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- Giunta, Riccardo E., et al.
(författare)
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ESPRAS Survey: National and European Societies for Plastic Surgeons
- 2024
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Ingår i: HANDCHIRURGIE MIKROCHIRURGIE PLASTISCHE CHIRURGIE. - 0722-1819 .- 1439-3980.
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Tidskriftsartikel (refereegranskat)abstract
- Background The European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) comprises 40 national societies across Europe. In addition to ESPRAS, there are 8 different European Plastic Surgery societies representing Plastic Surgeons in Europe. The 4 th European Leadership Forum (ELF) of ESPRAS, held under the motto "Stronger together in Europe" in Munich in 2023, aimed to collect and disseminate information regarding the national member societies of ESPRAS and European societies for Plastic Surgeons. The purpose was to identify synergies and redundancies and promote improved cooperation and exchange to enhance coordinated decision-making at the European level. Material and methods An online survey was conducted regarding the organisational structures, objectives and challenges of national and European societies for Plastic Surgeons in Europe. This survey was distributed to official representatives (Presidents, Vice Presidents and General Secretaries) and delegates of national and European societies at the ELF meeting. Missing information was completed using data obtained from the official websites of the respective European societies. Preliminary results were discussed during the 4 th ELF meeting in Munich in March 2023. Results The ESPRAS survey included 22 national and 9 European Plastic Surgery societies representing more than 7000 Plastic Surgeons in Europe. Most national societies consist of less than 500 full members (median 182 members (interquartile range (IQR) 54-400); n=22). European societies, which covered the full spectrum or subspecialities, differed in membership types and congress cycles, with some requiring applications by individuals and others including national societies. The main purposes of the societies include research, representation against other disciplines, specialisation and education as well as more individual goals like patient care and policy regulation. Conclusion This ESPRAS survey offers key insights into the structures, requirements and challenges of national and European societies for Plastic Surgeons, highlighting the relevance of ongoing close exchange between the societies to foster professional advancement and reduce redundancies. Future efforts of the ELF will continue to further explore strategies for enhancing collaboration and harmonisation within the European Plastic Surgery landscape.
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| 2. |
- Gordon, Daniela, et al.
(författare)
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Sentinel Node Location in Trunk and Extremity Melanomas: Uncommon or Multiple Lymph Drainage Does Not Affect Survival
- 2014
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Ingår i: Annals of Surgical Oncology. - : Springer Science and Business Media LLC. - 1534-4681 .- 1068-9265. ; 21:11, s. 3386-3394
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Tidskriftsartikel (refereegranskat)abstract
- Patients with cutaneous melanoma (CM) on the trunk have a worse prognosis than those with extremity CM. One reason could be multiple or uncommon (outside axilla or groin) sentinel node locations (SNLs). We identified 859 patients who underwent sentinel node biopsy for trunk (n = 465) or extremity (n = 394) CM in three Swedish healthcare regions from 2000 to 2008. We collected patient, tumor, and sentinel node characteristics through clinical registers and medical records. We investigated the distribution of SNLs in a logistic regression model, and risk of overall and melanoma-specific death through 2011 in a multivariable Cox regression model. Trunk CM was associated with multiple SNLs (31 vs. 7 %; odds ratio [OR] 7.1; 95 % confidence interval [CI] 4.6-11.5; p < 0.001) but not uncommon SNLs (8 vs. 7 %; OR 1.1; 95 % CI 0.6-1.9; p = 0.75) compared with extremity CM. The increased risk of melanoma-specific death was confirmed for trunk CM (hazard ratio [HR] 1.9; 95 % CI 1.3-2.9; p = 0.003), especially on the upper back (HR 2.3; 95 % CI 1.4-3.6; p < 0.001) compared with extremity CM. Uncommon SNLs (HR 0.5; 95 % CI 0.2-1.4; p = 0.21) or multiple SNLs (HR 1.1; 95 % CI 0.4-2.9; p = 0.81) were not associated with melanoma-specific death compared with those with common/single SNL. Trunk melanomas were associated with multiple lymph drainage, but the worse prognosis of trunk melanomas could not be explained by the increased frequency of multiple or uncommon SNLs.
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| 3. |
- Lindegren, Anna, et al.
(författare)
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Improved patient-reported outcomes after autologous fat transplantation and corrective surgery after breast surgery
- 2019
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 53:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Autologous fat transplantation (AFT) is being increasingly used to improve the results after breast-conserving surgery and breast reconstruction. However, studies on patient-reported outcomes (PROs) and health-related quality of life (HRQoL) after AFT are scarce. The aim of this prospective longitudinal case-series study was to assess PRO in women who had undergone AFT after surgery for breast cancer or risk-reducing mastectomy.METHODS: Fifty women, who had undergone breast-conserving surgery or breast reconstruction, needing corrective surgery, were consecutively included between 2008 and 2013. A 20-item study-specific questionnaire (SSQ) and the Short Form Health Survey (SF-36) were used pre-operatively and 6 months, 1 year and 2 years post-operatively, to evaluate PRO and HRQoL.RESULTS: The patients underwent three (1-4) AFT procedures, with the injection of 164 ml (median) (range 40-516) fat. Thirty-eight and 34 patients completed the study-specific questionnaire and the SF-36, respectively, both pre-operatively and after 2 years. Sixteen of the 20 items in the SSQ were improved after 2 years, including breast size (p < 0.0001), shape (p < 0.0001), appearance (p < 0.0001), softness of the breast (p = 0.001), pain in the region (p = 0.005), scarring from previous breast surgery (p < 0.001) and willingness to participate in public physical activities (p < 0.001). HRQoL did not largely differ before and after AFT, or between the study group and a reference population.CONCLUSIONS: AFT alone or in combination with other corrective surgical procedures, improved PRO after breast-conserving surgery and breast reconstruction in both irradiated and non-irradiated women.
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| 4. |
- Schultz, Inkeri
(författare)
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Rectal prolapse, internal rectal intussusception and the ripstein rectopexy : a clinical, physiological and radiological study
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of these studies was to increase the knowledge about rectal prolapse and internal rectal intussusception, with special reference to bowel function and treatment with the Ripstein rectopexy. Results after the Ripstein rectopexy in 69 patients with rectal prolapse and in 43 patients with internal metal intussusception were evaluated. There was no operative mortality and early postoperative morbidity was 33%. The majority of complications were minor. Severe early complications were one faecal impaction and one ureteral stricture. Recurrencies and late complications were studied in 63 of the patients with rectal prolapse. Median length follow-up was 7.0 (range, 1.7-16.5) years. There was one recurrence. Forty-two of the patients with internal rectal intussusception were followed-up during median 5.4 (range, 1.1-16.5) years. Severe complications were two rectovaginal fistulae and one faecaloma in the sigmoid colon with perforation and lethal peritonitis. Pre- and postoperative functional evaluation was carried out in 76 patients. Anal continence improved postoperatively and the number of bowel movements per week decreased. Emptying difficulties did not change significantly in patients operated for rectal prolapse but increased in those operated for internal rectal intussusception. Results of repeated defaecography studies in patients with internal rectal intussusception were analyzed. Among 38 patients with a second investigation after mean 5.6 (range, 1.1-19.5) years one had developed a rectal prolapse. The remaining patients were further followed-up: one developed a rectal prolapse, 7 underwent surgery for internal metal intussusception, 29 did not develop a rectal prolapse during a mean follow-up of 5.8 (range, LO- 14.6) years. Anorectal manometry was carried out preoperatively and 7 days and 6 months postoperatively in 42 patients. Patients operated on for rectal prolapse had increased anal maximum resting pressure 6 months postoperatively but not after 7 days. Anal maximum squeeze pressure did not change significantly. No significant changes in anal maximum resting or squeeze pressures were seen in the patients with internal rectal intussusception. Anal continence improved. Preoperative electrophysiological assessment (conventional needle EMG, FD-assessment and pudendal nerve latency) was compared with pre- and postoperative functional evaluation regarding anal continence in 43 patients. Electrophysiological examination could not predict the outcome of Ripstein rectopexy with respect to anal continence. Whole gut transit studies were undertaken pre- and postoperatively in 30 patients. Retention of markers increased after the Ripstein rectopexy. The number of bowel movements per week decreased but constipation was mainly experienced as emptying difficulties. There was a correlation between preoperative retention of markers and postoperative emptying difficulties. Conclusion: Rectal prolapse and internal rectal intussusception can be treated by the Ripstein rectopexy with low mortality and low frequency of serious complication. Tle functional putcome.is difficult to predict. Anal continence is often improved. Emptying difficulties often increase in patients with internal rectal intussusception. The risk of developing a rectal prolapse is small in patients with internal rectal intussusception.
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