Ashbyzamora8533

It remains controversial whether the advantages of laparoscopic surgery for colorectal cancer (CRC) are beneficial in elderly patients (EP, age ≥ 80years). The present study aimed to evaluate whether age itself is an independent risk factor for laparoscopic surgery by comparing short- and long-term outcomes between non-EP and EP groups.

We retrospectively analyzed 730 consecutive patients with stage I-III CRC who had undergone elective surgery between 2010 and 2017, using propensity score-matched analysis.

Median follow-up was 49months. After matching, we enrolled 228 patients. In the matched cohort, estimated operative time, estimated blood loss, lymph node dissection ≥ D3, number of lymph nodes harvested < 12, conversion rate, multivisceral resection rate, postoperative complication rate, and length of postsurgical stay were similar between the two groups. Before matching, compared with the non-EP group, the EP group had significantly shorter overall survival (OS) (p < 0.01), cancer-specific survival (CSS) (p < 0.01), recurrence-free survival (RFS) (p < 0.01), and higher frequency of local recurrence (LR) (p = 0.01); however, there was no significant difference in terms of incidence of LR or CSS between the two groups in the matched cohort. click here Prior to matching, multivariate analysis identified age ≥ 80years as an independent prognostic factor for OS (p < 0.01), CSS (p < 0.01), and RFS (p = 0.01); however, after matching, age ≥ 80years was not an independent poor prognostic factor for OS or CCS.

Laparoscopic surgery offers a safe, effective option for CRC in EP aged ≥ 80years.

Laparoscopic surgery offers a safe, effective option for CRC in EP aged ≥ 80 years.

Access to surgery is a challenge for low-income countries like Malawi due to shortages of specialists, especially in rural areas. District hospitals (DH) cater for the immediate surgical needs of rural patients, sending difficult cases to central hospitals (CH), usually with no prior communication.

In 2018, a secure surgical managed consultation network (MCN) was established to improve communication between specialist surgeons and anaesthetists at Queen Elizabeth and Zomba Central Hospitals, and surgical providers from nine DHs referring to these facilities.

From May to December 2018, DHs requested specialist advice on 249 surgical cases through the MCN, including anonymised images (52% of cases). Ninety six percent of cases received advice, with a median of two specialists answering. For 74% of cases, a first response was received within an hour, and in 68% of the cases, a decision was taken within an hour from posting the case on MCN. In 60% of the cases, the advice was to refer immediately, in 26% not to refer and 11% to possibly refer at a later stage.

The MCN facilitated quick access to consultations with specialists on how to manage surgical patients in remote rural areas. It also helped to prevent unnecessary referrals, saving costs for patients, their guardians, referring hospitals and the health system as a whole. With time, the network has had spillover benefits, allowing the Ministry of Health closer monitoring of surgical activities in the districts and to respond faster to shortages of essential surgical resources.

The MCN facilitated quick access to consultations with specialists on how to manage surgical patients in remote rural areas. It also helped to prevent unnecessary referrals, saving costs for patients, their guardians, referring hospitals and the health system as a whole. With time, the network has had spillover benefits, allowing the Ministry of Health closer monitoring of surgical activities in the districts and to respond faster to shortages of essential surgical resources.

Esophageal lipomatous tumors, also reported as fibrovascular polyp, fibrolipoma, angiolipoma, and liposarcoma, account for less than 1% of all benign mesenchymal submucosal tumors of the esophagus. Clinical presentation and therapy may differ based on location, size, and morphology. A comprehensive and updated systematic review of the literature is lacking.

A systematic review of the literature was performed according to PRISMA guidelines. Pubmed, Embase, Cochrane, and Medline databases were consulted using MESH keywords. Non-English written articles and abstracts were excluded. Sex, age, symptoms at presentation, diagnosis, tumor location and size, surgical approach and technique of excision, pathology, and morphology were extracted and recorded in an electronic database.

Sixty-seven studies for a total of 239 patients with esophageal lipoma or liposarcoma were included in the qualitative analysis. Among 176 patients with benign lipoma, the median age was 55. The main symptoms were dysphagia (64.2%), t. Minimally invasive transoral and laparoscopic/thoracoscopic techniques represent the therapeutic approach of choice.Bradycardic arrhythmias have a broad spectrum of symptoms which range from mild dizziness to cardiac syncope. Pacemaker therapy continues to be the cornerstone of treatment and can effectively treat symptoms. Despite an implanted cardiac pacemaker, patients may experience continued or even new symptoms. We report on a 73-year-old woman with postoperative new palpitations due to a very rare intraoperative complication.The loss of a guidewire in the subclavian vein represents an unpleasant complication during pacemaker implantation with venous access by puncture in Seldinger's technique. Using another venous puncture and a gooseneck snare, this problem can be solved quickly and without any trace.A bacterial strain, designated 17J36-26T, was isolated from the UV-irradiated soil from Jeju Island, South Korea. Cells are Gram negative, strictly aerobic, non-motile, non-spore forming, rod shaped, and catalase and oxidase positive. The major fatty acids of strain 17J36-26T were summed feature 4 (171 iso I/171 anteiso B), summed feature 3 (161 ω6c/161 ω7c), C161 ω5c and iso-C150. The polar lipid profile contained phosphatidylethanolamine, unidentified aminophospholipid, phospholipids and four unidentified lipids. The G+C content of the strain 17J36-26T was 62.6 mol%. The 16S rRNA gene sequence analysis showed that strain 17J36-26T was phylogenetically related to Hymenobacter qilianensis DK6-37T and Hymenobacter roseosalivarius AA718T (97.5% and 96.8% sequence similarity, respectively). Strain 17J36-26T showed resistance to UV radiation. Both average nucleotide identity (ANI) and in silico DNA-DNA hybridization (isDDH) values between strains 17J36-26T and type strains of Hymenobacter species were lower than the cut-off (≥ 95-96% for ANI and ≥ 70% for isDDH) to define a bacterial new species.