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    10997 results match your criteria Annals of the Royal College of Surgeons of England[Journal]

    1 OF 220

    Day-case holmium laser enucleation of the prostate: feasibility, safety and predictive factors.
    Ann R Coll Surg Engl 2018 Mar 15:1-5. Epub 2018 Mar 15.
    Department of Urology, Southend University Hospital , Westcliff-on-Sea , UK.
    Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. Read More

    Biodynamic excisional skin tension lines for surgical excisions: untangling the science.
    Ann R Coll Surg Engl 2018 Mar 15:1-8. Epub 2018 Mar 15.
    University of Queensland, School of Medicine , Brisbane, Queensland , Australia.
    Objective There remains confusion between Langer's lines and wrinkle lines with respect to the optimal orientation of elliptical excisions on the trunk. This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. Read More

    Benefits of pre-emptive analgesia by local infiltration at day-case general anaesthetic open inguinal hernioplasty.
    Ann R Coll Surg Engl 2018 Mar 15:1-4. Epub 2018 Mar 15.
    Aneurin Bevan University Health Board , UK.
    Introduction The open prosthetic repair of inguinal hernias under local anaesthesia (LA) is well established, with the concept of intraoperative 'pre-emptive analgesia' evolving so that patients are as comfortable as possible. We used a peri-incisional LA solution in patients undergoing day-case inguinal hernioplasty under general anaesthesia (GA) and recorded use of analgesia in the immediate postoperative period. Methods In this observational cohort study, 100 consecutive unselected men underwent open inguinal hernia repair as a day case. Read More

    Successful endoscopic management of a persistent bronchobiliary fistula with Histoacryl/Lipiodolmixture.
    Ann R Coll Surg Engl 2018 Mar 15:e1-e5. Epub 2018 Mar 15.
    King's College Hospital NHS Foundation Trust , UK.
    Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis. Read More

    Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype.
    Ann R Coll Surg Engl 2018 Mar 15:1-6. Epub 2018 Mar 15.
    Division of Endocrine Surgery, National University Hospital , Singapore.
    Introduction The annual incidence of thyroid cancer is known to vary with geographic area, age and gender. The increasing incidence of thyroid cancer has been attributed to increase in detection of micropapillary subtype, among other factors. The aim of the study was to investigate time trends in the incidence of thyroid cancer in Singapore, an iodine-sufficient area. Read More

    Polymeric clips are a quicker and cheaper alternative to endoscopic ligatures for securing the appendiceal stump during laparoscopic appendicectomy.
    Ann R Coll Surg Engl 2018 Mar 15:1-5. Epub 2018 Mar 15.
    Department of General Surgery, NHS Tayside, Ninewells Hospital and Medical School , Dundee , UK.
    Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Read More

    Contributory factors in surgical incidents as delineated by a confidential reporting system.
    Ann R Coll Surg Engl 2018 Mar 15:1-5. Epub 2018 Mar 15.
    School of Psychology, Faculty of Medicine and Health, University of Leeds , Leeds , UK.
    Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Read More

    Intraspinal schwannoma and neurogenic bladder.
    Ann R Coll Surg Engl 2018 Mar 15:e1-e4. Epub 2018 Mar 15.
    Department of Surgery, Taipei Tzu Chi Hospital and Buddhist Tzu Chi University , Taiwan.
    Most lumbar intradural schwannomas present initially as radiculopathies with sensory disturbances. However, neurogenic bladder dysfunction may be one of the earliest manifestations and can cause long-term disability. We present the case of a patient with a L3-4 schwannoma (newly diagnosed owing to recurrent urinary retention and urinary tract infection) who finally underwent surgical resection. Read More

    Are we doing better? Barium enema reduction of intussusception.
    Ann R Coll Surg Engl 2018 Mar 15:1-4. Epub 2018 Mar 15.
    Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex , Champs Fleurs , Trinidad and Tobago.
    Introduction Intussuception remains one of the most common surgical abdominal emergencies in the paediatric population. The aim of this study was first to re-evaluate our non-operative reduction rate of intussusception using multiple interval barium enemas and second to investigate or discuss an audit cycle, providing evidence and validating the modification of clinical practice. Materials and methods This five-year retrospective study performed at one of two institutions at which a paediatric surgical service is offered. Read More

    Use of serum and peritoneal CEA and CA19-9 in prediction of peritoneal dissemination and survival of gastric adenocarcinoma patients: are they prognostic factors?
    Ann R Coll Surg Engl 2018 Mar 15:1-10. Epub 2018 Mar 15.
    Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University , Fatih, Istanbul , Turkey.
    Introduction To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. Materials and methods Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Read More

    The changing practice of transurethral resection of the prostate.
    Ann R Coll Surg Engl 2018 Mar 15:1-4. Epub 2018 Mar 15.
    York Teaching Hospital NHS Foundation Trust , UK.
    Introduction Transurethral resection of the prostate (TURP) is considered the gold standard surgical treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The number of TURPs performed has declined significantly over the last three decades owing to pharmaceutical therapy. TURP data from a single institution for the years 1990, 2000 and 2010 were compared to assess the difference in performance. Read More

    Postoperative monitoring of the free jejunal flap: use of colour duplex and systematic review of available techniques.
    Ann R Coll Surg Engl 2018 Mar 15:1-6. Epub 2018 Mar 15.
    Department of Plastic and Reconstructive Surgery, Barts Health NHS Trust, Royal London Hospital , London , UK.
    Introduction The free jejunal flap represents the gold standard for circumferential defects in upper digestive tract reconstruction. It is a technically demanding procedure with significant failure rates. Unrecognised failure leads to flap necrosis and potentially fatal sequelae, including sepsis and carotid artery bleed. Read More

    Ensuring patient safety when implementing a new diagnostic pathway for thyroid nodules.
    Ann R Coll Surg Engl 2018 Mar 15:1-5. Epub 2018 Mar 15.
    Ear, Nose and Throat Department, William Harvey Hospital, East Kent Hospitals University Foundation Trust, Willesborough , Ashford , UK.
    Introduction The aim of this study was to determine whether ultrasound alone is sufficient to safely exclude malignancy in thyroid nodules in a district general hospital setting, to comply with the latest British Thyroid Association guidelines. Methods This retrospective study investigated the quality of ultrasound reporting and the correlation between ultrasound report and histology for individual thyroid nodules. Cases were selected from the thyroid multidisciplinary meeting and included all patients having undergone surgery for a thyroid malignancy in a one-year period. Read More

    A case report of an angiomyxoma in the liver.
    Ann R Coll Surg Engl 2018 Mar 15:1-4. Epub 2018 Mar 15.
    Central Manchester University Hospitals NHS Foundation Trust , UK.
    Angiomyxomas are uncommon myxoid tumours arising most commonly from the pelvis. A 46-year-old woman with a history of polycystic kidney disease presented asymptomatically for surveillance ultrasonography; changes were noted in the size and morphology of her liver cysts. Subsequent radiological assessment displayed features suspicious of malignancy and a right hemihepatectomy was performed with curative intent. Read More

    Anaemia as a risk stratification tool for symptomatic patients referred via the two-week wait pathway for colorectal cancer.
    Ann R Coll Surg Engl 2018 Mar 15:1-7. Epub 2018 Mar 15.
    Non-author contributors: J Abercrombie, S Asgari, B Bharathan, R Briggs, H Edis, C Maxwell-Armstrong, K Mohiuddin, M Robinson, J Scholefield, K Thomas, K Walter, J Williams.
    Introduction Anaemia is associated with cancer. In 2014 a new form was introduced in our department requesting a haemoglobin (Hb) result on every two-week wait referral for suspected colorectal cancer (CRC). The aim of this study was to review the impact of this intervention. Read More

    Management of Paediatric Testicular Torsion - Are we adhering to Royal College of Surgeons (RCS) recommendations.
    Ann R Coll Surg Engl 2018 Mar 15:1-4. Epub 2018 Mar 15.
    Paediatric Surgery Department, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust , London , UK.
    Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Read More

    A cost-effective cell- and matrix-based minimally invasive single-stage chondroregenerative technique developed with validated vertical translation methodology.
    Ann R Coll Surg Engl 2018 Mar;100(3):240-246
    Department of Orthopaedic Surgery, College of Medicine, Catholic University of Korea , Gyeonggi-do , Republic of Korea.
    Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation. Read More

    A standardised pathway for the surveillance of stable vestibular schwannoma.
    Ann R Coll Surg Engl 2018 Mar;100(3):216-220
    King's College Hospital NHS Foundation Trust, UK , UK.
    Introduction Conservative management of patients with a stable vestibular schwannoma (VS) places a significant burden on National Health Service (NHS) resources and yet patients' surveillance management is often inconsistent. Our unit has developed a standardised pathway to guide surveillance imaging of patients with stable VS. In this article, we provide the basis for our imaging protocol by reviewing the measurement, natural history and growth patterns of VS, and we present a cost analysis of implementing the pathway both regionally and nationally. Read More

    Type II papillary renal cell carcinoma with heterotrophic ossification: a case report.
    Ann R Coll Surg Engl 2018 Mar;100(3):e49-e50
    Clinical Pathology , Agra , India.
    Heterotrophic ossification in tumours is an uncommon phenomenon. The presence of ossification in renal cell carcinomas is extremely rare. In this report, we present a unique case of type II papillary renal cell carcinoma associated with heterotrophic ossification. Read More

    The NORSe: changing the way we communicate.
    Ann R Coll Surg Engl 2018 Mar;100(3):161-164
    Kettering General Hospital , Kettering , UK.
    Introduction Rapid, reliable and efficient communication in healthcare systems with finite resources promises to improve patient care. Telephone engagement has effectively monopolised the referral process in the acute setting. Hence, traditional inter-hospital referral networks are potentially time consuming, not expeditious and frustrating. Read More

    Gastric liposarcoma in a patient with severe obesity.
    Ann R Coll Surg Engl 2018 Feb 27:e1-e3. Epub 2018 Feb 27.
    Department of Surgery, Riviera-Chablais Hospital , Monthey , Switzerland.
    Liposarcoma is the most common soft tissue sarcoma in adults. Predominant locations are the limbs and retroperitoneum. Intra-abdominal liposarcoma represents only 2% of all cases and visceral location is exceptional. Read More

    Laparoscopic cholecystectomy: a prospective cohort study assessing the impact of grade of operating surgeon on operative time and 30-day morbidity.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):178-184. Epub 2018 Feb 27.
    Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust , Birmingham , UK.
    Introduction There is an increasing trend towards day case surgery for uncomplicated gallstone disease. The challenges of maximising training opportunities are well recognised by surgical trainees and the need to demonstrate timely progression of competencies is essential. Laparoscopic cholecystectomy provides the potential for excellent trainee learning opportunities. Read More

    Risk stratification of 282 differentiated thyroid cancers found incidentally in 1369 total thyroidectomies according to the 2015 ATA guidelines; implications for management and treatment.
    Ann R Coll Surg Engl 2018 Feb 27:1-6. Epub 2018 Feb 27.
    First Department of General Surgery and Transplantation, 'Evangelismos' General Hospital , Athens , Greece.
    Introduction The purpose of this study was to evaluate the incidence of incidental differentiated thyroid carcinoma in thyroid operations for a benign preoperative diagnosis, to identify the risk factors involved and to risk stratify the cancer patients according to the 2015 American Thyroid Association (ATA) guidelines. Materials and methods The study was a retrospective review of all thyroidectomy operations performed in a single institution (January 2004 to January 2009). We excluded patients with a preoperative diagnosis of thyroid malignancy. Read More

    Hartmann's procedure, reversal and rate of stoma-free survival.
    Ann R Coll Surg Engl 2018 Feb 27:1-7. Epub 2018 Feb 27.
    Department of Colorectal Surgery, Good Hope Hospital, Sutton Coldfield , Birmingham , UK.
    Background Hartmann's procedure is a commonly performed operation for complicated left colon diverticulitis or malignancy. The timing for reversal of Hartmann's is not well defined as it is technically challenging and carries a high complication rate. Methods This study is a retrospective audit of all patients who underwent Hartmann's procedure between 2008 and 2014. Read More

    Synchronous subcutaneous granular cell tumours, a rare presentation.
    Ann R Coll Surg Engl 2018 Feb 27:e1-e3. Epub 2018 Feb 27.
    Department of Surgical Oncology, Fox Chase Cancer Center , Philadelphia, PA , United States.
    We describe a unique presentation of a rare disease presentation of a granular cell tumour. A 36-year-old woman presents with a large symptomatic left flank mass that had been slowly increasing in size. Multiple synchronous subcutaneous masses were found at presentation on the left breast, right auricle and right cheek. Read More

    Early outcomes of patients transferred with ruptured suprarenal aneurysm or dissection.
    Ann R Coll Surg Engl 2018 Feb 27:1-6. Epub 2018 Feb 27.
    Vascular Surgery Unit, Imperial Healthcare NHS Trust , London , UK.
    Objective Despite centralisation of the provision of vascular care, not all areas in England and Wales are able to offer emergency treatment for patients with acute conditions affecting the aorta proximal to the renal arteries. While cardiothoracic centres have made network arrangements to coordinate care for the repair of type A dissections, a similar plan for vascular care is lacking. This study investigates early outcomes in patients with ruptured suprarenal aortic aneurysm or dissection (rSRAD) transferred to a specialist centre. Read More

    The use of a novel adhesive tissue patch as an aid to anastomotic healing.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):230-234. Epub 2018 Feb 27.
    York Teaching Hospital NHS Foundation Trust , UK.
    Introduction One of the most feared complications of colorectal surgery is anastomotic leak. Numerous techniques have been studied in the hope of decreasing leakage. This study was designed to assess the handling characteristics of a novel adhesive tissue patch (TissuePatch™; Tissuemed, Leeds, UK) applied to colorectal anastomoses in a pilot study. Read More

    The spectrum and outcome of blunt trauma related enteric hollow visceral injury.
    Ann R Coll Surg Engl 2018 Feb 27:1-6. Epub 2018 Feb 27.
    University of Kwa Zulu-Natal , Pietermaritzburg , South Africa.
    Introduction This audit focused on patients who sustained enteric injury following blunt abdominal trauma. Methods Our prospectively maintained electronic registry was interrogated retrospectively, and all patients who had sustained blunt abdominal trauma between December 2011 and January 2016 were identified. Results Overall, 2,045 patients had sustained blunt abdominal trauma during the period under review. Read More

    Ductal carcinoma in-situ arising within benign phyllodes tumours.
    Ann R Coll Surg Engl 2018 Feb 27:1-6. Epub 2018 Feb 27.
    Division of Breast Surgery, Department of Surgery, National University Health System , Singapore.
    Ductal carcinoma in situ arising within a benign phyllodes tumour is a rare neoplasm of the breast. We present a case of a 19-year-old woman who had a right breast lump for six months with the above diagnosis together with a mini-review of the literature. Ultrasound revealed a 5-cm breast lump and core biopsy revealed ductal carcinoma in situ. Read More

    The surgical arrest of post-tonsillectomy haemorrhage: Hospital Episode Statistics 12 years on.
    Ann R Coll Surg Engl 2018 Feb 27:1-3. Epub 2018 Feb 27.
    Gloucester Royal Hospital , Gloucester , UK.
    Introduction The risk of returning to theatre for arrest of haemorrhage following tonsillectomy can be determined from analysis of the Hospital Episode Statistics data provided by the Department of Health website. This method was employed previously for data between 1998-2002 and was repeated in this study to observe any changes over this time period. Materials and methods Hospital Episode Statistics data for England from 2010-2016 were used. Read More

    A comparison of operative and margin outcomes from surgeon learning curves in robot assisted radical prostatectomy in a changing referral practice.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):226-229. Epub 2018 Feb 27.
    Cambridge University Hospitals NHS Foundation Trust , UK.
    Introduction The aim of this study was to explore the impact of increasing proportions of high risk referrals on surgical margin outcomes of a surgeon's learning curve in robotic prostatectomy. Methods All patients in this study underwent robot assisted radical prostatectomy (RARP) performed by three different consultant urological surgeons. Data collected included preoperative clinical stage, Gleason score and prostate specific antigen levels, which were used to risk stratify patients according to National Institute for Health and Care Excellence criteria. Read More

    Routine blood group and antibody screening prior to emergency laparoscopy.
    Ann R Coll Surg Engl 2018 Feb 27:1-4. Epub 2018 Feb 27.
    Dudley Group NHS Foundation Trust , UK.
    Introduction Studies show that rates of blood transfusion associated with general surgical laparoscopy are low. Currently, there are no national guidelines in the UK regarding blood group and antibody screening (G&S) for patients undergoing emergency laparoscopy. The aim of this study was to assess whether using G&S before emergency laparoscopic general surgery routinely is worthwhile by identifying rates of perioperative transfusion. Read More

    Bowel obstruction caused by broad ligament hernia sucessfully repaired by laparoscopy.
    Ann R Coll Surg Engl 2018 Feb 27:e1-e3. Epub 2018 Feb 27.
    Department of Surgery, Erfan Hospital , Tehran , Iron.
    Internal hernais are rare bowel obstructions. We present a case of small bowel obstruction in a 37-year-old woman caused by internal herniation through a defect in broad ligament, which was managed by laparoscopic surgery. Read More

    Massive intussusception caused by a solitary Peutz-Jeghers type hamartomatous polyp.
    Ann R Coll Surg Engl 2018 Feb 27:e1-e3. Epub 2018 Feb 27.
    Surgical Department, General Hospital of Agrinio , Agrinio, Aitoloakarnania , Greece.
    Intussusception is a rare cause of intestinal obstruction in adults and represents a diagnostic challenge for the surgeon. In the majority of cases, presenting symptoms are not specific, making preoperative diagnosis difficult. Several medical conditions may cause intestinal intussusception. Read More

    Gastric lipoma: a rare cause of haematemesis.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):e41-e43. Epub 2018 Feb 27.
    Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
    Gastric lipomas are rare benign tumours of the stomach, representing less than 3% of all benign gastric neoplasms. They are usually asymptomatic but larger lesions can present with abdominal pain, gastric outlet obstruction and haematemesis. Malignant transformation is extremely rare. Read More

    Giant central lumbar disc herniations: a case for the transdural approach.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):e53-e56. Epub 2018 Feb 27.
    Neurosurgical Department, Atkinson Morley Wing, St George's Hospital , London , UK.
    Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscectomy technique. This is the first report to date of a giant central L3/4 disc protrusion being successfully treated through a transdural microdiscectomy approach. Read More

    Cervical tuberculous lymphadenitis: diagnosis and demographics, a five-year case series in the UK.
    Ann R Coll Surg Engl 2018 Feb 27:1-5. Epub 2018 Feb 27.
    Ear Nose and Throat Department, Milton Keynes Hospital , Eaglestone, Milton Keynes , UK.
    Introduction Cervical tuberculous lymphadenitis is a low-volume condition in the UK with a potential for delayed diagnosis. This study describes typical demographic and clinical features of patients diagnosed with cervical tuberculous lymphadenitis in a UK population. The utility of cytological, histological and microbiological investigations is reviewed with comparison between fine-needle aspiration and open biopsy. Read More

    Comparison of gait kinetics in total and unicondylar knee replacement surgery.
    Ann R Coll Surg Engl 2018 Feb 27:1-8. Epub 2018 Feb 27.
    Department of Orthopaedics, TORT Centre, Ninewells Hospital, University of Dundee , Dundee , UK.
    Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Read More

    Is sarcopenia a useful predictor of outcome in patients after emergency laparotomy? A study using the NELA database.
    Ann R Coll Surg Engl 2018 Feb 27:1-5. Epub 2018 Feb 27.
    Combined Gastroenterology Research Unit, Scarborough General Hospital , Scarborough , UK.
    Introduction Studies have reported on the use of frailty as a prognostic indicator in patients undergoing elective surgery. Similar data do not exist for patients undergoing emergency surgery. The aim of this study was to evaluate the effect of preoperative sarcopenia measured by computed tomography (CT) on outcome following emergency laparotomy. Read More

    Giant gastrointestinal stromal tumour of the stomach: a case report with surgical treatment.
    Ann R Coll Surg Engl 2018 Mar 27;100(3):e46-e48. Epub 2018 Feb 27.
    Department of Hepatobiliary Surgery, Tianjin Third Central Hospital , Tianjin , China.
    We report a case of giant gastrointestinal stromal tumour of the stomach in a 71-year-old woman, with emphasis on its going through surgical resection. The physical examination and radiological findings revealed that a giant mass occupied most of the abdominal cavity. The patient underwent an en-block resection of the mass, partial resection of the distal stomach and Billroth II gastrojejunostomy. Read More

    The infraclavicular approach for Paget-Schroetter syndrome.
    Ann R Coll Surg Engl 2018 Feb;100(2):83-91
    Cardiff and Vale University Health Board , UK.
    Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. Read More

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