The current status of surgical pilonidal sinus disease therapy in Germany

European Surgery - Treatment of pilonidal sinus disease (PSD) requires a tailored approach. A national guideline was published in 2014. The current status of surgical PSD therapy...     

Étude exploratoire sur le rôle des antécédents de tentatives de suicide et de l’agressivité pro et réactive dans le risque de récidive violente auprès d’une population d’hommes incarcérés

The objective of this exploratory study was to understand the risk factors for violent recidivism in a population of incarcerated men (n = 21), through an investigation of the role of psychopathic traits, proactive and reactive hetero-aggressiveness, self-aggressiveness and suicide attempts. The analysis of our results highlights various vulnerability factors associated with an increased probability of recidivism. Factors among which we find: (1) a predominance of the behavioural sphere of psychopathy (Factor 2); (2) the presence of hetero-aggressive behaviours, and more particularly (3) reactive types; and finally, (4) the presence of a history of suicide attempt(s). This study fulfills its main objective by identifying certain psychopathological modalities that play a key role in the process of violent recidivism. In this sense, a focus on the different expressions of aggressiveness and on psychopathic traits is an interesting prism for understanding the problem of violent recidivism. A clinical reading of our data leads us to formulate the hypothesis: deficiencies in representations and mental elaboration processes are crucial elements in understanding the repetition of violent action.     

Laparoscopy for living donor left nephrectomy: Comparison of three‐dimensional and two‐dimensional vision

The main objective of this preliminary study was to evaluate the feasibility and safety of 3‐D laparoscopic living donor left nephrectomy (LDLN). The secondary objective was to compare intraoperative and postoperative outcomes between 3‐D and 2‐D laparoscopic LDLN. All patients who underwent a laparoscopic LDLN from January 2015 to April 2018 in a university center were included. All surgeries were performed by three experienced surgeons. Seventy three patients were included the following: 16 underwent a 3‐D laparoscopic LDLN (3‐D group), and 57 underwent a 2‐D laparoscopic LDLN (2‐D group). Operative time and warm ischemia time (WIT) were significantly lower in the 3‐D group (operative time: 80.9 ± 10.2 vs 114.1 ± 32.3 minutes in the 3‐D and 2‐D groups, P = .0002) (WIT: 1.7 ± 0.6 vs 2.3 ± 0.9 minutes in the 3‐D and 2‐D groups, P = .02). No conversion to open surgery occurred in both groups. Length of hospital stay was significantly shorter in the 3‐D group. No major postoperative complications (Clavien ≥ III) occurred. One‐year postoperative GFR was similar to 3‐D and 2‐D groups. Our preliminary study demonstrates that 3‐D laparoscopic LDLN is a feasible and safe surgical procedure. Intraoperative and postoperative outcomes were similar in both 2‐D and 3‐D vision systems, but 3‐D vision systems allow reduction in WIT and operative time.