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Neonatal tachypnea caused by diaphragmatic paralysis:A case report
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作者 Yan Zeng Pei Luo +2 位作者 Di-Ran Zhao Feng-Yang Wang Bin Song 《World Journal of Clinical Cases》 SCIE 2024年第22期5253-5257,共5页
BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUM... BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUMMARY We report a 39-week-old newborn delivered via vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations.The infant was initially diagnosed with pneumonia.However,the newborn still exhibited tachypnea despite effective antibiotic treatment.Chest radiography revealed right diaphragmatic elevation.M-mode ultrasonography revealed decreased movement of the right diaphragm.The infant was subsequently diagnosed with diaphragmatic paralysis.After 4 weeks,tachypnea improved.Upon re-examination using M-mode ultrasonography,the difference in bilateral diaphragmatic muscle movement was smaller than before.CONCLUSION Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation. 展开更多
关键词 diaphragmatic paralysis M-mode ultrasonography Birth trauma NEWBORN Case report
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Analysis of the Effect of Extracorporeal Diaphragmatic Pacing Combined with Noninvasive Ventilator on the Respiratory Function and Prognosis of COPD Patients
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作者 Wei Xu Fei Wang Fang Wang 《Journal of Clinical and Nursing Research》 2024年第4期73-78,共6页
Objective: To investigate the effect of extracorporeal diaphragmatic pacing combined with noninvasive ventilators on the respiratory function and prognosis of chronic obstructive pulmonary disease (COPD) patients. Met... Objective: To investigate the effect of extracorporeal diaphragmatic pacing combined with noninvasive ventilators on the respiratory function and prognosis of chronic obstructive pulmonary disease (COPD) patients. Methods: A total of 50 COPD patients were selected between January 2023 to December 2023 and randomly grouped into an observation group and a control group, with 25 cases. The observation group was given extracorporeal diaphragm pacing combined with a noninvasive ventilator, while the control group was given a conventional treatment mode. After the treatment, the results of each index in the two groups were compared. Results: Compared with the diaphragm function indexes of the two groups, the data of the observation group were more dominant (P < 0.05). The rehospitalization rate of the observation group was lower than that of the control group (P < 0.05). The COPD assessment test (CAT) and mMRC (Modified Medical Research Council) Dyspnoea scale scores after treatment between the two groups were significantly different (P < 0.05). Compared with the control group, the lung function indexes of the observation group were more dominant (P < 0.05). Conclusion: Extracorporeal diaphragmatic pacing combined with a noninvasive ventilator promoted the improvement of the patient’s prognosis and improved their respiratory function. 展开更多
关键词 COPD Extracorporeal diaphragmatic pacing Noninvasive ventilator Respiratory function PROGNOSIS
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Maternal diaphragmatic hernia in pregnancy:A systematic review with a treatment algorithm
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作者 Goran Augustin Diana Kovač +3 位作者 Vesna Sokol Karadjole Vendy Zajec Mislav Herman Pero Hrabač 《World Journal of Clinical Cases》 SCIE 2023年第27期6440-6454,共15页
BACKGROUND Diaphragmatic hernia(DH)is extremely rarely described during pregnancy.Due to the rarity,there is no diagnostic or treatment algorithm for DH in pregnancy.AIM To summarize and define the most appropriate di... BACKGROUND Diaphragmatic hernia(DH)is extremely rarely described during pregnancy.Due to the rarity,there is no diagnostic or treatment algorithm for DH in pregnancy.AIM To summarize and define the most appropriate diagnostic methods and therapeutic options for DH in pregnancy based on scarce literature.METHODS Literature search of English-,German-,Spanish-,and Italian-language articles were performed using PubMed(1946–2021),PubMed Central(1900–2021),and Google Scholar.The PRISMA protocol was followed.The search terms included:Maternal diaphragmatic hernia,congenital hernia,pregnancy,cardiovascular collapse,mediastinal shift,abdominal pain in pregnancy,hyperemesis,diaphragmatic rupture during labor,puerperium,hernie diaphragmatique maternelle,hernia diafragmática congenital.Additional studies were identified by reviewing reference lists of retrieved studies.Demographic,imaging,surgical,and obstetric data were obtained.RESULTS One hundred and fifty-eight cases were collected.The average maternal age increased across observed periods.The proportion of congenital hernias increased,while the other types appeared stationary.Most DHs were left-sided(83.8%).The median number of herniated organs declined across observed periods.A working diagnosis was correct in 50%.DH type did not correlate to maternal or neonatal outcomes.Laparoscopic access increased while thoracotomy varied across periods.Presentation of less than 3 days carried a significant risk of strangulation in pregnancy.CONCLUSION The clinical presentation of DH is easily confused with common chest conditions,delaying the diagnosis,and increasing maternal and fetal mortality.Symptomatic DH should be included in the differential diagnosis of pregnant women with abdominal pain associated with dyspnea and chest pain,especially when followed by collapse.Early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.A proposed algorithm helps manage pregnant women with maternal DH.Strangulated DH requires an emergent operation,while delivery should be based on obstetric indications. 展开更多
关键词 Maternal diaphragmatic hernia PREGNANCY Differential diagnosis Maternal mortality Fetal mortality ALGORITHM
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Right Diaphragmatic Rupture with Passage of an Intrathoracic Ileal Segment Apropos of a Case and Review of the Literature at the Kankan Regional Hospital
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作者 Aly Mampan Koundouno Saikou Yaya Diakite +8 位作者 Saa Yawo Kondano Fodé Lansana Camara Labilé Togba Soumaoro Soryba Naby Camara Abdoulaye Korsé Balde Hamidou Sylla Aissatou Taran Diallo Moussa Doumbouya Aboubacar Toure 《Open Journal of Internal Medicine》 2023年第2期126-130,共5页
Traumatic rupture of the right diaphragmatic dome with herniation of a segment of the hail into the thorax is a rare lesion. It is often the result of a thoraco-abdominal trauma. It can generally lead to early or late... Traumatic rupture of the right diaphragmatic dome with herniation of a segment of the hail into the thorax is a rare lesion. It is often the result of a thoraco-abdominal trauma. It can generally lead to early or late cardiopulmonary complications due to compression. The objective of this clinical case is to study the physiopathological mechanisms, the diagnostic and therapeutic modalities of this complication. The diagnosis is often difficult in front of a diaphragmatic rupture since there are no specific clinical signs. In our case, the clinical picture on arrival was that of a high occlusion in an immediate postoperative context. The X-ray which makes it possible to visualize the ascended organs but more difficultly the rupture itself could not be carried out. Treatment is essentially surgical. Although the thoracic approach is preferred by several surgeons because of the difficulties of exposing the diaphragm in the presence of the liver, we chose the abdominal approach instead. The postoperative course is made up of parietal suppuration. 展开更多
关键词 RUPTURE diaphragmatic Intrathoracic Ileal Segment
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Right Post-Traumatic Diaphragmatic Hernia with Liver Dislocation
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作者 Erragh Anas Khaleq Khalid +3 位作者 Benaddi Loubna Bouhouri Aziz Nsiri Afak Alharrar Rachid 《Case Reports in Clinical Medicine》 2023年第4期102-107,共6页
Diaphragmatic hernia is a rare consequence of thoraco-abdominal trauma. It may be associated with high morbidity and mortality, particularly if surgical intervention is delayed. We report a case of a right diaphragmat... Diaphragmatic hernia is a rare consequence of thoraco-abdominal trauma. It may be associated with high morbidity and mortality, particularly if surgical intervention is delayed. We report a case of a right diaphragmatic hernia in a 75-year-old woman. The patient was referred to our hospital with mild dyspnea. Chest radiograph showed an overtly elevated right hemi-diaphragm. Thoracic and abdominal computed tomographic scan was requested and showed a defect of the right diaphragmatic muscle wall with intrathoracic ascension of the liver. During the postoperative course, the patient was still on mechanical ventilation, hemodynamically unstable. She developped urinary peritonitis and an extensive bowel ischemia worsening. We report this case to show that the prognosis is related to associated injuries and possible complications. The possibility of a diaphragmatic rupture should be kept in mind and surgery is mandatory in order to avoid complications. 展开更多
关键词 Thoraco-Abdominal Trauma Right diaphragmatic Hernia Rare Complication Liver Dislocation
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New direction for surgery:Super minimally invasive surgery
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作者 En-Qiang Linghu 《World Journal of Gastroenterology》 SCIE CAS 2024年第12期1676-1679,共4页
The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm... The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS. 展开更多
关键词 Super minimally invasive surgery Minimally invasive surgery Treatment mode Traditional surgery New direction for surgery
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Indocyanine green:The guide to safer and more effective surgery
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作者 Pietro Fransvea Maria Michela Chiarello +2 位作者 Valeria Fico Maria Cariati Giuseppe Brisinda 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期641-649,共9页
In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyan... In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal surgery.They also highlight future perspectives of the use of indocyanine green in mini-invasive surgery.Indo-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in humans.It can be administered in-travenously or intra-arterially.Since its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and burns.For these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant surgery.Co-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic leakage.The regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient outcomes.Using the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic leak.The use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency scenarios.However,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine green guided surgery into standard practice. 展开更多
关键词 Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery Surgical oncology
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Safety and feasibility of enhanced recovery after surgery-based management model for ambulatory pediatric surgical procedures
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作者 Gui-Quan Fan Xin-Dan Zhang +4 位作者 Yong-Ke He Xiao-Gang Lu Ji-Yong Zhong Zong-Yang Pang Xi-Yang Gan 《World Journal of Clinical Cases》 SCIE 2024年第22期4965-4972,共8页
BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safe... BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safety and feasibility of the enhanced recovery after surgery(ERAS)-based management model for ambulatory pediatric surgical procedures.METHODS We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People’s Hospital of Liangshan Yi Autonomous Prefecture.Of these,220 received ERAS-based management(research group)and 100 received routine management(control group).General information,postoperative ambulation activities,surgical outcomes(operation time,postoperative gastro-intestinal ventilation time,and hospital stay),postoperative pain visual analogue scale,postoperative complications(incision infection,abdominal distension,fever,nausea,and vomiting),and family satisfaction were compared.RESULTS The general information of the research group(sex,age,disease type,single parent,family history,etc.)was comparable to that of the control group(P>0.05),but the rate of postoperative(2 h,4 h,and 6 h after surgery)ambulation activities was statistically higher(P<0.01),and operation time,postoperative gastrointestinal ventilation time,and hospital stay were markedly shorter(P<0.05).The research group had lower visual analogue scale scores(P<0.01)at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group(P=0.001).The research group had higher family satisfaction than the control group(P=0.007).CONCLUSION The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion. 展开更多
关键词 Ambulatory pediatric surgery Ambulatory surgery Enhanced recovery after surgery SAFETY FEASIBILITY
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Parallel pathways:A chronicle of evolution in rectal and breast cancer surgery
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作者 Antonio Pesce NicolòFabbri +1 位作者 Diletta Iovino Carlo Vittorio Feo 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第4期1091-1096,共6页
In this editorial,we have analyzed the historical evolution of rectal and breast cancer surgery,focusing on the progressive reduction of demolitive approaches and the increasing use of more conservative strategies,acc... In this editorial,we have analyzed the historical evolution of rectal and breast cancer surgery,focusing on the progressive reduction of demolitive approaches and the increasing use of more conservative strategies,accompanied by a growing emphasis on perioperative treatments aimed at enhancing surgical outcomes.All of these changes have been made possible due to an increased awareness and understanding of oncological diseases and improved perioperative treatments. 展开更多
关键词 Rectal cancer HISTORY Breast surgery Demolitive treatment Conservative surgery
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Bariatric surgery and diabetes:Current challenges and perspectives
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作者 Yan-Fei He Xiao-Dong Hu +2 位作者 Jun-Qiang Liu Hu-Ming Li Shuang-Feng Lu 《World Journal of Diabetes》 SCIE 2024年第8期1692-1703,共12页
Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are ... Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice. 展开更多
关键词 Bariatric surgery Diabetes mellitus OBESITY Metabolic surgery CHALLENGE
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Artificial Intelligence and Computer Vision during Surgery: Discussing Laparoscopic Images with ChatGPT4—Preliminary Results
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作者 Savvas Hirides Petros Hirides +1 位作者 Kouloufakou Kalliopi Constantinos Hirides 《Surgical Science》 2024年第3期169-181,共13页
Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce... Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come. 展开更多
关键词 Artificial Intelligence surgery Image Recognition Autonomous surgery
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Does enhanced recovery after surgery programs improve clinical outcomes in liver cancer surgery?
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作者 Belinda Sánchez-Pérez JoséM Ramia 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第2期255-258,共4页
Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed... Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects. 展开更多
关键词 Enhanced recovery after surgery programs Liver surgery Key components Long-term oncological outcomes Enhanced recovery after surgery compliance
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Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates
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作者 Michele Marchioni Giulia Primiceri +7 位作者 Alessandro Veccia Marta Di Nicola Umberto Carbonara Fabio Crocerossa Ugo Falagario Ambra Rizzoli Riccardo Autorino Luigi Schips 《Asian Journal of Urology》 CSCD 2024年第1期48-54,共7页
Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms inste... Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes. 展开更多
关键词 Prostatecancer Transurethral surgery of the prostate Prostate surgery Population-based analysis Benign prostatic hyperplasia LASERsurgery
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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal
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作者 Papa Amath Diagne Jean Claude Ndiogou Dione +14 位作者 Papa Ousmane Ba Momar Sokhna Diop El Hadji Boubacar Ba Momar Dioum Marième Soda Mbaye Moussa Seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw Abdoul Khoudoss Diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé Ba Anta Mbaye Sall Papa Salmaneba Amadou Gabriel Ciss 《World Journal of Cardiovascular Surgery》 2024年第4期45-60,共16页
This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular ris... This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care. 展开更多
关键词 Coronary Bypass surgery Coronary Lesions Cardiac surgery Senegal
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Maxillofacial Surgery Education: Where Is It Heading?
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作者 Carlos Aurelio Andreucci 《Health》 2024年第5期405-424,共20页
Oral and maxillofacial surgery have a long history dating back to ancient civilizations such as the Egyptians. Since then, surgeons have treated craniofacial trauma and alveolodental fractures. In 1846, Hullihen perfo... Oral and maxillofacial surgery have a long history dating back to ancient civilizations such as the Egyptians. Since then, surgeons have treated craniofacial trauma and alveolodental fractures. In 1846, Hullihen performed a mandibular body osteotomy to correct prognathism, marking a significant milestone in the field. Over time, the specialty has evolved significantly. The field of craniofacial surgery has undergone several phases, including its involvement in conflicts during world wars and the treatment of craniofacial fractures and discrepancies. The process of learning and teaching specialties has evolved differently in various countries throughout the 20th century. Currently, there is no uniformity in the training and registration of specialized professionals, resulting in distinct scenarios. Considering the accessibility of scientific knowledge through technology and globalization, it is crucial to provide an objective overview of the current state of education in the field. This paper focuses on effective professional training as the primary subject of residency courses in this specialty. A proposal is presented for education, emphasizing the significance of providing quality professional training that is tailored to the specific legislation of each country. 展开更多
关键词 Maxillofacial surgery Medical Residency OMS Education OMS Specialization
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Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions
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作者 Davina Perini Jacopo Martellucci 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第2期270-275,共6页
Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency setting.Clinical trials have consistently s... Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency setting.Clinical trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective setting.It is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been highlighted.The present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal emergencies.Furthermore,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute situations.In the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute cases.We then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two fields.In emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality rates.The need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures. 展开更多
关键词 Indocyanine green Fluorescence Navigation surgery ANGIOGRAPHY Emergency surgery Decision-making
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Enhanced recovery after surgery:Progress in adapted pathways for implementation in standard and emerging surgical settings
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作者 Mohamed Wishahi Nabawya M Kamal Mohamed Saied Hedaya 《World Journal of Clinical Cases》 SCIE 2024年第25期5636-5641,共6页
The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an elemen... The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an element in the field of perioperative care.ERAS had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service cost.ERAS has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and modified.Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal transplantation.The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative pathways.ERAS costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are higher.ERAS is in progress in the fields of anesthetic tasks,pediatric surgery,and organ transplantation.Although ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of ERAS.Several challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included. 展开更多
关键词 Enhanced recovery after surgery ANESTHESIA Nurses ELDERLY Bowel preparation ERAS Perioperative nutrition Major&ambulatory surgery
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Congenital Heart Disease Referred for Surgery: Analysis and Epidemiological Description in the Cardiology Department of CHU Ignace Deen
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作者 Bah Mamadou Bassirou Diallo Mamadou Tahirou +8 位作者 Doumbouya Amadou Dioulde Balde Elhadj Yaya Camara Abdoulaye Diallo Mamadou Balde Thierno Siradio Bah Abdoulaye Bah Mamadou Dian Samoura Sana Balde Mamadou Dadhi 《World Journal of Cardiovascular Diseases》 CAS 2024年第4期234-251,共18页
Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developin... Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease. 展开更多
关键词 Congenital Heart Disease CARDIOLOGY Epidemiology surgery Ignace Deen University Hospital
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Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery
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作者 Peng Liu Yong-Wei Chen +5 位作者 Che Liu Yin-Tao Wu Wen-Chao Zhao Jian-Yong Zhu Yang An Nian-Xin Xia 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第3期288-292,共5页
Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-pres... Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks. 展开更多
关键词 GALLSTONE Gallbladder-preserving surgery RECURRENCE Risk factors NOMOGRAM
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Are there sex-based disparities in cataract surgery?
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作者 Matthew D.Geiger Anne M.Lynch +6 位作者 Alan G.Palestine Nathan C.Grove Karen L.Christopher Richard S.Davidson Michael J.Taravella Naresh Mandava Jennifer L.Patnaik 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第1期137-143,共7页
AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patien... AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine.Data collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.RESULTS:A total of 11977 eyes from 7253 patients were included in the study.Ocular comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for confounders.Males had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer significant.Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/25.CONCLUSION:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males.However,observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes. 展开更多
关键词 cataract surgery sex-based disparity PHACOEMULSIFICATION outcomes
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