Missed Gallstones in the Bile Duct and Abdominal Cavity: A Case Report

WOS: 000258504600027PubMed: 1871977

Surgeon-performed intraoperative ultrasonography-guided excision of nonpalpable breast masses with adequate surgical margins under local anaesthesia

WOS: 000317861600006Aim With the improvement of expertise in technique and skills of ultrasonography (US), many surgeons now perform image-guided procedures for breast masses themselves. To minimize operative time, and to achieve adequate surgical margins with an acceptable cosmetic outcome, we designed a safe and simple hybrid technique to excise suspicious nonpalpable masses, which is described herein for the first time. Patients and Methods Intraoperatively-marked incision is performed, and a needle is advanced at a 0.5-cm distance to the lesion according to real-time ultrasound measurements. Four deep sutures are passed to fix and hang the predicted specimen adjacent to the needle in four directions. En bloc excision with aimed surgical margins of approximately 0.5cm is achieved by means of retracting sutures, and confirmed by specimen and tumour bed US. Results In the present study, there were 25 women (17 with malignant and 8 with benign lesions), with a mean age of 50.88 years (range: 3069) and mean tumour diameter of 10.6mm (range: 615). All lesions were correctly identified and localized by intraoperative US, and free margins of excision were obtained in all malignant lesions by means of the presented technique. The combined operative technical approach with surgeon-performed intraoperative US-guided needle placement and retracting sutures were feasible, simple and beneficial. We achieved complete tumour removal in all dimensions with no reexcision. The procedure was performed under local anaesthesia in an outpatient fashion with no complications. Conclusion Our report of the operative technique demonstrates that a combination of surgeon-performed image-guided localizations, together with a suture-oriented fashion to assure negative surgical margins in all dimensions, improves margin clearance rate at the time of first surgical intervention. This method can be performed with operative and cost efficiency, and might become a valuable tool to minimize operative time and yield minimal sacrifice of normal breast tissue with maximal cosmetic outcome

Short-term effects of sleeve gastrectomy on weight loss and diastolic function in obese patients

Objective: Bariatric surgery has been shown to improve cardiac structure and function in obese patients. This study was an examination of the short-term effects of sleeve gastrectomy on body measurements and diastolic function

Protective effect of erythropoietin against lipid peroxidation on a renal ischemia and reperfusion injury model

44th ERA-EDTA Congress -- JUN 22-24, 2007 -- Barcelona, SPAINWOS: 000253320600686ERA-EDT

The contribution of extrarenal tissues to oxidative stres, in an experimental model of renal ischemia and reperfusion injury

44th ERA-EDTA Congress -- JUN 22-24, 2007 -- Barcelona, SPAINWOS: 000253320600679ERA-EDT

Oxidized LDL accumulation in experimental renal ischaemia reperfusion injury model

43rd ERA-EDTA Congress -- JUL 15-18, 2006 -- Glasgow, SCOTLANDWOS: 000239919002077ERA, EDT

Diagnostic adequacy of surgeon-performed ultrasound-guided fine needle aspiration biopsy of thyroid nodules

WOS: 000313708600017PubMed: 22766655Background Surgeon-performed ultrasonography (US) of thyroid nodules might serve as a potential therapeutic guide to designate accurate surgical or clinical intervention. Objective To evaluate the diagnostic adequacy of surgeon-performed ultrasonography guided fine needle aspiration biopsy (FNAB) of thyroid nodules, the factors responsible for diagnostic adequacy and the impact of surgeon-performed US on treatment approach. Methods Retrospective review of a single surgeon performed 621 US-guided FNABs without on-site cytological specimen assessment. Outside US findings were compared to the surgeon-performed US. Measured variables and outcomes for the study included diagnostic adequacy rates and the effects of detected differences between US reports on treatment variability. Results Diagnostic adequacy rate of surgeon-performed US-guided FNAB was determined to be 94.52% without on-site specimen evaluation by cytologist. Non-diagnostic specimens occurred in 34 of 621 (5.48%) nodules. The differences detected between the outside US and surgeon-performed US altered invasive treatment algorithm in 30 (5.47%) patients. FNAB was avoided for 15 (2.7%) patients. Total thyroidectomy became the preferred surgical option in 15 (2.7%) patients after the discovery of additional nodules in the contralateral lobe. Conclusion Surgeon-performed US offers clear clinical benefits in terms of diagnostic yield of FNAB with providing valuable additional data that might alter surgical treatment approach. J. Surg. Oncol. 2013;107:206210. (c) 2012 Wiley Periodicals, Inc