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Topic Review
Screw Fixation in Patients with Osteoporotic Spine
Osteoporosis is a common disease in elderly populations and is a major public health problem worldwide. It is not uncommon for spine surgeons to perform spinal instrumented fusion surgeries for osteoporotic patients. In patients with severe osteoporosis, instrumented fusion may result in screw loosening, implant failure or nonunion because of a poor bone quality and decreased pedicle screw stability as well as increased graft subsidence risk.
  • 524
  • 30 May 2022
Topic Review
The Challenge of Perihilar Cholangiocarcinoma
Perihilar cholangiocarcinomas (pCCA) are rare yet aggressive tumors originating from the bile ducts. While surgery remains the mainstay of treatment, only a minority of patients are amenable to curative resection, and the prognosis of unresectable patients is dismal. The introduction of liver transplantation (LT) after neoadjuvant chemoradiation for unresectable pCCA in 1993 represented a major breakthrough, and it has been associated with 5-year survival rates consistently >50%. Despite these encouraging results, pCCA has remained a niche indication for LT, which is most likely due to the need for stringent candidate selection and the challenges in preoperative and surgical management.
  • 521
  • 27 Mar 2023
Topic Review
Drug Regimen and Pneumonectomy
Pneumonectomy is an entire lung removal and is indicated for both malignant and benign diseases.
  • 516
  • 27 Apr 2021
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. 
  • 515
  • 18 Jan 2022
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 . 
  • 515
  • 28 Sep 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. 
  • 513
  • 08 Dec 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
  • 513
  • 09 Dec 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.
  • 511
  • 02 Nov 2021
Topic Review
Percutaneous Endoscopic Necrosectomy
The Percutaneous Endoscopic Necrosectomy (PEN) technique consists of percutaneous puncture of the pancreatic necrotic collection from retroperitoneal, or less frequently, transperitoneal access, under ultrasound or CT guidance. Next, a fully-coated, self-expandable esophageal stent is inserted across the puncture, with its distal end reaching the necrotic collection lumen and its proximal end located outside the patient’s body. During PEN, a flexible endoscope (usually a gastroscope) is inserted along the esophageal stent lumen and necrosectomy (mechanical evaluation of necrotic debris from the cavity) is performed using various endoscopic instruments. During the procedure, the cavity is extensively flushed, usually with physiological saline, and the contents are aspirated. If subsequent PEN procedures are required, the esophageal stent is retained in the percutaneous location, with the introduction of plastic endoprostheses or drainage tubes along its lumen for passive or active post-procedural drainage of the necrotic collection, respectively. After the completion of endoscopic treatment using percutaneous access, the esophageal stent is removed and the site is secured with an ostomy pouch to collect the residual contents of the necrotic cavity.
  • 510
  • 20 Jul 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. 
  • 501
  • 07 Jan 2022
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