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Topic Review
Electrodiagnostic and Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS), first described in 1863 by Sir James Paget, is the most common focal entrapment mononeuropathy. It is defined as a compression of the median nerve at the wrist associated with decreased function of the nerve at this level. There are several risk factors of CTS including genetic heredity, diabetes mellitus, thyroid disease, obesity, rheumatoid arthritis, and pregnancy.
  • 953
  • 30 Jun 2021
Topic Review
Biomaterials-Based Regenerative Therapies for Intervertebral Disc
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. Recent advances in regenerative medicine and tissue engineering suggest the potential of biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse.
  • 951
  • 28 Mar 2022
Topic Review
Corpus Callosotomy for Controlling Epileptic Spasms
Epileptic spasms (ESs) are a type of epileptic seizure characterized as brief muscle contractions with ictal polyphasic slow waves on an electroencephalogram and a main feature of West syndrome. Resection surgeries, including frontal/posterior disconnections and hemispherotomy, have been established for the treatment of medically intractable ES in patients with unilaterally localized epileptogenic regions. Corpus callosotomy (CC) has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. However, CC has also been adopted for ES treatment. 
  • 936
  • 18 Jan 2022
Topic Review
Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs)
Pancreatic neuroendocrine tumours (pNETs) are a group of rare neoplasms with an incidence of 1–2/100,000 inhabitants/year. They represent 2% of all pancreatic neoplasms and are characterized by a great heterogeneity according to their genetic or sporadic origin, their functional or non-functional character, their degree of locoregional or systemic invasion and their single or multiple localization. The reference curative treatment is surgical resection of the pancreatic tumor in specialized high-volume centres, after a multidisciplinary discussion involving surgeons, oncologists, radiologists and pathologists.
  • 933
  • 14 Jan 2022
Topic Review
Elective Early Upper Gastrointestinal Study
Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear.  It aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention. 
  • 928
  • 23 Nov 2021
Topic Review
Merkel Cell Carcinoma
Merkel cell carcinoma (MCC) is an uncommon type of skin cancer with poor prognosis. It is seen predominantly in old age in sun-exposed body areas. Racial and geographical differences are seen in its occurrence. Viral infection and radiation exposure are the two leading factors implicated in its causation. Small, firm to hard nodule (usually in sun-exposed areas), red with a history of a rapid increase in size is a common personation of the disease. Other body parts such as upper limbs, trunk, and even lower limbs may be also involved. The disease is diagnosed by taking a tissue sample (biopsy) for examination, and other radiological investigations are needed to reach a proper diagnosis with the staging of the disease. There are various treatment options including surgery, radiotherapy, and chemotherapy. Surgery is the primary treatment option though some patients may not be the candidates for operation where other treatment options come into play. 
  • 928
  • 17 Dec 2021
Topic Review
Damage Control Surgery after Burn Injury
Burn injuries with cutaneous loss result in a severe systemic response when profound injuries exceed 20% of the total body surface area. The management of severely burned patients is a complex and dynamic process. Timely and safe operative interventions are critical components of multidisciplinary care. Effective management of severely burned patients, their cutaneous injuries, and the associated systemic disease requires a comprehensive understanding of the pathophysiologic response to trauma, objective indicators of patient status, and an appreciation for the dynamic nature of these parameters.
  • 928
  • 26 Apr 2022
Topic Review
Sinistral Portal Hypertension after Pancreaticoduodenectomy
To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has been widely accepted in high-volume centers for pancreatic resection due to its favorable outcomes compared with non-operative treatment. However, in patients with long-term survival, sinistral portal hypertension (SPH) occurs as a late-onset postoperative complication. These patients present gastrointestinal varices due to congested venous flow from the spleen, which may cause critical variceal bleeding.
  • 921
  • 02 Nov 2021
Topic Review
Parenchyma Sparing Liver Resection versus Regenerative Liver Surgery
Liver resection for malignant tumors should respect oncological margins while ensuring safety and improving the quality of life, therefore tumor staging, underlying liver disease and performance status should all be attentively assessed in the decision process. The concept of parenchyma-sparing liver surgery is nowadays used as an alternative to major hepatectomies to address deeply located lesions with intricate topography by means of complex multiplanar parenchyma-sparing liver resections, preferably under the guidance of intraoperative ultrasound. Regenerative liver surgery evolved as a liver growth induction method to increase resectability by stimulating the hypertrophy of the parenchyma intended to remain after resection (referred to as future liver remnant), achievable by portal vein embolization and liver venous deprivation as interventional approaches, and portal vein ligation and associating liver partition and portal vein ligation for staged hepatectomy as surgical techniques. Interestingly, although both strategies have the same conceptual origin, they eventually became caught in the never-ending parenchyma-sparing liver surgery vs. regenerative liver surgery debate. However, these strategies are both valid and must both be mastered and used to increase resectability.
  • 919
  • 24 Oct 2022
Topic Review
Reconstruction and Rehabilitation of Jaw following Ablative Surgery
The reconstruction and rehabilitation of jaws following ablative surgery have been transformed by the development of computer-assisted surgery and virtual surgical planning. With strides made in computer-assisted surgery and patient-specific implants, the individual functional reconstruction of the jaw is evolving rapidly and the prompt rehabilitation of both the masticatory function and aesthetics after jaw resection has been made possible.
  • 915
  • 29 Aug 2022
Topic Review
Adipose-Derived Stem/Stromal Cells in Kidney Transplantation
Kidney transplantation (KT) is the gold standard treatment of end-stage renal disease. Among the many peri-operative complications that can jeopardize transplant outcomes, ischemia–reperfusion injury (IRI) deserves special consideration as it is associated with delayed graft function, acute rejection, and premature transplant loss. Adipose stem/stromal cells (ASCs) possess specific characteristics that could help prevent, reduce, or reverse IRI. 
  • 906
  • 22 Nov 2021
Topic Review
Appropriate Antibiotic Therapy for Intra-Abdominal Infections
Adequately controlling the source of infection and prescribing appropriately antibiotic therapy are the cornerstones of the management of patients with intra-abdominal infections (IAIs). Correctly classifying patients with IAIs is crucial to assessing the severity of their clinical condition and deciding the strategy of the treatment, including a correct empiric antibiotic therapy. Best practices in prescribing antibiotics may impact patient outcomes and the cost of treatment, as well as the risk of “opportunistic” infections such as Clostridioides difficile infection and the development and spread of antimicrobial resistance.
  • 903
  • 26 Oct 2022
Topic Review
Klebsiella pneumoniae vs. Non-Klebsiella pneumoniae Pyogenic Liver Abscess
Pyogenic liver abscess (PLA) is a common global public health problem as it contributes to 13% of intra-abdominal abscesses. With advancements in diagnostic microbiology, imaging technology, improved understanding of sepsis and critical care, and minimally invasive image-guided interventions such as percutaneous drainage (PD), clinical outcomes continue to improve; however, PLA-related mortality remains high, in the range of 10–30%. Klebsiella pneumoniae (KP) is the leading causative organism for PLA, followed by Escherichia coli (EC). Klebsiella pneumoniae pyogenic liver abscess (KPPLA) is associated with DM and gas formation, possibly impacting clinical outcomes.
  • 900
  • 07 Sep 2022
Topic Review
Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic
The Coronavirus Disease 2019 (COVID-19) pandemic has impacted volume, management strategies and patient outcomes of acute appendicitis. There is a significantly higher incidence of complicated appendicitis in children during the COVID-19 pandemic than in the pre-COVID-19 period. Additionally, a significantly higher proportion of children was managed via the NOM during the pandemic in comparison to the pre-pandemic period. 
  • 898
  • 07 Jan 2022
Topic Review
Systemic Antibiotic Prophylaxis in Maxillofacial Trauma
Infection after maxillofacial trauma remains an important complication, with a significant socio-economic impact. While consensus exists that systemic antibiotic prophylaxis reduces the risk of infection in the management of maxillofacial fractures, the type, and duration remain controversial. 
  • 894
  • 22 Jun 2022
Topic Review
Artificial Intelligence in Breast Surgery
Breast reconstruction is a pivotal part of the recuperation process following a mastectomy and aims to restore both the physical aesthetic and emotional well-being of breast cancer survivors. In recent years, artificial intelligence (AI) has emerged as a revolutionary technology across numerous medical disciplines. The role of AI in the domain of breast reconstruction is explored. 
  • 882
  • 17 Aug 2023
Topic Review
Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection
Among primary liver cancers, hepatocellular carcinoma (HCC) is the most common. Surgical resection and liver transplantation both represent potentially curative treatments not only in the case of the first occurrence, but also in those cases of disease recurrence if a proper selection of patients is performed ahead. Incidentally, the type and the time of relapse carry important weight on patient prognosis and overall survival. For these cases, proper management has still not been exactly defined.
  • 881
  • 11 Feb 2023
Topic Review
Decision Making during the Learning Curve of MIMVS
Minimally invasive mitral valve surgery is evolving rapidly since the early 1990’s and is now increasingly adopted as the standard approach for mitral valve surgery. It has a long and challenging learning curve and there are many considerations regarding technique, planning and patient selection when starting a minimally invasive program.
  • 877
  • 05 Nov 2022
Topic Review
Perianal Fistula with Crohn’s Disease
Crohn’s disease (CD) is a relapsing systemic inflammatory disease that can cause persistent transmural inflammation anywhere along the gastrointestinal tract.
  • 860
  • 12 Nov 2021
Topic Review
Augmented Reality and Image-Guided Robotic Liver Surgery
Robotic surgery has gained much attention in liver resection for its potential to increase surgical dexterity in a minimally invasive scenario. In liver surgery, robotic systems help surgeons to localize tumors and improve surgical results with well-defined preoperative planning or increased intraoperative detection. Furthermore, they can balance the absence of tactile feedback and help recognize intrahepatic biliary or vascular structures during parenchymal transection. In addition, the robotic system presents the advantage of creating a hybrid interface in which pre- and intra-operative imaging tools could be exploited alone or together in order to guide surgical resection.
  • 859
  • 24 Jan 2022
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