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Abstract Kidney autotransplantation is a surgical procedure with multiple indications and advancing technological approaches. Kidney autotransplantation is used to address complex kidney-related diseases including renal vascular lesions, ureteral diseases, tumors, loin pain-hematuria syndrome, and conditions affecting a solitary kidney or both kidneys. Renal artery lesions, including aneurysms and stenoses, often necessitate kidney autotransplantation in cases involving renal artery bifurcation or distant failure of endovascular repair. Complex ureteral lesions such as ureteral avulsions are commonly treated with kidney autotransplantation. Renal tumors, especially centrally located tumors or those involving the renal hilum, are treated using this technique while preserving renal function. It is worth emphasizing that this would be a rarely used last-resort technique in the modern era of minimally invasive nephron-sparing surgery. Kidney autotransplantation may be indicated for the rare condition of loin pain-hematuria syndrome when conservative measures fail. Additionally, individuals with solitary or bilateral kidney disease benefit from kidney autotransplantation to preserve their renal function. Traditional open-kidney autotransplantation involves renal extraction, workbench repair, and renal reimplantation. Technological advancements have introduced minimally invasive techniques including laparoscopic- and robot-assisted kidney autotransplantation, which reduce surgical trauma and recovery times. These techniques have shown promising outcomes, and robotic platforms have the potential to further reduce complications. In this study, we reviewed diverse indications and recent technological innovations in the field of kidney autotransplantation.

Introduction: The aim of the study was to assess and compare the efficacy of autotransplantation of molars with complete and incomplete root formation, by checking the viability of the procedure to replace non‑restorable molar teeth in the extraction sockets. Materials and Methods: Twenty patients with non‑restorable molars were included in this study. They were divided into two groups with complete and incomplete root‑formed third molars, which needed to be transplanted in place of non‑restorable molars. A routine surgical procedure was performed to remove infected molars. Atraumatic removal of the third molar was performed and reimplanted in the socket of previously extracted infected molars. Results: Results were evaluated based on clinical observation and radiographic analysis of the transplanted tooth. Out of 20 transplants, one transplant, despite good initial stability, was extracted after one month because of abnormal horizontal and axial mobility; this was the single failure case (5%). Of the rest, 19/20 (95%) transplants were followed up for 6 months and showed no failure. Conclusion: This study clearly indicated that the benefits of autotransplantation over other treatment options are numerous, and the results are not affected by whether the root of the transplanted tooth is complete or incompletely formed. [ABSTRACT FROM AUTHOR]

Background: This article contains two cases with accompanying surgical videos, illustrating the use of a Tutoplast plug to create a watertight seal in the corneoscleral fistula formed after tube shunt removal. Case description: These cases demonstrate that Tutoplast can be cut into a strategic geometric shape to both plug the fistula formed at the tube entry site and reinforce adjacent areas of scleral thinning during tube removal or repositioning surgery. Specifically, a piece of dehydrated scleral Tutoplast was shaped into a small rectangle with an attached larger rectangle. The smaller rectangle or "head" would plug the fistula, while the attached larger rectangle or "body" could be used to reinforce the adjacent area of scleral thinning. The patch graft was sutured to the sclera at the four corners and resembled a turtle with four sutures for legs, with its head in the fistula. Hence, this technique is called the scleral "Turtle-Plast." Conclusion and clinical significance: This "Turtle-Plast" technique is advantageous over direct suturing of the tube track because the head of the turtle provides an astigmatically neutral, watertight seal for the short anterior fistula, which can often be technically challenging to secure. Meanwhile, the body of the turtle can serve as a more substantive piece of patch graft to suture down to the underlying sclera that may be susceptible to thinning. [ABSTRACT FROM AUTHOR]

Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root resorption of tooth 3.7. Extraction of 3.7 and autotransplantation of 3.8 was planned, following a 6-week orthodontic phase for periodontal ligament activation and teeth mobilization. Due to the different root morphology between the compromised and donor teeth and the high mandibular bone density, the receiving socket preparation was performed using guided surgery templates. Two surgical splints were designed with a surgical planning software. Tooth 3.7 was extracted, the recipient site was guided-milled, and tooth 3.8 was transplanted into the new socket in approximately one second of extra-alveolar time. The rapidity of the extra-alveolar time facilitated complete healing without resorting to root canal treatment. Five-year radiological control does not show any periapical lesion or root resorption. The surgical procedure for tooth autotransplantation is fundamental: it must be as atraumatic as possible to preserve the periodontal ligament of the tooth and the receiving socket, and the dentist must minimize the extra-alveolar time. Guided surgery is a reliable solution to combine all these aspects. [ABSTRACT FROM AUTHOR]

Aim: To use auto‐transplantation of a central incisor and canine and repositioning of a lateral incisor with corticotomy as an alternative to complex lengthy orthodontics and possible tooth loss. Method: Following initial consultation in a joint orthodontic/oral surgery clinic in Guy's Hospital, the decision was made to carry out auto‐transplantation of the ectopic teeth under general anaesthesia. The procedure included extraction of retained primary teeth, auto‐transplantation of upper right permanent central incisor and canine, segmental osteotomy/corticotomy to reposition the lateral incisor, followed by splinting of the upper 3–3 for 6 weeks. The patient was reviewed multiple times over a 2.5‐year period and no signs of inflammation, ankylosis, sensitivity, root resorption, mobility or loss of vitality was noted. Discussion: Auto‐transplantation is an underutilised technique despite being used for over 70 years. It does, however, have its limitations and there are several factors that can affect its success and predictability. This case highlights that it can be an excellent alternative to lengthy and difficult orthodontic treatment and resulted in avoidance of loss of teeth. This treatment method reduced time and cost to the NHS as well as improved the patient journey. It is important to work closely with colleagues and adopt a multidisciplinary approach to treatment planning and have an awareness for alternative treatment options that are available for joint orthodontic/oral surgery cases. Conclusion: Auto‐transplantation, in certain cases and conditions, can be very successful and save both patient and the NHS time and money. Greater awareness of this technique is required so that it can be offered more regularly as a treatment option. [ABSTRACT FROM AUTHOR]

Abstract Introduction The spleen is a responsible significant part of the immune system; after Splenectomy following trauma, the immune system changes; splenic autotransplantation can preserve the immune system after trauma and Splenectomy. Background Patients can be protected from immune dysfunction by autotransplanting splenic tissues after splenectomy following trauma because their immune systems and spleens are changed. Patients can gain their immune function after splenic autotransplantation. Methods Patient classification methods are into three categories, Group A, 6 cases with auto-translation; Group B, 6 cases without transplantation; Group C, seven regular people serving as the control. Aim of work The aim of the work is not to compare outcome methods or compare types of autotransplantation; This work aims to document postoperative radiological, immunological, clinical, and hematological investigations. We concentrated on the results of investigations more than the types of operation or approach or types of autotransplantation. Results We showed that, after comparing each group with normal individuals subjects, patients who did not undergo autotransplantation had significantly higher platelet counts, a more significant percentage of micronucleated reticulocytes, increased levels of naive B lymphocytes, changes in class-switched memory and class-unswitched memory B cells, and higher levels of PD1 on CD8 + T lymphocytes. Nevertheless, neither splenic autotransplant patients nor the average general population showed any appreciable variations in any of the parameters. Conclusions Spleen’s activities with adequate hemocatheter activity and recovery of the immunological deficit after splenic autotransplantation.

To present the efficacy of autologous neurosensory retinal transplantation in macular holes surgery with rhegmatogenous retinal detachment. Eleven eyes of 11 patients with rhegmatogenous retinal detachment associated to a large macular hole were enrolled between January 2019 and January 2021 in the Department A of the Hedi Rais Institute of Ophthalmology (Tunis, Tunisia). All patients underwent a 23 G pars plana vitrectomy. An autologous neurosensory retinal patch was placed inside the macular hole. Long-acting silicone tamponade was carried out. Clinical features of the macular area, best-corrected visual acuity (BCVA), fundus examination, and SD-OCT were recorded before surgery, at 1- and 3-month follow-up after surgery. The mean age of our population was 56.6 ± 10.33 years old, ranged from 45 to 76 years old. Final retinal reattachment was achieved clinically in all eyes. The Spectral domain-Optical Coherence Tomography (SD-OCT) follow-up showed the macular hole closure. The retinal patch was demonstrated by OCT at each control. BCVA improved from 1.52 ± 0.23 Logarithm of the Minimum Angle of Resolution (LogMAR) to 0.89 ± 0.16 LogMAR 3 months after surgery (p= 0.014). No adverse events were registered during the study. Autologous neurosensory retinal transplantation has been efficient to treat macular hole associated to rhegmatogenous retinal detachment. Further multicentric studies with a large number of patients are needed to establish the results of this technique in complex cases. [ABSTRACT FROM AUTHOR]

To present an alternative evisceration technique with long-term follow-up data. This technique involves the insertion of an acrylic implant into a modified scleral shell which is closed using an autologous scleral graft. This was a retrospective analysis of eviscerations performed in a district-general hospital in the UK. All patients underwent conventional ocular evisceration after total keratectomy. A full thickness scleral graft is harvested from the posterior sclera, using an internal approach, with an 8 mm dermatological punch. An 18–20 mm acrylic implant is placed into the shell, and the scleral graft is used to close the anterior defect. Demographic characteristics, implant size and type, and cosmetic results from pictures of all patients were recorded. All patients were invited for a review to measure motility, eyelid height, patient recorded satisfaction and complications. Of the five patients identified, one had since died. The remaining four attended a review in person. The mean time between surgery and review was 48 months. The mean implant size was 19 mm. There were no cases of implant extrusion or infection. All four had a <1 mm asymmetry in measured eyelid height and ≥5 mm horizontal gaze motility. All patients self-reported "good" cosmesis. An independent assessment identified "mild asymmetry" in two cases and "moderate" in the other two. Evisceration with this novel autologous scleral graft technique restores volume in the anterior orbit with good cosmetic results, and with no cases of implant exposure reported in this small case series. This technique should be compared prospectively to established techniques. [ABSTRACT FROM AUTHOR]

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The breast is essential to a woman's physical integrity. There are numerous techniques for breast reconstruction, so that the needs and limitations of each patient can be respected. The individual preferences of the patient play an important role in the decision of silicone implants vs. autologous tissue, size, and shape of the breast as well as the timing of the surgery. The only reasons not to perform a reconstruction are a locally incompletely removed tumor or the explicit wish of the patient against reconstruction. The costs for reconstruction are covered by the health insurance for all procedures, including symmetrizing the opposite breast, nipple reconstruction and autologous fat grafting. [ABSTRACT FROM AUTHOR]

Osteoid osteoma occasionally occur in the spine, but their malignant transformation is not common. We present an extremely rare case of the malignant transformation of an osteoid osteoma to high-grade osteosarcoma that formed in the pedicle and spread to the lateral mass of the cervical spine. We report the case of an 18-year-old man who suffered from neck pain as an initial symptom. The size of the radiolucent lesion was 12 mm in diameter at the time of diagnosis. Intralesional tumour resection and autologous bone grafting were performed. The remaining tumour grew gradually for 40 months after the surgery; therefore, the tumour had grown rapidly till 51 months after the initial diagnosis. At this stage, the tumour size was approximately 6-fold larger than the initial size, and resulted in progressive paraplegia. A biopsy revealed that the tumour had transformed into a high-grade osteosarcoma. Heavy charged particle irradiation was performed to control tumour growth. There is a possibility of malignant transformation of osteoid osteoma. Patients with osteoid osteoma or osteoblastoma should be carefully observed, especially for recurrent tumours after an intralesional resection. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to establish an in vivo large mammalian model that can form the basis for future immunosuppression research, nerve recovery research, surgical applicability, and training studies. Materials and Methods: An 18-month-old, 40 kg, curly breed sheep was used. A whole-eye autotransplantation was planned, including the upper and lower eyelids, lacrimal gland, and extraocular muscles. Intracranial intervention and inclusion of the bone segment were not considered. The frontozygomatic approach was used in the operation. Circulation was established by anastomoses of the internal ophthalmic vein and artery with elongated superficial temporal artery and vein with vein grafts. The optic nerve was repaired last. Blood circulation and the retina were checked by means of postoperative bleeding and indirect ophthalmoscope. Results: Using the internal carotid system, circulation of the entire eye and its appendages was achieved in the early period. The frontozygomatic approach facilitated nerve and vessel repairs and therefore shortened the ischemia time (16 min). Although circulation was established in the retina, local bleeding foci were detected. Pupillary, corneal, and palpebral reflexes could not be obtained from the animal. The animal died on the 10th day. Circulation of the autotransplanted tissue was present at this time, including the eyelids and appendages of the eye. Conclusion: The composite whole-eye autotransplantation model was successfully planned in vivo in a large mammal, the sheep, without the need for intracranial intervention, and by including all of the eye attachments based on the internal ophthalmic artery.

Purpose: To evaluate the safety and efficacy of autologous parathyroid transplantation in laparoscopic total thyroidectomy combined with central lymph node dissection (CLND). Methods: Retrospective analysis of clinical data of 152 patients admitted to the General Surgery Department of Gansu Provincial People's Hospital who underwent endoscopic total thyroidectomy combined with CLND from June 2018 to December 2021. The intraoperative parathyroid glands were divided into the orthotopic preservation group (non-transplantation group) and the immediate active autologous transplantation group (transplantation group) according to the different treatment management of parathyroid glands during operation. The levels of Ca2+ in parathyroid blood and the incidence of hypoparathyroidism were compared between the two groups before operation and 1 day, 3 day, 1 week, 1 month, 3 months and 6 months after operation. Results: There was no significant difference in PTH between the preoperative transplantation group compared and the non-transplantation group (P>0.05); The PTH in the transplantation group was lower than that of the nontransplantation group 1 and 3 d after surgery, and the difference was statistically significant (P<0.05); No statistically significant difference in PTH between patients in the transplantation group compared with those in the non-transplantation group at 1 week postoperatively (P>0.05); PTH was significantly higher in the transplant group than in the non-transplant group at 1, 3 and 6 months after surgery, with statistically significant differences (P<0.05); there was no statistically differences (P>0.05) in serum Ca2+ between the preoperative, 1d, 3d and 1 week postoperative transplantation group and the non-transplantation group; Blood Ca2+ was significantly higher in the transplant group than in the non-transplant group at 1, 3 and 6 months after surgery, with statistically significant differences (P<0.05); The rate of temporary hypoparathyroidism in the transplantion group was higher than that in the non-transplantion group, and the rate of permanent hypoparathyroidism was lower than that in the non-transplantion group (P=0.044); There was no significant difference in the concentration of PTH in the cephalic vein of the elbow between the transplanted side and the non-transplanted side at 1 day and 3 days postoperatively (P>0.05); the concentration of PTH in cephalic vein of the elbow was significantly higher than that in non-transplanted side at 1 week, 1 month, 3 months and 6 months postoperatively (P<0.001); the number central area dissection and metastasis dissection in the transplantation group were significantly higher than those in the non-transplantation group (P<0.05). Conclusions: Most autologous parathyroid glands, having functional parathyroid autograft, is helpful to the occurrence of hypoparathyroidism after endoscopic total thyroidectomy with CLND, and it is an effective strategy to prevent permanent hypoparathyroidism, and more thorough area dissection is beneficial to the disease prognosis. [ABSTRACT FROM AUTHOR]

Renal artery aneurysms involving segmental branches pose a technical challenge to repair. Both endovascular and open repair techniques have been described. This case illustrates the clinical presentation of a patient with a symptomatic renal artery aneurysm with thromboembolic renal infarction managed with laparoscopic nephrectomy, ex vivo aneurysm resection, renal artery reconstruction, and autotransplantation.

Objective: This paper aimed to evaluate the clinical value of performing an endoscopic total parathyroidectomy through anterior chest approach with autotransplantation (EACtPTx+AT) in treating secondary hyperparathyroidism (SHPT) to summarize and share the clinical experience. Methods: 24 patients with SHPT were retrospectively analyzed:11 patients underwent open total parathyroidectomy with autotransplantation (OtPTx+AT Group) and 13 patients underwent endoscopic parathyroidectomy through anterior chest approach with autotransplantation (EACtPTx+AT Group). Comparing the two groups regarding the following factors: (1) operating conditions, such as the blood loss during the operation, the length of time spent on the operating table, the number of parathyroid glands removed, postoperative drainage volume and hospital stay. (2) clinical efficacy, parathyroid hormone (PTH) and serum calcium (Ca) levels. (3) postoperative complications. Results: First, there were no significant differences in the number of parathyroid gland resection, operation time, intraoperative blood loss and hospital stay between the two groups. While there were significant differences in postoperative drainage volume between the two groups. Second, the two groups preoperative PTH and preoperative serum calcium decreased significantly compared with those of the two groups after surgery and there was a statistically significant difference. Thirdly, there was no postoperative bleeding, hoarseness or choking in the two groups and no conversion to open surgery case in EACtPTx+AT group. Conclusion: Endoscopic treatment of SHPT using the anterior chest approach with forearm autotransplantation significantly improves clinical symptoms and lowers levels of PTH and serum calcium after the operation. The results confirm the operation’s safety and effectiveness. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to evaluate the US features of the parathyroid glands (PTGs) using surgical specimens of normal PTGs obtained during thyroid surgery. Materials and Methods This study included 34 normal PTGs from 17 consecutive patients who underwent thyroid surgery between December 2020 and March 2021. All normal PTGs were histologically confirmed by intraoperative frozen-section biopsy for autotransplantation. Surgically resected parathyroid specimens were scanned in sterile normal saline using high-resolution US prior to autotransplantation. The US features of echogenicity (hyperechogenicity or hypoechogenicity), echotexture (homogeneous or heterogeneous), size, and shape (ovoid or round) were retrospectively evaluated. The echogenicity of the three PTGs was compared with that of the thyroid parenchyma of the resected thyroid specimens in two patients. Results All PTGs showed hyperechogenicity similar to that of gauze soaked in normal saline. Homogeneous hyperechogenicity was observed in 32/34 (94.1%) patients, and the echogenicity of the three PTGs was hyperechoic compared with that of the thyroid parenchyma. The long diameter of the PTGs ranged from 5.1 mm to 9.8 mm (mean, 7.1 mm) and the shape of the PTGs was ovoid in 33/34 (97.1%) patients. Conclusion The echogenicity of normal PTG specimens was consistently hyperechoic, and the small ovoid homogeneously hyperechoic structure was a characteristic US feature of the PTGs. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical effect of total parathyroidectomy with forearm autotransplantation on secondary hyperparathyroidism. Methods From January 2017 to December 2020, calcium, phosphorus, intact parathyroid hormone, alkaline phosphatase and clinical symptoms of 26 patients who received total parathyroidectomy with forearm autotransplantation in our hospital were studied. The patients with end-stage renal disease in this study had persistent dialysis in the treatment of secondary hyperparathyroidism before admission. Results A total of 105 parathyroid glands of all patients were removed. The symptoms including ostalgia and itch of skin were improved or removed in all cases. Amount of calcium, phosphorus, alkaline phosphatase and intact parathyroid hormone in serum decreased significantly post-operative 3 and 6 months than before (P

Background: To investigate how number of autotransplanted parathyroid glands (PGs) affects the incidence of postoperative hypoparathyroidism and the recovery of parathyroid function. Methods: A systematic search was performed in the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases. The evaluated indices included the incidence of postoperative transient and permanent hypoparathyroidism and parathyroid hormone (PTH) levels during follow-up. Results: Twenty articles with 7291 patients were included. A higher incidence of transient hypoparathyroidism was found in the PG autotransplantation group than in the preservation group (odds ratio [OR]: 2.37; 95% confidence interval [CI]: 1.90, 2.96). However, there was no significant difference between the two groups regarding permanent hypoparathyroidism (OR: 1.17; 95% CI: 0.71, 1.91). Parathyroid hormone (PTH) levels in the PG autotransplantation group changed significantly more than the preservation group at postoperative 1-day and 1-month, but became similar at the 6-month, 1-year and 2-year follow-up. Autotransplantation of 2 and 3 PGs demonstrated a higher incidence of transient hypoparathyroidism than 1 PG (OR: 2.09; 95% CI: 1.41, 3.11 and OR: 9.70; 95% CI: 2.11, 44.39, respectively), but no significant difference was observed between the autotransplantation of 3 and 2 PGs (OR: 0.99; 95% CI: 0.03, 29.06). Additionally, the incidence of permanent hypoparathyroidism was not significantly different when different number of PGs was autotransplanted. Conclusions: PG autotransplantation is an effective mid- and long-term strategy for the preservation of parathyroid function. Although transient hypoparathyroidism was positively correlated with the number of autotransplanted PGs, no remarkable correlation was observed for permanent hypoparathyroidism.

Objective: The purpose of this study was to describe a surgical technique of bone resection with periosteal preservation and reconstruction in patients with high-grade bone malignant tumors and to determine its effect on local recurrences, and time and quality of bone union in bone autografting reconstruction. Patients and methods: We retrospectively reviewed 11 cases of high-grade malignant bone tumors in children aged 4 to 16 years, who were treated with chemotherapy and tumor resection while preserving partially the adjacent periosteum. Tumors were located in the lower limb in eight cases; three tumors were in the humerus. The mean length of the bone defect after resection was 15.8 cm (range, 6–34.5 cm). Reconstruction was provided by non-vascularized autograft in eight cases (lower limb) and polymethyl methacrylate spacer in three cases (upper limb). Patients were followed up for a mean of 71 months. Results: At the last follow-up, no patients had local recurrence. Three patients were dead because of metastasis. Bone union was good in time and quality in all children who had bone autografting. In cases of PMMA reconstruction, there was periosteal bone formation around the spacer. According to the MSTS functional score, patients with lower limb localizations had a mean score of 27.75 points and patients with upper limb localizations had a score of 24/30. Conclusion: Preservation of the periosteum in bone resection for malignant tumors could be a good adjuvant alternative for bone reconstruction, without increasing the risk of local recurrence. However, patients must be carefully selected. [ABSTRACT FROM AUTHOR]

The development of new drugs for inflammatory bowel disease (IBD) is remarkable, and treatment strategies using multiple agents and various techniques are required; however, the treatment strategy is likely to be complex. Therefore, appropriate evaluation of traditional surgical treatment strategies and accurate knowledge of the efficacy and limitations of novel treatments are required. Total infectious complications were found to be associated with the use of corticosteroids and anti‐tumor necrosis factor‐α agents, but not with immunomodulators, anti‐integrin agents, and 5‐aminosalicylic acid. Regarding surgical procedures for IBD, conceived anastomosis methods, including Kono‐S for Crohn's disease stenosis, are associated with better outcomes than conventional techniques. Autologous cell transplantation for Crohn's fistulae has been shown to have a favorable outcome. Diverticulitis is increasing and will be treated more frequently in the future. Risk factors for the incidence of diverticulitis and differences in pathogenesis according to right or left side diverticulitis have been reported. Antibiotic therapy may be omitted for uncomplicated diverticulitis. Moreover, regarding surgical procedures, both bowel resection and anastomosis are associated with favorable short‐term outcomes, higher stoma closure rate, and superior medical economy compared to Hartmann's procedure. Risk factors for recurrence after diverticulitis surgery may provide better postoperative follow‐up. In this review, we explore the current topics of colorectal benign diseases, focusing on IBD and diverticulitis, based on clinical trials and meta‐analyses from 2020‐2021. This review consolidates the available knowledge and improves the quality of surgical procedures and perioperative management for IBD and diverticulitis. [ABSTRACT FROM AUTHOR]

Autotransplantation is a relatively rare method used in cardiac surgery. It gives the surgeon excellent opportunities for precise surgical treatment of hard-to-reach pathologies located in the heart cavities, which is especially important when the aim of procedure is to remove maximal amount of malignant neoplastic cells. In this article, we describe the use of autotransplantation in a 32-year-old man finally diagnosed with Undifferentiated Pleomorphic Sarcoma (UPS). The course of the disease, the operative strategy, and the most common pathologies will be described.

Background: This retrospective study aimed to evaluate the safety and learning curve of ex vivo liver resection and autotransplantation (ELRA).Methods: A total of 102 consecutive end-stage HAE patients who underwent ELRA between 2014 and 2020 in West China Hospital were enrolled. The primary endpoint was major postoperative complications (comprehensive complication index, CCI > 26). The ELRA learning curve was evaluated using risk-adjusted cumulative sum (RA-CUSUM) methods. The learning phases were determined based on RA-CUSUM analysis and tested for their association with intra- and post-operative endpoints.Results: The median surgery time was 738 (659–818) min, with a median blood loss of 2,250 (1,600–3,000) ml. The overall incidence of major morbidity was 38.24% (39/102). Risk-adjusted cumulative sum analysis demonstrated a learning curve of 53 ELRAs for major postoperative complications. The learning phase showed a significant association with the hemodynamic unstable time (HR −30.29, 95% CI −43.32, −17.25, P < 0.0001), reimplantation time (HR −13.92, 95% CI −23.17, −4.67, P = 0.004), total postoperative stay (HR −6.87, 95% CI −11.33, −2.41, P = 0.0033), and postoperative major morbidity (HR 0.25, 95% CI 0.09, 0.68, p = 0.007) when adjusted for age, disease course, liver function, and remote metastasis.Discussion:Ex vivo liver resection and autotransplantation is feasible and safe with a learning curve of 53 cases for major postoperative complications.

Primary surgery for macular hole (MH) closure has a high success rate with current methods of pars plana vitrectomy and internal limiting membrane (ILM) peeling. When primary surgery fails, there are several options available for secondary repair, including extension of the ILM peel, creation of an ILM flap, pedunculated ILM flap, lens capsule flap transplantation, autologous retinal transplantation, use of a human amniotic membrane plug, adjuvant autologous platelet concentrate, induction of macular detachments with subretinal blebs, and creation of retinal incisions. In this review, we discuss the practical approach to each of these surgical techniques for the management of recurrent or persistent MHs. [ABSTRACT FROM AUTHOR]

Introduction: Severe hypocalcemia is a rare but serious complication of secondary hyperparathyroidism (SH) surgery. Continuous intravenous calcium replacement is required and patients are not discharged. Cryopreserved parathyroid autotransplantation (CPA) is the most effective and lasting treatment option for severe hypocalcemia. However, a cryopreservation laboratory is necessary for this procedure. Methods: Subtotal parathyroidectomy performed 150 SH cases (age range: 26-69 years, mean age: 39.5 years, men/women: 2/1) were retrospectively evaluated. Severe hypocalcemia (serum calcium level of <6.5 mg/dL) was developed in 7 (4.6%) cases. CPA was performed and cases were observed in a minimum of 18 months. Results: After transplantation in five cases, intravenous and oral calcium replacement was ceased and cases were discharged. Transplantation failed in two cases, thus second time CPA. After the second CPA, intravenous calcium is ceased and cases were discharged. Any side effects or complications were not seen during the observation period. Conclusion: CPA is the most effective and lasting treatment option for severe hypocalcemia. CPA is not difficult to perform but a cryopreservation laboratory and experienced laboratory team are necessary for this procedure. The presence of this laboratory in SH surgery performed centers reduces the risk of mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objectives. This study investigated the long-term surgical outcomes of functional cholesteatoma surgery with canal wall reconstruction using autologous bone grafts as the primary material in patients with acquired cholesteatoma. Subjects and Methods. Medical charts were retrospectively reviewed for all patients admitted to one institution for surgical intervention between 2010 and 2018. We analyzed 66 patients (66 ears) who underwent functional tympanomastoidectomy involving the use of autologous bone grafts for canal wall defect reconstruction. Surgical outcomes were evaluated by comparing preoperative audiometric results with followup data (at least 36 months after surgery). Logistic regression analyses were performed to determine prognostic factors related to long-term hearing success. These factors included classification and stage of cholesteatoma, stapes condition, ossicular chain damage, active infection of the middle ear, state of the contralateral ear, preoperative hearing thresholds, gender, and age. Results. The mean follow-up period was 49.2 months. The recidivism rate was 6% (four of 66 ears). The pure-tone average significantly improved from 50.78 ± 19.98 to 40.81 ± 21.22 dB hearing level (HL; p < 0.001). Air–bone gaps significantly improved from 26.26 ± 10.53 to 17.58 ± 8.21 dB HL (p < 0.001). In multivariate logistic regression analysis, early-stage disease (p = 0.021) and pars flaccida cholesteatoma (p = 0.036) exhibited statistically significant correlations with successful hearing preservation. Conclusion. Functional cholesteatoma surgery with autologous bone grafts reconstruction is an effective approach to significantly improve hearing with low recidivism rates. Localized disease and pars flaccida cholesteatoma were two independent predictors of successful hearing preservation. [ABSTRACT FROM AUTHOR]

In the article titled "Autologous Fat Grafting in Total Temporomandibular Joint Replacement Surgery", published on pages 299-302, Issue 2, Volume 8 of Annals of Maxillofacial Surgery,[[1]] the author name "Van Bogaert" was misspelled as "Van Bogaret" in the running title. [Extracted from the article]

Abstract Background Ex situ liver resection and autotransplantation is among the most advanced techniques which has been introduced in recent years. Case presentation A 24-year-old male referred with chief complaints of abdominal pain, nausea, and vomiting from 1 month prior to admission. Computed tomography showed a large liver mass in the left lobe of the liver with involvement of retrohepatic inferior vena cava (IVC), in favor of hepatocellular carcinoma. After hepatectomy, the common bile duct was completely removed. A 4-cm Dacron graft was anastomosed to the inferior and top of the IVC. A temporary portocaval shunt was placed, and ex situ resection of the left lobe of the liver was done. Remnant of the liver was implanted. Reconstruction of the bile duct was done using a Roux-en-Y technique, and autotransplantation of the liver was then completed. During a 4-year follow-up, the patient had no complaints and is in good conditions. Conclusion With appropriate consideration of patients, despite surgical complexities, ex situ resection of unresectable HCC can provide excellent prognosis.

Ex vivo liver surgery techniques have been proposed almost two decades ago in order to extend the indications and feasibility of liver resections for large, but not absolutely unresectable liver lesions. However, the procedure remains a demanding one, being associated with high risks of postoperative complications; therefore it should be performed only in specialized centers. This is a literature review of the largest studies conducted on the theme of ex vivo liver resection for tumoral pathology.

Background: The amount of bone remaining at the transplant site for autogenous tooth transplantation can facilitate successful healing. Therefore, this retrospective study evaluated the factors influencing the healing of 50 successful autogenous tooth transplantations with insufficient bone support at the transplanted site without a bone graft. Methods: The factors were classified as pre- and peri-operative factors, and the healing outcomes were clinical and radiographic observations. The factors were statistically analyzed using the chi-square test to identify correlations between the pre- and peri-operative factors and the clinical and radiographic outcomes. The T-test or one-way analysis of variance was used to compare the percent bone change in each factor. Results: The results indicated that gingival healing was delayed in the intra-arch transplantations, and pulp obliteration was seen earlier when transplanted in the maxilla. Patients under 18-years-old demonstrated a greater percent bone change than the over 18-year-old patients, while the peri-operative variables did not have a relationship with clinical healing and the amount of bone change over 12 months. Furthermore, the percent bone change significantly increased during the first three months. Conclusions: In conclusion, pre-operative factors, age and transplant site, influenced the healing rate of autogenous transplanted teeth. In contrast, the peri-operative factors were not related with the clinical and radiographic outcomes. Generating the least trauma to the periodontal ligament cells is the most important concern. [ABSTRACT FROM AUTHOR]

The surgical treatment of traumatic leptomeningeal cyst (LMC) is repair of the dural defect with or without cranioplasty. The dural substitutes used are either autografts (which may not be enough) or artificial grafts (which are foreign-body implantations and which also may be too expensive in a low-resource practice). In this report from a developing country, we present the surgical description of the use of the cyst capsule as a cost-free autologous graft in the surgical repair of the dural defects of two cases of traumatic leptomeningeal cyst. [ABSTRACT FROM AUTHOR]

Background: Autogenous tooth transplantation of impacted maxillary canines can be considered in cases where traditional treatment options are prone to failure. We report a clinical case of autogenous tooth transplantation of bilateral impacted maxillary canines with adverse outcome and failure of treatment. Methods: Clinical and radiographic data of a fifteen years old girl was collected over a 12-months period. Results: This case demonstrates difficulties and possible adverse outcomes that can be faced when performing this surgical technique. Lack of proper presurgical planning and training in the specific autotransplantation procedure, and inadequate use of the surgical technique may not only be followed by failure of treatment and loss of the transplanted teeth but can also jeopardize neighboring healthy teeth, thus complicating further treatment. Conclusions: This case report of a 15-year old patient with severe complications after autotransplantation of bilateral impacted maxillary canines calls for the need of proper presurgical planning and training with regard to the specificities of the treatment strategy and surgical technique when performing this type of surgery.