| 1. |
- Fransén, Jian, et al.
(författare)
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Evaluating topical opioid gel on donor site pain : A small randomised double blind controlled trial
- 2016
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 4, s. 5-9
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAutologous donor skin harvested for transplantation is a common procedure in patients with burns, and patients often feel more pain at the donor site than is justified by the extent of trauma. Topical morphine gels have been thought to have an effect on peripheral opioid receptors by creating antinociceptive and anti-inflammatory effects, which could potentially reduce the systemic use of morphine-like substances and their adverse effects.MethodsWe therefore did a paired, randomised, double-blind placebo study to investigate the effect of morphine gel and placebo on dual donor sites that had been harvested in 13 patients. Pain was measured on a visual analogue scale (VAS) 15 times in a total of 5 days.ResultsThe mean (SD) VAS was 1.6 (2.3) for all sites, 1.5 (2.2) for morphine, and 2.0 (2.5) for placebo. The pain relieving effects of morphine gel were not significantly better than placebo.ConclusionThe assessment of pain at donor sites is subjective, and more systematic and objective studies are needed.
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| 2. |
- Gulevski, Stephanie, et al.
(författare)
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Significance, diagnosis and treatment of lateral lymph nodes in rectal cancer : A systematic review
- 2019
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 21, s. 73-82
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Patients with low rectal cancer are at risk for lateral lymph node metastasis (LLNM). Neoadjuvant chemoradiotherapy (CRT) is used to eradicate LLNM in the West, whereas in Japan the addition of lateral lymph node dissection (LLND) to total mesorectal excision (TME) is performed. A systematic review was conducted to assess incidence, location, risk factors and diagnosis of LLNM and lateral lymph node (LLN) treatment outcomes. Method: The Medline, Embase and Cochrane databases were searched for English-language articles pertaining to LLNs in rectal cancer. Results: 242 studies were identified and 15 prospective studies selected for qualitative analysis. LLNM was detected in 7–40% of patients who underwent LLND, and lower incidence occurred in patients without preoperative suspicion of LLNM. LLNs located along the middle rectal artery were most common. LLNM was associated with female sex, advanced T stage and positive mesorectal nodes. LLN short-axis diameter of ≥10 mm on preoperative imaging appeared to predict LLNM after neoadjuvant CRT. The addition of LLND to TME seemed to decrease LR and improve survival rates, with comparable results seen for CRT. LLND appeared to be associated with longer operation time, greater blood loss and increased risk of sexual and urinary dysfunction. Conclusion: LLND could be advantageous for patients with suspected LLNM, but associated morbidities need to be considered. Further studies are needed to improve preoperative identification of LLNs and to determine how to manage persistent enlarged LLNs after CRT. Furthermore, the applicability of LLND in a Western population needs to be investigated.
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| 3. |
- Johansen, Karin, et al.
(författare)
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High resection rate improves overall survival in elderly patients with pancreatic head cancer - A cohort study
- 2021
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Ingår i: International Journal of Surgery Open. - : Elsevier Science Ltd. - 2405-8572. ; 34
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence that a high hospital volume of pancreaticoduodenectomy improves short-and long-term outcomes, but there are few population-based studies on the effect of a high resection rate in the population. The aim of this national, observational study was primarily to investigate differences in overall survival among elderly patients with cancer in the pancreatic head between high and low resection rate groups and secondarily to determine if counties with high resection rates of pancreaticoduodenectomy had more severe complications after surgery. Materials and methods: All patients in the Swedish National Registry for tumours in the pancreatic and periampullary region diagnosed between 2010 and 2018 with pancreatic head cancer were included in this retrospective cohort study. Patients were divided into low and high resection rate groups according to the yearly resection rates in the respective counties. For operative outcomes, all patients who had undergone pancreaticoduodenectomy were included regardless of diagnosis. The primary outcome of the study was overall survival among patients aged >= 70 years with pancreatic head cancer. Results: Among 13 933 patients in the registry, 7661 were 70 years or older, of whom 3006 had pancreatic head cancer. Overall survival was longer in high resection rate groups for patients aged >= 70 years, as for the age subgroups 70-79 years and >= 80 years (all p < 0.001). Among patients who had undergone pancreaticoduodenectomy aged >= 80 years the high resection rate counties showed an increased rate of severe complications, but no increase in 90-day mortality. Conclusion: High resection rate groups show a significantly longer overall survival among elderly patients with pancreatic head cancer in Sweden. This implies that there could be a survival benefit from increasing resections in low resection rate groups. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.
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| 4. |
- Moghamis, Isam Sami, et al.
(författare)
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First case of mechanical compression by methylprednisolone crystals following transforaminal lumbar nerve root block for left sciatic pain leading to hyperesthesia and progressive weakness : A case report
- 2021
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Ingår i: International Journal of Surgery Open. - : Elsevier. - 2405-8572. ; 34:100364
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Lumbosacral nerve root blocks and epidural corticosteroid injections are commonly used for short-term pain relief among patients with degenerative spinal disc disease. Serious complications following these injections are rare, and there are only a few published papers on this subject. It is important that spine surgeons are aware of the potential complications, and the possible factors that contribute to such complications. Presentation of case: 32-year-old Lebanese female presented with progressive weakness and hyperesthesia following a transforaminal lumbar nerve root corticosteroid particulate injection. The case was managed by surgical lumbar decompression. Discussion: Neurological complications following transforaminal/selective nerve root block are the most feared of all possible associated complications with epidurals blocks. It has been hypothesized that such a complication is mainly due to a spinal cord infarct from corticosteroid crystal. However, there are no previous reports that such progressive weakness and hyperesthesia could be due to the mechanical compression caused by corticosteroid particulate crystals themselves as confirmed in the current case. Conclusions: Progressive weakness and hyperesthesia following nerve root block could be due to the effect of the corticosteroid particles used in the injectate. Such complications could be simply avoided by the use of more dilutional volume of the local anaesthetic agent and/or using a non-particulate corticosteroid in order to avoid the adherence of the corticosteroid crystals to the nerve root sheath. This is the first case of post-nerve root block neurological complications due to mechanical compression caused by corticosteroid particulate crystals.
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| 5. |
- Rahman, Heshu Sulaiman, et al.
(författare)
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The transmission modes and sources of COVID-19 : A systematic review
- 2020
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 26, s. 125-136
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Forskningsöversikt (refereegranskat)abstract
- The current rampant coronavirus infection in humans, commonly known as COVID-19, a pandemic that may cause mortality in humans, has been declared a global emergency by the World Health Organization(WHO). The morbidity and mortality rates due to the pandemic are increasing rapidly worldwide, with the USA most affected by the disease. The source COVID-19 is not absolutely clear; however, the disease may be transmitted by either by COVID-19-positive individuals or from a contaminated environment. In this review, we focused on how the COVID-19 virus is transmitted in the community. An extensive literature search was conducted using specific keywords and criteria. Based on the published report, it is concluded that COVID-19 is primarily transmitted human-to-human via oral and respiratory aerosols and droplets with the virus-contaminated environment play a lesser role in the propagation of disease. Healthcare providers and the elderly with comorbidities are especially susceptible to the infection.
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| 6. |
- Rahman, Heshu Sulaiman, et al.
(författare)
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Wet cupping therapy ameliorates pain in patients with hyperlipidemia, hypertension, and diabetes : A controlled clinical study
- 2020
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 26, s. 10-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cupping therapy has long been practiced in several cultures for the treatment of ailments and improvement of general well-being. Thus, the aim of this current study is to observe the clinical efficacy and safety of wet cupping treatments in relieving headache, chest pain and muscle ache in patients recently have diagnosed with hyperlipidemia, diabetes and high blood pressure.Materials and methods: This study determines the effects of wet cupping on some blood parameters and pressure in 50 males and 50 female patients aged between 35 and 55 years undergoing wet cupping therapy at the Sheefa Cupping and Acupuncture Private Center after they have been diagnosed clinically to have hyperglycemia, diabetes and high blood pressure by a specialist at Department of Chronic Diseases, Sulaimani Teaching Hospital. Venous blood was obtained, and blood pressure taken from patients immediately before and 72 h after cupping therapy. The hematological parameters and serum lipid profile, fasting blood sugar, ferritin, urea, and creatinine concentrations were determined.Results: Wet cupping significantly reduced the cholesterol, triglyceride, low-density lipoprotein, fasting blood sugar, ferritin, urea, and creatinine, lowered blood pressure but did not significantly affect the erythrocyte parameters, leukocyte or platelet counts in the patients. The normal hematological parameters in patients after wet cupping therapy showed that the treatment is not detrimental to health. The treated patients showed significantly reduced headache, chest pain and muscle ache verbally.Conclusion: Wet cupping therapy is beneficial as a prophylactic and/or complementary treatment for hyperlipidemia, hyperglycemia, and hypertension and in prevention and control of diabetes mellitus and kidney disease, hence reducing the headache, chest pain and muscle ache.
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| 7. |
- Sahli, Hannah, et al.
(författare)
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Risk factors for recurrence and complications in acute uncomplicated diverticulitis : A retrospective cohort study
- 2022
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Antibiotics for acute uncomplicated diverticulitis (AUD) have been questioned in several studies. Thus, it is of value to identify risk factors for recurrence and complications to identify the best strategy for treatment. The aim was to investigate risk factors for recurrence and complications within at least 1 year after hospitalization for AUD. Methods: This is a retrospective study, including patients hospitalized with AUD at Helsingborg Hospital and Skåne University Hospital in Sweden during January 1st, 2015–December 31st, 2017. The cohort was primarily collected via the in-patient registry. Patients with multiple registrations, acute complicated diverticulitis, ongoing antibiotics, other diagnoses, immunosuppression and non-CT-verified diagnosis were excluded. Follow-up was ≥1 year. SPSS was used for statistical analysis. Results: Out of 596 patients, 23% experienced recurrences and 3% experienced complications. Previous diverticulitis [OR 2.86 (CI 1.85–4.55) P < 0.001] and complications [OR 1.35 (CI 1.18–1.42) P < 0.001] were independent risk factors for recurrence. A higher Charlson morbidity index (CMI) [OR 1.27 (1.0–1.61) P = 0.04] and previous diverticulitis [OR 3.68 (1.24–10.9) P = 0.013] were associated with complications. 75% of the patients received antibiotics but this did not significantly improve outcomes. Conclusion: A history of previous diverticulitis or complications increases the risk for AUD recurrence. A higher CMI and a history of previous diverticulitis may be risk factors for complications but needs to be further assessed. Treatment with antibiotics does not appear to improve the outcome. Choice of treatment should therefore be individualized and based on risk factors for complications and recurrence.
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| 8. |
- Svensson Neufert, Rebecca, et al.
(författare)
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Rectal washout in rectal cancer surgery : A survey of Swedish practice – Questionnaire: Rectal washout in Swedish rectal cancer surgery
- 2018
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 15, s. 32-36
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: To reduce local recurrence rates when performing anterior resection in rectal cancer surgery Swedish national guidelines recommend rectal washout. This study aimed to describe current Swedish practice of rectal washout. Methods: Questionnaires were sent to Swedish surgical departments performing rectal cancer surgery. Results: Thirty-five units performed open rectal cancer surgery, and 91% (32/35) performed minimally invasive surgery. Forty percent (14/35) had a protocol on rectal washout. Rectal washout was most commonly performed using sterile water or an alcohol based solution and with a minimum volume of 100–499 ml. A catheter was used at most units, prior to transection of the rectum and with the bowel clamped. Routine use of rectal washout varied with the type of surgical procedure, with no differences between open and minimally invasive surgery: low anterior resection (97% (34/35) vs 94% (30/32); p = 0.60), high anterior resection (94% (33/35) vs 97% (31/32); p = 1.00), Hartmann's procedure (80% (28/35) vs 84% (27/32); p = 0.75), abdominoperineal resection (6% (2/35) vs 16% (5/32); p = 0.25). Conclusion: Swedish colorectal units perform rectal washout routinely with no differences between open and minimally invasive procedures. A minority have a procedure protocol.
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| 9. |
- Vidal, Manuel S., et al.
(författare)
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Scientometric analysis of global research output in robotic gynecologic surgery
- 2022
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Ingår i: International Journal of Surgery Open. - : Elsevier BV. - 2405-8572. ; 47
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Tidskriftsartikel (refereegranskat)abstract
- Study objectiveThere has been a surge in publications on robotic gynecologic surgery. This study determined the characteristics and trends of published articles in robotic gynecologic surgery using bibliometric analysis, and also identified socioeconomic indicators associated with scientific productivity in this field.MethodsThe Scopus database was used to retrieve articles related to robotic gynecologic surgery from 2001 until 2021. Analyses and network visualization were conducted using Bibliometrix package in R platform, VOSviewer software, and GraphPad Prism software.Main resultsA total of 642 articles spanning from 2001 to 2021 were published, with exponential increase starting in 2007. The most productive country in this field is the USA, while the most productive institution is the Memorial Sloan-Kettering Cancer Center. The Journal of Minimally Invasive Gynecology produced the most significant number of research articles, while Gynecologic Oncology received the highest total citations. The central themes of research from 2001 to 2009 include the keywords “radical hysterectomy” and “laparoscopy” while from 2010 to 2021, the keywords include “robotic surgery” and “cervical cancer”. Gross domestic product and the number of international collaborations had the highest correlation with scientific productivity in robotic gynecologic surgery.ConclusionThis study showed the research landscape – the leading authors, institutions, and countries – in robotic gynecologic surgery. The top institutions and countries in this field were from developed countries. This study emphasizes more investment in research, support for researchers and physicians, and foster more collaborations with leading countries and institutions, all to improve clinical care for gynecologic patients globally.
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