JournalTOCs

Archives of Surgery and Clinical Research
Number of Followers: 1

This is an Open Access Journal

Open Access journal
ISSN (Online) 2576-9537
Published by Heighten Science Publication Corporation

[23 journals]

The Predictive Value of Diaphragm Thickness Fraction on Postoperative
Pulmonary Complications after Digestive Cancer Curative Surgery
- Authors: Oussama Ssouni*; Abdelilah Ghannam, Brahim El-Ahmadi, Zakaria Belkhadir, Khalid Abidi, Amal Bouziane, Redouane Abouqal
  Abstract: Background: Postoperative Pulmonary Complications (PPCs) escalate mortality, hospitalization, and costs. This study aimed to predict PPCs after curative digestive cancer surgery using thickness fraction (TFdi) determined by ultrasonography. Methods: A prospective study was conducted over a period of 9 months. Diaphragmatic ultrasound was performed pre-surgery and repeated postoperatively (within 24 hours of ICU admission, then day 3). Right and left hemidiaphragm thickness at end-expiration (TEE) and peak-inspiration (TPI) were measured using ultrasonography. The maximal diaphragm thickening fraction during inspiration (TFdi,max) was calculated: TFdi,max = (TPI–TEE)/TEE. Patients were classified into No-PPCs and PPCs groups. Results: 159 patients participated, 55 (34.6%) developed PPCs. ICU stay was longer in PPCs patients with more deaths. TFdi,max decreased postoperatively and remained lower in PPCs patients [44.83% ± 11.07 vs. 31.54% ± 8.45; p < 0.001]. The receiver operating characteristic curve yielded an area under the curve of 0.83 [95% IC: 0.754 – 0.887]. TFdi,max < 37% had 72.7% sensitivity (95% IC: 59.0% – 83.8%) and 80.8% specificity (95% IC: 71.8% – 87.8%), Positive and negative Likelihood Ratios were 3.7 (95% IC: 2.4 – 5.7) and 0.3 (95% IC:0.2 – 0.5), respectively. In multiple logistic regression, preoperative risk factors for PPCs included TFdi,max < 37% [OR: 7.10; 95% CI: 1.71 – 18.60; p < 0.001] and supramesocolic surgery [OR: 9.94; 95% CI: 3.62 – 27.29; p < 0.001]. Epidural administration was protective [OR: 0.21; 95% CI: 0.052 – 0.87; p = 0.031]. Conclusion: A low preoperative TFdi,max identifies high-risk PPCs patients after digestive cancer surgery, aiding targeted preventive strategies like inspiratory muscle preoperative training.
  PubDate: 2023-08-14 12:19:51
Extracorporeal Membrane Oxygenation in Acute Aluminum Phosphide (AlP)
Poisoning
- Authors: Oussama Ssouni*; Latifa Oualili, Tarek Dendane, Amine Ali Zeggwagh, Khalid Abidi
  Abstract: Introduction: Aluminum Phosphide (AlP) poisoning is a life-threatening condition that commonly occurs in developing countries, often resulting in cardiac, respiratory, and metabolic complications, leading to multi-organ failure and mortality. Extracorporeal Membrane Oxygenation (ECMO) has been proposed as a potential therapy for severe AlP poisoning cases refractory to conventional management, though its use remains controversial. Methodology: for this literature review, we conducted a comprehensive analysis of existing literature concerning the utilization of ECMO in patients with severe AlP poisoning. We meticulously examined available publications to explore the relationship between ECMO initiation and patient outcomes. Discussion: The review reveals that early ECMO initiation within 6 hours of presentation is associated with better outcomes and higher survival rates in severe AlP poisoning cases. However, uncertainties persist regarding the optimal timing and duration of ECMO support, and potential complications, including bleeding, acute renal injury, and ventilator-associated pneumonia, need careful consideration. Conclusion: Despite promising results in certain cases, the risks and benefits of ECMO in AlP poisoning require meticulous evaluation. Ethical considerations, encompassing resource allocation and implications for other patients, necessitate appropriate patient selection criteria.
  PubDate: 2023-07-28 17:20:32
Review Article on the All-On-Four Treatment Concept in Dental
Implants
- Authors: Vladimir Soyfer*
  Abstract: Edentulism, a condition characterized by the absence of teeth, significantly impacts facial aesthetics, eating efficiency, and speech fluency, thereby diminishing the quality of life. This paper aims to explore the All-On-Four Treatment Concept in Dental Implants, a promising solution to this issue. The All-On-Four approach, though complex, offers a pathway to restore smile and functionality by using four strategically positioned implants to hold a temporary prosthesis. This prosthesis is later replaced by a permanent version after approximately four months. This swift oral restoration technique significantly enhances a patient’s self-confidence and overall life quality. The significance of this treatment lies in its potential to provide a less invasive and more affordable solution for severe jawbone atrophy, where the proximity of critical anatomical structures and compromised bone conditions may hinder other prosthetic solutions. The paper concludes with a discussion on the potential of the All-On-Four treatment to revolutionize dental implant procedures, offering a beacon of hope for individuals suffering from edentulism.
  PubDate: 2023-07-19 17:08:15
Results of a prospective strategy for focused Minimally Invasive
Parathyroidectomy (MIP)
- Authors: Rosyli Reveron-Thornton; Jeffrey Norton*
  Abstract: Neck exploration for primary HPT is the standard operation in which 4 parathyroid glands are identified and one abnormal parathyroid gland is removed. This is recommended for all patients with primary HPT. We hypothesized that most patients with primary HPT have a single abnormal parathyroid gland (adenoma) and parathyroid imaging studies will identify it and support a focused minimally invasive parathyroidectomy (MIP). This can be combined with ioPTH monitoring making bilateral exploration unnecessary. This paper reports a 93.4% success rate in 249 consecutive prospective patients with primary HPT over a 15-year period with a short operating time and few complications. The findings suggest that this alternate surgical MIP approach should be the procedure of choice for HPT patients.
  PubDate: 2023-05-03 16:39:13
Single brain metastasis as onset of stage I endometrial carcinoma in
patient affected by multiple sclerosis: the first case in literature
- Authors: Marco Marinaccio*; Clark Christopher, Porfido Valeria, Carmen Zaza, Giovanni Falcicchio, Roberta Pellicciari, Maria Luigia Mastronardi, Alessia Giannoccaro, Miriam Dellino, Ettore Cicinelli
  Abstract: Brain metastases in any gynecological cancer are a rare occurrence. Even more so, it is extremely rare for a gynecological malignancy to manifest itself with symptoms indicative of cerebral involvement. Literature regarding the association between MS and cancer is conflicting. We herein report a rare presentation of single metastasis of endometrial carcinoma in a 59-year-old woman affected by Primary Progressive Multiple Sclerosis (PPMS). A head CT scan was performed, which revealed the presence of an expansive lesion in the left parietal region. After careful assessment, a high-grade endometrial carcinoma was diagnosed and a decision was made to remove both the primary lesion and the brain metastasis in one sitting, through a conjoined surgery session involving neurosurgeons and gynecologists. The postoperative course was free from complications up until a few days after being transferred to a rehabilitation center, where she died following respiratory complications.
  PubDate: 2023-04-25 17:40:01
A case of true hermaphroditism: presenting as congenital bilateral
inguinal hernia
- Authors: Sherrin Jacob; Charanjeet Ahluwalia
  Abstract: True hermaphroditism (TH) is a cause of intersexuality in which both ovarian and testicular tissue is present in the same individual [1]. The gonadal distribution in cases of true hermaphroditism varies from [2]
  PubDate: 2023-03-20 17:30:09