bluuebunny/crossref_metadata_2025_split huggingface dataset:
SURGICAL TREATMENT IN RAYNAUD'S DISEASE
Authors: Núñez García B , Álvarez García N , Pérez-Gaspar M , Esteva Miró C , Betancourth Alvarenga J E , Jiménez Gómez J , Santiago Martínez S , Jiménez Arribas P 
Published: May 2021

Abstract

INTRODUCTION
In primary or refractory cases of Raynaud's Disease (RD), with severe symptoms (pain, ulcers, and disability), minimally invasive surgical treatments such as thoracoscopic sympathectomy have recently been proposed.
The objective of this study will be to evaluate the viability, feasibility and results of this therapeutic option in this type of patient.

MATERIAL AND METHODS
Descriptive prospective study from January 2017 to January 2019 where all patients with a diagnosis of RD, with poor clinical control and disability, and refractory to medical treatment are collected.

RESULTS
Seven girls (9-15 years old) were collected. All underwent bilateral thoracoscopic sympathectomy, T2-T4, with a mean surgical time of 55 min. No need for pleural drainage. All of them were discharged before 36 hours after surgery (12-36 hours) without any immediate intra or postoperative complications.
All reported an immediate postoperative period without incident, without new episodes of pain or intense vasoconstriction. However, 6 months after surgery, 3 of the 7 (42.85%) presented partial reappearance of the symptoms. However, the 7 presented 100% satisfaction with the surgical results.

CONCLUSIONS
There are currently very few published studies regarding this surgical option.
We believe that our series is the first pediatric series to be collected, although it is very limited. However, the results obtained to date, in global terms, are encouraging.
We consider that thoracoscopic sympathectomy is a feasible and safe surgical technique to consider in patients with RD refractory to conservative treatment.
CURCUMIN PREVENTING INTESTINAL ISCHEMIA-REPERFUSION INJURY
Authors: Velasco X , Herrero de la Parte B , Palomares T , García-Alonso I 
Published: May 2021

Abstract

INTRODUCTION
Ischemia-reperfusion injury is a clinically relevant process. Several drugs have been tested to prevent or reduce its deleterious effects. Curcumin is a natural substance, common in many diets, known to have antioxidant proprieties. Our aim is to check its capacity to prevent intestinal reperfusion injury.

METHODS
Four groups of six WAG/RijHsd rats (males, 240 g). Three of them had 1 h clamping of the superior mesenteric artery, being sacrificed 4 hours later. One of these groups received no other treatment (control), other was given Curcumin 24h and 2 h prior to ischemia (200 mgr/kg, oral), and the third one was given alpha-Tocopherol 2h prior to ischemia (20 mgr/kg, ip). To assess histological injury four samples from distal ileon were retrieved from each animal. Once embedded in paraffin, histological sections were stained with H-E and blinded, prior to assessing the damage according to Chiu’s scale. Results were analyzed with ANOVA & Dunnet’s and Sidak’s multiple comparison tests.

RESULTS
In healthy animals, over a scale ranging from 0 to 12, the damaged registered was 0.92 ± 0.56. Ischemic control animals showed an index damage of 10.14 ± 1.43, while those receiving Curcumin only reached 6.15 ± 1.71. Animas pre-treated with alpha-Tocopherol showed an even lower index damage: 4.05 ± 0.62. So both treatments significantly reduced histological damage following intestinal reperfusion (p &lt; 0.0001), being slightly bigger the effect of alpfa-Tocopherol (p &lt; 0.05).

CONCLUSION
Curcumin given the day before significantly reduces intestinal reperfusion injury, though it does is as much effective as alpha-Tocopherol pre-treatment.
NEW MOLECULAR RECEPTORS FOR DIAGNOSIS AND THERAPY OF PANCREATIC DUCTAL ADENOCARCINOMA
Authors: Lorenzo Gómez R , Miranda Castro R , García Ocaña M , de los Toyos J R , Barneo L , de los Santos Álvarez N , Lobo Castañón M J 
Published: May 2021

Abstract

INTRODUCTION
Pancreatic ductal adenocarcinoma (PDAC) is one of the cancers with worst prognosis due to the intense desmoplastic reaction that occurs in this disease, which hinders the action of therapeutic agents and contributes to cancer progression. A possible way to develop new strategies for PDAC diagnosis and therapy is the study of the abnormal components of the tumor stroma. However, new receptors capable of detecting these components are needed.

MATERIALS AND METHODS
Two types of molecular receptors, monoclonal antibodies and aptamers, were developed in parallel targeting an extracellular matrix protein with potential as a PDAC marker. Antibodies were generated using mice of the DBA/1J strain, while aptamers were obtained by means of an in vitro selection method called SELEX. The analytical characteristics of the developed receptors were studied by ELISA-like assays, as well as cytochemistry on positive and negative cell lines for the protein of interest.

RESULTS
A total of 44 potential aptamers were identified. After a first bioinformatic screening, 9 candidates were chosen for evaluating their binding affinity in vitro. Two of them showed dissociation constants in the nanomolar range. One of the aptamers also showed specific staining of cells positive for the marker protein, as did one of the generated antibody clones.

CONCLUSIONS
The newly developed receptors have shown a great potential in the study of PDAC. However, their diagnostic and therapeutic usefulness requires a more in-depth evaluation, currently in progress.

ACKNOWLEDGEMENTS
This research was funded by the Spanish Government (RTI-2018-095756-B-I00) and Principado de Asturias Government (IDI2018-000217), co-financed by FEDER funds. R.L.G. thanks the Spanish Government for a predoctoral FPU fellowship (FPU16/05670).
THE MOST REALISTIC SURGICAL SIMULATION MODEL TO GAIN SKILLS IN LAPAROSCOPIC SURGERY IS THE CADAVERIC MODEL THIEL, ACCORDING TO OPINIONS OF DIFFERENT SPECIALIST SURGEONS
Authors: Soler Silva A , Sanchís López A , Sánchez Guillén L , Triguero Cánovas D , López Rodríguez Arias F , Aranaz Ostáriz V , Alcaide Quirós M J , Arroyo Sebastián A 
Published: May 2021

Abstract

INTRODUCTION
Laparoscopic procedures are still a challenge for the surgeon residents and young surgeon physicians. Different learning systems have been used without achieving a realism faithful to the lived in the operation room. All existing surgical simulation systems should be compared, with the aim of identifying the most realistic of them, for improving the surgical learning.

MATERIAL AND METHODS
An 18-item survey was sent to different specialized surgeons (general surgeons, gynecologists and urologists) who participated in international postgraduate laparoscopic surgery courses on cadavers embalmed by Thiel method. Participants were asked to the differences and improving skills in each surgical procedure, about the different surgical simulation models that the participants had already used. Surgeons were asked if they would recommend doing it during residency to improve their confidence in the operating room.

RESULTS
Attendees (n = 104) had a response rate of 92% (96 replies). The 91.8% surgeons recognized that Thiel model was more realistic than others simulation methods. The 97.9 % of respondents believed that had improved their surgical skills. Globally, 96.9% (93) of the participants surveyed recommended the conducting of these courses with Thiel cadavers to different colleagues of other specialties as a reliable simulation measure during the residency period.

CONCLUSIONS
Participants in the laparoscopic surgery course on the cadaver Thiel recognized that this is more realistic surgical simulation model than conventional models, one of the best ways to gain confidence and improve laparoscopic skills in operation room for inexperienced surgeons.
SPLENIC ANGIOGRAPHIC EMBOLIZATION IN IV AND V-GRADE SPLENIC INJURIES. DOES IT WORK? OUR EXPERIENCE ON THE MANAGEMENT OF SPLENIC INJURIES IN THE LAST 14 YEARS
Authors: Lucas Guerrero V , Montmany S , Rebasa P , Luna A , Navarro S 
Published: May 2021

Abstract

INTRODUCTION
Spleen is frequently damaged in abdominal trauma. Patients with splenic injury with hemodynamic instability, peritonism signs or other surgical injuries need emergent surgery. Hemodynamically stable patients are treated conservatively. Splenic embolization is indicated in injuries with blush, pseudoaneurysms or arteriovenous fistulas. It is unclear its indication in IV and V-grade splenic injuries without contrast extravasation.
Our hypothesis is that IV and V-grade splenic injuries embolization decreases conservative treatment failure.

MATERIAL AND METHODS
Retrospective observational study, including all patients with blunt splenic injuries, prospectively included in our registry of polytraumatic patients (&gt;16 years) since 2006.

RESULTS
One hundred and seventy patients have been included since 2006. In 2006-2013, when splenic injuries with active bleeding, pseudoaneurysms or arteriovenous fistulas were embolized, 94 patients were included. 37,2% required surgery and 62,8% conservative treatment. Splenic embolization was performed in 17% of patients who were treated conservatively. Conservative treatment failure was 16,9%: 10 cases out of those who underwent medical treatment (4 required embolization and 6 needed surgery).
From 2014 to the present, when IV and V-grade injuries were included in the indications for embolization, 76 patients have been included. 38,2% required surgery and 61,8% were treated conservatively (40,4% were embolized and the rest were treated medically). One case (3,6%) of those treated medically and another (5,3%) of those embolized failed. Overall failure of conservative treatment was 4,3%.

CONCLUSION
Embolization of IV and V-grade splenic injuries decreases conservative treatment failure from 16,9% to 4,3%.
LONG-TERM OUTCOMES OF TRANSANAL TOTAL MESORECTAL EXCISION FOR RECTAL CANCER
Authors: Labalde Martínez M , Vivas Lopez A , Ocaña Jimenez J , García Villar O , Nevado García C , Narvaez Chavez C , García Borda F J , Ferrero Herrero E 
Published: May 2021

Abstract

INTRODUCTION
Transanal total mesorectal excision (TaTME) for rectal cancer offers a better vision of the dissection planes and facilitates the distal transection of the rectum. The aim of this study was to compare functional outcomes, local recurrence rate y 2-years overall survival and disease free survival rates of TaTME and laparoscopic total mesorectal excision (LPC TME).

MATERIAL AND METHODS
From December 2016 to October 2018, 50 patients (36 males and 14 females) with low rectal cancer and an age of 67 (55.7-75.2) years underwent TME (20 TaTME and 30 LPCTME).

RESULTS
Clinical features and quality indicators for rectal cancer surgery were similar in both groups. After a median follow-up of 35 (30-40) months, low anterior resection syndrome rate was 14% (15% vs 13%, p = 0.043), fecal incontinence rate was 8% (15% vs 3%, p = 0.017) and sexual dysfunction was 8% (15% vs 3%, p = 0.017). Systemic recurrence rate was 10% (15% vs 6%, p = 0.377). One patient presented local recurrence 2 years after TATME. 2-years overall survival rate was 98% (95% vs 100%, p = 0.400) and 2-years disease free survival rate was 90 % (85% vs 93%, p = 0.377).

CONCLUSION
Although 2-years overall survival and disease free survival rates were similar in TaTME and LPC TME group, functional outcomes were worse after TATME in our study.
PREVENTION OF INCISIONAL HERNIA AFTER MIDLINE LAPAROTOMY WITH MODIFICATION OF CLOSURE TECHNIQUE: SYSTEMATIC REVIEW AND META ANALYSIS
Authors: Lozada Hernández E E , Hernández Bonilla J P , Hinojosa Ugarte D 
Published: May 2021

Abstract

INTRODUCTION
Incisional hernia is the main complication after laparotomy, the prevention of this is currently aimed at preoperative rehabilitation, modification of the closure technique and the use of prophylactic mesh. The objective of the study was to measure the effectiveness of the modification in the laparotomy closure technique to reduce the incidence of incisional hernia.

MATERIAL AND METHODS.
A systematic review and meta-analysis were carried out following the PRISMA guidelines. The first objective was to determine the incidence of incisional hernia at one year of follow-up, comparing the modification in the closure technique with the usual closure. The secondary objective was to determine the difference in wound dehiscence and surgical site infection between these two groups. Only clinical trials were included and the random effects method was used for their analysis.

RESULTS
Seven clinical trials were included, comparing 1612 patients, the incidence of incisional hernia was significantly lower in the surgical technique modification group OR 0.55 (95% CI 0.38-79). Efficacy to reduce the incidence of wound dehiscence was also analyzed without finding a difference between the two groups OR 0.58 (95% CI 0.27-1.21). There was no statistically significant difference between both groups when comparing seroma hematoma and surgical site infection.

CONCLUSIONS
The modification in the laparotomy closure technique reduces the incidence of incisional hernia. However, when analyzing globally, only the Small bites and Reinforced tension line techniques contributed to this result.
IS EMERGENCY CHOLECISTOSTOMY STILL VALID IN THE MANAGEMENT OF ACUTE CHOLECYSTITIS? ANALYSIS OF OUR EXPERIENCE IN A SERIES OF 145 PATIENTS
Authors: Pujante Menchón M , Mella Laborde M , Rius Acebes l , Aparicio Navarro J , Morales Calderón M , Compañ Rosique A F 
Published: May 2021

Abstract

INTRODUCTION
Laparoscopic cholecystectomy may not be suited in elderly patients with comorbidities. Our objective is to evaluate whether our indication for cholecystostomy is in accordance with the 2018 Tokio Guidelines and to determine the clinical-epidemiological and analytical characteristics as well as the clinical results depending on the treatment (surgical, conservative or cholecystostomy).

MATERIAL AND METHODS
Retrospective observational study with patients diagnosed with acute cholecystitis between the 25/01/2019 and the 13/03/2020.

RESULTS
Out of 145 patients, 87 (60%) underwent cholecystectomy (average age 63 years), 47 (32,4%) treated conservatively (74,8) and 11 (7,6%) by cholecystostomy (85,8). The multivariate analysis showed that suffering from cardio and cerebrovascular diseases, CKD, taking anticoagulants and altered levels of creatinine, Quick or CRP, multiplies by 5.2, 6.4, 10.9, 4.6, 1.2 and 1.1 the probability of cholecystostomy versus cholecystectomy (p &lt; 0,005). Both the time of admission and of antibiotic treatment was longer in the cholecystostomy group (15.2 and 11.5 days) compared to conservative (7 and 9) and surgical (5.3 and 5.8) (p = 0,000 and p = 0,011). Only one patient in the cholecystostomy group underwent subsequent surgery compared to 50% in the conservative group. The mortality rate did no differ. Out of 11 cholecystostomies, 6 met the Tokio Guidelines criteria.

CONCLUSIONS
1. Patients undergoing cholecystostomy are older, multipathological and present greater systemic involvement (KD, coagulopathy and elevated APR). They require a longer hospital stay and duration of antibiotic treatment.
2. 54,54% of the cholecystostomies performed were adapted to the 2018 Tokio Guidelines.
3. Conservative treatment means higher long-term complication rates.
A NOVEL EXTENSIVE EX-VIVO OCT DATABASE FROM MURINE MODELS OF COLORECTAL CANCER
Authors: Bote J , Ortega-Morán J F , Saratxaga C L , Pagador B , Picón A , Terradillos E , Moreno-Lobato B , Sánchez-Margallo F M 
Published: May 2021

Abstract

INTRODUCTION
New non-invasive technologies for improving early diagnosis of colorectal cancer (CRC) are demanded by clinicians. Optical Coherence Tomography (OCT) provides sub-surface structural information and offers diagnosis capabilities of colon polyps, further improved by machine learning methods. Databases of OCT images are necessary to facilitate algorithms development and testing.

MATERIALS AND METHODS
A database has been acquired from rat colonic samples with a Thorlabs OCT system with 930nm centre wavelength that provides 1.2KHz A-scan rate, 7μm axial resolution in air, 4μm lateral resolution, 1.7mm imaging depth in air, 6mm x 6mm FOV, and 107dB sensitivity. The colon from anaesthetised animals has been excised and samples have been extracted and preserved for ex-vivo analysis with the OCT equipment.

RESULTS
This database consists of OCT 3D volumes (C-scans) and 2D images (B-scans) of murine samples from: 1) healthy tissue, for ground-truth comparison (18 samples; 66 C-scans; 17,478 B-scans); 2) hyperplastic polyps, obtained from an induced colorectal hyperplastic murine model (47 samples; 153 C-scans; 42,450 B-scans); 3) neoplastic polyps (adenomatous and adenocarcinomatous), obtained from clinically validated Pirc F344/NTac-Apcam1137 rat model (232 samples; 564 C-scans; 158,557 B-scans); and 4) unknown tissue (polyp adjacent, presumably healthy) (98 samples; 157 C-scans; 42,070 B-scans).

CONCLUSIONS
A novel extensive ex-vivo OCT database of murine CRC model has been obtained and will be openly published for the research community. It can be used for classification/segmentation machine learning methods, for correlation between OCT features and histopathological structures, and for developing new non-invasive in-situ methods of diagnosis of colorectal cancer.
STUDY OF THE QUALITY OF LIFE AND COSTS OF PATIENTS ON THE WAITING LIST AGAINST PATIENTS UNDERTAKEN FOR BARIATRIC SURGERY
Authors: López Negrete Cueto E , García Santos G , Llosa Pérez J , Carrasco Aguilera B , Díaz Vico T , Moreno Gijón M , Rodicio Miravalles J L , Sanz Álvarez L 
Published: May 2021

Abstract

INTRODUCTION
Bariatric surgery is the only effective long-term treatment for patients with morbid obesity, being the deterioration of the quality of life of these patients one of the main reasons for surgery. In this work, we prospectively analyze the impact of health-related quality of life (HRQoL) and comorbidities among patients who underwent bariatric surgery versus those on the waiting list.

MATERIAL AND METHODS
Between January and December 2017 139 patients (70 operated on and 69 on waiting list) were included in the study, with a 2-year follow-up. Quality of life was measured using the SF-12v2 and IWQoL-Lite questionnaires. Sociodemographic, clinical, and surgical variables were collected. The cost was evaluated through analytical accounting of Diagnosis-Related Groups.

RESULTS
12 and 24 months follow-up showed statistically significant improvement in all areas of the HRQoL in the surgical group (p &lt; 0.001). Likewise, this group showed a reduction in comorbidities and healthcare needs. On the other side, those patients on the waiting list showed a deterioration in most of HRQL parameters. The surgical cost is estimated at 3.558€ per patient.

CONCLUSIONS
Bariatric surgery significantly improves both quality of life and patients’ comorbidities. This, along with the fact that the surgical cost of 3.558€ pays for itself in just two years, could justify a greater investment in these types of procedures as a suitable healthcare strategy.
RELATIONSHIP BETWEEN SURGEON'S PHYSIOLOGICAL AND KINEMATIC PARAMETERS AND THE QUALITY OF SURGICAL PERFORMANCE AND WORKLOAD IN LAPAROSCOPIC TRAINING
Authors: Sánchez-Margallo J A , Castillo Rabazo J , Durán Rey D , López-Agudelo I , González-Portillo M R , Gloor P A , Sánchez-Margallo F M 
Published: May 2021

Abstract

INTRODUCTION
This study presents the first steps and results towards the development of a system for predicting the quality of surgical performance and workload in laparoscopic training.

MATERIAL AND METHODS
Surgeons wore a smartwatch which recorded their heart rate and hand motion during each laparoscopic procedure. Data was then correlated with both the Surgery Task Load Index (SURG-TLX) subjective questionnaire and the Global Operational Assessment of Laparoscopic Skills (GOALS) objective evaluation tool. Statistical analysis was conducted in order to study the relationship between parameters and to compare the results according to the surgeons’ level of experience.

RESULTS
Nine laparoscopic surgeons participated in this study, five gynecologists and four digestive surgeons. Gynecological surgeons showed a positive correlation between their level of experience, heart rate, hand motion, and GOALS score, except for bimanual dexterity. The reduction in the variability of hand accelerations led to improved tissue handling. Digestive surgeons showed a negative correlation between their level of experience and the reported temporal demand and complexity of the procedure. Novice digestive surgeons reported increased workload during surgery, mainly in mental, physical, and temporal workload. In both surgical specialties, it was observed that reduction in surgical workload was associated with improved GOALS score.

CONCLUSIONS
Preliminary results showed that bimanual dexterity is independent of the experience of gynecological surgeons. During laparoscopic surgical procedures, reduced variability in hand accelerations leads to better tissue manipulation. In addition, in gynecological and upper gastrointestinal procedures, reduced surgical workload is associated with improved surgical performance.
PREDICTIVE FACTORS OF INCISIONAL HERNIA AFTER NEPHRECTOMY
Authors: Martínez Izquierdo G , Arnaiz Pérez A R , Escolano Fernández E , Merayo Álvarez M , Carrasco Aguilera B , Ibero Casadiego P , Rodicio Miravalles J L , Molina Escudero R 
Published: May 2021

Abstract

INTRODUCTION
Kidney diseases’ surgical approach is multiple, tending to reduce postoperative complications such as incisional hernia, a complication with an incidence around 5-15% and which usually appears after the first year of surgery, being this the possible trigger of serious pathologies that make essential the need to identify predictive factors of its appearance.

MATERIAL AND METHODS
A retrospective observational study was carried out in 269 patients undergoing nephrectomy (partial or radical) or nephroureterectomy between 2004 and 2018, with the aim of identifying possible predictive factors of incisional hernia after these surgeries. Preoperative (epidemiological and comorbidities), intraoperative (type of surgery, approach and closure, duration) and postoperative data (different possible complications) were taken into account. A univariate and multivariate analysis were performed, using Chi-square test and logistic regression, respectively.

RESULTS
The median follow-up time was 52.2 months (SD = 39.5), time in which 22 patients had an incisional hernia (8.2%), showing this association with preoperative and postoperative variables. As preoperative data COPD, obesity, ASA and a history of previous laparotomy were related in the univariate analysis, while only obesity was associated in the multivariate analysis (p = 0.003); among postoperative items surgical wound infection, postoperative pulmonary complication, seroma and the need for transfusion and reoperation showed association in the univariate analysis, but only surgical wound infection was the one confirmed in the multivariate analysis (p = 0.049).

CONCLUSIONS
Obesity and surgical wound infection were proved to be the main predictive factors for the appearance of incisional hernia after nephrectomy.