Degradability of cross-linked polyurethanes/chitosan composites

Polyurethanes with synthetic poly([R,S]-3-hydroxybutyrate) in the soft segment and with polycaprolactone triol as cross-linker were blended with chitosan and degraded in hydrolytic and oxidative solutions. Progress of the degradation of the samples was evaluated by changes in their weight, surface topography and thermal properties. Increasing the poly([R,S]-3-hydroxybutyrate) content in soft segment as well as blending with chitosan resulted in an increase in degradability of cross-linked polyurethanes in both solutions.Centre of Polymer and Carbon Materials, Polish Academy of Sciences, University of Wolverhampton, University of the Basque Country (UPV/EHU), Gdynia Maritime Universit

Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography:an international expert consensus

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.]

Esophageal exclusion and bypass for corrosive injury: The lessons learnt

While it is always preferable to excise and replace the diseased esophagus in corrosive injuries, the surgeon may be compelled to exclude and bypass it by a substernal conduit in select situations wherein excision is technically hazardous. This case illustrates the lessons learnt from a potentially life-threatening complication of bipolar esophageal exclusion

Laparoscopic management of hydatid cysts using long ribbon gauze: An initial experience of 37 consecutive cases

Objective: The laparoscopic approach is becoming the standard of care for many surgical disorders. However, in the case of hydatid cysts, laparoscopic management is challenging due to the risk of spillage of hydatid fluid, which can cause an anaphylactic reaction and recurrence. Here, we report our initial experience with laparoscopic partial pericystectomy of hydatid cysts using long ribbon gauze to decrease intra-operative spillage. Method: This was a retrospective study (between January 2010 and December 2021) in the Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, a tertiary care referral center in northern India. Here, we have included 37 consecutive patients with hydatid cysts of the liver and spleen. Diagnosis was made by laboratory and imaging findings (abdominal sonography or contrast enhanced CT scans). All patients were managed with laparoscopic partial pericystectomy. Intraoperatively, a betadine-soaked long ribbon gauze, high-pressure suction canula, and an endo-bag were used in all patients. The collected data included patient demography, location, size, and number of cysts, WHO type, operative time, blood loss, postoperative complications, hospital stay and follow-up. Result: In our series, the mean age was 38.4 ± 13.6 years, 15 (40.5%) were men and 22 (59.5%) were women. The right lobe of the liver was the most commonly affected site (21, 56.8%). The mean operative time was 80.0 ± 32.0 min, and intraoperative blood loss was 23.6 ± 11.5 mL. Bile leak was present in 6 (16.2%) patients. There was no mortality. The hospital stay was 5 (3, 9) days, and no recurrence was observed at a median follow-up of 36 months. Conclusion: Laparoscopic partial pericystectomy using this technique is safe in the management of hydatid cysts. Simply, proper packing and safe removal of soaked gauzes can minimize the incidence of postoperative complications and recurrence

Anterior resection for rectal carcinoma - risk factors for anastomotic leaks and strictures

AIM: To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection (AR) and its subsequent management