Lietuvos chirurgija
https://www.journals.vu.lt/lietuvos-chirurgija
<p>Founded in 1993 and dedicated to publishing surgical articles.</p>Vilniaus universiteto leidykla / Vilnius University PressenLietuvos chirurgija1392-0995<p>Please read the Copyright Notice in <a href="http://www.zurnalai.vu.lt/lietuvos-chirurgija/journalpolicy">Journal Policy</a>. </p>Intrathoracic Displacement of the Humeral Head with Polytrauma: Case Report
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/33509
<p><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Intrathoracic displacement of the humeral head is rarely documented due to high mortality of the trauma. As a result, there is no clear consensus about how such case should be approached. In this report we reviewed our successful case, and reviewed the literature. The patient arrived after car accident with a broken humerus and upon taking X-ray found to have the humeral head lodged in the chest cavity. After humeral head removal and arthroplasty, patient was discharged without complications. In literature several cases were found in which a patient usually suffers because of high energy trauma with arm typically in abducted position. In all cases treatment involves removing humeral fragment from chest and prosthetic arthroplasty of the glenohumeral joint. Although some authors suggest leaving humeral fragment in some cases while others suggest to always remove. Exact indications of such decision are unclear. Cases like this pose a high risk of neurological and circulatory complications, although no complications were observed in this case. Nevertheless, there have been too few similar cases described to establish a proper methodology.</span></p>
Clinical PracticedislocationhumerusarthroplastyshoulderKipras SasnauskasRobert VrublevskiPovilas MasionisSigitas Ryliškis
Copyright (c) 2024 Kipras Sasnauskas | Robert Vrublevski | Povilas Masionis | Sigitas Ryliškis
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07566010.15388/LietChirur.2024.23(1).8Iatrogenic Tracheal Rupture after Endotracheal Intubation: A Case Report
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34801
<p class="ISSN-abst-virsus" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="en-US">Iatrogenic tracheal rupture is very rare condition and has a lot off causes (intubation, tracheostomy, bronchoscopy, esophagectomy), but orotracheal intubation is the most common. Diagnosis is based on the occurrence of symptoms that are not specific but highly suggestive: subcutaneous emphysema, respiratory insufficiency, pneumothorax, and hemoptysis. The appearance of subcutaneous emphysema as a first sign plays a main role for early diagnosis and rapid appropriate treatment. Diagnostic confirmation is possible by chest<span xml:lang="ar-SA"> </span>X-ray, thoracic computed tomography and bronchoscopy which confirmed the size and site of the lesion. Treatment can be conservative, in patients with small ruptures, less than 2<span xml:lang="ar-SA"> </span>cm, and surgical in the majority of ruptures over 2<span xml:lang="ar-SA"> </span>cm in length.</p> <p class="ISSN-abst-vidus" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="en-US">Our case report presents an iatrogenic post-intubation tracheal rupture treated conservatively. Our patient was a 71-year-old woman, admitted in our hospital with fracture of right humerus for elective surgery. Her medical history was only arterial hypertension. She underwent general anesthesia, intubated with flexible ET tube, positioned in beach-chair position after introduction, and no complication occurred during surgery. 18<span xml:lang="ar-SA"> </span>hours after surgery, after severe coughing, she suddenly developed subcutaneous emphysema of the facial, neck and upper anterior chest. Tracheal rupture was confirmed with a thoracic computed tomography and tracheobronchial fiber endoscopy. It showed a posterior tracheal transmural rupture 1<span xml:lang="ar-SA"> </span>cm long, located 4<span xml:lang="ar-SA"> </span>cm above the carina, covered with small tissue that opened in inspirium. Conservative treatment with antibiotic cover was performed, and the patient was discharged home in good condition, fourteen days after the initial injury.</p>
Clinical Practicetracheal ruptureendotracheal intubationsubcutaneous emphysemapneumothoraxcomputed tomographytracheobronchial fiber endoscopyconservative treatmentsurgical treatmentSilvana KralevaTatjana TrojikjDarko TalevskiDola MalefskiGordana Bozinovska Beaka
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07455110.15388/LietChirur.2024.23(1).6Transanal Hemorrhoidal Dearterialization (THD): A Single Center Experience on 100 Consecutive Cases
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34799
<p><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Introduction. </em><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Surgeons, using all available means for the treatment of the hemorrhoidal disease, must make compromises between the radicality of the potential surgical treatment (to prevent recurrence) and the maintenance of the postoperative functionality of the anorectum (avoiding stricture, anal fissures, incontinence, reduction of postoperative pain etc.). </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Materials and methods.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">All patients treated with the THD method using a system manufactured by THD S.p.A., Correggio, Italy, consisting of a proctoscope equipped with a</span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="ar-SA" data-mce-fragment="1"> </span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Doppler probe and a light source was used to perform the operation. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Results.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Out of 100</span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="ar-SA" data-mce-fragment="1"> </span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">operated patients, 64 (64%) were men and 36 (36%) were women. 54</span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="ar-SA" data-mce-fragment="1"> </span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">patients had third degree hemorrhoidal disease, 32 had fourth degree, 7</span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="ar-SA" data-mce-fragment="1"> </span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">patients had fourth degree hemorrhoidal disease with active bleeding and 7</span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" xml:lang="ar-SA" data-mce-fragment="1"> </span><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">patients had second degree hemorrhoidal disease with active bleeding. In the follow-up period, anal fissure formation in two patients and prolapse of a hemorrhoidal node in a treated patient with fourth-degree hemorrhoidal disease were noted. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Discussion. </em><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">It is estimated that more than 50% of the general population will experience at least one episode of symptomatic hemorrhoids during their lifetime. Morphological and hemodynamic changes that occur in patients with hemorrhoidal disease is the finding of an increased diameter of the terminal branches of the superior rectal artery that supplies the hemorrhoidal nodes. These branches are 10–11 in number, of which ligation of up to six is allowed for effective treatment with the THD method. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Conclusion.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">If the THD technique is used according to the established standards, postoperative complications in patients in the form of fecal incontinence and chronic pain have not been described, which is also confirmed in our series. The absence of serious complications while addressing a hemorrhoidal disease at the level of the cause of its occurrence, makes the THD+mucopexy technique applicable in most cases. Correct manipulation of the instruments, precision in dearterization, mucopexy of the rectal mucosa and submucosa are imperative for achieving excellent results.</span></p>
Original research workhemorrhoidsdearterializationmucopexytransanalAleksandar MitevskiVladko CvetanovskiPetar MarkovIlija Milev
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07343910.15388/LietChirur.2024.23(1).4Bedside Teaching in Undergraduate Surgical Education: A Pilot Study of Students’ Perspective
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34798
<p><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Background.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Bedside teaching is an important tool in medical education. In recent years, studies have shown that this tool has witnessed gradual deterioration</span><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">due to various reasons. Hence this pilot study was conducted to assess the students’ perspective about this tool and suggest remedies for the deficiencies. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Methodology. </em><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">An anonymous questionnaire was designed and students were requested to register the response offline. Data was analysed and inferences made. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Results.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Various deficiencies were highlighted by the students that require correction and improvement.</span><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Unavailability of suitable patients is a significant barrier. Communication skills and understanding of infection control protocols had got improved in 84% and 94% students respectively. Half of the students were fully satisfied or satisfied with the overall conduct of the bedside teaching and the other half were either partially satisfied or dissatisfied. </span><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Conclusion.</em><strong style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> </strong><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">There is a need to improve bedside teaching in Undergraduate Surgery course. Simulation sessions need to be devised and enhanced. Faculty development sessions to train the teachers are required.</span></p>
Original research workbedside teachingsimulationcommunication skillsinfection controlMohammed Alfehaid
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07182410.15388/LietChirur.2024.23(1).3In Memoriam Marius Petrulionis (1987–2023)
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34797
<p>-</p>
Other-Tomas Poškus
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07141710.15388/LietChirur.2024.23(1).2In Memoriam Steffen Bülow (1943 04 03–2023 12 29)
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34796
<p>-</p>
Other-Hans Jorgen Nielsen
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07121310.15388/LietChirur.2024.23(1).1Editorial Board and Table of Contents
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/34795
<p>-</p>
Front Matter-Narimantas Evaldas Samalavičius
Copyright (c) 2024 Authors
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07111An Unusual Case of Cheiralgia Paresthetica Caused by Lipoma
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/33872
<p><em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Cheiralgia paresthetica</em><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (CP) is a distinctive clinical condition arising from the compression of the superficial branch of the radial nerve (SBR). Typically, CP manifests as a burning-type pain in the dorsal and radial aspect of the hand. Existing literature highlight various etiological factors contributing to this condition, including constriction of the wrist, as with tight wristwatches or handcuffs. Symptoms may also arise from blunt traumas, distal radius fractures, and iatrogenic causes. However, CP induced by a lipoma is an exceptionally rare phenomenon. In this context, we present a case exemplifying the diagnosis and management of lipoma-induced CP.</span></p>
Clinical PracticeCheiralgia parestheticaSuperficial radial nerveLipomaPseudolipomaTomas MačiulaitisAira JucaityteMindaugas Minderis
Copyright (c) 2024 Tomas Mačiulaitis | Aira Jucaityte | Mindaugas Minderis
https://creativecommons.org/licenses/by/4.0
2024-03-072024-03-07404410.15388/LietChirur.2024.23(1).5Hemothorax Caused by Liver Biopsy – Rare Iatrogenic Complication
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/33732
<p>Liver biopsy is the most accurate interventional procedure to diagnose hepatic diseases. According to the information provided by the Institute of Hygiene, 968 percutaneous liver biopsies were performed in Lithuania in 2022. The Lithuanian scientific literature does not, however, publish information on complications associated with this procedure. According to international literature, the frequency of complications after this procedure ranges from 2.4% to 9.5%. The most common are mild complications: hematomas, fever, pain at the biopsy site. Particularly rare are hemothorax, pneumothorax, damage to the organs of the thoracic and abdominal cavity, which occur in up to 0.04% of cases. This article presents an extremely rare complication – liver biopsy induced hemothorax, whose success was determined by early diagnosis and timely surgical intervention.</p>
Clinical Practiceliver biopsyiatrogenic complicationhemothoraxretained hemothoraxDiana Samiatina-MorkūnienėRūta SilickytėGabija Jankauskaitė
Copyright (c) 2023 Authors
https://creativecommons.org/licenses/by/4.0
2023-11-292023-11-2924524810.15388/LietChirur.2023.22(4).7Second Suburethral Sling Implantation for the Recurrent Urinary Incontinence after Radical Prostatectomy when First Sling Surgery was Non-Effective: Case Report
https://www.journals.vu.lt/lietuvos-chirurgija/article/view/33731
<p>Stress urinary incontinence is a complication after radical prostatectomy. The suburethral sling implantation operation is often performed for mild to moderate male urinary incontinence after radical prostatectomy. There are non-adjustable suburethral slings that are effective up to 73.7% and adjustable slings that are effective up to 92%. We present a case report of a 62-year-old man who underwent radical prostatectomy due to prostate cancer in 2018 and experienced moderate degree urinary incontinence. After non-effective conservative treatment in 2020-02-27, the suburethral transobturator sling implantation was performed in another hospital, but it did not yield effective results. After further examinations in 2023-03-25, an adjustable ATOMS system suburethral male sling implantation was performed and it was effective. 2023-05-03 ATOMS system was adjusted and after this there was no urinary incontinence. ATOMS system is an effective surgical method for the treatment of male recurrent urinary incontinence or for cases where the initial sling implantation has failed.</p>
Clinical Practicemale urinary incontinencepost-prostatectomy incontinencesuburethral slingsecond sling implantationfailed sling implantationAušra ČerniauskienėIeva Rimaitė
Copyright (c) 2023 Authors
https://creativecommons.org/licenses/by/4.0
2023-11-292023-11-2923824410.15388/LietChirur.2023.22(4).6