The surgical management of goiter: Part I. preoperative evaluation

2010 ◽  
Vol 121 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Jennifer J. Shin ◽  
Hermes C. Grillo ◽  
Doug Mathisen ◽  
Mark R. Katlic ◽  
David Zurakowski ◽  
...  
2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.


1998 ◽  
Vol 6 (2) ◽  
pp. 138-140
Author(s):  
Berent Discigil ◽  
Mehmet Boga ◽  
Ugur Gürcün ◽  
Cahide Soydas ◽  
Münevver Yüksel

We report a case of extracardiac unruptured aneurysm of the noncoronary sinus of Valsalva presenting with massive aortic regurgitation and high fever. The preoperative evaluation, echocardiographic and cardiac catheterization findings, and surgical management of this rare condition are discussed.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16535-e16535
Author(s):  
Fabian Trillsch ◽  
Jan David Ruetzel ◽  
Uwe Herwig ◽  
Ulrike Doerste ◽  
Linn Lena Woelber ◽  
...  

e16535 Background: Surgery is the central aspect of clinical management in patients with borderline ovarian tumors (BOT). As patients have excellent overall prognosis after successful surgery, perioperative morbidity is a critical point for decision regarding the primary surgical approach. Methods: Clinical and surgical parameters of patients undergoing surgery for primary BOT at two gynecologic cancer centers between 1993 and 2008 were analyzed with regard to perioperative morbidity depending on the surgical approach (laparoscopy vs. laparotomy). Results: A total of 105 patients were analyzed (44 with primary laparoscopy [42%], 61 with primary laparotomy [58%]). Primary laparoscopy was often performed with diagnostic intention and resulted in complete surgical staging in only 9.1% with subsequent formal indication for re-staging procedures. In contrast, complete surgical staging was achieved in 47.5% at primary laparotomy (p < 0.001). Tumor rupture was significantly more frequent during laparoscopy compared to laparotomy (29.5% vs. 13.1%, p = 0.038) but no other intraoperative complications were seen in laparoscopic surgery in contrast to 7 of 61 laparotomies (0% vs. 11.5%, p = 0.020). Postoperative complication rates were similar in both groups (19.7% vs. 18.2%, p = 0.848). Conclusions: Irrespective of the surgical approach, surgical management of BOT has acceptable rates of perioperative complications and morbidity. Choice of initial surgical approach can therefore be made independent of complication-concerns. As the recently published large retrospective AGO ROBOT study observed similar oncologic outcome for both approaches, laparoscopy should be considered as the preferred surgical approach for staging of patients with BOT if this appears feasible in preoperative evaluation.


2021 ◽  
Vol 35 (02) ◽  
pp. 088-097
Author(s):  
Rami P. Dibbs ◽  
Edward Chamata ◽  
Andrew M. Ferry ◽  
Jeffrey D. Friedman

AbstractFacial rejuvenation procedures have become more commonly performed due to an increasing elderly population and greater general public acceptance. As a result, patients are now increasingly undergoing secondary and tertiary rhytidectomies to treat natural aging and/or to correct complications from prior procedures. Revision face and neck lifts are more complex by nature of the procedure and require a comprehensive preoperative assessment for enhanced outcomes. In this review, we discuss the preoperative evaluation, surgical challenges encountered, primary face and neck lift deformities, and their surgical management for patients undergoing secondary face and neck lifts.


2005 ◽  
Vol 95 (1) ◽  
pp. 85-90 ◽  
Author(s):  
Alan R. Catanzariti ◽  
Robert W. Mendicino

Tarsometatarsal arthrodesis is indicated for degenerative joint disease after trauma. Deformity is often associated with post-traumatic arthropathy. Outcomes after surgical management are directly related to realignment. This article reviews the indications, preoperative evaluation, technical execution, and postoperative management of tarsometatarsal arthrodesis. Special emphasis is placed on realignment and restoration of normal foot architecture. (J Am Podiatr Med Assoc 95(1): 85–90, 2005)


2018 ◽  
Vol 45 (3) ◽  
pp. E3 ◽  
Author(s):  
Jonathan Pindrik ◽  
Nguyen Hoang ◽  
Luke Smith ◽  
Mark Halverson ◽  
Mary Wojnaroski ◽  
...  

OBJECTIVEDespite perioperative risks, epilepsy surgery represents a legitimate curative or palliative treatment approach for children with drug-resistant epilepsy (DRE). Several factors characterizing infants and toddlers with DRE create unique challenges regarding optimal evaluation and management. Epilepsy surgery within children < 3 years of age has received moderate attention in the literature, including mainly case series and retrospective studies. This article presents a systematic literature review and explores multidisciplinary considerations for the preoperative evaluation and surgical management of infants and toddlers with DRE.METHODSThe study team conducted a systematic literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, targeting studies that investigated children < 3 years of age undergoing surgical treatment of DRE. Using the PubMed database, investigators selected peer-reviewed articles that reported seizure outcomes with or without developmental outcomes and/or perioperative complications. Studies were eliminated based on the following exclusion criteria: sample size < 5 patients; and inclusion of patients > 3 years of age, when demographic and outcomes data could not be separated from the cohort of patients < 3 years of age.RESULTSThe study team identified 20 studies published between January 1990 and May 2017 that satisfied eligibility criteria. All selected studies represented retrospective reviews, observational studies, and uncontrolled case series. The compiled group of studies incorporated 465 patients who underwent resective or disconnective surgery (18 studies, 444 patients) or vagus nerve stimulator insertion (2 studies, 21 patients). Patient age at surgery ranged between 28 days and 36 months, with a mean of 16.8 months (1.4 years).DISCUSSIONThe study team provided a detailed summary of the literature review, focusing on the etiologies, preoperative evaluation, surgical treatments, seizure and developmental outcomes, and potential for functional recovery of infants and toddlers with DRE. Additionally, the authors discussed special considerations in this vulnerable age group from the perspective of multiple disciplines.CONCLUSIONSWhile presenting notable challenges, pediatric epilepsy surgery within infants and toddlers (children < 3 years of age) offers significant opportunities for improved seizure frequency, neuro-cognitive development, and quality of life. Successful evaluation and treatment of young children with DRE requires special consideration of multiple aspects related to neurological and physiological immaturity and surgical morbidity.


2020 ◽  
Vol 41 (6) ◽  
pp. 951-959 ◽  
Author(s):  
A.E. Goldman-Yassen ◽  
J.T. Goodrich ◽  
T.S. Miller ◽  
J.M. Farinhas

1987 ◽  
Vol 96 (1) ◽  
pp. 58-60 ◽  
Author(s):  
Barry L. Wenig ◽  
Allan L. Abramson

Bronchogenic cysts arise as congenital anomalies of the primitive foregut. Although bronchogenic cysts arising from and partially occluding the trachea have been reported in adults, this entity has not as yet been documented in children. We report a case of an infant with respiratory distress resulting from an intratracheal bronchogenic cyst. In view of its ability to create airway compromise, the pathogenesis, preoperative evaluation, and surgical management of this rare lesion will be discussed.


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