Surgery For Removal Research Articles

Painful Peroneal Tendon Subluxation in a Patient With a Prior Ankle Fusion.

This case report describes a patient who underwent an ankle fusion using a lateral approach and fibular-onlay strut 14 years ago. She presented with increasing lateral ankle pain and giving way. Despite bracing and steroid injections, she had continued symptoms and surgery for hardware removal was recommended. While under anesthesia, she was found to have subluxation of her peroneal tendons. Operative findings included impingement of the peroneal brevis on the screw head from her fibular-onlay strut and a peroneal tendon tear. Hardware removal, a peroneal tenodesis, and reconstruction of the peroneal retinaculum were performed with a good clinical result.Level of Evidence: V (case report).

AN ADDITIVE SUBDISTRIBUTION HAZARDS MODEL FOR COMPETING RISKS DATA

Competing risk failure time data occur frequently in medical a number of methods have been proposed for the analysis of these data. The classic approach is to model all cause-specific hazards and then estimate the cumulative incidence curve based on these cause-specific hazards. Unfortunately, the cause-specific hazard function does not have a direct interpretation in terms of survival probabilities for the particular failure type. In this paper, we consider a more flexible model for the subdistribution. It is a combination of the additive model and the Cox model and allows one to perform a more detailed study of covariate effects. One advantage of this approach is that our regression modeling allows for non-proportional hazards. This leads to a new simple goodness-of-fit procedure for the proportional subdistribution hazards assumption that is very easy to use. We applied this method to melanoma data and estimated the cumulative death rate for those who died from melanoma after surgical removal of the tumor. It was found that two covariates had a time-varying effect and two other covariates had a constant effect in predicting the cumulative incidence curve in patients who died of melanoma following tumor removal surgery.

Removals and Revisions of Cervical Total Disc Replacement Devices in a Consecutive Series of 1626 Patients Beginning With the First Case Experience in 2003.

Retrospective cohort study. The purpose of this study was to investigate the rate of cervical total disc replacement (TDR) device removal or revision. Cervical TDR has gained acceptance as an alternative to anterior cervical discectomy and fusion in appropriately selected patients. There have been concerns over device safety, one measure of which is subsequent surgery related to device problems. A consecutive series of 1626 patients undergoing cervical TDR from 2003 to June 2021 were included, consisting of TDRs up to 3 levels and hybrids (TDR and fusion). TDR removal or revision surgeries and reasons for these surgeries, procedures performed, and duration from index procedure were recorded. Data were analyzed to determine the removal/revision rate and factors possibly related to these events. There were 24 removals/revisions (1.48%) in the 1626 patients. Removal was performed in 23 cases (1.41%) and revision in 1 (0.06%). Among removal cases, anterior cervical discectomy and fusion was performed in 18 and TDR was replaced with another TDR in 5. Removals with fusion included 5 cases of osteolysis with/without Cutibacterium acnes , 4 device displacement/migration, 4 posterior spinal pathology, and one for each of the following: metal allergy, approach-related complications, malpositioning, subsidence, and hypermobility. The revision involved TDR repositioning 3 days after index surgery. There were 66 patients for whom a minimum of 10-year follow-up was confirmed, and none had removal/revision surgery 10 or more years after index surgery. There was no relationship between the occurrence of removal/revision and age, sex, body mass index, or physician experience (learning curve). The removal/revision rate was significantly higher in FDA trials versus postapproval (4.1% vs . 1.3%, P < 0.05). In this large consecutive series of patients, 1.48% of cervical TDRs were removed/revised. The low rate of removals/revisions over a long period of time provides support for the devices' safety. Level IV.

Exploring the economic viability of Jatobá (Hymenaea courbaril L.) bark extraction: A comparative study

The aim of this study was to provide a comprehensive economic evaluation for the transition from lab-scale to large-scale production of jatobá bark extracts containing phenolic compounds. Building upon previous technical research, the present work compares conventional agitation (AG) to modern supercritical fluid extraction (SFE), and ultrasound-assisted extraction (UAE). SuperPro Designer was used to estimate the project’s economic indicators. Moreover, freeze drying and spray drying were evaluated as possible operations for water removal from the extract. The operating costs (OPEX) analysis at the most economical process condition showed the primary influence of raw material cost (CRM), regardless of the technique. Additionally, utilities cost (CUT) had a greater impact on UAE and AG than SFE. A sensitivity analysis revealed that extract selling price and productivity significantly impacted return on investment (ROI), followed by CRM and CUT. In summary, SFE, AG, and UAE were feasible for the recovery of phenolic extracts from jatobá bark, with payback times of 4.2, 2.0, and 3.4 years, respectively. This work shows the economic feasibility and potential scalability of these extraction processes, laying a foundation for future industrial implementation and commercialization of jatobá bark extracts.

Phase Transformation of Arsenic, Antimony and Lead in High-Grade Copper Matte Converting

The duration of the high-grade matte converting process is short, the amount of slag is small, and it is difficult for the original impurity removal operation in the low-grade matte converting process to meet the current production demand. Because the removal method for impurity elements during high-grade matte converting is unclear, the phase transformation of impurity elements during this process is investigated in this study. The results show that arsenic exists mainly in the form of FeAsO4 and As2O5, antimony in the form of Sb and Sb2O5, and lead in the form of PbS and PbO in high-grade matte. During the converting process, arsenic and antimony mainly exist in the melt in the form of oxides and gradually aggregate into large particles with increasing copper content in the melt. Lead exists in matte in the form of PbS until the end of the converting process, and PbS is not completely oxidized until the matte converted to blister copper phase. The phase transformation characteristics of copper, iron, sulfur and impurity elements in the process of high-grade matte converting were revealed. This study provides a theoretical reference for the formulation of an efficient impurity removal scheme for the converting process.

Unnecessary Explantation of IDEAL IMPLANT Structured Saline Breast Implants Prompted byRadiologic Misdiagnosis of Rupture.

The unique dual-lumen and baffle design of the IDEAL IMPLANT Structured Saline breast implant gives it specific advantages over both silicone gel-filled and the original saline-filled implants. This internal baffle structure also gives it an appearance on various radiologic imaging studies that may be misinterpreted as a rupture because of similarities to the well-known radiologic appearance of a ruptured silicone gel implant. Patients may present with various misinterpreted imaging studies, highlighting the need for plastic surgeons and radiologists to be familiar with the normal appearance of the intact IDEAL IMPLANT and be able to distinguish it from a ruptured IDEAL IMPLANT. The radiology findings must be correlated with the clinical findings, or an intact IDEAL IMPLANT misdiagnosed as ruptured, may cause unnecessary patient worry, and may prompt unnecessary surgery for removal or replacement.

Effect of Strain Hardening on Burr Control in Drilling of Austenitic Stainless Steel

Austenitic stainless steel has been widely used in various industries, such as aerospace, medical, and hydrogen energy, due to its high strength over a wide range of temperatures, corrosion resistance, and biocompatibility. However, stainless steel is a difficult-to-cut metal because its ductility and low thermal conductivity induce a strain hardening with significant plastic deformation at high temperatures. Burr formed at the back side of a plate is a critical issue which deteriorates the surface quality, especially in drilling. Burr removal operation, therefore, should be done in the machine shop. This study discusses the effect of strain hardening of austenitic stainless steel, SUS 316L, on burr formation. Hardness and cutting tests were conducted to compare the strain hardening effect for three types of workpieces: as-received, pre-machined, and tensile treated specimens. In the employed specimens, the tensile treated specimen is harder than the as-received specimen. Those specimens have uniform hardness in the depth direction from surfaces. Pre-machined specimen, in which the back side of the plate was finished by face milling, has a distribution of hardness in the depth direction from a surface. The highest hardness appears in the subsurface of the pre-machined specimen. The cutting forces in the steady processes, in which the entire edges remove material, were nearly the same as the tested specimens each other. However, remarkable differences were confirmed in the chip thickness and burr formation. The higher strain hardening of the tensile treated specimen is effective to suppress burr formation. The cutting characteristics are then identified to associate burr control with the shear plane model of orthogonal cutting using an energy-based force model. The shear stresses, shear angles, and friction angles of the tensile treated and as-received specimens are compared to discuss the effect of strain hardening on reduction of burr formation.

A Method to Reduce Tension Differences in Pull/Push Manipulation for a Robot in Fluorescence Emission-Guided Surgical Microscopy.

A fluorescence emission-guided microscope used to monitor the outcome of cancer removal surgery is highly effective when employing a manipulator to motorize and switch the observation direction. It is necessary to minimize the alignment of looper tension between the stands for pull/push to change the direction of the manipulator and reduce the error rate caused by tension differences. This paper presents a method to minimize the error rate of looper tension between the stands. \The looper is inserted between the stands of the manipulator to minimize the difference in tension and make the stress on the pull and push of the looper constant. The constant stress allows the manipulator to move stably in left/right, up/down, and left/right movements, which will be effective for full-camera observation and close-up shots of the end effector. Reducing the tolerance for differences in the manipulator's looper tension (angle and tension) is crucial. When the input value of the looper tension angle is 50°, the output should closely match 50°. Consequently, the measured response has a tolerance of ±49.98%, resulting in an error rate of .02% (1/50th level). A method is proposed to minimize the error rate of the manipulator's looper tension in a robot-based fluorescence emission-guided microscope used to observe the status of cancer surgery. As a result, a stable manipulator with a minimal error rate can achieve a 3.986x magnification for close-up observation by switching between high and low orientations.

The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

Background/purposeAutologous dentin materials are among the most promising bone substitutes for preventing osseous defects on the distal side of the lower second molar. This study aimed to investigate the effects of autologous demineralized dentin matrix on postoperative complications and wound healing after lower third molar surgery. Materials and methodsThirteen patients with bilateral symmetrical lower third molars participated in this split-mouth randomized clinical trial. After removal surgery, one socket of the lower third molar was grafted with dentin material (demineralized dentin matrix side), and a piece of collagen sponge was used for the tooth socket of the remaining side (control side). The upper third molar on the same lateral side was extracted immediately before lower third molar surgery and used to create a demineralized dentin matrix according to the manufacturer's protocol (KometaBio). After lower third molar surgery, pain, swelling, trismus, and Inflammatory Proliferative Remodeling Scale scores were used to evaluate postoperative complications and wound healing. ResultsPain, swelling, and trismus of the demineralized dentin matrix and control sides were not significantly different at any assessment time (P > 0.05). The wound-healing scores of the demineralized dentin matrix side were better than those of the control side; however, the differences were only significant at 7th and 30th days (P < 0.05). ConclusionGrafting autologous demineralized dentin matrix into the tooth socket did not increase the postoperative complications after lower third molar surgery. However, wound healing on the graft side was comparatively better than that on the control side. Clinicaltrials.gov identifierNCT06073639, date 10 October, 2023. This is a retrospectively registered trial.

Bile Duct Injury in Laparoscopic Cholecystectomy; A Multi Centre Experience

Background: Laparoscopic cholecystectomy (LC), a minimally invasive gallbladder removal surgery, has revolutionized the field with benefits like quicker recovery. However, it is not without risks, and bile duct injury (BDI) is a severe but rare complication. BDI incidence during LC varies (0.4%-0.9%), with potentially life-threatening consequences. Surgeon experience, intraoperative cholangiography, and careful handling are crucial in preventing and managing BDIs. Aim of the study: This study aims to present and analyze a Multi centre experience regarding the management of these bile duct injuries in LC. Methods: This retrospective study, conducted at UAE medical institutions from 2014 to 2024, analyzed 2400 Laparoscopic Cholecystectomy surgeries over ten years. Out of 18 patients, thirteen patients were treated with ERCP, while five required additional surgery. Inclusion criteria involved patients aged 30 to 70+, of both genders, with BDIs. Exclusion criteria included minor BDIs and comorbidities. Two diagnostic techniques, including intraoperative cholangiography and postoperative assessments, identified BDIs. Treatment varied based on Strasberg classification, involving suturing, ERCP, stent placement, and Roux-en-Y hepaticojejunostomy. Data analysis employed SPSS, presenting results through tables and graphs with statistical parameters. Result: The study focused on Laparoscopic Cholecystectomy-related Bile Duct Injuries (BDI), with a cohort primarily aged 51-70 (66.67%). This age group showed higher susceptibility to BDI. The average participant age was 55.21±12.54 years, with a male majority (55.56%). Among 18 Endoscopic Retrograde Cholangiopancreatography (ERCP) cases, five had BDI, diagnosed intra/postoperatively. Two patients with clinical symptoms had postoperative diagnosis through Percutaneous Transhepatic Cholangiography (PTC). Strasberg classification revealed 60% Type A injuries; Types E1 and E2 each constituted 20%. Treatment modalities varied, with ERCP for Type A injuries (60%) and Roux-en-Y Hepaticojejunostomy (RYHJ) for Types E1 and E2. Conclusion: ERCP is a valuable method for diagnosing and managing Bile Duct Injuries (BDIs). The predominant type of BDIs, specifically Type A, is typically diagnosed after surgery. ERCP demonstrates its efficacy in addressing the majority of Strasberg Type A BDIs. In substantial and intricate BDIs, the Roux-en-Y Hepaticojejunostomy is a secure and efficient approach.

Surface Elevation Change Monitoring Based on ICESat-2 Satellite Altimetry Data

The ICESat-2 (Ice, Cloud and Land Elevation Satellite-2), launched by NASA on September 18, 2018, offers higher precision in surface elevation monitoring. This study aims to investigate the surface elevation changes over different time periods in the Delong and Bulianta open-pit mines in Wulanmuren Township, Ordos City, using ICESat-2 laser data. The study utilizes the spatial distribution information of each photon from ATL03 (terrain elevation data) and the classification information of each photon from ATL08 (vegetation canopy height and surface elevation data) to extract surface photon elevation data for different periods in the same area. The precision of ICESat-2 satellite elevation data is validated using the on-board radar data from Henan Polytechnic University's Feima unmanned aerial vehicle D2000 in Jiaozuo City, Henan Province.Results indicate that in the No.1 area of the Delong open-pit mine, the surface subsided by approximately 16.3 meters between November 14, 2019, and November 10, 2021, due to soil removal operations. In the No.2 and No.3 areas of the Bulianta open-pit mine, the surface was uplifted by 3.1 meters and 13.6 meters, respectively, between May 16, 2019, and August 13, 2020, due to backfilling after mining. Additionally, the No.4 area was uplifted by about 10.5 meters between November 14, 2019, and November 10, 2021.Furthermore, the accuracy assessment yielded the following results: R2=0.956, RMSE=0.324, and MAE=0.105 meters, indicating that ICESat-2 data can be used as scientific data for inverting surface elevation changes.

Reasons for Silicone Breast Implant Removal After Long-Term Implantation in Chinese Patients Without Complications: A Questionnaire-Based Study.

There are few studies of Chinese patients who request siliconebreast implant removal after at least 10 years of implantation without any complications. This study aimed to study the characteristics of these patients, explore their reasons for breast implant removal andassociate factors that affect their choice, so as to provide valuable information on clinical decision making. A total of 55 eligible female patients (110 breasts) were enrolled from 2016 to 2022. A preoperative questionnaire survey before removal surgery and a telephone follow-up 1 year after removal surgery were conducted to collect data. The mean age of the patients was 40.6±8.8 years with the average time from breast augmentation to implant removal or replacement ranged from 10 to 15 years. Concerns about the aging of silicone gel-filled breast implant and the adverse effects of its long-term placement on body health were the top two reasons for breast implant removal. 63% of patients refused implant replacement, who were nearly 10 years older than those accepted implant replacement (p<0.05). Older age at implant removal (OR=0.67; 95%CI: 0.44-0.89) and a history of basic diseases (OR=0.02; 95%CI: 0.00-0.39) were statistically associated with lower rate of implant replacement. Concerns about the aging of silicone gel-filled breast implant were the main reason for uncomplicated patients to remove their breast implants. A comprehensive analysis based on patient's subjective choice and physical condition was suggested when an uncomplicated patient asks for implant removal. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Causes of cataract progression in glaucoma patients (report 1)

The incidence of combined cataract and glaucoma ranges from 14.6% to 76%, and increases to 85% in the case of pseudoexfoliation syndrome. Analysis of the literature revealed the influence of factors associated with glaucoma on the process of cataract development. Previously performed laser surgery or glaucoma surgery leads to cataract progression in glaucoma patients in 23.3% and 81% of cases, respectively. To solve this problem, some researchers suggest performing combined one-stage lens removal surgery with a hypotensive component, which reduces intraocular pressure and improves visual function. Up to 13.7% of cases associated with complications of glaucoma surgery lead to cataract progression. Cataract surgery in patients with glaucoma in most cases is performed at the moderate (44.6–59.8%) and advanced (18.7–30.3%) stages, which does not eliminate the theory of the influence of optic neuropathy progression on the process of cataract development. The incidence of cataract and pseudoexfoliation glaucoma comorbidity can reach 40.5–90%. Pseudoexfoliation syndrome leads to cataract progression with disruption of the suspensory apparatus of the lens due to the deposition of exfoliative material in the anterior segment of the eye. Presence of lens subluxation causes difficulties at the time of cataract extraction and increases the risk of intraoperative complications.

Clinical outcomes and challenges of surgical extirpation for carotid body paraganglioma in South Korea: a single-center retrospective study

BackgroundCarotid body paraganglioma (CBP) is a rare, highly vascularized, and slow-growing neuroendocrine tumor. Surgical resection is the definitive treatment for CBP, however, it remains challenging due to the tumor’s proximity to critical blood vessels and cervical cranial nerves. This study aimed to document the characteristics of CBP and examine the clinical outcomes of patients following surgical extirpation of CBP.MethodsThis is a single-center retrospective review analyzed patients who underwent CBP extirpation. We examined the patient demographics, preoperative clinical features, tumor characteristics, levels of catecholamines and their metabolites in the serum and urine. Surgeries were performed by one vascular surgeon with follow-ups at 1,3,6 months and yearly thereafter. Logistic regression analysis was conducted to identify risk factors associated with the occurrence of either permanent or temporary cervival cranial nerve palsy (CNP).ResultsFrom September 2020 to February 2023, this study examined 21 cases of CBP removal surgeries that were carried out in 19 patients. The mean age of the patients was 38.9 ± 10.9 years and the percentage of males was 57.1% (n = 12). The most common preoperative clinical feature was painless neck mass (n = 12; 57.1%). Complete resection was achieved in 20 cases; excluding one case with pathologically proven sclerosing paraganglioma. Vascular procedures were performed in four cases (ECA resection, n = 2; primary repair of ICA tear without carotid shunting, n = 1; and ICA patch angioplasty with carotid shunting, n = 1). Temporary cranial neurologic complications, specifically aspiration and hoarseness occurred in four (19.0%), and three (14.3%) cases, respectively. Hoarseness associated with permanent CNP persisted for more than 6 months in two cases (9.5%). No recurrence or mortality was observed during the follow-up period.ConclusionsSurgical resection is the primay treatment approach for CBP; however, it poses risks of vascular or cervical CNP. The intraoperative estimated blood loss was the only identified risk factor for CNP.

Assessment of ocular neuropathic pain following vitreoretinal surgery using 23-gauge sclerotomy

Ocular neuropathic pain refers to persistent post-operative perception of ocular discomfort in the absence of painful stimuli. This study investigates persistent ocular pain following 23-gauge pars plana vitreoretinal surgery. In the present study, patients who underwent either 23-gauge vitrectomy or silicone oil removal, under local or general anesthesia, were included. The symptoms of ocular neuropathic pain were evaluated using the brief pain inventory questionnaire before and 2 months after surgery. In addition, the impact of reported ocular symptoms on quality of life was assessed. We also evaluated the correlation between ocular pain and factors such as patient demographics and underlying systemic conditions. This study includes 75 eyes of 75 patients with an average age of 58.93 &amp;plusmn; 12.05 years. Of the included patients, 31 (41.3%) were female. Among the participants, 67 (89.3%) underwent pars plana vitrectomy, and 8 (10.7%) experienced silicone oil removal surgery. Analysis using paired t-test or Wilcoxon signed-rank test, based on data normality, indicated no significant change in eye pain scores 2 months after surgery. However, the percentage of patients using analgesics increased from 4% before surgery to 17.3% 2 months after surgery (P = 0.021). Furthermore, based on a linear regression model, patients who reported increased analgesic usage 2 months after surgery also scored worse on the quality-of-life questionnaire (P &lt; 0.05). We also found that those who reported ocular pain, facial pain, and photophobia before surgery had a higher likelihood of using analgesics after surgery (P = 0.03, 0.003, and 0.001, respectively). In addition, regression analysis revealed that patients with migraine headaches and lower levels of education were more likely to develop eye symptoms postoperatively (P = 0.017 and 0.044, respectively). In conclusion, surgeries involving 23-gauge scleral incisions do not significantly induce ocular neuropathic pain within 2 months after surgery. However, there is an observed increase in the use of analgesics following surgery.

Controlling the lifetime of biodegradable electronics: from dissolution kinetics to trigger acceleration

Biodegradable electronics have revolutionized the field of medical devices by offering inherent advantages such as natural disintegration after a useful functional period, thereby eliminating the need for removal surgery. This paradigm shift addresses challenges with long-term implantation, the risks of secondary surgeries, and potential complications, offering a safer and more patient-friendly approach to temporary implantable devices. This review delves into the dissolution kinetics of materials and strategies for lifetime control providing a comprehensive overview of recent advancements in biodegradable electronics. Understanding the kinetics is crucial for meeting the required functional lifetime for implantable medical applications, which varies based on application scope and target diseases. The dissolution kinetics of silicon and biodegradable metals form the core of the discussion, focusing on recent studies aimed at controlling the dissolution rate and enhancing properties. The exploration extends to ideas for accelerating material degradation or initiating on-demand degradation in biodegradable electronics after stable function. Additionally, the compilation of encapsulation layer materials and strategies enhances understanding of how to improve the stable operation time of devices. Emphasis is placed on efforts to adjust the lifetime of biodegradable electronics, particularly in medical applications.

Multiple Intracranial Schwannomas of the Vestibular and Trigeminal Nerves: A Technical Note

BackgroundA schwannoma is a nerve sheath tumor that is formed by Schwann cells. Vestibular schwannomas are thought to account for the majority of intracranial schwannomas. Non-vestibular schwannomas account for about 10%, about half of which are trigeminal schwannomas. Multiple intracranial schwannomas originating from different cranial nerves are extremely rare. Observation(s)We describe the clinical case of a 42-year-old female patient with vestibular schwannoma and multiple trigeminal schwannomas. That case shows how multiple trigeminal schwannomas were identified intraoperatively during elective surgery for vestibular schwannoma removal, most of which were resected. No new neurological deficits were observed in the patient. LessonsThe presence of multiple intracranial schwannomas is extremely rare in neurosurgical practice and can change the intraoperative strategy and the course of the surgery.

Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study

Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study

Comparison of estimated blood loss during living kidney transplantation according to the number of double-filtration plasmapheresis

BackgroundPlasmapheresis is an important preoperative desensitization treatment for ABO-incompatible living kidney transplantation. However, in cases with plasma exchange therapy (PET), it is necessary to consider the risks of perioperative bleeding and healthcare economic costs. This study investigated the association between intraoperative blood loss and the frequency of preoperative double-filtration plasmapheresis (DFPP) and explored the correlation between DFPP frequency and coagulation factors. Furthermore, the study examined the incidence of perioperative bleeding complications.MethodsWe enrolled 294 patients (205 men and 89 women) who underwent living kidney transplantation at our institution between January 2020 and March 2023, without PET or with only DFPP performed as PET. A single dose of rituximab (200 mg) was administered to ABO-incompatible living kidney transplant patients within 7 days before transplantation. In these patients, PET was performed until anti-blood group IgG and IgM antibody titers were reduced to 32 times or less.ResultsThe intraoperative blood loss increased in accordance with the DFPP sessions. The amount of bleeding significantly increased when DFPP was performed ≥ 2 sessions. Considering this, we initiated serum fibrinogen level measurements from the middle of the study and observed that serum fibrinogen levels decreased in correlation with the number of DFPP sessions. Fibrinogen levels dropped to critical levels (< 100 mg/dL) after three sessions of DFPP. Within the entire cohort, four patients (1.4%) underwent post-transplantation hematoma removal surgery, and among them, three had received DFPP before transplantation.ConclusionsThe number of DFPP procedures was associated with the amount of bleeding and serum fibrinogen levels during living kidney transplantation.

Anatomical study of the morphometry of portal caudate veins

The caudate lobe is a relatively unknown part of the liver due to its location and many variations. The caudate lobe is a separate entity that is located behind the trunk of the portal vein.It constitutes the hepatic dorsal area that comprises of only segment I. Thus, this lobe can be vascularized by caudate veins (CV) born either from the right branch of the portal vein (PV),from the left branch or from both. Therefore, the work allows us to study the morphometry of caudate veins. Based on the exploitation of vascular mussels of the inferior vena cava and the portal vein after injection-corrosion of the liver, the study conducted from April 2018 to March 2019 involved 41 livers of which 30 were exploited for caudate veins. These were from fresh adult subjects, both sexes free of any hepatobilio-pancreatic pathology or trauma. The injection-corrosion parts of his vascular mussels included the hepatobasement junction and the hepatic pedicle. The PV and its right and left branches provided accessory caudate branches for the caudate lobe at the level of the hepatic hilum. Thus, for all livers, we found 102 branches cauded by accessories. The accessory caudate veins were born either from the left branch of the PV in 28 livers out of 30 (93.37% ), by 1 to 4 vessels with an average distance between its branches and the portal bifurcation being 17 mm with extremes ranging from 7 to 39 mm; either from the right branch of the PV in 23 livers out of 30(76.6%), by 1 to 3 vessels with an average distance of 12.9 mm between its branches and the portal bifurcation, with extremes ranging from 9 to 18 mm. The stem of the portal vein gave branches to the caudate lobe in 11 livers on 30(36.6%),by 1 to 2 vessels whose diameter varied from 1 mm to 3 mm. We studied on 30 liver samples the anatomical variations related to CV. This is a contribution to the fundamental foundations of liver removal surgery because too little work (and often radiological) exists in Africa on the subject. However, this lack of comparative anthropometric data confirms the diversity of anatomical variations in caudate veins. On the therapeutic level these anatomical data contribute to the peri-operative safety of liver surgery.