International Surgery Journal
ISSN / EISSN : 2349-3305 / 2349-2902
Published by: Medip Academy (10.18203)
Total articles ≅ 5,183
Latest articles in this journal
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222075
Background: Bariatric surgery has now been well established for long enough that revisional procedures have become more numerous and common, the importance to evaluate services and establish good evidence for our knowledge surrounding reoperations is vital. Methods: A retrospective analysis was conducted, for patients undergone revisional bariatric surgery between June 2010 and July 2017 at a single tertiary centre in the United Kingdom (UK). Revision rates and weight loss for the most common bariatric procedures were established, as well as the documented indications. Data was analysed with Mann-Whitney-U test. Results: The1619 bariatric procedures were recorded, of which 61 were revisional weight loss procedures. The most common performed primary procedure was gastric bypass (678). Revision rate for gastric band was highest (7%), followed by gastric bypass 5.6% and 2.60% for sleeve gastrectomy. The overall revision rate was 5%. Best weight loss outcomes were shown in conversion of gastric band to sleeve gastrectomy. Main indication for revision weight regain (30%) followed by gastric reflux (21%). Mean duration between primary and revisional procedure was 7 years. Conclusions: Most revisional surgery is performed within the first decade of primary procedure, with weight regain and GORD being most common causes. It is important that revisional surgery, its indications, prevalence, and risks are discussed with patients at the time of primary bariatric surgery.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222061
A flap is one with a persistent blood supply that does not rely on the recipient's bed to perfuse donor tissue. Free flaps are used in a different context. Before reconstructing any wound bed, the surgeon must ensure that the receiving bed is properly prepared. The wound must be free of any necrotic or ischemic tissue. In addition, signs of infection such as local cellulitis, significant edema, or purulent drainage should have decreased. Flaps have wide applicability and choice, with an almost infinite range of flaps available to cover even the most complex defects. It is necessary to consider the aesthetic and functional results, as well as the comorbidities and possible morbidity of the donor site. The routine use of flaps has drastically expanded the surgeon's ability to care for the injured patient. In addition, previously unresectable cancers have become resectable with the ability to offer flap reconstruction. The ability to move tissues has improved the quality of life of countless patients.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222076
Background: The development of blood clots (thrombi) in the deep veins is known as deep vein thrombosis (DVT). It frequently affects the deep pelvic veins or the deep leg veins (such as the calf veins, femoral vein, or popliteal vein). It is a potentially fatal condition that may result in morbidity and mortality that can be prevented. Aim was to assess the effectiveness of thrombectomy in treating patients with DVT. Methods: The 196 patients with DVT reporting to VKP’s VJ hospital, Tirunelveli, Tamil Nadu, were selected for this retrospective study. Thrombectomy was chosen as the treatment modality in this study. Results: Most patients were in the age group between 41 to 60 years (59.5%), with male predominance noted (77.4%). Pain and swelling are the most typical clinical features, 64.6% of patients presented with this sign. In patients with chronic and sub-acute DVT, 25% and 10.2% had residual thrombus visualized in doppler. Late complication, varicose veins were seen higher in patients with common iliac vein thrombosis (2/3) 66.7%, 52.6% (10/19) in external iliac vein thrombosis and 34.8% (8/23) in popliteal vein thrombosis. Late complication recurrence was seen higher in patients with partial occlusion (5/14) 35.7%, 21.4% (3/14) had varicose veins. Conclusions: The best course of treatment for DVT patients is thrombectomy, which can restore venous patency, stop DVT from returning, alleviate PTS, and prevent pulmonary embolism.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222077
Gastrointestinal stromal tumors (GIST) are neoplasms of mesenchymal origin. We present the case of a patient with low gastrointestinal tract bleeding secondary to a gastrointestinal stromal tumor, as well as her diagnostic clinical approach in a third-level medical unit, as well as a brief review of the literature. The treatment of this neoplasm is surgical and ideally consists of complete resection with negative margins (R0). GISTs mostly affect patients between 4-6 decades of life with a slight predominance in women, with the stomach and small intestine being the most frequently affected organs. The immunohistochemical study shows positivity for c-KIT and CD34 in 100% and 63% of cases. The treatment is surgical which usually by maintaining free margins is curative
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222069
The use of stereolithographic models and virtual planning in plastic surgery have been used mainly in craniomaxillofacial reconstructions secondary to trauma, oncological reconstructions, orthognathic surgery and correction of craniofacial developmental anomalies of craniofacial development, among others, making surgical planning a less tedious process and reducing surgical time. In this article we present the experience using this technology in a referral center. Eight cases are exposed where the different applications of virtual planning and 3D models can be evidenced. Pre-op and post-op images are presented showing the similarity with the planning. We have implemented its use not only for facial trauma reconstructions with free flaps, but also for the correction of sequelae, correction of complex craniofacial abnormalities, oncological defects, and hand reconstructions. Our experience has been favorable since it allowed us to obtain satisfactory functional and predictable results and a reduced surgical time, especially in complex cases. If available, this technology should be considered as a useful tool to obtain predictable and reliable results.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222062
Background: Breast cancer is one of the most common cancers among women around the world. Some occult breast cancers can be missed when using ultrasound or mammogram alone. Considering this background, the study was performed to highlight the improved diagnostic efficacy of identifying breast cancer when using both ultrasound and mammogram as a combined modality. Methods: A total of 150 cases of suspected breast cancer were studied over a period of 2 years. Ultrasonography, and mammography were done by two independent radiologists and the results were analyzed. The patients were tested for BRCA1/2 gene mutations. Histopathology was done finally to confirm the diagnoses. Results: The39 cases out of 150 asymptomatic women screened for breast cancer showed that they were positive for breast cancer by histopathology and 38 were positive by mammogram and ultra-sonogram. Cancer was prominently diagnosed in the age group of more than 40 years (92.3%) and 82.1% of women were in premenopausal stage. High BMI had a statistically significant correlation with breast cancer. The 71.7% of breast cancer cases were obese and 25.6% were overweight individuals. 89.7% of breast cancer cases were from the urban population. Detection of mutation in the BRCA gene showed 28 cases with a mutation in the BRCA-1 gene and 4 cases with a mutation in the BRCA-2 gene. Conclusions: The study confirms that mammography in addition to ultrasonography improves the sensitivity of detection of occult breast cancer in asymptomatic women.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222060
One surgical method per year for every 22 people is developed. Stem cells are those that are known to have an important and unique potential for renewal. They have the functionality to make a difference in many different cell types throughout the early stages of life and growth. Skin is the largest organ in the body and has a variety of functionalities. Compartments of the dermis, epidermis and hair follicles house stem cells important for homeostasis and regeneration of the dermis. These stem cells contribute to wound repair, which results in total tissue replacement and damaged tissue function. The authors agree on the theoretical role of stem cells in the treatment of surgical wounds. Treatment must be individualized, and variables such as adverse effects must be taken into account, however, it seems to be a promising therapeutic.
International Surgery Journal; https://doi.org/10.18203/2349-2902.isj20222059
Background: In patients with acute biliary pancreatitis, cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results: A total of 70 patients were enrolled at tertiary care hospital in central India. Of them, 35were randomized to the early group and 35 patients to the delayed group using simple randomization technique. Conclusions: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.
International Surgery Journal, Volume 9, pp 1438-1445; https://doi.org/10.18203/2349-2902.isj20221897
Background: Urolithiasis has affected humans since antiquity. The aim of the study was to evaluate the efficacy and outcome of retroperitoneal laproscopic pyelolithotomy and open pyelolithotomy in patients with renal stones. Methods: The present prospective randomized clinical study was carried out in department of surgery from June 2017 to April 2021 in patients with renal stones. A total of 100 patients with solitary renal pelvic stone were properly assessed radiologically and clinically before planning the surgical intervention. Results: The overall mean age of presentation among patients undergoing pyelolithotomy was 41.9±12.30 years (χ2=5.14, p≤0.001). Minimum number of patients were 41-60 years age group i.e.; 58 patients. 70 patients were males while 30 patients were females with male to female ratio 2.33:1. The mean stone size among patients undergoing LP and OP was 1.9±0.5 cm. The mean operative time (min) among patients undergoing LP group (123.9±9.5 minutes) was more as compared to OP group was 80.1±17.5 min. The mean duration of return to work was 3.86±1.39 days. The mean duration of return to work in LP group was 3.87±1.37 days, while in OP group was 5.87±1.34 days (χ2=18.56, p<0.02). Conclusions: Retroperitoneal laproscopic pyelolithotomy proved to be safer in all the aspects than open pyelolithotomy.
International Surgery Journal, Volume 9, pp 1486-1488; https://doi.org/10.18203/2349-2902.isj20221906
Blue rubber bleb naevus syndrome (BRBNS) is a rare syndrome of AV malformation which mainly involves skin, soft tissue, gastrointestinal tract and other parts of the body. Its occurrence is usually sporadic, although cases of autosomal dominant inheritance is reported. At presentation symptoms depend on the organs involved. Patients may present with acute or chronic gastrointestinal bleed and it usually seen in children and rarely in adults. We herein reported a rare case of BRBNS in 17 years old male patient who suffered from Malena for four years with past history of haemangioma excision on back. Patient was on regular blood transfusion for six months. Endoscopy revealed multiple AV malformation in gastrointestinal tract. Patient underwent laparotomy with resection of involved segments of ileum with primary end to end anastomosis. Post-operative recovery was uneventful. So here we can conclude that the definitive management of BRBNS affecting the gastrointestinal tract is excision. This article was an original case review of management of BRBNS. The clinical presentation, required investigations and management of the same.