Effect of Age on Surgical Outcomes of Extended Gastrectomy With D2 Lymph Node Dissection in Gastric Carcinoma: Prospective Cohort Study

Background and Purpose  

As a life expectancy increases, the proportion of aged patients diagnosed with gastric cancer has increased over the past decades, but the optimal surgical approach to these patients remains a dilemma because of the presumed risk associated with extended surgery.     

Quality of life is not influenced by the extent of surgery in patients with benign goiter

Introduction  

The surgical approach to benign goiter is becoming increasingly radical due to the risk of recurrent goiter. The aim of this prospective study was to evaluate the impact of surgery on health-related quality of life (HRQoL) of patients with benign goiter.     

Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? a systematic review

Background  

Carpal tunnel syndrome is a common disorder in hand surgery practice. Both surgical and conservative interventions are utilized for the carpal tunnel syndrome. Although certain indications would specifically indicate the need for surgery, there is a spectrum of patients for whom either treatment option might be selected. The purpose of this systematic review was to compare the efficacy of surgical treatment of carpal tunnel syndrome with conservative treatment     

Surgical Site Infections Following Bariatric Surgery in Community Hospitals: A Weighty Concern?

Background  

Although obesity is a well-known risk factor for surgical site infection (SSI), specific risk factors for SSI among obese patients undergoing bariatric surgery (BS) have not been well-defined.     

Total laparoendoscopic single-site surgery (LESS) hysterectomy in low-risk early endometrial cancer: a pilot study

Background  

In the last few years, technical advances have produced a dramatic shift from traditional open surgery toward a minimally invasive approach, even in oncological procedures. We present our initial experience with laparoendoscopic single-site surgery (LESS) in the surgical treatment of early-stage endometrial cancer patients.     

Sixty Percent 10-year Survival of Patients With Chondrosarcoma After Local Recurrence

Background  

Chondrosarcoma is treated primarily by surgery. The prognosis of patients after local recurrence is not well defined. Both the survival of patients and the risk of further local relapse after surgical treatment of local recurrence have yet to be established.     

Arthrodesis of the subtalar and talonavicular joints through a medial surgical approach: a series of 15 cases

Introduction  

We report a series of 15 double-hindfoot (subtalar and talonavicular joint) arthrodeses through a single medial approach on 14 patients. Mean age at surgery was 59.3 years. The chosen surgical technique was always identical using a medial approach and performed by a single surgeon. The average follow-up was 20.6 months.     

Effects of microendoscopy-assisted reduction and screw fixation through a single mini-incision on posterior cruciate ligament tibial avulsion fracture

Introduction  

There are various surgical approaches for the treatment of posterior cruciate ligament (PCL) injury-associated tibial fracture avulsion, including arthroscopy-assisted surgery and open posterior surgery. However, none of these treatments are perfect. We have established a simple procedure with microendoscopy-assisted reduction and cannulated screw fixation for the treatment of this disease through a single mini-incision. In this study, we delineated the effects of this surgical approach for patients with PCL tibial avulsion fracture.     

Computer-assisted hemivertebral resection for congenital spinal deformity

Background  

No studies have reported on osteotomies utilizing a navigation system in congenital scoliosis surgery. This study aimed to evaluate the surgical outcomes of eight patients with congenital scoliosis or kyphoscoliosis due to hemivertebrae treated by computer-assisted hemivertebral resection using only a posterior approach.     

Patient noncompliance before surgery

Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVE

To assess patient compliance with preoperative instructions and to determine causes and factors of noncompliance, as noncompliance might affect surgical outcome and has potential medicolegal implications.

PATIENTS AND METHODS

One surgeon counselled 101 consecutive patients before undergoing laparoscopic renal surgery. Deliberate discussions instructed patients to bring their radiograph films on the day of surgery and complete a preoperative bowel preparation. Noncompliance was defined as failure to bring films and/or complete bowel preparation. Patient demographics, socio‐economic and clinical variables were analysed, and reasons for failure to comply with instructions were also recorded.

RESULTS

Twenty‐four of the 101 (24%) patients were not compliant, 13 with films only, seven with bowel preparation only, and four with both sets of instructions. Univariate analysis showed that language and race were factors for noncompliance. Multivariate analysis showed that non‐Caucasians had 17 times the risk of noncompliance (P < 0.001); long distance from home to the site of care had five times the risk of noncompliance (P = 0.041), and each day between the initial consultation and the date of surgery had 1.05 times the risk of noncompliance (P < 0.001). The most common reason given by patients for noncompliance was that they were never given the preoperative instructions.

CONCLUSIONS

Noncompliance with preoperative surgical instructions is a significant issue and is increased in non‐Caucasian patients, those travelling long distances, and those whose surgery date is long after their preoperative consultation. A systems‐based approach is needed to address this significant issue.     

Laparoscopic Versus Open Biliopancreatic Diversion: A Prospective Comparative Study

Background  

Bariatric surgery is playing an increasingly important role in our society. The surgical approach should be chosen in consistent with the patients' problem. The purpose of this study was to compare surgical outcomes in patients who underwent laparoscopic Scopinaro's biliopancreatic diversion (BPD) versus open BPD in our institute experience.     

Revision Laparoscopic Gastric Bypass: An Effective Approach Following Failure of Primary Bariatric Procedures

Background  

The laparoscopic approach plays an important role in the primary surgical management of morbid obesity. This study evaluated the potential role of the laparoscopic approach to revision Roux-en-Y gastric bypass (LRYGB) in the management of selected patients who fail to lose adequate weight or regain weight after primary bariatric surgery.     

Giant Cell Tumor of Bone: Are We Stratifying Results Appropriately?

Background  

There is no consensus as to which surgical approach to the treatment of giant cell tumor of bone is most appropriate or which patients are at a higher risk for recurrence or metastasis.     

Minimally invasive total hip arthroplasty using a transpiriformis approach: a preliminary report

Background  

Continuing efforts have been made to develop minimally invasive surgery techniques for THA. One of the most commonly performed of these techniques is the mini-posterior approach. All reported series using this approach describe surgical detachment of the short external rotators of the hip. In 2008, Penenberg et al. described an innovative surgical technique that preserves the short external rotators. We present the results of a single-incision modification of this technique in 135 patients.     

Prognostic Value of Putative Circulating Cancer Stem Cells in Patients Undergoing Hepatic Resection for Colorectal Liver Metastasis

Background  

Although surgery is the gold standard treatment of hepatic metastasis from colorectal cancer (CRC), many patients ultimately die of their disease. We tested the hypothesis that the detection of circulating tumor cells (CTC) might identify patients at high risk of dying of disease recurrence after apparently radical liver surgery.     

Results of breast conserving surgery in clinical stage I–II breast carcinoma

Background  

The role of breast conserving surgery with radiotherapy is well established and has become a widely used procedure in breast cancer. Patient selection, a multidisciplinary approach, and expert surgical technique are important factors to avoid locoregional recurrence. The aim of this study was to analyse the outcomes of patients treated with breast conserving surgery in stage I–II breast cancer.     

Pancreas Divisum: A Differentiated Surgical Approach in Symptomatic Patients

Background  

Some patients with pancreas divisum (PD) develop symptoms of recurrent pancreatitis. This is probably caused by insufficient drainage of the pancreatic duct. We report the results of our follow-up of patients who underwent surgery for symptomatic pancreas divisum according to an individualized surgical approach.     

Oncoplastic Techniques Extend Breast-Conserving Surgery to Patients with Neoadjuvant Chemotherapy Response Unfit for Conventional Techniques

Background  

Oncoplastic surgery is extending the role of breast-conserving surgery in an increasing number of patients who are unsuitable for conventional breast-conserving techniques. The aim of this retrospective study was to analyze the surgical approach, oncoplastic surgery guided by bracketing, used in the treatment of patients who required a wide breast tissue excision after neoadjuvant chemotherapy. The parameters evaluated were as follows: margin status, rate of re-excision for positive margin, early ipsilateral recurrence, and cosmetic outcomes.     

Unipolar versus bipolar Exeter hip hemiarthroplasty: a prospective cohort study on 830 consecutive hips in patients with femoral neck fractures

Background  

Hip replacement using a hemiarthroplasty (HA) is a common surgical procedure in elderly patients with fractures of the femoral neck. Data from the Swedish Hip Arthroplasty Register suggest that there is a higher risk for revision surgery with the bipolar HA compared with the unipolar HA.     

The Effects of Bariatric Surgery on Asthma Severity

Background  

Excess body weight increases both the risk and severity of asthma. Several studies indicate that bariatric surgery decreases asthma severity, but either enrolled few patients or were not focused primarily on asthma. Furthermore, none compared the effects of different bariatric surgical procedures.