1,721,017 research outputs found
Incisional Hernia rates between Intracorporeal and Extracorporeal Anastomosis in Minimally Invasive Ileocolic Resection for Crohn's disease
No full textOne-third of patients with Crohn’s disease require multiple surgeries during their lifetime, an ileocolic resection most frequently. So, reducing the incisional hernia rate in patients with Crohn’s Disease is crucial. Minimally invasive ileocolic resection with an intracorporeal anastomosis allows using a Pfannenstiel incision as extraction-site, while extracorporeal anastomosis is usually performed with a midline vertical incision. To date, there is limited data regarding incisional hernia after minimally invasive surgery in Crohn’s Disease. To define incisional hernia rates after minimally invasive ileocolic resection for Crohn’s disease, comparing intracorporeal anastomosis with Pfannenstiel incision (ICA-P) versus extracorporeal anastomosis with midline vertical incision (ECA-M).
This retrospective cohort of minimally invasive ileocolic resections compares ICA-P versus ECA-M. Data are retrieved from a prospectively maintained database of consecutive minimally invasive ileocolic resections performed between 2014 and 2021 in a referral center for inflammatory bowel diseases specialized in minimally invasive surgery. Exclusion criteria were different extraction-site incision, conversion, and no anastomosis performed. The primary outcome was incisional hernia differentiated between extraction-site incisional hernia (Pfannenstiel or midline vertical incision) and port-site incisional hernia. The incisional hernia was confirmed by imaging with a median follow-up of 15 (4-28) months. Secondary outcomes included 30-day postoperative complications, hospital length of stay, and 30-day readmission.
Between 274 patients, 25 were excluded (14 different extraction-site incisions, 8 conversions, 3 no anastomosis). Of the 249 patients included in the analysis: 59 were in the ICA-P group, 190 in the ECA-M group. The surgical approach of the ileocolic resection was 166 (67%) laparoscopic and 83 (33%) robotic. Both groups were similar according to age, sex, BMI, diabetes mellitus, smoking, ASA score, previous surgery, Crohn’s disease preoperative medical treatments, malnutrition, serum laboratory test, preoperative antibiotics, drainage of intra-abdominal collection, nutritional support, associated intraoperative procedures and ventral hernia repair. Overall, 22 (8.8%) patients developed an imaging-proven incisional hernia: seven at the port-site and 15 at the extraction-site. All 15 extraction-site incisional hernias were midline vertical incisions [7.9%; p=0.025], and 8 patients (53%) required surgical repair with mesh placement. Time-to-event analysis showed a 20% rate of extraction-site incisional hernia in the ECA-M group after 48 months (p =0.037). Port-site incisional hernia rate was similar between the two groups, all were < 20mm, contained preperitoneal fat tissue, and none underwent surgical repair. The overall 30-day postoperative complication rate was 28.1% [ICA-P: 11 (18.6) vs. ECA-M: 59 (31.1); p=0.064], and severe complications (Clavien-Dindo classification ≥ 3) occurred in 16 (6.4%) patients. The length of stay was lower in the ICA-P group [ICA-P: 3.3±2.5 vs. ECA-M: 4.1±2.4 days; p=0.02] with similar 30-day readmission rates [ICA-P: 7 (11.9) vs. ECA-M: 18 (9.5); p=0.59].
Patients in the ICA-P group did not encounter any incisional hernias while having shorter hospital length of stay and similar 30-day postoperative complications or readmission compared to ECA-M. Time-to-event analysis showed a 20% rate of extraction-site incisional hernia in the ECA-M group after 48 months. Therefore, strong consideration should be given to performing intracorporeal anastomosis with Pfannenstiel incision during Ileocolic resection in patients with Crohn’s to reduce hernia risk
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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