Venous anastomosis using a non‐penetrating vascular closure system in orthotopic liver transplantation

Background

A non‐penetrating vessel closure system (VCS‐AnastoClip^®) may facilitate vascular anastomosis. The purpose of this study is to explore the utilization of a non‐penetrating VCS in orthotopic liver transplantation (OLT).

Methods

From January 2015 to February 2017, patients who underwent OLT were divided into two groups, ie, those who underwent non‐penetrating VCS application for inferior vena cava (IVC) and portal vein (PV) reconstructions and those who underwent hand sewing for these purposes. Clinical data, venous anastomotic times, anhepatic phases, and the recovery of liver function were compared between the groups.

Results

One hundred and fifteen patients underwent OLT (63 in the VCS group and 52 in the suture group). No differences between the two groups were observed in the baseline characteristics. The venous anastomotic time and anhepatic phase in the VCS group were significantly shorter than those in the suture group (P < .01). The alanine transaminase and total bilirubin levels in the VCS group were comparable to those in the suture group (P = .39 and P = .06, respectively). The complication, mortality, and patency rates of the PV reconstructions did not differ significantly between the two groups.

Conclusions

In OLT, the reconstruction of the PV and IVC with a non‐penetrating VCS system is a safe alternative method that has the advantage of shortening the anastomotic time and the anhepatic phase compared to the results of conventional hand suturing. However, the use of this VCS system had no influence on the recovery of graft function.     

Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination

Background  

In epidemiological studies on neck-shoulder disorders, physical examination by health professionals, although more expensive, is usually considered a better method of data collection than self-administered questionnaires on symptoms. However, little is known on the comparison of these two methods of data collection. The agreement between self-administered questionnaires and the physical examination on the presence of neck-shoulders disorders was assessed in the present study.     

Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation

Background  

At present, there is no conclusive evidence regarding the best treatment method for reducible unstable fractures of the distal radius. This study compared the effectiveness of two methods used in surgical treatment of such fractures: percutaneous pinning and external fixation.     

Minimizing hepatic trauma with a novel liver retraction method: a simple liver suspension using gauze suture

Background  

Prolonged liver retraction during radical gastrectomy for adequate exposure of the hepatogastric ligament may lead to hepatic trauma. The authors offer a new minimally traumatic liver retraction method using a simple liver suspension with a gauze suture and compare it with the modified liver-puncture method.     

Management of patients with incurable colorectal cancer: a retrospective audit

Aim

Counselling patients and their relatives about non‐curative management options in colorectal cancer is difficult because of a paucity of published data. This study aims to determine outcomes in patients unsuitable for curative surgery and the rates of subsequent surgical intervention.

Method

This was an analysis of all colorectal cancers managed without curative surgery in a district general hospital from a prospectively maintained cancer registry between 2009 and 2016, as decided by a multidisciplinary team. Primary outcomes were overall survival and secondary outcomes were subsequent intervention rates and impact of tumour stage.

Results

In all, 183 patients out of 976 patients (18.8%) were identified. The median age at diagnosis was 81 years [interquartile range (IQR) 71–87 years]. Overall median survival from diagnosis was 205 days (IQR 60–532 days). One‐year mortality was 62.3%. Patients were classified into two groups depending on the reason for a non‐curable approach: patient‐related (PR) or disease‐related (DR). The difference in survival between PR (median 277 days, IQR 70–593) and DR (median 179 days, IQR 51–450) was 98 days (P = 0.023). Twenty‐four patients were alive at the end of the study period; 19 out of 91 cases in PR (20.8%) and five out of 92 cases in DR (5.4%). Overall intervention rates were 11.9%, with higher rates in the DR group (P = 0.005). Disease stage was not associated with subsequent surgical intervention between the two groups (P = 0.392).

Conclusion

Life expectancy for non‐curatively managed patients within our unit was 6.8 months with one in nine patients requiring subsequent surgical admission for palliation. This information may be useful when counselling patients with incurable colorectal malignancy.     

Flexor tendon repair using a new suture technique: a comparative in vitro biomechanical study

Introduction  

The purpose of this experimental study was to evaluate the biomechanical characteristics of two new four-strand core suture techniques for flexor tendon repair.     

An assessment of surgery for portal hypertensive patients performed at a single community hospital

Purpose  

The outcomes of surgery for portal hypertensive patients at a single community hospital in the last two decades were retrospectively examined.     

A rapid method for the generation of uniform acellular bone explants: a technical note

Background  

Bone graft studies lack standardized controls. We aim to present a quick and reliable method for the intra-operative generation of acellular bone explants.     

Biomechanical analysis of a transiliac internal fixator

Purpose  

We evaluated the biomechanical characteristics of the transiliac internal fixator (TIFI) as compared to two well-established methods of internal posterior pelvic ring fixation.     

Feasibility of single-port laparoscopic cholecystectomy using a homemade laparoscopic port: a clinical report of 50 cases

Aim  

To report the clinical experience of transumbilical single-port laparoscopic cholecystectomy (TUSPLC), using a homemade laparoscopic access port composed of two inexpensive and common pieces of equipment readily available in the operating room.     

Hip fracture surgery and performance indicators: an analysis of 941 patients operated in a large teaching hospital

Background  

In the Netherlands, two performance indicators for the treatment of hip fracture patients have been recently implemented. Both indicators state that surgery within 24 h after admission improves the outcome with regard to 1-year mortality and the amount of re-operations within 1 year. To determine the value of these performance indicators, we conducted a retrospective analysis of 941 hip fracture patients.     

Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

Purpose  

Total hip arthroplasty has been a very succesful orthopaedic procedure. The optimal fixation method of the acetabular component however, has not yet been defined.     

Spleen and gastrosplenic ligament preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy

Background  

As a modification of hand-assisted laparoscopic pancreatectomy, we devised a method of spleen and gastrosplenic ligament preserving distal pancreatectomy, in which pancreatic resection is performed under direct vision extracorporeally.     

Three-dimensional measurement of femoral antetorsion: comparison to a conventional radiological method

Purpose  

The aim of our study was to produce a 3-D reconstruction of a CT dataset and compare it to the conventional method, with that same dataset, in terms of precision and the influence of femoral positioning.     

Lumbar interbody fusion: a parametric investigation of a novel cage design with and without posterior instrumentation

Introduction  

A finite element model of the L4-L5 human segment was employed to carry out a parametric biomechanical investigation of lumbar interbody fusion with a novel “sandwich” cage having an inner stiff core and two softer layers in the areas close to the endplates, with and without posterior fixation.     

Endoscopic full-thickness resection of gastric lesions using a novel grasp-and-snare technique: evaluation in a porcine survival model

Background  

Endoscopic full-thickness resection (EFTR) is a less-invasive method of en bloc removal of gastrointestinal tumors. In a previous nonsurvival animal experiment, the feasibility of a novel grasp-and-snare EFTR technique using a prototype tissue-lifting device was demonstrated. The objective of this study was to evaluate the safety and outcomes of this EFTR method in a porcine survival model.     

Video-assisted thoracic surgery (VATS) as a safe alternative for the resection of pulmonary metastases: a retrospective cohort study

Background  

VATS has become a preferred method for benign surgical conditions, yet still remains controversial for malignancies. The purpose of this study was to review our results of pulmonary metastasectomies using both conventional open thoracotomy and VATS techniques.     

Perioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial

Purpose  

We hypothesized that a high dose of dexmedetomidine (1 μg/kg/h) could reduce postoperative analgesic requirements of patients.     

Ultrasound-based computer navigation of the acetabular component: a feasibility study

Introduction  

This feasibility study investigated the accuracy of anterior pelvic reference plane (APP) registration and acetabular cup orientation in two cadavers with different BMIs.     

Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

Background  

Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass.