3 research outputs found
Vacuum-assisted closure for treating chronic pelvic abscess following rectal stump leak after Hartmann’s procedure for low rectal cancer
No full textRectal stump leak following Hartmann’s procedure resulting in an abscess formation is quite a rare complication. The size of the cavity, the healing process, neoadjuvant radiotherapy, and the patient’s overall condition may play a huge role in the stoma reversal rates, functional outcomes, and the patient’s quality of life. Moreover, it can lead to septic complications if not treated properly. We present a case of a 75-year-old male patient who underwent Hartmann’s procedure due to low rectal carcinoma. He presented one month after the procedure in our office with a fever and anal secretion. He was treated with three different types of antibiotics, drainage of the abscess cavity, and dressing twice a day of the wound with a povidone-iodine solution without success. Amputation of the rectal stump, debridement of the necrotic tissue, and VAC therapy resolved the symptoms and closed the perineal defect. VAC therapy may be used successfully for chronic pelvic inflammatory complications after Hartmann’s procedure
Virtual reality and biofeedback in surgical training: a review and proposal for comparative study between novice and experienced surgeons
No full textVirtual reality (VR) is increasingly adopted in surgical education as a safe and controlled environment for developing technical and non-technical skills. Parallel to this, physiological biofeedback has emerged as a promising method for assessing stress, workload, and cognitive performance during complex tasks. This review explores the current evidence on VR and biofeedback in surgical training, highlighting their synergistic potential. We discuss how VR simulations replicate operative scenarios with high fidelity and how biofeedback parameters such as heart rate variability and galvanic skin response can provide objective insights into surgeon performance and stress regulation. We then outline a pilot study design in which novice and experienced surgeons are placed in a VR operating room scenario, with biofeedback metrics recorded. We hypothesise that experienced surgeons will demonstrate more stable physiological responses and superior task performance, reflecting greater resilience and expertise. Such findings could inform adaptive, personalised training models that adjust difficulty levels or provide targeted feedback in real time. Integrating VR and biofeedback into surgical education has the potential to enhance skill acquisition, improve stress management, and bridge the gap between simulation and the operating room
Nationwide analysis of the breast cancer guidelines adherence in Bulgaria
No full textIntroduction: The diagnosis and treatment of breast cancer have tremendously changed in the last decades improving the survival and quality of life of the patients. Adherence to clinical practice guidelines in oncology significantly improves patients’ recurrence-free and overall survival. Nowadays, no national registry/database for breast cancer patients is available. This study aims to perform a nationwide analysis of the breast cancer guidelines adherence in Bulgaria, in particular regarding the diagnostic methods for histological confirmation and the types of radical surgery performed using an artificial intelligence (AI) powered software. Materials and methods: We analyzed data from January 2019 to August 2023 nationwide using the platform with access to anonymized medical information from Bulgaria's leading territorial oncology hospitals. A total of 13,790 patients met the inclusion criteria. Results: The gold standard diagnostic tool, CNB, was done in 5427 patients (39.35%), an intraoperative frozen section was performed as a method for confirmation of breast cancer in 6257 patients (45.37%) and the standard technique for lymph node evaluation, sentinel lymph node biopsy, was done in 357 patients (2.99%). Conclusion: In Bulgaria, there are still difficulties in achieving comparable rates of core-needle biopsy for the diagnosis of breast cancer and we have demonstrated unacceptably high rates of frozen section use for intraoperative diagnosis of breast cancer. Breast-conserving surgery is widely accepted and available, but still, the rates are lower than usual for developed countries. The rates of sentinel lymph node biopsy, however, are unreasonably low
