Large thoracic duct cyst - a case report and review of the literature

Large thoracic duct cysts are rare and standard lateral thoracotomy is usually used for resection. In the reported case the combination of an antero-lateral thoracotomy with a partial longitudinal median sternotomy (hemiclamshell approach) allowed an excellent visualization and dissection of a large thoracic duct cyst expanding in the anterior cervico-thoracic junction, and was associated with an uncomplicated recover

Routine prophylactic abdominal drainage versus no-drain strategy after distal pancreatectomy: A multicenter propensity score matched analysis

Background: /Objectives Postoperative pancreatic fistula (POPF) remains the most common complication after distal pancreatectomy (DP). Traditionally, surgical drains are placed routinely after DP, but some question its efficacy and postulate that the use of drains may convert a self-limiting postoperative collection into a POPF. This study aimed to compare outcomes between three institutions with varying drainage strategies. Methods: The study is a retrospective propensity score-matched analysis of intraoperative prophylactic drain placement during DP (2010–2019). The primary outcome is major morbidity. Propensity score matching was used to obtain comparable groups. Results: Overall, 963 patients after DP were included. One center did not place a surgical drain routinely, but decided to place a drain when unsatisfactory pancreatic closure occurred. Prophylactic abdominal drains were placed in 805 patients (84%) of which 74 could be matched to 74 patients without a drain. The rate of major morbidity (8% vs 19%, p = 0.054) and radiological interventions (5% vs 12%, p = 0.147) were non-significantly lower in the no-drain group as compared to the prophylactic drain group, respectively. The rates of POPF (4% vs 16%, p = 0.014) were lower in the no-drain group. Conclusion: In this international retrospective multicenter study, a selective no-drain strategy after DP was not associated with higher rates major morbidity or radiological interventions as compared to routine prophylactic abdominal drainage. Although the rate of POPF was lower in the no-drain group, randomized trials should confirm the safety and outcome of a no-drain strategy after DP

Kommentar zum schweizerischen Zivilgesetzbuch /

Cited as Berner Kommentar.Bd. I. Einleitung / erläutert von Max Gmür. Personenrecht / von Ernst Hafter -- Bd. II. Familienrecht: 1. Abt. Das Eherecht / von Max Gmür. 2. Abt. Die Verwandtschaft / von Alfred Silbernagel und P. Wäber. 3. Abt. Die Vormundschaft / von Joseph Kaufmann -- Bd. III. Erbrecht / von Peter Tuor -- Bd. IV. Sachenrecht. 1. Abt. Art. 641-729. 2. Abt. Art. 730-918 / von Hans Leemann. 3. Abt. Art. 919-977 / von Fritz Ostertag -- Bd. V. Schlusstitel. I. Abschnitt von Paul Mutzner. II. Abschnitt von Emil Beck -- Bd. IV. Obligationenrecht. 1. Abt. Allgemeine bestimmungen. 2. Abt. Die einzelnen Vertrags Verhältnisse / von H. Becker. Kommentar zum revidierten Burgschfsrecht / von S Giovanoli -- Bd. VII. Obligationenrecht. 1. Abt. Die Handelsgesellschaften und die Genossenschaft : Kollektiv- und Kommanditgesellschaft / von W. Hartmann. 3. Abt. Die Gesellschaft mit beschränkter Haftung / von A. Janggen und H. Becker. 4. Abt. Handelsregister, Geschaftsfirmen und kaufmannische Buchführung / von Eduard His. 6. Abt. Anleihensobligationen / von A. Ziegler. 7. Abt. Schluss- und Übergangsbestimmungen / von W. Stauffer.Mode of access: Internet

Avalanches in a fluctuationless first-order phase transition in a random-bond Ising model

We study the behavior of the random-bond Ising model at zero temperature by numerical simulations for a variable amount of disorder. The model is an example of systems exhibiting a fluctuationless first-order phase transition similar to some field-induced phase transitions in ferromagnetic systems and the martensitic phase transition appearing in a number of metallic alloys. We focus on the study of the hysteresis cycles appearing when the external field is swept from positive to negative values. By using a finite-size scaling hypothesis, we analyze the disorder-induced phase transition between the phase exhibiting a discontinuity in the hysteresis cycle and the phase with the continuous hysteresis cycle. Critical exponents characterizing the transition are obtained. We also analyze the size and duration distributions of the magnetization jumps (avalanches)