Clinical diagnostic advances in intestinal anastomotic techniques:Hand suturing,stapling,and compression devices

The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture formation.The healing process involves various phases:hemostasis and inflammation,proliferation,and remodeling.Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines.Compression anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and efficacy.However,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary concern.Newer devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to stapling.Magnetic technology is also being explored for other medical treatments.While there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.

Epileptic brain network mechanisms and neuroimaging techniques for the brain network

Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.

Bicuspidization Using the Open-Sleeve Technique for Congenital Aortic Stenosisduring Infancy

Congenital aortic stenosis(cAS)frequently requires intervention during the neonatal or infantile period.However,surgical repair is challenging because of the narrow surgical space.We performed bicuspidization using the open-sleeve technique for cAS with a unicuspid aortic valve in two patients.Postoperatively,the patients were doing well without reintervention for the aortic valve for 8 and 6 years,respectively.Their aortic annular diameter increased along with somatic growth.Bicuspidization for neonates or infancy can be performed safely using the open-sleeve technique as its midterm results have been satisfactory.

An Insight Survey on Sensor Errors and Fault Detection Techniques in Smart Spaces

The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness ofIoT devices. These devices, present in offices, homes, industries, and more, need constant monitoring to ensuretheir proper functionality. The success of smart systems relies on their seamless operation and ability to handlefaults. Sensors, crucial components of these systems, gather data and contribute to their functionality. Therefore,sensor faults can compromise the system’s reliability and undermine the trustworthiness of smart environments.To address these concerns, various techniques and algorithms can be employed to enhance the performance ofIoT devices through effective fault detection. This paper conducted a thorough review of the existing literature andconducted a detailed analysis.This analysis effectively links sensor errors with a prominent fault detection techniquecapable of addressing them. This study is innovative because it paves theway for future researchers to explore errorsthat have not yet been tackled by existing fault detection methods. Significant, the paper, also highlights essentialfactors for selecting and adopting fault detection techniques, as well as the characteristics of datasets and theircorresponding recommended techniques. Additionally, the paper presents amethodical overview of fault detectiontechniques employed in smart devices, including themetrics used for evaluation. Furthermore, the paper examinesthe body of academic work related to sensor faults and fault detection techniques within the domain. This reflectsthe growing inclination and scholarly attention of researchers and academicians toward strategies for fault detectionwithin the realm of the Internet of Things.

Advances in the application of auxiliary imaging techniques in parathyroid diseases

Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.

Software Defect Prediction Using Hybrid Machine Learning Techniques: A Comparative Study

When a customer uses the software, then it is possible to occur defects that can be removed in the updated versions of the software. Hence, in the present work, a robust examination of cross-project software defect prediction is elaborated through an innovative hybrid machine learning framework. The proposed technique combines an advanced deep neural network architecture with ensemble models such as Support Vector Machine (SVM), Random Forest (RF), and XGBoost. The study evaluates the performance by considering multiple software projects like CM1, JM1, KC1, and PC1 using datasets from the PROMISE Software Engineering Repository. The three hybrid models that are compared are Hybrid Model-1 (SVM, RandomForest, XGBoost, Neural Network), Hybrid Model-2 (GradientBoosting, DecisionTree, LogisticRegression, Neural Network), and Hybrid Model-3 (KNeighbors, GaussianNB, Support Vector Classification (SVC), Neural Network), and the Hybrid Model 3 surpasses the others in terms of recall, F1-score, accuracy, ROC AUC, and precision. The presented work offers valuable insights into the effectiveness of hybrid techniques for cross-project defect prediction, providing a comparative perspective on early defect identification and mitigation strategies. .

Optimization of tracheoesophageal fistula model established with Tshaped magnet system based on magnetic compression technique

BACKGROUND The magnetic compression technique has been used to establish an animal model of tracheoesophageal fistula(TEF),but the commonly shaped magnets present limitations of poor homogeneity of TEF and poor model control.We designed a Tshaped magnet system to overcome these problems and verified its effectiveness via animal experiments.AIM To investigate the effectiveness of a T-shaped magnet system for establishing a TEF model in beagle dogs.METHODS Twelve beagles were randomly assigned to groups in which magnets of the Tshaped scheme(study group,n=6)or normal magnets(control group,n=6)were implanted into the trachea and esophagus separately under gastroscopy.Operation time,operation success rate,and accidental injury were recorded.After operation,the presence and timing of cough and the time of magnet shedding were observed.Dogs in the control group were euthanized after X-ray and gastroscopy to confirm establishment of TEFs after coughing,and gross specimens of TEFs were obtained.Dogs in the study group were euthanized after X-ray and gastroscopy 2 wk after surgery,and gross specimens were obtained.Fistula size was measured in all animals,and then harvested fistula specimens were examined by hematoxylin and eosin(HE)and Masson trichrome staining.RESULTS The operation success rate was 100%for both groups.Operation time did not differ between the study group(5.25 min±1.29 min)and the control group(4.75 min±1.70 min;P=0.331).No bleeding,perforation,or unplanned magnet attraction occurred in any animal during the operation.In the early postoperative period,all dogs ate freely and were generally in good condition.Dogs in the control group had severe cough after drinking water at 6-9 d after surgery.X-ray indicated that the magnets had entered the stomach,and gastroscopy showed TEF formation.Gross specimens of TEFs from the control group showed the formation of fistulas with a diameter of 4.94 mm±1.29 mm(range,3.52-6.56 mm).HE and Masson trichrome staining showed scar tissue formation and hierarchical structural disorder at the fistulas.Dogs in the study group did not exhibit obvious coughing after surgery.X-ray examination 2 wk after surgery indicated fixed magnet positioning,and gastroscopy showed no change in magnet positioning.The magnets were removed using a snare under endoscopy,and TEF was observed.Gross specimens showed well-formed fistulas with a diameter of 6.11 mm±0.16 mm(range,5.92-6.36 mm),which exceeded that in the control group(P<0.001).Scar formation was observed on the internal surface of fistulas by HE and Masson trichrome staining,and the structure was more regular than that in the control group.CONCLUSION Use of the modified T-shaped magnet scheme is safe and feasible for establishing TEF and can achieve a more stable and uniform fistula size compared with ordinary magnets.Most importantly,this model offers better controllability,which improves the flexibility of follow-up studies.

Comparison of prognosis and postoperative morbidities between standard pancreaticoduodenectomy and the TRIANGLE technique for resectable pancreatic ductal adenocarcinoma

BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially locally,still inhibits the treatment efficacy.The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC.However,there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.PDAC.METHODS Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study.All the patients were divided into PDstandard and PDTRIANGLE groups according to the surgical procedure.Baseline characteristics,surgical data,and postoperative morbidities were recorded.All of the patients were followed up,and the date and location of tumor recurrence,and death were recorded.The Kaplan-Meier method and log-rank test were used for the survival analysis.RESULTS There were 93 patients included in the study and 37 underwent the TRIANGLE technique.Duration of operation was longer in the PDTRIANGLE group compared with the PDstandard group[440(410-480)min vs 320(265-427)min](P=0.001).Intraoperative blood loss[700(500-1200)mL vs 500(300-800)mL](P=0.009)and blood transfusion[975(0-1250)mL vs 400(0-800)mL](P=0.009)were higher in the PDTRIANGLE group.There was a higher incidence of surgical site infection(43.2%vs 12.5%)(P=0.001)and postoperative diarrhea(54.1%vs 12.5%)(P=0.001)in the PDTRIANGLE group.The rates of R0 resection and local recurrence,overall survival,and disease-free survival did not differ significantly between the two groups.CONCLUSION The TRIANGLE technique is safe,with acceptable postoperative morbidities compared with standardized PD,but it does not improve prognosis for patients with resectable PDAC.

Treatment of bilateral developmental dysplasia of the hip joint with an improved technique:A case report

BACKGROUND Developmental dysplasia of the hip(DDH)is a common osteoarticular deformity in pediatric orthopedics.A patient with bilateral DDH was diagnosed and treated using our improved technique"(powerful overturning acetabuloplasty)"combined with femoral rotational shortening osteotomy.CASE SUMMARY A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally,and sought surgical treatment to solve the problem of double hip extension and standing.As this child had high dislocation of the hip joint and the acetabular index was high,we changed the traditional acetabuloplasty to"powerful turnover acetabuloplasty"combined with femoral rotation shortening osteotomy.During the short-term postoperative follow-up(1,3,6,9,12,and 15 months),the child had no discomfort in her lower limbs.After the braces and internal fixation plates were removed,formal rehabilitation training was actively carried out.CONCLUSION Our"powerful overturning acetabuloplasty"combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children.This technology may be widely used in the clinic.

Research Progress on Detection Techniques of Fungicide Residues in Chinese Chives

Chinese chive is a kind of medicinal and edible plant,with many diseases,and chemical fungicides are usually used for control.In order to find out the risk of pesticide residues in Chinese chives,this paper summarized relevant literatures published in recent years,and sorted out and analyzed the types of pesticides used and detection techniques of common diseases in Chinese chives.

Prediction of high-embankment settlement combining joint denoising technique and enhanced GWO-v-SVR method

Reliable long-term settlement prediction of a high embankment relates to mountain infrastructure safety.This study developed a novel hybrid model(NHM)that combines a joint denoising technique with an enhanced gray wolf optimizer(EGWO)-n-support vector regression(n-SVR)method.High-embankment field measurements were preprocessed using the joint denoising technique,which in-cludes complete ensemble empirical mode decomposition,singular value decomposition,and wavelet packet transform.Furthermore,high-embankment settlements were predicted using the EGWO-n-SVR method.In this method,the standard gray wolf optimizer(GWO)was improved to obtain the EGWO to better tune the n-SVR model hyperparameters.The proposed NHM was then tested in two case studies.Finally,the influences of the data division ratio and kernel function on the EGWO-n-SVR forecasting performance and prediction efficiency were investigated.The results indicate that the NHM suppresses noise and restores details in high-embankment field measurements.Simultaneously,the NHM out-performs other alternative prediction methods in prediction accuracy and robustness.This demonstrates that the proposed NHM is effective in predicting high-embankment settlements with noisy field mea-surements.Moreover,the appropriate data division ratio and kernel function for EGWO-n-SVR are 7:3 and radial basis function,respectively.

Establishment of acquired tracheoesophageal fistula using a modified magnetic compression technique in rabbits and its postmodeling evaluation

BACKGROUND Previous studies have validated the efficacy of both magnetic compression and surgical techniques in creating rabbit tracheoesophageal fistula(TEF)models.Magnetic compression achieves a 100%success rate but requires more time,while surgery,though less frequently successful,offers rapid model establishment and technical maturity in larger animal models.AIM To determine the optimal approach for rabbit disease modeling and refine the process.METHODS TEF models were created in 12 rabbits using both the modified magnetic compression technique and surgery.Comparisons of the time to model establishment,success rate,food and water intake,weight changes,activity levels,bronchoscopy findings,white blood cell counts,and biopsies were performed.In response to the failures encountered during modified magnetic compression modeling,we increased the sample size to 15 rabbit models and assessed the repeatability and stability of the models,comparing them with the original magnetic compression technique.RESULTS The modified magnetic compression technique achieved a 66.7%success rate,whereas the success rate of the surgery technique was 33.3%.Surviving surgical rabbits might not meet subsequent experimental requirements due to TEF-related inflammation.In the modified magnetic compression group,one rabbit died,possibly due to magnet corrosion,and another died from tracheal magnet obstruction.Similar events occurred during the second round of modified magnetic compression modeling,with one rabbit possibly succumbing to aggravated lung infection.The operation time of the first round of modified magnetic compression was 3.2±0.6 min,which was significantly reduced to 2.1±0.4 min in the second round,compared to both the first round and that of the original technique.CONCLUSION The modified magnetic compression technique exhibits lower stress responses,a simple procedure,a high success rate,and lower modeling costs,making it a more appropriate choice for constructing TEF models in rabbits.

The Impact of Model Based Offset Scaling Technique on the Amplitude Variation with Offset Responses from 3D Seismic Data Acquired from the Tano Basin, Offshore Ghana

Amplitudes have been found to be a function of incident angle and offset. Hence data required to test for amplitude variation with angle or offset needs to have its amplitudes for all offsets preserved and not stacked. Amplitude Variation with Offset (AVO)/Amplitude Variation with Angle (AVA) is necessary to account for information in the offset/angle parameter (mode converted S-wave and P-wave velocities). Since amplitudes are a function of the converted S- and P-waves, it is important to investigate the dependence of amplitudes on the elastic (P- and S-waves) parameters from the seismic data. By modelling these effects for different reservoir fluids via fluid substitution, various AVO geobody classes present along the well and in the entire seismic cube can be observed. AVO analysis was performed on one test well (Well_1) and 3D pre-stack angle gathers from the Tano Basin. The analysis involves creating a synthetic model to infer the effect of offset scaling techniques on amplitude responses in the Tano basin as compared to the effect of unscaled seismic data. The spectral balance process was performed to match the amplitude spectra of all angle stacks to that of the mid (26°) stack on the test lines. The process had an effect primarily on the far (34° - 40°) stacks. The frequency content of these stacks slightly increased to match that of the near and mid stacks. In offset scaling process, the root mean square (RMS) amplitude comparison between the synthetic and seismic suggests that the amplitude of the far traces should be reduced relative to the nears by up to 16%. However, the exact scaler values depend on the time window considered. This suggests that the amplitude scaling with offset delivered from seismic processing is only approximately correct and needs to be checked with well synthetics and adjusted accordingly prior to use for AVO studies. The AVO attribute volumes generated were better at resolving anomalies on spectrally balanced and offset scaled data than data delivered from conventional processing. A typical class II AVO anomaly is seen along the test well from the cross-plot analysis and AVO attribute cube which indicates an oil filled reservoir.

Economic Power Dispatching from Distributed Generations: Review of Optimization Techniques

In the increasingly decentralized energy environment,economical power dispatching from distributed generations(DGs)is crucial to minimizing operating costs,optimizing resource utilization,and guaranteeing a consistent and sustainable supply of electricity.A comprehensive review of optimization techniques for economic power dispatching from distributed generations is imperative to identify the most effective strategies for minimizing operational costs while maintaining grid stability and sustainability.The choice of optimization technique for economic power dispatching from DGs depends on a number of factors,such as the size and complexity of the power system,the availability of computational resources,and the specific requirements of the application.Optimization techniques for economic power dispatching from distributed generations(DGs)can be classified into two main categories:(i)Classical optimization techniques,(ii)Heuristic optimization techniques.In classical optimization techniques,the linear programming(LP)model is one of the most popular optimization methods.Utilizing the LP model,power demand and network constraints are met while minimizing the overall cost of generating electricity from DGs.This approach is efficient in determining the best DGs dispatch and is capable of handling challenging optimization issues in the large-scale system including renewables.The quadratic programming(QP)model,a classical optimization technique,is a further popular optimization method,to consider non-linearity.The QP model can take into account the quadratic cost of energy production,with consideration constraints like network capacity,voltage,and frequency.The metaheuristic optimization techniques are also used for economic power dispatching from DGs,which include genetic algorithms(GA),particle swarm optimization(PSO),and ant colony optimization(ACO).Also,Some researchers are developing hybrid optimization techniques that combine elements of classical and heuristic optimization techniques with the incorporation of droop control,predictive control,and fuzzy-based methods.These methods can deal with large-scale systems with many objectives and non-linear,non-convex optimization issues.The most popular approaches are the LP and QP models,while more difficult problems are handled using metaheuristic optimization techniques.In summary,in order to increase efficiency,reduce costs,and ensure a consistent supply of electricity,optimization techniques are essential tools used in economic power dispatching from DGs.

Modified Black Widow Optimization-Based Enhanced Threshold Energy Detection Technique for Spectrum Sensing in Cognitive Radio Networks

This study develops an Enhanced Threshold Based Energy Detection approach(ETBED)for spectrum sensing in a cognitive radio network.The threshold identification method is implemented in the received signal at the secondary user based on the square law.The proposed method is implemented with the signal transmission of multiple outputs-orthogonal frequency division multiplexing.Additionally,the proposed method is considered the dynamic detection threshold adjustments and energy identification spectrum sensing technique in cognitive radio systems.In the dynamic threshold,the signal ratio-based threshold is fixed.The threshold is computed by considering the Modified Black Widow Optimization Algorithm(MBWO).So,the proposed methodology is a combination of dynamic threshold detection and MBWO.The general threshold-based detection technique has different limitations such as the inability optimal signal threshold for determining the presence of the primary user signal.These limitations undermine the sensing accuracy of the energy identification technique.Hence,the ETBED technique is developed to enhance the energy efficiency of cognitive radio networks.The projected approach is executed and analyzed with performance and comparison analysis.The proposed method is contrasted with the conventional techniques of theWhale Optimization Algorithm(WOA)and GreyWolf Optimization(GWO).It indicated superior results,achieving a high average throughput of 2.2 Mbps and an energy efficiency of 3.8,outperforming conventional techniques.

Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique

BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.

Treatment of anastomotic stricture after rectal cancer operation by magnetic compression technique:A case report

BACKGROUNDThe treatment of postoperative anastomotic stenosis(AS)after resection of colorectalcancer is challenging.Endoscopic balloon dilation is used to treat stenosisin such cases,but some patients do not show improvement even after multipleballoon dilations.Magnetic compression technique(MCT)has been used for gastrointestinalanastomosis,but its use for the treatment of postoperative AS aftercolorectal cancer surgery has rarely been reported.CASE SUMMARYWe report a 72-year-old man who underwent radical resection of colorectal cancerand ileostomy one year ago.An ileostomy closure was prepared six months ago,but colonoscopy revealed a narrowing of the rectal anastomosis.Endoscopic balloondilation was performed three times,but colonoscopy showed no significantimprovement in stenosis.The AS was successfully treated using MCT.CONCLUSIONMCT is a minimally invasive method that can be used for the treatment of postoperativeAS after colorectal cancer surgery.

Clinical feasibility of laparoscopic left lateral segment liver resection with magnetic anchor technique:The first clinical study from China

BACKGROUND Magnetic anchor technique(MAT)has been applied in laparoscopic cholecystectomy and laparoscopic appendectomy,but has not been reported in laparoscopic partial hepatectomy.AIM To evaluate the feasibility of the MAT in laparoscopic left lateral segment liver resection.METHODS Retrospective analysis was conducted on the clinical data of eight patients who underwent laparoscopic left lateral segment liver resection assisted by MAT in our department from July 2020 to November 2021.The Y-Z magnetic anchor devices(Y-Z MADs)was independently designed and developed by the author of this paper,which consists of the anchor magnet and magnetic grasping apparatus.Surgical time,intraoperative blood loss,intraoperative accidents,operator experience,postoperative incision pain score,postoperative complications,and other indicators were evaluated and analyzed.RESULTS All eight patients underwent a MAT-assisted laparoscopic left lateral segment liver resection,including three patients undertaking conventional 5-port and five patients having a transumbilical single-port operation.The mean operation time was 138±34.32 min(range 95-185 min)and the mean intraoperative blood loss was 123±88.60 mL(range 20-300 mL).No adverse events occurred during the operation.The Y-Z MADs showed good workability and maneuverability in both tissue and organ exposure.In particular,the operators did not experience either a“chopstick”or“sword-fight”effect in the single-port laparoscopic operation.CONCLUSION The results show that the MAT is safe and feasible for laparoscopic left lateral segment liver resection,especially,exhibits its unique abettance for transumbilical single-port laparoscopic left lateral segment liver resection.

Urethroplasty among Elderly Men, Surgical Techniques and Outcomes

Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.

Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure

BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.