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Showing 1201 - 1400 of 2281 Journals sorted alphabetically
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.33, h-index: 29)
J. of Earth Science     Hybrid Journal   (Followers: 6, SJR: 0.299, h-index: 11)
J. of Earth System Science     Open Access   (Followers: 16, SJR: 0.466, h-index: 27)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.669, h-index: 15)
J. of Echocardiography     Hybrid Journal   (Followers: 3, SJR: 0.136, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 25, SJR: 5.251, h-index: 54)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.231, h-index: 11)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.463, h-index: 20)
J. of Economics and Finance     Hybrid Journal   (Followers: 7, SJR: 0.238, h-index: 15)
J. of Educational Change     Hybrid Journal   (Followers: 6, SJR: 0.694, h-index: 14)
J. of Elasticity     Hybrid Journal   (Followers: 4, SJR: 0.821, h-index: 38)
J. of Electroceramics     Hybrid Journal   (SJR: 0.566, h-index: 49)
J. of Electronic Materials     Hybrid Journal   (Followers: 2, SJR: 0.752, h-index: 68)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.241, h-index: 24)
J. of Electronics (China)     Hybrid Journal   (Followers: 3, SJR: 0.127, h-index: 7)
J. of Elementary Science Education     Hybrid Journal   (Followers: 7)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (SJR: 0.294, h-index: 7)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.484, h-index: 21)
J. of Evolution Equations     Hybrid Journal   (SJR: 1.312, h-index: 22)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.127, h-index: 9)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.878, h-index: 42)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 2, SJR: 0.565, h-index: 34)
J. of Experimental Criminology     Hybrid Journal   (Followers: 23, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (SJR: 0.256, h-index: 12)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.532, h-index: 27)
J. of Family Violence     Hybrid Journal   (Followers: 15, SJR: 0.552, h-index: 45)
J. of Financial Services Research     Hybrid Journal   (Followers: 14, SJR: 1.196, h-index: 29)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.467, h-index: 10)
J. of Fluorescence     Hybrid Journal   (Followers: 4, SJR: 0.553, h-index: 47)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.104, h-index: 1)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.839, h-index: 21)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.578, h-index: 22)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.271, h-index: 10)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.248, h-index: 36)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.263, h-index: 6)
J. of Fusion Energy     Hybrid Journal   (Followers: 2, SJR: 0.389, h-index: 16)
J. of Gambling Studies     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 50)
J. of Gastroenterology     Hybrid Journal   (Followers: 13, SJR: 1.724, h-index: 73)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.371, h-index: 36)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.632, h-index: 87)
J. of General Internal Medicine     Hybrid Journal   (Followers: 12, SJR: 2.379, h-index: 115)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.357, h-index: 17)
J. of Genetic Counseling     Hybrid Journal   (Followers: 3, SJR: 0.535, h-index: 32)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.42, h-index: 24)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 4.049, h-index: 48)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.58, h-index: 14)
J. of Geographical Systems     Hybrid Journal   (Followers: 2, SJR: 0.839, h-index: 32)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.496, h-index: 23)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.349, h-index: 13)
J. of Global Optimization     Hybrid Journal   (Followers: 2, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 7)
J. of Grid Computing     Hybrid Journal   (SJR: 0.727, h-index: 32)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 14, SJR: 0.785, h-index: 30)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.194, h-index: 11)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.718, h-index: 43)
J. of High Energy Physics     Hybrid Journal   (Followers: 4, SJR: 1.027, h-index: 139)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.102, h-index: 1)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.553, h-index: 21)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.317, h-index: 15)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.28, h-index: 7)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.573, h-index: 29)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.459, h-index: 41)
J. of Indian Philosophy     Hybrid Journal   (Followers: 10, SJR: 0.179, h-index: 7)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.165, h-index: 5)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 10, SJR: 1.064, h-index: 68)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 7, SJR: 0.411, h-index: 11)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.65, h-index: 39)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 0.902, h-index: 31)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.182, h-index: 66)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 6, SJR: 0.316, h-index: 27)
J. of Insect Behavior     Hybrid Journal   (Followers: 8, SJR: 0.537, h-index: 36)
J. of Insect Conservation     Hybrid Journal   (Followers: 9, SJR: 0.775, h-index: 36)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.501, h-index: 36)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.427, h-index: 39)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.095, h-index: 44)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 1.073, h-index: 38)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 16)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.385, h-index: 9)
J. of Labor Research     Hybrid Journal   (Followers: 14, SJR: 0.228, h-index: 21)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 5, SJR: 0.63, h-index: 20)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 1, SJR: 0.773, h-index: 48)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 1, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 4, SJR: 1.845, h-index: 32)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 3.22, h-index: 73)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.383, h-index: 26)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.134, h-index: 4)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.343, h-index: 8)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.317, h-index: 22)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.19, h-index: 5)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 2, SJR: 0.392, h-index: 16)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.666, h-index: 31)
J. of Materials Science     Hybrid Journal   (Followers: 18, SJR: 1.006, h-index: 101)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3, SJR: 0.697, h-index: 48)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4, SJR: 0.926, h-index: 77)
J. of Mathematical Biology     Hybrid Journal   (Followers: 13, SJR: 1.183, h-index: 61)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.407, h-index: 41)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.709, h-index: 17)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 1.25, h-index: 44)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.358, h-index: 19)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.32, h-index: 20)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 12, SJR: 1.042, h-index: 14)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 1)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 2, SJR: 0.589, h-index: 20)
J. of Medical and Biological Engineering     Hybrid Journal   (SJR: 0.434, h-index: 13)
J. of Medical Humanities     Hybrid Journal   (Followers: 17, SJR: 0.251, h-index: 13)
J. of Medical Systems     Hybrid Journal   (Followers: 2, SJR: 0.604, h-index: 32)
J. of Medical Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.765, h-index: 21)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.209, h-index: 11)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.971, h-index: 75)
J. of Micro-Bio Robotics     Hybrid Journal  
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.641, h-index: 35)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.296, h-index: 11)
J. of Molecular Evolution     Hybrid Journal   (Followers: 11, SJR: 1.07, h-index: 99)
J. of Molecular Histology     Hybrid Journal   (Followers: 1, SJR: 0.791, h-index: 43)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.452, h-index: 100)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.55, h-index: 42)
J. of Molecular Neuroscience     Partially Free   (Followers: 8, SJR: 1.242, h-index: 61)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 11)
J. of Muscle Research and Cell Motility     Hybrid Journal   (SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 2, SJR: 0.777, h-index: 66)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.586, h-index: 22)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.857, h-index: 48)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.331, h-index: 23)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.302, h-index: 77)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.342, h-index: 80)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.239, h-index: 36)
J. of Neurology     Hybrid Journal   (Followers: 12, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (SJR: 1.367, h-index: 63)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 7, SJR: 0.452, h-index: 22)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.772, h-index: 36)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 38)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.456, h-index: 60)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 16, SJR: 0.886, h-index: 50)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.174, h-index: 3)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 11, SJR: 1.166, h-index: 43)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (SJR: 0.144, h-index: 8)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 1.031, h-index: 46)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.228, h-index: 8)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 2, SJR: 0.831, h-index: 2)
J. of Optics     Hybrid Journal   (Followers: 4)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 20)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthop√§die     Hybrid Journal   (SJR: 0.667, h-index: 27)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.684, h-index: 42)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 1.284, h-index: 58)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.272, h-index: 5)
J. of Pediatric Neuropsychology     Hybrid Journal  
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.002, h-index: 21)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 7, SJR: 0.617, h-index: 14)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.16, h-index: 2)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 22, SJR: 0.567, h-index: 41)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.367, h-index: 31)
J. of Philosophical Logic     Hybrid Journal   (Followers: 7, SJR: 0.94, h-index: 20)
J. of Physiology and Biochemistry     Hybrid Journal   (Followers: 3, SJR: 0.741, h-index: 30)
J. of Plant Biochemistry and Biotechnology     Hybrid Journal   (Followers: 5, SJR: 0.257, h-index: 17)
J. of Plant Biology     Hybrid Journal   (Followers: 9, SJR: 0.52, h-index: 16)
J. of Plant Growth Regulation     Hybrid Journal   (Followers: 1, SJR: 0.761, h-index: 47)
J. of Plant Research     Hybrid Journal   (Followers: 4, SJR: 1.055, h-index: 43)
J. of Police and Criminal Psychology     Hybrid Journal   (Followers: 412, SJR: 0.328, h-index: 10)
J. of Polymer Research     Hybrid Journal   (Followers: 6, SJR: 0.649, h-index: 27)
J. of Polymers and the Environment     Hybrid Journal   (Followers: 1, SJR: 0.618, h-index: 39)
J. of Population Ageing     Hybrid Journal   (Followers: 4, SJR: 0.357, h-index: 3)
J. of Population Economics     Hybrid Journal   (Followers: 16, SJR: 2.455, h-index: 42)
J. of Population Research     Hybrid Journal   (Followers: 1, SJR: 0.404, h-index: 10)
J. of Porous Materials     Hybrid Journal   (Followers: 3, SJR: 0.523, h-index: 34)
J. of Primary Prevention     Hybrid Journal   (Followers: 6, SJR: 0.816, h-index: 30)
J. of Productivity Analysis     Hybrid Journal   (Followers: 2, SJR: 0.825, h-index: 48)
J. of Pseudo-Differential Operators and Applications     Hybrid Journal   (SJR: 1.275, h-index: 5)
J. of Psycholinguistic Research     Hybrid Journal   (Followers: 9, SJR: 0.445, h-index: 37)
J. of Psychology and Judaism     Hybrid Journal   (Followers: 2)
J. of Psychopathology and Behavioral Assessment     Hybrid Journal   (Followers: 1, SJR: 0.949, h-index: 39)
J. of Psychosocial Rehabilitation and Mental Health     Hybrid Journal   (Followers: 2)
J. of Public Health     Hybrid Journal   (Followers: 23, SJR: 0.262, h-index: 17)
J. of Quantitative Criminology     Hybrid Journal   (Followers: 6, SJR: 2.481, h-index: 44)
J. of Racial and Ethnic Health Disparities     Hybrid Journal   (Followers: 1)
J. of Radiation Oncology     Hybrid Journal   (Followers: 1)
J. of Radioanalytical and Nuclear Chemistry     Hybrid Journal   (Followers: 4, SJR: 0.515, h-index: 44)
J. of Radiosurgery     Hybrid Journal   (Followers: 2)
J. of Rational-Emotive & Cognitive-Behavior Therapy     Hybrid Journal   (Followers: 1, SJR: 0.394, h-index: 19)
J. of Real-Time Image Processing     Hybrid Journal   (Followers: 6, SJR: 0.356, h-index: 16)
J. of Regulatory Economics     Hybrid Journal   (Followers: 7, SJR: 1.081, h-index: 35)
J. of Religion and Health     Hybrid Journal   (Followers: 10, SJR: 0.483, h-index: 18)
J. of Religious Education     Hybrid Journal   (Followers: 3)
J. of Risk and Uncertainty     Hybrid Journal   (Followers: 19, SJR: 2.34, h-index: 46)
J. of Robotic Surgery     Hybrid Journal   (SJR: 0.227, h-index: 11)
J. of Russian Laser Research     Hybrid Journal   (SJR: 0.326, h-index: 18)
J. of Scheduling     Hybrid Journal   (Followers: 2, SJR: 1.417, h-index: 38)
J. of Science Education and Technology     Hybrid Journal   (Followers: 16, SJR: 0.754, h-index: 30)
J. of Science Teacher Education     Hybrid Journal   (Followers: 15, SJR: 1.128, h-index: 22)
J. of Scientific Computing     Hybrid Journal   (Followers: 18, SJR: 1.771, h-index: 42)

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Journal Cover European Surgery
  [SJR: 0.166]   [H-I: 13]   [5 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1682-4016 - ISSN (Online) 1682-8631
   Published by Springer-Verlag Homepage  [2281 journals]
  • Attitudes and compliance to the WHO Surgical Safety Checklist; a review
    • Abstract: Background This review aimed to assess surgical safety checklist compliance (SSC) and evaluate surgical team attitudes, post checklist implementation. Method A thorough search of MEDLINE and PUBMED databases for English language studies using any adapted form of the WHO SSC was conducted. In total 26 studies; 13 assessing SSC compliance and 13 investigating surgical team attitudes of the checklist, were evaluated. Results Compliance studies demonstrated a checklist initiation rate of >90 %, but showed completion rates to be significantly lower across studies. ‘Sign out’ was the most poorly performed phase (<50 %) with ‘Time out’ being the best. Verification of patient identity and procedure demonstrated high (>90 %) compliance, while ‘Verification of team-members’ varied greatly. Surgical team attitudes noted improved teamwork, communication, patient safety and staff awareness of adverse events. Conclusion SSC compliance is highly dependent on staff perceptions, training and effective leadership. While, surgical teams have positive attitudes towards the SSC, resolving key barriers will improve compliance across all phases of SCC.
      PubDate: 2016-04-27
  • The importance of protective ileostomy during rectal resection
    • Abstract: Introduction Anastomotic leakage is one of the most important complications that occur after surgical low anterior resection for rectal cancer. Protective ileostomy or transversostomy is used during rectal resection to reduce the consequences of rectal anastomotic failures. Many studies strictly recommend performing these protective stomies for the reduction of anastomotic leakage. On the other hand, the closure of protective stomies is associated with a high morbidity rate (20 %), and the reoperation rate is 8 %. For this reason, in the Czech Republic, protective stomies are only used where generally known leakage risk factors have been presented at the Surgical Department in Pardubice. Objective To determine the efficacy of the protective stoma in low anterior rectal resection and to determine whether standard leakage risk factors are the appropriate criteria for providing protective stomies. Results In the period from January 1, 2010 to May 30, 2015 we provided 399 procedures for rectal cancer, of which 197 cases were resection types. During these rectal resections we performed 34 (17.25 %) protective ileostomies or transverstomies in cases where the leakage risk factors were presented. In the group of patients with ileostomy we detected 4 (13.3 %) patients with the complication of ileostomy; 3 (10 %) of these needed surgery. Overall, 24 anastomotic insufficiencies were noticed (12.18 %); 5 of these were in the group with the protective ileostomy. Six  patients with anastomotic leakages were treated by axial transversostomy; one of these by loop ileostomy, seven  patients underwent rectal amputation, two  patients Hartmann resection, six patients were treated by manual or endoscopic lavage and two were just observed. However, only five protective stomies were performed in the cases where leakages were noticed. Conclusion Providing protective stomies in every case of rectal resection is associated with a high rate of complications, predominantly during the closure of these stomies. The use of the rectal resection leakage risk factors for indication of protective stomies represents another way to indicate protective stomies. But our experience shows that this approach is not appropriate in every case. Indication of protective stomies still remains an open question in the field of low rectal resections.
      PubDate: 2016-04-27
  • Resectability of rectal cancer after neoadjuvant treatment – current
    • Abstract: Background The purpose of the study was to compare our experience to recent trends of multimodal treatment of patients with locally advanced rectal cancer. Patients and methods 209 patients with histologically proven adenocarcinoma of the rectum were treated for 3 years by a multimodal approach in a single center. Patients were evaluated for clinical and pathologic response. The type of surgical procedure and the number of retrieved lymph nodes and postoperative complications were recorded. Results Neoadjuvant Chemoradiotherapy (CRT) had a downstaging effect in more than half of our patients (50.61 %), and about one quarter of them achieved a complete pathologic response (22.22 %). Conclusions Preoperative CRT produced an encouraging down-staging effect with acceptable toxicity and perioperative complications.
      PubDate: 2016-04-27
  • Pediatric liver transplantation experience
    • Abstract: Background In this study, we aimed to evaluate pediatric liver transplantation in terms of outcomes, complications, and long-term follow-up results. Materials and methods Between September 2001 and August 2015, 215 pediatric liver transplants were performed in our institution. Results Posttransplant biliary complications were biliary leakage (16.2 %) and biliary stricture (14.8 %). Complication rates in hepatic artery and portal vein were 16.7 % and 4.6 %. Overall mortality rate was 17.8 %. The overall 5‑year survival rate was 82.3 % and 10-year survival rate was 78.9 %. Conclusion With improved care of younger children and the combined efforts of the parents and medical team, the number of the children receiving transplants with good outcomes will continue to increase.
      PubDate: 2016-04-27
  • Emergency management of penetrating cardiac injuries without a heart
    • Abstract: Background In penetrating chest injury, trauma to the heart does not occur frequently. However, an unstable patient must be operated on immediately. Methods A small group of patients, who were admitted to the hospital with thoracic injury and consequently became unstable during CT examination, is presented. Results In total, five patients were transferred immediately to the operating room. Penetrating heart injury was found. All patients were successfully treated and dismissed from hospital. Conclusion A general surgeon must be able to manage penetrating heart injury in unstable patients.
      PubDate: 2016-04-27
  • Use of an anatomical self-gripping Progrip™ laparoscopic mesh in
           TAPP hernia repair. Possible standard' Preliminary results of
           a prospective study
    • Abstract: Background By common perspective, it is generally considered that laparoscopic inguinal hernia repairs (LIHR) are comparable to conventional operative methods, as an equivalent treatment methodology in the management of inguinal hernias. The results of current studies, however, favour an LIHR in comparison to an open mesh repair (OMR) in selected patient populations. The advantages of LIHR lie in the clearer view of the spermatic cord contents it offers, and, as a result, it is a safer method in the preservation of testicular function, with fewer incidences of acute and chronic pain, and a significantly better quality of life postoperatively in comparison to OMR. One of the last unexplained questions regarding LIHR techniques (especially concerning the transabdominal preperitoneal inguinal hernia repair (TAPP) operation) was with regards to the fixation of the mesh. The goal of this study, based on single-centre prospective collection of data from the Internet-based multicentre Herniamed® register, is to demonstrate the safety and efficacy of the use of Parietex™ ProGrip™ Laparoscopic mesh in standardized LIHR with the TAPP technique. Methods Data analysis encompassed all patients who underwent inguinal hernia surgery within the period from May 1, 2013 to December 31, 2014, who fulfilled the inclusion criteria. There were two surgeons with experience in this particular technique contributing on the surgeries. Data were entered and subsequently analysed on the Herniamed® platform. All patients were managed in compliance with a standard protocol and were then re-evaluated 1 and 12 months postoperatively with a standardized questionnaire. Patients with a fixed scrotal hernia or an American Society of Anesthesiologists (ASA) stage IV were excluded from the study. Results In total, 95 patients were listed in the prospective, completely processed documentation on the Herniamed® platform. In total, 156 hernias were operated on. From the demographic point of view, there were 85 men (89.47 %) and 10 women (10.53 %). Representation of females in the group was around one-tenth: 10/95 (10.53 %), while these were mostly bilateral hernias. The average operation time was 64 min, while time taken for bilateral hernias was 67 min. Majority of operated hernias, i. e. 143 hernias (91.67 %) had hernia openings of moderate and large sizes (types 2 and 3, >1.5 cm and <4 cm); medial hernias were predominant on both sides. During the surgery, no complications were demonstrated; postoperative complications were evaluated as significant in relation to previous surgical procedures (major) and as less significant (minor), which did not influence the duration of hospitalization, and these were managed conservatively on an outpatient basis. Postoperative pain of moderate degree (4–6 Visual analogue scale [VAS]) lasting over 3 months in the groin was reported in one case (1.05 %). At the 1‑year assessment, mild discomfort was reported in the groin in 2 from 57 patients (3.51 %), which had no effect on any patient’s usual activity and did not require any therapy (1–3 VAS). After 1 year, there was no patient with chronic postherniorrhaphy inguinal pain (CPIP) reported. There was no recurrence of inguinal hernia confirmed in the followed-up group. Conclusion The legitimacy of the use of the self-fixation mesh was demonstrated in an experiment, in open inguinal hernia repair, laparoscopic totally extraperitoneal hernioplasty (TEP) technique and in TAPP technique. Our study demonstrates that LIHR using the TAPP technique with implantation of a new Parietex™ ProGrip™ laparoscopic self-fixation mesh is a fast, effective and reliable method in experienced hands, which combines the advantages of laparoscopic approach with simple and practical implantation of self-fixation mesh, which, according to our results, reduces the occurrence of CPIP and the recurrence rate.
      PubDate: 2016-04-27
  • Acute Superior Mesenteric Artery Occlusion – Combined Treatment
    • Abstract: Background Acute occlusion of the proximal superior mesenteric artery is still a life-threatening disease. Different surgical and endovascular treatment strategies exist. Methods The technical and clinical outcome of first line endovascular treatment of proximal superior mesenteric artery occlusion in an academic teaching hospital was evaluated. Endovascular treatment included angioplasty, stent, lysis and/or aspiration and was performed on 38 patients (median age 78 years, range 44 to 88 years). These represent the study population. They presented with abdominal pain or other peritoneal signs. Technical success was defined as revascularization of the superior mesenteric artery with residual stenosis of not more than 30 % and reperfusion of the entire bowel. Clinical success was staged into initial cure, need for second line operation and resection of bowel or death of the patient. Results Complete endovascular technical success was reached in 37 of 38 patients. Laparotomy and additional bowel resection was necessary only in a minority of patients. Mortality after 30 days was 45 %. Conclusion Endovascular treatment of acute occlusion of the proximal superior mesenteric artery continues to be the promising first line treatment option with a high potential for primary technical success and clinical benefit.
      PubDate: 2016-04-27
  • Perspectives of surgery in the third millennium
           in all continents from an interdisciplinary point of view
    • Abstract: Abstract There are ten simple questions concerning the philosophy and future discussed in this editorial, in which reflects the main topic of the Jubilee World Congress of ICS, organized for the 80th anniversary of the founding of this oldest world surgical organization in Prague and in Pilsen in September 2015 (see Tab. 1).
      PubDate: 2016-04-27
  • Solid organ transplantation—where we are and how far can we possibly
    • Abstract: Background Solid organ transplants, e. g., kidney, pancreas, and liver, are well-established transplant methods at the Institute for Clinical and Experimental Medicine (IKEM), Czech Republic. Looking at the waiting lists, results, and also population in detail, some patients still suffer. Methods For the described reasons we have introduced some novel transplant methods since the second half of 2011. Kidney patients stay on dialysis; few get the best treatment method, which is live-donor kidney transplantation. Therefore, the live-donor program has been reorganized, kidney paired donation program introduced, miniinvasive donor nephrectomy used in all cases. Some liver patients suffer as well, especially small adults and children, also fulminant liver failure cases and those with multivisceral thrombosis. For these groups of patients we have introduced split-liver transplantation, ABO incompatible (AB0i) liver transplantation, live-donor liver transplantation, auxiliary liver transplantation, and also small bowel/multivisceral transplantation. Results Thanks to the changes, the number of live-donor kidney transplants has increased, the number of liver transplants doubled, many fulminant liver patients survived thanks to AB0i and auxiliary transplantation, and pediatric liver cases waiting time dropped dramatically. The small bowel transplant program started successfully with two multivisceral cases. Conclusion The novel methods and some program changes led to more transplants and also better outcomes. There is still room for further expansion and developments; there are for sure more transplant methods to be introduced. Also, the number of some transplants, e.g., live-donor kidney, still remains low.
      PubDate: 2016-04-27
  • Predictive factors of non-sentinel lymph node involvement in breast
           cancer patients with positive sentinel lymph nodes; a 5‑year single
           centre experience
    • Abstract: Background The aim of our study was to determine the number of sentinel nodes (SN) and non-sentinel nodes (NSN) involved and to identify predictive factors of non-sentinel lymph node involvement in breast cancer patients. Methods The analysis was performed retrospectively on 1350 patients referred for sentinel lymph node biopsy (SLNB) during the 5-year period 2010–2014. Results Metastatic involvement of SN was found in 286 patients (21 %). A subgroup of 274 (96 %) patients, of whom 90 (33 %) had NSN involvement, underwent axillary lymph node dissection (ALND). A prediction model was developed using the significant predictors detected by the univariate analysis. Conclusion The most important predictive factors of NSN involvement were the ratio of positive-to-removed SN, size of metastases and a tumour lympho-vascular invasion (LVI). The model may serve to optimize treatment strategies for patients presenting more of the identified risk factors for NSN involvement.
      PubDate: 2016-04-25
  • Gastric carcinoma presenting with severe rectal stenosis:
           ‘Schnitzler’s metastasis’: case report and review
           of the literature
    • Abstract: Background Distant metastasis of primary gastric carcinoma may occur via venous, lymphatic spread and/or peritoneal seeding. Herein we report on an atypical presentation of clinical, endoscopic, and radiologic features of metastatic gastric adenocarcinoma with symptoms mainly due to rectal carcinomatous involvement. Methods Case report and review of the literature Results We presented the case of 39-year-old-woman with a clinical history of 6 months of dyspepsia, abdominal discomfort, and constipation, who was admitted to hospital with a full-blown picture of mechanical bowel obstruction. These symptoms occurred owing to secondary linitis plastica of the rectum. An extended Hartmann procedure was performed, and the patient was referred to systemic chemotherapy. The overall survival was 5.5 months. The symptoms, findings, preoperative management, and treatment choices are discussed with a review of published cases of Schintzler’s metastasis. Conclusion Gastric linitis plastica is the most common cause of secondary neoplastic infiltration of the colon. An unusual case of Schnitzler’s metastasis to the rectum, synchronously or metachronously, should occur from diffuse type signet-ring cell gastric carcinoma. The clinical findings of severe rectal stenosis with a poorly differentiated gastric adenocarcinoma must call attention to the entity of rectal Schnitzler’s metastasis.
      PubDate: 2016-04-19
  • Packing of the thoracic cavity – Damage control surgery
           for severe intra thoracic haemorrhage
    • Abstract: Background Severe, uncontrollable intra thoracic haemorrhage is a life threatening situation for the patient in extremis and a challenge for the surgeon. Due to bleeding several serious pathophysiological changes occur in the organism. In addition to the threat of exsanguination itself, a “lethal triad” of acidosis, hypothermia and coagulopathy drive the patient into a hazardous situation. Methods In our prospective single centre study we present 19 patients with major bleeding aged 17 to 74 years (mean 48.36 years.). Results After successful packing the bleeding control was 100 % and no reoperation for bleeding was needed. There were two patients after trauma where the operation procedure came too late for successful packing. We observed a 5-day-mortality rate of 15.8 % (3 out of 19) and a 30-day-mortality rate of 31.2 % (5 out of 16). The overall mortality rate was 42.1 % (8 out of 19). Conclusions Damage control surgery (DCS) can save patients in extremis in spite of their serious condition. Thoracic packing as a DC procedure in patients with uncontrollable haemorrhage has only been published in a small series of patients or case reports over the last 30 years. In almost all case reports and publications, only patients with traumatic thoracic haemorrhage were treated by thoracic packing.
      PubDate: 2016-04-19
  • Facial reconstruction with a unique osteomyocutaneous DCIA perforator flap
           variant: a case report
    • Abstract: Summary Background Anatomical variance of the deep circumflex iliac artery is of high clinical value in facial reconstruction using a deep circumflex iliac artery perforator (DCIAP) flap. Methods We present the case of a 76-year-old woman treated with an osteomyocutaneous DCIAP flap variant for facial reconstruction. We also review here the literature on DCIA perforator flaps and the different anatomical variances, which might bring clinical benefits. Results The observed anatomy in our patient offered the possibility to raise a free flap variant with high mobility of a large skin paddle and a long vascular pedicle combined with a variable osteomuscular portion. Conclusion The characteristics of the flap thus raised help overcome the disadvantages of the conventional DCIAP flap and offer excellent options for facial reconstruction.
      PubDate: 2016-04-01
  • Relationship between atrophic gastritis, gastric intestinal metaplasia and
           Helicobacter pylori on endoscopic screening of upper gastrointestinal
           tract and a brief review of the literature
    • Abstract: Summary Objective Gastric cancer mortality rates have been declining in Japan and Korea where gastric cancer is common, but mass screening programs are being conducted. However, this practice is difficult to implement in some countries with low gastric cancer incidence because of the expenses. Thus, the screening and following of high-risk patients should be performed at those countries where the patients entail high costs of time and money. The aim of our study is to determine the gastric cancer-related risk factors such as atrophic gastritis (AG) and intestinal metaplasia (IM), to identify high-risk patients in our region, to evaluate the relationship between the disease and Helicobacter pylori (H. pylori), as well as other risk factors and short-term results. Patients and methods Endoscopic, and histological biopsy results of 3096 patients, who had upper endoscopy because of upper gastrointestinal symptoms such as epigastric pain and dyspepsia, were retrospectively reviewed. All of these endoscopies had been performed between 2012 and 2014 in the endoscopy unit of our hospital. Results In total, 382 IM cases were found. A high correlation was observed between H. pylori positive patients and female gender (p = 0.02) and a significant association was detected between H. pylori negativity and IM (p = 0.001). While a high significant relation was revealed between female gender (p < 0.0001) and IM, a significant inverse relationship was detected between IM and AG (p = 0.001). The existence of H. pylori organism and being over the age of 40 were stated as significant risk factor for IM. After treatment of these patients, a significant decline was observed in IM. Conclusion Endoscopic diagnosis and histopathological verification of AG and IM, evaluating related risk factors, identifying high-risk patients, and inclusion of the individuals into treatment and screening programs are important in terms of preventive medicine.
      PubDate: 2016-04-01
  • Ischemia reperfusion-facilitated sinusoidal endothelial cell injury in
           liver transplantation and the resulting impact of extravasated platelet
    • Abstract: Summary Background The exact sequence of events leading to ultimate hepatocellular damage following ischemia/reperfusion (I/R) is incompletely understood. In this article, we review a mechanism of organ dysfunction after hepatic I/R or immunosuppressive treatment, in addition to the potential of liver sinusoidal endothelial cell (LSEC) protection and antiplatelet treatment for the suppression of hepatocellular damage. Methods A review of the literature, utilizing PubMed-NCBI, was used to provide information on the components necessary for the development of hepatocellular damage following I/R. Results It is well-established that LSECs damage following hepatic I/R or immunosuppressive treatment followed by extravasated platelet aggregation (EPA) is the root cause of organ dysfunction in liver transplantation. We have classified three phases, from LSECs damage to organ dysfunction, utilizing the predicted pathogenic mechanism of sinusoidal obstruction syndrome. The first phase is detachment of LSECs and sinusoidal wall destruction after LSECs injury by hepatic I/R or immunosuppressive treatment. The second phase is EPA, accomplished by sinusoidal wall destruction. The various growth factors, including thromboxane A2, serotonin, transforming growth factor-beta and plasminogen activator inhibitor-1, released by EPA in the Disse’s space of zone three, induce portal hypertension and the progression of hepatic fibrosis. The third phase is organ dysfunction following portal hypertension, hepatic fibrosis, and suppressed liver regeneration through various growth factors secreted by EPA. Conclusion We suggest that EPA in the space of Disse, initiated by LSECs damage due to hepatic I/R or immunosuppressive treatment, and activated platelets may primarily contribute to liver damage in liver transplantation. Endothelial protective therapy or antiplatelet treatment may be useful in the treatment of hepatic I/R following EPA.
      PubDate: 2016-04-01
  • TAPP surgery with mesh fixation and peritoneal closure using
           n-butyl-2-cyanoacrylate (LiquiBand®FIX8 TM )—initial experience
    • Abstract: Summary Introduction Laparoscopic procedures in groin hernia repair have been established since many years. Adhesive techniques for mesh fixation in the transabdominal pre-peritoneal (TAPP) procedure are now being increasingly discussed. Currently, there are three categories of adhesives available: synthetic adhesives (cyanoacrylate), biological products (e.g. fibrin glue) and genetically produced polymer protein adhesives. The objective of this observation study was to evaluate the adhesive technique for mesh fixation and peritoneal closure using n-butyl-cyanoacrylate. Material and method Between January and February 2015, 20 consecutive male patients underwent TAPP surgery with mesh fixation and peritoneal closure with cyanoacrylate. The investigations encompassed complication rate and postoperative pain after 6 days and 3 months. Results Postoperative complication rate was low, one haematoma and one bulging. According to a standardised visual analogue scale (VAS 0–10), the average preoperative pain score was 2.8 (0–7), 1.2 (0–3) after 6 days and 0.1 (0–2) after 3 months. The mean operation time was 69 min. No hernia recurrence was detected during follow-up. Conclusion Our initial experience shows that mesh fixation and peritoneal closure using n-butyl-2-cyanoacrylate is save and sufficient.
      PubDate: 2016-04-01
  • The effect of ozone treatment on experimental colon anastomosis in rats
    • Abstract: Summary Background Colonic anastomosis is a common surgical procedure. Complications after such surgery are still a major problem despite advances in techniques. We aimed to evaluate the effects of pre-operative and postoperative ozone administration on the recovery of colonic anastomoses in rats in this study. Methods An end-to-end colon anastomosis was created in the left colon under anesthesia in all experiment group animals. The control group was left alone for 4 days. The other two groups were administered intraperitoneal ozone at a dose of 1 mg/kg once a day. Ozone therapy was started 24 h after surgery to one group (ozone) and 1 h before surgery to the other group (pre-ozone). Samples for biochemical measurements were obtained from the operation site after adhesion scoring was performed and the burst pressure measured. Results The burst pressure and OH-proline measurements in the ozone group were found to be significantly higher than in the other groups (p ˂ 0.05). These values were not different between the pre-ozone and control groups (p ˃ 0.05). The MDA values of the ozone group were significantly lower but the antioxidant enzyme levels (except superoxide dismutase) were significantly higher than the other two groups. The TNF-α and IL-6 levels of the ozone group were significantly lower while the IL-10 levels were significantly higher compared with the other two groups. Conclusion We therefore feel that ozone treatment after surgery could be important in terms of accelerating colon anastomosis recovery. Ozone administration supports recovery by reducing oxidative stress and proinflammatory cytokines.
      PubDate: 2016-04-01
  • Poly(ADP-ribose) Polymerase inhibition improves wound healing in the
           colonic anastomoses of rats
    • Abstract: Summary Aims Colonic anastomosis is a widely used surgical procedure and leads to morbidity and mortality with anastomotic leaks. It has been shown that PARP inhibition has beneficial effects against various pathological conditions. In this study, we aimed to evaluate the possible effects of 3-aminobenzamide (3-AB), a PARP-1 inhibitor, on experimental wound healing and tensile strength in the colonic anastomosis of rats. Methods A total of 14 Sprague-Dawley rats were divided into two random groups of equal number: Control and 3-AB groups. Control group was given standard left colon resection and end-to-end anastomosis; 3-AB group was given colonic resection + anastomosis + received 3-AB. 3-AB group received 20 mg/kg/day 3-AB intraperitoneally following surgical procedure and continued once a day for consecutive 4 days. A relaparatomy was given on the 5th day to evaluate malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), interleukin (IL)-10, IL-6, tumor necrosis factor-alpha (TNF-α), hydroxy (OH)-proline levels and anastomotic burst pressure. Results The burst pressure values and the tissue OH-proline levels increased in the treatment group significantly compared with controls. Additionally, when compared the control group, tissue MDA, MPO, TNF-α and IL-10 levels were markedly decreased while tissue SOD and GSH-Px activities were statistically increased in the treatment group (p < 0.05). Conclusion Our data showed that 3-AB medication after colonic surgery increased the mechanical tissue strength of anastomotic line in rats. Consequently, these findings suggest that it would be possible to improve the anastomotic wound healing by using PARP inhibitors, and decrease the anastomotic complication rates.
      PubDate: 2016-04-01
  • Acute abdomen
    • PubDate: 2016-03-31
  • Surgical science publishes: “σωζειν
           τα ϕαινομενα”
    • PubDate: 2016-03-29
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