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.
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.
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.
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.
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.
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.
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.
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.
Marina Temelkovska Stevanovska
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.
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.
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.
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.
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.
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.
Juan A. Mira, Ernesto Delgado Cidranes, Vakhtang Shoshiashvili, Ashraf EL-Molla, Ulf Thorsten Zierau, Sang-Hwan Do
5th International Conference on Anaesthesia was successfully
hosted by Conferenceseries LLC Ltd during July
01-02, 2019. The conference was organized around the
theme “Gaining a broader practical understanding of
global approaches used in Anesthesia” with the purpose
to strengthen the future of Anesthesia and Surgery.
Ernesto Delgado Cidranes
A case study was performed by evaluating 23 patients
using PET-MRI by implication of neuro inflation in patients
with poor response to usual treatments. PET-MRI
was performed on all patients. According to the diagnosis
of uptake, the therapeutic behaviour to be followed was
defined, as well as the comparison with the final result
and degree of satisfaction and decrease of the inflammatory
focus for the control of persistent chronic pain. The
results were satisfactory and definitive in all of the patients
and we concluded that PET-MRI in real-time is a
powerful tool for the resolution of complex patients with
chronic pain.
Mangal Ahlawat
Introduction: Neurofibromatosis (NF1) is a autosomal
dominant disease and can involve numerous organs and
organ-systems of our body. Neurofibromas (cutaneous)
are the characteristic lesion of NF1 and spinal neurofibromas
are also commonly seen in patients with NF1.
Frequency of spinal neurofibroma is thoracic, followed
by cervical, lumbar and rarely sacral region. Of these spinal
neurofibromas, majority are intra-dural extra-medullary,
and few are intra-meduallary(1%) in location.
Souvic Sarkar
Reperfusion-induced ventricular fibrillation after aortic
cross clamp is one of the important complications of open
heart surgery. This study aimed to evaluate the efficacy of
Amiodarone, Lignocaine and agnesium sulphate by the
way of pump circuit 3-5 minutes before ACC release and
observe the haemodynamic alterations in intra-op and
post op period and compare the results in randomised
controlled trial.
T Dessain, S Tahir, D Dabrowska
Background: Single dose of intravenousdexamethasone
has been shown to improve post operative analgesia in
obstetric patients Our aim was to establish if a single dose
of dexamethasone would improve pains cores and reduce
opioid consumptionas part of multimodalanalgesic regime.
Vakhtang Shoshiashvili
Postdural puncture headache (PDPH) is a major complication
of neuraxial anesthesia that can occur following
spinal anesthesia and with inadvertent dural puncture
during epidural anesthesia. Risks factors include female
sex, young age, pregnancy, vaginal delivery, low body
mass index, and being a non-smoker. Needle size, design
and the technique used also affect the risk.
