Alcohol associated liver disease and bariatric surgery:Current perspectives and future directions

Bariatric surgery is a routinely performed procedure and is associated with a reduction in all-cause mortality in patients with obesity.However,bariatric sur-gery has also been linked to increased alcohol use with up to 30%of these patients developing alcohol use disorder(AUD).The mechanism of AUD after bariatric surgery is multifactorial and includes anatomic,metabolic,and neurohumoral changes associated with post-surgical anatomy.These patients are at increased risk of alcohol associated liver disease and,in some cases,require liver trans-plantation.In this article,we provide a scoping review of epidemiology,patho-physiology,and clinical outcomes of alcohol-related health conditions after bariatric surgery.

Acute acquired concomitant esotropia with congenital paralytic strabismus:A case report

BACKGROUND An unusual case of acute acquired concomitant esotropia(AACE)with congenital paralytic strabismus in the right eye is reported.CASE SUMMARY A 23-year-old woman presented with complaints of binocular diplopia and esotropia of the right eye lasting 4 years and head tilt to the left since 1 year after birth.The Bielschowsky head tilt test showed right hypertropia on a right head tilt.She did not report any other intracranial pathology.A diagnosis of AACE and right congenital paralytic strabismus was made.Then,she underwent medial rectus muscle recession and lateral rectus muscle resection combined with inferior oblique muscle myectomy in the right eye.One day after surgery,the patient reported that she had no diplopia at either distance or near fixation and was found to be orthophoric in the primary position;furthermore,her head posture immediately and markedly improved.CONCLUSION In future clinical work,in cases of AACE combined with other types of strabismus,we can perform conventional single surgery for both at the same time,and the two types of strabismus can be solved simultaneously.

Experience with the surgical treatment of patients with both esophageal carcinoma and bullous emphysema

Objective： We aimed to investigate the security and feasibility of the simultaneous surgery for patients with both esophageal carcinoma and bullous emphysema. Methods： We described simultaneous surgery performed on 49 cases with both esophaoeal carcinoma and buUous emphysema, accounting for 2.5% of all esophagectomy patients from January 2000 to January 2003. Radical resection of upper and mid-thoracic esophageal cancer was performed in 31 cases, including three approaches from the right chest, left neck and midsection. Thirty-six patients were underwent cervical anastomosis and 13 cases were operated by intrathoracic anastomosis. Results： No perioperative period death occurred. And postoperative com- plications were as follows： cervical anastomotic leakage in 9 cases, lung infection in 11 cases, pulmonary air leak in 13 cases （2 cases lasted for 4 weeks）, recurrent laryngeal nerve damage in 4 cases, supraventricular tachycardia in 4 cases. Patients all recovered and left the hospital with average hospitalization time of 17.5 days. Conclusion： Patients with both esophageal carcinoma and bullous can perform the esophageal carcinoma resection and lung volume reduction surgery （LVRS） simulta- neously. It will not increase the mortality rate and show the feasibility and safety in patients.

The role of ureteroscopy for treatment of staghorn calculi: A systematic review

Objective:To define the role of ureteroscopy for treatment of staghorn calculi.Methods:A systematic review was conducted using the Scopus and Medline databases.Original articles and systematic reviews were selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Only studies relating to the role of ureteroscopy for treatment of staghorn calculi were included.Results:In five studies on ureteroscopic monotherapy,stone-free rate(SFR)ranged from 33%to 93%,with a maximum four ureteroscopy sessions per patient and no major complications.Endoscopic combined intrarenal surgery(ECIRS)was compared with percutaneous nephrolithotomy(PNL)in two studies and reached significantly higher SFR(88%e91%vs.59%e65%)and lower operative times(84e110 min vs.105e129 min).The role of salvage ureteroscopy for residual stones after primary PNL has been highlighted by two studies with a final SFR of 83%e89%.One study reported on the feasibility of ureteroscopy for ureteral stones and same-session PNL for contralateral staghorn calculi,with a SFR of 92%.Conclusion:Ureteroscopy plays a pivotal role in the setting of a combined approach to staghorn calculi.Ureteroscopy is also particularly suitable for clearance of residual stones.In specific cases,ureteroscopy may become the sole applicable therapeutic option to staghorn calculi.Technological advances and refinement of techniques suggest a major role of ureteroscopy for staghorn calculi treatment in close future.