World journal of surgery
-
World journal of surgery · Dec 2010
Meta AnalysisOutcomes of staple fixation of mesh versus nonfixation in laparoscopic total extraperitoneal inguinal repair: a meta-analysis of randomized controlled trials.
Staple fixation of mesh during laparoscopic total extraperitoneal (TEP) inguinal repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase surgical complications and pain. Therefore, a meta-analysis of randomized controlled trials (RCTs) was conducted to compare the outcomes of nonfixation with fixation of mesh by metal tacks during TEP inguinal hernia repair. ⋯ Elimination of tack fixation of mesh in TEP inguinal hernia repair is associated with decreased operative cost and significantly reduce operative time and in-hospital stay, but no difference in the risk of hernia recurrence, complications, and postoperative pain. For more detailed evaluation, further well-structured trials with improved standardization of hernia type, operative technique, and surgeon experience are necessary.
-
World journal of surgery · Dec 2010
Historical ArticleReflections of the Hippocratic Oath in modern medicine.
Hippocratic Oath indicates a prevailing ethos rather than a professional approach, and it is still regarded as the cornerstone and foundation of the medical profession. Medicine in Ancient Greece was strongly influenced by the values of classical philosophy as introduced by its main representatives: Plato and Aristotle. Hippocrates himself has been recognized not only as a pioneering physician, but also as an outstanding philosopher. ⋯ The Hippocratic Oath constitutes a synopsis of the moral code of Ancient Greek medicine and contributes to the stabilization of the tri-part relationship among the physician, the patient, and the illness, as described by Hippocrates. The harmony of this interactive triangle has been deranged by several factors, such as technological evolution, public media, and cost-effective modalities with multiple consequences. In these terms, the reevaluation of the Hippocratic Oath and its time-enduring messages seems essential to reinstate the relationship between the physician and the patient under a new philosophico-medical prism.
-
World journal of surgery · Dec 2010
Differential pathologic variables and outcomes across the spectrum of adenocarcinoma of the esophagogastric junction.
Adenocarcinoma of the esophagogastric junction (AEG) as described by Siewert et al. is classified as one entity in the latest (7th Edition) American Joint Cancer Committee/International Union Against Cancer (AJCC/UICC) manual, compared with the previous mix of esophageal and gastric staging systems. The origin of AEG tumors, esophageal or gastric, and their biology remain controversial, particularly for AEG type II (cardia) tumors. ⋯ In this series AEG type I is associated with more favorable pathologic features and improved outcomes compared with AEG type II and III. This may reflect earlier diagnosis, but an alternative possibility, that type I may be a unique paradigm with more favorable biology, requires further study.
-
World journal of surgery · Dec 2010
Combined use of contrast-enhanced intraoperative ultrasonography and a fluorescence navigation system for identifying hepatic metastases.
The purpose of this study was to assess the concomitant use of contrast-enhanced intraoperative ultrasound (CE-IOUS) using the new microbubble agent Sonazoid, and to assess the fluorescence navigation system (Photo Dynamic Eye, or PDE) using indocyanine green (ICG) as a novel tool for identifying colorectal metastatic lesions compared with preoperative contrast-enhanced multiple row-detected computed tomography (MDCT) and gadoxetic acid-enhanced MRI. ⋯ The present results suggested that the concomitant use of CE-IOUS with the Sonazoid and PDE system may be a useful and safe method, in addition to CT or MRI.
-
World journal of surgery · Nov 2010
ReviewSystematic review of the use of a mesh to prevent parastomal hernia.
Parastomal hernia is a major complication after stoma placement. Surgical procedures for repairing parastomal hernia are difficult and their failure rate is high. The use of a mesh implanted at the primary operation has shown promising results. Therefore, we performed a systematic review of the literature to evaluate the results of the placement of mesh at the time of stoma formation with the aim of preventing parastomal hernia. ⋯ Prophylactic use of mesh at the time of stoma formation is a safe procedure and reduces the risk of parastomal hernia. For more detailed evaluation, additional large, double-blinded, randomized controlled trials with long-term follow-up are necessary.