Surgery today
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Case Reports
Sternal wound dehiscence after transverse thoracosternotomy for bilateral lung transplantation: report of a case.
Transverse thoracosternotomy is the standard approach for bilateral lung transplantation (BLT), but all measures must be taken to prevent breakdown of the sternal wound. We report a case of sternal dehiscence with subcutaneous and peristernal air collections, which occurred 1 month after BLT, performed through a transverse thoracosternotomy, in a 38-year-old man. ⋯ We repaired the injured lungs and reapproximated the sternum; however, a pseudo-joint of the sternum developed postoperatively. We report the clinical course of this post-transplant patient to highlight the impact and management of sternal dehiscence.
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Video-assisted surgery for esophageal cancer is an advanced surgical technique. It has been developed on the basis of the concept of minimally invasive surgery. Given that there are several options regarding the operative procedures for thoracic esophageal cancer, several laparoscopic approaches have been proposed. ⋯ Moreover, a video-assisted Ivor-Lewis esophagectomy by right thoracotomy with intrathoracic anastomosis has also been performed. Furthermore, laparoscopic gastric mobilization and gastroplasty are also widely accepted substitutions for open laparotomy. This article reviews the literature on the laparoscopic approaches for esophageal cancer.
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Reactive oxygen species (ROS) and reactive nitrogen species (RNS), generated during tissue reperfusion, are characteristic of ischemia/reperfusion (I/R) injury. We conducted this study to evaluate the protective effect of alpha-lipoic acid (alpha-LA) and ebselen against intestinal I/R injury. ⋯ alpha-Lipoic acid and ebselen played an important role in attenuating I/R injury of the intestine by scavenging ROS and RNS.
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Case Reports
Ruptured hepatic abscess caused by fish bone penetration of the duodenal wall: report of a case.
The accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon; however, the development of a hepatic abscess secondary to foreign body perforation is extremely rare. We report the case of a ruptured hepatic abscess caused by fish bone penetration of the duodenal bulb, resulting in generalized peritonitis. ⋯ We diagnosed a ruptured hepatic abscess caused by a calcified foreign body, which was managed by peritoneal lavage, drainage of the hepatic abscess, and removal of the fish bone, followed by simple closure of the hepatoduodenal fistula. The patient's postoperative course was complicated by systemic inflammatory response syndrome, but he recovered eventually.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial comparing intravenous antimicrobial prophylaxis alone with oral and intravenous antimicrobial prophylaxis for the prevention of a surgical site infection in colorectal cancer surgery.
The use of preoperative oral antibiotics during preparation for elective colorectal surgery remains controversial. This was a prospective randomized clinical trial to compare the efficacy of intravenous antimicrobial prophylaxis alone with combined oral and intravenous antimicrobial prophylaxis for surgical site infection (SSI) in patients undergoing elective colorectal surgery. ⋯ The addition of oral antibiotics to intravenous antimicrobial prophylaxis showed no advantage in the prevention of SSI.