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Addepalli P, Sawangsri W, Ghani SAC. A scientometric analysis of bone cutting tools & methodologies: Mapping the research landscape. Injury 2024; 55:111458. [PMID: 38432100 DOI: 10.1016/j.injury.2024.111458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/15/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
This study undertakes a Scientometric analysis of bone-cutting tools, investigating a corpus of 735 papers from the Scopus database between 1941 and 2023. It employs bibliometric methodologies such as keyword coupling, co-citation, and co-authorship analysis to map the intellectual landscape and collaborative networks within this research domain. The analysis highlights a growing interest and significant advancements in bone-cutting tools, focusing on their design, the materials used, and the cutting processes involved. It identifies key research fronts and trends, such as the emphasis on surgical precision, material innovation, and the optimization of tool performance. Further, the study reveals a broad collaboration among researchers from various disciplines, including engineering, materials science, and medical sciences, reflecting the field's interdisciplinary nature. Despite the progress, the analysis points out several gaps, notably in tool design optimization and the impact of materials on bone health. This comprehensive review not only charts the evolution of bone-cutting tool research but also calls attention to areas requiring further investigation, aiming to inspire future studies that address these identified gaps and enhance surgical outcomes.
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Zhou X, Liang D, Li Q, Zhao L, Bin Y, Ma F, Wu R, Lv Y, Li Q. The sealing effect of magnetic-sealing uterine manipulator in isolated uterus from patients with early-stage cervical cancer: a pre-clinical study. J Gynecol Oncol 2023; 34:e78. [PMID: 37477101 PMCID: PMC10627758 DOI: 10.3802/jgo.2023.34.e78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 06/11/2023] [Accepted: 06/24/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE Traditional uterine manipulator is considered as the main reason for short survival of patients with early-stage cervical cancer during minimally invasive surgery. This study aims to assess the sealing effect of magnetic-sealing uterine manipulators (MUMs) in isolated uteruses. METHODS The study was performed on isolated uterus from patients with early-stage cervical cancer who underwent open abdominal radical hysterectomy between November 2019 to April 2021. Right-angle forceps closure tests (groups 1 and 3) were defined as control tests. One experimental MUM closure test (group 2) and 2 control tests were respectively carried out in each of the isolated uterus. DNA ploidy analysis system was used to observe exfoliated cells. Statistical analysis was performed using Wilcoxon signed-rank test to assess the sealing effect of MUM. RESULTS We identified 36 patients. No regional node metastasis was discovered and only one tumor was larger than 4.0 cm in diameter. The mean of exfoliated tumor cells in groups 1, 2, and 3 were 1, 1, and 2, respectively. There was no significant difference in the quantity of exfoliated cells between groups 1 and 3 (p=0.476), so the results of the 2 groups were merged. Subsequently, a significant difference was observed between combined right-angle forceps closure tests and MUM closure tests (p=0.022). CONCLUSION The sealing effect of MUM was better than that of right-angle forceps. MUM can effectively seal cervical cancer cells in the cup cover, avoiding the dissemination of tumor cells. TRIAL REGISTRATION Chinese Clinical Trial Register Identifier: ChiCTR1900026012.
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Affiliation(s)
- Xue Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dongxin Liang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qing Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, China
| | - Lanbo Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yadi Bin
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Feng Ma
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Provincial Key Laboratory of Magnetic Medicine, Xi'an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Provincial Key Laboratory of Magnetic Medicine, Xi'an, China
| | - Yi Lv
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Provincial Key Laboratory of Magnetic Medicine, Xi'an, China.
| | - Qiling Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Provincial Key Laboratory of Magnetic Medicine, Xi'an, China.
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Yamamoto A, Tanioka S, Fujimoto M, Nishikawa H, Kamei Y, Ikezawa M, Ishida F, Miyazaki T, Suzuki H, Mizuno M. An alternative method to evaluate lumbar interbody fusion status focusing on position change of screw-rod constructs. Eur Radiol 2023; 33:1545-52. [PMID: 36305899 DOI: 10.1007/s00330-022-09194-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The evaluation of lumbar interbody fusion status is generally subjective and may differ among raters. The authors examined whether the assessment of position change of screw-rod constructs could be an alternative method for the evaluation of fusion status. METHODS Sixty-three patients undergoing lumbar interbody single-level fusion were retrospectively reviewed. Three-dimensional images of screw-rod constructs were created from baseline CT examination on the day after surgery and follow-up CT examinations (3-5 months, 6-11 months, and ≥ 12 months) and superposed, with position change of screw-rod constructs being evaluated by the distance between the 3-dimensional images at baseline and follow-up. The evaluation was repeated twice to confirm the reproducibility. Fusion status on follow-up CT examinations was assessed by three raters, where inter-rater reliability was evaluated with Fleiss' kappa. The results of the fusion status were classified into fusion and incomplete fusion groups in each timing of follow-up CT examinations, where the amount of position change was compared between the two groups. RESULTS The evaluation of position change was completely reproducible. The Fleiss' kappa (agreements) was 0.481 (69.4%). The medians of the amount of position change in fusion and incomplete fusion groups were 0.134 mm and 0.158 mm at 3-5 months (p = 0.21), 0.160 mm and 0.190 mm at 6-11 months (p = 0.02), and 0.156 mm and 0.314 mm at ≥ 12 months (p = 0.004). CONCLUSIONS The assessment of position change of screw-rod constructs at 6 months or more after surgery can be an alternative method for evaluating lumbar interbody fusion status. KEY POINTS • Lumbar interbody fusion status (satisfactory, incomplete, or failed) is associated with the quantification of position change of screw-rod in this study. • Reference values for the evaluation of position change in identifying interbody fusion status are provided. • Position change of screw-rod could be a supportive method for evaluating interbody fusion status.
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Wong JM, Moore KJ, Carey ET. Investigation of the Association Between Surgeon Sex and Laparoscopic Device Ergonomic Strain in Gynecologic Surgery. J Minim Invasive Gynecol 2022:S1553-4650(22)00169-8. [PMID: 35513300 DOI: 10.1016/j.jmig.2022.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/28/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE To assess if female compared to male sex is associated with greater ergonomic strain with use of 4 advanced energy laparoscopic devices (LigaSure, HALO PKS, ENSEAL, and Harmonic scalpel). DESIGN Online survey distributed by e-mail using the REDCap platform. All responses were anonymous. SETTING Nationwide survey in the United States. PARTICIPANTS Gynecologic surgeons were surveyed through the Society of Gynecologic Surgeons listserv and 4 Obstetrics and Gynecology departmental listservs. INTERVENTIONS The survey was distributed between 5/01/2020-11/01/2020. The primary outcome was the presence of physical complaints due to laparoscopic devices. Descriptive statistics compared surgeon characteristics and ergonomic symptoms. Logistic regression was performed, adjusted for surgeon characteristics. MEASUREMENTS AND MAIN RESULTS The response rate was 39%, comprising 149 women (78%) and 41 men (22%). Women compared to men had a significantly younger age (mean 34 vs 44 years old, p<.01), smaller glove size (mean 6.5 vs 7.5, p<.01), shorter height (median 66 vs 71 in, p<.01), and were less frequently in practice for >10 years (19% vs 49%, p<.01). Women significantly more often reported physical complaints related to use of laparoscopic devices (79% vs 41%, p<.01). Women reported all devices had too large a fit for appropriate use (p<.01). Women were found to have 5.37 times the odds of physical complaints attributed to the use of laparoscopic instruments (cOR 5.37, 95% CI 2.56-11.25); with adjustment for glove size, age, and laparoscopic case volume and duration, this was no longer significant (aOR 2.02, 95% 0.59-6.93). CONCLUSION Women significantly more often report physical complaints and inappropriate fit of the LigaSure, HALO PKS, ENSEAL, and Harmonic scalpel. Female sex is associated with fivefold greater odds of physical complaints with laparoscopic device use. Further investigation of the surgeon factors underlying device-related strain is a critical next step to understanding and reducing surgeon ergonomic injury.
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Joaquim RDM, Nuernberg TG, Fattah T, Silva RLD. Evaluation of Ventricular Remodeling and Prognosis in Patients with Aortic Stenosis Who Underwent Surgical or Percutaneous Transcatheter Aortic Valve Replacement. Braz J Cardiovasc Surg 2022; 37:153-160. [PMID: 35244379 PMCID: PMC9054147 DOI: 10.21470/1678-9741-2021-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Aortic stenosis is the most common heart valve disease in the world, and patients that present with symptoms have a high mortality rate. Aortic valve replacement has the objective of promote left ventricular remodeling, reduce symptoms, and increase overall survival. The objective of this study is to evaluate reverse remodeling of the left ventricle in patients with severe and symptomatic aortic stenosis who underwent surgical or percutaneous transcatheter aortic valve replacement. Methods This is a longitudinal, prospective, non-concurrent, non-randomized unicentric study with patients who underwent aortic valve replacement. Echocardiogram was performed before and after replacement procedure to evaluate several remodeling indexes. Results Of 91 patients, 77 (84.6%) underwent surgical aortic valve replacement, and 14 (15.4%) underwent percutaneous transcatheter aortic valve replacement. Mean age was 68,96±11,98 years, and most patients were male. Remodeling evaluation revealed that patients who decreased left ventricular index mass (53% vs. 38.9%; P=0,019) and those who reduced the mass/volume ratio (30.4% vs. 68.9%; P<0,001) presented with positive left ventricular remodeling. No endpoint difference was found in those with positive remodeling. Conclusion Regarding the left ventricular remodeling in patients with severe and symptomatic aortic valve stenosis who underwent percutaneous transcatheter or surgical valve replacement, there is a positive increment in remodeling, however it remains in concentric hypertrophic shape. Implication of these findings remains uncertain and to be studied in large dedicated trials with clinical endpoints.
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Affiliation(s)
- Rodrigo de Moura Joaquim
- Interventional Cardiology Service, Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
| | - Tiago Ghislandi Nuernberg
- Interventional Cardiology Service, Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
| | - Tammuz Fattah
- Interventional Cardiology Service, Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil.,Interventional Cardiology Service, Hospital Universitário Professor Polydoro Ernani de São Thiago, Florianópolis, Santa Catarina, Brazil
| | - Roberto Leo da Silva
- Interventional Cardiology Service, Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil.,Interventional Cardiology Service, Hospital Universitário Professor Polydoro Ernani de São Thiago, Florianópolis, Santa Catarina, Brazil
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Tan L, Xie X, Xu Y, Tian Q, Zhang Q, Lan G, Wang H, Zhao Y, Peng L. Skills to Perform Vessel Eversion in Mouse Cervical Cardiac Transplantation with Cuff Technique. Braz J Cardiovasc Surg 2021; 36:318-322. [PMID: 33355791 PMCID: PMC8357381 DOI: 10.21470/1678-9741-2020-0125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The mouse heterotopic cardiac transplant model has been extensively used to explore transplant immunity. Although the cuff technique facilitates the operation, the procedure remains difficult, and vessel eversion is the most difficult step. Cuff movement and everted vessel wall slippage are the main adverse factors in vessel eversion. Traditional strategies to prevent these factors focus on cuff fixation, while more steps or surgical instruments would be required. METHODS According to the reported protocols and our experience, the vessel eversion skills were modified and used for transplantation. Cardiac grafts from C57BL/6(H-2b) or BALB/c(H-2d) mice were transplanted into C57BL/6(H-2b) mice. The operating times of recent 90 operations, which were divided into 9 groups according to their sequence, were summarized and analyzed. RESULTS The mouse cervical cardiac transplantation was successfully performed by using the modified vessel eversion skills. The cuff movement, which is the most important adverse factor to prevent vessel eversion, was effectively prevented. In the recent 90 operations, the total operating time was 47.3±7.9 min and the success rate was 98%. CONCLUSIONS The modified surgical skills simplify the vessel eversion in mouse cervical cardiac transplantation with cuff technique, characterized by less cuff movement, fewer steps, and surgical instruments. Using these surgical skills, the transplant can be performed in a short time.
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Affiliation(s)
- Liang Tan
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Clinical Research Center for Organ Transplantation in Hunan Province, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xubiao Xie
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Clinical Research Center for Organ Transplantation in Hunan Province, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanan Xu
- Transplantation Biology Research Division, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Qianchuan Tian
- Transplantation Biology Research Division, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Qian Zhang
- Transplantation Biology Research Division, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Gongbin Lan
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Clinical Research Center for Organ Transplantation in Hunan Province, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongxia Wang
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yong Zhao
- Transplantation Biology Research Division, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Longkai Peng
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Clinical Research Center for Organ Transplantation in Hunan Province, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Abdel Khalek Y, Bitar R, Christoforou C, Garzon S, Tropea A, Biondi A, Sleiman Z. Uterine manipulator in total laparoscopic hysterectomy: safety and usefulness. Updates Surg 2019; 72:1247-1254. [PMID: 31606857 DOI: 10.1007/s13304-019-00681-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 09/21/2019] [Indexed: 12/19/2022]
Abstract
The aim of this review is to evaluate the effectiveness and safety of uterine manipulators in facilitating total laparoscopic hysterectomy (TLH). A literature search in MEDLINE, EMBASE, Cochrane Library, UpToDate, SpringerLink, ClinicalKey and Elsevier ScienceDirect databases was performed, and articles describing TLH with or without the use of uterine manipulators were retrieved. Complications related to the use of uterine manipulators are numerous, and although uterine manipulator seems to facilitate TLH, the procedure without a uterine manipulator seems to have a comparable safety and effectiveness, although evidence based on a direct comparison of the two approaches is limited without available controlled trials. Uterine manipulator may provide support in cases of large uteri, severe endometriosis, recto vaginal adhesions and regional anesthesia, while its use may increase complications in cases of vaginal stenosis and nulliparity. Therefore, to perform TLH, the surgeon should individualize for each case if uterine manipulator is needed and which manipulator best suits the surgical procedure requirements and case characteristics. Further studies comparing the two approaches are mandatory.
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Affiliation(s)
- Yara Abdel Khalek
- Department of Obstetrics and Gynecology, Saint Joseph University, Beirut, Lebanon
| | - Roger Bitar
- Department of Obstetrics and Gynecology, Lebanese American University, Zahar Street, Beirut, Lebanon
| | | | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Alessandro Tropea
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT(Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), University of Pittsburgh Medical Center Italy, Palermo, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Zaki Sleiman
- Department of Obstetrics and Gynecology, Saint Joseph University, Beirut, Lebanon.
- Department of Obstetrics and Gynecology, Lebanese American University, Zahar Street, Beirut, Lebanon.
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Abstract
Introduction: Unintentionally retained foreign bodies (RFBs) can be accompanied with acute reactions such as inflammatory responses, infections and abscesses within a few days or weeks after surgery with adverse consequences for patients and surgeons. Case Report: An 84-year-old woman was admitted to hospital with weakness, lethargy and infectious secretions of the umbilicus. The patient had undergone hysterectomy 21 years before. Clinical examinations and accurate umbilicus explorations found a 0.5-mm fibrin and smelly umbilical secretions. Dragging found the fibrin to be a surgical gauze thread. The patient was therefore identified as a candidate for laparotomy, which revealed a long gauze attached to a band and a metal ring in the umbilicus and hypogastric regions as well as a large abscess containing 200 ml of infectious secretions, severe adhesions of the intestines to each other and to the abdominal wall, a 10×10 cm cavity and an approximately 1-cm fistula or laceration in the Ileum due to the foreign body (long gauze). The patient was discharged from the hospital in good health conditions after the final surgery. Conclusion: Given the possibility of leaving foreign bodies in the surgery site, surgical teams are required to precisely control surgical instruments after surgery.
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Song IH, Lee SJ, Lee SY. The usefulness of a trans-illuminated introducer during the Nuss procedure. Asian Cardiovasc Thorac Ann 2018; 26:377-381. [PMID: 29719984 DOI: 10.1177/0218492318772226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background There has been an increase in the number of patients undergoing the Nuss procedure for cosmetic purposes, thus increasing the need for safer surgery. However, there are reports of massive hemorrhage and organ damage during the Nuss procedure which involves dissection of the anterior mediastinum. We have developed the trans-illuminated introducer that allows safe surgery while maintaining a small surgical incision of less than 1 cm. Methods This study was a retrospective review of 306 patients aged 3-40 years who underwent the Nuss procedure using the trans-illuminated introducer at our hospital between April 2006 and December 2014. Results There were 29 (9.5%) early postoperative complications. The most common early complication was pneumothorax (15 cases, 4.9%). Five (1.6%) patients developed hemothorax in the early postoperative period, which occurred independently of the dissection process of the anterior mediastinum. None of these patients required reoperation or blood transfusion. There were no complications caused by the introducer during dissection of the anterior mediastinum. Conclusions Using the trans-illuminated introducer, we were able to dissect the anterior mediastinum without a major complication, such as massive hemorrhage from the mediastinum, while maintaining a small surgical incision for cosmetic purposes. Therefore, we consider that the trans-illuminated introducer is useful for improving the outcome of the Nuss procedure.
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Affiliation(s)
- In-Hag Song
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Cheonan, Seoul, Korea
| | - Seung Jin Lee
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Cheonan, Seoul, Korea
| | - Seock Yeol Lee
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Cheonan, Seoul, Korea
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Tirelli G, Del Piero GC, Valentinuz G, Monte A, Gatto A, Rebelli A, Quatela E. New generation cut-and-seal devices in oral and oropharyngeal cancer resection: clinical and cost-effectiveness study. J Laryngol Otol 2018; 132:341-8. [PMID: 29248016 DOI: 10.1017/S0022215117002377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To evaluate the clinical efficacy and cost-effectiveness of ultrasonic shears and the electrothermal bipolar vessel sealing system, in comparison to the traditional cold knife and bipolar forceps, in oral and oropharyngeal cancer surgery. METHODS Patients who underwent oral or oropharyngeal cancer resection and neck dissection with either ultrasonic shears (n = 36) or electrothermal bipolar vessel sealing (n = 32) were enrolled. Surgical time, intra-operative bleeding, blood drainage, post-operative pain, neck oedema, complications and hospitalisation duration were compared to those of an historical cohort of 36 patients treated using a cold knife and bipolar forceps. Additionally, a cost-effectiveness evaluation was performed. RESULTS Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, were advantageous compared to the traditional techniques. The cost of ultrasonic shears and electrothermal bipolar vessel sealing was completely offset by declining time-driven costs for the surgical team and operating theatre. CONCLUSION Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, are more advantageous compared to the traditional techniques, from both a clinical and economic point of view.
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Joo SP, Kim TS. The Clinical Importance of Perforator Preservation in Intracranial Aneurysm Surgery: An Overview with a Review of the Literature. Chonnam Med J 2017; 53:47-55. [PMID: 28184338 PMCID: PMC5299129 DOI: 10.4068/cmj.2017.53.1.47] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 12/29/2022] Open
Abstract
Clipping for intracranial aneurysms is done to achieve complete occlusion of the aneurysm without a remnant sac. Despite modern advancements of neurosurgical techniques, morbidity related to the clipping of intracranial aneurysms still exists. Clip occlusion of a parent artery or small hidden perforators commonly leads to permanent neurological deficits, and is a serious and unwanted complication. Thus, preserving blood flow in the branches and perforators of a parent artery is very important for successful surgery without postoperative morbidity and mortality. The aim of this review article is to discuss the consequences of perforator injury and how to avoid this phenomenon in aneurysm surgeries using intraoperative monitoring devices.
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Affiliation(s)
- Sung-Pil Joo
- Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Tae-Sun Kim
- Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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Kim TJ, Yoon G, Lee YY, Choi CH, Lee JW, Bae DS, Kim BG. Robotic high para-aortic lymph node dissection with high port placement using same port for pelvic surgery in gynecologic cancer patients. J Gynecol Oncol 2015. [PMID: 26197858 PMCID: PMC4510339 DOI: 10.3802/jgo.2015.26.3.222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective This study reports our initial experience of robotic high para-aortic lymph node dissection (PALND) with high port placement using same port for pelvic surgery in cervical and endometrial cancer patients. Methods Between July 2013 and January 2014, we performed robotic high PALND up to the left renal vein during staging surgeries. With high port placement and same port usage for pelvic surgery, high PALND was successfully performed without repositioning the robotic column. All data were registered consecutively and analyzed retrospectively. Results All patients successfully underwent robotic high PALND, followed by hysterectomy and pelvic lymph node dissection. Median age was 45 years (range, 39 to 51 years) and median body mass index was 22 kg/m2 (range, 19.3 to 23.1 kg/m2). Median operative time for right PALND and left PALND was 37 minutes (range, 22 to 65 minutes) and 44 minutes (range, 36 to 50 minutes), respectively. Median number of right and left para-aortic lymph node by pathologic report was 12 (range, 8 to 15) and 13 (range, 5 to 26). Conclusion With high port placement and one assistant port, robotic high PALND with the same port used in pelvic surgery is feasible to non-obese patients.
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Affiliation(s)
- Tae Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gun Yoon
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yoo Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk Soo Bae
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byoung Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Ameri E, Ghandhari H, Hesarikia H, Rasouli HR, Vahidtari H, Nabizadeh N. Comparison of harrington rod and cotrel-dubousset devices in surgical correction of adolescent idiopathic scoliosis. Trauma Mon 2013; 18:134-8. [PMID: 24350172 PMCID: PMC3864399 DOI: 10.5812/traumamon.14663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/01/2013] [Indexed: 11/16/2022] Open
Abstract
Background Since the time of Paul Harrington numerous implants have been introduced for correction of scoliosis, but none are ideal. Newer devices are very expensive, and in our country some patients cannot afford them. Objectives The aim of this study was to compare the results of the Harrington rod (HR) device and the newer Cotrel-Dubousset (CD) device in treatment of adolescent idiopathic scoliosis (AIS). Materials and Methods A retrospective review assessed patients with AIS admitted for spinal curve correction treated with HR (n = 120) and CD devices (n = 138) between October 1988 to April 2001 at the Shafa Yahyaeian Hospital, Tehran, Iran. We extracted information from the patient’s file and radiographs before, after and two years post-operation. Results The mean age of patients was 16.7 ± 2.5 years. There was no statistically significant difference between the two groups regarding gender, age, curve before surgery, and percentage of flexibility. The mean curvature was 70 ± 20.7 in the HR and 64.81 ± 19.4 in the CD group before surgery (P = 0.09); and the mean curvature was 40 ± 16.3 and 26.58 ± 15.37 in HR and CD groups respectively after surgery (P = 0.156). The mean curvature was 47.2 ± 15.9 in HR and 31.2 ± 15.4 in CD groups at two years follow-up (P = 0.156). Conclusions Results of many studies have shown no significant impairment in long-term quality of life and function in patients treated with Harrington rods. According to previously performed studies and the current study, surgical correction with Harrington rods seem to be comparable with the newer more expensive CD device. Although there is no doubt that the preference is to use newer devices in view of some disadvantages of HR, but this does not preclude using it for patients that cannot afford the newer devices.
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Affiliation(s)
- Ebrahim Ameri
- Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hasan Ghandhari
- Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hamid Hesarikia
- Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Hamid Hesarikia, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel.: +98-2122491993, Fax: +98-2188053766, E-mail:
| | - Hamid Reza Rasouli
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hossein Vahidtari
- Department of Orthopedic Surgery, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Navid Nabizadeh
- Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran
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Vieira JS, da Silva Herrero CFP, Porto MA, Arlet V, Defino HLA. FUNCTIONAL AND RADIOGRAPHIC COMPARISON OF ANTERIOR AND POSTERIOR INSTRUMENTATION FOR THE CORRECTION OF ADOLESCENT IDIOPATHIC SCOLIOSIS. Rev Bras Ortop 2010; 45:557-64. [PMID: 27026964 PMCID: PMC4799174 DOI: 10.1016/s2255-4971(15)30303-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 04/26/2010] [Indexed: 11/03/2022] Open
Abstract
Objective: This was a retrospective study to compare the anterior instrumentation (AI) and posterior instrumentation (PI) results among patients diagnosed with adolescent idiopathic scoliosis (Lenke type I) who were treated surgically. Methods: The results from 24 patients aged 11 to 18 years with Lenke type I idiopathic scoliosis who underwent surgery with AI (12 patients) or PI (12 patients) were compared. All the patients were operated by the same surgeon and were followed up for a minimum period of five years. The variables for comparison included: coronal and sagittal correction, distance from apical vertebra to midline, apical vertebral rotation, number of instrumented vertebrae and functional variables (by means of the SRS-22 questionnaire). The data obtained were analyzed using the SAS software, version 9. The two groups were compared using Student's t-test with a significance level of 5% (0.05). Results: The correction of the curve in the frontal plane was higher in the group of patients with the anterior approach, in the immediate (p=0.031) and late (p=0.043) postoperative periods, as was the apical vertebral rotation during the immediate (p=0.002) and late (p=0.019) evaluations. The number of instrumented vertebrae was 7.69 ± 1.38 in the AI group and 11.38 ± 2.92 in the PI group (p = 0.021). Functional assessment (SRS-22) did not show any significant difference (p > 0.05) between the groups. Conclusion: The patients who underwent scoliosis correction with AI presented greater correction in the frontal plane, greater derotation of apical vertebrae and a smaller number of fused vertebrae.
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Affiliation(s)
- Juliano Silveira Vieira
- Postgraduate Student in the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas, Ribeirao Preto School of Medicine, USP, Ribeirao Preto, SP, Brazil
| | - Carlos Fernando Pereira da Silva Herrero
- Postgraduate Student in the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas, Ribeirao Preto School of Medicine, USP, Ribeirao Preto, SP, Brazil
| | - Maximiliano Aguiar Porto
- Postgraduate Student in the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas, Ribeirao Preto School of Medicine, USP, Ribeirao Preto, SP, Brazil
| | - Vincent Arlet
- Professor of Orthopedic Surgery and Professor of Neurosurgery, Department of Orthopedic Surgery, University of Virginia Chair of Spinal Deformity Research, King Saud University
| | - Helton Luiz Aparecido Defino
- Titular Professor of the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas, Ribeirao Preto School of Medicine, USP, Ribeirao Preto, SP, Brazil
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