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Journal of Surgery

ISSN: [Jurnalul de chirurgie]
ISSN: 1584-9341

Open Access

Current Issue

Volume 16, Issue 2 (2020)

    Review Pages: 1 - 24

    Current Surgical Treatment of Esophageal Cancer-Distal Adenocarcinoma, Multidisciplinary Approach, Evolving Minimal-Invasive Approach at High-Volume Centers

    Ulrich Klaus Fetzner*, Pinghai Hu, Hesham Ahmed Gamaleldeen Elwan, Ahmed Milad Mohamed El Meghrawi, Christian Maret, Mathias Stefan Silvester Loehnert and Peter Philipp Grimminger

    Even in 2020 esophageal cancer stays a severe disease and means a caesura in the life of the affected.

    Early carcinoma under strict indications and conditions can be safely resected by interventional endoscopy. In locally advanced esophageal cancer of the mid and lower third radical resection stays the gold-standard. The favored approach is the transthoracic esophagectomy with 2-field lymphadenectomy and reconstruction by gastric pullup. In recent years, progress resulted in a notable decrease in morbidity and mortality of these procedures and in an acceptable life quality despite resection and reconstruction.

    Additionally, multidisciplinary treatment-especially neoadjuvant chemo- and radiochemotherapy-improved long-term survival. Overall it is clear, that the treatment of esophageal cancer in high volume centers is safer and more effective.

    Challenges for the future are the further development of minimally invasive procedures by laparoscopic, thoracoscopic, or robot-assisted approaches, which results in minimizing the operative trauma and reducing pulmonary complications.

    With further progress in decoding the esophageal cancer gene, gene-products, and pathways more specific prevention and more targeted therapy could be applied.

    Standards of treatment of esophageal cancer differ from country to country. This lies mostly in the ethnic differences like incidence, the unequal distribution of squamous cell carcinoma and adenocarcinoma, and in broad differences in concepts and the capability of the health systems. This review focuses on the current surgical diagnostic and curative treatment of esophageal cancer at the majority of high volume centers in Germany by reviewing the associated literature and imbedded by the author's own clinical and academic experiences.

    Research Pages: 1 - 6

    Accidental Ingestion of Foreign Bodies in Children: Experience from Developing Countries

    M Rohaizak*, RA Mukhlis and NFHA Dalek

    Introduction: Accidental ingestion of foreign bodies in children is uncommon, regardless of whether in the developed or underdeveloped countries. Reports in the United States show that the most common object is a coin. The majority of the patients are asymptomatic. As the patients are asymptomatic, most of the patients were treated conservatively as the foreign bodies pass out spontaneously. In certain cases, an endoscopy is needed to retrieve the objects. This study illustrates the experience in managing the condition in a developing country.

    Methods: This is a retrospective study looking into the management of accidental foreign body ingestion in the local hospital. A computer search was made into the hospital database searching for a diagnosis of foreign body ingestion between April 2017 to May 2018. The parameters of the patients were retrieved from the computer database. Patients with incomplete data were excluded

    Result: 14 patients were identified with the diagnosis of ingested foreign bodies. One was excluded due to incomplete data. The patients' age ranges from 1 to 10 years old with 6/13 (46%) are 3 years or below. The most common objects ingested is coin (46%) followed by coin cell battery (23%). Only in one patient, the ingested material was radiolucent (stone) which was not seen on a radiograph. The majority (76.9%) of the ingested material passed out spontaneously except in 3/13 (23%), endoscopic retrieval of the material needed to be performed. There was no patient needed exploratory laparotomy.

    Conclusion: Accidental ingestion of coin is still the most common objects in children. Coin cell battery which is commonly used in an electronic device is getting more common. The majority of the objects can be visualized by radiograph and in the majority of cases, the material passed out spontaneously without any intervention.

    Research Pages: 1 - 5

    Evaluation of Efficacy of Clopidogrel Plus Aspirin vs. Aspirin Alone of Early Clinical Outcomes Following Off Pump Coronary Artery Bypass Graft Surgery

    Hamid Reza Soltani, Mehdi Latif, Mehdi Hadadzadeh, Azadeh Shahidzadeh and Arezoo Shahidzadeh

    Introduction: Clopidogrel improves intravascular stent patency reduces ischemic events but there are little data on its effect fallowing OPCAB. This study was designed to
    Material and Method: In this randomized clinical trial, 413 patients undergoing OPCAB were randomized to receive aspirin 80 mg plus Clopidogrel 75 mg (n=214,
    intervention group) or aspirin 80 mg (n=199, control group) for three days after surgery and then were treated in accordance with the common guidelines. Patients with
    coagulation disorders and those who rejected taking drugs were excluded. The data were then analyzed by using Student t-test and Chi-square test through SPSS ver.
    20.
    Result: Mean age of patients was 61.081 ± 10.84 years. There was no significant difference between in two groups in pre and perioperation data. Mean of bleeding in the
    mean of bleeding during three days between two groups (p: 0.013).
    Conclusion: According to our findings patients treated with Clopidogrel plus aspirin had significantly less bleeding compared with the group treated with aspirin alone
    during three days. It seems that the effect of Clopidogrel on outcomes of operation is considerable and Clopidogrel can be introduced as a qualified supplement therapy
    for aspirin although the side effect of recombinant antiplatelet therapy is also controversial.

    Research Pages: 1 - 4

    Factors Used by Program Directors in the Orthopedic Sports Medicine Fellowship Match

    Travis Menge*, Ashley Nord, Kendall Hamilton, Monica LaPointe and Peter J.L. Jebson

    Background: Obtaining an orthopedic sports medicine fellowship position is becoming more difficult, as the number of residents seeking post-graduate training continues to increase.

    Objective: To identify factors that orthopedic surgery sports medicine fellowship program directors deem valuable in selecting applicants.

    Methods: A web-based questionnaire was sent to all ACGME accredited sports medicine fellowship program directors in the United States in 2016. The questionnaire was designed to identify the most important criteria in selecting applicants for an interview, and ranking candidates to match into their program.

    Results: Thirty-five of ninety-one program directors responded. The criteria for offering an applicant an interview were quality of recommendation letter, technical competence, and residency program reputation. Letters of recommendation that held the highest value were from the chief of sports medicine and another sports medicine surgeon in the department. The most important features of the interview were the applicant’s ability to articulate thoughts, the maturity of the applicant, and the ability of the applicant to listen well. The attributes deemed most important in high ranking a candidate included the applicant’s commitment to hard work, quality of the interview, and quality of letters of recommendation.

    Conclusion: There are identifiable factors considered important by sports medicine fellowship directors when selecting candidates for an interview and ranking them in the match process. With increasing costs of the application process and competition among applicants, this information can be valuable to medical students and residents considering a career in orthopedic sports medicine.

    Review Pages: 1 - 3

    Peripheral Nerve Blocks in Hip Arthroscopy

    Collin LaPorte, Michael Rahl and Travis J. Menge*

    Hip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. We present a comprehensive review of the current literature regarding the utilization of peripheral nerve blocks for pain management in patients undergoing hip arthroscopy.

    Case Report Pages: 1 - 4

    Spontaneous Splenic Rupture Case Report

    Saad Slaiki*, Hicham El Bouhaddouti, Abdelmalek Ousadden, Khalid Ait Taleb and El Bachir Benjelloun

    A spontaneous splenic rupture is a rare entity. The classic treatment remains splenectomy but several recent works has highlighted the value of conservative treatment. We report the case of a young man who had a spontaneous spleen rupture in association with idiopathic thrombocytopenia purpura and who benefited from a conservative treatment.

    Editorĺs Note Pages: 1 - 1

    Editorial Note for Journal of Surgery [Jurnalul de chirurgie]

    Isabelle Gomez

    I am pleased to mention that during the year 2019, all issues of volume 15 were published online well within the time and the print issues were also brought out and dispatched within 30 days of publishing the issue online.
    Journal of Surgery [Jurnalul de chirurgie] during this year also brought out 4th Global Meeting on Plastic, Aesthetic and Reconstructive Surgery, which consisted of ~11 abstracts.
    The JCR Impact factor of JOS for the year 2018 was 1.91, while the current SJR index dropped to 0.256. The H-index of the journal, however, increased to 50 and JOS ranked first among all journals in the field of Surgical Sciences published in India, 2nd in Asia and 48th in the world.
    During the calendar year 2019, JOS received a total of 62 papers, out of which 36 articles (58%) were rejected in the preliminary screening due to plagiarism or being out of the format and peer review process. During 2019 around 14 articles were subjected for publication after they are accepted in the peer review process. In the 3 issues of Volume 15 published during the year 2019, a total of 14 articles were published (at an average of 8 articles per issue) of which, articles were published from authors all around the world. A total of 110 research scientists from all over the world reviewed the 14 articles published in volume 15. Average publication lag time of an article was further reduced to 2-3 weeks.
    During the calendar year 2019, a total of 32 Editors, 15 Reviewers joined the board of JOS and contributed their invaluable services towards contribution as well as publication of articles.
    I take this opportunity to acknowledge the contribution of Eugen Tarcoveanu and Radu Moldovanu during the final editing of articles published and the support rendered by the editorial assistant, Isabelle Gomez in bringing out issues of JOS in time. I would also like to express my gratitude to all the authors, reviewers, the publisher, the advisory and the editorial board of JOS, the office bearers for their support in bringing out yet another volume of JOS and look forward to their unrelenting support to bring out the Volume 16 of JOS in scheduled time.

    Volume 16, Issue 3 (2020)

      Case Report Pages: 1 - 3

      A Symptomatic Cyst of the Falciform Ligament of the Liver: A Case Report and Review of the Literature

      Seyed Mostafa Shiryazdi, Hamid Reza Soltani* and Ariana Abadyan

      Falciform ligament cysts are very rare, with only 12 cases being reported so far. Patients may be asymptomatic or may present with symptoms such as abdominal pain
      and abdominal mass. In this report, we introduce a symptomatic case with abdominal pain. She was diagnosed with falciform ligament cyst using ultrasound imaging
      confirmed during laparotomy.

      Editorial Pages: 1 - 2

      Research Contribution and Achievement

      Ashraf EL-Molla

      Share this article
      Extended Abstract Pages: 1 - 1

      Perforation peritonitis is a common serious condition encountered in day to day surgical practice in any hospital

      Nirbhaibir Singh

      Perforation peritonitis is a common serious condition encountered in day to day surgical practice in any
      hospital. One of the reasons for high mortality in these conditions is lack of risk stratifications resulting
      in delay in providing adequate management, although a number of scoring systems are available to
      stratify these patients according to severity, but most of these cannot be used in developing countries
      like India due to their dependency on sophisticated investigation which are usually lacking in most parts
      of these countries. So a simple prognostic scoring system which could be easily reproduced without
      sophisticated investigations and also provide a reliable objective assessment of severity and operative
      risk is required.

      Volume 16, Issue 4 (2020)

        Editorial Pages: 1 - 2

        Young Research Forum-Young Scientist Awards: Surgery Asia Pacific 2020, Tokyo, Japan, May 20-21, 2020

        Marina Temelkovska Stevanovska

        Surgery Asia Pacific 2020 invites research scholars & young scientists, to submit the
        nominations for Young Scientist Awards: Surgery Asia Pacific 2020.This Surgery Asia
        Pacific 2020 Young Scientist Awards will be announced at the upcoming “12th
        International Conference on Surgery and Anesthesia” at Tokyo, Japan this May 2020.

        Editorial Pages: 1 - 2

        Young Research Forum-Young Scientist Awards: Surgery Congress 2020, Kyoto, Japan, March 30-31, 2020

        Jhon Bella

        Surgery Asia Pacific 2020 invites research scholars & young scientists, to submit the
        nominations for Young Scientist Awards: Surgery Asia Pacific 2020. This Surgery Asia
        Pacific 2020 Young Scientist Awards will be announced at the upcoming “11th
        International Conference on Surgery” at Kyoto, Japan this March 2020.

        Case Report Pages: 1 - 4

        Laryngeal Adenoid Cystic Carcinoma-A Case Report and Review of Literature

        Jakub Pachla, Malgorzata Czesak, Ewa Osuch Wojcikiewicz, and Kazimierz Niemczyk

        Objectives: Adenoid Cystic Carcinoma (ACC) is an extremely rare malignant neoplasm of the glandular tissues. In this article, we present a case of ACC in the larynx along with its clinical, pathological and therapeutic aspects. Methods: A 53-year-old man presented with suspected laryngeal ACC. Diagnostic tests were performed, including computed tomography and magnetic resonance imaging. Due to its clinical advancement, T4aN0 was qualified for surgical treatment. Results: Complete laryngectomy was performed with removal of the lobe of the thyroid on the right and selective cervical lymph node removal on the right, and formation of a tracheopharyngeal fistula with implantation of a voice prosthesis. Due to the type of malignant tumor and the degree of local advancement, the patient underwent complementary radiotherapy to the area of the laryngeal bed and regional lymph nodes, bilaterally. Twenty-four months after surgery, the patient remains disease-free. Conclusion: ACC constitutes less than 1% of all head and neck tumors. It is a highly aggressive malignancy with a high rate of recurrences and a tendency towards distant metastases. Currently, surgical resection with adjuvant radiotherapy is the gold standard in ACC treatment. Long-term follow up is required in ACC patients.

        Research Pages: 1 - 4

        Surgical Smoke-Do We Know Enough About It?

        Asad Abbas, Sehrish Altaf, Farrukh Javeed, Muhammad Sohail Umerani and Syed Raza Khairat Rizvi

        Surgical smoke is a dangerous by-product generated from the use of surgical energy based devices. Medical personnel have always been exposed to surgical smoke, most of them unknowingly and this has accounted for several health risks consequently. There is enough literature to back the claim of surgical smoke to be hazardous towards the patients and the medical personnel involved in patients’ care. The objective of this article is to assess the current awareness level among medical personnel regarding the hazards of surgical smoke, and what measures they take to minimize the risk of exposure. A total of 440 respondents, working in a operating room, between ages 22-55 years filled the questionnaire among which 300 (68.2%) work in public hospitals while 140 (31.8%) work under private setups. Although many of the respondents believed that surgical smoke was harmful, adequate measures were not taken to tackle this health hazard.

        Case Report Pages: 1 - 3

        Complete Resolution of Bilateral Pulmonary Artery Embolism and Aneurysmal Dilatation with Behcets Disease after Intravenous Cyclophosphamide Therapy Only: A Case Report and Review of the Literature

        Ahmed A. Abd Alkader, Ahmed K. Awad, Sheref A. Elseidy

        Bechet syndrome is a multisystemic illness that leads to vasculitis. The classic constellation of symptoms is recurrent aphthous ulcers of the mouth and genitalia, hyperreactivity of the skin to penetrating trauma (pathergy reaction), other skin lesions, arthritis, and panuveitis. Vascular involvement can involve arteries and veins of all sizes and types. however venous involvement tends to be more common than arterial vasculitis mostly in the form of lower extremity vein thrombosis. Interestingly the disease manifestation of vasculitis itself seems to favor males than females and with a unique geographical distribution. Arterial vasculitis tends to affect the pulmonary vasculature, though Pulmonary involvement in Bechet’s disease is rare, occurring 1–7.7 of patients. Pulmonary artery aneurysms with or without “in situ" thrombosis is the most common form of arterial involvement and are the leading causes of increased mortality.

        Different management modalities have been proposed. of these immunosuppressive therapies have shown to decrease the inflammation and lead to resolution of the aneurysmal dilatation itself. however, this treatment is reserved for patients with minor to moderate hemoptysis and who are vitally stable.

        In this case, we report a patient with Behcet induced pulmonary artery aneurysm and in situ thrombosis who presented with massive hemoptysis and was managed with only immunosuppressive therapy after initial stabilization that leads to complete resolution of the aneurysm.

        COVID-19 Special Issue: Future of Anesthesia and Surgery (2020)

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