Drain-site hernia after laparoscopic rectal resection:A case report and review of literature

BACKGROUND Drain-site hernia(DSH)has an extremely low morbidity and has rarely been reported.Small bowel obstruction is a frequent concurrent condition in most cases of DSH,which commonly occurs at the≥10 mm drain-site.Here we report a rare case of DSH at the lateral 5 mm port site one month postoperatively without visceral incarceration.Simultaneously,a brief review of the literature was conducted focusing on the risk factors,diagnosis,and prevention strategies for DSH.CASE SUMMARY A 76-year-old male patient was admitted to our institution with intermittent abdominal pain and a local abdominal mass which occurred one month after laparoscopic radical resection of rectal cancer one year ago.A computed tomography scan showed an abdominal wall hernia at the 5 mm former drain-site in the left lower quadrant,and that the content consisted of the large omentum.An elective herniorrhaphy was performed by closing the fascial defect and reinforcing the abdominal wall with a synthetic mesh simultaneously.The postoperative period was uneventful.The patient was discharged seven days after the operation without surgery-related complications at the 1-mo follow-up visit.CONCLUSION Emphasis should be placed on DSH despite the decreased use of intra-abdominal drainage.It is recommended that placement of a surgical drainage tube at the≥10 mm trocar site should be avoided.Moreover,it is advisable to have a comprehensive understanding of the risk factors for DSH and complete closure of the fascial defect at the drainage site for high-risk patients.

关于放射科住院医生物理学教育计划的方法和资源:调查结果

在过去的2年里，通过不懈的努力，我们能够重新评价及建立对放射科住院医生进行物理学教育的方法。通过对来自北美放射科住院医生计划的主管及全体教员的调查以了解教授物理学的方法以及目前所用资源。物理学方面额外的教育资源被证实是必需的，以便更好地把物理学融入到临床培训中，标准化的物理学课程紧密地结合到美国放射学委员会（American Board of Radiology）的初级资格考试中。

Asymptomatic cryptococcal antigenemia in HIV-infected patients:a review of recent studies

The prevalence of asymptomatic cryptococcal antigenemia(ACA)in human immunodeficiency virus(HIV)infected individuals has been observed to be elevated.The prevalence of ACA ranges from 1.3%to 13%,with different rates of prevalence in various regions of the world.We reviewed studies conducted internationally,and also referred to two established expert consensus guideline documents published in China,and we have concluded that Chinese HIV-infected patients should undergo cryptococcal antigen screening when CD4+T-cell counts fall below 200 cells/μL and that the recommended treatment regimen for these patients follow current World Health Organization guidelines,although it is likely that this recommendation may change in the future.Early screening and optimized preemptive treatment for ACA is likely to help decrease the incidence of cryptococcosis,and is lifesaving.Further studies are warranted to explore issues related to the optimal management of ACA.

Strategies to prevent and mitigate common complications in gender affirming penile inversion vaginoplasty

While the number of gender-affirming procedures continues to boom all over the world,resulting complications from genital surgeries are on the rise as well.This paper aims to review some of the most commonly described complications of gender-affirming vaginoplasties and provide our expert opinion on how to mitigate them based on the senior author’s experience.Specifically,poor cosmesis,soft tissues related complications,rectal and urethral injuries,neovaginal stenosis,as well as intraoperative and postoperative bleeding will be addressed.