Surgery today
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To investigate the results of wide rhomboid excision with Limberg transposition flap reconstruction to treat pilonidal sinus. ⋯ These results provide further evidence that wide excision with a Limberg transposition flap reconstruction is an effective surgical method for primary or recurrent pilonidal sinus, associated with a low complication rate, short hospitalization and disability, and a low recurrence rate. A modification of the technique was devised to further enhance wound healing and reduce the risk of recurrence.
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We report a case of transaortic mitral valve repair combined with aortic root and arch replacement in a patient with Marfan's syndrome. Preoperative computed tomography and echocardiography showed acute aortic dissection (DeBakey type 1), severe aortic regurgitation, annuloaortic ectasia, and mild mitral regurgitation (MR). ⋯ The patient is well 55 months after the operation, with minimal MR. We think that the transaortic approach is a good alternative for exposure and correction of the AML and its apparatus in special circumstances.
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Case Reports
Successful resection of a recurrent mediastinal liposarcoma invading the pericardium: report of a case.
Primary liposarcoma of the mediastinum is rare, but cases of recurrence have been reported in the English literature. We successfully resected a recurrent pericardial liposarcoma, detected 5 years after the initial resection of a liposarcoma of the anterior mediastinum invading the pericardium. ⋯ As cine-magnetic resonance imaging suggested that the tumor was resectable, an operation was performed. Histopathology confirmed the diagnosis of recurrent liposarcoma and showed clear surgical margins.
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Pylephlebitis is extremely rare and associated with high mortality, even in this modern era. It usually occurs secondary to infection in the region drained by the portal systems or in the structure contiguous to the portal vein. ⋯ Postoperative histopathological examination confirmed a diagnosis of appendicitis and septic thrombophlebitis of the portal vein and SMV. The patient recovered completely with appropriate medical and surgical treatment.
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Comparative Study
Lung injury after intestinal ischemia-reperfusion may be avoided by the reduced absorption of locally produced cytokines.
It has been suggested that inflammatory mediators such as cytokines released during intestinal ischemia and reperfusion increase permeability in the lungs. Cytokines exist at concentrations several hundred times higher at the site of inflammation than in the blood. When absorbed, the locally produced cytokines may affect multiple remote organs. We thus investigated whether the isolation of the intestine in a bag during ischemia and reperfusion can reduce subsequent lung injury. ⋯ The isolation of the intestine during ischemia and reperfusion was found to reduce the degree of subsequent lung injury, possibly due to the reduced absorption of locally produced cytokines via the parietal peritoneum.