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Topic Review
Innovative Strategies in Microvascular Head and Neck Reconstruction
The field of reconstructive microsurgery has witnessed considerable advancements over the years, driven by improvements in technology, imaging, surgical instruments, increased understanding of perforator anatomy, and experience with microsurgery. However, within the subset of microvascular head and neck reconstruction, novel strategies are needed to improve and optimize both patient aesthetics and post-operative function. Given the disfiguring defects that are encountered following trauma or oncologic resections, the reconstructive microsurgeon must always aim to innovate new approaches, reject historic premises, and challenge established paradigms to further achieve improvement in both aesthetic and functional outcomes. 
  • 556
  • 24 Aug 2023
Topic Review
Gut Microbiome and Colorectal Cancer Development
Traditionally considered a disease common in the older population, colorectal cancer is increasing in incidence among younger demographics. Evidence suggests that populational- and generational-level shifts in the composition of the human gut microbiome may be tied to the recent trends in gastrointestinal carcinogenesis. 
  • 553
  • 18 Feb 2024
Topic Review
Entero-Cutaneous and Entero-Atmospheric Fistulas
Enteric fistulas are a common problem in gastrointestinal tract surgery and remain associated with significant mortality rates, due to complications such as sepsis, malnutrition, and electrolyte imbalance. The increasingly widespread use of open abdomen techniques for the initial treatment of abdominal sepsis and trauma has led to the observation of so-called entero-atmospheric fistulas. Because of their clinical complexity, the proper management of enteric fistula requires a multidisciplinary team. The main goal of the treatment is the closure of enteric fistula, but also mortality reduction and improvement of patients’ quality of life are fundamental. Successful management of patients with enteric fistula requires the establishment of controlled drainage, management of sepsis, prevention of fluid and electrolyte depletion, protection of the skin, and provision of adequate nutrition.
  • 551
  • 28 Feb 2024
Topic Review
Surgery in Autoimmune Pancreatitis
Autoimmune pancreatitis (AIP) was first described as a clinical entity in 1961 by Sarles et al. who described a type of sclerosing pancreatitis associated with hypergammaglobulinemia.
  • 546
  • 06 Feb 2023
Topic Review
Orbital Metastases
Orbital metastases may significantly worsen the functional status of oncological patients, leading to debilitating visual impairments. Surgical resection, orbital exenteration, and complementary therapies may result in heterogeneous clinical outcomes. Most orbital metastases occur at later stages after primary tumors, frequently showing diffuse location within the orbit and rarely invading intracranial structures. Biopsy-only techniques were more frequently preferred in view of the less invasive approaches, but surgical resection and orbital radiotherapy were related to improved clinical outcomes. Although patients with primary breast cancer and patients undergoing resection showed superior prognoses, overall survival rates were generally poor, suggesting the need to better understand orbital metastases’ microenvironments for devising optimal systemic treatment strategies.
  • 540
  • 12 Jan 2022
Topic Review
Surgery for Non-Small-Cell Lung Cancer
Circulating tumor cells (CTCs) are dislodged from the primary tumor into the bloodstream, travel within the bloodstream to distant organs, and finally extravasate and proliferate as epithelial metastatic deposits.  In surgery for malignancies, the surgical manipulation of tumors and tissues around the tumor may lead to the release of CTCs into the bloodstream. The non-touch isolation technique (NTIT) has been advocated to prevent the release of CTCs during surgery. The concept of NTIT is the prevention of intraoperative increment of CTCs from the primary tumor by the early blockade of outflow vessels, and ‘pulmonary vein (PV)-first lobectomy’ during surgery for non-small-cell lung cancer (NSCLC) corresponds to this technique. 
  • 537
  • 16 Mar 2022
Topic Review
Multi-Disciplinary Approach to Colorectal Liver Metastasis
Colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States. Despite best efforts, 5-year survival for unresectable metastatic CRC is only about 20%. CRC is a heterogeneous disease and the underlying genetic differences inform behavior, treatment strategy, and prognosis. Given the limitations of cytotoxic chemotherapy and the growing role of molecular profiling, research has focused on identifying and developing targeted therapies.
  • 532
  • 13 Jul 2023
Topic Review
The Rationale of Hyperthermic Intraperitoneal Chemotherapy Treatment
Peritoneal metastases (PM) are observed in approximately 8% of patients diagnosed with colorectal cancer, either synchronously or metachronously during follow-up. PM often manifests as the sole site of metastasis. PM is associated with a poor prognosis and typically shows resistance to systemic chemotherapy. Consequently, there has been a search for alternative treatment strategies. For intraperitoneal (IP) therapy to exhibit promise, it either needed to be combined with the removal of larger tumor nodules during cytoreductive surgery or administered as repeated intermittent treatments over an extended duration to affect macroscopic tumor nodules. Cytoreductive surgery, with hyperthermic intraperitoneal chemotherapy (HIPEC) treatment as an adjunct, emerged as a solution for the former situation.
  • 528
  • 31 Jan 2024
Topic Review
NAFLD and Bariatric/Metabolic Surgery as Its Treatment Option
The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has considerably increased over the last years. NAFLD is currently the most common cause of chronic liver disease in the developing world. The diagnosis of NAFLD/NASH is often incidental, as the early-stage of disease is frequently free of symptoms. Most patients recognized with NAFLD have severe obesity and other obesity-related disease such as type 2 diabetes mellitus (T2DM), insulin-resistance, dyslipidemia and hypertension. The only proven method for NAFLD improvement and resolution is weight loss. Bariatric surgery leads to significant and long-term weight loss as well as improvement of coexisting diseases. 
  • 526
  • 22 Dec 2021
Topic Review
Surgical Management of Gastroesophageal Junction Adenocarcinoma
Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last two decades to incorporate a multidisciplinary approach, including endoscopic intervention, neoadjuvant chemotherapy/chemoradiation, and open or minimally invasive surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and, more recently, proximal gastrectomy. 
  • 515
  • 21 Feb 2024
Topic Review
Endoscopic Salvage of Gastrointestinal Anastomosis Leaks
Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. 
  • 499
  • 07 Oct 2023
Topic Review
Innovations in Breast Cancer Care
Breast cancer care has seen tremendous advancements through various innovations to improve early detection, diagnosis, treatment, and survival. These innovations include advancements in imaging techniques, minimally invasive surgical techniques, targeted therapies and personalized medicine, radiation therapy, and multidisciplinary care.
  • 495
  • 07 Jun 2023
Topic Review
Complications Associated with Oblique Lumbar Interbody Fusion
The main advantage of Oblique Lumbar Interbody Fusion (OLIF) is its ability to provide safe access to the lumbar spine while being a robust interbody fusion technique through a minimally invasive approach. The rate of major complications after OLIF is minimal, making it a safe procedure with significant benefits outweighing the risks. The advantages of OLIF L2-5 with posterior stabilisation over stand-alone OLIF L2-5 is a subject of discussion.
  • 492
  • 22 Dec 2023
Topic Review
Effect of Er:YAG Laser Exposure
In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers.
  • 488
  • 28 Jul 2023
Topic Review
Anti-Angiogenic Agents in Thymic Epithelial Tumor Treatment
Thymomas and thymic carcinomas are included in the rare group of cancers of the anterior mediastinum known as thymic epithelial tumors (TET). Their origin is the thymus’ epithelial cells. Anti-angiogenics have shown their potential efficacy in many solid tumors; however, their place in the treatment of thymic epithelial tumors (TET) comprising thymoma and thymic carcinoma (TC) is less clear. Angiogenesis significantly influences TET carcinogenesis. Both thymomas and TC overexpress VEGF-A and VEGFR-1 and -2.
  • 472
  • 15 Dec 2023
Topic Review
Clinical Application of Liquid Biopsy in Pancreatic Cancer
Pancreatic ductal adenocarcinoma contributes significantly to global cancer-related deaths, featuring only a 10% survival rate over five years. The quest for novel tumor markers is critical to facilitate early diagnosis and tailor treatment strategies for this disease, which is key to improving patient outcomes. In pancreatic ductal adenocarcinoma, these markers have been demonstrated to play a crucial role in early identification, continuous monitoring, and prediction of its prognosis and have led to better patient outcomes. Nowadays, biopsy specimens serve to ascertain diagnosis and determine tumor type. However, liquid biopsies present distinct advantages over conventional biopsy techniques. They offer a noninvasive, easily administered procedure, delivering insights into the tumor’s status and facilitating real-time monitoring. Liquid biopsies encompass a variety of elements, such as circulating tumor cells, circulating tumor DNA, extracellular vesicles, microRNAs, circulating RNA, tumor platelets, and tumor endothelial cells.
  • 464
  • 26 Feb 2024
Topic Review
Early Complications of Esophagectomy
Esophagectomy is a technically complex operation performed for both benign and malignant esophageal disease. Medical and surgical advancements have led to improved outcomes in esophagectomy patients over the past several decades; however, surgeons must remain vigilant as complications happen often and can be severe. Post-esophagectomy complications can be grouped into early and late categories.
  • 455
  • 29 Dec 2023
Topic Review
Management of Hepatocellular Carcinoma Associated with NAFLD
Non-alcoholic fatty liver disease (NAFLD) has gained attention due to its increasing prevalence worldwide becoming a global epidemic. The increasing incidence of NAFLD and the concurrent increase in the number of hepatocellular carcinoma (HCC) cases at a global level is a matter of concern. HCC has several risk factors, of which NAFLD and its associated metabolic disturbances—type 2 diabetes mellitus, obesity, and dyslipidemia—are of great interest due to their accelerating rise in incidence worldwide. There is a high amount of data derived from basic and clinical studies that reveal the molecular pathways that drive NAFLD-associated HCC. Based on these findings, new prevention, surveillance, and treatment strategies are emerging. 
  • 451
  • 17 Oct 2023
Topic Review
Cytokine Gene Vaccine Therapy for Brain Tumor Treatment
A glioma is a malignant brain tumor with a poor prognosis. Attempts at the surgical removal of the tumor are the first approach, but additional treatment strategies, including radiation therapy and systemic or local chemotherapy, are necessary. Furthermore, the treatments are often associated with significant adverse side effects. Normal and malignant cells generally have antigenic differences, and this is the rationale for clinical immunotherapeutic strategies. Cytokines such as IL-15 or IL-2, which stimulate an anti-tumor immune response, have been shown to have a particularly high potential for use in immunotherapy against various tumors.
  • 451
  • 01 Nov 2023
Topic Review
Complications of Pancreaticoduodenectomy with Concurrent Colectomies
A pancreaticoduodenectomy (PD) is one of the most challenging abdominal surgical procedures and is associated with increased rates of postoperative complications, including severe ones, potentially leading to postoperative deaths. Even at very high-volume centers for pancreatic resections, the morbidity rates after PD are relatively high, while the perioperative mortality cannot be neglected. Multi-visceral resections for colon and pancreatic cancer (PDAC) are feasible, safe, and justified for early and late outcomes. However, the use of pancreaticoduodenectomy (PD) with concurrent colectomies is highly debatable in terms of morbidity and oncological benefits.
  • 450
  • 29 Dec 2023
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