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Preprint ARTICLE | doi:10.20944/preprints202305.1737.v1

Oncological Outcomes after Laparoscopic and Open Liver Resection in patients with Colorectal Liver Metastases: A Single Centre Propensity Score Matched Study

Alberto Diaz-Garcia, Alex Gordon-Weeks, Robert Young, Timothy Gilbert, Adeeb Rehman, Hassan Malik, Stephen Fenwick, Robert P Jones, Rafael Diaz-Nieto

Subject: Medicine And Pharmacology, Surgery Keywords: liver surgery; colorectal cancer; laparoscopy; survival

Online: 25 May 2023 (05:14:42 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.1664.v1

Diagnosis and Management of Severe Water-Related Skin and Soft Tissue Sepsis: A Summative Review of the Literature

Shanisa Naidoo, Arnold M Zwane, Ahmed Paruk, Timothy Craig Hardcastle

Subject: Medicine And Pharmacology, Surgery Keywords: Soft tissue; necrotizing infection; water borne; vibrio; fungal; aeromonas; debridement; negative pressure wound care

Online: 23 May 2023 (14:43:28 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.1575.v1

Application of Heisenberg’s Uncertainty Principle in the Diag-Nostic Dilemma of Children With Acute Appendicitis: Negative Appendectomy Versus Complicated Appendicitis Rates

Stylianos Roupakias, Sotirios Fouzas, Eirini Kostopoulou, Despoina Gkentzi, Theodore Dassios, Ioannis Spyridakis, Xenophon Sinopidis

Subject: Medicine And Pharmacology, Surgery Keywords: complicated appendicitis; negative appendectomy; Heisenberg’s principle; diagnostic uncertainty; children

Online: 23 May 2023 (04:58:36 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.1241.v1

A Systematic Review and Meta-Analysis of Aortic Morphological Changes after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Paolo Righini, Dor Avishay, Daniela Mazzaccaro, Marina Galliagani, Giovannii Nano

Subject: Medicine And Pharmacology, Surgery Keywords: Blunt thoracic aortic injury; Thoracic endovascular aortic repair; Thoracic aortic sizing; Systematic review; aortic diameters; Endovascular aortic repair; Thoracic aorta imaging

Online: 17 May 2023 (10:55:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1183.v1

Under the Hood: Understanding the Features of Mucin in Pseudomyxoma Peritonei

Pedro Villarejo-Campos, Mariano García-Arranz, Siyuan Qian, Santos Jiménez de los Galanes, Victor Dominguez-Prieto, Juan Felipe Vélez Pinto, Ismael Guijo Castellano, Montiel Jiménez-Fuertes, Hector Guadalajara, Damian Garcia-Olmo

Subject: Medicine And Pharmacology, Surgery Keywords: pseudomyxoma peritonei; mucin; MUC-2; microbiome; pseudomonas.

Online: 17 May 2023 (04:33:59 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202305.1155.v1

Achalasia Post-Bariatric Surgery, Placement Roux-en-Y Gastric Bypass. Case Report

Juan Pablo Landeros-Ruiz, Lourdes Marlene Zúñiga-Ramos, Daniela Cárdenas-Guerrero, Quitzia Libertad Torres

Subject: Medicine And Pharmacology, Surgery Keywords: Achalasia; Roux-en-Y Bypass; Bariatric surgery; Bariatric Surgery

Online: 16 May 2023 (10:41:28 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0580.v1

Prevalence of Clinical Signs and Symptoms of Temporomandibular Joint Disorders Registered in the EUROTMJ Database: A Prospective Study in a Portuguese Center

David Faustino Ângelo, Beatriz Mota, Ricardo São João, David Sanz, Henrique José Cardoso

Subject: Medicine And Pharmacology, Surgery Keywords: Temporomandibular joint disorders; parafunctional habits; risk factors; chronic diseases

Online: 9 May 2023 (07:10:29 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0128.v1

Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery

Gioia Brachini, Matteo Matteucci, Paolo Sapienza, Roberto Cirocchi, Alessandro Favilli, Stefano Avenia, Isaac Cheruiyot, Giovanni Domenico Tebala, Piergiorgio Fedeli, Justin Davies, Justus Randolph, Bruno Cirillo

Subject: Medicine And Pharmacology, Surgery Keywords: obturator artery (OA); Internal Iliac Artery (IIA); External Iliac Artery (EIA)

Online: 3 May 2023 (10:09:47 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.1200.v1

The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Bowel Obstruction: Recommendations for perioperative care

Orestis Ioannidis, Jose M Ramirez, Javier Martinez Ubieto, Carlo V. Feo, Antonio Arroyo, Petr Kocian, Louis Sanchez Guillen, Ana Pascual Bellosta, Adam Whitley, Alejandro Bona Enguita, Marta Teresa, Elissavet Anestiadou

Subject: Medicine And Pharmacology, Surgery Keywords: bowel obstruction; perioperative care; care program; surgical rehabilitation; EUPEMEN project

Online: 29 April 2023 (03:46:32 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.1103.v1

Assessment of Lipid Balance Parameters after Laparoscopic Sleeve Gastrectomy in 1-Year Observation

Patrycja Pawłuszewicz, Paweł Andrzej Wojciak, Aleksander Łukaszewicz, Jan Chilmonczyk, Jerzy Robert Ładny, Arkadiusz Nadolny, Hady Razak Hady

Subject: Medicine And Pharmacology, Surgery Keywords: obesity; sleeve gastrectomy; atherogenic dyslipidemia; lipid metabolism

Online: 28 April 2023 (04:17:28 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1101.v1

Role of point of care diagnostics in Lower-and Middle-income countries and austere environments

Feroz Abubaker Ganchi, Timothy Craig Hardcastle

Subject: Medicine And Pharmacology, Surgery Keywords: Diagnosis; Point-of-care; Mobile laboratory; imaging; LMIC

Online: 28 April 2023 (04:03:03 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1050.v1

The Role of CT Scan in the Work-Up and Management of Blunt and Penetrating Trauma and Acute Surgical Emergencies - A Focused Literature Review

Thobekile Nomcebo Shangase, Timothy Craig Hardcastle

Subject: Medicine And Pharmacology, Surgery Keywords: Multidetector CT; blunt trauma; penetrating trauma; acute surgical emergencies; imaging; utility

Online: 27 April 2023 (05:50:23 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202304.0581.v1

Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy

Taiki Nabekura, Takashi Oshiro, Kotaro Wakamatsu, Natsumi Kitahara, Yuki Moriyama, Kengo Kadoya, Ayami Sato, Tomoaki Kitahara, Tasuku Urita, Yu Sato, Masaru Tsuchiya, Shinich Okazumi

Subject: Medicine And Pharmacology, Surgery Keywords: laparoscopic sleeve gastrectomy; bariatric and metabolic surgery; complication; iatrogenic piriform fossa and esophageal injury; orogastric calibration tube

Online: 19 April 2023 (09:43:56 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202304.0213.v1

The Value of Indocyanine Green Image-Guided Surgery in Patients with Primary Liver Tumors and Liver Metastases

Benjamin Weixler, Leonard A. Lobbes, Luis Scheiner, Johannes C. Lauscher, Sebastian M. Staubli, Markus Zuber, Dimitri A. Raptis

Subject: Medicine And Pharmacology, Surgery Keywords: indocyanine green; icg; near infrared light; liver; surgery; colorectal metastasis

Online: 11 April 2023 (08:33:57 CEST)

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Introduction: Successful R0 resection is crucial for the survival of patients with primary liver cancer (PLC) or liver metastases. Up to date, surgical resection lacks a sensitive, real-time intraoperative imaging modality to determine R0 resection. Real-time intraoperative visualization with near-infrared light fluorescence (NIRF) using indocyanine green (ICG) may have the potential to meet this demand. This study evaluates the value of ICG visualization in PLC and liver metastases surgery regarding R0 resection rates. Materials and Methods Patients with PLC or liver metastases were included in this prospective cohort study. ICG 10mg was administered intravenously 24 hours before surgery. Real-time intraoperative NIRF visualization was made with the SpectrumTM Fluorescence Imaging Camera System. First, all liver segments were inspected with the fluorescence imaging system and intraoperative ultrasound for identification of the known tumor as well as additional lesions, compared to preoperative MRI. PLC, liver metastases, and additional lesions were then resected according to oncological principles. Of all resected specimens the resection margins were analyzed with the fluorescence imaging system for ICG positive spots right after resection. Histology of additional detected lesions as well as ICG fluorescence compared to histological resection margins were assessed. Results Of the 66 included patients median age was 65.5 years (IQR 58.7 - 73.9), 27 (40.9%) were female and 18 (27.3%) were operated laparoscopically. Additional ICG positive lesions were detected in 23 (35.4%) patients of which nine (29%) were malignant. In patients with no fluorescent signal at the resection margin, R0 rate was 93.9%, R1 rate was 6.1%, and R2 rate was 0% compared to a ICG positive resection margin with a R0 rate of 64.3%, R1 rate of 21.4%, and R2 rate of 14.3% (p=0.005). One and two year overall survival were 95.2% and 88.4%, respectively. Conclusion The here presented study provides significant evidence that ICG NIRF guidance helps to identify R0 resection intraoperatively. This offers a true potential to verify radical resection and improve patients´ outcome. Furthermore, implementation of NIRF guided imaging in liver tumor surgery allows to detect a considerable amount of additional malignant lesions.

Preprint ARTICLE | doi:10.20944/preprints202304.0015.v1

Serum Biomarkers of Inflammation in the Identification and Prognostication of Frail Patients Undergoing Emergency Laparotomy

Michael George, Rajarshi Mukherjee

Subject: Medicine And Pharmacology, Surgery Keywords: Frailty; elderly; inflammageing; inflammation; biomarkers; prognosis; outcomes; emergency; laparotomy; surgery

Online: 3 April 2023 (08:20:39 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202104.0787.v5

Introducing a Structured Daily Multi-Disciplinary Board Round to Safely Enhance Surgical Ward Patient Flow in the Bed Shortage Era: A Quality Improvement Research Report

Roberto Valente, Gregorio Santori, Lorna Stanton, Ajit Abraham, Mohamed Thaha

Subject: Medicine And Pharmacology, Surgery Keywords: Patient flow; Surgery; Quality improvement

Online: 1 February 2023 (11:47:37 CET)

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Hospital bed shortage is a worldwide concern. Beds unavailability has caused elective surgery cancellations, at our hospital peaking in spring 2016 at over 50%. This is often due to difficult patient step-down from intensive care (ICU) and high-dependency units (HDU). In our general/digestive surgery service admitting approximately 1000 patients yearly, ward rounds were run on a consultant firm basis. We report a quality improvement (ISRCTN13976096) introducing in our service a structured daily multi-disciplinary board round framework (SAFER Surgery R2G) adapted from the “SAFER patient flow bundle” and the "Red to Green days” approaches to enhance flow, comparing the previous year to 2017, when our framework was applied for 12 months.We used a Plan-Do-Study-Act (PDSA) methodology. Our intervention consisted in 1) systematic communication of the key care plan after the afternoon ward rounds to the nurse in charge; 2) 30’ 10AM Monday-to-Friday multidisciplinary board rounds, attended daily by the senior-team and weekly by hospital and site managers, revising the key care plan aiming at safe, early discharges, assessing the appropriateness of each inpatient day and tackling any cause of delay. We measured patient flow by average length of stay (LOS), ICU/HDU step-downs and operation cancellations count, monitoring safety through early 30-day readmissions. Compliance was assessed by board round attendance and staff satisfaction rate surveys.After 12 months (PDSA 2, N=1032), LOS significantly decreased from 7.2(±8.9) to 6.3(±7.4) days (p=0.003); ICU/HDU bed step-down flow increased by 9.3% from 345 to 375 (p=0.197), surgery cancellations dropped from 38 to 15 (p=0.100). 30-day re-admissions increased from 0.9% (N=9) to 1.3% (N=14)(p=0.390). Average cross-specialty attendance was 80%. Satisfaction rates were >75%, regarding enhanced teamwork and faster decisions.The SAFER Surgery R2G framework has shown an increase in patient flow in the context of an enhanced multidisciplinary approach, requiring senior staff commitment to remain sustainable.

Preprint ARTICLE | doi:10.20944/preprints202212.0397.v2

The Influence of Skin Commensals on the Therapeutic Outcomes of Surgically-Debrided Diabetic Foot Infections – A Large Retro-Spective Comparative Study

Ilker Uçkay, Dan Lebowitz, Benjamin Kressmann, Benjamin Alan Lipsky, Karim Gariani

Subject: Medicine And Pharmacology, Surgery Keywords: antibiotic therapy; diabetic foot infections; non-beta-lactam antibiotics; skin commensals; treatemet failures; associations with treatment failures

Online: 20 January 2023 (15:13:51 CET)

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Preprint ARTICLE | doi:10.20944/preprints202212.0560.v1

Outcomes of Total Elbow Arthroplasty in Trauma Patients Compared with Patients Following Fixation of Distal Humerus Fractures

David Maman, Nada Weishahe, Doron Norman, Yaniv Keren, Mitchell Yelton, Yaniv Trior, Elad Apt Apt, Bezalel Peskin, Nabil Ghrayeb, Jacob Shapira

Subject: Medicine And Pharmacology, Surgery Keywords: Total Elbow Arthroplasty; Distal Humerus Fractures; Patient Reported Outcomes; Open Reduction Internal Fixation of Distal Humerus

Online: 29 December 2022 (11:33:17 CET)

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Background and purpose: Total elbow arthroplasties (TEA) aim to replicate anatomy and provide stability in the treatment of distal fractures of the humerus. In the presence of an aging population with higher functional demand, improving patients’ well-being is crucial. This study aimed to analyze patients’ reported outcomes and functional outcomes for TEA in comminuted fractures of the distal humerus and to compare these outcomes with their counterpart patients who have been treated with open reduction and internal fixation (ORIF). In addition, this study aims to compare the secondary procedures rate between the two groups.Patients and Methods: Eligible patients were those who underwent TEA or ORIF of the distal humerus and completed several patient-reported outcome (PRO) questionnaires including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, 12-Item Short Form Health Survey Physical and Mental components (SF-12 P and SF-12 M, respectively) scores, visual analog scale (VAS) score for pain, and patient satisfaction ratings (1-5). A physical examination including range of motion, instability, and strength was performed for all patients. Results: This study found that patients following TEA have shown significantly lower pain levels (TEA: 3.72±2.8; ORIF 5.2±2.98, P=0.019) and higher satisfaction levels (TEA: 4.18±1.17; ORIF 3.57±1.46, P=0.035) compared with patients following ORIF. DASH score (TEA: 33.7±29.4; ORIF 39.75±24.6, P=0.31) and SF-12 score (TEA: 31.7±9.67; ORIF 31.25±10.2, P=0.85) were not statistically different between TEA and ORIF.Patients following TEA have demonstrated an advantage in flexion compared with patients following ORIF (P=0.045). Both patients following TEA and ORIF demonstrated no statistically significant difference in pronation and supination of the operated elbow compared to the contralateral side. Although, a decreased range in extension and flexion of the operated elbow compared with the contralateral side was demonstrated in both groups (extension P=0.005, flexion P<0.001). The grip Test showed no significant difference between the patients who were treated by TEA or ORIF (P=0.99). Moreover, ORIF in comminuted fractures of the distal humerus in elders may be associated with a higher complication rate compared with TEA.Conclusion: TEA following comminuted fractures of the distal humerus is associated with favorable satisfaction, pain levels, and range of motion in flexion compared with patients following ORIF of the distal humerus. Additionally, TEA may be associated with a lower rate of secondary procedures.

Preprint ARTICLE | doi:10.20944/preprints202212.0397.v1

The Influence of Skin Commensals on the Therapeutic Outcomes of Surgically-Debrided Diabetic Foot Infections

Ilker Uçkay, Dan Lebowitz, Benjamin Kressmann, Benjamin Alan Lipsky, Karim Gariani

Subject: Medicine And Pharmacology, Surgery Keywords: antibiotic therapy; diabetic foot infections; non beta-lactam antibiotics; skin commensals; treatment failures; associatons

Online: 21 December 2022 (09:23:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202210.0314.v1

Evaluation of Different Cannulation Strategies for Aortic Arch Surgery Using a Cardiovascular Numerical Simulator

Beatrice De Lazzari, Massimo Capoccia, Roberto Badagliacca, Claudio De Lazzari

Subject: Medicine And Pharmacology, Surgery Keywords: Aortic surgery; Aortic arch; Three-way cannulation approach; Carotid artery perfusion; Pressure-volume loop; Lumped parameter model; Software simulation; Cardiovascular modelling.; CARDIOSIM

Online: 20 October 2022 (14:19:25 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202207.0451.v1

Impact of Sleep Deficiency on Surgical Performance: A Prospective Assessment

Stuart F. Quan, Christopher P. Landrigan, Laura K. Barger, Justin D. Buie, Cynthia Dominguez, Jay M. Iyer, Akindele Majekodunmi, Elizabeth Lerner Papautsky, Rebecca Robbins, Burton H. Shen, Joshua T. Stephens, Matthew D. Weaver, Charles A. Czeisler

Subject: Medicine And Pharmacology, Surgery Keywords: sleep deficiency; insufficient sleep; surgery; surgical complications; attending surgeon; surgical outcomes

Online: 29 July 2022 (06:27:15 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202207.0142.v1

Comparison of the Short-term Surgical Outcomes in Patients with Closed Traction Injuries to Brachial Plexus

Vladimir Ulyanov, Sergey P. Bazhanov, Stanislav D. Shuvalov, Galina A. Korshunova, Vladimir V. Ostrovskij

Subject: Medicine And Pharmacology, Surgery Keywords: brachial plexus; traction injury; surgical treatment; electrostimulation

Online: 9 July 2022 (16:47:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202207.0017.v1

Evaluation of Intraorbital Soft Tissue Modifications after Traumatic Injuries Management

Cristian Mihail Dinu, Tiberiu Tamas, Gabriela Agrigoroaei, Sebastian Stoia, Simion Bran, Gabriel Armencea, Avram Manea

Subject: Medicine And Pharmacology, Surgery Keywords: soft; tissue; orbit; trauma; reconstruction; PSI; segmentation; enopthtalmy

Online: 1 July 2022 (16:14:49 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202204.0175.v1

Pushpinder Walia, Yaoyu Fu, Jack Norfleet, Steven D. Schwaitzberg, Xavier Intes, Suvranu De, Lora Cavuoto, Anirban Dutta

Subject: Medicine And Pharmacology, Surgery Keywords: error; motor learning; surgical skills; EEG; fNIRS; neurovascular coupling

Online: 19 April 2022 (05:48:50 CEST)

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Fundamentals of Laparoscopic Surgery (FLS) is a training module designed to provide basic surgical skills. During skill training of the FLS "suturing and intracorporeal knot-tying" task – the most difficult among the five psychomotor FLS tasks, learning from errors is one of the basic principles of motor skill acquisition where appropriate contextual switching of the brain state on error is postulated. This study investigated changes in the brain state following an error event based on the fusion of simultaneously acquired functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) signals. Here, human error processing is postulated to differentiate experts from novices based on the differences in the error-related chain of mental processes. Thirteen right-handed novice medical students and nine expert surgeons participated in this study. Error-related microstate analysis was performed using 32-channel EEG data at a high temporal resolution. Six microstate prototypes were identified from combined EEG data from experts and novices during the FLS task. Analysis of variance (ANOVA) found that the proportion of the total time spent in different microstates during the 10 sec error epoch was significantly affected by the skill level (p<0.01), microstate type (p<0.01), and the interaction between the skill level and the microstate type (p<0.01). Then, the EEG band power (1-40Hz) related to slower oxyhemoglobin (HbO) changes were found using regularized temporally embedded Canonical Correlation Analysis of the fNIRS-EEG signals. The HbO signal from the fNIRS channel overlying ‘Frontal_Inf_Oper_L’, ‘Frontal_Mid_Orb_L’, ‘Postcentral_L’, ‘Temporal_Sup_L’, ‘Frontal_Mid_Orb_R’ cortical areas from Automatic Anatomical Labelling showed significant (p<0.05) difference between experts and novices in the 10-sec error epoch. Here, the frontal/prefrontal cortical areas are postulated to be related to the perception and the activation of the primary somatosensory cortex at the postcentral cortical area is hypothesized to be related to the action underpinning perception-action coupling model for the error-related chain of mental processes. Therefore, our study highlighted the importance of error-related brain states from portable brain imaging when comparing complex surgical skill levels.

Preprint REVIEW | doi:10.20944/preprints202112.0479.v1

The Technique and Advantages of Contrast-Enhanced Ultrasound in the Diagnosis and Follow-up of Traumatic Abdomen Solid Organ Injuries

Marco Di Serafino, Francesca Iacobellis, Maria Laura Schillirò, Roberto Ronza, Francesco Verde, Dario Grimaldi, Giuseppina Dell'aversano Orabona, Martina Caruso, Vittorio Sabatino, Chiara Rinaldo, Luigia Romano

Subject: Medicine And Pharmacology, Surgery Keywords: CEUS; blunt trauma; non operative management; follow-up.

Online: 30 December 2021 (07:48:03 CET)

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Preprint REVIEW | doi:10.20944/preprints202112.0465.v1

New Techniques in Hemorrhoidal Disease but the Same Old Problem: Anal Stenosis

Sezai Leventoglu, Bulent Mentes, Bengi Balci, Halil Can Kebiz

Subject: Medicine And Pharmacology, Surgery Keywords: Anal stenosis; hemorrhoidectomy; diamond flap; house advancement flap; rhomboid flap; Y-V flap

Online: 29 December 2021 (12:18:26 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0019.v1

Using Resonance Acoustic Emission Vibrations as a Method for Implant Insertion Assessment in Total Hip Arthroplasty

Jonathan CJ Wei, Willem HA Crezee, Hilda Jongeneel, Tobias SA De Haas, Wesley LA Kool, Bryan J Blaauw, Jenny Dankelman, Tim Horeman

Subject: Medicine And Pharmacology, Surgery Keywords: Medical device; surgery; hip arthroplasty; acoustics; vibration emissions

Online: 1 December 2021 (13:43:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0003.v1

Investigation Into Cervical Spine Biomechanics Following Single, Multilevel and Hybrid Disc Replacement Surgery With Dynamic Cervical Implant and Fusion: A Finite Element Study

Muzammil Mumtaz, Iman Zafarparandeh, Deniz Ufuk Erbulut

Subject: Medicine And Pharmacology, Surgery Keywords: cervical spine; finite element; dynamic cervical implant; multi-level fusion; hybrid surgery; disc replacement

Online: 1 December 2021 (10:24:47 CET)

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Preprint REVIEW | doi:10.20944/preprints202110.0048.v1

How is the Digital Surgical Environment Evolving? The Role of Augmented Reality in Surgery and Surgical Training

Maria Georgi, Sonam Patel, Devansh Tandon, Ayush Gupta, Alexander Light, Arjun Nathan

Subject: Medicine And Pharmacology, Surgery Keywords: Augmented reality (AR); Virtual reality (VR); Simulation; Training; Navigation

Online: 4 October 2021 (11:04:55 CEST)

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Preprint REVIEW | doi:10.20944/preprints202108.0378.v1

Vascular Resection in Perihilar Cholangiocarcinoma

Alejandro Serrablo, Leyre Serrablo, Ruslan Alikhanov, Luis Tejedor

Subject: Medicine And Pharmacology, Surgery Keywords: perihilar cholangicarcinoma; advance perihilar cholangiocarcinoma, perihilar cholangiocarci-noma vascular involvement; biliary cancer.

Online: 18 August 2021 (13:22:01 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202108.0202.v1

Implants versus Lipograft – Analysis of Long-Term Results after Congenital Breast Asymmetry Procedure

Vanessa Brebant, Maximilian Weiherer, Vivien Noisser, Stephan Seitz, Lukas Prantl, Andreas Eigenberger

Subject: Medicine And Pharmacology, Surgery Keywords: congenital breast asymmetry; PROM, autologous fat injections, fat grafting, lipograft, implant augmentation, breast augmentation, 3D volumetry, three-dimensional imaging, Breast-QTM; human adipose stem cells

Online: 9 August 2021 (15:06:09 CEST)

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Preprint REVIEW | doi:10.20944/preprints202107.0382.v1

Microfluidic Surgery in Single Cells and Multicellular Systems

Kevin Zhang, Ambika Nadkarni, Rajorshi Paul, Adrian Martin, Sindy Tang

Subject: Medicine And Pharmacology, Surgery Keywords: Microfluidics; surgery; single cell; multicellular systems; sectioning; ablation; biopsy; fusion

Online: 16 July 2021 (14:53:11 CEST)

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Preprint TECHNICAL NOTE | doi:10.20944/preprints202105.0016.v1

Naviculectomy as a Third Way Beyond Minimally Invasive and Extensive Soft Tissue Releases for Ambulatory Children with Complex Congenital Vertical Talus: A Technical Note

Ahmad Aly, Shady Mahmoud, Shady Samir, Tamer El-Sobky

Subject: Medicine And Pharmacology, Surgery Keywords: Congenital Foot Deformities; Rigid Flatfoot; Congenital Convex Pes Valgus; Congenital Vertical Talus; Rocker-Bottom Foot; Resection Arthroplasty; Reverse Ponseti Technique

Online: 4 May 2021 (13:39:50 CEST)

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Preprint REVIEW | doi:10.20944/preprints202103.0227.v1

Prosthetic Meshes for Hernia Repair: State of Art, Classification, Antimicrobial Approaches, and Fabrication Methods

Ángel Serrano-Aroca, Salvador Pous-Serrano

Subject: Medicine And Pharmacology, Surgery Keywords: meshes; hernia; biomaterials; antimicrobials; surgery; abdominal wall

Online: 8 March 2021 (13:54:28 CET)

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Working Paper REVIEW

The Polymer-Based Technology in the Endovascular Treatment of Abdominal Aortic Aneurysms

Gianmarco de Donato, Edoardo Pasqui, Claudia Panzano, Brenda Brancaccio, Gaia Grottola, Giuseppe Galzerano, Domenico Benevento, Giancarlo Palasciano

Subject: Medicine And Pharmacology, Surgery Keywords: Endovascular Aneurysm Repair; EVAR; Aortic Aneurysm; PEG; polymer; Vascular Surgery; aortic endograft.

Online: 24 February 2021 (10:00:44 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202010.0085.v2

Variability in Anesthesia Models of Care In Cardiac Surgery

Dianne McCallister, Bethany Malone, Jennifer Hanna, Michael S Firstenberg

Subject: Medicine And Pharmacology, Surgery Keywords: Cardiothoracic Surgery; Anesthesia Staffing Models; Outcomes; Operating Room Staffing; Handoffs; Quality; Communication

Online: 25 November 2020 (13:58:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202011.0157.v1

Determinants of Surgical Case On-Time Start and On-Time Finish in Perioperative Services

Majbah Uddin, Lawrence Fredendall, Nathan Huynh, Kevin Taaffe, Robert Allen

Subject: Medicine And Pharmacology, Surgery Keywords: case on-time start; case on-time finish; perioperative services; team familiarity; OR efficiency

Online: 3 November 2020 (14:16:44 CET)

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Preprint REVIEW | doi:10.20944/preprints202009.0545.v1

Post-Operative Infectious Complications in Pancreatic Surgery – A Systemic Review and Updated Meta-analysis

BHAVIN Vasavada, hardik patel

Subject: Medicine And Pharmacology, Surgery Keywords: Meta-analysis; Procalcitonin; pancreatic surgery; pancreaticoduodenectomy; Infectious complications

Online: 23 September 2020 (08:07:40 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202008.0061.v1

Nonsurgical Procedure Related Postoperative Complications Predicts 30 Days Perioperative Mortality, in Abdominal Surgeries. A Propensity Score Matched Analysis.

Bhavin B. Vasavada, Hardik Patel

Subject: Medicine And Pharmacology, Surgery Keywords: Mortality; Hepatobiliary: Surgery; Surgical critical care; Complications

Online: 3 August 2020 (01:04:55 CEST)

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Aims and Objectives: Our primary aim was to study association between nonsurgical techniques related complications and mortality and our secondary aim was to determine factors responsible for non surgical technique related complications. Material and Methods: All gastrointestinal and hepatobiliary procedures performed in last 3 years have been evaluated retrospectively. Nonsurgical procedure related postoperative complications were defined as perioperative complications nonrelated to surgical procedures or techniques and related to patients’ physiological health or comorbidities. To avoid selection bias in attempt to evaluate effect of non-surgical procedural related complication on mortality, we did 1:1 propensity score matching analysis with nonsurgical technique related complications as dependent factor. Propensity scores were calculated using logistic regression. Pre operative confounding factors like age, sex, American society of Anesthesia score (ASA), emergency surgery, type of surgeries like HPB surgeries, Upper gastrointestinal surgeries, small bowel surgeries, colorectal surgeries, hernia surgeries, open or laparoscopic surgeries were entered in model as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: Total 348 patients underwent various abdominal surgeries (gastrointestinal and hepatobiliary) in our department from April 2017 to March 2020. Total 24 patients developed nonsurgical technique related complications. Before Propensity score matching nonsurgical technique related complications were significantly higher in Upper Gastrointestinal surgeries (gastric and esophageal), emergency surgeries, Open surgeries, in patients who developed intraoperative hypotension, patients operated for malignancies, patients with higher ASA grades, patients in whom more blood products were used and patient who had more operative time. ASA scores independently predicted nonsurgical technique related complications. [P=0.001. Odds Ratio 3.955 (95% C.I.) 1.774-8.813)]. After Matching 24 patients patients were included in nonsurgical complication related complication group and they were compared with 23 matched controls. After matching also nonsurgical procedural related complications were significantly associated with mortality. (p< 0.0001). No intraoperative factors like intraoperative hypotension, blood product requirement, operative time predicted non-surgical technique related complication. Surgery related complications were not associated with mortality after matching. Conclusion: Nonsurgical technique related complications are associated with significant increase risk of mortality.

Working Paper ARTICLE

Towards An App to Estimate Patient-specific Perioperative Femur Fracture Risk

Vincenzo Minutolo, Luca Esposito, Massimiliano Fraldi, Paolo Gargiulo

Subject: Medicine And Pharmacology, Surgery Keywords: total hip arthroplasty; intra-operative femur fracture risk; bone elastic-plastic behavior

Online: 23 July 2020 (09:41:30 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202005.0431.v1

Prediction of Postoperative Outcomes Following Hip Fracture Surgery: Independent Validation and Recalibration of the Nottingham Hip Fracture Score

William J. Doherty, Thomas A. Stubbs, Andrew Chaplin, Mike R. Reed, Avan A. Sayer, Miles D. Witham, Antony K. Sorial

Subject: Medicine And Pharmacology, Surgery Keywords: Hip fracture; Casemix; Validation; Discrimination; Risk score; Calibration

Online: 26 May 2020 (11:40:33 CEST)

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Objectives: Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay and postoperative complications. Design: Analysis of routinely collected prospective data. Setting and Participants: Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014-2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. Methods: C-statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and ASA grade for in-hospital, 30- and 120-day mortality, functional independence at discharge, 30-days and 120-days, length of stay, and postoperative complications. Results We analysed data from 3208 individuals, mean age 82.6 (SD 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30-days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no functional mobility at 120-days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (IQR 8-28). For mortality, c-statistics for the NHFS ranged from 0.68-0.69, similar to ASA and AMTS. For functional independence, the c-statistics for the NHFS ranged from 0.74-0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (p<0.001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. The best predictor of postoperative complications was ASA grade (0.56-0.64), whilst NHFS (0.49-0.59) and AMTS (0.48-0.57) performed similarly poorly. Conclusions and Implications: The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.

Preprint ARTICLE | doi:10.20944/preprints202005.0306.v1

Post Operative Acute Kidney Injury after HPB Surgeries – A Single Centre Retrospective Analysis

Bhavin B. Vasavada, Hardik Patel

Subject: Medicine And Pharmacology, Surgery Keywords: acute kidney injury; HPB surgery; perioperative care; critical care

Online: 18 May 2020 (17:29:02 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202004.0117.v1

Using Negative Pressure Wound Therapy in the Treatment of Wounds After Fasciotomy in Acute Compartment Syndrome - Retrospective Case Series Study

Jaroslaw P. Miszczuk, Maria Błońska-Staniec, Anna Michalska, Bartosz Stemplewski

Subject: Medicine And Pharmacology, Surgery Keywords: acute compartment syndrome; negative pressure wound therapy; vacuum assisted wound closure; fasciotomy

Online: 8 April 2020 (04:50:32 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202003.0142.v1

Effects of Phased Rehabilitation Programs after Total Knee Arthroplasty: A Randomized Controlled Trial

Jing Chao, Mingzhu Lee, Qi Gong, Xuehua Bai, Peilei Yang

Subject: Medicine And Pharmacology, Surgery Keywords: total knee arthroplasty; rehabilitation program; knee osteoarthritis; exercise rehabilitation; postoperative care

Online: 8 March 2020 (16:50:41 CET)

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Preprint ARTICLE | doi:10.20944/preprints201907.0150.v1

Dual-Channel Microarray Sensor System for Lung Cancer-Related Volatile Organic Compounds Identification in Exhaled Breath

Yonghong Xu, Jihong Jiang, Huimin Bu, Pengcheng Zhu, Jiebang Jiang, Yejiao Wu, Rongpeng Li

Subject: Medicine And Pharmacology, Surgery Keywords: dual-channel sensor; efficient capture; lung cancer biomarker; lung cancer screening

Online: 10 July 2019 (11:37:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201907.0076.v1

Surgical Site Infection after Breast Surgery: Retrospective Analysis of 5-year Postoperative Data from a Single Center in Poland

Anna Palubicka, Radoslaw Jaworski, Marcin Wekwejt, Beata Swieczko-Zurek, Michal Pikula, Janusz Jaskiewicz, Jacek Zielinski

Subject: Medicine And Pharmacology, Surgery Keywords: surgical site infection; breast surgery; breast implants; complications

Online: 4 July 2019 (11:32:17 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201905.0015.v1

Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

Chong-Chi Chiu, Wen-Li Lin, Hon-Yi Shi, Chien–Cheng Huang, Jyh-Jou Chen, Shih-Bin Su, Chih-Cheng Lai, Chien-Ming Chao, Chao-Jung Tsao, Shang-Hung Chen, Jhi-Joung Wang

Subject: Medicine And Pharmacology, Surgery Keywords: laparoscopic; open surgery; non-metastatic colorectal cancer; single surgeon experience

Online: 5 May 2019 (11:25:43 CEST)

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Working Paper ARTICLE

Combined Hysterectomy/Salpingo-oophorectomy and Mastectomy for Female-to-Male Transgender Persons: A Retrospective Update

Marlene Hager, Johannes Ott, René Wenzl, Sabine Roethlin, Daphne Gschwantler-Kaulich, Mick van Trotsenburg, Werner Haslik, Christine Kurz, Ulrike Kaufmann

Subject: Medicine And Pharmacology, Surgery Keywords: transsexuals; hysterectomy; mastectomy; reassignment surgery

Online: 4 April 2019 (12:26:30 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201812.0245.v1

The Effect of Laparoscopic Sleeve Gastrectomy on Obstructive Sleep Apnea Syndrome

Tuğrul Çakır, Hülya Eyigör, Arif Aslaner, Nurullah Bülbüller, Mehmet Tahir Oruç, Cemal Polat, Özgür Balasar, Himmet Durgut, Ömer Tarık Selçuk, Üstün Osma

Subject: Medicine And Pharmacology, Surgery Keywords: Laparoscopic sleeve gastrectomy; OSAS; polysomnography

Online: 20 December 2018 (09:55:02 CET)

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Preprint ARTICLE | doi:10.20944/preprints201810.0152.v1

Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?

Shagufta Shaheen, Salman Otoukesh, Brice Jabo, Manmeet Kaur, Nicole Wheeler, Said Mirshahidi, Salman Zaheer, Hamid R. Mirshahidi

Subject: Medicine And Pharmacology, Surgery Keywords: video assisted thoracic surgery, open thoracotomy, recurrence-free survival, overall survival, positive margins, postoperative length of stay.

Online: 8 October 2018 (15:23:21 CEST)

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Background: Video assisted thoracoscopic surgery (VATS) has become the recommended approach for treatment of resectable lung cancer. However, no large randomized clinical trial has been conducted formally comparing surgical resections completed by VATS to those done by open thoracotomy (OT) in low volume centers. The current study sought to assess differences in recurrence-free survival (RFS), overall survival (OS), positive margins and postoperative length of stay (LOS) between VATS and OT lobectomies in our center. Method: A single institution retrospective chart review from May 2005 through May 2015 was conducted. All patients diagnosed with stage I through III lung cancer who underwent surgical resection were selected. Patient and tumor characteristics recorded included age at diagnosis, sex, tobacco use, tumor location (side and lobe), stage, size and receipt of chemotherapy or radiotherapy. Chis-square and Wilcoxon-Mann-Whitney tests were used to compare demographics, tumor characteristics and LOS. Multiple logistic and Cox regression analyses were used to compute relative risk (RR) for positive margins and mortality hazard ratios along with 95 percent confidence intervals (95%CI), respectively. Results: Of the 235 patients, 101 subjects had VATS while OT was performed in 134 patients. Age at diagnosis, sex, tobacco use, tumor location, and size were comparable for VATS and OT. No significant difference was observed in the relative risk of positive margins for VATS versus OT, RR = 0.56 (95%CI = 0.26, 1.05). However, VATS had shorter median LOS compared to OT (4 vs. 6 days, respectively), p = 0.002. A comparison of VATS versus OT showed no significant difference in the risk of recurrence, HR = 1.21 (95%CI = 0.74, 2.00), or death, HR = 1.34 (95%CI = 0.88, 2.06), in the intent-to-treat population. Similarly, no significant differences in recurrence or mortality risk were observed between VATS versus OT for analyses conducted separately for each cancer stage group or those limited to patients with negative margins. Conclusion: Our study indicates that compared to OT, VATS leads to shorter LOS while achieving comparable margins status, recurrence-free and overall survival regardless of tumor stage at diagnosis.

Preprint ARTICLE | doi:10.20944/preprints201809.0342.v1

Origami Needle Guide for CT-Guided Interventions

Austin Taylor, Sheng Xu, Bradford J. Wood, Zion Tsz Ho Tse

Subject: Medicine And Pharmacology, Surgery Keywords: origami; percutaneous biopsy; computed tomography; radiologic phantom; 3D printing

Online: 18 September 2018 (10:32:24 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201804.0356.v1

Chronification of Tympanic Perforation with Mitomycin C in a Rat Model

Tomás Esteban, Noemí M. Atucha, José María Moraleda, Joaquín García-Estañ, Carmen L. Insausti, Javier Moraleda-Deleito

Subject: Medicine And Pharmacology, Surgery Keywords: animal model; chronic tympanic membrane perforation; mitomycin C; myringotomy; dexamethasone

Online: 27 April 2018 (08:36:00 CEST)

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Preprint TECHNICAL NOTE | doi:10.20944/preprints201804.0064.v1

Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note

Praveen Satarasinghe, D. Kojo Hamilton, Michael Jace Tarver, Robert J. Buchanan, Michael T. Koltz

Subject: Medicine And Pharmacology, Surgery Keywords: pedicle screw; virtual technique; neuronavigation; spine; surgery; three-dimensional; stryker; ziehm

Online: 5 April 2018 (05:53:24 CEST)

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Medicine and Pharmacology