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Diabetologia Notes de lecture     Hybrid Journal  
Diabetology Intl.     Hybrid Journal   (Followers: 1, SJR: 0.273, h-index: 5)
Dialectical Anthropology     Hybrid Journal   (Followers: 8, SJR: 0.314, h-index: 9)
Die Weltwirtschaft     Hybrid Journal   (Followers: 2)
Differential Equations     Hybrid Journal   (Followers: 2, SJR: 0.364, h-index: 15)
Differential Equations and Dynamical Systems     Hybrid Journal   (Followers: 1, SJR: 0.63, h-index: 7)
Digestive Diseases and Sciences     Hybrid Journal   (Followers: 5, SJR: 1.19, h-index: 89)
Directieve therapie     Hybrid Journal  
Discrete & Computational Geometry     Hybrid Journal   (Followers: 2, SJR: 1.269, h-index: 40)
Discrete Event Dynamic Systems     Hybrid Journal   (Followers: 2, SJR: 0.42, h-index: 32)
Distributed and Parallel Databases     Hybrid Journal   (Followers: 4, SJR: 0.766, h-index: 30)
Distributed Computing     Hybrid Journal   (Followers: 2, SJR: 1.41, h-index: 31)
DNP - Der Neurologe und Psychiater     Full-text available via subscription  
Documenta Ophthalmologica     Hybrid Journal   (Followers: 2, SJR: 0.946, h-index: 40)
Doklady Biochemistry and Biophysics     Hybrid Journal   (Followers: 2, SJR: 0.2, h-index: 10)
Doklady Biological Sciences     Hybrid Journal   (SJR: 0.248, h-index: 10)
Doklady Botanical Sciences     Hybrid Journal  
Doklady Chemistry     Hybrid Journal   (SJR: 0.272, h-index: 12)
Doklady Earth Sciences     Hybrid Journal   (SJR: 0.48, h-index: 17)
Doklady Mathematics     Hybrid Journal   (SJR: 0.345, h-index: 13)
Doklady Physical Chemistry     Hybrid Journal   (SJR: 0.299, h-index: 12)
Doklady Physics     Hybrid Journal   (Followers: 1, SJR: 0.293, h-index: 17)
Douleur et Analg├ęsie     Hybrid Journal   (SJR: 0.113, h-index: 6)
Drug Delivery and Translational Research     Hybrid Journal   (Followers: 2, SJR: 0.607, h-index: 8)
Drug Safety - Case Reports     Open Access  
Drugs : Real World Outcomes     Hybrid Journal   (Followers: 1)
Dynamic Games and Applications     Hybrid Journal   (Followers: 2, SJR: 0.481, h-index: 5)
Dysphagia     Hybrid Journal   (Followers: 87, SJR: 0.822, h-index: 52)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 9, SJR: 0.279, h-index: 9)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 14, SJR: 0.466, h-index: 16)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.282, h-index: 7)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 7, SJR: 0.303, h-index: 29)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.482, h-index: 21)
Earthquake Science     Hybrid Journal   (Followers: 8, SJR: 0.418, h-index: 9)
East Asia     Hybrid Journal   (Followers: 7, SJR: 0.18, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 9, SJR: 0.362, h-index: 27)
EcoHealth     Hybrid Journal   (Followers: 2, SJR: 0.88, h-index: 26)
Ecological Research     Hybrid Journal   (Followers: 8, SJR: 0.847, h-index: 43)
Economia e Politica Industriale     Hybrid Journal  
Economia Politica     Hybrid Journal   (SJR: 0.375, h-index: 6)
Economic Botany     Hybrid Journal   (Followers: 9, SJR: 0.527, h-index: 44)
Economic Bulletin     Hybrid Journal   (Followers: 4)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.264, h-index: 9)
Economic Theory     Hybrid Journal   (Followers: 9, SJR: 2.557, h-index: 34)
Economic Theory Bulletin     Hybrid Journal   (Followers: 2)
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.408, h-index: 14)
Ecosystems     Hybrid Journal   (Followers: 19, SJR: 1.909, h-index: 93)
Ecotoxicology     Hybrid Journal   (Followers: 9, SJR: 1.333, h-index: 56)
Education and Information Technologies     Hybrid Journal   (Followers: 84, SJR: 0.366, h-index: 16)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 19, SJR: 0.374, h-index: 15)
Educational Psychology Review     Hybrid Journal   (Followers: 17, SJR: 2.776, h-index: 61)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 8, SJR: 0.273, h-index: 9)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 11, SJR: 0.825, h-index: 32)
Educational Technology Research and Development     Partially Free   (Followers: 73, SJR: 1.785, h-index: 52)
Electrical Engineering     Hybrid Journal   (Followers: 15, SJR: 0.336, h-index: 18)
Electrocatalysis     Hybrid Journal   (SJR: 0.883, h-index: 10)
Electronic Commerce Research     Hybrid Journal   (Followers: 3, SJR: 0.582, h-index: 16)
Electronic Markets     Hybrid Journal   (Followers: 5, SJR: 0.411, h-index: 8)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 1.407, h-index: 15)
Elemente der Mathematik     Hybrid Journal   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.678, h-index: 25)
Emission Control Science and Technology     Hybrid Journal   (Followers: 1)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.319, h-index: 16)
Empirical Economics     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 31)
Empirical Software Engineering     Hybrid Journal   (Followers: 7, SJR: 1.285, h-index: 39)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 3, SJR: 0.361, h-index: 15)
Endocrine     Hybrid Journal   (Followers: 6, SJR: 0.878, h-index: 57)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.638, h-index: 31)
Energy Efficiency     Hybrid Journal   (Followers: 12, SJR: 0.732, h-index: 14)
Energy Systems     Hybrid Journal   (Followers: 11, SJR: 1.176, h-index: 7)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.433, h-index: 30)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.144, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 29, SJR: 0.419, h-index: 29)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.458, h-index: 32)
Environmental and Resource Economics     Hybrid Journal   (Followers: 18, SJR: 1.632, h-index: 54)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.725, h-index: 58)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 2, SJR: 0.741, h-index: 28)
Environmental Earth Sciences     Hybrid Journal   (Followers: 12, SJR: 0.724, h-index: 63)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 6, SJR: 0.524, h-index: 4)
Environmental Evidence     Open Access   (Followers: 1)
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.437, h-index: 24)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 1.013, h-index: 36)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 3, SJR: 0.522, h-index: 19)
Environmental Management     Hybrid Journal   (Followers: 32, SJR: 0.942, h-index: 66)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 10, SJR: 0.533, h-index: 31)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 9, SJR: 0.685, h-index: 52)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 14, SJR: 0.885, h-index: 46)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 4, SJR: 1.4, h-index: 17)
Epileptic Disorders     Hybrid Journal   (SJR: 0.608, h-index: 38)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.287, h-index: 63)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.731, h-index: 89)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.641, h-index: 62)
EPMA J.     Open Access   (SJR: 0.284, h-index: 6)
ERA-Forum     Hybrid Journal   (Followers: 2, SJR: 0.128, h-index: 3)
Erkenntnis     Hybrid Journal   (Followers: 13, SJR: 0.621, h-index: 16)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.206, h-index: 9)

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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  [2299 journals]
  • How to report multiple outcome metrics in virtual reality simulation
    • Abstract: Summary Background Virtual reality (VR) simulation is increasingly used in surgical disciplines. Since VR simulators measure multiple outcomes, standardized reporting is needed. Methods We present an algorithm for combining multiple VR outcomes into dimension summary measures, which are then integrated into a meaningful total score. We reanalyzed the data of two VR studies applying the algorithm. Results The proposed algorithm was successfully applied to both VR studies. Conclusions The algorithm contributes to standardized and transparent reporting in VR-related research.
      PubDate: 2015-06-16
  • Stent-supported percutaneous transluminal angioplasty in patients
           suffering from symptomatic benign or malignant central venous occlusive
    • Abstract: Summary Background The aim of this study was to investigate the outcome of patients suffering from benign or malignant superior vena cava (SVC), brachiocephalic (BCV), and subclavian (SV) vein lesions treated with nitinol stents. Methods Retrospective analysis of consecutive patients in a university-based tertiary care center. Results Twenty-two patients suffering from central venous occlusive disease (CVD) (9 malignant, mean age 58 years; 13 benign, mean age 66 years) were treated 2/2003–1/2012. In total, 89 % of malignant central venous occlusive disease (mCVD) patients underwent successful primary stenting (one reintervention 6 months after primary stenting). Two stent occlusions (22 %) were seen at last follow-up. All mCVD patients died within a median follow-up of 2 months (range: 0.8–54 months). In all, 92 % of benign central venous occlusive disease (bCVD) patients underwent primary stenting of SV (n = 8), BCV (n = 5), and SVC (n = 1). Six repeat interventions were performed in 42 % of patients. There was one stent occlusion (8 %) at last follow-up. Of all, 69 % of bCVD patients died within a median follow-up of 12.7 months (range: 1.3–82 months); 22 % of mCVD and 8 % of bCVD patients underwent bypass surgery as bail out procedure due to primary (n = 2) or secondary (n = 1) endovascular failure. All CVD patients experienced immediate post-interventional relief of symptoms. Conclusion Technical success of CVD stenting is high and leads to immediate relief of symptoms in patients with short life expectancy.
      PubDate: 2015-06-16
  • Surgery with qualities or: “how to foster yourself”
    • PubDate: 2015-06-11
  • Reduction of adhesions with autogen tissue-covered polypropylene mesh
           implants for incisional hernia repair: an experimental study
    • Abstract: Summary Background Incisional hernia is a complication that is encountered with a rate of 2–11 % and can lead to morbidity, work loss, and even mortality. Prosthetic materials that are used in hernia repair are still being tested, and the ideal one has not been proposed yet. While the recurrence rates with primary repair are found to be 30–50 %, these rates are decreased to 0–15 % with mesh repair. These rates emphasize the importance of meshes. The most important criteria in their usage are the advantages and disadvantages of types of meshes. Our aim is to cover the mesh with the subject’s own collagen tissue, then to repair the defect with this autogen collagen-covered propylene mesh, and lastly, to prevent or decrease adhesions against the mesh. Methods A total of 14 male, healthy, 250–300 g Wistar-Albino rats were included in the study. They were separated into two equal groups as Group A (control group) and Group B (study group). In Group A, full-thickness defects were repaired with polypropylene meshes. In Group B, meshes of the same size were placed under the skins of the rats and excised on the ninth day. After creating a full-thickness defect, it was repaired with the rat’s own mesh. On the 21st day, in both groups, the adhesions between intra-abdominal organs and the mesh were evaluated by two independent observers according to adhesion scoring system. The groups were compared in means of fibrosis and inflammation scores. The pathologist was not informed about which preparate belonged to which group. Results In Group A, adhesion area, adhesion strength, inflammation, collagen tissue, and fibroblast activity were significantly higher than Group B. Conclusions According to our results, after in-lay placement of autogen tissue-covered polypropylene meshes, adhesions can decrease and complications due to intra-abdominal adhesions can be prevented, and relatively low costs may contribute to health expenditure.
      PubDate: 2015-06-09
  • Extensive pancreatic heterotopia in distal esophagus mimicking esophageal
    • Abstract: Summary Background We report an unusual and rare case of a young adult patient with extensive symptomatic pancreatic heterotopia in the distal esophagus that appeared on imaging as a malignant tumor. After comprehensive preoperative workup, the soft tissue mass was treated surgically according to intraoperative histology that revealed its benign nature. Methods A young male patient with worsening epigastric pain, gastroesophageal reflux, and weight loss presented in a university hospital for a comprehensive diagnostic workup. Apart from clinical examination and laboratory tests, he underwent gastroscopy, esophageal manometry, endoscopic ultrasound, barium meal study, computed tomography (CT), and positron emission tomography (PET-CT). Finally an interdisciplinary board recommended surgical removal of a mediastinal mass and final diagnosis was reached by intraoperative histology. Results The clinical examination and laboratory test were unremarkable, esophageal manometry suggested achalasia due to simultaneous spastic and retrograde contractions with high amplitude. Barium meal showed mild compliant stenosis of the distal esophagus, but gastroscopy found no explanation. CT and later also PET-CT revealed a large soft tissue mass with avid accumulation of 18F-fluorodeoxyglucose surrounding the distal esophagus. Endoscopic ultrasound was very limited and no representative tissue samples were obtained prior to surgery. The surgeon accessed the mediastinum through the left thoracotomy and found a noncompliant well-defined mass surrounding the distal esophagus. Intraoperative histology showed nothing but common structures of pancreatic tissue. Conclusions A large soft-tissue mass of pancreatic heterotopia in the distal esophatus is extremely rare and preoperative workup inconclusive. Only surgical exploration and (intraoperative) histology are in a position to reveal its true nature.
      PubDate: 2015-06-02
  • Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal
           hernia prevention and treatment
    • Abstract: Summary Background Funnel mesh implants can be used for both prevention and repair of parastomal hernia (PSH). We aimed to prove the practice of such implants as well as the magnetic resonance (MR) presentability in humans. Methods Five patients were surgically treated for laparoscopic PSH prevention, and five patients underwent laparoscopic repair of manifest and symptomatic PSH with iron-loaded 3-D funnel meshes in an intraperitoneal onlay technique. MR investigation was performed on postoperative day 7 to assess mesh delineation, and additionally 6 and 12 months postoperatively to evaluate hernia recurrences and biocompatibility of mesh integration. Results We could demonstrate precise mesh depiction and delineation with MR in all 10 cases, as well as accurate assessment of the surrounding tissue. No funnel alterations and no functional change of the stoma bowel patency occurred due to the tightly fitting funnel implant. We documented no mesh-related complications, no PSH formation, and no stoma prolapse occurrence during the follow-up period of 1 year comprising all ten cases. Conclusion The pilot use of a new method of MR investigation using a mesh with enhanced signal through the addition of iron particles into the polyvinylidene fluoride base material provides detailed mesh depiction. Furthermore, funnel mesh implantation seems to offer a safe and promising surgical alternative for both PSH prevention and treatment.
      PubDate: 2015-05-30
  • “Rendez-vous” over-the-scope endoclipping for
           tracheoesophageal fistula: case report and review of the literature
    • Abstract: Summary Background Management of tracheoesophageal fistula is challenging and is associated with high morbidity and mortality. Malignancy and cuff-related tracheal decubitus are the most common causes of tracheoesophageal fistula. Open surgical division and closure of the fistula orifices with or without tissue interposition has represented the standard of care for decades. Endoscopic management of tracheoesophageal fistula is still debated and only a few cases have been described in the literature. Methods A 57-year-old male patient with chronic tracheoesophageal fistula occurring 1 year after esophagectomy for squamous-cell carcinoma was treated with a “rendez-vous” over the scope endoclipping technique using the OVESCO R system. The pertinent literature on the topic has been reviewed and compared to the present case. Results The patient was discharged home on postoperative day 6 on a semisolid diet and remains asymptomatic at 5 month follow-up. Conclusions The OVESCO R system seems to be safe and effective in the treatment of small tracheoesophageal fistula.
      PubDate: 2015-05-30
  • Long-term follow-up of patients diagnosed with nonspecific abdominal pain
           (NSAP): identification of pathology as a possible cause for NSAP
    • Abstract: Summary Background Nonspecific abdominal pain (NSAP) accounts for 40 % of all general surgical admissions. Data suggest that conditions such as irritable bowel syndrome and gynaecological pathologies can be misdiagnosed as NSAP. Delayed diagnosis and management can cause increased morbidity. Our aim was to follow-up a cohort of patients with an initial diagnosis of NSAP to determine their eventual diagnosis. Method Hospital episode statistic (HES) data were reviewed to identify 100 acute surgical admissions coded as NSAP at discharge between January and December 2008. Medical records were systematically reviewed over a 3-year follow-up period to identify further investigations, operations and any eventual diagnoses in patients who fulfilled NSAP criteria. General practitioners were contacted to evaluate any further GP surgery visits and hospital referrals for this cohort of patients. Results A total of 59 were incorrectly coded as NSAP; only 41 fulfilled the criteria of NSAP at discharge from the initial acute admission. The majority of patients correctly diagnosed as NSAP were female (71 %) individuals. Median age across both genders was 25.7 years (interquartile range 19.4–37.7 years). At three yearly follow-up, 54 % of patients appropriately labelled as NSAP were diagnosed with a specific pathology. Conclusion This study highlights that around half of patients correctly labelled with NSAP were subsequently diagnosed with a specific pathology. Our results suggest that patients diagnosed with NSAP should be followed up to avoid additional morbidity from misdiagnosis. Furthermore, the current coding system for NSAP needs to be modified.
      PubDate: 2015-05-27
  • Bilateral superficial cervical plexus block combined with bilateral
           greater occipital nerve block reduces the impact of different sources of
           pain after thyroid surgery with less consumption of morphine-PCA: a
           randomized trial
    • Abstract: Summary Background Our aim was to demonstrate the analgesic efficacy of the bilateral superficial cervical plexus block (BSCPB) combined with bilateral greater occipital nerve block (BGONB) on different sources of pain after thyroid surgery; in terms of pain scores and morphine-PCA consumption in the first 24 h. Materials and method Sixty patients were randomized into three groups; Group C (n = 20) to receive management without blocks; Group GS (n = 20), the combination of BSCPB and BGONB; and Group S (n = 20), BSCPB alone. Levobupivacaine of 0.25 % (15 ml (each side) for BSCPB; 5 ml (each side) BGONB) was used for nerve blocks. All patients received morphine-PCA for the first 24 h postoperatively. In all, 0 h, 1 h, 2 h, 4 h, 6 h, 12 h, and 24 h were the measurement times for incision pain at rest, pain on swallowing, headache, and posterior neck pain scores (VAS) and PONV. Requirement for rescue analgesics and 24 h morphine consumption were recorded. Results Incision pain scores at rest and on swallowing was lower in Groups GS and S (p  < 0.001). Posterior neck pain scores were lower in Group GS (p  < 0.001). Headache was similar in all groups, but the number of patients with pain scores VAS > 3 was lower in Group GS (p < 0.001). In Groups GS and S 24 h morphine consumption was lower, compared to Group C (p  < 0.001). PONV and rescue analgesic use were similar. Conclusion The combination of three-injection technique BSCPB with BGONB performed before surgical incision by using 0.25 % levobupivacaine, significantly reduced incision pain at rest, incision pain on swallowing, headache and posterior neck pain after thyroid surgery, while reducing morphine consumption in 24 h postoperatively.
      PubDate: 2015-05-27
  • Patch, interposition graft or stent for treatment of restenosis after
           carotid endarterectomy: a retrospective study
    • Abstract: Summary Background Uncertainty surrounding the indication for treatment of post carotid-endarterectomy restenosis (pCEAR) exists. Conventional patch angioplasty (rCEA), carotid interposition graft (CIG), and stent-assisted angioplasty (CAS) have been studied; comparisons of these techniques have not been performed. Methods A time to event analysis of consecutive patients undergoing treatment for pCEAR was performed. Primary end-point was any cerebrovascular or myocardial event or death. Long-term results were expressed in Kaplan–Meier estimates. Results From 02/1997 to 03/2013, 93 procedures for severe pCEAR were performed in 89 consecutive patients. Group 1 consisted of 37 rCEA (40 %), group 2 included 33 CIG (35 %), and group 3 contained 23 CAS (25 %). Median time from primary CEA was significantly longer in group 2 compared with group 3 (118 vs. 54 months; p = 0.02). Groups were comparable with regard to degree of stenosis and cardiovascular risk factors. Five patients (6 %) underwent initial angiography with intention of CAS, but the procedures could not be completed (insufficient access n = 3, neurological symptoms n = 2) and open surgery was performed (rCEA: n = 4; CIG: n = 1). One perioperative death related to major stroke occurred in group 3 (3.6 %). There were no differences in 4-year estimated survival and event-free survival, whereas patients in group 3 were more likely to undergo a tertiary intervention (13 % at 4 years 95 % CI: 11–45 % p = 0.014). Conclusions All three groups presented with similar long-term outcome with regard to the predefined endpoints. Although associated with less perioperative complications, CAS required significantly more tertiary interventions. Carotid interposition graft was not superior to redo patch plasty.
      PubDate: 2015-05-27
  • 56th Annual Meeting of the Austrian society of surgery
    • PubDate: 2015-05-20
  • Stapled hemorrhoidopexy versus Milligan–Morgan hemorrhoidectomy: a
           short-term follow-up on 640 consecutive patients
    • Abstract: Summary Background The aim of the present study is to report our data on the treatment of third-and fourth-degree hemorrhoids with stapled technique and Milligan–Morgan operation in terms of postoperative results, costs, and recurrence. Methods From 2008 to 2011, 640 consecutive patients with third- and fourth-degree hemorrhoids underwent hemorrhoidectomy or hemorrhoidopexy. Patients have been randomly assigned to Milligan–Morgan or stapled treatment according to the possibility of use 60 staplers/year. In all, 400 patients have been treated by Milligan–Morgan procedure: 357 in one-day surgery; 240 patients underwent stapled hemorrhoidopexy: 197 in one-day surgery (p = 0.011). Results Immediate readmissions have been: 5 cases among Milligan–Morgan group and of 9 cases among stapled group (p two-tailed = 0.049). Acute postoperative rectal bleeding with readmission have been: 4 cases among Milligan–Morgan group (1 %) and 8 cases among stapled group (3.33 %) (p = 0.037). Recurrence have been: 2 patients after Milligan–Morgan procedure (0.5 %) and 20 patients after stapled operation (8.33) (p < 0.0000011). Total direct costs have been 668 € higher for each stapled patient. Conclusion In conclusion, Milligan–Morgan hemorrhoidectomy for third- and fourth-degree hemorrhoids is superior to stapled operation when comparing hospital stay, major postoperative bleeding, hospital cost, and recurrence.
      PubDate: 2015-05-20
  • Significant relationship between preoperative serum concentration of
           anti-heat shock protein 70 antibody and postoperative morbidity in
           patients with esophageal cancer
    • Abstract: Summary Background Heat shock protein 70 is a molecular chaperone important in host responses to stress, including infection, injury, oxidative damage, hypoxia, and thermal stress. This study analyzed the correlation between preoperative serum concentrations of anti-HPS70 antibody and postoperative morbidity in patients with esophageal cancer. Materials and methods Serum samples were obtained preoperatively from 50 esophageal carcinoma patients (46 men and 4 women) who underwent potentially curative surgery without preoperative therapy. Serum anti-HSP70 antibody concentrations were measured by enzyme-linked immunosorbent assays. Results The mean concentration of anti-HSP70 antibody was 187.0 μg/mL. When patients were dichotomized relative to this cutoff, we observed no significant relationships between perioperative inflammatory markers (maximum body temperature, white blood cell count and C-reactive protein concentration) and anti-HSP70 antibody concentration. The incidence of postoperative complications was significantly lower in patients with anti-HSP ≥ 187.0 μg/mL than < 187.0 μg/mL (p = 0.0336). Conclusions Preoperative serum concentration of anti-HSP70 antibody was significantly related to postoperative morbidities in patients with esophageal cancer.
      PubDate: 2015-05-14
  • Pathophysiology of airway obstruction caused by wound hematoma after
           thyroidectomy: an ex vivo study
    • Abstract: Summary Background Airway obstruction by postoperative hemorrhage after thyroid resection is a serious adverse and potentially life-threatening event. The aim of this study is to investigate if the possible pressure caused by a postoperative hematoma in the neck would be sufficient to compress the trachea and therefore leads to a mechanical airway obstruction. Methods In this ex vivo model varying pressures (0–250 mmHg) were applied on 30 human cadaver tracheas. The primary outcome was the anterior-posterior and latero-lateral tracheal diameter during the application of different pressures. Results At the highest pressures of 250 mmHg, there was an average compression of only 67.80 % in anterior-posterior direction and of 60.09 % in latero-lateral direction. Conclusions This study suggests that even pressures of 250 mmHg in neck-hematomas would be insufficient to cause a mechanical airway occlusion.
      PubDate: 2015-05-12
  • Liposarcoma with lymph node spread: a case presentation and a systematic
           review of the literature
    • Abstract: Summary Background Liposarcomas are neoplasms of mesodermic origin derived from adipose tissue. Metastases at the time of initial presentation are uncommon, and the spread to regional nodes is extremely infrequent. The aim of this work is to present a rare case of a giant liposarcoma, presenting with regional lymph node extension, and composed of three different histological subtypes and present a systematic review of all the cases described in the literature of liposarcoma with lymphatic extension. Methods A 71-year-old woman presented with a giant retroperitoneal liposarcoma with lymph node invasion. Excision of the tumor en bloc with right radical nephrectomy and lymphadenectomy was performed. Histological analysis revealed a mixed-type liposarcoma consisting of well-differentiated, myxoid, and pleomorphic components, and lymph node involvement. A systematic review of the literature of the cases of liposarcoma with lymph node involvement was performed. Results This is the first description of a retroperitoneal liposarcoma with lymphatic involvement. There are only seven articles, including 9 patients, in literature describing lymph node invasion of liposarcomas. The majority are dedifferentiated liposarcomas. Conclusions Giant retroperitoneal liposarcomas with mixed histological pattern and lymph node invasion are rare presentation in the literature and associated with a poor prognosis. The available data are spare, and our understanding of these tumors is limited, with no known effective therapy.
      PubDate: 2015-05-07
  • 8th Annual Meeting of Chinese College of Surgeons and 19th Annual Meeting
           of the European Society of Surgery
    • PubDate: 2015-05-01
  • Antecolic anastomosis and delayed gastric emptying: still a benefit in
           patients without intra-abdominal complications'
    • Abstract: Summary Background/Aims The etiology of delayed gastric emptying (DGE) after pylorus-preserving pancreatoduodenectomy (PPPD) is unclear. This study aimed to ascertain the incidence of DGE in a transmesocolic anastomosis (TA) versus an antecolic anastomosis (AA) group of patients. Methods Retrospective study including the last 40 consecutive patients with TA (2004–2006) and the first 40 consecutive patients with AA (2006–2010) performed at our centre. Preoperative, surgical and postoperative data were prospectively collected until patient discharge. Results No preoperative differences were found. Overall postoperative morbidity was higher in the TA group (75  vs 47 %; p = 0.012). No significant differences in DGE were found (TA: 35 % vs AA: 20 %; p = 0.1). Termino-terminal pancreatic anastomosis, gastrostomy, prophylactic somatostatin and the presence of intra-abdominal collections were associated with DGE. On multivariate analysis, only intra-abdominal collections (OR: 4.95 % CI: 1.36–11.8; p = 0.012) predicted DGE. Among patients without other surgical complications (n = 46), DGE rate was significantly higher in the TA group (TA: 38 % vs AA: 12 %, p = 0.04). Conclusions Overall, no significant differences in DGE were found between groups. AA could be a protective factor for DGE when no other surgical complications appear.
      PubDate: 2015-04-21
  • Surgical intervention does not affect short-term plasma citrulline levels
           in infants: implications for citrulline as a marker of postoperative
           intestinal complications
    • Abstract: Summary Background and aims Detection of intestinal ischemia is often delayed causing extensive complications. Serum citrulline is an important parameter for bowel integrity and functionality; however, no data is available on its response on postoperative intestinal impairment in children. The aim of this study was to evaluate the native effects of intestinal surgery on the postoperative citrulline course in children. Material and methods In two groups, of each five children under the age of 2, undergoing either intestinal surgery (IS) or non-intestinal surgery (NIS), we monitored unspecific intestinal impairment parameters (lactate, C-reactive protein (CRP), leukocytes) and citrulline prior to surgery and on the 3rd postoperative day. Results In both groups the postoperative course was uneventful, including unproblematic transition to a normal diet and regular stool. Postoperatively, CRP levels were slightly increased (IS p > 0.05; NIS p < 0.05) while leukocytes and lactate levels did not show any significant changes. The citrulline levels remained constant in the perioperative period. Conclusions This data suggests that IS does not affect perioperative citrulline levels in children under the age of 2 years with uneventful postoperative course. Changes in citrulline following surgery might be a sign of intestinal impairment and therefore further investigations are necessary on this field.
      PubDate: 2015-04-15
  • Thymoma with extensive ossification in a young woman
    • Abstract: Summary Background Osseous metaplasia is an extremely rare histological variation of thymus tumors. Despite intratumoral calcifications are described ossification is exceptional. Case report A 27-year-old woman with no relevant medical history was referred to our department for the treatment of a full-calcified anterior mediastinal tumor. It was detected on a spinal X-ray performed for chronic back pain and confirmed by a chest X-ray. On the computed tomography, a bulky anterior mediastinal tumor containing heterogeneous calcification was confirmed. The patient underwent a posterolateral thoracotomy. Intraoperatively there was a large hard stony mass in the anterior mediastinum extending to the right hemi thorax. Complete excision of the mass including thymectomy was done. The patient underwent uneventful recovery. Histopathology reported a thymoma type B1 with osseous metaplasia according to the World Health Organization classification and Masaoka I stage according to intraoperative findings. Results To our knowledge it is the third case published in all literature of a thymus tumor with complete osseous metaplasia in an adult and the first case that tumor is almost entirely ossified. Conclusion The mechanism of osseous metaplasia is unknown. Several theories have been given. Certain cell mediators would stimulate and influence connective tissue to be replaced by heterotopic bone. Further cases of osseous metaplasia will be necessary to figure out pathogenesis, prognosis and treatments outcomes of these particular types of thymomas.
      PubDate: 2015-04-10
  • Effect of perioperative epidural anesthesia in elective laparoscopic
           colorectal resections
    • Abstract: Summary Background The role of general anesthesia combined with epidural anesthesia in laparoscopic colorectal surgery is still controversial. In this retrospective study of 84 consecutive patients, the rate of successfully placed epidural catheter and its effect on perioperative pain and outcome are analyzed. Methods A total of 84 patients, 36 (43 %) female, with a median (range) age of 64 (19–82) years and a median (range) body mass index of 25 (15–37) kg/m2, were operated; 12 (14 %) procedures were performed via single-incision laparoscopic technique. Results The rate of successfully placed epidural anesthesia was 27 % (23), and less postoperative pain (p = 0.04) and need for opioids (p = 0.00) were observed on the day of surgery and first postoperative day. No effect was observed on bowel function, tolerance of solid food, or hospital stay. Conclusions In daily surgical laparoscopic practice, the rate of epidural anesthesia is low. Less pain and less need for opioids, but no effect on bowel function or hospital stay, could be demonstrated.
      PubDate: 2015-03-13
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