WUTH publication: The Impact of Drain and Reinforcement on the Outcomes of Bariatric Surgery: A Prospective Study

Citation: Cureus. 2021, 13(12), e20382. eCollection 2021 Dec.  
Author: Mohamed A Salman, Ahmed Safina, Ahmed Salman, Mohamed Farah, Khaled Noureldin, Mohamed Issa, Ahmed Dorra, Mohamed Tourky, Hossam El-Din Shaaban, Mohammed Aradaib 
Abstract: Purpose We aimed to investigate the impact of reinforcement and abdominal drains on the outcome of laparoscopic sleeve gastrectomy (LSG). Methods The present study was a prospective study that included obese patients scheduled to undergo LSG. Patients were assigned to receive drain, reinforcement, or both according to the surgeon's preference and followed up for one month after surgery. The present study's primary outcome was the identification of the association between intraoperative drain/reinforcement and the incidence of postoperative complications. Results A total of 125 (20.3%) patients received intraoperative drains. The proportion of postoperative morbidity was comparable between the drain and non-drain groups (3.2% versus 1.6%; p = 0.25). Patients in the drain group had similar incidence of blood transfusion (2.4% versus 1.7% in non-drain group; p = 0.43) and postoperative leakage (0.8% versus 0.2% in non-drain group; p = 0.36). The incidences of blood transfusion (p = 0.56) and reoperation (p = 0.98) were comparable between the drain and non-drain groups. There were no statistically significant differences between the drain and non-drain groups regarding postoperative mortality and wound infection (p > 0.05). On the other hand, 440 (71.3%) patients received reinforcement. The proportion of postoperative morbidity was comparable between the reinforcement and non-reinforcement groups (1.6% versus 2.8%, p = 0.07). Patients in the reinforcement group were less likely to develop postoperative bleeding (0.7% versus 4% in the non-reinforcement group; p = 0.004), while no significant difference was detected in terms of postoperative leakage (p = 0.33) and in-hospital mortality. Conclusion In conclusion, abdominal drainage did not reduce the complications of LSG patients. Reinforcement has some role in controlling the bleeding but not leaks. Both techniques did not significantly impact the mortality rate. In the future, additional, large randomized trials are needed to examine the gastrointestinal-related quality of life.
Keywords: bariatric; bariatric surgery; complications; drain; reinforcement; surgery.

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WUTH publication: A Systematic Review Examining the Experimental Methodology Behind In Vivo Testing of Hiatus Hernia and Diaphragmatic Hernia Mesh

Citation: Journal of Gastrointestinal Surgery. 2021 Dec 21. Online ahead of print
Author: Thomas Whitehead-Clarke, Victoria Beynon, Jessica Banks, Rustam Karanjia, Vivek Mudera, Alastair Windsor, Alvena Kureshi 
Abstract: Introduction: Mesh implants are regularly used to help repair both hiatus hernias (HH) and diaphragmatic hernias (DH). In vivo studies are used to test not only mesh safety, but increasingly comparative efficacy. Our work examines the field of in vivo mesh testing for HH and DH models to establish current practices and standards.
Method: This systematic review was registered with PROSPERO. Medline and Embase databases were searched for relevant in vivo studies. Forty-four articles were identified and underwent abstract review, where 22 were excluded. Four further studies were excluded after full-text review-leaving 18 to undergo data extraction.
Results: Of 18 studies identified, 9 used an in vivo HH model and 9 a DH model. Five studies undertook mechanical testing on tissue samples-all uniaxial in nature. Testing strip widths ranged from 1-20 mm (median 3 mm). Testing speeds varied from 1.5-60 mm/minute. Upon histology, the most commonly assessed structural and cellular factors were neovascularisation and macrophages respectively (n = 9 each). Structural analysis was mostly qualitative, where cellular analysis was equally likely to be quantitative. Eleven studies assessed adhesion formation, of which 8 used one of four scoring systems. Eight studies measured mesh shrinkage.
Discussion: In vivo studies assessing mesh for HH and DH repair are uncommon. Within this relatively young field, we encourage surgical and materials testing institutions to discuss its standardisation. Keywords: Hernia; Hiatus; In vivo; Mesh; Testing. 

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WUTH publication: Re: Clinical evaluation of a deep-learning-based computer-aided detection system for the detection of pulmonary nodules in a large teaching hospital

Citation: Clinical Radiology. 2021, S0009-9260(21), 00540-7. Online ahead of print
Author: I S Boon, R P J Teo, M H Yap, J S Lim, H L Goh, C S Boon, T P T Au Yong 

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WUTH publication: Advances of Cancer Genomics in Oncology Care

Citation: Clinical Oncology. 2021, S0936-6555(21), 00432-5. Online ahead of print
Author: I  S Boon, J Tan, R P J Teo, T P T Au Yong, C S Boon 

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