scholarly journals The fat anchor orchiopexy technique: results and outcomes from 150 cases surgical experience

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Alessia Bertocchini ◽  
Gianmartin Cito ◽  
Marco Ghionzoli ◽  
Silvia Strambi
Keyword(s):  
Undescended Testis ◽  
Healing Process ◽  
Day Surgery ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Surgical Wounds ◽  
Bilateral Cryptorchidism ◽  
Long Time ◽  
History Of

Abstract Purpose The purpose of the study is to evaluate results and outcomes in a long-time follow-up period, by performing a novel testicular fixation procedure, known as “fat anchor orchidopexy” (FAO), for the treatment of palpable low inguinal undescended testis. Materials and methods We retrospectively reviewed all patients who underwent scrotal orchiopexy technique, from May 2013 to May 2019, at the Pediatric Surgery Division of Department of Surgical Pathology, University of Pisa (Italy). FAO (Spinelli’s technique) consists in anchoring the testicles to sub-scrotal fat with a single trans-scrotal incision. All the patients enrolled had history of unilateral or bilateral undescended testis. Data collected included patient’s age, operative times and complications. Results A total of 150 children with cryptorchidism were treated using a single trans-scrotal orchiopexy. Of them, 130 patients (86.7%) had unilateral undescended testis and 20 (13.3%) bilateral cryptorchidism. Mean patient’s age was 21 months (range: 14–28 months). All the procedures were planned in a day-surgery setting. Trans-scrotal orchiopexy was successful in all cases and no patients required an additional groin incision. No intraoperatively and postoperatively major complications were observed. Patients’ post-operative pain was mild (mean pediatric visual analog scale = 2). In all cases, the healing process was rapid and no surgical wounds infections were reported during the post-operative period, referring excellent cosmesis results. During a mean 48-month follow-up period, no testicular retraction, recurrence or testis atrophy was reported. Conclusion The original Spinelli’s technique (FAO) proves to be a safe and effective method for the treatment of palpable or distal-to-external-inguinal-ring testes. No immediate and delayed post-surgery complications were reported. In all cases, the anchored testicle remained in the scrotal position with normal vascularization. This novel surgical technique could give better options for scrotal fixation in case of low-lying cryptorchid testes.

scholarly journals Rare Etiology of Odynophagia in a Female Adolescent

2021 ◽  
pp. 352-358
Author(s):  
Anastasios Koutsoumourakis ◽  
Asterios Gagalis ◽  
Maria Fotoulaki ◽  
Maria Stafylidou
Keyword(s):  
Antiviral Treatment ◽  
Healing Process ◽  
Rare Condition ◽  
Female Adolescent ◽  
Mucosal Barrier ◽  
Esophageal Mucosa ◽  
Intact Immune System ◽  
History Of ◽  
Orolabial Herpes

Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.

scholarly journals A Solitary Giant Neurofibroma of Inguinal Region—A Case Report

2020 ◽  
Author(s):  
Haiying Zhou ◽  
Hui Lu
Keyword(s):  
Tumor Resection ◽  
Clinical Manifestations ◽  
Inguinal Region ◽  
Case Presentation ◽  
Neurogenic Tumors ◽  
Long Time ◽  
Giant Neurofibroma ◽  
History Of ◽  
Recurrence Tendency

Abstract Background:Neurofibroma is a rare nerve sheath tumorofneuroectodermal origin, especially the huge and isolated neurofibroma located in the inguinal region. To our knowledge, no such case has previously been reported.Case presentation:We report a case of 34-year-old male patient with a 4-year history of progressive enlargement of the medial root mass in his left thigh with sitting and standing disorders along with pain. The tumor was completely removed by operation, and pathological diagnosisshowed neurofibroma. There was no obvious neurologic defect after surgery, and no recurrence tendency was found in the follow-up of 2years.Conclusions:For a large solitary mass with slow growth and no malignant clinical manifestations for a long time, clinicians can not rule out the hypothetical diagnosis of neurofibroma, even though its growth site is very rare, such as this case of a huge tumor located in the groin. For neurogenic tumors, early operation should be performed, and the prognosis of patients after tumor resection isexcellent.

The Treatment of Long-Standing Venous Ulcers with an Extract of Early Placenta – a Pilot Study

1991 ◽  
Vol 6 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Tina Beaconsfield ◽  
Olga Genbačev ◽  
R.S. Taylor
Keyword(s):  
Pilot Study ◽  
Physiological Activity ◽  
Healing Process ◽  
Complete Healing ◽  
Wound Dressings ◽  
Cytosol Fraction ◽  
Venous Ulcers ◽  
Surgical Wounds ◽  
Early Placenta

The human placenta and its membranes have been used intermittently as wound dressings for more than 70 years. Term placenta is known to contain a number of growth factors essential to the healing process. The intense physiological activity of early placenta suggested that it should have similar attributes and we tested this hypothesis on one of the most refractory of all wounds – ulcers caused by chronic venous insufficiency. The cytosol fraction of 6–8 week placenta was incorporated under sterile conditions into an inactive cream vehicle and applied daily to the ulcer. The preparation and quality control of this extract are described. Eighteen patients were treated in this pilot study. The chronicity of the ulcers varied from 12 weeks to 30 years, and all had previously received conventional therapy. Ten patients with bilateral ulcers had treatment with the test preparation on one side only thereby serving as their own controls. Granulation tissue appeared between the 7th and 17th day after starting treatment, and epithelialization began within 2 weeks thereafter. The preparation produced complete healing in all cases and took 12 to 24 weeks, depending on ulcer size. None of the untreated ulcers were closed at the end of the trial. No breakdown has been seen so far on follow-up. The healing effect suggests that trophoblast might supply the missing factor(s) normally operative in surgical wounds and uninfected traumatic wounds.

Notfallmäßige Carotis Endarterektomie im Stadium progredienter neurologischer Defizite

VASA ◽  
2001 ◽  
Vol 30 (2) ◽  
pp. 115-121 ◽  
Author(s):  
R. Brandl ◽  
R.B. Brauer ◽  
P.C. Maurer
Keyword(s):  
Complete Recovery ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Symptomatic Carotid ◽  
Urgent Surgery ◽  
Post Surgery ◽  
Elective Treatment ◽  
Carotid Stenoses ◽  
History Of

Background: Carotid endarterectomy (CEA) is well established as the elective treatment for moderate or severe carotid stenoses with a history of neurologic symptoms. In contrast, the merits of carotid revascularisation performed in emergency in patients with acute stroke or fluctuating neurological deficit remain controversial. Patients and methods: A total of 445 CEAs were performed on 424 patients for 212 (48%) asymptomatic and 233 (52%) symptomatic carotid stenoses within a 5 years period between January, 1995, and December, 1999. Of the latter, CEA was performed in emergency on 16 patients (3.8%) within 4 to 24 hours after the onset of symptoms. Patients selected for urgent surgery fulfilled the following criteria: acute onset of fluctuating hemispheric neurological symptoms, significant carotid pathology, absence of cerebral hemorrhage, uncompromised vigilance and stable cardiopulmonary conditions. Selected patients presented with a crescendo-TIA (n = 7) or fluctuating neurological deficits (n = 9) corresponding to a contralateral carotid stenosis. Results: Following CEA, the neurological deficits improved instantaneously to complete recovery in 9 patients. The symptoms of 4 patients improved to non-disabling deficits, remained unchanged in one and worsened in 2 patients from hemihypaesthesia to hemiparesis. 14/16 patients were discharged within 8 days after admission. The neurologic status after discharge did not deteriorate in any of the patients during follow up of 19.3 ± 13 months, but improved in 4 of the patients. Conclusion: Our retrospective study suggests that rescue CEA may be beneficial for selected patients with stroke in evolution and fluctuating neurological deficits. Careful adherence to selection criteria, intraoperative shunting, intensive care post surgery surveillance and an experienced team are recommended.

Natural history of an immediately detectable PSA following radical prostatectomy: A description of a contemporary cohort.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 356-356
Author(s):  
Peter Eoin Lonergan ◽  
Samuel L. Washington ◽  
Janet E. Cowan ◽  
Hao Nguyen ◽  
Matthew R. Cooperberg ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Natural History ◽  
Locally Advanced ◽  
Specific Antigen ◽  
Salvage Treatment ◽  
Post Surgery ◽  
History Of

356 Background: Radical prostatectomy (RP) can provide good long-term oncological outcomes in patients with localized and locally advanced prostate cancer (PCa). After RP, prostate specific antigen (PSA) represents the corner stone for follow-up of patients. A persistently detectable PSA immediately following RP is an unfavourable prognostic factor. We described the natural history of the management and outcomes in men with a detectable PSA in an academic cohort. Methods: A retrospective review of prospectively collected clinical and pathologic data from consecutive patients who underwent RP for non-metastatic PCa between 2000 and 2018 was performed. A detectable PSA was defined as PSA ≥ 0.05 ng/ml between 2-6 months post-surgery. Biochemical recurrence (BCR) was defined as two consecutive PSA values ≥ 0.2 ng/ml after 6 months post-surgery or any salvage treatment for a rising PSA. Second recurrence was defined as additional treatment after post-RP salvage treatment. Outcomes were defined as time to other cause mortality (OCM) or prostate cancer specific mortality (PCSM). Results: We identified 499 men with a detectable PSA within 6 months following RP. Median PSA at diagnosis was 7.95 ng/ml (IQR 5.57-12.97). Median CAPRA-S score was 5 (IQR 2-7). Median follow-up was 41 months (IQR 20-77). 296 (59%) underwent salvage treatment for a rising PSA at a median of 5 months. 33 (23%) of these men required further treatment (10 for bone metastases) at a median of 7 months. 203 (41%) of men with an immediately detectable PSA did not undergo any further treatment after RP. Treatment-free survival after post-RP salvage (31 on ADT and 2 underwent salvage RT) in men with a detectable vs undetectable PSA was 86% vs 92% at 1 year, 78% vs 89% at 3 years, 72% vs 86% at 5 years and 70% vs 76% at 10 years (Log-rank p =0.02). Prostate cancer specific survival in men with a detectable vs undetectable PSA was 100% vs 100% at 1 year, 99% vs 100% at 3 years, 96% vs 100% at 5 years and 91% vs 99% at 10 years (Log-rank p < 0.01). Conclusions: This report describes the natural history of the management and outcomes in men with a detectable PSA following RP. We demonstrate that men with a detectable PSA after RP may have excellent long-term outcomes.

scholarly journals Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017–2019)

2021 ◽  
Vol 8 ◽  
Author(s):  
McKenna K. Caspers ◽  
Chris D. Bell ◽  
Dane M. Tatarniuk
Keyword(s):  
Data Analysis ◽  
Postoperative Complications ◽  
Exercise Intolerance ◽  
Retrospective Data ◽  
Post Surgery ◽  
Retrospective Data Analysis ◽  
History Of ◽  
Owner Satisfaction ◽  
Clinical Cases

Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy.Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by phone or email for a follow-up questionnaire.Results: Twenty-four horses underwent unilateral EVC, performed transendoscopically under sedated restraint, using monopolar electrosurgical instrumentation successfully. One horse experienced excessive intraoperative hemorrhage. No horses demonstrated postoperative complications. Twenty cases had a history of increased airway noise prior to surgery. In 15 of these cases (15/20, 75%), the airway noise was reported as fully improved post-surgery. Eighteen cases had a history of exercise intolerance prior to surgery. In 15 of these cases (15/18; 83%), the exercise intolerance was reported as resolved.Conclusion: EVC, in conjunction with prosthetic laryngoplasty, can contribute to improvement of RLN symptoms and aid in the effective return to athletic work. Performing transendoscopic ventriculocordectomy with monopolar electrosurgical instrumentation provides comparable clinical outcomes to traditional techniques using a diode laser or direct excision via laryngotomy.

scholarly journals Method development and characterization of the low molecular weight peptidome of human wound fluids

2020 ◽  
Author(s):  
Mariena J.A. van der Plas ◽  
Jun Cai ◽  
Jitka Petrlova ◽  
Karim Saleh ◽  
Sven Kjellström ◽  
...  
Keyword(s):  
Wound Healing ◽  
Method Development ◽  
Healing Process ◽  
Unmet Need ◽  
Wound Healing Process ◽  
Promising Tool ◽  
Physiological Processes ◽  
Post Surgery ◽  
Surgical Wounds ◽  
Novel Biomarkers

AbstractWound infections are significant challenges globally, and there is an unmet need for better diagnosis of wound healing status and infection. The wound healing process is characterized by proteolytic events that are the result of basic physiological processes involving coagulation and complement activation, but also dysfunctional activations by endogenous and bacterial proteases. Peptides, downstream reporters of these proteolytic actions, could therefore serve as a promising tool for diagnosis of wound healing and infection. In the present study, we demonstrate a method for the characterisation of the complete peptidome of human wound fluids. We compare acute non-infected wound fluids obtained post-surgery with plasma samples and find significantly higher protein and peptide numbers in wound fluids, which typically were also smaller in size as compared to plasma-derived peptides. Finally, we analyse wound fluids collected from dressings after facial skin graft surgery and compare three uninfected and normally healing surgical wounds with three inflamed and S. aureus infected wounds. The results identify unique peptide patterns of various selected proteins including coagulation and complement factors, as well as proteases and antiproteinases. Together, the work defines a workflow for analysis of peptides derived from human wound fluids and demonstrate a proof-of-concept that such wound fluids can be used for analysis of qualitative differences of peptide patterns derived from wound fluids on larger patient cohorts, providing novel biomarkers for wound healing and infection.

scholarly journals CLINICAL PERFORMANCE OF LAMBDA PLATES IN THE MANAGEMENT OF SUBCONDYLAR FRACTURES

2020 ◽  
pp. 1-3
Author(s):  
Marbon Joevitson ◽  
Annamalai Thangavelu ◽  
Eshona Pearl ◽  
Thiruneelakandan Thiruneelakandan ◽  
Janarthanan Janarthanan
Keyword(s):  
Clinical Performance ◽  
Mouth Opening ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Attractive Option ◽  
Delayed Complications ◽  
Condylar Fractures ◽  
Open Fixation

Background and Aim: Several options are available for open fixation of sub-condylar fractures. The seven-hole lambda plate is believed to demonstrate favorable outcomes for sub-condylar fractures, more so in cases with limited available bone surface. The study aimed to evaluate the outcome of sub-condylar fractures managed using lambda plates. Method: The study comprised on 10 diagnosed cases of sub-condylar fracture indicated for open fixation and were managed using the seven-hole lambda plate. Surgery was carried out under general anesthesia following standard surgical procedure. Post surgery, the cases were evaluated for immediate post-operative complications and followed up for 6 months for delayed complications. Results and Conclusion: All 10 cases showed excellent outcomes post fracture fixation using the lambda plate. Significant improvement in mouth opening was noted in all the cases at 6 weeks and 6 months follow up. No significant post surgical complications were noted in the cases except one where post operative pain persisted for a week. Lambda plates provide an attractive option for the management of sub-condylar fractures with minimal complications.

scholarly journals Educational Intervention on Self Efficacy among Postoperative Fracture: A Literature Review

2021 ◽  
Vol 4 (2) ◽  
pp. 231-242
Author(s):  
Sri Wirayuni Ni Luh Putu ◽  
Sri Yona
Keyword(s):  
Literature Review ◽  
Self Efficacy ◽  
Healing Process ◽  
Rehabilitation Program ◽  
Surrounding Tissue ◽  
Nursing Interventions ◽  
Post Surgery ◽  
Long Time ◽  
Postoperative Fracture ◽  
Rehabilitation Exercises

Fracture is a disruption of the normal discontinuity of bone and causes the surrounding tissue to be disrupted. Management of fractures is generally divided into recognition, reduction, retention, and rehabilitation. Exercises in the postoperative fracture patient rehabilitation program require patience and take a long time to achieve maximum cure. Nurses' therapeutic action in helping patients do rehabilitation exercises is by increasing the patient's self-efficacy to be independent in carrying out activities. Efforts to increase self-efficacy can be made through nursing interventions. This literature review aimed to explore the appropriate interventions on improving self-efficacy among postoperative fracture patients. Methods: This study was obtained from 4 databases, namely EBSCO, Key clinical, Willey, and Proquest, using inclusion and exclusion criteria. Results obtained. Decreased self-efficacy can occur in cases that require long action both for the healing process and chronic disease and when taking actions to maintain health, including post-surgery fractures. In conclusion, educational media will make it easier to provide interventions in increasing self-efficacy by paying attention to the factors that affect self-efficacy, namely master experience, vicarious experience, verbal persuasion, and emotional Arousal. The recommendation is that patients need support for adjusting the use of tools in providing education, providing logistics from samples in the application of education through technology media and to parents

scholarly journals Recurrent mandibular ameloblastoma in soft tissue and rib graft 17 years after initial presentation

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Omar Hamdy ◽  
Sara Raafat ◽  
Gehad A. Saleh ◽  
Shadi Awny ◽  
Abdelhadi M. Shebl ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Previous History ◽  
Initial Presentation ◽  
Management Approach ◽  
En Bloc ◽  
Best Management ◽  
Long Time ◽  
History Of

Abstract Background Ameloblastoma is the commonest odontogenic tumour of epithelial origin with a high incidence for developing local recurrence. We present a patient who developed local recurrence in both soft tissue and bone graft 17 years after the initial presentation. Case presentation A 75-year-old female with a previous history of right hemimandibulectomy and rib reconstruction for ameloblastoma in 1999 presented to our centre with a large cystic mouth floor swelling, biopsy from which revealed recurrent ameloblastoma. The patient underwent excision of the recurrent mass en bloc with the cystic swelling through oral and cervical approaches. The patient was discharged after 5 days with an uneventful postoperative course and with a free 2-year follow-up from further recurrence. Conclusion Ameloblastoma is a locally aggressive tumour for which wide local excision with adequate margins is the best management approach. Recurrence of ameloblastoma even after adequate resection is not uncommon, and its management is considered a surgical challenge. A very long time may pass between the initial presentation and the development of recurrence.

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