Garrettmckenna2317

Only 3 (10%) patient showed postoperative grade II complications, according to Clavien-Dindo classification. Midline abdominal incision was used in 18 patients, subcostalsurgical incision in 5 patients and bilateral subcostal surgical incision in 3 patients. 3 right nephrectomy was necessary to remove the entire tumor mass. An en bloc R0 tumor resection was accomplished in all cases.There was no intra and perioperative mortality. All patients recovered well from surgery. The mean follow-up period was 15 (range=6-48) months. CONCLUSION In conclusion, our retrospective study points out the role of open adrenalectomy as the treatment of choice in selected cases with known or suspected malignant adrenal tumors and with size greater than 12 cm.BACKGROUND The robotic arm-assisted (Mako) arthroplasty was introduced in Greece in January 2014, through the years of financial crisis. The purpose of this study is to demonstrate its evolution per procedure throughout the years. MATERIALS AND METHODS Data regarding type of procedure partial knee arthroplasty (PKA), total knee arthroplasty (TKA) and total hip arthroplasty (THA) were collected from the official distributor of the Mako platform in Greece. The number of Mako arthroplasties were calculated annually and monthly per procedure type from January 2014 to December 2018. RESULTS A total of 1081 robotic arm-assisted arthroplasties have been performed in Greece in two private hospitals. Mako cases showed overall 163.06% increase, while THA showed 235.1% increase, during the study period. On the other hand PKA showed 61% decrease, while in during one year (2017-2018) TKA showed 402% increase. CONCLUSIONS Introducing robots into the orthopedic operating theater may improve precision, could lead to lower complication rates and finally may offer higher patient satisfaction scores. However, the total growth of robotic arm-assisted arthroplasties in Greece should be interpreted with caution, since all surgeries were performed in private institutions and, therefore, the economic burden of these procedures may have been withstood by specific social class patients.INTRODUCTION The delayed diagnosis in emergency surgery can be associated with significant morbidity and mortality and often lead to litigations. The aim of the present work is to analyse the outcome in cases with non-trauma surgical emergencies wrongly admitted in non-surgical departments. METHODS A retrospective trial in two independent University hospitals was conducted. The first group encompassed the patients worked-up in the Surgical unit of Emergency department (2014-2018). The second one included all cases visited Emergency department (2018). Only cases with acute abdomen and delayed diagnosis and operation were included. The analysis included the proportion of the delayed diagnosis, time between admission and operation, intraoperative diagnosis, complications and mortality rate. RESULTS In the first group there were 30 194 visits in the surgical unit with 15 836 hospitalizations (52.4%). Twenty patients of the last (0.13%) were admitted in the Clinic of Infectious disease and subsequently operated. The mean delay between hospitalization and operation was 3 days (1-10). Seventeen patients (85%) were operated with mortality of 10%. In the second group, there were a total of 22 760 visits with 11 562 discharged cases. Of the last, 1.7% (n=192) were re-admitted in a surgical ward, 25 of which underwent urgent surgery (0.2%). CONCLUSIONS The missed surgical cases represent only a small proportion of the patients in emergency department. The causes for wrong initial admissions in our series were misinterpretation of the symptoms, insufficient clinical examination and underuse of US and CT. Epigenetic Reader Domain inhibitor The careful clinical assessment, point-of care US and CT may decrease the rate of the delayed diagnosis.The loss or deficiency of a tissue or organ is a serious health problem and severely affects the patients' quality of life. In the near future, an option for solving this problem will be the development of bio-derived extracellular matrices (ECM) from huPlastic Romaman or animal tissues and their usage for in vitro or in vivo cellular reseeding. Many researchers are working on this development. Nowadays, different decellularization protocols have been developed to manufacture ECMs but there is not yet a consensus about the most efficient procedures. This review aims to describe the state of the art in the field of decellularization of complex mucosal tissues, analizing and comparing the most recent and most valiant articles published about this procedure.BACKGROUND Over the past 25 years, mini-invasive adrenalectomy has become the treatment of choice for most adrenal diseases, and even adrenal malignancies in selected cases. The aim of this retrospective evaluation is to assess the effectiveness of laparoscopic adrenalectomy as a treatment of choice for adrenal metastases. METHODS From 2008 to 2018, 207 laparoscopic adrenalectomies have been performed in our Department of Surgery. Among these, in 12 cases the indication to adrenalectomy was metastatic adrenal lesion. RESULTS The right adrenal gland was removed in 8 cases and the left adrenal gland in 4 cases. A complete resection (R0) was achieved in all patients. The median operative time was 130.6 ± 23.3 min. The median postoperative hospitalization was 3.5±2.0 days. Only one patient showed postoperative grade II complications, according to Clavien-Dindo classification. All patients underwent follow-up at 6-12-18 months without showing disease recurrence. There was no intra and perioperative mortality. Conversion to laparotomic surgery has never been performed. Mean tumor size was 2.4 cm ±1.6 cm. CONCLUSIONS Laparoscopic adrenalectomy for metastasis permits to achieve similar results to the open approach in term of oncological outcomes, but gaining in terms of postoperative hospitalization, intra and post-operative complications as well a greater patient compliance.AIM The purpose of this study is to analyze the outcome of elderly patients with perforated peptic ulcer comparing laparoscopic treatment versus open approach. METHODS In our General and Emergency Surgery Unit in the last 3 years, 20 elderly patients with perforated peptic ulcer were performed. We considered elderly all patients over the age of 65 years (10 females and 10 males; the mean age was 75 years). 16 patients (80%) were submitted to laparoscopic repair with omentoplasty and 4 (20%) to open repair. The patients were classified using the Boye's score which influenced the choice of surgical treatment and the outcoEmergency Romame. The two groups were compared in terms of operative surgery times, complication rate, mortality and postoperative outcomes. DISCUSSION Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The potential advantages of laparoscopy, both in terms of diagnosis and therapy, are clear and the major advantages may be observed in cases with peritonitis secondary as a perforated peptic ulcer where laparoscopy allows the confirmation of the diagnosis, the identification of the position of the ulcer and the repair.