Risk factors related to amputation in diabetic foot patients: single center outcomes.

This study aimed at identifying factors that worsen the prognosis of diabetic foot, one of the most common complications seen in patients with diabetes.

The role of extended resection in locally recurrent colorectal cancer with invasion of the aortoiliac bifurcation: a rare clinical case.

Colorectal carcinoma (CRC) is the third most common cancer and the fourth deadliest. Despite recent advances in screening methods and preoperative imaging techniques, the threat of colorectal cancer remains at an all-time high. Moreover, even after curative treatment, disease recurrence occurs in up to 40% of all cases.

EUS-Guided Combined Injection Therapy as a Secondary Prophylaxis of Gastric Variceal Bleeding in a Patient Contraindicated for TIPS: Case Report.

: Although bleeding from gastric varices is less observed than esophageal variceal bleeding (VB) (25% vs. 64%), it is associated with an exceedingly high mortality rate of up to 45%. Current guidelines suggest that endoscopic cyanoacrylate injection therapy (ECI) is the first-line treatment for gastric variceal bleeding (GVB).

PAPILLARY MICROCARCINOMA OF THE THYROID GLAND - DOES SIZE MATTER?

Introduction: Papillary thyroid microcarcinoma has provoked discussion among the endocrinological community due to the extremely diverse therapeutic methods adopted in international guidelines. From the radical approach of total thyroidectomy with prophylactic central lymphatic dissection to "active monitoring" and opinions such as "papillary microcarcinoma is not carcinoma".

Aim: To investigate the factors of invasiveness in papillary microcarcinoma.

Comparison of short term results following robotic and laparoscopic total gastrectomy and D2 lymph node dissection.

In the last decade, there has been a progressive shift from open to mini-invasive operative techniques for surgical resection of gastric cancer. Advanced equipment of surgical robots, with its 3D visualization, steady camera view, flexible instrument tips, attracts more and more practitioners in performing robotic gastrectomy with D2 dissection in gastric cancer patients. Thus, the comparison of some basic oncological as well as some surgical variables related to laparoscopic and robotic gastrectomy and D2 lymphadenectomy is necessary.

Intraoperative ultrasound for nonpalpable breast lesions - experience and operative time.

Introduction: The essential tools doctors need to diagnose breast cancer tumors at the early stages and with no clinical presentation are screening mammography and ultrasonography. Nonpalpable breast lesions are a current problem nowadays and there are various types of navigation techniques that are utilized in order to achieve cancer cell-free resection margins in the first place. Intraoperative ultrasound has been proven to be a safe and effective way to excise this type of breast tumors.

Prophylactic Central Neck Lymph Node Dissection Adds No Short-Term Benefit to Total Thyroidectomy for Differentiated Thyroid Cancer.

: To answer the research question: "Is prophylactic central neck lymph node dissection (pCNLD) beneficial among differentiated thyroid carcinoma (DTC) patients?" : This was a retrospective cohort study enrolling DTC patients treated at the University Hospital Kaspela, Bulgaria, from 30 January 2019 to October 2021. The predictor variable was presence of pCNLD (total thyroidectomy with vs. without pCNLD).

Diverting ileostomy in low anterior resection: single center retrospective analysis.

<b> Introduction:</b> Low anterior resection (LAR) is the standard procedure for distal rectal cancer allowing anal sphincter preservation. Anastomotic leakage remains one of the most dangerous complications following LAR and its management is difficult. </br></br> <b>Aim:</b> This study reviews our experience of LAR with and without protective ileostomy (PI).

Prophylactic central lymph node dissection in differentiated thyroid cancer - benefits and risk.

Papillary thyroid cancer is the most common thyroid malignancy. Lymph nodes involvement is common in differentiated thyroid cancer, and cervical lymph node micrometastases are observed in up to 85% of patients with papillary thyroid cancer during surgery. While the therapeutic central lymph node dissection has been accepted, the debate on the prophylactic in differentiated thyroid carcinoma (DTC) continues.

Robotic-assisted colorectal surgery - initial results.

The mini invasive procedure in colorectal surgery is gaining ground as an alternative to conventional surgery. Colorectal surgery has significantly evolved since the advent of the automatic stapler devices and subsequently with the minimally invasive approach. The next logical step - the robotic assisted surgery was developed to satisfy surgeons' needs to the area of colorectal surgery and to offer a new and safer method to patients.

Portal vein reconstruction during pancreaticoduodenal resection using an internal jugular vein as a graft.

Portal vein involvement by malignant tumours of the head of the pancreas is observed in almost 50% of the patients. In the past, this finding usually rendered the tumor inoperable. Over the past 30 years, the operative morbidity and mortality rate of pancreatectomy combined with portal vein resection has greatly decreased, and portal vein resection in pancreatic surgery has become a well-tolerated operative procedure in large-volume centres.

Total extra peritoneal inguinal hernia repair: a single-surgeon preliminary findings report.

Introduction: Inguinal hernia repair is one of the most frequent operations in general surgery. Various techniques have been used to repair inguinal hernias since the first reconstructive technique described by Bassini in 1887. In 1989 Lichtenstein reported a new technique: tension free inguinal hernia repair.

Risk Factors for Anastomotic Leakage after Low Anterior Resection.

Introduction: Low anterior resection (LAR) is a standard surgical procedure for distal rectal carcinoma that allows creation of a colorectal anastomosis, with anal sphincter preservation and permanent colostomy avoidance. Anastomotic leakage (AL) is a potential complication of LAR present in 3% to 20% of cases leading to a significant increase in postoperative morbidity. AL represents a communication between the intra luminal and extra luminal compartments caused by a violation of the integrity of the intestinal wall.

Comparing patient safety culture in Bulgarian, Croatian and American hospitals - preliminary results.

Background And Aims: Patient safety culture (PSC) is an essential component of the quality of healthcare. Improving PSC is considered a priority in many developed countries. A specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017.

Feasibility of a New Wearable Device to Estimate Acute Stress in Novices During High-fidelity Surgical Simulation.

Background: Stress associated with learning of a psychomotor task can influence the trainees learning ability. Surgical simulation is a validated training milieu designed to replicate real-life situations, prevent biases and provide objective metrics. However, the complexity of stress mechanisms and the absence of a reliable detection method make stress estimation difficult to quantify and to interpret.

Novel insights into transcriptional dysregulation in colorectal cancer.

Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Although CRC has been comprehensively characterized at the molecular level, the tumor heterogeneity hinders the identification of reliable diagnostic, prognostic and predictive biomarkers. Molecular stratification of CRC is based on prevalent gene mutations and transcription profiles but its significance for clinical practice remains obscure.

The effect of neck dissection on quality of life in patients with differentiated thyroid cancer.

Cervical lymph node metastases are very common in patients with differentiated thyroid cancer (DTC). The overall long term survival rate in patients with DTC is higher than 90%, with variations in subsets of groups. Despite that DTC has an excellent prognosis, lymphatic spread is associated with increased risk of loco-regional recurrence, which significantly impairs quality-of-life (QOL) and can alter prognosis of the patient.

Laparoscopic resection of the pancreatic tail with preservation of the spleen in a patient with a large pseudopapillary tumor of the pancreas.

Laparoscopic resections of the pancreas have gained in popularity in the last few years. Those preserving the integrity of the spleen are performed very rarely and are a challenge for every surgeon. We hereby report a case of laparoscopic resection of the pancreatic tail with preservation of the spleen and the integrity and the blood supply to the spleen in a 26 year-old patient with a large pseudopapillary tumor of the pancreas.

Laparoscopic exploration of bile ducts in patients with calculosis. Indications, methods and first results.

Introduction: In the last few years there has been a resurgence of laparoscopic exploration of the common bile duct as an alternative to endoscopic retrograde cholangiopancreatography (ERCP), the primary method for diagnosis and treatment of biliary tract calculosis.

Aim: The aim of this study was to clarify the indications and methods for performing laparoscopic bile duct exploration, based on our experience in the field and data from the literature.

Patients And Methods: We recruited 12 patients who underwent laparoscopic exploration and stone extraction from the common bile duct (CBD) in the surgical ward of Kaspela Hospital, Plovdiv over the period January 2011 to January 2012.

Minimally invasive approach to thyroid gland surgery--indications, methods, first results.

Unlabelled: After the introduction of minimally invasive operative techniques in the surgery of organs located in body cavities, extensive work has been done in the last five years with respect to their application in thyroid gland surgery as well.

Materials And Methods: In 2011, 406 patients underwent thyroid surgery at the Department of Surgery, Kaspela General Hospital for Active Treatment EOOD - Plovdiv. The study involved 48 of these patients, chosen at random and divided into two groups (A-minimally invasive thyroidectomy (MIT) - 26 patients, and B - minimally invasive video-assisted thyroidectomy (MIVAT) - 22 patients).

Intraabdominal hypertention--predisposing factor for visceral alterations and abdominal compartment syndrome.

Unlabelled: Compartment syndrome (CS) is a condition in which increased pressure in a confined anatomical space adversely affects the function and viability of the tissues therein.

Aim: The aim of the following research is to detect the influence of the intraabdominal hypertension (IAH) as an often met condition in visceral surgery on the organs in the abdominal cavity and outside it and on musculus rectus abdominis.

Methods: We used adult Wister rats for creating an experimental model of IAH, using our own experimental method with many advantages.

[Drainage in thyroid surgery--prospective randomized study].

During the period of 2003-2004 years 100 consecutive thyroid surgeries was done in the clinic. Despite of clinical diagnosis or type of surgery they were separated into two groups. The first one (43) patients with post operative drainage, and the second one (57) with no drains.

[Safety and efficacy of modified radical lymph nodes dissection in patients with papillary thyroid cancer (PTC) and clinically manifested lymph metastasis].

Introduction: Papillary cancer of the thyroid gland is well known as lymphotropic type. In more than 50 percent of cases it metastized in regional lymph nodes. The extent of surgical exploration remains controversial.

Acute perforated diverticulitis of the colon as a rare cause for development of abdominal compartment syndrome.

Aim: The aim of the present retrospective study was to assess the surgical approaches to acute perforated diverticulitis of the colon causing peritonitis and in some cases complicated with abdominal compartment syndrome (ACS).

Patients And Methods: A total of eight patients (6 males and 2 females) have been operated on for 5 years for perforated diverticulum of the colon. The males had a mean age of 72 +/- 2.

Efficacy and safety of tigecycline compared with vancomycin or linezolid for treatment of serious infections with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci: a Phase 3, multicentre, double-blind, randomized study.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are causing serious nosocomial infections. Tigecycline was evaluated in hospitalized patients with MRSA or VRE infection.

Patients And Methods: A randomized (3:1), double-blind, multicentre, Phase 3 study compared the safety and efficacy of tigecycline with vancomycin or linezolid in hospitalized patients with MRSA or VRE infection, respectively.