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Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study
Ryosuke Kita,
Daisuke Yamashita,
Koji Kitamura,
Masato Kondo,
Hiroyuki Kobayashi,
Kenji Uryuhara,
Hiroki Hashida,
Satoshi Kaihara
Issue:
Volume 10, Issue 2, April 2022
Pages:
57-61
Received:
6 February 2022
Accepted:
22 February 2022
Published:
3 March 2022
Abstract: Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.
Abstract: Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients w...
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Quality Assurance in Primary Total Knee Arthroplasty
Christos Koutras,
Isabel Becker,
Stavros Antoniou,
Hansjoerg Heep
Issue:
Volume 10, Issue 2, April 2022
Pages:
62-66
Received:
14 February 2022
Accepted:
1 March 2022
Published:
11 March 2022
Abstract: This study aims to compare internal and external documentation methods, to assess differences in complication rates through time and the potential association of patient parameters with morbidity. Data concerning primary knee arthroplasties performed between 2004 and 2014 were prospectively collected. The Pearson’s chi-squared test or the Fisher’s exact test was used to compare internal with external data and complications documented during 2005-2009 and 2010-2014. The Mann-Whitney U test was used to compare continuous outcomes in the two periods. Furthermore, binary logistic regression analyses were performed with occurrence of surgical complications as dependent variable. The total number of knee arthroplasties was 2100. Postoperative complications were experienced by 212 patients (median age: 72 years) and 30% were male. A significant difference between the internal and external datasets was detected in the “inability to walk at discharge” (p<0.0001) and the “total number of complications” (p=0.02). A significant reduction of the complication rate was observed in the second observation period (p<0.0001). The variables “length of hospital stay” and “duration of operation” independently predicted the occurrence of complications. The observed reduction of complications through time may be attributed to acquired surgical experience and the application of quality assurance measures.
Abstract: This study aims to compare internal and external documentation methods, to assess differences in complication rates through time and the potential association of patient parameters with morbidity. Data concerning primary knee arthroplasties performed between 2004 and 2014 were prospectively collected. The Pearson’s chi-squared test or the Fisher’s ...
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Research Article
Conditions Associated with Wound Healing Complications After Adjuvant Radiotherapy in Patients with Non-Melanoma Skin Cancer: A Retrospective Analysis
Sarah Hobelsberger,
Fabian Lohaus,
Steffen Löck,
Henriette Rönsch,
Julia Brütting,
Friedegund Meier,
Stefan Beissert,
Jörg Laske
Issue:
Volume 10, Issue 2, April 2022
Pages:
67-74
Received:
14 February 2022
Accepted:
3 March 2022
Published:
11 March 2022
DOI:
10.11648/j.js.20221002.13
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Views:
Abstract: In the treatment of highly malignant skin tumors postoperative radiotherapy may be indicated after wound closure. In the University Hospital Carl Gustav Carus Dresden, Germany, a retrospective study of 75 patients, who received postoperative radiotherapy after wound closure, was conducted. In all 75 patients (56 male, 19 female), radical doses of irradiation (40-70 Gy in 20–35 fractions) were administered. The median time interval between surgery and radiation therapy was 7 weeks (range 3-48 weeks). The incidence of wound healing complications (WHCs) increased after radiotherapy (p<0.001). Univariable analysis showed that WHCs were associated with immunosuppression (p=0.002), split thickness skin graft (p=0.007) lymphoma or leukemia (p=0.032) and diabetes mellitus (p=0.046). Multivariable logistic regression showed that independent risk factors for WHCs were split thickness skin transplantation (odds ratio: 3.85, 95% confidence interval (CI): 1.13–13.1, p=0.031) and immunosuppression (odds ratio: 4.69, 95% CI: 1.18–18.7, p=0.029). The authors observed no association between surgical site infections and WHCs (p=1.0). Univariable analysis showed that SSIs were associated with leukemia or lymphoma (p=0.019). Together, the results show an increased incidence of WHCs after radiotherapy. Other conditions associated with WHCs were leukemia or lymphoma and diabetes mellitus. Immunosuppression and split thickness skin transplantation were independent risk factors for WHCs.
Abstract: In the treatment of highly malignant skin tumors postoperative radiotherapy may be indicated after wound closure. In the University Hospital Carl Gustav Carus Dresden, Germany, a retrospective study of 75 patients, who received postoperative radiotherapy after wound closure, was conducted. In all 75 patients (56 male, 19 female), radical doses of i...
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Acute Bowel Obstruction Indicative of Meckel Diverticulum: About a Case at the National Hospital in Conakry
Barry Alpha Madiou,
Balde Abdoulaye Korse,
Camara Soriba Naby,
Camara Fode Lansana,
Balde Habiboulaye,
Diakite Saikou Yaya,
Doumbouya Bourlaye,
Toure Aboubacar,
Diallo Aiisatou Taran,
Diallo Biiro
Issue:
Volume 10, Issue 2, April 2022
Pages:
75-77
Received:
8 November 2021
Accepted:
7 March 2022
Published:
15 March 2022
Abstract: The aim of this study was to contribute to the study of Meckel's diverticula in the visceral surgery department of the national hospital of donka, Rare pathology and the diagnosis is difficult to make clinically. Observation: We report here a case of Meckel's diverticulum discovered in a 22-year-old girl who consulted for an occlusive syndrome; Meckel's diverticulum was incidentally discovered intraoperatively. We proceeded to the resection of the diverticulum followed by the ileo-ileal anastomosis. Conclusion: The diagnosis of DM is rarely evoked clinically because of the diversity of its clinical manifestations and is often of surgical discovery. It should be mentioned in any abdominal emergency.
Abstract: The aim of this study was to contribute to the study of Meckel's diverticula in the visceral surgery department of the national hospital of donka, Rare pathology and the diagnosis is difficult to make clinically. Observation: We report here a case of Meckel's diverticulum discovered in a 22-year-old girl who consulted for an occlusive syndrome; Mec...
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Correlation Between Symptomatic Knee Osteoarthritis and Serological Examination: A Longitudinal Study in China
Tongyi Zhang,
Yudian Qiu,
Jianhao Lin,
Nan Min,
Yaonan Zhang,
Qingyun Xue,
Qiang Wang,
Liangyuan Wen
Issue:
Volume 10, Issue 2, April 2022
Pages:
78-82
Received:
28 February 2022
Accepted:
15 March 2022
Published:
23 March 2022
Abstract: Background: The correlation between symptomatic knee osteoarthritis (OA) and whole blood cell count (CBC) has not been well studied based on large-scale population. The purpose of this study was to analyze its correlation with serological examination, especially with CBC tests. Methods: Samples in our study was derived from China Health and Retirement Longitudinal Study (CHARLS), wave 3. Blood samples from 13,420 participants were collected. We define a subject as symptomatic knee OA patient if both questions (Individuals were asked whether they were troubled with knee pain and had a doctor-diagnosed arthritis) were responded positively. A total of 12,952 individuals were classified into four groups. Post hoc multiple comparisons were conducted then. The criterion of significance is p<0.05. Results: Among the 20967 people included in the analysis, 19692 answered the diagnosis questions. Our results showed that the prevalence of symptomatic knee OA was 9.18%. The level of hemoglobin (Hgb) (13.34±1.80 g/dl) in patients with symptomatic knee OA was significantly lower than that in other individuals. The HCT level of symptomatic knee OA individuals (40.53±5.32%) was significantly lower than that of other individuals. Patients with arthritis but without ongoing knee pain had the lowest PLT level (199.09±76.88 × 109/L） when compared with other groups. Conclusion: symptomatic knee osteoarthritis is common in China. Patients with symptomatic knee OA showed a downward trend in the serological results of hemoglobin and hematocrit compared with other populations. More research on symptomatic knee osteoarthritis needs to be carried out.
Abstract: Background: The correlation between symptomatic knee osteoarthritis (OA) and whole blood cell count (CBC) has not been well studied based on large-scale population. The purpose of this study was to analyze its correlation with serological examination, especially with CBC tests. Methods: Samples in our study was derived from China Health and Retirem...
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Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit
Barbakh Mohamed Khaled Eyadah,
Muganza Adelin,
Luvhengo Thifhelimbilu Emmanuel,
Nel Marietha
Issue:
Volume 10, Issue 2, April 2022
Pages:
83-88
Received:
25 March 2022
Accepted:
9 April 2022
Published:
20 April 2022
Abstract: Introduction: Surgical site infection accounts for approximately 38% of hospital-acquired infections globally and is associated with increased length of hospitalization and mortality. The aim of the study was to determine the incidence of surgical site infection, causative organisms and factors which were associated with its occurrence at a central hospital in South Africa. Methods: A retrospective review of records of patients who developed surgical site infection over a 12-months period was conducted. Data were extracted from records of weekly morbidity and mortality meetings of the Department of Surgery. Data retrieved included demographic information, co-morbidities, nature of surgery, class of surgical site infection and microscopy, culture and sensitivity results and overall outcome including the length of hospital stay. Results: During the study period 3 005 surgical procedures were performed of which 46.8% were elective operations. A total of 147 records of patients who developed surgical site infection were found. The mean age of these 147 patients who developed surgical site infection was 47.3±17.21 years. The incidence of reported surgical site infection was 4.8% (147/3 005) with 72.6% (93/147) occurring in males. Nineteen of the 147 cases had to be excluded and thus only 128 patient files were suitable for the study. Of patients who developed surgical site infection, 30.5% (39/128) had diabetes mellitus, 21.9% (28/128) had hypertension and 18.8% (24/128) had both diabetes and hypertension, while 15.6% (20/128) of patients were known to be HIV positive. Sixty-four percent (64.1%: 82/128) of the patients who developed SSI had positive culture results and the two most commonly cultured organisms were E. coli (44%, 36/82) and P. aeruginosa (29.3%, 24/82). Conclusion: The overall rate of occurrence of surgical site infection was 4.8% and most of the infections were diagnosed in male patients. The two most commonly cultured organisms were E. coli and P. aeruginosa. Thirty-one percent who had surgical site infection had diabetes mellitus.
Abstract: Introduction: Surgical site infection accounts for approximately 38% of hospital-acquired infections globally and is associated with increased length of hospitalization and mortality. The aim of the study was to determine the incidence of surgical site infection, causative organisms and factors which were associated with its occurrence at a central...
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Large Locking Fusion Plate and Cable Fixation in the Treatment of Periprosthetic Femoral Fracture (PFF) After Total Hip Arthroplasty
Dong Fei,
Tong Kai,
Zhang Tongren,
Li Aiguo
Issue:
Volume 10, Issue 2, April 2022
Pages:
89-94
Received:
7 April 2022
Accepted:
21 April 2022
Published:
28 April 2022
Abstract: Objective To investigate the clinical effect of large locking fusion plate and cable fixation in the treatment of Periprosthetic femoral fracture (PFF) after total hip arthroplasty (THA). Methods Clinical data of 15 cases of PFF after THA treated with large locking fusion plate and cable fixation from June 2012 to June 2019 in our hospital were retrospectively analyzed. These cases included 4 males and 11 females, whose age were 61-82 years old, with an average age of 71.3 years, 6 cases on the left side and 9 cases on the right side. We performed total hip arthroplasty in 10 patients and hemiarthroplasty in 5 patients. There were 5 cases of Type B1 fracture, 8 cases of type B2 fracture, and 2 cases of type B3 fracture. Preoperative and postoperative hip function, HSS score, Harris score and surgical complications were observed and evaluated. Results 15 patients were followed up 15-77 months after the operation (mean 36.9 months), and the hip function was significantly improved. The preoperative HSS score of knee function was 4.13±1.69, and the postoperative HSS score of knee function was 90.93±3.06, with11 excellent cases, 4 good cases and 0 general cases, with an excellent rate of 100%. Preoperative Harris score of knee function was 3.73±1.16. Harris score of hip function was 89.33±3.73 at the last follow-up. Among of all Harris scores, 10 cases were excellent, 3 cases were good, and 2 cases were general, with an excellent rate of 86.7%. Postoperative HHS and Harris scores were higher than those before surgery (P=0.031, P<0.001). No blood vessel or nerve injury occurred during the operation. During the postoperative follow-up, no complications such as periprosthetic infection, loosening, dislocation, nonunion of fracture and refracture occurred in 14 cases, and one case suffered refracture after the operation, which was healed after the nail and stick system fixation. Conclusion The application of large locking fusion plate and cable in the treatment of femoral periprosthetic fractures after total hip arthroplasty is simple, easy to operate, less complications, satisfactory clinical results, and worthy of promotion.
Abstract: Objective To investigate the clinical effect of large locking fusion plate and cable fixation in the treatment of Periprosthetic femoral fracture (PFF) after total hip arthroplasty (THA). Methods Clinical data of 15 cases of PFF after THA treated with large locking fusion plate and cable fixation from June 2012 to June 2019 in our hospital were ret...
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Safety and Efficacy of Oblique Lateral Interbody Fusion (OLIF) in the Treatment of Degenerative Lumbar Spinal Stenosis
Qiang He,
Jie Mei,
Nianwei Yao,
Weiqing Qian,
Hong Yin,
Xin Sun
Issue:
Volume 10, Issue 2, April 2022
Pages:
95-100
Received:
10 April 2022
Accepted:
22 April 2022
Published:
28 April 2022
Abstract: Background: Lumbar spinal stenosis is a common degenerative disease of the elderly and adequate decompression is the most critical determinant for the surgical management of degenerative DLCS. Objective: To compare and analyse the safety and effectiveness of the oblique lateral interbody fusion (OLIF) technique and conventional lumbar posterior laminar decompression for lumbar spinal stenosis (DLCS). Methods: Sixty-eight patients over 60 years of age with lumbar spinal stenosis were included from October 2019 to November 2021, and were divided into the OLIF group and the conventional decompression group (conventional posterior laminar decompression and internal fixation) according to their treatment methods. The general data, operation time, intraoperative bleeding, hospital stay, surgical complications, clinical efficacy evaluated by modified MacNab criteria, and the patients' preoperative and final postoperative pain visual analogue scale scores (VAS) and Oswestry dysfunction index (ODI) were statistically analysed in the two groups. Results: There was no statistically significant difference in age, gender, BMI, duration of disease, lesion segment, VAS score and ODI index between the two groups of patients before treatment (p > 0.05). After treatment, the OLIF group had a greater advantage in terms of operative time, intraoperative bleeding, length of hospital stay and operative complications than the conventional decompression group, with statistical significance between the groups (P < 0.05). Compared with the pre-treatment period, the VAS scores and ODI scores of patients in both groups showed significant improvement (P < 0.05). A comparison between the two groups revealed a statistically significant difference (P < 0.05) in the improvement of VSA and ODI scores at the end of the postoperative period in the OLIF group compared with the conventional decompression group. The clinical efficacy of the two groups evaluated by the modified MacNab criteria at the final follow-up was 90.625% in the OLIF group and 80.55% in the conventional decompression group, respectively, with a statistical difference (P < 0.05). Conclusion: Compared with traditional decompression fusion, the use of OLIF technique can safely and effectively decompress DLCS, and also has many advantages such as less trauma, less bleeding, shorter operation time and hospital stay, and lower postoperative complications, which is worthy of clinical preference.
Abstract: Background: Lumbar spinal stenosis is a common degenerative disease of the elderly and adequate decompression is the most critical determinant for the surgical management of degenerative DLCS. Objective: To compare and analyse the safety and effectiveness of the oblique lateral interbody fusion (OLIF) technique and conventional lumbar posterior lam...
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