Journal Description
Surgeries
Surgeries
is an international, peer-reviewed, open access journal on findings and developments in surgery published quarterly online by MDPI. The Academy of Surgical Research is affiliated with Surgeries and its members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), Scopus, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.9 days after submission; acceptance to publication is undertaken in 2.7 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Latest Articles
The Effect of Antihypertensive Agents on Dental Implant Stability, Osseointegration and Survival Outcomes: A Systematic Review
Surgeries 2024, 5(2), 297-341; https://doi.org/10.3390/surgeries5020027 - 29 Apr 2024
Abstract
Antihypertensive agents are commonly prescribed to manage hypertension and are known to be beneficial for bone formation and remodeling. The aim of this systematic review was to assess the impact that antihypertensive agents have on dental implant stability, osseointegration, and survival outcomes. A
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Antihypertensive agents are commonly prescribed to manage hypertension and are known to be beneficial for bone formation and remodeling. The aim of this systematic review was to assess the impact that antihypertensive agents have on dental implant stability, osseointegration, and survival outcomes. A review of the literature was conducted using articles from 11 data sources. PRISMA guidelines were followed, and a PICO question was constructed. The search string “Antihypertensive* AND dental implant* AND (osseointegration OR stability OR survival OR success OR failure)” was used for all data sources where possible. The Critical Appraisal Skills Programme (CASP) was used for study appraisal, including the risk of bias. The search resulted in 7726 articles. After selection according to eligibility criteria, seven articles were obtained (one randomized control trial, two prospective cohort studies, three retrospective cohort studies, and a case control study). Five papers investigated the effects of antihypertensive agents on primary stability, but there were discrepancies in the method of assessment. Inhibition of the renin–angiotensin–aldosterone system was linked to higher primary stability. Secondary stability was usually higher than primary stability, but it is unknown if antihypertensive agents caused this. Survival outcomes were increased with certain antihypertensive agents. It is possible that inhibition of the renin–angiotensin–aldosterone system may lead to greater bone mineral density, improved primary stability, and improved survival outcomes although the effects on osseointegration are unknown. However, more research is needed to confirm this theory.
Full article
(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)
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Open AccessCase Report
Pleural Effusion following Yoga: A Report of Delayed Spontaneous Chylothorax and a Brief Review of Unusual Cases in the Literature
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Gabriel Hunduma, Paolo Albino Ferrari, Farouk Alreshaid, Tayyeba Kiran, Aiman Alzetani and Alessandro Tamburrini
Surgeries 2024, 5(2), 288-296; https://doi.org/10.3390/surgeries5020026 - 25 Apr 2024
Abstract
Chylothorax is a rare condition where the extravasated chyle accumulates into the pleural space. It is most commonly associated with malignancies, infective or inflammatory disorders and iatrogenic causes. Extremely rarely, it could occur spontaneously. We present the case of a healthy 40-year-old woman
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Chylothorax is a rare condition where the extravasated chyle accumulates into the pleural space. It is most commonly associated with malignancies, infective or inflammatory disorders and iatrogenic causes. Extremely rarely, it could occur spontaneously. We present the case of a healthy 40-year-old woman who presented with acute right shoulder and neck pain associated with shortness of breath and loss of consciousness. This was preceded by a yoga class two weeks prior. Chest imaging showed right pleural effusion, and tapping revealed a milky fluid which was confirmed to be chylothorax. Conservative management failed and the patient was successfully treated with video-assisted thoracoscopic drainage, thoracic duct ligation and mechanical pleurodesis. Chylothorax association with yoga is not reported in the literature.
Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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Open AccessReview
Technology Readiness Level of Robotic Technology and Artificial Intelligence in Dentistry: A Comprehensive Review
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Leonardo Mohamad Nassani, Kanza Javed, Rafat Samih Amer, Ming Hong Jim Pun, Ahmed Z. Abdelkarim and Gustavo Vicentis Oliveira Fernandes
Surgeries 2024, 5(2), 273-287; https://doi.org/10.3390/surgeries5020025 - 18 Apr 2024
Abstract
This comprehensive review assessed the integration of robotics and artificial intelligence (AI) in dentistry, offering a transparent overview of developments across dental fields. Covering articles in prosthodontics, orthodontics, implantology, surgery, and radiology, the review included 39 articles on robotics and 16 on AI.
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This comprehensive review assessed the integration of robotics and artificial intelligence (AI) in dentistry, offering a transparent overview of developments across dental fields. Covering articles in prosthodontics, orthodontics, implantology, surgery, and radiology, the review included 39 articles on robotics and 16 on AI. Screening adhered to PRISMA guidelines, with searches conducted on Medline, Google Scholar, and IEEE. Incorporating the search strategy, the review used keywords related to dentistry, robotics, and AI. For robotics, 296 articles were screened, resulting in 39 qualifying for qualitative synthesis. A separate AI search on PubMed identified 142 studies within the last decade, with 16 studies selected for a detailed full-text analysis, offering a consolidated overview of the current state-of-the-art knowledge in the AI domain. Geographic distribution highlighted East Asia as a major research contributor. The findings indicate an increasing trend in dentistry robotics since 2000 and, particularly since 2016, in AI dentistry. The majority of the literature fell under the category of basic research. The technology readiness level did not cross “three” (proof of concept) in 41% of all articles. Therefore, the overall literature quality remains low, particularly regarding clinical validation.
Full article
(This article belongs to the Special Issue Dental Surgery and Care)
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Open AccessArticle
Comparison of Closed and Open Surgical Technique for Second to Fifth Metacarpal Shaft Fractures: A Multicenter, Retrospective Study in a Dutch City Population
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Marcel Libertus Johannes Quax, Maarten Kielman, Sven Albert Meylaerts and Alexander Pieter Antony Greeven
Surgeries 2024, 5(2), 264-272; https://doi.org/10.3390/surgeries5020024 - 18 Apr 2024
Abstract
The aim of this study was to assess surgical treatment in metacarpal shaft fractures of the second to fifth ray to determine the functional outcomes and complications in open reduction and internal fixation (ORIF) versus closed reduction and internal fixation (CRIF). This was
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The aim of this study was to assess surgical treatment in metacarpal shaft fractures of the second to fifth ray to determine the functional outcomes and complications in open reduction and internal fixation (ORIF) versus closed reduction and internal fixation (CRIF). This was a retrospective study that included patients with metacarpal shaft fractures of the second to fifth rays who were treated surgically between 1 January 2007 and 31 December 2019. Functional outcomes were scored using the QuickDASH and Eq5D score. A total of 231 treated patients were included. Single fractures were seen in 180 patients, and multiple fractures in 51 patients. ORIF was applied in 141 patients and CRIF in 90 patients. The functional outcomes were not significantly different between the groups. Complications were found in 41 (29%) of the ORIF patients and 15 (17%) of the CRIF patients. The functional outcomes after single or multiple metacarpal shaft fractures were similar in the ORIF and CRIF patients. ORIF showed significantly more complications, such as functional impairment and infections and a higher reoperation rate. In conclusion, CRIF is as safe as ORIF for the surgical treatment of metacarpal shaft fractures in terms of its functional outcome and slightly preferable due to its lower complication rate.
Full article
(This article belongs to the Topic Orthopaedic Diseases and Innovative Intervention Strategies, 2nd Volume)
Open AccessSystematic Review
Opportunistic Salpingectomy at the Time of General Surgery Procedures: A Systematic Review and Narrative Synthesis of Current Knowledge
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Kevin Verhoeff, Kimia Sorouri, Janice Y. Kung, Sophia Pin and Matt Strickland
Surgeries 2024, 5(2), 248-263; https://doi.org/10.3390/surgeries5020023 - 13 Apr 2024
Abstract
Opportunistic salpingectomy (OS) for the primary prevention of ovarian cancer is performed by gynecologists. Advocates have suggested expanding its use to other surgical specialties. General surgeons are the other group to routinely perform intraperitoneal operations in women and could play a role in
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Opportunistic salpingectomy (OS) for the primary prevention of ovarian cancer is performed by gynecologists. Advocates have suggested expanding its use to other surgical specialties. General surgeons are the other group to routinely perform intraperitoneal operations in women and could play a role in ovarian cancer prevention. Herein, we review the current evidence and perioperative factors requiring consideration prior to OS implementation in select general surgery cases. A systematic search was conducted for English-language studies evaluating OS during general surgery. The primary outcomes of this study were the feasibility and safety of OS during general surgery procedures. Secondary outcomes included pre-operative considerations (patient selection and the consent process), operative factors (technique and surgical specialty involvement), and post-operative factors (follow-up and management of operative complications). We evaluated 3977 studies, with 9 meeting the eligibility criteria. Few studies exist but preliminary evidence suggests relative safety, with no complication attributable to OS among 140 patients. Feasibility was reported in one study, which showed the capacity to perform OS in 98 out of 105 cholecystectomies (93.3%), while another study reported quick visualization of the fallopian tubes in >80% of cases. All patients in the included studies were undergoing elective procedures, including cholecystectomy, interval appendectomy, colorectal resection, bariatric surgery, and laparoscopic hernia repair. Studies only included patients ≥ 45 years old, and the mean age ranged from 49 to 67.5 years. Gynecologists were frequently involved during the consent and surgical procedures. OS represents a potential intervention to reduce the risk of ovarian cancer. Ongoing studies evaluating the general surgeon’s understanding; the consent process; the feasibility, operative outcomes, and risks of OS; and surgeon training are required prior to consideration.
Full article
(This article belongs to the Special Issue Surgical Resection)
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Open AccessReview
Advancements in Anterior Cruciate Ligament Repair—Current State of the Art
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Francesco Bosco, Giuseppe Rovere, Fortunato Giustra, Virginia Masoni, Salvatore Cassaro, Marcello Capella, Salvatore Risitano, Luigi Sabatini, Ludovico Lucenti and Lawrence Camarda
Surgeries 2024, 5(2), 234-247; https://doi.org/10.3390/surgeries5020022 - 10 Apr 2024
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While anterior cruciate ligament reconstruction (ACL-R) has been considered the gold standard for ACL tears, renewed interest in ACL repair has emerged. This review aims to examine the current knowledge regarding ACL repair. A comprehensive literature search was conducted on the PubMed, Web
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While anterior cruciate ligament reconstruction (ACL-R) has been considered the gold standard for ACL tears, renewed interest in ACL repair has emerged. This review aims to examine the current knowledge regarding ACL repair. A comprehensive literature search was conducted on the PubMed, Web of Science, Scopus, and Embase databases, focusing on the most recent studies up to January 2024. Arthroscopic ACL repair has several advantages, such as resulting in a natural ligament with proprioceptive properties, preservation, and donor graft comorbidity absence. Several ACL repair surgical procedures have been developed thanks to the advancement in new fixation devices. The current literature showed that when performed on a suitable patient with the appropriate lesion type, corresponding to the proximal third with good tissue quality, ACL repair leads to satisfactory outcomes. Despite the benefits of ACL repair with promising results, ACL-R remains the gold standard for ACL lesions. There is still a lack of literature analyzing long-term outcomes; large series with homogenous populations and types of lesions are lacking. Based on the current evidence, further research and higher-quality studies investigating ACL repair will be necessary.
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Open AccessArticle
Patients with High Pre-Operative Physical Activity Take Longer to Return to Baseline
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Roberta E. Redfern, David A. Crawford, Adolph V. Lombardi, Jr., Krishna R. Tripuraneni, David C. Van Andel, Mike B. Anderson and Jason M. Cholewa
Surgeries 2024, 5(2), 220-233; https://doi.org/10.3390/surgeries5020021 - 04 Apr 2024
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Patients with end-stage osteoarthritis are recommended to engage in physical activity (PA) to reduce pain and improve function but may avoid PA due to joint pain. Our goal was to investigate patient-reported outcomes and objective mobility metrics (step counts) in total hip arthroplasty
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Patients with end-stage osteoarthritis are recommended to engage in physical activity (PA) to reduce pain and improve function but may avoid PA due to joint pain. Our goal was to investigate patient-reported outcomes and objective mobility metrics (step counts) in total hip arthroplasty (THA) patients as a function of pre-operative PA levels. In total, 1647 patients enrolled in a multicenter prospective cohort study investigating a smartphone-based care management platform for self-directed rehabilitation that underwent THA and were included in analysis. The entire cohort’s step count was divided into quartiles to categorize patients with low, moderate, and high baseline PA. Outcomes including pain, EQ-5D-5L, HOOS JR, and step counts were compared according to activity group by ANOVA. Pre-operative pain scores were lowest, with smallest improvements, in the high-baseline PA group. Low-PA patients demonstrated the greatest improvements in EQ-5D-5L, while changes in EQ-VAS, HOOS JR, and satisfaction were similar between groups. Low- and moderate-PA patients increased physical activity by six weeks, reaching 180% and 114% of pre-operative steps; high-PA patients did not return to full step counts until one-year post-operation. Patients who perform high levels of PA undergoing THA report lower levels of pain and higher function pre-operatively but may appreciate less improvement in PA up to one year post-operatively. These results may be helpful in appropriate counseling of patient expectations prior to surgery.
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Open AccessArticle
Utilizing a Porcine Fat Grafting Model for Translational Research: Surgical Approach, Complications, and Expected Outcomes
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Shawn Jeffrey Loder, Alexandra M. Vagonis, Bahaa Shaaban, Amr Elmeanawy, Fuat Baris Bengur, Yadira Villalvazo, Vincent W. Nerone, Yusuf Surucu, Pooja Humar, Jose Antonio Arellano, Hamid Malekzadeh, Andreea Gavrilescu, Rachel E. Ricketts, J. Peter Rubin and Lauren E. Kokai
Surgeries 2024, 5(2), 206-219; https://doi.org/10.3390/surgeries5020020 - 04 Apr 2024
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Autologous fat grafting, or lipotransfer, is an important surgical approach to relocate adipose tissue within an individual to create volume. While used extensively in plastic and reconstructive surgery, significant drawbacks exist, including unpredictable volume retention. Thus, considerable research has been undertaken to identify
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Autologous fat grafting, or lipotransfer, is an important surgical approach to relocate adipose tissue within an individual to create volume. While used extensively in plastic and reconstructive surgery, significant drawbacks exist, including unpredictable volume retention. Thus, considerable research has been undertaken to identify surgical or therapeutic approaches that improve outcomes, primarily utilizing a xenograft immunocompromised mouse model. Large animal models are an important step in translating preclinical laboratory studies to the clinic, and previous studies utilizing pigs have been applied successfully for fat grafting research, but protocol variability exists across studies, and no previous publication has adequately described the impact of the swine breed on the experimental outcomes. In this report, we provide information on the critical attributes of the swine fat grafting model, including the following: (1) model selection; (2) donor site and surgical harvest approach; (3) tissue processing; (4) recipient site location and preparation; (5) post-operative care; and (6) longitudinal fat grafting assessments. Our experience comparing the use of Yorkshire and Yucatan breeds in our model showed that Yorkshire adipose tissue was fibrotic, extremely difficult to obtain through liposuction, and labor intensive to process into injectable formats. Alternatively, Yucatan adipose was more similar to human tissue, could be readily obtained through the surgical excision of inguinal fat pads, was amenable to mincing with surgical scissors, and yielded injectable tissue with a 95% efficiency. We determined that generation of a surgical pocket reduced the graft migration and spread, consequently facilitating the graft retrieval without significantly impacting retention. Using 5 cc grafts, the ultimate 3-month volume retention in 16 grafts was 19% ± 17% (or 1.14 cc ± 1.08 cc). While the use of ultrasound did not readily enable graft volume approximation during the study, it was a useful method to visualize the graft placement and ensure injection into the subcutaneous adipose layers.
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Open AccessArticle
Pregnancy-Related Decision-Making and Perceptions of Risk among Reproductive-Age Females Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Single-Surgeon Cross-Sectional Study
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Dhruv S. Shankar, Zachary I. Li, Jairo Triana, Jordan A. Eskenazi, Rae Lan, Andrew J. Hughes and Thomas Youm
Surgeries 2024, 5(2), 194-205; https://doi.org/10.3390/surgeries5020019 - 04 Apr 2024
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Females of reproductive age constitute one of the largest demographics of the hip arthroscopy population, but it is unclear as to how pregnancy planning affects decision-making regarding surgery or vice versa. The purpose of this study was to assess perceived risks to pregnancy
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Females of reproductive age constitute one of the largest demographics of the hip arthroscopy population, but it is unclear as to how pregnancy planning affects decision-making regarding surgery or vice versa. The purpose of this study was to assess perceived risks to pregnancy from hip pain and/or hip arthroscopy among reproductive-age females who underwent arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). A cross-sectional study was conducted involving females aged 18–44 years who underwent hip arthroscopy for the treatment of FAIS, with a single surgeon included in the study. Subjects completed a survey that assessed obstetric and gynecologic history, decision-making regarding the planning and timing of hip surgery and pregnancy, and perceived risks to pregnancy from hip pain and/or hip surgery. Subjects were classified as nulligravid (Group 1), pregnant at least once before hip surgery but never again following hip surgery (Group 2), or pregnant at least once following hip surgery (Group 3). A total of 85 patients were enrolled with a mean age of 32.3 ± 6.5 years at the time of surgery. The mean follow-up time was 51.9 ± 34.5 months. There were 39 subjects in Group 1 (45.9%), 20 in Group 2 (23.5%), and 26 in Group 3 (30.6%). About half of all subjects expressed “some” to “a lot of” concern that their hip pain could get worse during pregnancy (49.4%), and about half had “no concern” that hip arthroscopy would affect the health of their fetus/baby (54.1%). Reproductive-age females undergoing hip arthroscopy for FAIS generally consider the procedure to be safe with respect to future pregnancy outcomes.
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Open AccessCase Report
Long-Term Survival of a Child with Atypical Teratoid-Rhabdoid Tumor and Acute Lymphoblastic Leukemia: A Case Report
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Kolcheva Maria Andreevna, Kumirova Ella Vyacheslavovna, Gorbatykh Svetlana Valeryevna, Makhmudova Gunai Nariman, Livshits Matvey Igorevich, Chmutin Gennadiy Yegorovich, Kislyakov Alexey Nikolaevich, Umerenkov Viktor Nikolaevich, Manuel de Jesus Encarnacion Ramirez and Nicola Montemurro
Surgeries 2024, 5(2), 184-193; https://doi.org/10.3390/surgeries5020018 - 03 Apr 2024
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Atypical teratoid-rhabdoid tumor (AT/RT) is a rare but one of the most aggressive embryonal tumors of the central nervous system (CNS), most often occurring in children under 3 years of age. AT/RT accounts for about 1–2% of all CNS neoplasms and has a
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Atypical teratoid-rhabdoid tumor (AT/RT) is a rare but one of the most aggressive embryonal tumors of the central nervous system (CNS), most often occurring in children under 3 years of age. AT/RT accounts for about 1–2% of all CNS neoplasms and has a very poor prognosis, high risk of secondary tumor development, recurrence and/or metastasis in patients in remission and limited therapeutic potential. The clinical manifestations are usually symptoms of increased intracranial pressure. The mainstay of tumor treatment is complex chemotherapy combined with radiation therapy. A clinical case of sequential occurrence of two cancers (AT/RT and leukemia) in a 3-year-old girl is presented.
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Open AccessTechnical Note
Endoscopically Assisted Exoscopic Surgery for Microvascular Decompression of the Trigeminal Nerve with Intraoperative Use of Indocyanine Green
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Rinat A. Sufianov, Nargiza A. Garifullina, Asiyat Sh. Magomedova, Michael G. Hevor, Manuel de Jesus Encarnacion Ramirez, Albert A. Sufianov and Nicola Montemurro
Surgeries 2024, 5(2), 172-183; https://doi.org/10.3390/surgeries5020017 - 01 Apr 2024
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Trigeminal neuralgia (TN) is a chronic condition that is typically caused by a blood vessel exerting pressure on the V cranial nerve at the root entry zone. The gold standard for TN treatment is microvascular decompression (MVD). This illustrative case shows an advanced
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Trigeminal neuralgia (TN) is a chronic condition that is typically caused by a blood vessel exerting pressure on the V cranial nerve at the root entry zone. The gold standard for TN treatment is microvascular decompression (MVD). This illustrative case shows an advanced surgical technique that combines the use of an exoscope and endoscope to treat TN with an innovative addition of intraoperative indocyanine green (ICG) control that can improve arterial and venous compression identification. The use of exoscopes and endoscopes, offering 360° root assessment, represents a significant evolution in surgical approaches. Enhanced visualization with ICG aided in identifying complex neurovascular conflicts, improving decompression accuracy. The use of both exoscope and endoscope, offering a 360° root assessment, represents a significant evolution in the microsurgical approach of TN. The additional use of ICG monitoring in a dynamic mode may be useful in identifying the complex arteriovenous form of neurovascular conflict. The endoscopically assisted exoscopic surgery with the intraoperative use of ICG for MVD of the trigeminal nerve can improve the identification of complex impingements underlining its effectiveness and potential in neurosurgical practice.
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Open AccessArticle
Minimizing Blood Loss in Laparotomic Myomectomy through the Tourniquet Use: Insights from Our Clinical Experience and Literature Review
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Giosuè Giordano Incognito, Ferdinando Antonio Gulino, Stefano Cianci, Sara Occhipinti, Dalila Incognito, Orazio De Tommasi, Fortunato Genovese and Marco Palumbo
Surgeries 2024, 5(2), 162-171; https://doi.org/10.3390/surgeries5020016 - 29 Mar 2024
Abstract
The uterine tourniquet is often not used to reduce intraoperative blood loss due to controversial opinions in the literature. The objective was to evaluate the effectiveness of this procedure in laparotomic myomectomy. This is a retrospective, monocentric case-control study, including patients who underwent
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The uterine tourniquet is often not used to reduce intraoperative blood loss due to controversial opinions in the literature. The objective was to evaluate the effectiveness of this procedure in laparotomic myomectomy. This is a retrospective, monocentric case-control study, including patients who underwent laparotomic myomectomy and were categorized into the Tourniquet Group (A) and No Tourniquet Group (B). The blood loss outcomes were compared. Intra-operative blood loss in Group A was 275 ± 200 mL, while in Group B was 410 ± 390 mL (p = 0.11). Notably, five patients in the No Tourniquet Group lost more than 1000 mL of blood and required blood transfusion, while no such cases were reported in the Tourniquet Group. Furthermore, the decrease in hemoglobin post-procedure was statistically significant, favoring Group A with a decrease of 1.9 ± 0.7 g/dL compared to Group B’s 2.8 ± 2.2 g/dL (p = 0.04). The use of the Foley catheter as a tourniquet during laparotomic myomectomy may represent a remarkable tool that profoundly impacts the surgical process by substantially reducing blood loss. Its use may play a role in significantly diminishing the likelihood of requiring blood transfusions, enhancing patient safety and outcomes, and should be systematically adopted.
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Open AccessReview
Styletubation versus Laryngoscopy: A New Paradigm for Routine Tracheal Intubation
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Hsiang-Ning Luk and Jason Zhensheng Qu
Surgeries 2024, 5(2), 135-161; https://doi.org/10.3390/surgeries5020015 - 26 Mar 2024
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Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VLs) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VLs have been repeatedly studied in both normal and difficult airways. The
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Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VLs) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VLs have been repeatedly studied in both normal and difficult airways. The superiority of VLs then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) was noticed two decades ago. Since then, sporadic clinical experiences of use have appeared in the literature. In this review article, we presented our vast use experiences of the styletubation (more than 55,000 patients since 2016). We found this technique to be swift (the time to intubate from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satisfaction and fast learning curve for the novice trainees) in both normal and difficult airway scenarios. We, therefore, propose that the styletubation technique can be feasibly applied as universal routine use for tracheal intubation.
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Open AccessReview
Dual-Mobility Cups in Patients Undergoing Primary Total Hip Arthroplasty with Prior Lumbar Spine Fusion: A Systematic Review
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Tariq Ziad Issa, Adam Pearl, Emelia Moore, Hannan Ahmad Maqsood and Khaled J. Saleh
Surgeries 2024, 5(2), 125-134; https://doi.org/10.3390/surgeries5020014 - 25 Mar 2024
Abstract
Spine and hip abnormalities frequently occur together in most of the orthopedic population; therefore, both of these abnormalities impact the outcomes of the modalities that are being used. Few studies have reported reduced dislocation and revision rates with the use of dual-mobility cups
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Spine and hip abnormalities frequently occur together in most of the orthopedic population; therefore, both of these abnormalities impact the outcomes of the modalities that are being used. Few studies have reported reduced dislocation and revision rates with the use of dual-mobility cups (DMCs) in high-risk lumbar spine fusion (LSF) patients undergoing primary total hip arthroplasty (THA). This study aims to clarify the relationship between pre-existing lumbar spinal fusion and the outcomes of THA with dual-mobility constructs. We systematically reviewed the current literature through several online databases following PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Interventions. We used the methodological index for non-randomized studies (MINORS) to evaluate the methodological quality of the included trials. Four studies examined the feasibility and effectiveness of dual-mobility cups in patients undergoing primary THA with prior LSF. Two studies were conducted in the United States, while the other two originated in Finland and France, respectively. The included studies enrolled 284 patients. Most of these patients had instrumented fusions. Seventy-eight percent of patients received one- or two-level fusions. The average age across the studies was 68.22 and the mean body mass index was 28. No cases of postoperative DMC implant dislocations were identified. The incidence of postoperative complications was 6% (10/173), including deep venous thrombosis, periprosthetic loosening, infection, and fracture, greater trochanteric fracture, and superficial wound infections. Most included studies had some methodological limitations, with an average MINORS score of 10.5 ± 5.8. The use of dual-mobility cups in these high-risk patients undergoing total hip arthroplasty may lead to reduced dislocation rates and postoperative complications. Further long-term follow-up studies are warranted to support these findings.
Full article
(This article belongs to the Topic Orthopaedic Diseases and Innovative Intervention Strategies, 2nd Volume)
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Open AccessArticle
Elderly Patients’ Outcomes following Emergency Laparotomy—Early Surgical Consultations Are Crucial
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Rachel Gefen, Samer Abu Salem, Asaf Kedar, Joshua Zev Gottesman, Gad Marom, Alon J. Pikarsky and Miklosh Bala
Surgeries 2024, 5(2), 115-124; https://doi.org/10.3390/surgeries5020013 - 23 Mar 2024
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We aimed to study the relationship between mortality following emergency laparotomy (EL) in elderly patients and admission to a hospital facility, hypothesizing that patients initially admitted to a general surgery service have a better outcome. A retrospective review of the medical records of
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We aimed to study the relationship between mortality following emergency laparotomy (EL) in elderly patients and admission to a hospital facility, hypothesizing that patients initially admitted to a general surgery service have a better outcome. A retrospective review of the medical records of all the elderly patients (≥65 years) who underwent EL over three years was conducted in a single tertiary medical center. The outcomes evaluated include postoperative morbidity, mortality, discharge destination, and readmission. A total of 200 patients were eligible for this study; 106 (53%) were male, with a mean age of 77 ± 8.3 years. The mortality rate was 29.5% (59 patients), and 55% of all patients were discharged home after initial admission. Bowel obstruction was the most common indication for surgery (91, 45.5%). Patients undergoing an operation from non-general surgical services had higher readmission, unfavorable discharge and mortality rates, a greater incidence of stoma formation, and required a tracheostomy or were TPN-dependent (all p < 0.001). The mortality rate is higher in elderly patients needing an EL when initially admitted through a non-general surgery service. A correct and rapid initial diagnosis and decision are crucial when treating elderly individuals; initial admission to a general surgery service increases the probability of discharge home.
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Open AccessSystematic Review
The Influence of Root Prominence on the Onset of Gingival Recession: A Systematic Review
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Girolamo Raso, Nuno Bernardo Malta dos Santos, Leonardo M. Nassani, Anna Carolina Volpi Mello-Moura, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes
Surgeries 2024, 5(1), 103-114; https://doi.org/10.3390/surgeries5010012 - 12 Mar 2024
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This systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was
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This systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was “In teeth with vestibular site-specific root or alveolar bone prominence, what are the chances that this will lead to gingival recession or difficulty in root coverage procedures, compared to teeth correctly positioned in the alveolar bone or without anatomical root prominence?”. A search was carried out on three databases: Embase, PubMed/MedLine, and Wiley Library. This initial search was complemented with manual research. It included any clinical study, such as a randomized clinical trial, controlled clinical trial, prospective/retrospective clinical study, case series, or case report, published in English from January 2012 to December 2023, which reported any involvement of the root/bone prominence approach. The exclusion criteria were clinical studies without report results/details of the case(s), studies based on questionnaires, editorial letters, any review, in vitro/in silica and animal studies, and interviews. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was applied for quality assessment. A total of 163 articles were found, but only three articles were included (k = 0.98). The included studies observed negative correlations when comparing the variables root prominence with linear root coverage, root surface area covered, and linear tissue thickness gain. It suggested a significant reduction in root coverage for prominences greater than 1 mm; therefore, relevant keratinized tissue gains can be achieved in gingival recession treatment after the application of the odontoplasty. The STROBE checklist evaluated 22 items, and all the included studies had a high-quality assessment (greater than 75%) with values greater than 85%. Then, it was not possible to draw conclusions due to the number of articles included, even though they had high-quality assessments. Otherwise, it is possible to suggest that the root prominence may impact gingival recession. Therefore, new and well-designed studies must be developed to establish a significant conclusion about this condition.
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Open AccessArticle
Ostomy Belt Use Improves Quality of Life in Patients with a Stoma
by
Elisa K. Karhu, Alexandra E. Hernandez, Ana M. Restrepo and Vanessa W. Hui
Surgeries 2024, 5(1), 92-102; https://doi.org/10.3390/surgeries5010011 - 08 Mar 2024
Abstract
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Ostomy formation is a vital component in the treatment of advanced gastrointestinal diseases, including colorectal cancer and inflammatory bowel disease. It usually involves externalizing a part of the colon or small bowel to the skin surface. Thus, the creation of an ostomy can
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Ostomy formation is a vital component in the treatment of advanced gastrointestinal diseases, including colorectal cancer and inflammatory bowel disease. It usually involves externalizing a part of the colon or small bowel to the skin surface. Thus, the creation of an ostomy can often have a major negative impact on quality of life. This study aimed to evaluate whether the use of an ostomy belt could improve quality of life measures in stoma patients through a prospective interventional open-label study of 17–80-year-old English- and Spanish-speaking patients with stomas who were using an ostomy belt for 8 weeks. Changes in quality of life were assessed using the Stoma Quality of Life Scale questionnaire at baseline, at 4 weeks, and at 8 weeks post ostomy belt use. A total of 45 patients enrolled (20 female, mean age 48) in the study. The ostomy belt significantly improved quality of life scores from baseline to 4 weeks regarding overall life satisfaction (F(2, 76) = 14.77, p < 0.001) and in the domains of work/social function (F(2, 72) = 30.32, p < 0.001), sexuality/body image (F(2, 68) = 3.34, p = 0.04), and stoma function (F(2, 72) = 8.72, p < 0.001). These improvements were sustained at the 8-week follow-up. No significant differences were observed in the domains of financial impact and skin irritation. This study represents the first prospective interventional study that provides evidence for the simple low-cost intervention of ostomy support belt use in improving quality of life in patients with a stoma.
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Open AccessCase Report
An Incidental Discovery of the Intrathoracic Accessory Liver Lobe in a 72-Year-Old Man: Case Report and Literature Review
by
Aleksandra Polikarpova, Harinder K. Bains, Samuel Thomson, Yijun Gao and David L. Morris
Surgeries 2024, 5(1), 84-91; https://doi.org/10.3390/surgeries5010010 - 07 Mar 2024
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Accessory liver lobe is a rare finding, with the most common cases being accessory liver tissue on the gallbladder wall separate from the orthotopic liver. As the incidence of the ectopic liver is low there are only several case reports in published literature
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Accessory liver lobe is a rare finding, with the most common cases being accessory liver tissue on the gallbladder wall separate from the orthotopic liver. As the incidence of the ectopic liver is low there are only several case reports in published literature that describe similar presentations. We report a case of intrathoracic liver lobe that was connected to the main liver by a thick pedicle. Due to benign presentation, the patient was discharged without any surgical intervention. This case highlights the importance of understanding anatomical variability of internal organs, understanding the risks of torsion and malignant transformation of the accessory liver tissue. The literature review provides an excellent overview of published case series and reports, and outlines current recommendations on imaging, diagnosis, and management.
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Open AccessArticle
The Influence of Insurance Status on Extensor Tendon Repair Outcomes
by
Stewart S. Dalton, Laura M. Maharjan, Hayyan Yousuf and William F. Pientka II
Surgeries 2024, 5(1), 73-83; https://doi.org/10.3390/surgeries5010009 - 29 Feb 2024
Abstract
Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior
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Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior outcomes due to more facile access to postoperative hand therapy and fewer barriers to appropriate postoperative care. Methods: A retrospective chart review was conducted of patients who underwent primary extensor tendon repair in any zone, excluding the thumb, at a single large safety-net hospital. Inclusion criteria included a minimum of eight weeks of follow-up, complete data available for review, and an extensor tendon injury requiring primary surgical repair. Four cohorts were examined: patients with commercial insurance, patients with Medicare/Medicaid, patients with county hospital-sponsored insurance, and uninsured patients. Statistical analysis was performed using Chi-Square and ANOVA analyses, with significance defined as p ≤ 0.05. Results: Of the 62 patients (100 digits) included, 20 had commercial insurance, 12 had Medicare/Medicaid, 13 had hospital-sponsored insurance, and 17 were uninsured. Except for mean age, there were no significant differences between groups in terms of demographic data, medical comorbidities, or digit characteristics. There were also no significant differences in mean follow-up, time to return to full activity, or surgical complications among groups. Procedure duration differed significantly between groups, with procedures lasting longer in uninsured patients. Postoperative final flexion total arc of motion (TAM) and extension measurements were similar across all groups. Additionally, hand therapy visits did not differ significantly between groups. Conclusions: Following extensor tendon repair, patient insurance status did not affect outcomes in terms of final range of motion, return to full activity, or postoperative complications.
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Open AccessSystematic Review
Biliary Leak from Ducts of Luschka: Systematic Review of the Literature
by
Antonio Vitiello, Maria Spagnuolo, Marcello Persico, Roberto Peltrini, Giovanna Berardi, Pietro Calabrese, Carlo De Werra, Carmela Rescigno, Roberto Troisi and Vincenzo Pilone
Surgeries 2024, 5(1), 63-72; https://doi.org/10.3390/surgeries5010008 - 26 Feb 2024
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Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a
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Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a bile leak from an LD. A total of 136 articles were retrieved from the searched databases. After the removal of duplicates and non-eligible papers, 48 studies reporting 231 leaks were included: 20 (41.6%) case reports, 2 (4.3%) comparative studies, 7 (14.9%) meeting abstracts and 19 (40.4%) retrospective cohort articles. The rate of LD leak ranges from 0.05% to 1.9%, but injury to a duct of Luschka was the second most common cause of biliary leakage in all the cohort studies (5.5% to 41%). In 21 (43.7%) cases, the leak was successfully treated with a sphincterotomy through Endoscopic Retrograde Cholangiopancreatography (ERCP) plus or minus stenting, and in 12 (25%), re-laparoscopy was necessary.
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