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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 1, SJR: 0.267, h-index: 14)
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.699, h-index: 8)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.676, h-index: 39)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 0.98, h-index: 63)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 3, SJR: 0.981, h-index: 50)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.284, h-index: 16)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.457, h-index: 17)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.419, h-index: 54)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.252, h-index: 11)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.342, h-index: 26)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 5)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.951, h-index: 70)
J. of Computers in Education     Hybrid Journal   (Followers: 5)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.725, h-index: 16)
J. of Consumer Policy     Hybrid Journal   (Followers: 3, SJR: 0.44, h-index: 23)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.115, h-index: 4)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 4)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 4, SJR: 0.441, h-index: 16)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.406, h-index: 13)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 6, SJR: 0.168, h-index: 8)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.412, h-index: 23)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.757, h-index: 6)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.598, h-index: 49)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.445, h-index: 24)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.183, h-index: 5)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 8, SJR: 0.207, h-index: 3)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.615, h-index: 23)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.535, h-index: 29)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 6, SJR: 0.296, h-index: 3)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.556, h-index: 22)
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: 28, 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: 7, 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: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, 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: 28, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, 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 Marketing     Hybrid Journal   (Followers: 3, SJR: 0.241, h-index: 6)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, 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: 3, 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: 3, 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: 13, 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: 4, 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: 3, 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: 4, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
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 Information Technology     Hybrid Journal   (Followers: 45, SJR: 1.659, h-index: 43)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 5)
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: 9, 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. Business Studies     Hybrid Journal   (Followers: 25, SJR: 4.835, h-index: 108)
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 Intl. Relations and Development     Hybrid Journal   (Followers: 19, SJR: 0.35, h-index: 15)
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: 2, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, 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 Marketing Analytics     Hybrid Journal   (Followers: 2)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, 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: 13, SJR: 1.042, h-index: 14)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 2)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 4, 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: 18, 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: 2, 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   (Followers: 1, SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, 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: 13, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, 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: 18, 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: 3, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 21)
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: 8, 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)

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Journal Cover European Surgery
  [SJR: 0.166]   [H-I: 13]   [4 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  [2335 journals]
  • Large bowel cancer in the setting of inflammatory bowel disease
    • Abstract: Summary Background Inflammatory bowel diseases (IBDs) are a well-known risk factor for the development of colorectal cancer (CRC). This risk relates to different aspects of the disease, such as the duration, activity, and extension, and tends to increase in the presence of associated conditions, such as family history of CRC or some extra-intestinal manifestations. Rectal cancer (RC) in IBD has been poorly investigated. Methods We reviewed the scientific literature for data on the features and management of RC in the setting of IBD. Here, we provide a practical insight into the diagnosis and management of the condition. Results Several genetic and environmental factors promote the development of CRC, including alterations of intestinal microflora and mutations in the genes responsible for the cell cycle and for DNA mismatch repair. Dysplasia is the main evidence of a clear conversion of normal epithelium to cancer. Dysplasia is often multifocal, in contrast to sporadic CRC, which explains the tendency toward the development of synchronous and metachronous CRC in patients with IBD. Other conditions that need attention are strictures, for which the threshold for surgery must be low. Treatment of RC in patients with IBD follows the same oncologic criteria as non-IBD-related RC, but patients are often diagnosed at more advanced stages, suggesting that this is frequently overlooked. This is ultimately associated with poorer outcomes in IBD patients. Conclusion There is a pressing need for more data on IBD-related RC. Implementing knowledge will result in optimization of survival for these patients.
      PubDate: 2016-07-18
  • Surgical use of fibrin glue-coated collagen patch for non-hemostatic
    • Abstract: Summary TachoSil and its predecessor products, TachoComb and TachoComb H, have been extensively used in a variety of multidisciplinary surgical settings since being introduced in the early 1990s. However, to date, TachoSil remains the first and only dual action patch for general tissue sealing and is frequently used in variety of surgical indications other than haemostasis. Classically, TachoSil is indicated for improvement of haemostasis. However, there is recently some evidence suggesting that it can be successfully used in promoting tissue healing, which could be useful in various non-hemostatic indications. TachoSil is safe and well tolerated, with occurrence of adverse events similar in TachoSil and non-TachoSil treated patients in controlled trials. The clinical implications of such an approach are obvious. Despite its cost, potential benefits could easily translate into cost savings due to avoidance of complications and to reduction of duration of hospital stay. Existing data are limited and further randomized controlled studies are needed to accurately establish the role of TachoSil for non-hemostatic indications in a variety of surgical indications, such as in abdominal and gastrointestinal surgery, pulmonary surgery, cardiothoracic surgery, renal surgery, gynecology, neurosurgery and more.
      PubDate: 2016-07-14
  • Advances in diagnosing GERD
    • Abstract: Summary Background This article aims to summarize the current technology available for evaluating esophageal function and gastroesophageal reflux disease (GERD), and to assess which of these examinations are necessary before antireflux surgery. Methods The Medline database was queried to identify relevant published information. Results Esophageal function testing is a useful adjunct to confirm or reject the diagnosis of GERD. Emerging technologies and new diagnostic methods may provide a better sensitivity in diagnosing GERD symptoms and could help in finding the right treatment for each patient. However, studies are needed to prove that these new tests truly add essential information. Conclusion Of the current available methods to identify the right treatment for each patient with symptoms of GERD, ambulatory reflux monitoring is still the most important one. Optimal preoperative diagnostic work-up for GERD should include pH testing along with upper endoscopy, barium esophagram, and manometry.
      PubDate: 2016-07-01
  • Role of needle core biopsy in patients presenting with a breast lump
           associated with trauma
    • Abstract: Summary Background Patients often present to the breast clinic with a lump following trauma to the breast. Routinely, triple assessment is performed on such patients. We investigated whether a proportion of them can be safely diagnosed on the basis of clinical and radiological assessment without the need for histological confirmation. Methods We prospectively assessed all patients with a history of trauma presenting to the breast clinic over a 5-year period. Results We included 135 patients, constituting 1 % of total patients seen. They were divided into two groups for analysis. Group A included patients with trauma-related pathologies (n = 70, 52 %), comprising 47 haematomas and 23 fat necrosis. This group had a higher proportion of anti-coagulant usage (20/70). Owing to concordant clinical and radiological benign features, core biopsy was only carried out in 16 cases (23 %). All patients in this group were followed up to confirm clinical and radiological resolution of findings with no case of delayed cancer diagnosis. Group B included patients with incidental pathologies (n = 65, 48 %), consisting of 23 cancers and 42 benign lesions. Comparatively fewer patients (13/65) were on anti-coagulants. They had a history of minimal trauma and mostly no bruising, but found a lump on self-examination. The 23 cancer patients in this group had prompt triple assessment and no delay in cancer treatment. Conclusion Triple assessment is vital in patients with suspicious clinical or radiological breast lesions. However, a core biopsy can be avoided in patients with a clear history of trauma with concordant clinical and radiological features and follow-up confirming complete resolution of findings.
      PubDate: 2016-06-24
  • Hepatic hydatid cysts
    • Abstract: Summary Background Hepatic hydatid cystic disease continues to be a serious health problem and is endemic in Iraq. There are of two types of cysts: noncomplicated and complicated cysts. Open surgery is widely practiced for both types. The aim of this study was to evaluate the clinical features, management, and outcome of surgical treatment in both types of cyst. Methods The study included 150 patients operated on between 1996 and 2014. The patients’ demographic data, location, number, size, type of cysts, surgical procedure performed, morbidity, recurrences, and duration of hospital stay were recorded. Results There were 102 female and 48 male patients with an age range of 4–70 years. There were more patients with noncomplicated cysts than complicated cysts – 94 and 56 patients, respectively. The complicated disease group had significantly more pronounced clinical presentations (p < 0.001) and higher postoperative morbidity (p < 0.001), and without significant change in recurrence rate (p = 0.059). Mean postoperative hospitalization time for noncomplicated cysts was 3.2 days, and for complicated cysts 5.6 days (p < 0.001). Conclusion The most common type of hydatid cyst is the noncomplicated type, which has lower complication rates and shorter hospital stay regardless of the management technique of the cyst cavity. Therefore, complicated and noncomplicated cysts should be considered as different forms of the disease entity with different outcomes.
      PubDate: 2016-06-22
  • Esophagectomy for eosinophilic esophagitis
    • Abstract: Summary Background Eosinophilic esophagitis (EoE) is a chronic allergen-driven disease in which eosinophilic infiltration of the esophagus results in fibrosis, causing symptoms of esophageal dysfunction. The natural history of EoE frequently results in progressive deterioration of patients’ quality of life. In selected cases, progressive manifestations of disease cannot be managed with the conventional treatment options, and patients therefore suffer from poor quality of life. Methods We present the case of a 27-year-old male patient whose therapy for long-standing EoE did not prevent his clinical deterioration, which in turn gradually led to worsening quality of life owing to the degree and extent of esophageal fibrosis-associated remodeling. The patient eventually underwent a combined thoracoscopic/laparoscopic esophagectomy as a last resort aimed at alleviating the severe esophageal dysfunction and poor quality of life that he experienced. Results The patient underwent a minimally invasive esophagectomy and recovered quickly, gaining weight as early as 4 weeks after surgery. The patient returned 5 months later complaining of dysphagia regarding solid food. Gastroscopy showed a mild anastomotic stenosis that was dilated to 18 mm. During follow-up, the patient gained 15 kg compared with his lowest body weight prior to surgery and has remained symptom free 2.5 years after his surgery. Conclusion Surgery can be considered as a last-resort option for managing the refractory manifestations of EoE and its complications.
      PubDate: 2016-06-21
  • The cleft lift procedure for complex pilonidal disease
    • Abstract: Summary Background The cleft lift procedure was introduced for the treatment of pilonidal sinus disease, with the aim of shifting the healing line off the midline. The aim of the present study is to provide a tuitional description of the cleft lift procedure for the treatment of complex pilonidal sinus disease. Methods After successful treatment of 40 cases of complex pilonidal disease, photographs recorded from the operations were reviewed and screened in order to present the indications, the key stages of the operation, the surgical variants, and the results. Results All of the procedures were performed as 1‑day surgery with no intraoperative complications. Partial wound dehiscence was experienced by 12.5 % of patients. No recurrence was observed after a mean follow-up of 21 months. Conclusion This technique is easy to learn and to perform, with minimal patient discomfort, limited in-patient stay, early recovery, and a good healing rate.
      PubDate: 2016-06-16
  • The importance of diagnostic awareness of groove pancreatitis
    • Abstract: Summary Background Groove pancreatitis is a form of focal chronic pancreatitis in the pancreatic tissue between the duodenal wall and the intrapancreatic portion of the common bile duct. Groove pancreatitis, paraduodenal pancreatitis, and duodenal dystrophy are regarded as synonyms by some authors whereas others use the term duodenal dystrophy. We aimed to review this rare entity and discuss its clinical features, diagnosis, and therapy. Methods We present a series of three cases of groove pancreatitis diagnosed at a tertiary medical center with a detailed review of the current medical literature. Results All patient were treated with conservative medical therapy, which consists of spasmolytic and analgesic therapy as well as antibiotic and enteral nutrition during hospitalization. Endoscopic drainage with endoscopic retrograde cholangiopancreatography (ERCP) was performed for two patients. No complications were observed after the ERCP procedure. Conclusion Groove pancreatitis can simulate, mask, or coexist with pancreatic carcinoma and it can be difficult to differentiate from adenocarcinoma. Clinical, radiological, and histological features may be helpful in making the differential diagnosis and should be keep in mind in the differential diagnosis of pancreatic head masses or duodenal wall stenosis.
      PubDate: 2016-06-16
  • Clinical and inflammatory response to first ileocolic resection for
           Crohn’s disease
    • Abstract: Summary Background The intention of the first ileocolic resection in Crohn’s disease is to remove local disease, which relieves symptoms of intestinal obstruction, but should also relieve clinically significant systemic inflammation and allow discontinuation of corticosteroids. Methods By means of five clinically relevant criteria for continued specific treatment, we evaluated the response of 117 patients to their first ileocolic resection for Crohn’s disease, which was undertaken at Karolinska University Hospital, Stockholm, Sweden, between 2000 and 2010. The five criteria were the persistence of systemic inflammation and continued or resumed corticosteroid therapy, high defecation frequency or presence of a stoma, and the need for new bowel surgery within 1 year. The presence of systemic inflammation and use of anti-inflammatory drugs were assessed 1 month preoperatively and 6–12 months after surgery. Other events of interest were assessed within 12 months. Results The median age was 31 years and 51 patients (44 %) were women. In all, 54 patients (46 %) were operated on within the first year of diagnosis and episodes of bowel obstruction were the prime surgical indication in 80 (68 %) patients. Of the patients, 100 (85 %) had an ileocolic resection and 17 (15 %) had terminal ileal surgery. As anticipated, C‑reactive protein (CRP), albumin, and hemoglobin concentrations all normalized significantly after surgery but 15 (13 %) patients still had CRP values of ≥ 30 mg/l and one fourth (29/117, 25 %) still used corticosteroids. Seventeen patients (15 %) had six or more defecations per day or a temporary stoma and four (3 %) patients had new surgery for symptomatic Crohn’s disease. Altogether, 46 (39 %) patients met one or more of the criteria for continued or renewed treatment within 1 year with a higher risk in patients with ileocolic disease as compared with ileal disease when adjusted for age and reoperation (p = 0.030). Conclusion The curable intention of the first ileocolic resection for Crohn’s disease often fails, as the need for continued or renewed medical or surgical treatment in the first year is high.
      PubDate: 2016-06-10
  • Application of modified small bladder patch-to-bladder double-layer
           sutures to improve renal transplantation in mice
    • Abstract: Summary Background This study aimed to introduce an improved surgical procedure to reduce the incidence of urinary tract complications after renal transplantation in mice using a modified bladder patch-to-bladder anastomosis technique. Methods Renal isotransplantation was performed in 28 male C57BL/6 mice. The urinary tract was reconstructed with a ureteral anastomosis between the donor’s small bladder patch and the recipient’s bladder. The bladder patch was secured through a cystotomy in the recipient’s bladder mucosa and seromuscular layers, which were sutured in a double-layer manner. The food intake and survival of mice were recorded for 100 days in addition to monitoring appearance, weight, and symptoms of pain. On post-transplantation day 7, the native kidney in the recipients was removed and the transplanted kidney assessed visually. Urine leakage from the transplanted graft was monitored by assessing the degree of ascites. Results The success rate of renal transplantation was 82 % (23 of 28 cases). Arterial thrombosis at the site of anastomosis occurred in 3 cases (11 %) and hemorrhagic shock in 2 cases (7 %). The mean ± SD time of the operation in recipients was 81 ± 5 min. No complications were noted in the successfully transplanted animals. Conclusions The modified procedure of a small bladder patch-to-bladder with double-layer suturing minimizes complications after renal transplantation in mice while requiring the same operating time as other approaches such as ureter to bladder anastomosis, which are associated with more complications.
      PubDate: 2016-06-09
  • Video-assisted mediastinoscopic removal of ectopic parathyroid adenoma
           combined with standard cervical exploration
    • Abstract: Summary Background Primary hyperparathyroidism (HPT) is one of the most common endocrine disorders. The standard treatment is surgical removal via a cervical incision. In rare cases, abnormal parathyroid tissue may be present in the mediastinum and therefore inaccessible through the standard incision. Case report A 57-year-old female presented in our clinic with high ionized calcium and high parathyroid hormone levels. A technetium-99m sestamibi scan showed a focal mass in the superior mediastinum. A single-stage cervical exploration and video-assisted mediastinoscopic (VAM) removal of the intrathoracic ectopic parathyroid adenoma was performed. Results Our approach proved to be successful. There were no surgical complications and the patient was discharged on postoperative day 2. Conclusion We suggest that in the case of occult mediastinal hyperfunctioning parathyroid tissue, a VAM is a valuable extension of the standard explorative neck surgery.
      PubDate: 2016-06-09
  • Morbidity and mortality of colorectal cancer surgery in octogenarians
    • Abstract: Summary Objectives The aim of this study was to determine common problems, preoperative assessment criteria, and postoperative morbidity and mortality of octogenarians with colorectal cancer. Materials and method We screened the medical records of patients aged 80 years or older (study group) and that of patients of 50–59 years of age (control group) who were operated for colon cancer. Demographic features, comorbidities, American Society of Anaesthesiologists (ASA) score, urgency of operation, tumor localization, presence of colostomy, duration of hospital stay, admission to and duration of stay in the intensive care unit (ICU), TNM (Tumor, Node, Metastasis) stage, postoperative morbidity, and mortality rates were recorded. Results The medical records of 23 patients aged above 80 years and 39 patients aged between 50–59 years were screened retrospectively. The two groups did not differ significantly with respect to the morbidity rate but the mortality rate was significantly higher in the study group (p = 0.583 and p = 0.016, respectively). The study group patients needed significantly more ostomy creation procedures. In the analysis of the octogenarian groups, the ASA score or the presence of comorbidities had no discernible effect on the morbidity and mortality rates. Conclusion Specific preoperative evaluations are needed for prediction of mortality risk in geriatric patients. Rational criteria for performing protective ostomy should also be determined in octogenarians.
      PubDate: 2016-06-08
  • Contribution of gallbladder polyp surgery to treatment
    • Abstract: Summary Background Surgery is the preferred treatment for gallbladder polyps, not only for relieving the symptoms but also for eliminating the potential risk of malignancy. In our study, we investigated whether patients who had undergone surgery truly had a surgical indication and beyond question required laparoscopic cholecystectomy due to malignancy. Materials and methods 185 patients who were prediagnosed with gallbladder polyps were operated in VKV American Hospital, Istanbul between January 2004 and July 2015. Retrospective data of all patients included patients’ age, gender, symptoms, preoperative ultrasonography, pathology reports, radiologic findings regarding the number and size of the polyps, and postoperative follow-up. Results 140 out of 185 patients were symptomatic before surgery. 85 patients (60.7 %) reported that their symptoms persisted after they had undergone surgery. 20 (14.3 %) of the patients with postoperatively persisting symptoms had no polyps in their pathologic examination. Only 35 out of 140 patients (25 %) reported relief of symptoms following surgery. Postoperative pathologic investigation revealed adenocarcinoma in only 1 patient and adenomatous polyps in 2 patients. Conclusion Postoperative pathologic investigations reveal only a very small percentage of premalignant and malignant polyps among patients who have undergone laparoscopic cholecystectomy. This finding clearly points out that we require new methods to differentiate cholesterol polyps from adenomatous polyps. Furthermore, the surgical indication criteria for patients with gall bladder polyps should be updated to prevent futile operations and morbidity.
      PubDate: 2016-06-07
  • Leadership in the 21st century
    • Abstract: Summary Background Leadership is considered important in academic health care systems and the demands on individual leaders are growing. Most often, leadership styles are self-taught by observation and practice. In the past, leadership was primarily defined by the tripod: research, patient care, and education. Beside the three traditional, tasks there is a business-oriented trend in health care, demanding an extreme diversity of abilities, e. g., skills in financial management, communication skills, conflict solving skills, networking, and rewarding skills. Integrating all these aspects to define the profile of a future chairperson has not been possible in the field of academic medicine. Methods A literature search for leadership in academic medicine was performed. In addition, the contributions to the conference “Chair4Medicine” were evaluated. Results Despite growing requirements for a leadership position, one essential property stayed the same over the years: a leader has to educate the next generation of surgeons and be a good motivator and inspiring teacher. Concerning education, surgery is facing a dilemma, displayed by a continuing decrease of applicants in surgical disciplines over the last years. Ten to 15 years ago, the number of applications for a surgical residency position was larger than the positions available. Today, this situation is clearly reversed, as indicated by a noticeable deficit in recruits. The decision to become a surgeon has become more and more unpopular. Reasons for this development are manifold, but often-mentioned causes are a lack of work–life balance, and a chaotic and non-inspiring training process combined with non-attractive leadership styles. Conclusions There is a need for defining objective criteria to identify a future chair in an academic medical center. If the ongoing trend of decreased applications in general surgery continues, we will face a lack of top-motivated surgeons in the close future. More than ever, leadership styles and centers have to rethink their way of teaching and define a new way of being “attractive” for young surgical residents to guarantee the succession of the next generation. Educational opportunities, a clearly structured curriculum, and a productive environment are assumed crucial prerequisites for the next generation. Objective guidelines and instruments for the improvement of education should be developed and implemented.
      PubDate: 2016-06-01
  • Young surgery: results of the survey among residents in Austria in 2015
    • Abstract: Summary Background The lack of doctors and the introduction of European Working Time Directive have influenced surgical training. Therefore, surgical training requires constant evaluation and development. Methods The Professional Association of Austrian surgeons (BÖC) and the Austrian Society of Surgery (ÖGC) carried out a survey via online survey software (Corporate Headquarters: QuestionPro Inc., San Francisco, USA). Results The survey was sent to 268 residents. Of these, 106 completed it. The response rate was thus 40.76 %. According to 73 % of the residents, there was no training structure or a rotation system at their training site. Only 38 % of the participants were satisfied with their surgical training. Conclusions The survey commissioned by the BÖC and the ÖGC showed that 73 % of residents in general surgery receive no structured surgical training.
      PubDate: 2016-06-01
  • Surgical residency in the United States–a personal European
    • Abstract: Summary Background Surgical education requires three things: dedication, mentorship, and exposure. This is true today as it was in 1878 when Dr. William Stewart Halsted travelled through Europe and returned to the United States (U.S.) to lay the ground stone for what would be the modern U.S. residency model. Methods This article is intended to help understand the evolution and current state of the U.S. residency model and is written through the lens of the first author who has trained in both systems. We hope to outline some key differences that we deem particularly interesting. Results Concrete lessons we can learn from the U.S. system are to abolish favoritism, enroll residents in formal training programs with a set start and finish date, consider implementing midlevel practitioners and establishing a steeper hierarchy within the residency itself. Conclusions The U.S. model, despite all its own inherent issues, has managed to balance the three ingredients of surgical education: dedication, mentorship, and exposure. Contrarily, in many European countries medical school is followed by years of uncertainty. With demographical and societal changes this deficiency has led to many potential young surgeons turning towards other specialties and industries.
      PubDate: 2016-06-01
  • Eine kurze Geschichte der Chirurgie in Österreich
    • PubDate: 2016-05-13
  • Surgical training under altered conditions
    • PubDate: 2016-05-12
  • Education in surgery: motivation counts
    • PubDate: 2016-05-11
  • What is needed for surgical training'
    • Abstract: Summary Surgical fields are renowned for being an interesting and attractive vocation on the one hand, but on the other they are afflicted with a notorious workload, poor work–life balance and a long training duration. This results in a noticeable scarcity of job applicants and trainees within the surgical fields per se. In order to tackle these circumstances, various surgical associations have formed task forces destined to cater for the needs and modern day challenges of young and aspiring surgeons. The CAJC (“Chirurgische Arbeitsgemeinschaft junger Chirurgen”/“surgical Working Group for Young Surgeons”) was created by the German Society for General and Visceral Surgery (DGAV) and is currently composed of approximately 120 members. Multiple workshops and joint discussions culminated in comprehensive and detailed recommendations on how precisely surgical training can be markedly improved in our hospitals. These suggestions were published on the website of the DGAV and parts of this essay “Weiterbildung to go”/“Training to go” are incorporated in this report.
      PubDate: 2016-05-11
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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Fax: +00 44 (0)131 4513327
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