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A Further Case Report from the United Kingdom of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and a Reason to Avoid the Subpectoral Plane
James Donaldson Frame,
Simon Smith,
Dia Kamel
Issue:
Volume 4, Issue 5, October 2016
Pages:
89-94
Received:
1 August 2016
Accepted:
11 August 2016
Published:
2 September 2016
Abstract: Breast Augmentation is only second to liposuction as the most commonly performed Aesthetic Surgery procedure in the United Kingdom with a “guestimated” 50,000 cases per annum. Silicone elastomer shells containing silicone gel implants have been used continuously for over 50 years in the UK. Recently Anaplastic Large Cell Lymphoma (BIA-ALCL) has been associated in women having breast implants with variants of a disease process that may remain intracapsular and resolved by removal of implant and total capsulectomy, or nodular and metastatic with proven risk of mortality. An MHRA ‘advisory notice’ merely confirms the views of the MHRA that breast augmentation is safe, nothing needs to be done for existing augmented patients and even if a women develops this condition it can be successfully treated. However there have been nine deaths from BIA-ALCL and actually what Surgeons urgently need is advice on best management protocol and encouragement for international collaboration and evidence based medicine. Diagnosis of BIA-ALCL is dependent upon awareness, correct diagnostic immune staining techniques and review by knowledgeable histopathologists. Recommendations on management of BIA-ALCL should follow the guidelines of Kim et al in 2015. It is important to collect data and outcomes on such patients. The use of submuscular plane for primary breast augmentation should be carefully reconsidered in ensuring safe and complete capsulectomy in the event of BIA-ALCL.
Abstract: Breast Augmentation is only second to liposuction as the most commonly performed Aesthetic Surgery procedure in the United Kingdom with a “guestimated” 50,000 cases per annum. Silicone elastomer shells containing silicone gel implants have been used continuously for over 50 years in the UK. Recently Anaplastic Large Cell Lymphoma (BIA-ALCL) has bee...
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The Effect of Transurethral Enucleation Resection of the Prostate for Benign Prostatic Hyperplasia on Immune and Stress Response
Bo-xiang Yuan,
Bin Pan,
Hui-lan Zeng,
Yong-lu Wu,
Shao-jiang Wang,
Jie Chen
Issue:
Volume 4, Issue 5, October 2016
Pages:
95-99
Received:
4 August 2016
Accepted:
13 August 2016
Published:
2 September 2016
Abstract: This thesis aims to examine the effects of the systemic immune response triggered by the transurethral enucleation and resection of the prostate (TRERP). 60 patients with benign prostatic hyperplasia (BPH) were randomly classified into enucleation group and resection group. The level of WBC, serum IL-6, IL-8, CRP, IgG, IgA, IgM, CD4+, CD8+,and ratio of CD4+ to CD8+ (BPH)were compared and analyzed preoperatively and on the 1st, 3rd, 5th of postoperative day. The result demonstrates the statistical significance of the differences between the two groups on the amount of resected tissues, postoperative blood loss, and operation time. To the contrary, there was no statistical significance of the differences on WBC, IL-6, IL-8 and CRP level. To elaborate, on the 1st postoperative day, the values of WBC, IL-6, IL-8 and CRP level were significantly higher, whereas the values of IgG, IgA, IgM, CD4+, CD8+ level and ratio of CD4+ to CD8+ of both groups were significantly lower. On the 3rd postoperative day, there was statistical significance of the differences between two groups on WBC, IL-6, IL-8, CRP level. On the 5th post operative day, however, no statistical significance of differences existed on the IgG, IgA, IgM, CD4+, CD8+ level and ratio of CD4+ to CD8+. It is concluded that compared to the transurethral resection of the prostate (TURP) for Benign prostatic hyperplasia (BPH), TRERP has prominent advantages of more radical resection, less blood loss and less immune suppression.
Abstract: This thesis aims to examine the effects of the systemic immune response triggered by the transurethral enucleation and resection of the prostate (TRERP). 60 patients with benign prostatic hyperplasia (BPH) were randomly classified into enucleation group and resection group. The level of WBC, serum IL-6, IL-8, CRP, IgG, IgA, IgM, CD4+, CD8+,and rati...
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Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head
Kai Sun,
Lin Zhou,
Zhizhong Li
Issue:
Volume 4, Issue 5, October 2016
Pages:
100-104
Received:
8 August 2016
Accepted:
16 August 2016
Published:
2 September 2016
Abstract: There is no definite protocol in management of Pipkin fracture in relation to operation approach and internal fixations. The aim is to explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures through the trochanteric flip osteotomy (TFO) approach. From January 2010 to December 2014, 12 cases of type I and II Pipkin fracture (including 8 type I,4 type II) treated through TFO approach and internal fixation with Herbert screws. All the patients were followed up 1-4 years with an average of 2.6 years. The whole osteotomies and acetabular fractures healed within 6 to 12 weeks. All patients achieved healing of femoral head fracture after 12-16 months without femoral head necrosis. Heterotopic ossification (HO) occurred in 1 cases after operation which were left untreated. At the last follow-up, excellent and good rate was 91.7%. Treatment of type I, II Pipkin fracture through TFO approach can provide good visualization and protect of the femoral head blood supply. The treatment of internal fixation with Herbert screws is effective for Pipkin type I and type II femoral head fracture.
Abstract: There is no definite protocol in management of Pipkin fracture in relation to operation approach and internal fixations. The aim is to explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures through the trochanteric flip osteotomy (TFO) approach. From January 201...
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Functional Assessment of the Esophagogastric Junction After Laparoscopic Sleeve Gastrectomy
Mosaad Mahmoud Morshed,
Mohamed Anwar Abdel-Razik,
Sabry Ahmed Ahmed Mahmoud,
Alaa Magdy Abou El-Fotouh,
Sameh Hany Emile,
Hosam Ghazy Elbanna,
Mohamed Youssef,
Emad Abdallah,
Nabil Ali Gad El-Hak
Issue:
Volume 4, Issue 5, October 2016
Pages:
105-113
Received:
22 August 2016
Accepted:
30 August 2016
Published:
13 September 2016
Abstract: The relation between bariatric procedures and gastroesophageal reflux disease (GERD) seems to be quite complex and unclear. The present trial aimed to assess the functional changes that occur in the esophagogastric junction (EGJ) after laparoscopic sleeve gastrectomy (LSG) using objective methods for assessment as esophageal manometry and ambulatory 24-hour pH monitoring in attempt to correlate these changes with either the deterioration or the alleviation of GERD symptoms after LSG. This prospective case series study was conducted on patients with morbid obesity who were treated with LSG in the General Surgery Department, Mansoura University Hospitals. All patients were assessed pre- and postoperatively for the presence of GERD both clinically and with esophagogastrodudenoscopy (EGD). Functional assessment of the EGJ was done before LSG and at six months of follow-up using esophageal manometry and ambulatory 24-hour esophageal pH monitoring. Twenty morbidly obese patients (16 females & 4 males) of a mean age of 29.4 years had underwent functional assessement of the EGJ before and at six months after LSG. The mean BMI at the time of surgery was 51.6 ± 8.7 kg/m². Thirteen patients had no symptoms related to GERD preoperatively, all of these patients remained symptom-free after LSG. Seven (35%) patients had preoperative symptoms of GERD, three reported no change in their symptoms at six months of follow-up, and four reported significant improvement of their symptoms six months after LSG. Overall, no significant changes in the manometric parameters were noticed. However, a significant decrease in the resting LES pressure was noticed after LSG in patients with no preoperative GERD symptoms, but not in patients with symptomatic GERD. Seven (35%) patients had high preoperative DeMeester scores and prolonged total acid reflux time percentage, all of them got normalized postoperatively except two patients. Absolute concordance of the four parameters studied was observed in seven (35%) patients only. Esophageal manometry has a limited utility in the detection or exclusion of GERD postoperatively since the significant decrease in the resting LES pressure observed was not associated with symptoms of GERD. On the other hand, 24-hour pH monitoring was able to detect improvement or persistence of GERD in the patients studied.
Abstract: The relation between bariatric procedures and gastroesophageal reflux disease (GERD) seems to be quite complex and unclear. The present trial aimed to assess the functional changes that occur in the esophagogastric junction (EGJ) after laparoscopic sleeve gastrectomy (LSG) using objective methods for assessment as esophageal manometry and ambulator...
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The Value of Laparoscopic Total Mesorectal Excision and Circumferential Resection Margin in the Treatment of Distal Rectal Cancer: Single Center Experience
Samy Abbas Elbaz,
Waleed Hassan Omar,
Hosam Ghazy Elbanna,
Mohamed Youssef,
Sameh Hany Emile,
Mohamed Farid
Issue:
Volume 4, Issue 5, October 2016
Pages:
114-121
Received:
22 August 2016
Accepted:
30 August 2016
Published:
18 September 2016
Abstract: Total mesorectal excision (TME) has emerged as a method for complete cure of rectal cancer with promising results. The present study aimed to evaluate the technical feasibility and the clinical and oncological outcomes of laparoscopic TME with abdominoperineal resection (APR) for distal rectal carcinoma. Twenty patients with distal rectal carcinoma were treated with laparoscopic APR and TME in the period of January 2012 to March 2015. Patients’ demographics, clinical symptoms, operation time, complications, pathological characteristics of the rectal tumor, and the local and distant recurrence of the tumor were recorded and analyzed. The study included 11 (55%) female and 9 (45%) male of a mean age of 46.9 ± 10.8 years. The mean distance of the tumor from the anal verge was 3.35 ± 0.9 cm. The mean operation time was 182 ± 7 minutes. Adenocarcinoma accounted for 55% of cases, whereas mucinous adenocarcinoma was detected in 40% of patients, and signet ring carcinoma in 5%. The mean circumferential resection margin (CRM) was 4.6 ±3.5 mm. The mean duration of hospital stay was 9.21± 6.9 days. Perioperative complications were recorded in seven patients (35%). Five (25%) cases were converted to open surgery. The median follow-up duration was 18 months. Local recurrence was diagnosed in two (10%) cases. Laparoscopic TME is a technically feasible procedure, yet requires adequate training and sufficient knowledge of the anatomy of the pelvis. Although all patients underwent APR and 90% of them received neoadjuvant treatment; the local recurrence was still higher than other studies which can be attributed to the pathologic characters and the stage of the tumors.
Abstract: Total mesorectal excision (TME) has emerged as a method for complete cure of rectal cancer with promising results. The present study aimed to evaluate the technical feasibility and the clinical and oncological outcomes of laparoscopic TME with abdominoperineal resection (APR) for distal rectal carcinoma. Twenty patients with distal rectal carcinoma...
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Sarcomatoid Renal Cell Carcinoma Arisen after the Renal Allograft from Donation after Citizen Death: A Case Report and Literature Review
Wu Yonglu,
Chen Jie,
Yuan Boxiang,
Su Zexuan,
Ding Hongwen,
Shi Liping,
Wang Shaojiang
Issue:
Volume 4, Issue 5, October 2016
Pages:
122-125
Received:
28 August 2016
Accepted:
12 September 2016
Published:
8 October 2016
Abstract: The aim of this study was to discuss the causes and preventions of sacromatoid renal cell carcinoma (SRCC) after renal allograft from donation after citizens death (DCD). It was reported on a 45-year-old male patient had undergone renal transplantation in other hospital because of chronic renal insufficiency uraemia in August of 2014. Two months later, lesions found in the renal parenchyma in the right iliac fossa via the color doppler ultrasound. The area of renal transplantation was bulged with tenderness. The renal dysfunction and microscopic haematuria were found. The review color doppler ultrasound and CT showed that the allograft kidney is enlarged rapidly. On 22nd December 2014, a surgical exploration was performed. An irregular and hard mass within the parenchyma of engrafted kidney was found, which was considered as malignant. The nephrectomy of the renal allograft was performed in the operation. First postoperative day, his condition was deteriorating rapidly. Finally, the patient died of cardiac functional failure. The tumor was pathologically diagnosed as sacromatoid renal cell carcinoma (SRCC). SRCC found in the donor allograft kidney is highly malignant and poorly prognosis. The repeated imaging investigations are necessary to exclude the hidden trouble of tumors, such as SRCC. Postoperative immunosuppressive regimens should be modified and the screening program of renal tumor for the early control and prevention should be strengthen.
Abstract: The aim of this study was to discuss the causes and preventions of sacromatoid renal cell carcinoma (SRCC) after renal allograft from donation after citizens death (DCD). It was reported on a 45-year-old male patient had undergone renal transplantation in other hospital because of chronic renal insufficiency uraemia in August of 2014. Two months la...
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