Τόμος 20, Τεύχος 3
Ιούλιος- Σεπτέμβριος 2015

82Woman in Surgery: Overcoming the barriers
G. Tsaousi , A. Shrewsbury , K. Kotzampassi
Πλήρες Κείμενο | Περίληψη
Despite the fact that the number of women enrolled into medical schools has steadily increased during the past three decades to nearly 50% today, the representation of the female gender in the faculty and in positions of power or leadership in academic medicine is disproportionately low. The inequality in the representation among males and females in certain fields of medicine is more striking in the field of surgery. These gender-related deviations are more pronounced in academic surgery, while an even lower percentage reaches the top ranks in academic surgery. The pattern of this gender-based disparity in the development of a surgical career is a complex constellation of factors, including: lifestyle considerations that originate from the effort to balance family and work commitments; lack of effective mentoring; perceived gender-based discrimination and stereotypes; professional isolation and different career motivations or priorities. Constraints of traditional gender roles can be addressed by a several tac-tics. Family issues can be approached with the objective of allowing women to cope efficiently with the existing demands of gen-eral surgery. Both early education and spreading of positive attitudes should be priority in medical schools and medical students should become familiar with gender-related issues and learn how to deal with negative behavior. Mentorship must also be im-proved, as effective mentoring plays a key role in addressing barriers to academic career advancement. By recognizing and changing gender-related patterns and behaviors the recruitment and retention of the most promising and well-qualified women to general surgery is expected to improve.

Ερευνητικές εργασίες
86The effects of diosmin+ hesperidin in experimentally induced renal ischemia-reperfusion model in rats
C. Dagl? , E. Yeldan , A. Senlikci , E. Kahya
Πλήρες Κείμενο | Περίληψη
By reducing cellular energy levels and causing an accumulation of toxic metabolites in tissue, ischemia triggers a chain of bio-chemical reactions that cause cell dysfunction and even cell death. The degree of injury increases with duration of ischemia as a result different clinical conditions ranging from prerenal azotemia without distinctive tissue damage to acute kidney failure re-sulting from tubular or cortical necrosis come about. The rats were assigned to 4 groups consisting of 10 rats each. When the control, Diosmin+Hesperidine, Ischemia-reperfusion and Ischemia- reperfusion+Diosmin+Hesperidine groups were compared it was discovered that in the Ischemia-reperfusion group statistically significant low glutation in renal tissue, and high serum urea and creatinine showed ischemia we induced caused kidney injury. Although statistically insignificant we discovered that kidneys, Diosmin+ Hesperidine we used reduced harmful effects in such injuries. Compared ?schemia- reperfusion group, in Ischemia-reperfusion+Diosmin+Hesperidine group serum urea and creatinine levels were lower, renal tissue glutation levels were higher; although difference was statistically insignifi-cant. The fact that no significant difference was seen in terms of renal tissue glutation levels or serum urea and creatinine levels between control and Diosmin+Hesperidine groups supports the fact that dose of diosmin + hesperidine used did not cause toxic effects on renal tissue. In conclusion, we are of the opinion that Diosmin+Hesperidine given to rats reduces the ischemia-reperfusion injury upto a cer-tain extent but do not bring about a statistically significant recovery of ischemia-reperfusion injury.
92Prospective Randomized study of Transcutaneous Electrical Nerve Stimulation (TENS) In Post Operative Pain Relief
V.S. Shah , H.V. Shah , A.P. Jain , A.K.Saxena
Πλήρες Κείμενο | Περίληψη
Background: Present study was aimed to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) for post operative pain relief Methods: A total 200 patients were enrolled in the study, 100 in TENS group and 100 in control group who were given tramadol hy-drochloride for analgesia. All the patients were above 18 years of age. Patients in study group given TENS immediately post opera-tively and then 8 hourly till third post operative day in contrast to control group given tramadol. In both groups pain was evaluated by VAS score. Results: The mean VAS score on day of surgery, 1st and 2nd post operative day in study group were 5.02, 3.92 and 2.83 and in control group were 6.01, 5.10 and 4.20. Which on t-TEST showed values were statistically significant (p<0.0001) leading to an inference that TENS analgesia group had better pain relief in contrast to control group. Conclusion: Pain control with Transcutaneous Electric Nerve Stimulation (TENS) is satisfactory in post operative pain relief. TENS is a non invasive mode of getting pain relief with no side effect. Analgesia with TENS does not show any deleterious effect on the wound healing in the study population, as no delay in suture removal or discharge from the hospital was observed.
96The laparoscopic appendectomy: indications and results in the General Surgery Department of the Aristide Le Dantec Teaching Hospital
Ο. Thiam , M. Cisse , M. Seck , ML. Gueye , AO. Toure , O. Ka , M. Dieng , A. Dia , CT. Tour
Πλήρες Κείμενο | Περίληψη
Introduction. Acute appendicitis is the most common abdominal surgical emergencies. Appendicectomy may be realized by laparotomy or laparoscopy. Laparoscopy has many advantages in the diagnosis, therapeutics and cosmetics. The aim of our study was to evaluate the indications and the results of laparoscopic appendicectomy in our service. Patients and Methods. It was a retrospective study in General Surgery Department of the Aristide Le Dantec Teaching Hospital in Dakar over a period of 8 years. There were 31 men and 19 women. The average age was 19.4 years. Were included all patients who were treated by laparoscopic appendectomy whatsoever the evolutionary stage of the appendicitis. Seven patients files were excluded because incomplete information. The parameters studied were the epidemiological data, surgical indications, operative and postoperative follow-up data. Results. Our study included 50 patients and represented 39.4% of the laparoscopic surgery activity in our service. Specific ab-dominal pain was 88%. Leukocytosis was found in 90%. The abdominopelvic ultrasound performed in 20% of cases (10 cases) was contributory to the diagnosis in 80%. In 22% of cases, the diagnosis of acute appendicitis was clinical and laboratory. Lapa-roscopy was a therapeutic means in 98% of procedures. The number of trocars used was 3 in 36 patients (72%). In exploration, appendix was retro-cecal in 50% and gangrenous in 54% of cases. The intraoperative diagnosis was appendical peritonitis in 58%. All appendectomy performed were "in". The overall conversion rate was 10%. The mean operating time was 68 minutes in case of laparoscopy alone. The sensitivity of laparoscopic diagnosis was 100%. The average time to recovery intestinal transit was 1.7 day. Morbidity rate was 6%. No mortality were recorded. Conclusion. Laparoscopy is an excellent approach for appendectomy and it is performed for diagnosis and treatment. It is the best indication in young women.

Ενδιαφέρουσες περιπτώσεις
100Thyroid carcinosarcoma, an extremely rare and aggressive malignancy: A case report
N. Kamargiannis , K. Valsamidis , K. Theocharidis , A. Nikolaidou , D. Papadopoulou
Πλήρες Κείμενο | Περίληψη
Thyroid carcinosarcoma is a very rare, aggressive thyroid malignancy with a clinical course similar to anaplastic carcinoma. A 64-year-old man with a 3-month history of hoareseness presented with a progressively increased neck swelling causing dysphagia and shortness of breath. Histopathological examination of the surgical biopsy specimen confirmed thyroid carcinosarcoma. This case report discusses the clinical course and management of thyroid carcinosarcoma, which can cause a diagnostic dilemma. A thorough literature search revealed limited information regarding its biological behavior. Thyroid carcinosarcoma has a high mortality rate despite aggressive multimodal treatment.
103A Rare Cause of Jaundice: Periampullary Duodenal Diverticula or Lemmel?s Syndrome
A. Sarici , Y. Duzkoylu , H. Bektas , S. Erdem , F. Sametoglu
Πλήρες Κείμενο | Περίληψη
Lemmel?s syndrome refers to extraluminal outpouchings of the duodenum in the periampullary region. Becase of the fact that it is a rare entity, it usually leads to misdiagnosis of extrahepatic cholestasis, especially in elderly patients. Although it has been treated with conventional surgical methods earlier, with the latest developments in endoscopic procedures, the disease can be diagnosed and treated with endoscopic retrograde cholangiopancreatography. The syndrome should always be kept in mind during the differential diagnosis of jaundice, especially in the presence of periampullary diverticula
106Surgical management of sizeable intragastric foreign bodies: two cases of selfharm in psychiatric patients
D. Paramythiotis , K. Kofina , P. Baggeas , S. Salonikidis , G. Tsakiris , V. Papadopoulos , A. Michalopoulos
Πλήρες Κείμενο | Περίληψη
Introduction: The presence of foreign bodies in the stomach may be after accidental or voluntary swallowing and it i s a relatively com mon cause of admission in emergency department. T reatment option still remains controversial considering the waiting po l- icy or promptly intervention either endoscopic or surgical . This case series presents our experience after surgical re moval of sizeable gastric objects in psychiatric p a tients in the attempt of self - harm action . Cases presentation : We present two cases of swallowed peculiar sizeable foreign objects , such as metallic spoon and key, where endoscopy wasn?t successful in remo ving them . Both cases were man aged with gast r otomy , through limited midline l aparot o my , and removal of the objects . P ostoperative period was un e ventful. Conclusion : Surgical intervention is crucial for gastrointestinal foreign body removal, either when end oscopy fails , especially in foreign obj ects of peculiar size and shape, or in case of gastrointestinal complications
110Auto-amputation of the adnexa in an adult: A rare entity and review of the literature
I. Tas , S. Culcu , Y. Duzkoylu , S. Eryilmaz , S. Zeren , D. Yilmaz
Πλήρες Κείμενο | Περίληψη
Adnexal torsion in one of the most common etiologic factors of acute abdominal pain, especially in adolescent females. Auto-amputation of the adnexa is a rare and serious complication of torsion, resulting from devascularization, followed by detachment. This entity can be encountered incidentally during an emergent operation for acute appendicitis. Here, we aimed to present a 37-year-old case with adnexal autoamputation, which is reported to be very rare in literature.
112Encysted Spermatic Cord Hydrocele in 65 year Male: A Case Report and Review Of Literature
P.K. Vaghela , R. K. Vaghela , R. Panchal , K. Vaghela , J. Vaghela
Πλήρες Κείμενο | Περίληψη
A hydrocele of the spermatic cord, which results from aberrant closure of the processus vaginalis, is an asymptomatic entity mainly. We are presenting a case of encysted hydrocele of spermatic cord in a 65 year old male. A 65-year-old male presented with swelling in the right inguinal region, which progressively increased in size within five years. He complained of intermittent dull aching meanwhile this period and severe pain since last 3 days. The traction test was negative. Ultra sonogram of right inguinal region revealed cystic lesion of 5 ?4 centimetres. On elective operation the cord hydrocele was found which was carefully skeletonised from spermatic cord structures. It was excised and sent for histopathology examination. A number of pathologies can present as groin swellings in adults. Among these, encysted hydrocele of the cord presenting a swelling in an adult is a rare. It may be mistaken as irreducible hernia many times. Excision is the treatment modality for it.
114Sigmoid Endometriosis: Diagnosis and Treatment with Minimally Invasive Surgery, A Case Report and Review of the Literature
Y. Duzkoylu , K. Buyukasik , B. Gurbulak , H. Bektas
Πλήρες Κείμενο | Περίληψη
Endometriosis is a common disesase among women of reproductive age, especially those with chronic abdominal pain. It is described as the the presence of functional ectopic endometrial tissue outside the uterus. Role of medical therapy is limited. Laparoscopic surgery is the gold standard today, for the diagnosis and treatment. Here, we aimed to report a case of young woman with chronic abdominal pain, who was diagnosed and treated with minimally invasive methods.

Εγχειρητική τεχνική
117Tackling TA stapler failure during Low Anterior Resection
B. Roy , P. Thambi , M. K. Roy , S. Banerjee , R. Gaurav
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Εικόνες στη χειρουργική
119Two anatomic variations of an aberrant right hepatic artery
D. Kostov , G. Kobakov , D. Yankov
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Εκπαιδευτικό video
120Laparoscopic left lateral hepatectomy for symptomatic left liver lobe tumor
G. Glantzounis , G. Lianos , V. Tatsis , C. Tsouras , A. Tsili , P. Tzimas , C. Katsios
Πλήρες Κείμενο | video

Επιστολές προς Εκδότη
121Vascular -Access Induced Distal Limb Ischemia- A devastating complication
G. Aggarwal , S. Adhikary
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123Will removal of the mesh pull me through this pain, doctor?
T. Dinc , S.I. Kayilioglu , F. Coskun
Πλήρες Κείμενο
124Renal hydatidosis presenting as non-functioning kidney and macroscopic hy-datiduria
N. Saxena , A. K. Gupta , P. Chaudhary
Πλήρες Κείμενο
126Is a caesarean birth the safest option? Audit of 400 cases
S. Sibtain , A. Koumousidis , C. Sofoudis , M. Carr , P. Sinha
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