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Topic Review
Defect Coverage after Forequarter Amputation
Autologous fillet flaps are a common reconstructive option for large defects after forequarter amputation (FQA) due to advanced local malignancy or trauma. FQA predominantly was a consequence of local malignancy. For vascular supply, the brachial artery was predominantly anastomosed to the subclavian artery and the brachial or cephalic vein to the subclavian or external jugular vein. 
  • 859
  • 01 Jul 2022
Topic Review
Intraoperative Imaging in Hepatopancreatobiliary Surgery
Hepatopancreatobiliary surgery belongs to one of the most complex fields of general surgery. An intricate and vital anatomy is accompanied by difficult distinctions of tumors from fibrosis and inflammation; the identification of precise tumor margins; or small, even disappearing, lesions on currently available imaging. The routine implementation of ultrasound use shifted the possibilities in the operating room, yet more precision is necessary to achieve negative resection margins. Modalities utilizing fluorescent-compatible dyes have proven their role in hepatopancreatobiliary surgery, although this is not yet a routine practice, as there are many limitations. Modalities, such as photoacoustic imaging or 3D holograms, are emerging but are mostly limited to preclinical settings. There is a need to identify and develop an ideal contrast agent capable of differentiating between malignant and benign tissue and to report on the prognostic benefits of implemented intraoperative imaging in order to navigate clinical translation.
  • 858
  • 23 Oct 2023
Topic Review
C-Arm-Free Minimally Invasive Technique for Spinal Surgery
C-arm-free MIS techniques can offer significantly reduced rates of postoperative complications such as inadequate decompression, blood loss, and instrumentation misplacement. Another advantageous long-term aspect is the notably diminished exposure to radiation, which is known to cause malignant changes. 
  • 852
  • 19 Oct 2023
Topic Review
Adipokines and Breast Cancer
Adipokines (also known as adipocytokines) is a vast group of heterogenous soluble factors produced by adipose tissue that function in different pathways involving metabolism, inflammation, and vascular homeostasis. Adipokines interact with and activate different pathways that contribute to the hallmarks of breast cancer since they express respective receptors for the interaction.
  • 844
  • 22 Mar 2023
Topic Review
Laparoscopy in Emergency
Laparoscopy must be considered a safe, extremely versatile and prompt surgical approach suggested with the highest grade of recommendation for acute cholecystitis, perforated gastroduodenal ulcers, acute appendicitis, gynaecological disorder and non-specific abdominal pain (NSAP). For the remaining surgical emergencies, the role of laparoscopy is still a matter of debate. 
  • 836
  • 10 Dec 2021
Topic Review
Mesenchymal Stromal Cell-Based Targeted Therapy Pancreatic Cancer
Pancreatic cancer is an aggressive malignancy with high mortality rates and poor prognoses. Despite rapid progress in the diagnosis and treatment of pancreatic cancer, the efficacy of current therapeutic strategies remains limited. Hence, better alternative therapeutic options for treating pancreatic cancer need to be urgently explored. Mesenchymal stromal cells (MSCs) have recently received much attention as a potential therapy for pancreatic cancer owing to their tumor-homing properties. 
  • 823
  • 15 Mar 2023
Topic Review
Drug Regimen and Pneumonectomy
Pneumonectomy is an entire lung removal and is indicated for both malignant and benign diseases.
  • 800
  • 27 Apr 2021
Topic Review
Urethral Strictures Treatment in Transmasculine
Genital gender-affirming surgery can be part of the transition process in transgender patients. The 2 standard options for transmasculine patients are phalloplasty and metoidioplasty. These complex procedures brings along the risk of complications such as fistulas or urethral strictures at the level of the neo-urethra. Urethral strictures pose a specific challenge to the reconstructive urologist, and studies that focus on the management of urethral strictures are scarce. This systematic review gives an overview of the known literature about strictures in transmasculine patients, the different treatments and the outcome . 
  • 797
  • 28 Sep 2021
Topic Review
Management of Advanced Aged Patients with Rib Fractures
Rib fractures are painful and disabling injuries found in chest trauma patients. Elderly patients (age > 60 years old) represent the majority of the victims of major trauma, and rib fractures account for 10% of all trauma admissions. Rib fracture management includes operative and non-operative approaches. Conservative treatment generally consists of satisfactory pain control, respiratory assistance, cough strategies, and deep breathing exercises. Surgical fixation in elderly patients seems to result in better outcomes than conservative treatment in terms of shorter hospitalization time, more favorable pain feedback and reduced associated morbidity. 
  • 794
  • 11 May 2022
Topic Review
High Infection Eradication of Two-stage Exchange Arthroplasty
Two-stage exchange arthroplasty remains the gold standard in the United States for treatment of chronic periprosthetic joint infection (PJI). This technique resulted in a relatively high infection eradication, however, the mortality rate is alarmingly high. Antibiotic resistant organisms appear to be highest risk factor for failure.
  • 794
  • 25 Mar 2022
Topic Review
Percutaneous Pedicle Screw
In percutaneous pedicle screw (PPS) fixation of the osteoporotic spine, rigid screw fixation obtaining strong stabilization is important for achieving successful treatment outcomes. However, in patients with severe osteoporosis, it is difficult to obtain PPS fixation with sufficient stability. PPS fixation has potential disadvantages with respect to maintaining secure stabilization in comparison to conventional pedicle screw fixation. In PPS fixation, bone grafting to achieve posterior spine fusion is generally not applicable and transverse connectors between the rods cannot be used to reinforce the fixation. Various augmentation methods, including additional hooks, sublaminar bands, and hydroxyapatite (HA) sticks, are available for conventional pedicle screw fixation.
  • 788
  • 13 May 2022
Topic Review
Nectins and Nectin-like Molecules in Colorectal Cancer
In 2020, colorectal cancer was the third most common type of cancer worldwide with a clearly visible increase in the number of cases each year. With relatively high mortality rates and an uncertain prognosis, colorectal cancer is a serious health problem. There is an urgent need to investigate its specific mechanism of carcinogenesis and progression in order to develop new strategies of action against this cancer. Nectins and Nectin-like molecules are cell adhesion molecules that take part in a plethora of essential processes in healthy tissues as well as mediating substantial actions for tumor initiation and evolution.
  • 786
  • 22 Dec 2022
Topic Review
Management of Low-Risk Thyroid Cancers
Thyroid cancer is the most common endocrine malignancy, representing 2.9% of all new cancers in the United States (US). It has an excellent prognosis, with a five-year relative survival rate of 98.3%, and has a higher frequency in females than males, with ratio of 3:1. Differentiated thyroid cancer (DTC) represents 90% of all thyroid malignancies and includes three main types: papillary thyroid cancer (PTC), the most common type, comprising 85% of all DTC; follicular thyroid cancer (FTC); and the rare subtype, Hürthle (oncocytic) cell thyroid cancer (2–5%).
  • 780
  • 16 Sep 2021
Topic Review
The Lymphatic System
Lymphedema is characterized by an abnormal accumulation of protein-rich fluid within the interstitium, resulting in swelling of the affected area. It can manifest as primary lymphedema when it results from a structural or developmental defect in the lymphatic system, or as secondary lymphedema, which is due to iatrogenic causes.
  • 753
  • 04 Sep 2023
Topic Review
Minimally Invasive Cardiac Surgery
Minimally invasive cardiac surgery (MICS) has gained a significant place due to the emergence of innovative tools and improvements in surgical techniques, offering comparable efficacy and safety to traditional surgical methods.
  • 749
  • 07 Dec 2023
Topic Review
MPM Nodal Status: Where are We at?
Due to the lack of both prospective trial and high-volume retrospective studies, the management of clinical N+ malignant pleural mesothelioma (MPM) patients remain highly debated. Node positive patients show poor survival compared with node-negative ones; thus, lymph node staging appears crucial in determining treatment strategy. Notwithstanding the improvement in pre-treatment staging and the update on lymph node classification in the 8th edition of TNM, several open controversies remain on N parameter. How should people stage suspected N+ patients? How should people treat node positive patients?  Which is the definition of “resectable patient”?  Is the site or the number the main prognostic factor for node positive patients?  The aim of the entry is to analyse the existing relevant literature on lymph node status in MPM.
  • 748
  • 09 Nov 2021
Topic Review
Artificial Intelligence for Surgeons
Computer vision (CV) is a field of artificial intelligence (AI) that deals with the automatic analysis of videos and images. Recent advances in AI and CV methods coupled with the growing availability of surgical videos of minimally invasive procedures have led to the development of AI-based algorithms to improve surgical care.
  • 742
  • 27 Aug 2022
Topic Review
Thymus Surgery in Myasthenia Gravis
The thymus is a lymphoid organ involved in the differentiation of T cells, and has a central role in the physiopathogenesis of Myasthenia Gravis (MG). This connection is proved by a series of changes in the level of neuromuscular junctions, which leads to a decrease in the amplitude of the action potential in the post-synaptic membrane. Because of this, the presence of anti-cholinergic receptor antibodies (AChR), characteristic of MG, is found, which causes the progressive regression of the effect of acetylcholine at the level of neuromuscular junctions, with the appearance of muscle weakness. The thymectomy is a surgical variant of drug therapy administered to patients with MG. In the case of patients with nonthymomatous MG, thymectomy has become a therapeutic standard, despite the fact that there is no solid scientific evidence to explain its positive effect. Videothoracoscopic surgery or robotic surgery led to a decrease in the length of hospital stay for these patients.
  • 738
  • 08 Mar 2024
Topic Review
Endoscopic Vacuum Therapy in the Upper Gastrointestinal Tract
Anastomotic leaks after gastrointestinal surgery have an important impact on surgical outcomes because of the high morbidity and mortality rates. Multiple treatment options exist requiring an individualized patient-tailored treatment plan after multidisciplinary discussion. Endoscopic vacuum therapy (EVT) is a novel treatment option that is nowadays recognized as an effective and useful endoscopic approach to treat leaks or perforations in both the upper and lower gastrointestinal tract.
  • 734
  • 28 Jun 2023
Topic Review
Minimally Invasive Surgery of the Thymus
The trend for thymoma surgery has been to increase utilization of minimally invasive options for resection; however, the primary objective should be to perform an oncological resection. One must consider the stage of tumor, presence of myasthenia gravis, presence of lymphadenopathy, and size of thymoma prior to deciding optimum surgical strategy.
  • 730
  • 10 Feb 2022
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