186,962 research outputs found
Chirurgia elettiva nella recidiva da cancro del colon con diffusione peritoneale: quando intervenire?
No full text..
Illustration of Peritoneal Cancer Index (PCI) by Sugarbaker.
No full text<p>(A) A composite score (0–3) of lesion size in abdomino-pelvic regions (0–12). (B) The scoring system of PCI adapted from Sugarbaker.</p
Keyhole versus Sugarbaker techniques in parastomal hernia repair following ileal conduit urinary diversion:a retrospective nationwide cohort study
No full textAbstract
Background: Previous research on parastomal hernia repair following ileal conduit urinary diversion is limited. This nationwide cohort study aims to present the results of keyhole and Sugarbaker techniques in parastomal hernia repair in the setting of ileal conduit urinary diversion.
Method: All patients in this cohort underwent primary elective parastomal hernia repair following ileal conduit urinary diversion in four university hospitals and one central hospital in Finland in 2007–2017. Retrospective clinical data were collected from patient registries to compare keyhole and Sugarbaker parastomal hernia repair techniques. The primary outcome was parastomal hernia recurrence during the follow-up from primary surgery to the last confirmed follow-up date of the patient. The secondary outcomes were reoperations during the follow-up and complication rate at 30 days’ follow-up.
Results: The results of 28 hernioplasties were evaluated. The overall parastomal hernia recurrence rate was 18%, the re-operation rate was 14%, and the complication rate was 14% during the median follow-up time of 30 (21–64) months. Recurrence rates were 22% (4/18) after keyhole repair and 10% (1/10) after Sugarbaker repair. Re-operation rates referred to keyhole repair were 22% and Sugarbaker repair 0% during follow-up. The majority of reoperations were indicated by recurrence. Complication rates were 17% after keyhole and 10% after Sugarbaker repair during the 30 days’ follow-up.
Conclusion: The results of parastomal hernia repair in the setting of ileal conduits are below optimal in this nationwide cohort comparing keyhole to Sugarbaker repair in elective parastomal hernia repair. Nonetheless, the Sugarbaker technique should be further studied to confirm the encouraging results of this cohort in terms of recurrence
Hernia paraestomal: Reparación de urgencia mediante Sugarbaker laparoscópico
No full textParastomal hernia is a common entity in ostomized patients. Diagnosis in the clinic is frequent, but fortunately there are only a few patients who require emergency intervention due to intestinal obstruction. We present the case of a patient with a parastomal hernia who was admitted for emergency due to intestinal obstruction with a large content in the hernia sac. It required urgent surgical intervention, opting in our center for laparoscopic Sugarbaker type repair.
This is the gold standard technique for the repair of parastomal hernia in a programmed surgery, with better results than the open pericolostomy technique or the Keyhole technique. Although its use in emergency surgery is very controversial, especially performing it by laparoscopy. In the case we present, it was a solution to the problem in a quick and effective way (without complications such as wound infection, problems with the stoma or prolonged adynamic ileus).La hernia parastomal es una entidad bastante frecuente en los pacientes ostomizados. Es frecuente el diagnóstico en consulta, pero afortunadamente pocos son los pacientes que requieren intervención de urgencia por obstrucción intestinal. Presentamos el caso de un paciente con hernia parastomal que ingresó de urgencia por obstrucción intestinal con gran contenido en el saco herniario. Requirió intervención quirúrgica urgente, optando en nuestro centro por reparación laparoscópica tipo Sugarbaker.
Se trata de la técnica gold standard para la reparación de hernia parastomal de forma programada, con mejores resultados que la técnica abierta pericolostómica o la técnica Keyhole. Aunque su uso en cirugía de urgencia es muy controvertido, sobre todo realizándola por laparoscopia. En el caso que presentamos fue una solución al problema de manera rápida y eficaz (sin complicaciones como infección de herida, problemas con el estoma o íleo adinámico prolongado)
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Pharmacokinetics of the Perioperative Use of Cancer Chemotherapy in Peritoneal Surface Malignancy Patients
No full textBackground. The peritoneal surface is an acknowledged locoregional failure site of abdominal malignancies. Previous treatment attempts with medical therapy alone did not result in long-term survival. During the last two decades, new treatment protocols combining cytoreductive surgery with perioperative intraperitoneal and intravenous cancer chemotherapy have demonstrated very encouraging clinical results. This paper aims to clarify the pharmacologic base underlying these treatment regimens. Materials and Methods. A review of the current pharmacologic data regarding these perioperative chemotherapy protocols was undertaken. Conclusions. There is a clear pharmacokinetic and pharmacodynamic rationale for perioperative intraperitoneal and intravenous cancer chemotherapy in peritoneal surface malignancy patients
Anesthaetic results in patients undergoing Sugarbaker: Experience at Fundación Santa Fe de Bogotá (Colombia) thirteen consecutive years
No full textIntroducción: Durante el intraoperatorio de todo procedimiento de Sugarbaker, se presentan diferentes desafíos que incluyen anormalidades electrolíticas, hipertermia, coagulopatía, desplazamiento de fluidos, aumento en el consumo de oxígeno, entre otros, que deben ser manejados por el anestesiólogo para mejorar los desenlaces. El objetivo fue describir el manejo anestésico y los eventos intraoperatorios de los procedimientos de sugarbaker realizados en el Hospital Universitario Fundación Santa Fe de Bogotá. Métodos: Estudio de tipo transversal, en el cual se analizan los eventos anestésicos ocurridos en pacientes intervenidos por Sugarbaker en el Hospital Universitario Fundación Santa Fe de Bogotá durante los años 2007-2020. Resultados: Con un total de 165 pacientes sometidos a 175 procedimientos de sugarbaker se encontró que el géneroque predominó fue femenino con 72.7%, la neoplasia primaria más común fue la de origen apendicular (50.9%). De forma intraoperatoria recibieron una mediana de 9.600 c. c. de cristaloides y 120 pacientes requirieron transfusión dehemoderivados. 87.2% presentaron anormalidades electrolíticas y 50.9% hiperglicemia que requirieron correcciónintraoperatoria. Ninguno presentó hipertermia sistémica. La edad mayor de 55 años fue un factor asociado a la necesidad de ventilación y mayor estancia hospitalaria con diferencias significativas (p 0.01). Las tasas de transfusiones, estancia hospitalaria, inicio de vía oral y deambulación similares a lo reportado en centros de referencia a nivel mundial. Conclusión: La cirugía de citorreducción más quimioterapia hipertérmica intraperitoneal es un procedimiento mayor que implica múltiples alteraciones fisiológicas que deben ser conocidas por el anestesiólogo para brindar un adecuado manejo perioperatorio.Fundación Santa Fe de BogotáEspecialista en AnestesiologíaEspecializaciónDuring the intraoperative, there are different challenges that include electrolyte abnormalities, hyperthermia, coagulopathy, fluid displacement, increased oxygen consumption, among others, which must be managed by the anesthesiologist to improve outcomes. The objective was to describe the anesthetic management and intraoperative events of the sugarbaker procedures performed at the Hospital Universitario Fundación Santa Fe de Bogotá. Methods: A cross-sectional study was performed, in which we analyzed all the patients operated on by Sugarbaker at the Fundación Santa Fe de Bogotá University Hospital during 2007-2020. Results: With a total of 165 patients submitted to 175 sugarbaker procedures, it was found that the gender predominated female with 72.7%, the most common primary neoplasm was appendicular origin (50.9%). Intraoperatively, they received a median of 9600 cc crystalloids and 120 patients required transfusion of blood products. 87.2% presented electrolyte abnormalities and 50.9% hyperglycemia that required intraoperative correction. None had systemic hyperthermia. Age over 55 years was a factor associated with the need for ventilation and longer hospital stay with significant differences (p 0.01). Transfusion rates, hospital stay times, intensive care unit times, oral initiation and ambulation are evidenced similar to those reported in reference centers worldwide. Conclusion: Cytoreduction surgery plus intraperitoneal hyperthermic chemotherapy is a major procedure that involves multiple physiological alterations that must be known by the anesthesiologist to provide adequate perioperative management that impacts patient outcomes
Mesh fracture as a cause for recurrence in laparoscopic Sugarbaker parastomal hernia repair:A case series
No full textBackground: Parastomal hernia is common and bothersome for patients. Parastomal hernia repair has become increasingly common, and although several different approaches exist, they all carry high risk of postoperative complications. Mesh fracture is a known, but rare complication in other types of hernia repair. We describe seven cases of mesh fracture as reason for recurrence in patients undergoing laparoscopic Sugarbaker parastomal hernia repair. Methods: This retrospective case series present seven patients with intraoperatively verified mesh fracture. All patients underwent primary laparoscopic Sugarbaker parastomal hernia repair between October 2014 and May 2016, using a monofilamentous composite polyester mesh (ParietexTM Composite Parastomal Mesh). All patients were diagnosed with hernia recurrence, and mesh fracture was confirmed during the surgical procedure for recurrence. Data on demography, perioperative findings and length of stay were presented. Results: During the inclusion period, a total of 41 patients underwent laparoscopic parastomal hernia repair in our department. Seven patients (17%) subsequently developed hernia recurrence requiring surgical intervention. Diagnosis of hernia recurrence occurred median 29 months (range, 20-36 months) after primary hernia surgery. Recurrence hernia surgery occurred median 32 months (range, 20-67 months) after primary hernia surgery. Three of these patients were emergencies due to hernia-related acute bowel obstruction. In all patients re-herniation was due to a fracture in the central part of the mesh. None of the patients with mesh fracture experienced postoperative complications at either primary or recurrence surgeries. Length of stay was median 7 days (3-8 days) after primary surgery and 4 days (3-9 days) after recurrence surgery. Conclusions: We describe seven cases of mesh fracture as reason for recurrence in patients undergoing primary laparoscopic parastomal Sugarbaker hernia repair. Our findings underline the importance of post-marketing surveillance of medical devices, and consideration should be given to centralization of these complicated procedures.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe 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
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe 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
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