Lohseskafte1022

Despite the use of blue dye and radioisotopes, sentinel lymph node biopsy (SLNB) is still associated with a high false-negative rate (FNR). The off-label use of indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging has been introduced with the objective of assisting SLNB and thereby improving regional control in melanoma. The objective of this study was to review and summarize the general experience, protocols and outcomes of the use of ICG and NIRF to assist SLNB in melanoma.

A systematic literature review was performed in December 2019 as per the PRISMA guidelines. Inclusion criteria were articles written in English describing the applications of ICG in patients with melanoma. buy CQ211 Systematic reviews, animal studies, case reports and letters to editors were excluded.

Of the 585 studies retrieved, 13 articles met the inclusion criteria. The reported sentinel lymph node (SLN) detection rate using ICG was between 86 and 100% of nodes identified by lymphoscintigraphy. The average number of nodes per patient detected using ICG was 2. ICG fluorescence imaging contributed to the identification of 2.0% of the total number of SLNs harvested.

ICG fluorescence may be a useful adjunct to lymphoscintigraphy, although high-level comparative data is lacking. It was found to be superior to blue dye at detecting sentinel lymph nodes.

ICG fluorescence may be a useful adjunct to lymphoscintigraphy, although high-level comparative data is lacking. It was found to be superior to blue dye at detecting sentinel lymph nodes.

The purpose of this study was to evaluate a series of retrieved sleeved ceramic femoral heads used in total hip arthroplasty (THA) and determine qualitative and quantitative damage and corrosion patterns.

An IRB-approved implant retrieval database was utilized to identify all sleeved ceramic femoral heads collected from 1995 to 2004. There were 16 implants with an average duration of in situ of 70 months (range, 13-241 months). The femoral stem was known in 14 cases and was titanium alloy in each of those cases. None were revised for metal-related complications. Ten implants (63%) were from primary THAs, and 6 (38%) were from revision THAs. Damage and corrosion were qualitatively graded using a modified Goldberg method. A quantitative assessment was performed with a coordinate measurement machine (CMM).

Among the 16 retrieved implants, 1 (6%) demonstrated severe Grade 4 corrosion, 5 (31%) had moderate Grade 3 corrosion, 5 (31%) had mild Grade 2 corrosion, and 5 (31%) had no visible corrosion at the inner sleeve that interfaces with the stem trunnion. The only case of grade 4 corrosion occurred in the only head-sleeve in the study that was not factory assembled and was mated with a titanium molybdenum zirconium ferrous (TMZF) alloy stem. The mean maximum linear corrosion depth at the taper interface, as measured by the CMM, was 7.7 microns (range, 0.9-32.9 microns).

This study is the first to quantify corrosion at the titanium interface of sleeved ceramic femoral heads. Potentially clinically significant damage and corrosion patterns were observed in a few failed retrievals; however, the majority of cases demonstrated minimal or no damage.

This study is the first to quantify corrosion at the titanium interface of sleeved ceramic femoral heads. Potentially clinically significant damage and corrosion patterns were observed in a few failed retrievals; however, the majority of cases demonstrated minimal or no damage.

The aim of this study is to evaluate medical and surgical complications of liver cirrhosis patients following total hip arthroplasty (THA), with attention to different etiologies of cirrhosis and their financial burden following THA.

In total, 18,321 cirrhotics and 722,757 non-cirrhotics who underwent primary elective THA between 2006 and 2013 were identified from a retrospective database review. This cohort was further subdivided into 2 major etiologies of cirrhosis (viral and alcoholic cirrhosis) and other cirrhotic etiology. Cirrhotics were compared to non-cirrhotics for hospital length of stay, 90-day mean total charges and reimbursement, hospital readmission, and major medical and arthroplasty-specific complications.

Cirrhosis was associated with increased rates of major medical complications (4.3% vs 2.4%; odds ratio [OR] 1.20, P < .001), minor medical complications, transfusion (3.4% vs 2.1%; OR 1.16, P= .001), encephalopathy, disseminated intravascular coagulation, and readmission (13.5% vs 8s and healthcare utilization following elective THA.

Postoperative pancreatic fistula/POPF is the most feared complication in pancreatic surgery. Although several systematic reviews investigated the impact of somatostatin analogues on POPF, no stratification was performed regarding type of pancreatic resection (pancreaticoduodenectomy/PD; distal pancreatectomy/DP) and different somatostatin analogues.

This study was planed according to the Preferred-Reporting-Items-for-Systematic -Review-and-Meta-Analysis/PRISMA-guidelines. After screening databases for randomized controlled trials/RCT, studies were stratified into pancreatic resection techniques and data were pooled in meta-analyses containing subgroups of octreotide, somatostatin, lanreotide, pasireotide and vapreotide.

The meta-analysis of studies with a mixed cohort of patients after pancreatic resection revealed a protective effect of somatostatin analogues for morbidity (RR 0.71, p<.00001) but not for mortality (RR 1.07,=0.78) or intra-abdominal abscesses (RR 1.00, p=1.00). Moreover, no effect was visible for mortality (RR 1.57, p=.15), morbidity (RR 0.87, p=.15) and intra-abdominal abscesses (RR 0.92, p=.48) after PD. The meta-analysis of patients after PD revealed no impact of somatostatin analogues on POPF (RR 0.87, p=.19) and clinically relevant POPF (RR 0.69, p=.30). However, treatment with somatostatin analogues in the mixed cohort showed less POPF (RR 0.60, p<.00001) and clinically relevant POPF (RR 0.47, p=.02), which was also the case after DP (RR 0.41, p=.03).

Somatostatin analogues did not affect POPF and clinically relevant POPF after PD, but seemed to be associated with less POPF after DP. As no sufficiently powered RCT could be identified by the systematic review, further RCTs are urgently needed to investigate the effect of somatostatin analogues after DP.

CRD42018099808.

CRD42018099808.