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Subtrochanteric femoral fracture with postoperative chronic osteomyelitis treated successfully by 1-stage operation: a case report.

Ann Transl Med 2021 Mar;9(6):514

Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Chronic osteomyelitis is a chronic infectious disease of bone tissue, which can cause necrosis of bone and surrounding soft tissue, and is a common complication of open fracture, internal fixation, diabetic foot and blood-borne bone infection. Traumatic osteomyelitis is caused by bone tissue infection after open fracture surgery or open reduction of fracture or other bone and joint surgery. The lesion is near the fracture end. Read More

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Wire fracture in postoperative Nuss procedure: a problem that cannot be ignored.

Transl Pediatr 2021 Mar;10(3):569-578

Department of pediatrics, Chongqing University Three Gorges Hospital, Chongqing, China.

Background: Surgical stainless wire has been widely used to stabilize pectus bar and ribs in Nuss procedure for pectus excavatum correction. However, wire fracture and its secondary complications are problems easily to be ignored but very important. The purpose of this article was to describe a series of cases with wire breakage, hoping to arouse the attention of worldwide thoracic surgeons to this potential threat, and to share our modifications on the fixation patterns and materials in Nuss procedure. Read More

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Can extended upper pole ureterectomy prevent ureteral stump syndrome after proximal approach for duplex kidneys?

Int Braz J Urol 2021 Jul-Aug;47(4):821-826

Unidade de Urologia Pediátrica, Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil.

Introduction: Symptomatic duplex kidneys usually present with recurrent urinary tract infection due to ureteral obstruction (megaureter, ureterocele or ectopic ureter) and/or vesicoureteral reflux. Upper-pole nephrectomy is a widely accepted procedure to correct symptomatic duplex systems with poor functioning moieties, also known as upper or proximal approach. The distal ureteral stump syndrome (DUSS) can be a late complication of this approach. Read More

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Clinical outcomes and complications of surgical interventions for multiple myeloma lesions in the extremities and pelvis: A retrospective clinical study.

Acta Orthop Traumatol Turc 2021 Mar;55(2):159-165

Department of Orthopaedic Surgery and Traumatology, Marmara University, School of Medicine, İstanbul, Turkey.

Objective: This study aimed to assess the pain and functional status of patients who underwent various surgical interventions for the stabilization of selected multiple myeloma (MM) lesions in the extremities and pelvis and to investigate the rate of complications requiring reintervention.

Methods: Patients with MM who underwent various surgical interventions for the extremity or pelvic lesions were retrospectively reviewed. Change in the pain intensity was assessed using visual analogous scale (VAS) preoperatively, at the time of discharge, and at the final follow-up. Read More

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[Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: 5 years of experience in Italy].

G Ital Cardiol (Rome) 2021 Mar;22(3):5-11

U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, Bologna - Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna.

Background: Balloon pulmonary angioplasty (BPA) represents a therapeutic option for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in patients who are not eligible for surgical pulmonary endarterectomy (PEA) or with persistent/recurrent symptomatic pulmonary arterial hypertension after PEA. This study evaluated the safety of BPA during 5 years of experience of the only Italian center systematically performing this procedure.

Methods: The BPA program was activated at the S. Read More

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Reduction in postoperative complications by robotic surgery: a case-control study of robotic versus conventional laparoscopic surgery for gastric cancer.

Surg Endosc 2021 Apr 12. Epub 2021 Apr 12.

Gastric Surgery Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan.

Background: Robotic gastrectomy (RG) is being increasingly performed globally; it is considered an evolved type of conventional laparoscopic surgery with excellent dexterity and precision, but higher costs and longer operation time. Thus, there is a need to identify the benefits from RG and its specific candidates.

Methods: This retrospective study analyzed data from a prospectively collected clinical database at our center. Read More

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Incidence, Risk Factors and Impact on Long-Term Outcome of Postoperative Delirium After Transcatheter Aortic Valve Replacement.

Front Cardiovasc Med 2021 26;8:645724. Epub 2021 Mar 26.

General and Interventional Cardiology, Heart and Diabetes Centre Nordrhein-Westfalen, Bad Oeynhausen, Germany.

The aim of the present study was to analyze incidence, risk factors, and association with long-term outcome of postoperative delirium (POD) after transcatheter aortic valve replacement (TAVR). Six hundred and sixty one consecutive patients undergoing TAVR were prospectively enrolled from January 2016 to December 2017. POD was assessed regularly during ICU-stay using the CAM-ICU test. Read More

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Novel interventional radiological management for lymphatic leakages after gynecologic surgery: lymphangiography and embolization.

Gland Surg 2021 Mar;10(3):1260-1267

Department of Radiology, Seoul National University Hospital, Seoul, Korea.

Post-operative lymphatic leakage is a common complication of a radical gynecologic surgery involving aggressive lymph node dissection. Its manifestation varies from asymptomatic lymphoceles to life-threatening chylous ascites. In the past, nuclear medicine lymphoscintigraphy was the sole imaging modality for the confirmation of the leakage, of which application is limited due to its poor spatial resolution. Read More

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Development and Validation of a Risk Score for Respiratory Failure After Cardiac Surgery.

Ann Thorac Surg 2021 Apr 8. Epub 2021 Apr 8.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital; Department of Cardiovascular Surgery, Houston Methodist Hospital.

Background: Postoperative respiratory failure, defined as ventilator dependency for more than 48 hours or unplanned reintubation within 30 days, is a costly complication of cardiac surgery that increases mortality and length of stay. Stratification of patients by risk upon intensive care unit admission could identify cases requiring early measures to prevent respiratory failure. This study aimed to develop and validate a risk score for postoperative respiratory failure after cardiac surgery. Read More

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What is the reality in epigastric hernia repair?-a trend analysis from the Herniamed Registry.

Hernia 2021 Apr 10. Epub 2021 Apr 10.

Pius Hospital, Department of General and Visceral Surgery, University Hospital of Visceral Surgery, Georgstrasse 12, 26121, Oldenburg, Germany.

Introduction: The proportion of epigastric hernias in the total collective of all operated abdominal wall hernias is 3.6-6.9%. Read More

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Risk of early complication following anterior vertebral body tethering for idiopathic scoliosis.

Spine Deform 2021 Apr 9. Epub 2021 Apr 9.

Division of Orthopaedic Surgery, Department of Surgery, IWK Health Center, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K-6R8, Canada.

Purpose: The purpose of this study was to determine peri-operative morbidity associated with anterior vertebral body tethering (aVBT) for idiopathic scoliosis.

Method: Of 175 patients treated with aVBT, 120 patients had 2 year follow up and were included in this study. Prospectively collected clinical and radiographic data was analyzed retrospectively. Read More

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Sinusoidal Obstruction Syndrome in Critically Ill Patients in the Era of Defibrotide: A Retrospective Multicenter Study.

Transplant Cell Ther 2021 Apr 17;27(4):338.e1-338.e7. Epub 2020 Dec 17.

Medical Intensive Care Unit, Saint Louis Hospital, Paris, France.

Sinusoidal obstruction syndrome (SOS) is a life-threatening liver complication of high- dose chemotherapy. Defibrotide is the only available therapeutic option approved for SOS. The prognosis of SOS in patients requiring intensive care unit (ICU) admission remains unknown. Read More

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Characterizing Immune-Mediated Cytopenias After Allogeneic Hematopoietic Cell Transplantation for Pediatric Nonmalignant Disorders.

Transplant Cell Ther 2021 Apr 20;27(4):316.e1-316.e8. Epub 2021 Jan 20.

University of Minnesota, Department of Pediatric Blood and Marrow Transplant; Minneapolis, MN, USA. Electronic address:

Immune-mediated cytopenias (IMC)-isolated or combined hemolytic anemia, thrombocytopenia, or neutropenia-are increasingly recognized as serious complications after allogeneic hematopoietic cell transplantation (HCT) for nonmalignant disorders (NMD). However, IMC incidence, duration, response to therapy, and risk factors are not well defined. This retrospective chart review identified cases of IMC with serologic confirmation among patients who underwent HCT for NMD at a single institution between 2010 and 2017. Read More

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Transhiatal Migration After Laparoscopic Sleeve Gastrectomy: Myth or Reality? A Multicenter, Retrospective Study on the Incidence and Clinical Impact.

Obes Surg 2021 Apr 9. Epub 2021 Apr 9.

Division of General Surgery & Bariatric Center of Excellence-IFSO EC, Department of Medico- Surgical Sciences and Biotechnologies, "La Sapienza" University of Rome, Rome, Italy.

Purpose: Only anecdotally reported, intrathoracic migration (ITM) represents an unacknowledged complication after sleeve gastrectomy (LSG) contributing to gastroesophageal reflux disease (GERD) development, both recurrent and de novo. The primary endpoint of this study was to evaluate the incidence of postoperative ITM ≥ 2 cm; the secondary endpoint was to determine the relationships between ITM, GERD, endoscopic findings, and percentage of patients requiring surgical revision.

Materials And Methods: A retrospective, multicenter study on prospective databases was conducted, analyzing LSGs performed between 2013 and 2018. Read More

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Utilization of a Newly Designed Asymmetric Dorsal Gull Wing Flap for the Treatment of Postoperative Web Creep After Syndactyly Surgery.

Ann Plast Surg 2021 Apr 5. Epub 2021 Apr 5.

From the Department of Burns and Plastic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China.

Background: Web creep is the most common long-term complication requiring revision after syndactyly surgery; however, few methods have been reported. The aim of this study was to introduce a newly designed asymmetric dorsal gull wing flap to reconstruct web for the postoperative web creep.

Methods: A retrospective analysis was performed for 20 patients from January 2016 to May 2019. Read More

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Chronic endogenous fungal endophthalmitis: diagnostic and treatment challenges: A case report.

Medicine (Baltimore) 2021 Apr;100(14):e25459

Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia.

Rationale: Endogenous fungal endophthalmitis (EFE) is a sight-threatening complication of systemic fungemia. As the prevalence rises, treatment remains a challenge especially when there is a failure in first-line treatment or drug-resistant fungus. This case report studies a case of chronic EFE, focusing on the diagnostic procedures, treatment options, monitoring parameters and the treatment outcome. Read More

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To drain or not to drain following carotid endarterectomy: a systematic review and meta-analysis.

J Cardiovasc Surg (Torino) 2021 Apr 8. Epub 2021 Apr 8.

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Universitary Teaching Hospital, Varese, Italy.

Introduction: A postoperative neck hematoma can be a life-threatening complication after carotid endarterectomy necessitating urgent surgical decompression to avoid airway compromise. The practice of routine incisional drain placement is variable with few published studies evaluating the "to drain versus not to drain" approach. We conducted a systematic review and meta-analysis of the safety and efficacy of neck drain placement for prevention of neck hematoma requiring re-exploration for decompression. Read More

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Staple-line reinforcement using barbed sutures in 1008 sleeve gastrectomies.

Langenbecks Arch Surg 2021 Apr 7. Epub 2021 Apr 7.

İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center, Hakkı Yeten Cad, Yeşil Çimen Sok, Polat Tower, No:12/407, Şişli, 34394, İstanbul, Turkey.

Purpose: Among various staple-line reinforcement methods applied during sleeve gastrectomy (SG), although data on full-thickness-continuous-suturing (FTCS) is nearly nil, it has been considered as potentially harmful. The safety/efficacy profile of FTCS is assessed.

Methods: All consecutive SGs completing 3-month follow-up were studied. Read More

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The Success Rate of Endotracheal Intubation in the Emergency Department of Tertiary Care Hospital in Ethiopia, One-Year Retrospective Study.

Emerg Med Int 2021 19;2021:9590859. Epub 2021 Mar 19.

Department of Emergency Medicine and Critical Care, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Background: Emergency medical care starts with airway assessment and intervention management. Endotracheal intubation is the definitive airway management in the emergency department (ED) for patients requiring a definitive airway. Successful first pass is recommended as the main objective of emergency intubation. Read More

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Group A Streptococcus necrotising myositis of the limbs secondary to cavitating pneumonia.

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Cardiothoracic Surgery, NHS Lothian, Edinburgh, UK.

Necrotising myositis is a rare complication of Group A Streptococcus infection requiring early and aggressive surgical management to prevent mortality. However, early diagnosis is difficult due to non-specific initial presentation and a low index of clinical suspicion given the paucity of cases. We highlight these challenges and present a case of a 22-year-old woman presenting with cough, fever and severe limb pain refractory to analgesia during the COVID-19 pandemic. Read More

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Single center experience with ultrasound guided axillary vein port placement.

J Vasc Access 2021 Apr 8:11297298211008094. Epub 2021 Apr 8.

Department of Radiology, Boston Medical Center, Boston, MA, USA.

Purpose: To retrospectively review a single institution experience of ultrasound guided axillary vein port placement.

Methods: In this retrospective study, a patient list was generated after searching our internal database from 1/1/2012 to 10/1/2018. Patients who had undergone axillary vein port placement were included. Read More

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Intraperitoneal Ultrasound-Guided Safe Laparoscopic Fenestration of Lymphocele After Kidney Transplantation.

J Laparoendosc Adv Surg Tech A 2021 Apr 6. Epub 2021 Apr 6.

Department of General Surgery and Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Lymphocele is a common complication after kidney transplantation, which does not require treatment unless it is symptomatic. In this study, we aimed to evaluate the incidence, clinical symptoms, treatment choices, and success of different treatment methods of symptomatic lymphocele. We evaluated 168 patients who had kidney transplantation between January 2012 and January 2020. Read More

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Predictors of appropriate shock after generator replacement in patients with an implantable cardioverter defibrillator.

Pacing Clin Electrophysiol 2021 Apr 7. Epub 2021 Apr 7.

Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Background: Implantable Cardioverter Defibrillators (ICDs) are indicated for the primary prevention of sudden cardiac death in patients with reduced left ventricular ejection fraction (LVEF). The ongoing risk/benefit profile of an ICD at generator replacement is unknown. This study aimed to identify predictors of appropriate implantable cardioverter defibrillator (ICD) shocks and therapies after first ICD generator replacement, and its procedure-related complications. Read More

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Timing of and risk factors for deep surgical site infection requiring implant removal following canine tibial plateau leveling osteotomy.

Vet Surg 2021 Apr 7. Epub 2021 Apr 7.

College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

Objective: To identify demographic risk factors for deep surgical site infection (SSI) requiring tibial plateau leveling osteotomy (TPLO) implant removal and time to implant removal.

Animals: Four hundred and thirty-three dogs that underwent a TPLO (144 that developed a deep SSI and required implant removal, 289 that did not).

Study Design: Retrospective case-control study. Read More

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Fertility considerations in targeted biologic therapy with tyrosine kinase inhibitors: a review.

J Assist Reprod Genet 2021 Apr 7. Epub 2021 Apr 7.

Department of Obstetrics, Gynecology and Women's Health, Spectrum Health Medical Group, Grand Rapids, MI, USA.

Purpose: To review the impact of tyrosine kinase inhibitors (TKIs) on fertility in men and women, embryo development, and early pregnancy, and discuss considerations for fertility preservation in patients taking TKIs.

Methods: A comprehensive literature search using the PubMed database was performed through February 2021 to evaluate the current literature on imatinib, nilotinib, dasatinib, and bosutinib as it relates to fertility and reproduction. Published case series were analyzed for pregnancy outcomes. Read More

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D-pouch: a modified ileal J-pouch for patients with ulcerative colitis and familial adenomatous polyposis.

Tech Coloproctol 2021 Apr 7. Epub 2021 Apr 7.

Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan University, Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Hubei Key Laboratory of Intestinal and Colorectal Diseases (Zhongnan Hospital of Wuhan University), Colorectal and Anal Disease Research Center of Medical School (Zhongnan Hospital of Wuhan University), Quality Control Center of Colorectal and Anal Surgery of Health Commission of Hubei Province, No. 169, DongHu Road, Wuhan, China.

Background: Ileal J-pouch anal anastomosis (J-IPAA) is the standard approach for patients requiring restorative proctocolectomy due to familial adenomatous polyposis (FAP) or ulcerative colitis (UC). To obviate the risk of a J-tip leak, we modified the J-pouch with a D-pouch anal anastomosis (D-IPAA) designed to eliminate the ileal stump. The aim of our study was to evaluate the feasibility, safety and medium-term functional outcomes of D-IPAA. Read More

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[Surgical treatment of a post-traumatic giant pseudoaneurysm of the axillary artery: a case report].

Angiol Sosud Khir 2021 ;27(1):159-163

Department of General Surgery #1, Perm State Medical University named after Academician E.A. Wagner under the RF Ministry of Public Health, Perm, Russia.

A false aneurysm of the axillary artery is an extremely rare complication of a lesion of this vessel. As few as several dozens of similar cases have been described in the available literature. We herein report a clinical case concerning surgical treatment of a 41-year-old patient who after a knife-inflicted injury had developed a 66x67 mm pseudoaneurysm of the axillary artery. Read More

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Intravenous drug abusers presenting with pseudoaneurysm and other surgical complications in Pakistan.

J Pak Med Assoc 2021 02;71(2(A)):556-558

King Edward Medical University, Lahore, Pakistan.

People who inject drugs (PWIDs) reuse injection equipment and other paraphernalia, which is a major source of transmission of human immunodeficiency (HIV) and hepatitis C virus (HCV) infections. PWIDs who use infected injections develop many surgical complications which are life- threatening. The most common complication is infected pseudoaneurysm. Read More

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February 2021

Warfarin Poisoning and Blunt Abdominal Trauma: A Rare Cause of Small Bowel Obstruction.

Cureus 2021 Feb 28;13(2):e13603. Epub 2021 Feb 28.

Surgery, Rutgers New Jersey Medical School, Newark, USA.

Intestinal intramural hematomas are a rare complication of blunt abdominal trauma in the setting of anticoagulation. A 52-year-old male presented to our surgical service with high-grade small bowel obstruction secondary to an extensive small bowel intramural hematoma requiring resection. The patient sustained a blunt abdominal assault several days earlier and workup revealed severe coagulopathy likely secondary to overexposure to a warfarin-based substance. Read More

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February 2021

Thoracic Surgery Consultations in COVID-19 Critically Ill Patients: Beyond Conservative Approach.

Crit Care Res Pract 2021 27;2021:6626150. Epub 2021 Mar 27.

Department of Critical Care, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Introduction: Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic surgeons' consultation and management. With the surge of COVID-19 cases particularly in the critical care settings, various types of complications have been observed that require intervention from thoracic surgeons.

Methods And Materials: A retrospective study was conducted in an academic healthcare institute in the Eastern Province of Saudi Arabia. Read More

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