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Enhanced recovery programme in colorectal surgery:Does one size fit all?

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World Journal of Gastroenterology 2012年第40期18卷 5661-5663页

作者： Alison Lyon Christopher J Payne Graham J MacKay Specialty registrar in General surgery West of Scotland RotationGlasgow G4 0SFUnited Kingdom Lister Department of surgery Glasgow Royal InfirmaryGlasgow G4 0SFUnited Kingdom

Enhanced recovery after surgery(ERAS) employs a multimodal perioperative care pathway with the aim of attenuating the stress response to surgery and accelerating *** has been difficult to determine the relative importance of some of the individual components of these pathways such as epidural analgesia and laparoscopic colorectal *** argue that only a rigid adherence to the published ERAS protocol can achieve the proposed benefits of fast-track *** this article,we explore some of the areas where the evidence base may be changing and ask whether a more flexible and individualised approach should be considered.

关键词： Enhanced recovery Fast-track Laparoscopic Intravenous fluid Postoperative analgesia

Severe monobacterial necrotizing soft tissue infection by group A Streptococcus:A surgical emergency

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Asian Pacific Journal of Tropical Biomedicine 2012年第3期2卷 250-252页

作者： Sophocles Lanitis Khan MAA Sgourakis G Kontovounisios C Papaconstandinou T Karaliotas C Second Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio" Red Cross Athens General Hospital Specialist registrar Department of Plastic and Reconstructive SurgeryCastle Hill Hospital

Eight percent of necrotizing soft tissue infections(NSTI) are attributable to group A Streptococci(GAS),and among these,50%develop streptococcal toxic shock *** reported mortality associated with NSTI reaches 32%.We present cases of two healthy individuals with minor GAS skin infection which developed to a rapidly progressed NSTI and sepsis despite of the antibiotic treatment,aiming to discuss the lessons learned from the course and management of these patients.

关键词： Necrotizing soft tissue infection Group A Streptococci Fulminant skin necrosis

Parathyroid surgery Outcome at King Salman Armed Forces Hospital

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Surgical Science 2022年第3期13卷 91-97页

作者： Mohannad Eledreesi Khalid Alsubaie Yaser Kelany Yousif Alalawi Attiya Alzahrani Senior registrar General surgery Department of Surgery in King Salman Aramed Forces Hospital Tabuk Saudi Arabia Consultant Breast and Endocrine surgery Department of Surgery in King Salman Aramed Forces Hospital Tabuk Saudi Arabia

Introduction: The aim of this study is to review the surgical outcome of parathyroidectomy at one institution over nine years in form of methods of diagnosis, type of surgery, postoperative complications and histopathology findings. Methods: This is a retrospective study from a single institution (King Salman North West Armed Forced Hospital (KSAFH), Tabuk, Saudi Arabia). All cases underwent parathyroidectomy from 1/1/2010 until 31/12/2018 were retrieved from the archives of the department of surgery. Data were extracted from the patients’ charts. They included demographical data, presence of comorbidities, laboratory and radiological investigations, type of surgery, postoperative complications and histopathology findings. Inclusion criteria include patients older than 13 years old. Exclusion criteria include patients younger than 13 years old, hyperparathyroidism cured with medication, patients unwilling to give informed consent and patients with serious underlying medical conditions that restrict diagnostic testing or therapy such as congestive cardiac failure. Results: A total of 30 patients underwent parathyroidectomy at KSAFH. 20 out of 30 patients were female (66.7%). The mean age was 35 - 45 years old. Diabetes mellitus was found in 5 patients (16.7%), while hypertension was seen in 10 patients (33.3%). 6 patients (20%) had end stage renal disease (ESRD). The data showed 24 patients with primary hyperparathyroidism (80%), 5 patients with secondary hyperparathyroisim (16.7%) and one patient with tertiary hyperparathyroidism (3.3%). Our study demonstrated that 23 patients underwent partial parathyroidectomy (76.6%), while 7 patients underwent total parathyroidectomy (23.3%). According to the method used for diagnosis of hyperparathyroidism, blood tests were used in 27 patients (90%), Sestamibi parathyroid scan in 26 patients (86.6%), ultrasound scanning in 28 patients (93.3%) and bone scan in 9 patients (30%). Sensitivity of Sestamibi scan in primary hyperparat

关键词： Parathyroid Parathyroid surgery Hyperparathyroidism

Type III/Type IV Giant Para-Oesophageal Herniae: Our Technique of Gastropexy with Biological Prosthesis

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Surgical Science 2016年第5期7卷 226-229页

作者： Kassem Alubaidi Ashish Kiran Shrestha Meera Joshi Sanjoy Basu Department of General surgery William Harvey Hospital Kent UK Department of surgery and Cancer Imperial College London UK Surgical registrar WHH Kent UK

Objective: To present our technique of laparoscopic repair of giant para-oesophageal hernia with biological prosthesis (porcine dermis). Method: Our technique involves creating a pneumoperitoneum with standard port placement for anti-reflux surgery, mediastinal sac dissection and excision, crura-plasty, tension free placement of the biological prosthesis for hiatal reinforcement, fundoplication and gastropexy. Conclusion: Our technique of laparoscopic repair of giant para-oesophageal hernia with biological mesh is feasible and safe with acceptable morbidity and outcome.

关键词： Giant Para-Oesophageal Herniae Hiatal Defect Biological Mesh Gastropexy

Sugammadex is associated with better respiratory recovery than neostigmine following reversal of anaesthesia-associated neuromuscular blockade in the morbidly obese patients following elective laparoscopic surgery

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Laparoscopic, Endoscopic and Robotic surgery 2018年第2期1卷 33-36页

作者： M.Johnson O.A.Khan E.R.McGlone A.A.Roman J.S.Qureshi A.Kayal Anaesthetic registrar St Helier HospitalWrythe LaneSM51AAUK St Georges NHS Trust LondonSW17 OQTUK

Complete and reliable neuromuscular reversal is important to successful anaesthetic recovery in the morbidly obese patient undergoing laparoscopic *** goal was to determine whether sugammadex,a selective reversal agent is associated with better respiratory recovery than neostigmine following the reversal of anaesthesia-associated neuromuscular blockade by rocuronium in the morbidly *** Expiratory Flow Rate a surrogate marker for respiratory function,was the primary outcome measured and secondary outcome measures included post-operative nausea and vomiting,pain and head *** found that patients reversed with sugammadex had a significantly higher post-operative PEFR as compared to those reversed with neostigmine and glycopyrrolate group.

关键词： Sugammadex Laparoscopic surgery Neuromuscular blockade Morbidly obese

The Radiological Outcome of Surgical Correction of Hallux Valgus with Combined Scarf and Akin Osteotomies

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Open Journal of Orthopedics 2023年第3期13卷 84-96页

作者： Sami Nogdallah Mohamed Alhassan Osman Montaser Fatooh Alaa Mohamed Mohamed Khairy Hozifa Mohammed Ali Abd-Elmaged Osama Gamal Nubi Orthopedics surgery Department Alneelain University Khartoum Sudan Bashaer Teaching Hospital Khartoum Sudan Orthopaedic registrar Sudan Medical Specialization Board Khartoum Sudan Orthopedics surgery Department Alzaiem Alazhari University Khartoum Sudan Bashaer University Hospital MBBS Al Neelan University Khartoum Sudan

Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.

关键词： Hallux Valgus Scarf Osteotomy Akin Osteotomy Valgus Angle Intermetatarsal Angle

Technical refinements of the modified central mound breast reduction

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Plastic and Aesthetic Research 2018年第9期5卷 1-11页

作者： Simon Nicholson Muhammad Adil Abbas Khan Muhammad Riaz Hand surgery Fellow Middlemore HospitalOtahuhuAuckland 2025New Zealand ST6 registrar in plastic surgery NHS TaysideDundee DD2 1GZUK Hull and East Riding Hospital AnlabyKingston upon Hull HU10 7AZUK

Aim: Common pitfalls with existing breast reduction techniques include poor aesthetic outcome, such as development of a 'boxy' breast shape, and pseudoptosis. Presented here are a series of modifications to the technique of central mound breast reduction, based on previous work, aimed at ensuring consistent aesthetic results which are maintained in the long-term. Methods: All patients undergoing bilateral breast reduction by the senior author over a 7-year period were included, with outcome data collected prospectively. A detailed description of the technique is offered. Results: One hundred and sixteen patients underwent bilateral breast reduction over the study period. Mean follow-up was 20.6 months. There were no cases of nipple necrosis or infection requiring antibiotics. There was one post-operative haematoma which required surgical evacuation. Three patients developed a degree of fat necrosis which was managed conservatively in two, but required surgical debridement for liquefactive necrosis in one. Results of these breast reductions at the second post-operative year and beyond are presented. Conclusion: The technique described offers benefits of improved predictability, consistency and longevity of aesthetic results over existing techniques. Development of pseudoptosis in particular is effectively delayed. The modifications described have not been shown to increase the rates of surgical complications.

关键词： Central mound breast reduction mastopexy technique technical refinement modification

前哨淋巴结活检目前是公认且广泛应用于乳腺癌和黑色素瘤的技术

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英国医学杂志中文版 2004年第6期7卷 325-326页

作者： Malcolm R Kell Michael J Kerin 赵卫红 senior specialist registrar Breast Check Eccles Unit Department of surgery Mater Misericordiae Hospital Dublin 7 Ireland

近10年来，前哨淋巴结活检已逐步成为评价恶性肿瘤病人区域淋巴结状况的微创技术，仅取出一小部分淋巴结就可以明确一个淋巴结群的状态。这些淋巴结位于区域淋巴结的前沿；如果恶性肿瘤侵袭区域淋巴结，必须首先经过前哨淋巴结。因此，... 详细信息

近10年来，前哨淋巴结活检已逐步成为评价恶性肿瘤病人区域淋巴结状况的微创技术，仅取出一小部分淋巴结就可以明确一个淋巴结群的状态。这些淋巴结位于区域淋巴结的前沿；如果恶性肿瘤侵袭区域淋巴结，必须首先经过前哨淋巴结。因此，若前哨淋巴结受侵，区域淋巴结中后面的淋巴结将可能受侵。

关键词：前哨淋巴结活检乳腺癌黑色素瘤微创技术

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梅尼埃病的诊断和治疗

英国医学杂志中文版 1998年第2期1卷 81-85页

作者： Shakeel R Saeed 翟所强熊敏 University Department of Otolaryngology-Head and Neck surgery Manchester Royal InfirmaryManchester M13 9WL senior registrar in otolaryngology

1861年,法国学者梅尼埃提出一种以听力减退、耳鸣、波动性眩晕为特征的综合征。虽然当时对其病因有不同看法,但梅尼埃准确地想到其病变在内耳。1938年Hallpike 和 Cairns 揭示梅尼埃病(旧称"美尼尔病"——编者注)

关键词：梅尼埃病内淋巴水肿听力减退美尼尔病 Cairns 前庭膜迷路切除术耳科学家听力损失耳科手术