International journal of surgery
-
The management of inferior parathyroid glands during central neck dissection (CND) for papillary thyroid carcinoma (PTC) remains controversial. Most surgeons preserve inferior parathyroid glands in situ. Autotransplantation is not routinely performed unless devascularization or inadvertent parathyroidectomy occurs. This retrospective study aimed to compare the incidence of postoperative hypoparathyroidism and central neck lymph node (CNLN) recurrence in patients with PTC who underwent inferior parathyroid glands autotransplantation vs preservation in situ. ⋯ Inferior parathyroid glands autotransplantation during CND of PTC (pN1) might reduce permanent hypoparathyroidism and CNLN recurrence. Further study enrolling more patients with long-term follow-up is needed to support this conclusion.
-
The spleen has an abundance of lymphoid tissue, including splenic macrophages that attack encapsulated organisms. Overwhelming post-splenectomy infection (OPSI) is a serious disease that can progress from a mild flu-like illness to fulminant sepsis in a short time period. However, recognition and clinical management of OPSI is not well established. ⋯ Although the mortality rate from OPSI has been reduced by appropriate vaccination and education. The precise pathogenesis and a suitable therapeutic strategy remain to be elucidated. Overwhelming postsplenectomy infection (OPSI) is a serious fulminant process that carries a high mortality rate.
-
Surgical procedures present an immense risk to patients, and adverse patient outcomes are frequently due to substandard non-technical skills amongst surgical staff. The implementation of a 19-item Surgical Safety Checklist, developed by the World Health Organization, is being enforced in operating theatres globally. The objective is to systematically analyze published literature to assess the use of the WHO Surgical Safety Checklist and their impact in on patient safety. ⋯ The recent use of checklists in surgery has shown improvements in patient outcomes post-operatively. A review was conducted to establish the impact of the checklist on different surgical specialities.
-
Systematic reviews and meta-analyses are important in shaping clinical practice, but the underlying quality of these studies is critical. The PRISMA guidelines for the reporting of systematic reviews, published in 2009, aimed to improve the quality of reporting of these studies. We looked at whether the reporting of systematic reviews relevant to vascular surgery had improved since the introduction of these guidelines. ⋯ Since the publication of the PRISMA guidance, there has been a marginal improvement in the quality of reporting of systematic reviews and meta-analyses in the field of vascular surgery. However, given the importance of these studies, this needs to be improved, especially as poor reporting may reflect poor methodology in conduct. Journals' instructions to authors should insist on submissions following the published guidance, and this intervention would likely improve both the methodology and quality of reporting of published systematic reviews.
-
Randomized Controlled Trial Comparative Study
Standard polypropylene mesh vs lightweight mesh for Lichtenstein repair of primary inguinal hernia: a randomized controlled trial.
The aim of the present clinical study was to compare early and late outcomes after inguinal hernia repair with the heavyweight mesh (HW) and lightweight mesh (LW) during a 3 year follow-up period. ⋯ Our research shows no significant difference in wound complications, hernia recurrence and chronic pain after Lichtenstein hernioplasty, by using of LW and HW meshes. The usage of the LW mesh was associated with less feeling of foreign body than that of the HW mesh, what can be considered as prevalence of LW mesh hernioplasty.