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Prognostic and Predictive Clinicopathologic Factors of Squamous Anal Canal Cancer in HIV-Positive and HIV-Negative Patients: Does HAART Influence Outcomes?
ConclusionIn our small series, HIV infection was not associated with a significantly higher relapse rate or worse 5-year OS among patients with anal SCC. HAART was associated with a higher rate of relapse in HIV-positive patients. AJCC staging predicted survival in both relapsed and non-relapsed patients regardless of HIV status. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Operative Results and Oncologic Outcomes of Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Versus Two-Stage Hepatectomy (TSH) in Patients with Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-Analysis
ConclusionWhile ALPPS may be a suitable approach for patients, the higher morbidity and mortality should be considered when determining the operative approach for patients with extensive CLM. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Preoperative Albumin –Bilirubin Grade Predicts Recurrences After Radical Gastrectomy in Patients with pT2-4 Gastric Cancer
This study included 283 patients who underwent radical gastrectomy for pT2-4 GC without preoperative treatment. ALBI was calculated as follows: (log10 bilirubin ( μmol/L) × 0.66) + (albumin (g/L) × −0.0852) and categorized into grades 1 (≤−2.60), 2 (−2.60
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Recovery of Voice After Reconstruction of the Recurrent Laryngeal Nerve and Adjuvant Nimodipine
ConclusionsIn this cohort study, we report the results of the first 19 consecutive cases at our center subjected to reconstruction of the RLN and adjuvant nimodipine treatment. The outcome of the current strategy is encouraging and should be considered after iatrogenic RLN transection injuries. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Response to Letter to the Editor, Regarding Hardcastle TC, Muckart DJJ, Maier RV. Ventilation in Trauma Patients: The First 24  h is Different! World Journal of Surgery 2017;41(5):1153–1158
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

External Validation of a Tube Thoracostomy Complication Classification System
ConclusionsDespite being developed in the USA, this classification system is robust and was able to comprehensively assign and categorize all the complications of TT in this South African trauma cohort. A universal standardized definition and classification system permits equitable comparisons of complication rates. The use of this classification taxonomy may help develop strategies to improve TT placement techniques and reduce the complications associated with the procedure.Level of evidenceV.Study typeSingle Institution Retrospective review. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Overall Survival of Papillary Thyroid Carcinoma Patients: A Single-Institution Long-Term Follow-Up of 5897 Patients
ConclusionsThe most important prognostic value for OS was patient age, indicating that PTC is generally indolent. However, the control of distant metastasis in older patients remains a future challenge in order to further improve their OS and CSS. PTC of ≥3 cm in young patients should be carefully followed, even in the absence of metastases, and these patients should undergo aggressive therapies for recurrent lesions and metastases. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Diagnostic and Prognostic Role of 18-FDG PET/CT in the Management of Resectable Biliary Tract Cancer
ConclusionPET/CT is a reliable imaging modality for metastatic lymph node detection in cholangiocarcinoma. Tumour SUV-max is an independent factor for oncological outcomes in patients with resectable disease. For patients who have TNM stage I or II cholangiocarcinoma, tumour SUV-max over 8 is associated with significantly inferior disease-free and overall survival even after curative resection. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Early Versus Delayed Source Control in Open Abdomen Management for Severe Intra-abdominal Infections: A Retrospective Analysis on 111 Cases
ConclusionEarly source control using OA management significantly improves outcome of patients with severe IAIs. This damage control approach well fits to the treatment of time-related conditions, particularly in case of critically ill patients. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Compartment Pressure Monitoring After Thyroid Surgery: A Possible Method to Detect a Rebleeding
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Acute Appendicitis: Still a Surgical Disease? Results from a Propensity Score-Based Outcome Analysis of Conservative Versus Surgical Management from a Prospective Database
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Is Laparoscopy Really Advantageous for Splenectomy Patients?
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 6, 2018 Category: Surgery Source Type: research

Defining Early Recurrence of Hilar Cholangiocarcinoma After Curative-intent Surgery: A Multi-institutional Study from the US Extrahepatic Biliary Malignancy Consortium
The objective of the current study was to investigate risk factors and prognosis among patients with early versus late recurrence of hilar cholangiocarcinoma (HCCA) after curative-intent resection.MethodsA total of 225 patients who underwent curative-intent resection for HCCA were identified from 10 academic centers in the USA. Data on clinicopathologic characteristics, pre-, intra-, and postoperative details and overall survival (OS) were analyzed. The slope of the curves identified by linear regression was used to categorize recurrences as early versus late.ResultsWith a median follow-up of 18.0  months, 99 (44.0%) ...
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

Data Improvement Through Simplification: Implications for Low-Resource Settings
ConclusionsIt is assumed that the most granular data and use of the largest number of variables for risk-adjusted predictions will increase accuracy. This complexity is often at the expense of utility. Using the single best predictor in surgical outcomes research, we have shown this is not the case.  In this example, we demonstrate that one can simplify ASA into a 3-category variable without losing any ability to predict outcomes. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

A Novel Indocyanine Green Fluorescence-Guided Video-Assisted Technique for Sentinel Node Biopsy in Breast Cancer
AbstractBackgroundThe equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique.MethodsThe technique for detecting SLN was radioisotope (RI) in 194 cases, video-assisted ICG-guided in 70 cases and a combined method in 71 cases. In the video-assisted ICG group, a full...
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

Acute Limb Ischemia Secondary to Native Artery Occlusion: Results of a Contemporary Case Series
ConclusionsRegardless of excellent limb salvage rates, patients currently suffering from an ALI are, when compared to previous studies, older than before and with an increased rate of mortality. Risk factors do not appear to be modifiable once the ALI appears so prevention strategies should be aimed to avoid the episode. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

Welcome New Associate Editor Anthony Kim to the World Journal of Surgery
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

Commentary on Burke TF et al. “Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya when No Anesthetist is Available: An Analysis of 1216 Consecutive Operative Procedures”
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 5, 2018 Category: Surgery Source Type: research

Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya When No Anesthetist is Available: Reply
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 2, 2018 Category: Surgery Source Type: research

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): Trading Six for a Risky Half Dozen: Reply
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 2, 2018 Category: Surgery Source Type: research

Neonatal Gastric Perforation: Case Series and Literature Review
ConclusionsThe mortality of neonatal gastric perforation is constantly decreasing. Associated gastrointestinal anomalies and the presence of musculature are found in a minority of this condition. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 1, 2018 Category: Surgery Source Type: research

Impact of 3D Printing Technology on Comprehension of Surgical Anatomy of Retroperitoneal Tumor
ConclusionThree-dimensional printed model improved the understanding of surgical anatomy of retroperitoneal tumor. (Source: World Journal of Surgery)
Source: World Journal of Surgery - February 1, 2018 Category: Surgery Source Type: research

Assessing Risk Factors for Intubation Difficulty in Thyroid Surgical Patients
(Source: World Journal of Surgery)
Source: World Journal of Surgery - February 1, 2018 Category: Surgery Source Type: research

A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved
This study aimed to validate those findings utilizing a larger, multi-institutional cohort.MethodsA retrospective review was performed of patients with PA who underwent AVS from 2 tertiary-care institutions. Laterality was predicted by an A/C ratio of>3:1 between the dominant and non-dominant adrenal. AVS results were compared to LAV/IVC ratios utilizing the published criteria (Lt  ≥ 5.5; Rt ≤ 0.5).ResultsOf 222 patients, 124 (57%) had UNI and 98 (43%) had BIL disease based on AVS. AVS and LAV/IVC findings were concordant for laterality in 141 (64%) patients (69 UNI, 72 BIL). Using only the LAV...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Trauma Leagues —A Novel Option to Attract Medical Students to a Surgical Career
ConclusionParticipation in Trauma League has been an effective strategy to encourage medical students to choose a career in general surgery in Campinas, Brazil. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Less is More: The Impact of Multidisciplinary Thyroid Conference on the Treatment of Well-Differentiated Thyroid Carcinoma
This study assessed the clinical impact of a MDTC on radioactive iodine (RAI) treatment patterns.MethodsA prospective database (2003 –2014) collected patient and tumor characteristics, RAI doses, and tumor recurrences. Patients treated with total thyroidectomy for differentiated thyroid carcinoma ≥1 cm were stratified based on American Thyroid Association (ATA) risk classification. RAI regimens were compared before initiatio n of MDTC (2003–2005,n = 88), after establishment of MDTC (2007–2009,n = 95), and after the release of 2009 ATA guidelines (2011–2014,n = 1...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Lymph Node Evaluation in Robot-Assisted Versus Video-Assisted Thoracoscopic Esophagectomy for Esophageal Squamous Cell Carcinoma: A Propensity-Matched Analysis
ConclusionsCompared with VATE, RATE resulted in a higher lymph node yield along the left RLN without increasing morbidity. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Feasibility of Preoperative Axillary Lymph Node Marking with a Clip in Breast Cancer Patients Before Neoadjuvant Chemotherapy: A Preliminary Study
ConclusionImage-guided marker-clip placement on positive ALNs before NAC and removal with SLNB is technically feasible. This technique can improve the accuracy of the residual disease evaluation on the axilla, especially in patients with negative SLNB results, and can identify candidates for limited axillary surgery after NAC. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Development of Severe Hyperparathyroidism Despite Short-Term Renal Replacement Therapy
AbstractBackgroundWe occasionally experience cases of severe secondary hyperparathyroidism (SHPT) that require parathyroidectomy (PTX) despite undergoing short-term renal replacement therapy (RRT). Because the characteristics of such cases have never been discussed, we aimed to elucidate the pathophysiology of severe SHPT after short-term RRT by retrospectively analyzing clinical data.MethodsA total of 1013 patients with severe SHPT underwent PTX between January 2007 and April 2016 at Nagoya Daini Red Cross Hospital. Of these patients, 570 underwent RRT for ≥10 years (long RRT group) and 23 for ≤1 year (sho...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Surgery for Primary Hyperparathyroidism with Normal Non-suppressed Parathyroid Hormone can be Both Challenging and Successful
AbstractBackgroundCriteria for diagnosing primary hyperparathyroidism (PHPT) include hypercalcemia in the presence of parathyroid hormone (PTH) levels that are either elevated (classic PHPT) or normal but non-suppressed. However, there is no standard definition of what constitutes normal non-suppressed levels, and data are lacking regarding the potential for surgical cure in these patients.MethodsA retrospective review of patients undergoing parathyroidectomy for sporadic PHPT between 2012 and 2014 was performed. Patients with normal PTH were compared to classic PHPT patients to assess demographics, imaging, operative find...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Radioembolization Versus Bland Embolization for Hepatic Metastases from Small Intestinal Neuroendocrine Tumors: Short-Term Results of a Randomized Clinical Trial
ConclusionHAE resulted in significantly higher RECIST response after 3  months, but no difference compared to RE remained after 6 months. These preliminary findings indicate that HAE remains a safe option for the treatment of liver metastases from SI-NET, and further studies are needed to establish the role of RE and the predictive value of MR-DWI. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Surgical Resources in South Africa: An International Comparison and Deficit Calculation
ConclusionStrengthening surgical systems will reduce the surgical burden of disease and improve health outcomes globally. This description of surgical infrastructure and workforce provided insight into the surgical capacity of South Africa. Furthermore, this research provided a comparison of surgical resources between South Africa and the rest of the world. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

Refining the Definitions of Biochemical and Clinical Cure for Primary Aldosteronism Using the Primary Aldosteronism Surgical Outcome (PASO) Classification System
AbstractIntroductionDetermination of outcomes after adrenalectomy for primary aldosteronism (PA) is limited by the lack of standardized definitions of cure. The Primary Aldosteronism Surgical Outcomes (PASO) group recently established new consensus definitions for biochemical and clinical cure of PA. We hypothesize that utilization of PASO definitions will better stratify patient outcomes after surgery compared to original and current criteria utilized to document cure.Materials and MethodsPatients undergoing adrenalectomy for PA from 1996 to 2016 were studied. Clinical data were reviewed. Three different sets of criteria ...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

An Evolving Understanding of the Clinical Implications of NIFTP
(Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

The Hair in the Sinus: Sharp-Ended Rootless Head Hair Fragments can be Found in Large Amounts in Pilonidal Sinus Nests
AbstractPurposeHair has been identified as the causative agent of Pilonidal Sinus Disease (PSD). Stiffer, dark hair as well as hairiness has been postulated as causative factors. Astonishingly, despite the early clinical significance of this condition (Hodges in Boston Med Surg J 2:485 –486,1880), macroscopic and microscopic examinations of hair inside pilonidal sinus cavities have been scarce. The purpose of this study was to study the morphological aspects of the hair found in PSD in order to determine the origin of the hair.MethodsHair from inside pilonidal sinus cavities was collected intraoperatively from 20 PSD...
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward: Methodological Issues
(Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

A Note from the New Editor in Chief
(Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward: Methodological Issues: Reply
(Source: World Journal of Surgery)
Source: World Journal of Surgery - January 10, 2018 Category: Surgery Source Type: research

An Enhanced Recovery After Surgery (ERAS) Protocol for Ambulatory Anorectal Surgery Reduced Postoperative Pain and Unplanned Returns to Care After Discharge
ConclusionsImplementation of a standardized ERAS protocol for ambulatory anorectal surgery decreased postoperative pain and unplanned return visits to emergency care. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 9, 2018 Category: Surgery Source Type: research

More Than Talking About the Weekend: Content of Case-Irrelevant Communication Within the OR Team
ConclusionThe high proportion of work-related CIC indicates that surgical teams deal with other tasks during surgeries. Surgical teams adapt CIC according to the demands of the procedure. Hospital policies should support these adaptations rather than attempt to suppress CIC entirely. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 9, 2018 Category: Surgery Source Type: research

Central Lymph Node Metastasis in Papillary Thyroid Carcinoma
(Source: World Journal of Surgery)
Source: World Journal of Surgery - January 5, 2018 Category: Surgery Source Type: research

The Benefit of Ultrasound in Deciding Between Tube Thoracostomy and Observative Management in Hemothorax Resulting from Blunt Chest Trauma
ConclusionIn the case of blunt trauma, TUS can rapidly and accurately evaluate hemothorax to avoid TT in patients who may not benefit much from it. As a result, the rate of non-therapeutic TT can be decreased, and the influence on shortening hospital length of stay may be further evaluated with prospective controlled study. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 5, 2018 Category: Surgery Source Type: research

Early Management of Retained Hemothorax in Blunt Head and Chest Trauma
AbstractBackgroundMajor blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3 –4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries.Materials and methodsFrom May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled. These patie...
Source: World Journal of Surgery - January 5, 2018 Category: Surgery Source Type: research

Which Patients Require Extended Thromboprophylaxis After Colectomy? Modeling Risk and Assessing Indications for Post-discharge Pharmacoprophylaxis
ConclusionApproximately one-third of post-colectomy VTE events occurred after discharge. Patients with predicted post-discharge VTE risk of ≥−5.00 should be recommended for extended post-discharge VTE prophylaxis. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 4, 2018 Category: Surgery Source Type: research

Implications of Stoma Formation as Part of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
AbstractBackgroundFormation of protective stoma as part of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS –HIPEC) may be an effective tool in reducing anastomotic leak incidence. Our aim was to evaluate the incidence and implications of stoma formation during CRS–HIPEC and to examine whether a creation of protective stoma reduces the postoperative morbidity.MethodsA cohort retrospective analysis of all CRS –HIPEC procedures performed between 2004 and 2016 was conducted. Predicting factors for stoma formation were assessed by comparing all patients who underwent stoma formation to...
Source: World Journal of Surgery - January 4, 2018 Category: Surgery Source Type: research

Does Surgery Without Lugol ’s Solution Pretreatment for Graves’ Disease Increase Surgical Morbidity?
ConclusionDespite the recommendation of iodine pretreatment, few of our non-pretreated patients experienced permanent nerve injury (2.37%) or permanent hypoparathyroidism (3.68%). These results are comparable to the outcomes from the literature. Randomized controlled trials are needed to determine whether iodine pretreatment is necessary before surgery for Graves ’ disease. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 4, 2018 Category: Surgery Source Type: research

Consensus on Training and Implementation of Enhanced Recovery After Surgery: A Delphi Study
ConclusionsWe propose an international expert consensus providing an ERAS training curriculum, a framework for successful implementation, methods for assessing effectiveness of training and a definition of ERAS training centres of excellence. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 4, 2018 Category: Surgery Source Type: research

Second Generation of a Fast-track Liver Resection Programme
ConclusionsFast-track principles for perioperative care and early discharge are safe even after major liver resection. The introduction of high-dose steroids preoperatively might have facilitated a shorter LOS. Routine discharge on POD 1 or 2 after laparoscopic resection and on POD 4 after open liver resection has proven to be feasible. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 4, 2018 Category: Surgery Source Type: research

Surgical Management of Intrahepatic Cholangiocarcinoma in Patients with Cirrhosis: Impact of Lymphadenectomy on Peri-Operative Outcomes
AbstractBackgroundThe consequences of lymphadenectomy (LND) on cirrhotic patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC) have not been investigated. We sought to analyze the impact of LND on morbidity among patients undergoing resection for ICC.MethodsA total of 1005 patients who underwent hepatectomy for ICC at one of the 14 participating institutions between 1990 and 2015 were identified. A propensity score match analysis was performed to reduce confounding biases between cirrhosis and non-cirrhosis groups.ResultsCirrhosis was diagnosed in 118 (11.7%) patients. Among non-cirrhotic patients, 63% ...
Source: World Journal of Surgery - January 3, 2018 Category: Surgery Source Type: research

Deaths in Incorrectly Identified Low-Surgical-Risk Patients
ConclusionASA grades appear to be misunderstood in the reporting of patient surgical risk. Many patient summaries list patients with severe systemic disease or expected deaths as ASA 1 or 2, contrary to the intended use of this classification system. Improved education on the use of the ASA grading system would be beneficial to clinicians. (Source: World Journal of Surgery)
Source: World Journal of Surgery - January 3, 2018 Category: Surgery Source Type: research