from the circulation into the tumor, but studies show that further diffusion of these agents is often not sufficient for efficient tumor eradication. Despite the hyperpermeable vasculature facilitating the delivery of drugs and tracers, the high density of stromal cells and matrix proteins, in combination with the elevated interstitial fluid pressure in the microenvironment of solid tumors, presents a barrier which limits the delivery of compounds to the core of the tumor. Reversing the cancer-cell-induced changes to the microenvironment as well as novel nanoparticle strategies to circumvent tumor-induced stromal changes have therefore been suggested as potential methods to improve the delivery of therapeutic molecules and drug efficacy. Strategies to modulate the TME, i.e., normalization of tumor vasculature and depletion of excessive stromal proteins and cells, show promising results in enhancing delivery of therapeutic compounds. Modulation of the TME may therefore enhance the efficacy of current cancer treatments and facilitate the development of novel treatment methods as an alternative for invasive resection procedures.
Full article
(This article belongs to the Special Issue The Next Generation: Collection of the Scientific Colloquium of the Dutch Surgical Society for Medical Students (DSSMS))
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Open AccessProject Report
ChatGPT and Bard in Plastic Surgery: Hype or Hope?
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Ania Labouchère and Wassim Raffoul
Surgeries 2024, 5(1), 37-48; https://doi.org/10.3390/surgeries5010006 - 16 Jan 2024
Abstract
Online artificial intelligence (AI) tools have recently gained in popularity. So-called “generative AI” chatbots unlock new opportunities to access vast realms of knowledge when being prompted by users. Here, we test the capabilities of two such AIs in order to determine the benefits
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Online artificial intelligence (AI) tools have recently gained in popularity. So-called “generative AI” chatbots unlock new opportunities to access vast realms of knowledge when being prompted by users. Here, we test the capabilities of two such AIs in order to determine the benefits for plastic surgery while also assessing the potential risks. Future developments are outlined. We used the online portals of OpenAI’s ChatGPT (version 3.5) and Google’s Bard to ask a set of questions and give specific commands. The results provided by the two tools were compared and analyzed by a committee. For professional plastic surgeons, we found that ChatGPT and Bard can be of help when it comes to conducting scientific reviews and helping with scientific writing but are of limited use due to the superficiality of their answers in specific domains. For medical students, in addition to the above, they provide useful educational material with respect to surgical methods and exam preparation. For patients, they can help when it comes to preparing for an intervention, weighing the risks and benefits, while providing guidance on optimal post-operative care. ChatGPT and Bard open widely accessible data to every internet user. While they might create a sense of “magic” due to their chatbot interfaces, they nonetheless can help to increase productivity. For professional surgeons, they produce superficial answers—for now—albeit providing help with scientific writing and literature reviews. For medical students, they are great tools to deepen their knowledge about specific topics such as surgical methods and exam preparation. For patients, they can help in translating complicated medical jargon into understandable lingo and provide support for pre-operative as well as post-operative care. Such AI tools should be used cautiously, as their answers are not always precise or accurate, and should always be used in combination with expert medical guidance.
Full article
Open AccessSystematic Review
Diagnostic Performance of Artificial Intelligence in Rib Fracture Detection: Systematic Review and Meta-Analysis
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Marnix C. L. van den Broek, Jorn H. Buijs, Liselotte F. M. Schmitz and Mathieu M. E. Wijffels
Surgeries 2024, 5(1), 24-36; https://doi.org/10.3390/surgeries5010005 - 16 Jan 2024
Abstract
Artificial intelligence (AI) is a promising tool for diagnosing rib fractures. To date, only a few studies have quantified its performance. The objective of this systematic review was to assess the accuracy of AI as an independent tool for rib fracture detection on
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Artificial intelligence (AI) is a promising tool for diagnosing rib fractures. To date, only a few studies have quantified its performance. The objective of this systematic review was to assess the accuracy of AI as an independent tool for rib fracture detection on CT scans or radiographs. This was defined as the combination of sensitivity and specificity. PubMed (including MEDLINE and PubMed Central) was systematically reviewed according to the PRISMA statement followed by citation searching among studies up to December 2022. Methods of the analysis and inclusion criteria were prespecified in a protocol and published on PROSPERO (CRD42023479590). Only diagnostic studies of independent AI tools for rib fracture detection on CT scans and X-rays reporting on sensitivity and/or specificity and written in English were included. Twelve studies met these criteria, which included 11,510 rib fractures in total. A quality assessment was performed using an altered version of QUADAS-2. Random-effects meta-analyses were performed on the included data. If specificity was not reported, it was calculated on a set of assumptions. Pooled sensitivity and specificity were 0.85 (95% CI, 0.78–0.92) and 0.96 (95% CI, 0.94–0.97), respectively. None of the included studies used X-rays. Thus, it can be concluded that AI is accurate in detecting rib fractures on CT scans. Overall, these findings seemed quite robust, as can be concluded from the study quality assessment, therefore AI could potentially play a substantial role in the future of radiological diagnostics.
Full article
(This article belongs to the Special Issue The Next Generation: Collection of the Scientific Colloquium of the Dutch Surgical Society for Medical Students (DSSMS))
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Open AccessArticle
Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability
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Kylie A. Limback, Alyssa H. Kendell, Micaela Motzko, Christopher C. Surek and Jennifer F. Dennis
Surgeries 2024, 5(1), 13-23; https://doi.org/10.3390/surgeries5010004 - 11 Jan 2024
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The supratrochlear artery (STA) demonstrates anatomical variability that impacts facial reconstruction with a paramedian forehead flap. STA branching patterns and the distance to the midline have been reported, but the STA pedicle has not been characterized. Our aim was to triangulate the STA
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The supratrochlear artery (STA) demonstrates anatomical variability that impacts facial reconstruction with a paramedian forehead flap. STA branching patterns and the distance to the midline have been reported, but the STA pedicle has not been characterized. Our aim was to triangulate the STA pedicle relative to known anatomical landmarks and identify a danger zone to aid surgeons in creating viable tissue flaps. The upper facial region was dissected bilaterally on 38 cadaveric donors. Measurements from the supraorbital neurovascular bundle, orbital rim, and medial canthus to the STA pedicle were collected. Data were tallied and statistically analyzed. Measurement means, range, and standard deviations were calculated; no significant differences were found in the laterality of the measurements (p > 0.05). Statistically significant, sex-based differences were identified for all measurements collected among male and female donors. This study characterizes a surgical danger zone for the STA pedicle specific to a paramedian forehead flap and identifies important differences within this danger zone among male versus female donors that surgeons should consider to prevent pedicle violation and enhance surgical success while maximizing flap length and mobility.
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Open AccessCase Report
Unique Constellation of Vascular Anomalies in a Female Cadaver: IVC, Renal Vein, and Left Colic Artery Variation
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Vishnu Bharani, Hannah Sidoti and Michelle B. Titunick
Surgeries 2024, 5(1), 6-12; https://doi.org/10.3390/surgeries5010003 - 04 Jan 2024
Abstract
Embryological development of the vascular system consists of growth and regression of developing vessels, often resulting in numerous variations. This cadaveric case report describes an individual with a duplicated inferior vena cava accompanied by multiple left accessory renal veins and a superior mesenteric
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Embryological development of the vascular system consists of growth and regression of developing vessels, often resulting in numerous variations. This cadaveric case report describes an individual with a duplicated inferior vena cava accompanied by multiple left accessory renal veins and a superior mesenteric artery-derived left colic artery. These structures may present clinical concerns when physicians are unaware of their presence during even routine surgeries. The 74-year-old female donor was dissected as part of a medical gross anatomy elective course. Anatomy was photographed and measurements were taken. Dissection revealed a duplicated inferior vena cava with a confluence between the right and left inferior venae cavae, known as the preaortic trunk. The left gonadal vein drained directly into the left inferior vena cava, inferior to the vena cava’s junction with the left renal vein. The multiple accessory left renal veins drained into the left inferior vena cava at the level of the primary left renal vein. All three anomalies examined in this donor have the potential to create complications during surgery. Promoting familiarity amongst physicians, particularly radiologists and surgeons, with vascular anomalies can aid in their ability to assess patients and provide better care.
Full article
(This article belongs to the Special Issue Surgical Resection)
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Open AccessEditorial
Introduction to a Novel End-of-the-Year Special Issue of Surgeries
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Cornelis F. M. Sier
Surgeries 2024, 5(1), 4-5; https://doi.org/10.3390/surgeries5010002 - 30 Dec 2023
Abstract
Dear readers, authors, reviewers, and editors of Surgeries, [...]
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Open AccessEditorial
The Christmas Procedure: A Surgical Approach to Holiday Cooking
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Vincent Q. Sier, Abbey Schepers, Žilvinas Dambrauskas, Joost R. van der Vorst and Roderick F. Schmitz
Surgeries 2024, 5(1), 1-3; https://doi.org/10.3390/surgeries5010001 - 20 Dec 2023
Cited by 1
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Surgeons are known for their steady hands, decision-making skills, and, according to some, their self-admiration [...]
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Open AccessProtocol
A Comparison between Open and Minimally Invasive Right Hemicolectomies in Patients with Locally Advanced UICC Stage III Colon Cancer: A Protocol for a Systematic Review and an Individual Patient Data Meta-Analysis
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Jule Reitz, Simon Lindner, Stefan Benz, Guido Schwarzer, Svetlana Hetjens, Maurizio Grilli, Christoph Reissfelder, Steffen Seyfried and Florian Herrle
Surgeries 2023, 4(4), 706-716; https://doi.org/10.3390/surgeries4040066 - 15 Dec 2023
Abstract
Despite the development of new technologies and multimodal therapies, improving the prognosis of patients with UICC stage III right colon adenocarcinoma remains challenging. Several randomized controlled trials have shown the oncological non-inferiority of minimally invasive surgery compared to open surgery for colon cancer
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Despite the development of new technologies and multimodal therapies, improving the prognosis of patients with UICC stage III right colon adenocarcinoma remains challenging. Several randomized controlled trials have shown the oncological non-inferiority of minimally invasive surgery compared to open surgery for colon cancer patients. However, for UICC stage III patients, carrying the highest risk for local recurrence and the worst survival, the evidence remains inconclusive. The aim of this systematic review and individual patient data meta-analysis is to improve the scarce evidence regarding minimally invasive surgery for this subgroup of patients. Data from adult patients with pathologically UICC stage III right adenocarcinoma of the colon will be included. The intervention to be assessed is the minimally invasive right hemicolectomy in comparison with the open procedure. The primary outcome will be the 5-year overall survival. Secondary outcomes will include further long-term outcomes, such as disease-free survival, short term, and histological outcomes. Only randomized controlled trials and quasi-randomized controlled clinical trials will be included. The literature search will be conducted in the following databases: PubMed, CINAHL, Cochrane Trials, ClinicalTrials.gov, and Web of Science. The review will be performed using the Cochrane methodology including GRADE tools. The findings of this meta-analysis will be important for choosing optimal treatment pathways and tailoring of surgical therapy in patients with locally advanced UICC stage III right colon cancer.
Full article
(This article belongs to the Special Issue Colorectal Cancer Surgery)
Open AccessArticle
Accurate Restoration of the Center of Rotation of the Hip Joint Based on Preoperative Planning Is Not Associated with Improved Clinical Outcomes
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Samuel Morgan, Nissan Amzallag, Or Shaked, Nimrod Snir, Aviram Gold, Itay Ashkenazi, Shai Factor and Yaniv Warschawski
Surgeries 2023, 4(4), 698-705; https://doi.org/10.3390/surgeries4040065 - 14 Dec 2023
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One of the main objectives of total hip arthroplasty (THA) is to recreate the center of rotation (COR). Accurate reconstruction of the COR is suggested to be within 5 mm of its anatomical location. The goal of our study was to assess whether
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One of the main objectives of total hip arthroplasty (THA) is to recreate the center of rotation (COR). Accurate reconstruction of the COR is suggested to be within 5 mm of its anatomical location. The goal of our study was to assess whether accurate reconstruction of the COR, based on preoperative planning, is associated with improved clinical outcomes. The study population consisted of patients who underwent THA at our institution between August 2018 and May 2020. All patients underwent preoperative digital templating. The position of the predicted COR was compared to its actual postoperative position. Patients were subsequently stratified into two subgroups based on the difference between the distance of the predicted COR and the reconstructed COR, over or under 5 mm. A 12-Item Short Form Health Survey (SF-12) and visual analogue scale (VAS) were taken for each patient. 90 patients were included in this study. 60 patients (66%) had their COR reconstructed within 5 mm of preoperative planning, whereas for 30 patients (33%), reconstruction was outside of 5 mm of preoperative planning. Between the two cohorts, no significant difference existed in the physical component summary (PCS) (p = 0.33), the mental component summary (MCS = 0.16), or the visual analogue scale (VAS) (p = 0.12). The accurate restoration of COR based on preoperative planning is not associated with improved clinical outcomes. During postoperative evaluation, surgeons should feel confident if the COR is slightly greater than 5 mm of preoperative limitations.
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Open AccessReview
Wilms Tumor: Updates about Pathogenesis and New Possible Clinical Treatments of the Most Frequent Pediatric Urogenital Cancer: A Narrative Review
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Giulio Perrotta and Daniele Castellani
Surgeries 2023, 4(4), 678-697; https://doi.org/10.3390/surgeries4040064 - 08 Dec 2023
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Background: Wilms tumor (or nephroblastoma) is a malignant and solid neoplasm that derives from the primitive renal bud. It represents the most frequent primary tumor of the urogenital tract in childhood, and treatment consists of surgery and chemo-radiotherapy. However, concerning quality of life,
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Background: Wilms tumor (or nephroblastoma) is a malignant and solid neoplasm that derives from the primitive renal bud. It represents the most frequent primary tumor of the urogenital tract in childhood, and treatment consists of surgery and chemo-radiotherapy. However, concerning quality of life, the new therapeutic frontier is exploring other safer and potentially more effective options, such as minimally invasive surgery and biological drugs. Method: Literature (PubMed) from January 2013 to July 2023 was reviewed, checking for innovations in diagnosis and treatment. Results: A total of 130 articles was included in the review. Conclusions: In addition to the therapeutic strategies already identified, such as classic surgery and pharmacological therapies, recent studies focus attention on the new frontiers of minimally invasive surgery, such as diagnostics using biomarkers and immunotherapy, which could represent a new therapeutic option and is possibly less risky than in the past, contributing in fact to the current knowledge of the scientific panorama in terms of “tumor microenvironment” and systemic implications deriving from oncological disease.
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Open AccessReview
Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature
by
Eike Wilbers, Samer Zawy Alsofy, Stephanie Schipmann, Christian Ewelt, Thomas Fortmann, Marc Lewitz and Michael Schwake
Surgeries 2023, 4(4), 665-677; https://doi.org/10.3390/surgeries4040063 - 06 Dec 2023
Abstract
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Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case
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Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a 25-year-old male admitted with headache, vertigo, and nystagmus. The MRI scan showed a tetraventricular hydrocephalus with a patent aqueduct. After endoscopic third ventriculostomy (ETV), symptoms resolved. We performed a systematic review of the literature, covering 26 years, with the aim to investigate the symptoms, therapy, and outcome of primary FVOO, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We found 9 case reports and 2 case series and could extract a total of 34 cases. After ETV all symptoms resolved in 10 of 23 cases (43.5%), and in 13 of 23 cases (56.5%) symptoms improved partially. Seven cases (30.4%) required additional surgery. A decrease in ventricular volume occurred in most cases. In the 10 patients who were operated via fenestration, all symptoms resolved in 6 cases. ETV seems to be an effective treatment option for patients with idiopathic FVOO in a majority of cases. In special cases, fenestration of the foramen of Magendie may be suitable.
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Open AccessSystematic Review
Myosteatosis as a Prognostic Marker for Postoperative Mortality in Adult Patients Undergoing Surgery in General—A Systematic Review
by
Onno Emanuel den Os, Rosalie Nielen and Elham Bidar
Surgeries 2023, 4(4), 647-664; https://doi.org/10.3390/surgeries4040062 - 29 Nov 2023
Abstract
Background: Assessing frailty is important in treating surgical patients to predict peri- and postoperative events like complications or mortality. The current standard is not optimal; therefore, new prognostic markers are being evaluated to enrich the current frailty assessment. One of these new markers
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Background: Assessing frailty is important in treating surgical patients to predict peri- and postoperative events like complications or mortality. The current standard is not optimal; therefore, new prognostic markers are being evaluated to enrich the current frailty assessment. One of these new markers is fat degeneration of the psoas muscle (myosteatosis). This can be assessed by measuring the psoas muscle density (PMD) with computed tomography (CT). The aim of this review is to investigate PMD, and, thus, myosteatosis, as a prognostic marker for postoperative mortality in adult patients undergoing general surgery. Methods: An electronic search was performed in PubMed to identify relevant studies associating PMD with postoperative mortality. The looked-upon period for mortality to occur did not matter for this review. The looked-upon outcome measure for this review was the hazard ratio. Results: From 659 potential articles from PubMed, 12 were included, for a total of 4834 participants. Articles were excluded when not focused on PMD, if the type of intervention was not specified, and when imaging other than with CT on the level of the third vertebra was performed. The included articles were assessed for bias with the Newcastle–Ottawa Scale (NOS). PMD was, after multivariable analyses, identified as an independent significant prognostic marker for several surgical cardiovascular interventions when we looked at the 5-year mortality rate and for fenestrated branched endovascular aortic repair (F-BEVAR) a slight significant protective correlation between postoperative mortality and PMD (when divided by psoas muscle area (PMI)) when we looked at the 30-day and 3-year mortality. Also, PMD was identified as an independent significant prognostic marker for a variety of surgical gastrointestinal interventions when we looked at 30-day/90-day/1-year/3-year/5-year mortality. PMD was not identified as a significant prognostic marker in urologic surgery. Conclusion: Myosteatosis has the potential to be a valuable contribution to the current frailty assessment for patients undergoing cardiovascular, gastrointestinal, or urologic surgery. However, more research must be conducted to further strengthen the prognostic value of myosteatosis, with special attention to, e.g., gender- or age-specific interpretations of the results.
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(This article belongs to the Special Issue The Next Generation: Collection of the Scientific Colloquium of the Dutch Surgical Society for Medical Students (DSSMS))
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