scholarly journals X-ray-free ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a comparative study with historical control

2020 ◽  
Vol 52 (12) ◽  
pp. 2253-2259
Author(s):  
Ponco Birowo ◽  
Putu Angga Risky Raharja ◽  
Harun Wijanarko Kusuma Putra ◽  
Reginald Rustandi ◽  
Widi Atmoko ◽  
...  
Keyword(s):  
Comparative Study ◽  
Percutaneous Nephrolithotomy ◽  
Good Alternative ◽  
Historical Control ◽  
Tube Placement ◽  
Complication Rates ◽  
Ultrasound Guided ◽  
Control Groups ◽  
X Ray ◽  
Significant Difference

Abstract Purpose To compare the outcomes and complications of supine X-ray-free ultrasound-guided percutaneous nephrolithotomy (XG-PCNL) with fluoroscopy-guided (FG)-PCNL in both prone and supine positions. Methods This was a comparative study that included a prospective cohort and historical control groups. This study analysed 40 consecutive patients who undergone supine XG-PCNL between October 2019 and March 2020. The control groups were composed of historical control formed from the last 40 consecutive patients who underwent FG-PCNL in both supine and prone positions from our PCNL database from January 2018 and September 2019. Patients’ demographics, stone characteristics and intraoperative and postoperative outcomes were compared. Results A total of 120 patients were classified into the supine XG-PCNL, supine FG-PCNL, and prone FG-PCNL groups (each N = 40). They had similar baseline characteristics and initial stone burden. The supine XG-PCNL group had higher puncture attempts, nephrostomy tube placement, and longer surgery duration than both the supine and prone FG-PCNL groups. However, the stone-free rate was similar in all groups (85%, supine XG-PCNL; 72.5%, supine FG-PCNL; 77.5% prone FG-PCNL; p = 0.39). No significant difference was found in the complication rate and length of stay among the three groups. Conclusion Supine XG-PCNL is an alternative to both supine and prone FG-PCNL with similar efficacy and complication rates for kidney stone patients. This could be a good alternative to urological centres with no access to fluoroscopy.

scholarly journals Single-Step Renal Dilatation Is a Novel Technique in Percutaneous Nephrolithotomy: A Prospective Randomised Study

2020 ◽  
Vol 20 (2) ◽  
pp. 70-73
Author(s):  
Md Shariful Islam ◽  
Md Shawkat Alam ◽  
AHM Mostofa Kamal ◽  
Md Asaduzzamman ◽  
Md Ruhul Quddus
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Perioperative Complications ◽  
Single Step ◽  
Safety And Efficacy ◽  
X Ray ◽  
Randomised Study ◽  
Operative Duration ◽  
Novel Technique ◽  
Significant Difference ◽  
Prospective Randomised Study

Purpose: To evaluate the feasibility, safety and efficacy of one-shot dilation (OSD) in percutaneous nephrolithotomy (PCNL). Materials and Methods: In a prospective randomised study including 62 patients divided into two groups, the first had RD before PCNL using the standard metallic telescopic dilators (Alken), and the second had RD using the 30-F Amplatz dilator over the central Alken dilator. The operative duration, with X-ray exposure, was calculated. The procedure outcome in terms of complications, stone-free rates and hospital stay was evaluated statistically. Results : The tract was dilated correctly in all cases. The operative duration and X-ray exposure was shorter in patients undergoing single-step RD (P < 0.05). There were perioperative complications, according to the Clavien grading system, in 15 (25%) patients but there was no statistically significant difference between the groups. The stone-free rates were comparable in both groups. Conclusion : A single-step RD during PCNL is feasible, with a shorter operative duration and X-ray exposure. The outcomes were comparable with those of a standard metallic telescopic RD Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.70-73

Can foam sclerotherapy be used to safely treat bilateral varicose veins?

2011 ◽  
Vol 27 (1) ◽  
pp. 19-24 ◽  
Author(s):  
R H Bhogal ◽  
C E Moffat ◽  
P Coney ◽  
I K Nyamekye
Keyword(s):  
Varicose Veins ◽  
Visual Disturbance ◽  
Complication Rates ◽  
Treatment Episode ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Systemic Complications ◽  
Complete Occlusion ◽  
Vein Occlusion ◽  
Significant Difference

Objective We assessed the use of ultrasound guided foam sclerotherapy (UGFS) to treat bilateral varicose veins either as synchronous or interval procedures. We specifically assessed total foam volume usage and its influence on early outcome and complications. Methods We reviewed our prospectively compiled computerised database of patients with bilateral varicose veins who have undergone UGFS. Duplex findings, foam volumes used and clinical outcome were assessed. Results One hundred and twelve patients had undergone UGFS for bilateral varicose veins. Sixty-one had bilateral UGFS (122 legs) and 51 had interval UGFS (102 legs). Seventy-eight percent bilateral and 60% interval procedures were for single trunk disease. Median foam volumes per treatment episode were: 17.5 mls bilateral, and 10 mls interval FS. At two weeks 81% of legs had complete occlusion after bilateral UGFS compared to 70% after interval UGFS. One patient in the bilateral UGFS developed transient visual disturbance. There was no systemic complications in the interval UGFS. Conclusions Bilateral foam sclerotherapy treatment did not adversly affect vein occlusion rates and there was no significant difference in complication rates between the two groups. Bilateral UGFS can be safely performed in selected patient presenting with bilateral varicose veins.

A Comparative Study on Microgap of Premade Abutments and Abutments Cast in Base Metal Alloys

2014 ◽  
Vol 40 (3) ◽  
pp. 239-249 ◽  
Author(s):  
Jaini Jaini Lalithamma ◽  
Sreekanth Anantha Mallan ◽  
Pazhani Appan Murukan ◽  
Rita Zarina
Keyword(s):  
Stainless Steel ◽  
Comparative Study ◽  
Base Metal ◽  
Analysis Of Variance ◽  
Metal Alloys ◽  
Cobalt Chromium ◽  
Control Groups ◽  
Nickel Chromium ◽  
Significant Difference ◽  
Range Test

The study compared the marginal accuracy of premade and cast abutments. Premade titanium, stainless steel, and gold abutments formed the control groups. Plastic abutments were cast in nickel-chromium, cobalt-chromium and grade IV titanium. The abutment/implant interface was analyzed. Analysis of variance and Duncan's multiple range test revealed no significant difference in mean marginal microgap between premade gold and titanium abutments and between premade stainless steel and cast titanium abutments. Statistically significant differences (P &lt; .001) were found among all other groups.

Comparison of outcomes following thoracoscopic versus thoracotomy closure for persistent patent ductus arteriosus

2020 ◽  
Vol 30 (10) ◽  
pp. 1433-1438
Author(s):  
Chen Wei ◽  
Steven Staffa ◽  
David Zurakowski ◽  
Susan Saleeb ◽  
Francis Fynn-Thompson ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Chest Tube ◽  
Operative Time ◽  
Ductus Arteriosus ◽  
Tube Placement ◽  
Complication Rates ◽  
Chest Tube Placement ◽  
Significant Difference ◽  
Median Operative Time ◽  
Patent Ductus

AbstractBackground:Patent ductus arteriosus closure is traditionally performed by thoracotomy approach. Video-assisted thoracoscopic surgery is a less frequently utilised alternative. We sought to compare elective surgical outcomes between the two methods via a single-centre retrospective cohort analysis.Methods:All patients >3.2 kg undergoing surgical patent ductus arteriosus ligation at a single institution from 2000 to 2018 were retrospectively reviewed. Propensity matching for age, weight, diuretic usage, and preterm status was conducted to adjust for differences in baseline patient characteristics. Outcome measures included operative time, hospitalisation duration, post-operative complications, and re-operation.Results:A total of 173 patients were included, 127 thoracoscopy and 46 thoracotomy. In the unmatched cohorts, no significant difference in closure success was found (94% thoracoscopy versus 100% thoracotomy, p = 0.192). Although median operative time was longer for thoracoscopy (87 versus 56 minutes, p < 0.001), hospitalisation duration was shorter (1.05 versus 2.41 days, p < 0.001), as was ICU stay (0.00 versus 0.75 days, p < 0.001). There were no significant differences in re-operation or complication rates, except chest tube placement (11% thoracoscopy versus 50% thoracotomy, p < 0.001). After matching (69 thoracoscopy versus 20 thoracotomy), these differences persisted, including median operative time (81 versus 56 minutes, p = 0.007; thoracoscopy versus thoracotomy), hospitalisation duration (1.25 versus 2.27 days, p < 0.001), and chest tube placement (17% versus 60%, p < 0.001). There remained no significant difference in complications or re-operations.Conclusions:Thoracoscopic ligation was associated with shorter ICU and hospital stays and less frequent chest tube placement, but longer operative times. Other risks, including bleeding, chylothorax, and recurrent laryngeal nerve injury, were similar.

Is Continuous Transpulmonary Pressure Better Than Conventional Respiratory Management of Hyaline Membrane Disease? A Controlled Study

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 800-808
Author(s):  
David A. Belenky ◽  
Rosemary J. Orr ◽  
David E. Woodrum ◽  
W. Alan Hodson
Keyword(s):  
Mechanical Ventilation ◽  
Transpulmonary Pressure ◽  
Hyaline Membrane Disease ◽  
Controlled Study ◽  
Complication Rates ◽  
Control Groups ◽  
Respiratory Management ◽  
Significant Difference ◽  
Hyaline Membrane ◽  
And Control

The influence of continuous positive airway pressure (CPAP) and positive end-expiratory pressure (PEEP) on mortality and complication rates in severe hyaline membrane disease (HMD) was evaluated in a randomized, prospective study. Patients were admitted to the study if the PO2 was ≤ 50 mm Hg with FiO2 ≥ 0.6. Twenty-four patients in each of three weight groups were equally divided between treatment and control groups. The treatment regimen included CPAP (6 to 14 cm H2O) for spontaneously breathing patients and PEEP for patients requiring mechanical ventilation for apnea or hypercapnia (PCO2 ≥ 65 mm Hg). Control patients received oxygen and were mechanically ventilated if they had apnea, hypercapnia, or PO2 ≤ 50 mm Hg with FiO2 ≥ 0.8. Oxygenation improved after the start of CPAP or PEEP; however, PCO2 rose after CPAP was initiated. There was no significant difference between treatment and control groups in mortality, requirement for mechanical ventilation, or incidence of pulmonary sequelae. The incidence of pulmonary air-leak was increased with PEEP. The findings suggest that CPAP and PEEP have not significantly altered the outcome of HMD.

Ultrasound-Guided Percutaneous Dilational Tracheostomy: A Systematic Review of Randomized Controlled Trials and Meta-Analysis

2018 ◽  
Vol 35 (5) ◽  
pp. 445-452 ◽  
Author(s):  
André L. N. Gobatto ◽  
Bruno A. M. P. Besen ◽  
Mino Cestari ◽  
Paolo Pelosi ◽  
Luiz M. S. Malbouisson
Keyword(s):  
Systematic Review ◽  
Anatomical Landmark ◽  
Controlled Trials ◽  
Complication Rates ◽  
Percutaneous Dilational Tracheostomy ◽  
Minor Complication ◽  
Ultrasound Guided ◽  
Control Groups ◽  
Randomized Controlled ◽  
Clinical Complications

Introduction: Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. Objective: To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks–guided PDT with regard to procedural-related and clinical complications. Methods: A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark–guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. Results: Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I2 = 0%). Conclusion: The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical landmark–guided PDT.

574 Percutaneous nephrolithotomy under X-ray control and totally ultrasound-guided percutaneous nephrolithotomy: The outcome comparison

2016 ◽  
Vol 15 (3) ◽  
pp. e574
Author(s):  
V. Atduev ◽  
D. Ledyaev ◽  
M. Dyrdik ◽  
D. Abramov ◽  
F. Sevryukov ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Ultrasound Guided ◽  
X Ray ◽  
Outcome Comparison

scholarly journals X-ray-free Ultrasound-guided Percutaneous Nephrolithotomy in Supine Position Using Alken Metal Telescoping Dilators in a Large Kidney Stone: A Case Report

2020 ◽  
Vol Volume 12 ◽  
pp. 287-293
Author(s):  
Ponco Birowo ◽  
Putu Angga Risky Raharja ◽  
Harun Wijanarko Kusuma Putra ◽  
Reginald Rustandi ◽  
Widi Atmoko ◽  
...  
Keyword(s):  
Case Report ◽  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Kidney Stone ◽  
Ultrasound Guided ◽  
X Ray

Percutaneous versus Open Tracheostomy in the Pediatric Trauma Population

2010 ◽  
Vol 76 (3) ◽  
pp. 276-278 ◽  
Author(s):  
Ashish Raju ◽  
D'Andrea K. Joseph ◽  
Cheickna Diarra ◽  
Steven E. Ross
Keyword(s):  
Injury Severity ◽  
Percutaneous Tracheostomy ◽  
Pediatric Trauma ◽  
Retrospective Chart Review ◽  
Feeding Tube ◽  
Tube Placement ◽  
Trauma Patients ◽  
Complication Rates ◽  
Trauma Population ◽  
Significant Difference

The purpose of this study was to determine the safety and efficacy of percutaneous versus open tracheostomy in the pediatric trauma population. A retrospective chart review was conducted of all tracheostomies performed on trauma patients younger than 18 years for an 8-year period. There was no difference in the incidence of brain, chest, or facial injury between the open and percutaneous tracheostomy groups. However, the open group had a significantly lower age (14.2 vs. 15.5 years; P < 0.01) and higher injury severity score (26 vs. 21; P = 0.015). Mean time from injury to tracheostomy was 9.1 days (range, 0 to 16 days) and was not different between the two methods. The majority of open tracheostomies were performed in the operating room and, of percutaneous tracheostomies, at the bedside. Concomitant feeding tube placement did not affect complication rates. There was not a significant difference between complication rates between the two methods of tracheostomy (percutaneous one of 29; open three of 20). Percutaneous tracheostomy can be safely performed in the injured older child.

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