scholarly journals Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

2020 ◽  
Author(s):  
Riccardo Coletta ◽  
Elisa Mussi ◽  
Adrian Bianchi ◽  
Antonino Morabito
Keyword(s):  
Feeding Time ◽  
Neurologically Impaired ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Technical Modification ◽  
Primary Surgery ◽  
Age At Surgery ◽  
Oesophageal Surgery ◽  
Bowel Continuity ◽  
Lower Oesophagus

AbstractAdhesions and fibrosis following failed primary surgery for severe gastro-oesophageal reflux (GOR) in neurologically impaired children (NI) can render mobilization of the lower oesophagus and oesophago-jejunal anastomosis a technically demanding exercise both at open surgery and laparoscopy. This paper presents the Modified Oesophago-Gastric Dissociation (M-OGD) as a less complex technical modification of the original Total Oesophago-Gastric Dissociation (TOGD). The stomach is detached from the oesophago-gastric junction with an articulated 5-mm stapler, leaving a 5-mm strip of stomach attached to the oesophagus. An end-to-side isoperistaltic oesophago-jejunostomy is created between the gastric stump and the isoperistaltic jejunal Roux loop. A jejuno-jejunal anastomosis restores bowel continuity. Between May 2018 and February 2020, M-OGD was performed on 3 NI patients with a weight of 9–27.3 kg (median = 14 kg). Median age at surgery was 60 months (18–180), median surgical time 170 min (146–280), median re-feeding time was 3 days (2–5), and median length of stay was 20 days (11–25). All patients healed primarily and after a median follow-up of 3 months, there were no problems related to the oesophago-jejunal anastomosis. M-OGD reduces the difficulties of redo oesophageal surgery following failed anti-reflux procedures, with a safer oesophago-jejunal anastomosis and a good long-term outcome.

Traumatic Brachial Plexus Palsy in Children: Long-Term Outcome and Strategy of Reconstruction

2021 ◽  
Author(s):  
Tarek A. El-Gammal ◽  
Amr El-Sayed ◽  
Mohamed M. Kotb ◽  
Waleed Riad Saleh ◽  
Yasser Farouk Ragheb ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Hand Function ◽  
Functional Restoration ◽  
Shoulder Abduction ◽  
Wrist Flexion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Age At Surgery ◽  
Flexion And Extension

Abstract Background Traumatic brachial plexus injuries in children represent a definite spectrum of injuries between adult and neonatal brachial plexus injuries. Their characteristics have been scarcely reported in the literature. The priority of functional restoration is not clear. Materials and Methods In total, 52 children with surgically treated traumatic brachial plexus injuries, excluding Erb's palsy, were reviewed after a minimum follow-up of 2 years. All children except nine were males, with an average age at surgery of 8 years. Forty-five children had exclusive supraclavicular plexus injuries. Twenty-one of them (46%) had two or more root avulsions. Seven children (13.5%) had infraclavicular plexus injuries. Time from trauma to surgery varied from 1 to 15 months (mean = 4.7 months). Extraplexal neurotization was the most common surgical technique used. Results Shoulder abduction and external rotation were restored to an average of 83 and 26 degrees, respectively. Elbow flexion and extension were restored to grade ≥3 in 96 and 91.5% of cases, respectively. Finger flexion and extension were restored to grade ≥4 in 29 and 32% of cases, respectively. Wrist flexion and extension were restored to grade ≥4 in 21 and 27% of cases, respectively. Results of neurotization were superior to those of neurolysis and nerve grafting. Among the 24 children with insensate hands, 20 (83.3%) recovered S3 sensation, 3 recovered S2, and 1 recovered S1. No case complained of neuropathic pain. Functional recovery correlated negatively but insignificantly with the age at surgery and time from injury to surgery. Conclusion Brachial plexus injuries in children are associated with a high incidence root avulsions and no pain. Neurotization is frequently required and the outcome is not significantly affected by the delay in surgery. In total plexus injuries, some useful hand function can be restored, and management should follow that of obstetric palsy and be focused on innervating the medial cord.

scholarly journals Two-year radiologic assessment of the Pinnacle cup—a migration analysis with EBRA

2020 ◽  
Author(s):  
Dietmar Dammerer ◽  
Alexander Ruzicka ◽  
Philipp Blum ◽  
David Putzer ◽  
Maximilian Liebsch ◽  
...  
Keyword(s):  
Term Outcome ◽  
Long Term Outcome ◽  
Press Fit ◽  
Age At Surgery ◽  
Registration Number ◽  
Cause Of Failure ◽  
Radiological Measurements ◽  
Medical Histories ◽  
Migration Analysis

Abstract Introduction The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by EBRA (Einzel-Bild-Roentgen-Analyse) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 1 milimeter (mm) within the first 2 years after surgery. In this study, we investigated the migration behaviour of an uncemented press-fit cup after 2 years follow-up. Materials and methods Applying a retrospective study design, we reviewed all consecutive patients who received an uncemented press-fit cup at our Department between 2013 and 2018. A total of 484 patients were identified. We reviewed medical histories and performed radiological measurements using EBRA-Cup software. EBRA measurements and statistical investigations were performed by two independent investigators. Results A total of 165 cups in 159 patients (female: 90; male: 69) met our inclusion criteria. Mean age at surgery was 66.7 (range 18.4–90.5) years. EBRA migration analysis showed a mean total migration of 0.7 mm (range 0.0–6.3) over our follow-up period of 2 years. Of the investigated cups, 53.2% showed less than 1 mm migration in the investigated follow-up period. Conclusion In conclusion, the Pinnacle cup used in our study provides low mean migration at final follow-up. Based on the assumption of secondary stabilization, good long-term outcome of the Pinnacle cup can be expected. Trial registration number and date of registration Number: 20181024-1875; Date: 2018-09-20

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

2007 ◽  
Vol 22 (4) ◽  
pp. 875-880 ◽  
Author(s):  
C. Capito ◽  
M.-D. Leclair ◽  
H. Piloquet ◽  
V. Plattner ◽  
Y. Heloury ◽  
...  
Keyword(s):  
Neurologically Impaired ◽  
Normal Children ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Laparoscopic Nissen

scholarly journals Initial overcorrection after surgery for intermittent exotropia in children less than 4 years old: Comparison with older children

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257465
Author(s):  
Jinju Choi ◽  
Dong Gyu Choi
Keyword(s):  
Older Children ◽  
Intermittent Exotropia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Age At Surgery ◽  
Angle Of Deviation ◽  
The Mean ◽  
The Relationship ◽  
Consecutive Esotropia

Purpose While initial overcorrection after exotropia-correcting surgery is widely accepted for a favorable long-term outcome, some have not advocated such overcorrection in younger children owing to concerns regarding rapid deterioration of bifixation ability. This study aimed to evaluate the relationship between initial overcorrection after intermittent exotropia surgery and the surgical outcome in patients aged <4 years. Methods In this retrospective study, 391 patients who had undergone surgery for intermittent exotropia were classified into two groups according to the age at surgery: <4 years old (group Y [young], 130 patients) and 4–16 years old (group O [old], 261). The patients were subdivided into three groups according to the angle of deviation at postoperative 1 week: esophoria-tropia (ET) ≥10 prism diopters (PD) (subgroup I), ET 1–9 PD (II), and orthotropia or exophoria-tropia (XT) (III). We compared the surgical outcomes between the two groups and among subgroups; then, we analyzed consecutive esotropia patients. Results The mean exodeviation was smaller in the order of subgroup I, II, and III at every postoperative visit (p<0.05) in group Y but showed no difference among subgroups after 2 years in group O. Consecutive esotropia occurred at 1 month, postoperatively, in 6.9% and 2.6% of the patients in groups Y and O (p = 0.133), respectively. However, it persisted in two and one patient in groups Y and O, respectively, until the last visit. Conclusion Early overcorrection after intermittent exotropia surgery was a safe and desirable result in terms of motor outcome in children aged under 4 years, as well as for children aged between 4–16 years.

Laparoscopic excision of recurrent endometriomas: long-term outcome and comparison with primary surgery

2006 ◽  
Vol 85 (3) ◽  
pp. 694-699 ◽  
Author(s):  
Luigi Fedele ◽  
Stefano Bianchi ◽  
Giovanni Zanconato ◽  
Nicola Berlanda ◽  
Ricciarda Raffaelli ◽  
...  
Keyword(s):  
Term Outcome ◽  
Long Term Outcome ◽  
Primary Surgery ◽  
Laparoscopic Excision
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