Control of severe portal bleeding by carrier-bound fibrin sealant

Bleeding during liver surgery and liver transplantation (LT) can be caused by coagulation disorders, portal vein hypertension, and adhesions from previous surgical procedures. We describe here how we controlled life-threatening bleeding from a portal vein anastomosis during a third cadaveric LT, by using a carrier-bound sealant (TachoSil). This technique proved effective to control severe anastomotic portal bleeding in this situation. It represents a helpful option in the field of LT, when vascular bleeding cannot be stopped by other method

Localization Recall Precision (LRP): A New Performance Metric for Object Detection

Average precision (AP), the area under the recall-precision (RP) curve, is the standard performance measure for object detection. Despite its wide acceptance, it has a number of shortcomings, the most important of which are (i) the inability to distinguish very different RP curves, and (ii) the lack of directly measuring bounding box localization accuracy. In this paper, we propose 'Localization Recall Precision (LRP) Error', a new metric which we specifically designed for object detection. LRP Error is composed of three components related to localization, false negative (FN) rate and false positive (FP) rate. Based on LRP, we introduce the 'Optimal LRP', the minimum achievable LRP error representing the best achievable configuration of the detector in terms of recall-precision and the tightness of the boxes. In contrast to AP, which considers precisions over the entire recall domain, Optimal LRP determines the 'best' confidence score threshold for a class, which balances the trade-off between localization and recall-precision. In our experiments, we show that, for state-of-the-art object (SOTA) detectors, Optimal LRP provides richer and more discriminative information than AP. We also demonstrate that the best confidence score thresholds vary significantly among classes and detectors. Moreover, we present LRP results of a simple online video object detector which uses a SOTA still image object detector and show that the class-specific optimized thresholds increase the accuracy against the common approach of using a general threshold for all classes. At https://github.com/cancam/LRP we provide the source code that can compute LRP for the PASCAL VOC and MSCOCO datasets. Our source code can easily be adapted to other datasets as well.Comment: to appear in ECCV 201

Emergency Left Colon Resection for Acute Perforation. Primary Anastomosis or Hartmann's Procedure? A Case-matched Control Study

Background: The optimal treatment remains controversial for acute left-sided colon perforation. Therefore, the effectiveness and safety of primary anastomosis versus Hartmann's operation (HP) was compared in a case-matched control study. Methods: Thirty consecutive patients with primary anastomosis and protective ileostomy (PAS) were matched to 30 HP patients, controlling for age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), and peritonitis severity (Hinchey). In a second analysis, PAS patients with purulent peritonitis (Hinchey 3) were matched to patients with primary anastomosis without ileostomy (PA). Results: Hospital mortality was similar between HP (17%) and PAS (10%). Complication frequency and severity (requiring re-intervention or admission to the Intensive Care Unit [ICU]) were comparable for the first operation (60% versus 56% and 30% versus 32%). The stoma reversal rate was higher in PAS than in HP (96% versus 60%, p=0.001), with significantly fewer complications (23% versus 66%, p=0.02), and lower severity (7% versus 33%, p=0.02). Additional analysis of PAS versus PA showed similar morbidity (52% versus 41%, p=0.45) and complication severity (18% versus 24%, p=0.51), whereas overall operation time and hospital stay were significantly shorter in PA (169 versus 320 min, p=0.003, 17 versus 28 days, p<0.001). Conclusions: Primary anastomosis and protective ileostomy is a superior treatment to HP in acute left-sided colon perforation. In the absence of feculent peritonitis an ileostomy appears unnecessar