Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 6 Articles
Objective: To report the experience of our department on adenocarcinoma of\nthe appendix through a series of six (6) cases. Materials and Methods: This is\na retrospective study carried out from January 2010 to June 2015 collating all\ncases of adenocarcinoma of the appendix diagnosed at the department of visceral\nsurgery B in Hassan II University Hospital in Fez. Results: Six cases of\nadenocarcinoma of the appendix were recorded during the determined period\nof study. The mean age was 54.67 �± 16.99 years with the extreme ages ranging\nfrom 28 to 78 years. There was a female predominance with a sex ratio of 2.\nAll patients had no specific medical history. The revealing symptoms were the\nfollowing: appendicitis syndrome (1 case), bowel obstruction (1 case), psoas\nabscess (1 case) and fortuitous discovery during laparotomy for another\nproblem (3 cases). The following histological types found were: colloid adenocarcinoma\n(3 cases), mucinous adenocarcinoma (2 case), mucinous cystadenocarcinoma\nassociated with a moderately differentiated adenocarcinoma\nof the appendix (1 case). The surgical procedure consisted of a right hemicolectomy\nin 3 patients. Appendectomy followed by a right hemicolectomy and\ndrainage of psoas abscess was performed in two patients. Palliative ileocecal\nresection and Bouilly-Volkmann ileocolostomy was performed in one patent\nwho had carcinosis. All patients received adjuvant chemotherapy. The following\noccurred during follow-up: carcinosis (2 patients), a locoregional recurrence\n(2 patients). Two patients never returned for follow-up. Conclusion:\nTumor of the appendix is a rare and exceptional pathology. These tumors are\ngenerally discovered fortuitously or during histology of appendectomy specimens.\nThe treatment is usually surgical....
Bariatric surgery was born in the 1950s at the University of Minnesota. From this time, it continues to evolve and, by the same\ntoken, gives new or better possibilities to treat not only obesity but also associated comorbidities. Metabolomics is also a\nrelatively young science discipline, and similarly, it shows great potential for the comprehensive study of the dynamic alterations\nof the metabolome. It has been widely used in medicine, biology studies, biomarker discovery, and prognostic evaluations.\nCurrently, several dozen metabolomics studies were performed to study the effects of bariatric surgery. LC-MS and NMR are the\nmost frequently used techniques to study main effects of RYGB or SG. Research has yield many interesting results involving not\nonly clinical parameters but also molecular modulations. Detected changes pertain to amino acid, lipids, carbohydrates, or gut\nmicrobiota alterations. It proves that including bariatric surgery to metabolic surgery is warranted. However, many molecular\nmodulations after those procedures remain unexplained. Therefore, application of metabolomics to study this field seems to be a\nproper solution. New findings can suggest new directions of surgery technics modifications, contribute to broadening knowledge\nabout obesity and diseases related to it, and perhaps develop nonsurgical methods of treatment in the future....
Thyroid reoperations are surgically challenging because of scarring and disturbances in the anatomy of the recurrent laryngeal\nnerve (RLN). This study was conducted on 49 patients who underwent redo surgery. 61 RLNs were identified and completely\nexposed. Their functional integrity was evaluated using intraoperative nerve monitoring (IONM). Indications for secondary\nsurgery, anatomical changes secondary to recurrent goiter mass and prior surgery, and results of IONM were studied. Frequent\nindications for redo surgery were multinodular goiter (MNG) in 19 (38.8%) and results of cytology in 14 (28.5%) patients. The\nmean time interval between primary and redo thyroid surgery was 23.4 years. We laterally approached 41 (67.2%) thyroid lobes\nbetween the sternocleidomastoid and sternohyoid muscles. 16 (26.2%) RLNs were found to be adherent to the lateral surface of the\ncorresponding thyroid lobe. The functional integrity of all RLNs was confirmed by IONM. The remnant thyroid tissue can then\nlead to goiter recurrence requiring secondary surgery after a long period of time.The indications for redo surgery were similar to\nprimary cases. Lateral displacement of the RLNwhich is adherent to the lateral surface of recurrent goiter mass is common anatomic\nvariation.Thyroid reoperations based on awareness of anatomical disturbances can be performed safely by an experienced surgeon\nwith support of ancillary electrophysiological technology....
Surgical patients are at high risk of developing postoperative cognitive dysfunction (POCD) and postoperative delirium (POD).\nPOCD and POD are associated with increased morbidity and mortality and worsening functional outcomes leading to severe\nsocioeconomic consequences for the patient and the society in general. Magnetic resonance imaging (MRI) offers a unique\nopportunity to study the anatomy and function of the brain. MRI thus plays an important role in elucidating the neuronal\ncomponent of POCD and POD. Our aim has been to systematically gather MRI findings that are related to POCD and POD.\nSystematic searches were conducted in PubMed, EMBASE, and PsycINFO: MRI studies investigating patients with POCD as\nidentified by perioperative cognitive testing or patients with delirium identified postoperatively by the Confusion Assessment\nMethod. A total of ten eligible papers were included with a total of 269 surgical patients, 36 patient controls, and 55 healthy\ncontrols who all underwent MRI examination. These studies suggested that reduction of thalamic and hippocampal volumes\nand reduction of cerebral blood flow may be associated with POCD, while presurgery/preexisting and postoperative white\nmatter pathology may be associated with POD. However, the evidence from these studies is rather weak. Future MRI studies are\nwarranted to verify the current findings....
Purpose: to compare the rebound tonometer ICare�® (RT) with the Goldmann\napplanation tonometer (GAT) in cataract surgery and to assess the influence\nof central corneal thickness (CCT) on intraocular pressure (IOP) measurements.\nDesign: retrospective, comparative study. Methods: a total of 472 patients\nunderwent IOP measurement using RT (time 0 = RTa). GAT IOP\nmeasurement was performed 5 minutes later, followed by a second RT IOP\nmeasurement after other 5 minutes (RTa + 10 min = RTb). CCT was obtained\nby ultrasound pachymetry. In 106 patients IOP was measured by means of RT\nand GAT before clear corneal cataract surgery (RT1 and GAT1) and at one\nday postoperatively (RT2 and GAT2). Results: RT IOP values > 5 mmHg\nwere overestimated, while RT IOP values < 15 mmHg were underestimated.\nEvery 100 �¼m of CCT an increase of 0.97 mmHg and 0.33 mmHg was found\nfor RT and GAT respectively. The difference between RT1 and RT2, GAT1\nand GAT2, RT1 and GAT1 was not statistically significant; while the difference\nbetween RT2 and GAT2 was statistically significant (p < 0.04). The difference\nbetween RTa and RTb was not statistically significant whereas the difference\nbetween RTa and GAT and RTb and GAT was statistically significant\n(p < 0.001). Conclusion: our results showed a good agreement between\nmeasurements obtained with RT and GAT in pre and postoperative cataract\nsurgery, although a significant statistically difference was found between RT\nand GAT measurements performed postoperatively. Moreover, CCT is a parameter\nto be considered for the IOP measurement, especially for values obtained\nwith RT....
Aims. There are two treatment modalities for early gastric cancer (EGC)ââ?¬â?surgery and endoscopic submucosal dissection\n(ESD). We aimed to compare the safety and efficacy of ESD with surgery. Method. The article was performed by searching\nPubMed databases. Data were extracted using predefined form and odds ratios (OR) with 95% confidence intervals (CI)\ncalculated and P value. Results. 13 studies were identified. The incidence of perforation in two groups was different [OR = 6.18\n(95% CI: 1.37ââ?¬â??27.98), P = 0 02]. The prevalences of synchronous and metachronous cancer in the ESD group were higher\nthan those in the surgery group [OR = 8.52 (95% CI: 1.99ââ?¬â??36.56), P = 0.004 and OR= 7.15 (95% CI: 2.95ââ?¬â??17.32), P < 0 0001].\nThe recurrence and complete resection rates were different [OR = 6.93 (95% CI: 2.83ââ?¬â??16.96), P < 0 0001 and OR= 0.32 (95% CI:\n0.20ââ?¬â??0.52), P < 0 00001]. Compared with the surgery group, the hospital stay was shorter [IV = âË?â??7.15 (95% CI: âË?â??9.08ââ?¬â??5.22),\nP < 0 00001], the adverse event rate was lower, and the quality of life (QOL) was better in the ESD group. The difference\nof bleeding was not found. Conclusion. ESD appears to be preferable for EGC, due to a lower rate of adverse events,\nshorter hospital stay, cheaper cost, and higher QOL....
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