Articles: surgery.
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OBJECT The associations among global spinal alignment, patient-reported disability, and surgical outcomes have increasingly gained attention. The assessment of global spinal alignment requires standing long-cassette anteroposterior and lateral radiographs; however, spine surgeons routinely rely only on short-segment imaging when evaluating seemingly isolated lumbar pathology. This may prohibit adequate surgical planning and may predispose surgeons to not recognize associated pathology in the thoracic spine and sagittal spinopelvic malalignment. ⋯ Such imaging is necessary for the assessment of spinopelvic and global spinal alignment, which can be important in operative planning. Deformity, particularly positive sagittal malalignment, may go undetected unless one maintains a high index of suspicion and obtains long-cassette radiographs. It is recommended that spine surgeons recognize the prevalence and importance of such deformity when contemplating operative intervention.
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Interact Cardiovasc Thorac Surg · Nov 2015
Case ReportsTransient limb ischaemia during extracorporeal membrane oxygenation: inappropriate venous cannula location.
Percutaneous placement of extracorporeal membrane oxygenation (ECMO) cannulas has many benefits. However, limb ischaemia still remains as an unresolved problem. We experienced an interesting case of limb ischaemia that was caused by external compression of the superficial femoral artery by the venous cannula. ⋯ The venous cannula, which was approaching the common femoral vein from the lateral side, was passing between the bifurcation area of the superficial and deep femoral arteries, directly compressing the superficial femoral artery from beneath. We rapidly removed the inappropriately placed venous cannula, and then re-inserted it at another location of the femoral vein. Although it was an unusual case where arterial occlusion was due to external compression of the venous cannula, successful limb reperfusion could be obtained through rapid identification and correction.
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Randomized Controlled Trial Multicenter Study
Cosmesis and Body Image in Patients Undergoing Single-port Versus Conventional Laparoscopic Cholecystectomy: A Multicenter Double-blinded Randomized Controlled Trial (SPOCC-trial).
To evaluate cosmesis, body image, pain, and quality of life (QoL) after single-port laparoscopic cholecystectomy (SPLC) versus conventional 4-port laparoscopic cholecystectomy (4PLC). ⋯ This is the first multicenter double-blinded RCT reporting superior short- and long-term cosmetic and body image, postoperative pain, and QoL in SPLC compared with 4PLC. Although cost-effectiveness is still a subject of ongoing debate, SPLC should be offered to patients undergoing surgery for benign gallbladder disease.