Smoking History and the Development of Incisional Umbilical Hernia After Laparoscopic and Laparoendoscopic Single-Site Cholecystectomy.

The aim of this study was to analyze umbilical hernia occurrences in patients who underwent laparoscopic or laparoendoscopic single-sight (LESS) cholecystectomy. Patients who underwent cholecystectomy by a single surgeon between 2015 and 2020 were surveyed. Data are presented as median (mean +/- standard deviation).

Idiopathic Small Bowel Diaphragm Disease Without Use of Non-steroidal Anti-inflammatory Drugs: A Case Report and Review of the Literature.

Small bowel diaphragm disease is a rare condition that is characterized by the presence of diaphragm-like strictures that causes intermittent or complete small bowel obstruction. Most cases are asymptomatic until presented with severe abdominal pain due to small bowel obstruction or diagnosed during anemia workup as a cause of occult gastrointestinal bleeding. Small bowel diaphragm disease is usually associated with long-term use of non-steroidal anti-inflammatory drugs (NSAIDs).

Integrating 31-Gene Expression Profiling With Clinicopathologic Features to Optimize Cutaneous Melanoma Sentinel Lymph Node Metastasis Prediction.

Unlabelled: National guidelines recommend sentinel lymph node biopsy (SLNB) be offered to patients with > 10% likelihood of sentinel lymph node (SLN) positivity. On the other hand, guidelines do not recommend SLNB for patients with T1a tumors without high-risk features who have < 5% likelihood of a positive SLN. However, the decision to perform SLNB is less certain for patients with higher-risk T1 melanomas in which a positive node is expected 5%-10% of the time.

Urethroplasty performed with an autologous urothelium-vegetated collagen fleece to treat urethral stricture in the minipig model.

Introduction And Objective: Tissue-engineered materials in urethral reconstructive surgeries are a promising field for innovative therapy. Collagen matrices increase stability of cell-based implants and can promote viability and proliferation of urothelial cells. In this study, a collagen type I-based cell carrier (CCC) with stratified multi-layer autologous urothelium was used for urethroplasty after induction of urethral stricture in eight minipigs.

Prediction of Hypoxic Acidemia in Last 2 Hours of Labour in Low-Risk Women.

Objective: Prediction of hypoxic acidemia in neonates using cardiotocogram (CTG) features continues to be challenging. The objective of this study was to explore the association between contraction frequency and fetal heart rate characteristics with hypoxic acidemia in low-risk women in labour.

Methods: Cases were singleton, vertex, in labour with umbilical artery pH ≤7.

Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years.

Introduction: Successful outcomes have been reported for the treatment of lower urinary tract symptoms (LUTS) with the prostatic urethral lift (PUL) in a number of clinical investigations. Our aim was to investigate PUL outcomes in patients treated in a day-to-day clinical setting without the rigid exclusion criteria of clinical studies.

Materials And Methods: We investigated the outcome of the PUL procedure at five German departments during the initial period when PUL was approved for the clinic (10/2012-06/2014).

Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging.

Objective: To perform a descriptive microscopic study of prostatectomy specimens from 19 patients which anatomically characterizes the distributions of periprostatic nerve qualities, and to visualize these using diffusion tensor imaging (DTI).

Materials And Methods: Serial whole-mounted sections were stained for cholinergic (neuronal nitric oxide synthase), adrenergic (tyrosine hydroxylase) and sensory (calcitonin gene-related peptide) nerves. Extracapsular stained nerves were counted by prostate surface sector, and classified by diameter.

Laparoscopic Heller Myotomy with Anterior Fundoplication Improves Frequency and Severity of Symptoms of Achalasia, Regardless of Preoperative Severity Determined by Esophagography.

This study was undertaken to determine whether postoperative outcomes after laparoscopic Heller myotomy with anterior fundoplication could be predicted by preoperative findings on esophagography. Preoperative barium esophagograms of 135 patients undergoing laparoscopic Heller myotomy with anterior fundoplication were reviewed. The number of esophageal curves, esophageal width, and angulation of the gastroesophageal junction (GEJ) were determined; correlations between these determined parameters and symptoms were assessed using linear regression analysis.

Sulfonylureas (not metformin) improve survival of patients with diabetes and resectable pancreatic adenocarcinoma.

Unlabelled: Patients with pancreatic adenocarcinoma have an increased propensity for diabetes. Recent studies suggest patients with diabetes and pancreatic adenocarcinoma treated with metformin have increased survival. This study was undertaken to determine whether metformin use is associated with increased survival in patients with pancreatic adenocarcinoma.

CT and 3-T MRI accurately identify T3c disease in colon cancer, which strongly predicts disease-free survival.

Aim: To compare the preoperative staging accuracy of computed tomography (CT) and 3-T magnetic resonance imaging (MRI) in colon cancer, and to investigate the prognostic significance of identified risk factors.

Materials And Methods: Fifty-eight patients undergoing primary resection of their colon cancer were prospectively recruited, with 53 patients included for final analysis. Accuracy of CT and MRI were compared for two readers, using postoperative histology as the reference standard.

Local staging and assessment of colon cancer with 1.5-T magnetic resonance imaging.

Objective:: The aim of this study was to assess the accuracy of 1.5-T MRI in the pre-operative local T and N staging of colon cancer and identification of extramural vascular invasion (EMVI).

Methods:: Between 2010 and 2012, 60 patients with adenocarcinoma of the colon were prospectively recruited at 2 centres.

Challenges for Restoration of Lower Urinary Tract Innervation in Patients with Spinal Cord Injury: A European Single-center Retrospective Study with Long-term Follow-up.

Unlabelled: Xiao and colleagues in China reported successful restoration of bladder control in patients with spinal cord injury (SCI) by establishing a somatic-autonomic reflex pathway through lumbar-to-sacral ventral root nerve rerouting. We evaluated long-term results in eight patients who underwent this procedure at a German university clinic between 2005 and 2007. The primary outcome was the occurrence of voiding upon stimulation of the skin, with normalization of bladder pressure when filling, as assessed with videourodynamics at each visit.

High-volume surgeons vs high-volume hospitals: are best outcomes more due to who or where?

Background: High-volume hospitals are purported to provide "best" outcomes. We undertook this study to evaluate the outcomes after pancreaticoduodenectomy when high-volume surgeons relocate to a low-volume hospital (ie, no pancreaticoduodenectomies in >5 years).

Methods: Outcomes after the last 50 pancreaticoduodenectomies undertaken at a high-volume hospital in 2012 (ie, before relocation) were compared with the outcomes after the first 50 pancreaticoduodenectomies undertaken at a low-volume hospital (ie, after relocation) in 2012 to 2013.

The Effect of Product Safety Courses on the Adoption and Outcomes of LESS Surgery.

Background And Objectives: As technology in surgery evolves, the medical instrument industry is inevitability involved in promoting the use and appropriate (ie, effective and safe) application of its products. This study was undertaken to evaluate industry-supported product safety courses in laparoendoscopic single-site (LESS) surgery, by using the metrics of surgeons' adoption of the technique, safety of the procedure, and surgeons' perception of the surgery.

Methods: LESS surgery courses that involved didactic lectures, operative videos, operation observation, collaborative learning, and simulation, were attended by 226 surgeons.

Tissue engineering in urothelium regeneration.

The development of therapeutic treatments to regenerate urothelium, manufacture tissue equivalents or neourethras for in-vivo application is a significant challenge in the field of tissue engineering. Many studies have focused on urethral defects that, in most cases, inadequately address current therapies. This article reviews the primary tissue engineering strategies aimed at the clinical requirements for urothelium regeneration while concentrating on promising investigations in the use of grafts, cellular preparations, as well as seeded or unseeded natural and synthetic materials.

Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication?

Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking.

Margin status impacts survival after pancreaticoduodenectomy but negative margins should not be pursued.

Negative margins are the goal with pancreaticoduodenectomy for pancreatic adenocarcinoma. Thereby, margins are assessed intraoperatively with frozen section analysis and negative margins are pursued. This study was undertaken to determine the impact of margin status with pancreaticoduodenectomy for pancreatic adenocarcinoma and the value of extending resections to achieve negative margins.

Artificial sphincter.

Purpose Of Review: This review examines the evidence to date, and summarizes the indications, technical and surgical aspects, risk factors and challenges of peer-reviewed artificial sphincters in the treatment of male stress urinary incontinence (SUI).

Recent Findings: Although new devices have been introduced, the AMS 800 continues to be the most implanted and reported on artificial urinary sphincter (AUS) worldwide. Although the AUS seems to be effective in the treatment of neurogenic and non-neurogenic SUI, large randomized, controlled trials are missing.

Nontherapeutic celiotomy incidence is not affected by volume of pancreaticoduodenectomy for pancreatic adenocarcinoma.

Nontherapeutic celiotomy for pancreatic adenocarcinoma is detrimental to patients by delaying medical treatment as a result of unnecessarily incurred postoperative recovery time. This study was undertaken to evaluate whether surgeon volume of pancreaticoduodenectomy for pancreatic adenocarcinoma impacted the incidence of nontherapeutic celiotomy. All patients undergoing an intended pancreaticoduodenectomy for pancreatic adenocarcinoma were evaluated from 2003 to 2012.

Intralesional injection of rose bengal induces a systemic tumor-specific immune response in murine models of melanoma and breast cancer.

Intralesional (IL) injection of PV-10 has shown to induce regression of both injected and non-injected lesions in patients with melanoma. To determine an underlying immune mechanism, the murine B16 melanoma model and the MT-901 breast cancer model were utilized. In BALB/c mice bearing MT-901 breast cancer, injection of PV-10 led to regression of injected and untreated contralateral subcutaneous lesions.

Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

Purpose: To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community.

Method: The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling.

Surgical reconstruction for male-to-female sex reassignment.

Background: The primary challenge of male-to-female reassignment surgery is to create natural-appearing female genitalia with neovaginal dimensions adequate for intercourse, neoclitoris sensitivity, and minimal risk of complications. Surgical positioning is an important component of the procedure that successfully minimizes the risk of morbidity.

Objective: We modified various vaginoplasty techniques to better position the urethral neomeatus in the proper anatomic location to minimize the chance for complications and enhance aesthetic satisfaction.

Outcomes after transjugular intrahepatic portosystemic stent shunt: a "bridge" to nowhere.

Background: Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation.

Methods: Patients undergoing TIPS from 2001 to 2010 at a teaching hospital with a transplant program were studied.

Immunotherapy for gastrointestinal malignancies.

Background: Gastrointestinal (GI) cancers are the most common human tumors encountered worldwide. The majority of GI cancers are unresectable at the time of diagnosis, and in the subset of patients undergoing resection, few are cured. There is only a modest improvement in survival with the addition of modalities such as chemotherapy and radiation therapy.