scholarly journals OUTCOMES OF SURGICAL MANAGEMENT OF POST LAPAROSCOPY ATYPICAL MYCO-BACTERIAL PORT SITE INFECTIONS: IS EARLY SURGERY A BETTER ALTERNATIVE?

2022 ◽  
pp. 100054
Author(s):  
DR VIKAS KUMAR HEER ◽  
DR SUHAIL KHUROO ◽  
DR AJAZ AHMED WANI ◽  
DR SONIA NAGYAL ◽  
DR BEENA JAD
Keyword(s):  
Surgical Management ◽  
Port Site ◽  
Early Surgery

Surgical management of diastatic linear skull fractures in infants

1973 ◽  
Vol 39 (4) ◽  
pp. 493-497 ◽  
Author(s):  
John B. Thompson ◽  
Thomas H. Mason ◽  
Gerald L. Haines ◽  
Robert J. Cassidy
Keyword(s):  
Brain Tissue ◽  
Surgical Management ◽  
Clinical Findings ◽  
Long Term Results ◽  
Early Surgery ◽  
Skull Fractures ◽  
Content Type ◽  
Subgaleal Space ◽  
Fine Print

✓ In seven infants, nondepressed diastatic linear skull fractures occurred with extrusion of brain tissue into the subgaleal space. These patients exhibited a triad of clinical findings that should encourage early surgery. Craniotomy and duroplasty seem to offer the most satisfactory long-term results.

Results and complications of surgical management of 809 intracranial aneurysms in 722 cases

1982 ◽  
Vol 56 (6) ◽  
pp. 753-765 ◽  
Author(s):  
Thoralf M. Sundt ◽  
Shigeaki Kobayashi ◽  
Nicolee C. Fode ◽  
Jack P. Whisnant
Keyword(s):  
Hospital Admission ◽  
Surgical Management ◽  
Intracranial Aneurysms ◽  
Intraoperative Complications ◽  
Aminocaproic Acid ◽  
Morbidity And Mortality ◽  
Early Surgery ◽  
Lower Grade ◽  
Operative Morbidity ◽  
Content Type

✓ Data from 722 consecutive cases with intracranial aneurysms were stored in a computer and later retrieved for analysis. Results and complications (including preoperative death and morbidity) of the surgical management of these patients were correlated with the Botterell grade of the patient in individuals with a recent subarachnoid hemorrhage (SAH), with the type of aneurysm, and with the timing of the surgical procedure. Patients with no SAH within 30 days prior to hospital admission were classified as “no SAH.” Approximately 30% of all patients had sustained more than one hemorrhage. Death and morbidity rates prior to surgery in good-grade patients with a recent SAH exceeded the risk of surgery itself. Rebleeding was the primary cause for death and morbidity in Grade 1 patients: 3% of Grade 1 patients died from a recurrent hemorrhage and 7% deteriorated to a lower grade. Deterioration from ischemia produced by vasospasm related or unrelated to rebleeding exceeded the risks of rebleeding in Grade 2 patients. There was an operative morbidity of 2% and mortality of 2% in patients who were classified as Grade 1 at the time of surgery, but an overall management morbidity of 3% and mortality of 6% in patients who were in Grade 1 at the time of hospital admission. Early surgery in Grade 1 patients was not associated with an increased incidence of delayed ischemia postoperatively. In Grade 2 patients, the operative morbidity and mortality was 7% and 4%, respectively, and the management morbidity and mortality 16% and 11%, respectively. Early surgery in this group was associated with a high frequency of postoperative delayed ischemia (particularly in patients with more than one SAH). Epsilon-aminocaproic acid appeared to protect against a rebleed, but was associated with a higher incidence of postoperative pulmonary emboli. Intraoperative complications were related both to the size of the aneurysm and to its location. Repair of multiple aneurysms did not adversely affect the result. The surgical approach, the importance of using a self-retaining brain retractor, and the technical complications in these cases are discussed.

scholarly journals Outcomes of early surgical management of complicated appendicitis in children

2018 ◽  
Vol 5 (3) ◽  
pp. 1063
Author(s):  
Pramod S. ◽  
B. Revanth Kumar
Keyword(s):  
Surgical Management ◽  
Laparoscopic Appendectomy ◽  
Leucocyte Count ◽  
Complicated Appendicitis ◽  
Early Surgery ◽  
High Morbidity ◽  
Paediatric Surgery ◽  
Delayed Presentation ◽  
Duration Of Stay ◽  
Pain Abdomen

Background: Appendicitis is the most common surgical emergency in children. Nearly 30% of children present with complicated appendicitis. Controversy exists between early or delayed surgery in complicated appendicitis. Present study was done to evaluate the outcome of early surgical management of complicated appendicitis in children and also to analyze risk factors for complicated appendicitis.Methods: A retrospective observational study conducted by the department of Paediatric Surgery, KIMS, hospital Bangalore. All children with complicated appendicitis (perforated, gangrenous and mass) from October 2014 to October 2017 were included in the study. Clinical, biochemical and imaging findings of these children were tabulated. Children underwent either open or laparoscopic appendectomy. Intra operative data regarding the type of complication, presence or absence of Fecolith, position of appendix was documented. Post operatively duration of stay and complications were analyzed.Results: 47 children were included in the study. Mean age of presentation was 10.38±2.84 years. Most common presentation was pain abdomen. 65% of the patient had pain abdomen for duration of three days or more. Total leucocyte count of more than 15000 was seen in about 50% of the children. 68% of children underwent laparotomy, 23.5% underwent laparoscopic appendectomy. Intra operatively, perforation of the appendix with generalized peritonitis was the commonest finding. Fecolith was present in 32% of the cases. Mean duration of stay was 7.46 days. Wound infection was seen in 15% of the children. Late complication in the form of adhesive obstruction was seen in 5 patients.Conclusions: Complicated appendicitis is associated with high morbidity. High leucocyte count, delayed presentation and Fecolith are possible indicators of complicated appendicitis. Early surgery in complicated appendicitis is safe, feasible. The complication rate is acceptable and most of them can be managed conservatively. Hence early surgery in complicated appendicitis is an option to be considered.

Is Port Site Resection Necessary in the Surgical Management of Gallbladder Cancer?

2011 ◽  
Vol 19 (2) ◽  
pp. 409-417 ◽  
Author(s):  
Ajay V. Maker ◽  
Jean M. Butte ◽  
Jacqueline Oxenberg ◽  
Deborah Kuk ◽  
Mithat Gonen ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Surgical Management ◽  
Port Site

scholarly journals Visual and Hormone Outcomes in Pituitary Apoplexy: Results of a Single Surgeon, Single Institution 15-Year Retrospective Review and Pooled Data Analysis

2020 ◽  
Author(s):  
Scott C. Seaman ◽  
Mark C. Dougherty ◽  
Mario Zanaty ◽  
Leslie A. Bruch ◽  
Scott M. Graham ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Data Analysis ◽  
Bayesian Inference ◽  
Surgical Management ◽  
Cavernous Sinus ◽  
Pituitary Apoplexy ◽  
Residual Tumor ◽  
Early Surgery ◽  
Visual Outcomes ◽  
Pooled Data

Abstract Introduction Pituitary apoplexy commonly presents with visual and hormonal deficits. While traditionally regarded as an emergency, there have been increasing trends toward conservative management. Our institutional practice consists of early surgery; therefore, we reviewed our series evaluating vision outcomes, hormone function, and complications compared with the present literature. Methods We retrospectively reviewed our institution's medical records to identify pituitary apoplexy patients who were treated via the endoscopic endonasal approach by a single neurosurgeon (senior author). We recorded basic demographics, radiographic and operative features, and preoperative and postoperative vision and hormone status. Univariate and multivariate statistical analyses were performed. Pooled data analysis of visual outcomes in the current literature using Bayesian inference was performed. Results We identified 44 patients with histologically confirmed pituitary apoplexy treated by endoscopic transsphenoidal decompression; 77% were treated within 24 hours of presentation. Total 45% had cranial nerve (CN) palsy, 36% anopsia, and 20% had visual acuity deficits. Postoperatively, 100% of CN palsies improved, 81% of anopsias improved, and 66.7% of visual acuity deficits improved. Long-lasting panhypopituitarism (25%) and hypothyrodism (22%) were common. Cavernous sinus involvement predicted residual tumor (p = 0.006). Pooled Bayesian inference showed 30% improvement in vision outcomes with surgical management compared with medical management with a number needed to treat of 3.3. Conclusion Early surgery for pituitary apoplexy was associated with excellent visual outcomes and the need for long-term hormone replacement is common. Cavernous sinus involvement is an independent predictor of residual tumor. Pooled statistical analysis favors aggressive surgical management of apoplexy for improved visual outcomes.

scholarly journals Is port-site resection necessary in the surgical management of gallbladder cancer?

2013 ◽  
Vol 150 (4) ◽  
pp. 277-284 ◽  
Author(s):  
D. Fuks ◽  
J.-M. Regimbeau ◽  
P. Pessaux ◽  
P. Bachellier ◽  
A. Raventos ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Surgical Management ◽  
Port Site

Surgical Management of Patients With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye
Keyword(s):  
Surgical Management ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Surgical Decision ◽  
Obstructive Sleep ◽  
Spine Abnormalities ◽  
Speech Assessment

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.

Sign in / Sign up

Export Citation Format

Share Document