Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Observational StudyChallenges and predictive radiological findings in the diagnosis of neuroendocrine tumors in patients with acute appendicitis.
Acute appendicitis is one of the most common surgical emergencies. With antibiotic-first treatment strategies gaining importance, the risk of an appendiceal tumor as an incidental finding or as the cause of appendicitis presents an obstacle to a conservative approach. Neuroendocrine tumors, the most frequent type of appendiceal tumors, are difficult to diagnose preopera-tively due to their small size. This study aims to identify predictive factors for neuroendocrine tumors in patients undergoing surgery for acute appendicitis by analyzing imaging and clinical characteristics, thereby enhancing preoperative diagnostic accuracy and guiding surgical interventions. ⋯ This study identifies mural nodules and intraluminal air as significant predictors of neuroendocrine tumors in patients with acute appendicitis, emphasizing the importance of meticulous preoperative imaging evaluations. Incorporating these predictors into diagnostic protocols could improve the preoperative identification of neuroendocrine tumors, enabling more appropriate surgical interventions. Future research should validate these findings through prospective studies and explore advanced imaging techniques to further enhance the detection of appendiceal neoplasms, ultimately improving patient outcomes and reducing overlooked malignancies.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Comparative StudyRadiological comparison of two immobilization methods in the non-surgical treatment of distal radius fractures in the elderly: Single sugar-tong splint shows similar efficacy to long-arm cast.
This study aims to compare the effectiveness of the long-arm cast (LAC) and the single sugar-tong splint (SSTS) in the non-operative treatment of distal radius fractures in the geriatric population. ⋯ In the non-operative management of geriatric distal radius fractures, the SSTS is an immobilization technique that is as effective as the LAC.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Comparative StudyComparison of outcomes of open reduction and internal fixation versus closed reduction and percutaneous pinning in Song type 4-5 pediatric lateral condyle fractures.
Lateral condyle fractures are the second most common peri-elbow fractures in children aged 6-10 years, following supracondylar fractures. In treating these fractures, either open or closed reduction fixation can be performed. However, it is not yet completely clear which type of fracture should be treated and how. The Song classification has been increasingly used by orthopedic surgeons for these fractures in recent years. A review of the literature reveals few studies comparing closed reduction and percutaneous pinning (CRPP) and open reduction and internal fixation (ORIF) in lateral condyle fractures (LCFs) with displacements of 2 mm or more. Based on this, we compared Song stage 4 and 5 fractures operated with open or closed reduction methods in our clinic in terms of radiological and clinical aspects. ⋯ This study demonstrates that in pediatric patients with lateral condyle fractures displaced by 2 mm or more, the choice between open or closed reduction has minimal impact on medium and long-term outcomes. Since there are not many studies on this subject in the literature, we believe that our results will provide valuable guidance for treatment decisions.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Reliability of ankle clonus evaluation for monitoring neural-tract integrity in pediatric spinal deformity surgery under different anesthetics protocols.
Although the ankle clonus test is a pathological finding in neurological examination, it may temporarily occur in neurologically intact individuals during awakening from anesthesia. Some studies suggest it as a marker indicating neural tract integrity in pediatric spinal deformity surgery. This study aims to investigate the consistency of the ankle clonus test under different anesthesia protocols in pediatric patients with spinal deformities. ⋯ The ankle clonus test is not a reliable method for monitoring neurological deficits during spinal surgery. It is not exactly known how such myoclonic contractions occur or how the pathway is inhibited or activated.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Comparative StudyComparison of three different methods for stump closure in laparoscopic appendectomy: Endoloop, Hem-o-lok clip, and endostapler.
Acute appendicitis is a common surgical emergency that causes acute abdominal pain and affects approximately 7-8% of the population during their lifetime. The closure of the appendix stump during laparoscopic appendectomy is one of the most critical steps of the surgery to prevent life-threatening complications such as postoperative fistula, peritonitis, and sepsis. The mate-rial chosen for appendix stump closure must be effective, safe, and economical. However, there is still no consensus on the optimal method for stump closure. In this study, we aimed to compare the advantages and reliability of three different methods used for appendix stump closure. ⋯ The use of endoloop, polymeric clips, and endostapler in laparoscopic appendectomy is safe and effective for appendectomy. All three methods can be successfully applied without an increase in intraoperative or postoperative complications. However, due to the higher treatment costs associated with endostapler, its use should be reserved for situations where securing the appendix stump cannot be achieved with endoloop or Hem-o-lok clip.