Surgery today
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A case demonstrating a false aneurysm in the palmar segment of the ulnar artery caused by a Fogarty's catheter, which had been inserted during a thrombectomy, is described. The diagnosis was suspected based on a clinical examination, and duplex ultrasonography and computed tomography (CT) confirmed an aneurysm in the palmar segment of the ulnar artery. The patient underwent a successful aneurysmectomy with end-to-end reanastomosis.
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Case Reports
Stanford type A aortic dissection which ruptured into the left atrium: report of a case.
A Stanford type A aortic dissection ruptures usually into the pericardial space or the mediastinal space. We herein report the rare surgical case of a Stanford type A aortic dissection which ruptured into the left atrium. ⋯ At operation, adhesions around the proximal aorta and between the aortic root and the left atrial roof were confirmed to be one of the causes for this rare form. A fistula to the cardiac cavity following an aortic dissection may occur in any patient, especially in those with a history of previous cardiac surgery.
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Randomized Controlled Trial Clinical Trial
Evaluation of oxidative stress in laparoscopic cholecystectomy.
We conducted a prospective study to evaluate the effect of CO2 pneumoperitoneum and increased intra-abdominal pressure on arterial blood gases, end-tidal CO2 (ETCO2), nitric oxide (NO), blood and tissue malondialdehyde (MDA), and total antioxidant (TAOx) levels during laparoscopic cholecystectomy. ⋯ These findings suggest that the antioxidant defense system is stimulated less with less oxidative stress, providing further evidence to support the opinion that LC is a safe technique.
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Review Case Reports
Spontaneous pneumothorax secondary to radiographically occult lung metastasis from parapharyngeal synovial sarcoma: report of a case.
This report describes a case of secondary pneumothorax caused by a radiographically occult lung metastasis from parapharyngeal synovial sarcoma, a relatively rare tumor known to be highly metastatic to the lung. Although chest X-ray and thoracic computed tomography scan failed to detect the metastatic nodule in the right lung, the surgically resected specimen proved to be a 3-mm lung metastasis. To our knowledge, only eight cases of lung metastases from synovial sarcoma causing pneumothorax have ever been reported. ⋯ However, in this patient, the metastatic lesion was not detected during examination. It is speculated that secondary pneumothorax caused by synovial sarcoma may occur during the early stages of lung metastasis. Therefore, if pneumothorax occurs in a patient with a synovial sarcoma, the possibility of lung metastasis should be carefully considered, even if it is undetectable on radiological examinations.
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Randomized Controlled Trial Clinical Trial
A novel approach to the prevention of postoperative delirium in the elderly after gastrointestinal surgery.
Postoperative delirium (POD) is known to be one of the most critical complications of major operative procedures in elderly patients. Since disorders of the sleep-wake cycle have been reported to be one of the key factors in POD, we attempted to clarify the effectiveness of improving sleep-wake cycle disorders with medication after surgery to prevent POD, by conducting a prospective randomized study of 42 elderly patients who underwent resection of either gastric or colon cancer through an open laparotomy. ⋯ These findings indicate that DFP treatment is effective for controlling POD in elderly patients after general surgery and does not appear to be associated with severe complications or side effects. To our knowledge, this is the first report proposing artificial control of the sleep-awake rhythm by medication as a means of preventing POD in elderly patients.