152 research outputs found
The effect of misunderstanding the St Matthew evangelical message on academic medical practice: The Matthew effect
No full textSleeve Gastrectomy Combined with Nissen Fundoplication as a Single Surgical Procedure, Is It Really Safe? A Case Report
No full textBACKGROUND Laparoscopic sleeve gastrectomy (LSG) has become the most common surgical procedure performed in bariatric surgery. Large hiatal hernias and Barrett's esophagus are the only contraindications recognized among experts. However, some studies have suggested that LSG may exacerbated gastroesophageal reflux disease (GERD) symptoms or induce postoperative GERD de novo. GERD and erosive esophagitis increase the risk of Barrett's esophagus. For this reason, in obese patients suffering from GERD, Roux-en-Y gastric bypass is considered the gold standard, or in the case of hiatal hernia, a laparoscopic hiatoplasty should be performed. In order to find some alternative techniques and extend the indication of LSG to obese patient with GERD symptoms, some authors have proposed a single step LSG and Nissen's fundoplication. CASE REPORT We report our experience with a male patient who after few months after a single step LSG and Nissen's fundoplication for morbid obesity and GERD, underwent emergency remnant gastrectomy and esophagojejunostomy because of gastric ischemic perforation. CONCLUSIONS We conclude that, despite being a well-tolerated and feasible surgical procedure, a single step LSG and gastric fundoplication could increase the risk of severe postoperative complications related to LSG, and we believe that, according to guidelines, gastric bypass or LSG with subsequent hiatoplasty should be preferred in obese patients with gastroesophageal reflux symptoms or hiatal hernia
Graciloplasty for recurrent recto-neovaginal fistula in a male-to-female transsexual
No full textRectovaginal fistula is usually a challenging condition for surgeons, but a fistula between the rectum and the neovagina in male-to-female transsexual is even more difficult to treat as it is a rare complication occurring in a patient with modified anatomy of the perineum, with heavy psychological implications for the patient. Here, we report a case of recurrent recto-neovaginal fistula in a male-to-female transsexual successfully treated by perineal graciloplasty
Nebulized Glubran 2 in patients at high risk of bleeding after Milligan-Morgan hemorrhoidectomy
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Physiological parameters predicting the outcome of surgical and nonsurgical treatment of fecal incontinence
No full textFecal incontinence is a multifactorial disease. Anorectal physiology studies play an outstanding role in the evaluation of its etiology and severity, the two main factors that constitute the basis for the correct choice of treatment. However, the prognostic role of clinical factors and anorectal physiological tests in predicting the outcome to either conservative or surgical treatment is questionable. © 2007 Springer-Verlag Italia
Gender distribution in the editorial boards of surgical journals: A snapshot from Western Europe
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