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Ann Vasc Surg 2021 Apr 6. Epub 2021 Apr 6.

Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade; Faculty of Medicine, University of Belgrade, Serbia.

Introduction: The aim of this paper is to report our single-center experience in the open surgical treatment of acute spontaneous infrarenal isolated abdominal aortic dissection (siIAAD).

Methods And Patients: This was a single center retrospective study. Between January 2015 and 2020 ten patients were treated due to acute siIAAD with open surgery. Read More

Ann Vasc Surg 2021 Apr 6. Epub 2021 Apr 6.

Department of Vascular Surgery and Kidney Transplantation, University of Strasbourg, Strasbourg, France; Groupe Européen de Recherche sur les Prothèses appliquées à la Chirurgie Vasculaire, Strasbourg, France.

Case Report: Classical surgical options for renal artery aneurysm (RAA) are usually restricted to endovascular surgery or open repair, either using an in-situ or ex-situ approach. A 45-year-old woman presenting with a 20-mm complex RAA with hilum location, not suitable for endovascular repair renal was treated with a mini-invasive robotic approach. This approach allowed an in-situ reconstruction in a complete mini-invasive manner with the Da Vinci Xi robot (Intuitive Surgical, Sunnyvale, CA). Read More

JBJS Case Connect 2021 Apr 9;11(2). Epub 2021 Apr 9.

Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland.

Case: A 36-year-old male competitive powerlifter sustained asynchronous bilateral Achilles tendon ruptures after using 2 types of selective androgen receptor modulators (SARMs). Both tendon ruptures occurred near the myotendinous junction and were treated with open surgical repair and an initial period of immobilization followed by progressive weightbearing and rehabilitation; no postoperative complications were observed.

Conclusion: Previous studies have reported that anabolic androgenic steroids have a deleterious impact on tendon structure and function. Read More

Transpl Int 2021 Apr 9. Epub 2021 Apr 9.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Aim: Following liver transplant (LT), osteoporosis is a severe complication that causes morbidity. However, the incidence and risk factors of osteoporosis and fractures have not been well described.

Methods: Single-arm meta-analysis of studies reporting osteopenia, osteoporosis and fractures post-LT was performed with meta regression for study period. Read More

Plast Reconstr Surg 2021 Apr 7. Epub 2021 Apr 7.

From the Department of Surgery, Divisions of Otolaryngology and Surgical Outcomes and Epidemiology, Yale School of Medicine; the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical School-Baystate; and the Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai.

Background: A deviated nose can be attributable to multiple anatomical factors, including asymmetric maxilla. A subalar graft helps to correct maxillary hypoplasia and may be a useful tool for correcting a deviated nose. The authors' objective is to show the effects of the subalar graft in improving nostril symmetry and to propose an algorithm for using this graft in open and endonasal rhinoplasty. Read More

Clin Orthop Relat Res 2021 Apr 8. Epub 2021 Apr 8.

D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA.

Background: Pain after rotator cuff repair is commonly managed with opioid medications; however, these medications are associated with serious adverse effects. Relaxation exercises represent a potential nonpharmacologic method of pain management that can be easily implemented without substantial adverse effects; however, the effects of relaxation exercises have not been studied in a practical, reproducible protocol after arthroscopic rotator cuff repair.

Questions/purposes: (1) Does performing relaxation exercises after arthroscopic rotator cuff repair (ARCR) decrease pain compared with standard pain management medication? (2) Does performing relaxation exercises after ARCR decrease opioid consumption? (3) What proportion of patients who used the relaxation techniques believed they decreased their pain level, and what proportion continued using these techniques at 2 weeks? (4) Does performing relaxation exercises after ARCR affect shoulder function?

Methods: During the study period, 563 patients were eligible for inclusion; however, only 146 were enrolled, randomized, and postoperatively followed (relaxation group: 74, control group: 72); 68% (384 of 563) of patients were not contacted due to patient and research staff availability. Read More

Plast Reconstr Surg 2021 Apr 7. Epub 2021 Apr 7.

From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; the Department of Biostatistics, Boston University School of Public Health; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush Medical College.

Background: Naso-orbitoethmoid fractures associated with ipsilateral zygomaticomaxillary complex fractures are more challenging injuries than zygomaticomaxillary complex fractures alone. However, there is a paucity of information on this complex fracture pattern in the pediatric population. This study investigated the cause, treatment, and outcomes of combined zygomaticomaxillary complex and naso-orbitoethmoid fractures versus isolated zygomaticomaxillary complex fractures in pediatric patients. Read More

Ann Otol Rhinol Laryngol 2021 Apr 9:34894211007240. Epub 2021 Apr 9.

Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle WA, USA.

Objectives: There is a paucity of data on postoperative infections after endoscopic sinus surgery and associated risk factors. Our objective was to evaluate a cohort of patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis to determine which perioperative factors may be associated with infection in the 30-day postoperative period.

Methods: A retrospective cohort study of adults who underwent ESS at a tertiary academic medical center from 2015 to 2018 was performed. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3):24-30

Petrovsky Russian Research Center of Surgery, Moscow, Russia.

Objective: To estimate the frequency of early postoperative neurological complications in patients undergoing planned surgery on the ascending aortic and arch of the aorta, and their long-term outcomes.

Material And Methods: The prospective study included 100 patients who were operated on at the FSBSI Petrovsky Russian Research Center of Surgery. In group I (=50), operations were performed on the aortic arch with hypothermic circulatory arrest (26 °C) and antegrade cerebral perfusion. Read More

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):31-33. Epub 2021 Apr 8.

Cardiothoracic Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.

Introduction/Study Goals: Thoracic sympathectomy is considered to be the most effective treatment for hyperhidrosis, a procedure traditionally performed under general anesthesia. Nowadays it's a minimally invasive procedure, which makes it possible to perform under sedation with local anesthesia. The goal in this study was to assess the efficacy and safety of this anesthetic technique in video-assisted thoracic sympathectomy. Read More

Investig Clin Urol 2021 Mar 31. Epub 2021 Mar 31.

Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.

Purpose: We sought to determine the role of body mass index (BMI) on quality indicators, such as length of stay and readmission. The National Surgical Quality Improvement Program (NSQIP) database was queried to examine the effect of obesity, defined as BMI >30, on outcomes after Minimally Invasive Radical Retropubic Prostatectomy (MI-RRP).

Materials And Methods: Utilizing the NSQIP database, patient records were identified using the Current Procedural Terminology (CPT) code 55866 (laparoscopy, surgical prostatectomy, radical retropubic) during a 10-year period (2007-2017). Read More

Investig Clin Urol 2021 Mar 25. Epub 2021 Mar 25.

Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA.

Purpose: Partial nephrectomy is associated with a 1%-2% risk of renal iatrogenic vascular lesion (IVL) that are commonly treated with selective angioembolization (SAE). The theoretical advantage of SAE is preservation of renal parenchyma by targeting only the bleeding portion of the kidney. Our study aims to assess the long-term effect of SAE on renal function, especially that this intervention requires potentially nephrotoxic contrast load injection. Read More

J Card Surg 2021 Apr 8. Epub 2021 Apr 8.

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background: The aim of this study is to evaluate the predictive utility of preoperative right ventricular (RV) global longitudinal strain (GLS) and free wall strain (FWS) on outcomes following left ventricular assist devices (LVADs) implantation.

Methods: Preoperative transthoracic echocardiograms were retrospectively reviewed in adults undergoing continuous-flow LVAD implantation between 2004 and 2018 at a single center. Patients undergoing pump exchange were excluded. Read More

J Spine Surg 2021 Mar;7(1):118-123

Department of Neurosurgery, Chungdam Wooridul Spine Hospital, Seoul, South Korea.

The use of full-endoscopic decompression for lumbar spinal stenosis has been increasing recently. It is a minimally invasive surgical procedure that has few complications. Spinal subdural hematoma (SSH) following endoscopic surgery has never been reported. Read More

J Spine Surg 2021 Mar;7(1):109-113

Division of Regional Anesthesia & Acute Pain Management, Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.

Posterior cervical spine surgery often requires large posterior midline incision which can result in poorly controlled postoperative pain, arises from iatrogenic mechanical damage, intraoperative retraction and resection to structures such as bone, ligaments, muscles, intervertebral disks, and zygapophysial joints. Local anesthetics may be utilized for infiltration of the surgical wound; however, their analgesic efficacy has not been studied in this surgical approach. Here we report a case series. Read More

Cureus 2021 Mar 4;13(3):e13684. Epub 2021 Mar 4.

Anesthesiology and Reanimation, Kartal Dr. Lutfi Kirdar Research& Education Hospital, Istanbul, TUR.

Scoring systems have been developed to predict the expected mortality and morbidity in surgical procedures. In this study, our aim was to compare the ASA (American Society of Anesthesiologists), APACHE (Acute Physiology and Chronic Health Evaluation) II, POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) scoring systems as predictors of mortality in patients who underwent gastrointestinal oncologic surgery, followed, and were admitted to the intensive care unit during the postoperative period. We examined the files of 82 patients who underwent oncologic gastrointestinal surgery and followed up in the intensive care units (ICUs). Read More

Clin Interv Aging 2021 30;16:559-568. Epub 2021 Mar 30.

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.

Purpose: Cytoreductive surgery (CRS) added with hyperthermic intraperitoneal chemotherapy (HIPEC) can improve the survival rate of certain patients with peritoneal metastasis (PM). However, the perioperative safety and long-term survival of this intricate and possibly life-threatening procedure in elderly patients (≥65 years) remain controversial.

Methods: Patients with PM due to appendiceal or colorectal tumours who underwent CRS/HIPEC were evaluated systematically at the National Cancer Center of China and the Huanxing Cancer Hospital between June 2017 and June 2019. Read More

Nat Rev Urol 2021 Apr 8. Epub 2021 Apr 8.

Specialty of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

Urinary incontinence is a common and predictable consequence among men with localized prostate cancer who have undergone radical prostatectomy. Despite advances in the surgical technique, urinary continence recovery time remains variable. A range of surgical and patient-related risk factors contributing to urinary incontinence after radical prostatectomy have been described, including age, BMI, membranous urethral length and urethral sphincter insufficiency. Read More

Ann Plast Surg 2021 Mar 18. Epub 2021 Mar 18.

From the Case Western Reserve University School of Medicine, Cleveland, OH Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH.

Background: Enhanced Recovery After Surgery (ERAS) pathways are multimodal approaches aimed at minimizing postoperative surgical stress, reducing hospitalization time, and lowering hospitalization charges. Enhanced Recovery After Surgery is broadly and increasingly implemented in hospitals across the country. Early reports have shown ERAS to reduce length of stay (LOS) after commonly performed pediatric surgeries. Read More

Ann Plast Surg 2021 Mar 31. Epub 2021 Mar 31.

From the Long Island Plastic Surgical Group, Garden City, NY Renaissance School of Medicine at Stony Brook University; Stony Brook, New York.

Purpose: Interest in labiaplasty as a way to alter and improve genital appearance has been on the rise. Labiaplasty procedures can be performed in the office setting under local anesthesia. However, these procedures are often performed under general anesthesia for patient comfort and to facilitate the operative technique and to potentially improve outcomes. Read More

Ann Plast Surg 2021 Mar 31. Epub 2021 Mar 31.

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University Hospital, Health Sciences Center T19-060, Stony Brook Medicine, Stony Brook, NY.

Purpose: In an attempt to reduce the incidence of infectious complications after tissue expander-based breast reconstruction, the routine administration of postoperative antibiotics regimen is common in many practices. In recent years, there has been a plethora of reports scrutinizing the prophylactic use of postoperative antibiotics in this setting. The aim of this study was to determine the efficacy of prolonged administration of postoperative antibiotics compared with perioperative-only antibiotic administration for prophylaxis after tissue expander placement for immediate mastectomy reconstruction. Read More

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

J ISAKOS 2021 Mar 12;6(2):120-123. Epub 2021 Feb 12.

Facultad de Medicina, Universidad CES, MedellÍn, Antioquia, Colombia.

This research aims to present a novel arthroscopic fixation technique that uses a double-row suture anchor for tibial spine avulsion and to evaluate its short-term clinical outcomes. The surgical technique is described and a retrospective case series is presented. Patients who presented with tibial spine avulsion type III and IV fractures according to the Meyers and McKeever classification and received the same surgical treatment from 2013 to 2018 in two specialised hospitals in Medellín City were included. Read More

HPB (Oxford) 2021 Feb 13. Epub 2021 Feb 13.

Department of Surgery, Aix-Marseille University, Institut Paoli-Calmettes, CRCM, Marseille, France.

Background: Emergency completion pancreatectomy (CP) after pancreatoduodenectomy (PD) is a technically demanding procedure. We report our experiences with a four-step standardized technique used at our center since 2012.

Methods: In the first step, the gastrojejunostomy is divided with a stapler to quickly access the pancreatic anastomosis and permit adequate exposure, especially in cases of active bleeding. Read More

AANA J 2021 Apr;89(2):161-167

is the executive director of the TriService Nursing Research Program, Bethesda, Maryland.

Postoperative nausea and vomiting (PONV) degrades patient experience and increases healthcare costs. Estimates of PONV range from 10% to 80%. The Apfel Simplified Score is an evidence-based instrument for determining individual risk of PONV. Read More

Anaesth Intensive Care 2021 Apr 8:310057X20982623. Epub 2021 Apr 8.

Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.

Published reports of uvular necrosis are uncommon and it is possibly an under-reported complication of oropharyngeal manipulation. Uvular necrosis is thought to develop due to ischaemia secondary to mechanical compression of the uvula from oropharyngeal devices. Patients typically present with symptoms of a sore throat within 48 hours postoperatively. Read More

Ann Palliat Med 2021 Apr 1. Epub 2021 Apr 1.

Department of General Surgery, Strategic Support Force Medical Center, Beijing, China.

Torsion of an epiploic appendage may result in epiploic appendagitis, which is a rare cause of acute abdominal pain. However, no previous reports have described an asymptomatic twisted epiploic appendage found during laparoscopic surgery to the best of our knowledge. This case describes a 66-year-old man who was admitted to our medical center with yellowness of the skin and eyes that had lasted over two months. Read More

Zhonghua Kou Qiang Yi Xue Za Zhi 2021 Apr;56(4):370-373

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, & Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou 450052, China.

To evaluate the clinical value of emergency endovascular embolization in the interventional treatment for oral hemorrhage caused by carcinoma, 32 patients with oral hemorrhage caused by carcinoma, who received emergency endovascular embolization due to unsatisfactory hemostatic effect of conventional conservative treatment in the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2019, were included in this study and their clinical data, laboratory data and imaging information were retrospectively analyzed. There were 16 males and 16 females, aged (60.6±13. Read More

Kyobu Geka 2021 Mar;74(3):174-180

Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan.

We aimed to evaluate the results of transapical transcatheter aortic valve implantation (TAVI) for aortic stenosis. Thirty patients who had aortic stenosis and underwent transapical TAVI between 2016 and 2020 were enrolled. Medical records were reviewed, and the following data were retrieved and analyzed:basic demographic data, and intraoperative data and postoperative outcomes. Read More

Kyobu Geka 2021 Mar;74(3):167-171

Department of Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan.

Objectives: This study aimed to consider the safety and feasibility of uniportal video-assisted thoracic surgery( VATS)[ u-VATS] compared with multiportal VATS( m-VATS).

Methods: Sixty-two patients underwent anatomical lung resection for primary lung cancer via u-VATS between February 2019 and May 2020 at our institution. We performed propensity score matching of these cases versus anatomical lung resection cases under m-VATS performed from January 2017 to December 2019, and compared the perioperative results. Read More