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Topic Review
Development of the Colorectal Cancer Obstructive Mechanism
The spontaneous evolution of colorectal cancer is always burdened by complications. The most common complication is low bowel obstruction, found in approximately 20% of the cases of colorectal cancer, and it can occur either relatively abruptly, or is preceded by initially discrete premonitory symptoms, non-specific (until advanced evolutionary stages) and generally neglected or incorrectly interpreted. Success in the complex treatment of a low neoplastic obstruction is conditioned by a complete diagnosis, adequate pre-operative preparation, a surgical act adapted to the case (in one, two or three successive stages), and dynamic postoperative care. The moment of surgery should be chosen with great care and is the result of the experience of the anesthetic-surgical team. The operative act must be adapted to the case and has as its main objective the resolution of intestinal obstruction and only in a secondary way the resolution of the generating disease.
  • 1.1K
  • 29 May 2023
Topic Review
Curcumin Embedded Electrospun Nanofibers for Wound Healing
Chronic wounds impose a significant burden on individuals and healthcare systems all over the world. Through clinical and preclinical investigations, inflammation and oxidative damage have been established as the primary causes of chronic wounds. These skin sores are easily exposed to microorganisms, which in turn cause inflammation and hinder the healing process. Additionally, microorganisms may cause an infection that prevents collagen production and reepithelialization. Curcumin’s antioxidant, anti-inflammatory, and anti-infectious characteristics, among others, have been identified as useful for diabetic wound healing management. However, curcumin has a few disadvantages, such as limited bioavailability, pH-dependent instability, water insolubility, slow cell absorption, and fast intracellular metabolism. These constraints necessitates the development of a suitable transporter to improve curcumin’s stability, bioavailability, therapeutic efficacy, and solubility. 
  • 1.1K
  • 24 Nov 2022
Topic Review
Treatment of Peritoneal Metastasis
Surgical and locoregional treatments of peritoneal metastasis have gained increasing acceptance. Apart from systemic chemotherapy and surgical removal of the tumor, locoregional therapies such as cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) or pressurized intraperitoneal aerosol chemotherapy (PIPAC) may improve tumor control. 
  • 1.0K
  • 25 Feb 2022
Topic Review
Etiopathogenetic Models on BIA-ALCL
BIA-ALCL is a rare T-cell lymphoma, CD30 positive, ALK-negative usually discovered after the diagnosis of spontaneous periprosthetic seroma or intracapsular mass around the breast implant.
  • 1.0K
  • 22 Sep 2021
Topic Review
Liver Transplantation for Perihilar Cholangiocarcinoma
Cholangiocarcinoma (CCA) encompasses all malignant neoplasms arising from the epithelial cells of the biliary tree. About 40% of CCAs are perihilar, involving the bile ducts distal to the second-order biliary branches and proximal to the cystic duct implant. About two-thirds of pCCAs are considered unresectable at the time of diagnosis or exploration. When resective surgery is deemed unfeasible, liver transplantation (LT) could be an effective alternative. The overall survival rates after LT at 1 and 3 years are 91% and 81%, respectively. The overall five-year survival rate after transplantation is 73% (79% for patients with underlying PSC and 63% for de novo pCCA). Multicenter case series reported a 5-year disease-free survival rate of ~65%.
  • 1.0K
  • 30 May 2023
Topic Review
Surgical Antibiotic Prophylaxis
In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP).
  • 1.0K
  • 02 Feb 2024
Topic Review
Intraoperative Mechanical Ventilation
Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient.
  • 1.0K
  • 30 Jun 2021
Topic Review
Treatment of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer, the fifth most frequently diagnosed cancer in men and the eighth most frequently diagnosed cancer in women in the United States. It is also the fourth leading cause of cancer-related death in developed countries.
  • 997
  • 25 Apr 2021
Topic Review
Foreign Bodies in the Liver in Children
Retention of foreign bodies (FB) in the liver parenchyma is a rare event in children but it can bring a heavy burden in terms of immediate and long-term complications. Multiple materials can migrate inside the liver. Clinical manifestations may vary, depending on the nature of the foreign body, its route of penetration and timing after the initial event. Moreover, the location of the FB inside the liver parenchyma may pose specific issues related to the possible complications of a challenging surgical extraction. Different clinical settings and the need for highly specialized surgical skills may influence the overall management of these children. 
  • 994
  • 19 Apr 2022
Topic Review
Retrosternal Goitre
Retrosternal goitres are thyroid tumefactions with a mediastinal portion more represented than the cervical one and they overrun the thoracic inlet by two fingers below, or by at least 4 cm. Retrosternal goitre can be divided into two types: “plongeant”, when the parenchymal tissue is connected to the thyroid gland and shares the vascularization (95–98% of cases), and autonomous (2–5% of cases), when this connection is not present and may be considered a mediastinal neoformation.
  • 991
  • 14 Mar 2022
Topic Review
Intraoperative Guidance Using Hyperspectral Imaging
Hyperspectral imaging (HSI) is a novel optical imaging modality, which has recently found diverse applications in the medical field. HSI is a hybrid imaging modality, combining a digital photographic camera with a spectrographic unit, and it allows for a contactless and non-destructive biochemical analysis of living tissue. HSI provides quantitative and qualitative information of the tissue composition at molecular level in a contrast-free manner, hence making it possible to objectively discriminate between different tissue types and between healthy and pathological tissue. 
  • 983
  • 29 Nov 2021
Topic Review
Impact of Bariatric Surgery on Adipose Tissue Biology
Bariatric surgery (BS) procedures are actually the most effective intervention to help subjects with severe obesity achieve significant and sustained weight loss. White adipose tissue (WAT) is increasingly recognized as the largest endocrine organ. Unhealthy WAT expansion through adipocyte hypertrophy has pleiotropic effects on adipocyte function and promotes obesity-associated metabolic complications. WAT dysfunction in obesity encompasses an altered adipokine secretome, unresolved inflammation, dysregulated autophagy, inappropriate extracellular matrix remodeling and insufficient angiogenic potential. 
  • 977
  • 08 Dec 2021
Topic Review
Hallux Valgus
Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.
  • 975
  • 23 Apr 2021
Topic Review
Tactile Displays for Conventional Laparoscopic Surgery
Laparoscopic surgery (LS) is a minimally invasive technique that offers many advantages over traditional open surgery: it reduces trauma, scarring, and shortens recovery time. Researchers review the applications and challenges in the development of tactile feedback technologies that can be implemented with conventional laparoscopic instruments
  • 974
  • 09 Dec 2022
Topic Review
3D-Assisted Acetabular Fracture Surgery
The techniques currently used in 3D-assisted acetabular fracture surgery are 3D printing and visual surgical planning, 3D printing and pre-contouring of implants, and custom-made patient-specific implants. Three-dimensional-assisted surgery compared to conventional surgery reduces operation time, intraoperative blood loss, intraoperative fluoroscopy usage, and complication rate. Evidence for the improvement of postoperative fracture reduction and physical functioning is limited, because of heterogeneity and varying qualities of the studies.
  • 973
  • 28 Oct 2021
Topic Review
Surgical Treatment for Grade C Postoperative Pancreatic Fistula
Postoperative pancreatic fistula (POPF) is a troublesome complication after pancreatic surgeries, and grade C POPF is the most serious situation among pancreatic fistulas. The incidence of grade C POPF varies from less than 1% to greater than 9%, with an extremely high postoperative mortality rate of 25.7%. The patients with grade C POPF finally undergo surgery with a poor prognosis after various failed conservative treatments. Although various surgical and perioperative attempts have been made to reduce the incidence of grade C POPF, the rates of this costly complication have not been significantly diminished. Hearteningly, several related studies have found that intra-abdominal infection from intestinal flora could promote the development of grade C POPF, which would help physicians to better prevent this complication.
  • 971
  • 03 Jan 2023
Topic Review
3D Imaging in Laparoscopic Liver Surgery
Liver resection is recognized worldwide as a potentially curative treatment for patients with primary and secondary malignancies and resectable disease.  Preoperative 3D reconstructions and printing as well as augmented reality can increase the knowledge of the specific anatomy of the case and therefore plan the surgery accordingly and tailor the procedure on the patient. Furthermore, the indocyanine green retention dye is an increasingly used tool that can nowadays improve the precision during laparoscopic hepatectomies, especially when considering anatomical resection. The use of preoperative modern imaging and intraoperative indocyanine green dye are key to successfully perform complex hepatectomies such as laparoscopic parenchymal sparing liver resections.
  • 967
  • 09 Dec 2021
Topic Review
Immuno-Inflammatory Signals in Liver Ischemia-Reperfusion Injury
Ischemia reperfusion injury (IRI) is a major obstacle in liver resection and liver transplantation. The initial step of IRI is mediated through ischemia which promotes the production of reactive oxygen species in hepatic cells. This promotes the activation of pro-inflammatory signaling cascades and the production of damage-associated molecular patterns (DAMPs). During the ischemic phase, DAMPs are released into the circulation by stressed cells upon reperfusion that further attracts neutrophils and other immune cells to the site of tissue injury. 
  • 960
  • 28 Jul 2022
Topic Review
Multidisciplinary Management of SBMs
The most frequent intracranial neoplasm is meningioma. About 30% of these are represented by skull base meningiomas (SBMs). Patients with SBMs can be treated with a multimodal approach based on surgery, medical treatment and radiation-based therapy; however, the gold standard treatment for the majority of symptomatic meningiomas is still surgery. Surgical intervention is performed with the goal of maximum safe resection. This, however, poses technical challenges because of the proximity of these tumors with deep critical neurovascular structures, tumoral texture and consistency. A multimodal treatment, in combination with stereotactic radiosurgery and radiation therapy, is thus of utmost importance to achieve a satisfactory functional outcome and tumor control.
  • 958
  • 06 Jun 2021
Topic Review
Human Acellular Dermal Matrix in Reconstructive Surgery
Reconstructive surgery often confronts large tissue defects. This creates a need to look for materials that are immunogenic but offer the possibility of tissue filling. ADM—acellular dermal matrix—is a biological collagen matrix without immunogenicity, which is more commonly used in surgical treatment. Reconstructive surgery is still searching for various biocompatible materials that can be widely used in surgery. The available materials have their advantages and disadvantages.
  • 954
  • 28 Jan 2023
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