Comparison of Intestinal Stent Placement Followed By Laparoscopic Surgery and Emergency Surgery in Obstructive Colorectal Cancer: A Retrospective Analysis and Meta-analysis

Background: For patients with colorectal cancer and malignant intestinal obstruction, it is still controversial to perform endoscopic intestinal stent placement followed by laparoscopic surgery. This study compares the endoscopic intestinal stent placement followed by laparoscopic surgery and emergency surgery in patients with colorectal cancer and malignant intestinal obstruction.Method: 11 compliant publications from Pubmed, Cochrane and Embase databases were analyzed using Revies Manager 5.2 software. SPSS 21 was used to retrospectively analyze 99 patients admitted to our center from 2014 to 2019.Results: There were significant differences between the two groups in three of the five criteria. In the SBTS group, the perioperative mortality rate was lower, with an OR of 0.46 (95% CI: 0.22-0.95, P=0.04), the incidence of postoperative wound infection was lower; OR was 0.44 (95% CI: 0.24-0.82, P=0.009); Postoperative hospital stay was shorter, MD was -2.07 (95% CI: -2.55--1.59, P<0.00001).Retrospective analysis of the clinical outcome differences between the SBTS group and ES group in our center: Compared to the ES group, the SBTS group displayed lower infection rate of surgical incision (χ2=3.94,P =0.04) ); no difference in the frequency of occurrence of anastomotic leakage (χ2=0.18,P=0.67), did not reduce perioperative mortality (χ2=0.94,P=0.33);shorter operating time (204.13±37.35 min) (t=5.08,P=0.000), lower intraoperative blood loss (155.65±94.90 ml) (t=3.90,P=0.001); and shorter postoperative hospital stay (12.91±5.47 d) (t=2.64, P=0.01).Conclusion: Compared the emergency surgery group, endoscopic intestinal stent placement followed by the laparoscopic surgery can reduce perioperative mortality, postoperative wound infection, intraoperative blood loss, and the length of postoperative hospital stay. There was no difference between the two methods as far as the incidence of posterior anastomotic leakage and operating time were concerned.

Dissection Methods in Abdominoplasty: A Systematic Review and Meta-Analysis

Abdominoplasty is one of the most common cosmetic procedures performed worldwide. Despite recent advances in surgical technique, the risk of complications remains high. The advantages of using various dissection devices as a method of flap elevation in abdominoplasty remains unclear. A systematic search was undertaken to identify studies comparing electrocautery dissection with scalpel dissection and plasma-kinetic energy-based dissection methods in abdominoplasty. A meta-analysis was performed using the selected studies. Seven studies were analyzed. These studies included a total of 1143 patients who underwent abdominoplasty using electrocautery (n = 617), steel scalpel (n = 457), or plasma dissection (n = 69). A meta-analysis was conducted, which showed an overall reduction in incidences of seroma, operative time, and length of hospital stay in the scalpel dissection group compared with the electrocautery group. The plasma dissection group showed a reduction in rate of postoperative wound infection and hematoma, as well as a reduction in drain output and length of hospital stay, compared with the electrocautery group. There are few studies comparing outcomes using different dissection techniques in abdominoplasty. These studies are small and heterogeneous in design. However, using plasma-kinetic energy-based devices or scalpel dissection appears to be associated with reduced complication rates, shorter operative time, lower drain volumes, and a reduction in the length of hospital stay.

ACTIVITY ASSAY OF SOME PROBIOTICS EXTRACT AS ANTI-Pseudomonas aeruginosa THAT ISOLATED FROM POSTOPERATIVE WOUND INFECTION IN ALNAJAF GOVRNORATE -IRAQ

Background and objectives: Probiotics was redefined as “live microorganisms administered in inadequate amount that confer a health profit on the human for that the aim of this study were possibility of using probiotics extract with some supporting substances in antibacterial that resistant antibiotics. Materials and methods:The methods of this study included isolated and identification of bacteria from postoperative wound infection of 50 women subjected to surgical birth process then selected the P.aeruginosa isolates and scanning the sensitivity test of some cephalosporin type of antibiotics and determine the presence of blaOXA-1 gene, also the study had tested activity of two types of probiotics (Bacillus clausii and Saccharomyces boulardii )extract with some supporting substances (acetic acid and citric acid) as antibacterial. Results: The results of identification of bacterial isolates showed that 22(44%) isolates that related to Pseudomonas aeruginosa, 5(10%) isolates related to E.coli, 10(20%) isolates related to Klibsella spp., 10(20%) isolates related to Staphylococcus aureus and 3(6%) isolated related to Protus mirabils, and Overall, 22 isolates of P.aruginosa were analyzed by Kirby Bauer disk diffusion method and notice the resistance or sensitive to cephalexin, cefotriaxon and cefpime where the results confirmed 14 cephalosporin resistant isolates of Pseudomonas aeruginosa. Also detect blaOXA-1 gene by genotypic test. Amplification of b-lactamase genes shows the presence of blaOXA-1 (at 427 bp line) on among (10/22) study isolates. The results of antibacterial activity showed that inhibition zone of probiotics extract only (14and 16)mm to S.bouldarii and B.clausii respectively but it showed synergism effect when supporting the S.bouldarii and B.clausii extract with acetic acid where (18 and 20.3)mm respectively while (19 and 23.5)mm with citric acid respectively with significantly increasing differences when subjecting the bacteria to cefime ,ceftriaxone and cephlaxin antibiotics so,the inhibition zones were(1.3,10.3 and 0)mm respectively. Conclusion :In light of the foregoing, we concluded the possibility of using probiotic extract with some supported substances as an anti-bacterial Pseudomonas aeruginosa isolated from surgical wound infection.

Results of using the infection avoidance Protocol for postoperative wounds in spinal surgery

Background. We developed a Protocol based on the results of a previous study of risk factors for infection of a postoperative wound: do not use monopolar coagulation on the skin and subcutaneous fat; remove hemostatic material from the wound; relax the established wound expander every 65 minutes; refuse to suture the muscles in the area of laminectomy, refuse to use an intradermal suture.The study objective is a verification of the received Protocol.Materials and methods. A comprehensive retrospective cohort study evaluated the results of surgical treatment of 575 spinal patients who were under the authors’ supervision in 2014–2016. Patients were divided into groups: operated in the period from 2014 to 2016 (control group), operated in 2017, in the treatment of which the Protocol for reducing complications was applied (main group).Results. It was found that after the introduction of the Protocol, the percentage of patients with postoperative wound infection decreased from 6.0 to 1.3 %.Conclusion. The resulting Protocol is an effective tool for reducing wound infection and can be recommended for prevention of the postoperative wound infection in patients with spinal with diseases and injuries.

Longitudinal-cross-linking method of the sternum osteosynthesis – an additional way for the prophylaxis of deep sternal infection in cardiac surgery patients

The OBJECTIVE of the study was to compare the results of using the longitudinal – cross-linking method of sternum osteosynthesis with other methods (single wire stitches, 8-shaped wire stitches) for cardiosurgery patients.METHODS AND MATERIALS. The study included 3,150 patients, which were operated on in Samara cardiology dispensary named after V. P. Poliakov from 2012 to 2018. Patients were divided into 2 groups. Group 1 (1397 patients, operated on from 2012 to 2014) used single wire stitches or 8-shaped wire stitches for sternum osteosynthesis. Group 2 (1753 patients, operated from 2015 to 2018) used the longitudinal -cross-linking method of sternum osteosynthesis. The incidence of instability of the sternum without infection, superficial postoperative wound infection, deep sternal infection and hospital mortality were evaluated.RESULTS. Groups (1–68 % of men, average age (59.4±9,9) years; 2–68 % of men, average age 62.3±8.5) were significantly different in obesity patients (25.6 & 29.3 %, p=0.02), amount of smokers (50.5 & 64.2 %, p<0.001) and amount of urgent cases (3 & 10 %, p<0.001). The incidence of sternal instability without infection was less in group 2 (0.64 & 0.29 %; OR, 2.29; 95 % CI, 0.76 to 6.8; p=0.1). The amount of deep sternal infection was significant less in group 2 (1.6 & 0.6 %; OR, 2.53; 95 % CI, 1.2 to 5.2; p=0.009). The hospital mortality was 3.9 % in group 1 and 2.96 % in group 2 (OR, 1.34; 95 % CI, 0.9 to 1.9; p=0.1).CONCLUSION. The longitudinal-cross-linking method of sternum osteosynthesis is the available method that can significantly reduce the incidence of deep sternal infection in cardiosurgery.