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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.
  • 497
  • 29 May 2023
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. 
  • 496
  • 28 Jul 2022
Topic Review
Experimental Animal Skin Flap Models
Skin flaps are necessary in plastic and reconstructive surgery for the removal of skin cancer, wounds, and ulcers. A skin flap is a portion of skin with its own blood supply that is partially separated from its original position and moved from one place to another. The use of skin flaps is often accompanied by cell necrosis or apoptosis due to ischemia–reperfusion (I/R) injury.
  • 486
  • 20 May 2022
Topic Review
Regenerative strategies in Cleft Palate
Cleft lip and/or palate (CLP) is a craniofacial malformation with a prevalence in newborns of 14 per 10,000 live births worldwide. 
  • 485
  • 01 Jul 2021
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.
  • 485
  • 29 Aug 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.
  • 479
  • 14 Mar 2022
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.
  • 478
  • 24 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.
  • 477
  • 07 Sep 2022
Topic Review
Treatment of Rectal Cancer
Rectal cancer poses a substantial healthcare challenge, emphasizing the critical need for effective treatment strategies. Among the various approaches available, surgical intervention, notably total mesorectal excision (TME), stands as the gold standard for rectal cancer management, consistently delivering exceptional oncological results. In certain instances of early-stage disease, endoscopic treatments and transanal resection techniques may be viable options, offering a more conservative approach. Additionally, for cases characterized by locally advanced tumors, radiotherapy has demonstrated significant benefits in augmenting the overall treatment efficacy.
  • 473
  • 04 Sep 2023
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. 
  • 470
  • 11 May 2022
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