Performance and Management of Long-Term Tracheostomy

1995 ◽  
Vol 112 (5) ◽  
pp. P67-P67
Author(s):  
Isaac Eliachar ◽  
Frank Miller
Keyword(s):  
Surgical Procedure ◽  
Postoperative Management ◽  
Educational Objectives

Educational objectives: To determine the indications of performing long-term tracheostomy, better understand the advantage, pitfalls, complications, etc., and to plan and perform this surgical procedure and become knowledgeable in the postoperative management.

Partial laryngectomy for the management of laryngeal masses in six cats

2021 ◽  
pp. 1098612X2110274
Author(s):  
Jasmine Moser ◽  
Georg Haimel ◽  
Alexander Tichy ◽  
Laurent Findji
Keyword(s):  
Surgical Procedure ◽  
Thyroid Cartilage ◽  
Clinical Signs ◽  
Postoperative Management ◽  
Partial Laryngectomy ◽  
Survival Times ◽  
Laryngeal Disease ◽  
Laryngeal Cartilages ◽  
Laryngeal Cyst

Objectives Partial laryngectomy is an organ-sparing surgical procedure for the removal of laryngeal masses which has not been described in cats. The aim of this study was to report on the surgical procedure and the short- and long-term clinical outcomes of cats that underwent partial laryngectomy. Methods Medical records were retrospectively collected over a 4-year period in two institutions. The following data were retrieved: signalment, history, clinical signs, diagnostic test results, surgical procedure, postoperative management, complications and outcome. Results Six cats underwent partial laryngectomy. The most common clinical signs in cats with laryngeal masses were stridor (n = 4) and dyspnoea (n = 4). In all cats, a full-thickness portion of one or several laryngeal cartilages was resected, including thyroid cartilage alone (n = 2), thyroid cartilage and arytenoid (n = 2), and arytenoid cartilage and epiglottis (n = 2). The resected laryngeal masses were reported to be lymphoma (n = 3), carcinoma (n = 1), laryngeal cyst (n = 1) and inflammatory laryngeal disease (n = 1). All cats survived the surgical intervention of partial laryngectomy. Four cats showed varying degrees of respiratory distress in the short-term postoperative period. A temporary tracheostomy tube was placed in two cats. No other postoperative complications were noted in the short- or long-term. Four cats were still alive at the time of writing. These cats survived at least 252 days. Conclusions and relevance In a small number of cases, our results show that successful long-term outcomes after partial laryngectomy are achievable, with longer survival times than previously reported. Therefore, partial laryngectomy should be considered as a viable treatment option in cats with laryngeal masses.

Outcome Predictors After Gamma Knife Radiosurgery for Recurrent Trigeminal Neuralgia

Neurosurgery ◽  
2010 ◽  
Vol 67 (6) ◽  
pp. 1637-1645 ◽  
Author(s):  
Hideyuki Kano ◽  
Douglas Kondziolka ◽  
Huai-Che Yang ◽  
Oscar Zorro ◽  
Javier Lobato-Polo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Pain Control ◽  
Surgical Procedure ◽  
Gamma Knife Radiosurgery ◽  
Sensory Loss ◽  
Failed Surgery ◽  
Gamma Knife Stereotactic Radiosurgery

Abstract BACKGROUND: Trigeminal neuralgia (TN) that recurs after surgery can be difficult to manage. OBJECTIVE: To define management outcomes in patients who underwent gamma knife stereotactic radiosurgery (GKSR) after failing 1 or more previous surgical procedures. METHODS: We retrospectively reviewed outcomes after GKSR in 193 patients with TN after failed surgery. The median patient age was 70 years (range, 26-93 years). Seventy-five patients had a single operation (microvascular decompression, n = 40; glycerol rhizotomy, n = 24; radiofrequency rhizotomy, n = 11). One hundred eighteen patients underwent multiple operations before GKSR. Patients were evaluated up to 14 years after GKSR. RESULTS: After GKSR, 85% of patients achieved pain relief or improvement (Barrow Neurological Institute grade I-IIIb). Pain recurrence was observed in 73 of 168 patients 6 to 144 months after GKSR (median, 6 years). Factors associated with better long-term pain relief included no relief from the surgical procedure preceding GKSR, pain in a single branch, typical TN, and a single previous failed surgical procedure. Eighteen patients (9.3%) developed new or increased trigeminal sensory dysfunction, and 1 developed deafferentation pain. Patients who developed sensory loss after GKSR had better long-term pain control (Barrow Neurological Institute grade I-IIIb: 86% at 5 years). CONCLUSION: GKSR proved to be safe and moderately effective in the management of TN that recurs after surgery. Development of sensory loss may predict better long-term pain control. The best candidates for GKSR were patients with recurrence after a single failed previous operation and those with typical TN in a single trigeminal nerve distribution.

scholarly journals Predictors for the Immediate and Long-Term Outcome of Avascular Surgical Procedure

2009 ◽  
Vol 98 (3) ◽  
pp. 164-168 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
J. Salenius
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Operative Mortality ◽  
Survival Rates ◽  
Term Outcome ◽  
Long Term Outcome

Background and Aims: The ability to predict post-operative mortality reliably will be of assistance in making decisions concerning the treatment of an individual patient. The aim of this study was to test the GAS score as a predictor of post-operative mortality in vascular surgical patients. Material and Methods: A total of 157 consecutive patients who underwent an elective vascular surgical procedure were included in the study. The Cox proportional hazards model was used in analyzing the importance of various preoperative risk factors for the postoperative outcome. ASA and GAS were tested in predicting the short and long-term outcome. On the basis of the GAS cut-off value 77, patients were selected into low-risk (GAS low: GAS < 77) and high-risk (GAS high: GAS > = 77) groups, and the examined risk factors were analyzed to determine which of them had predictive value for the prognosis. Results: None of the patients in the GAS low group died, and mortality in the GAS high group was 4.8% (p = 0.03) at 30 days' follow-up. The 12-month survival rates were 98.6% and 78.6% (p = 0.0001), respectively, with the respective 5-year survival rates of 76.7% and 44.0% (p = 0.0001). The only independent risk factor for 30-day mortality was the renal risk factor (OR 20.2). The combination of all three GAS variables(chronic renal failure, cardiac disease and cerebrovascular disease), excluding age, was associated with a 100% two-year mortality. Conclusions: Mortality is low for patients with GAS<77. For the high-risk patients (GAS> = 77), due to its low predictive value for death, GAS yields limited value in clinical practice. In cases of patients with all three risk factors (renal, cardiac and cerebrovascular), vascular surgery should be considered very carefully.

scholarly journals MANAGEMENT OF THE SURGICAL SOLUTIONS FOR FEEDING – A PREVENTION FACTOR FOR NUTRIENT BALANCE IMPAIRMENT

2017 ◽  
Vol 64 (3) ◽  
pp. 194-200
Author(s):  
Corneliu Tudor ◽  
◽  
Costel Şavlovschi ◽  
Cristian Brănescu ◽  
Ahed El-Khatib ◽  
...  
Keyword(s):  
Nutrient Balance ◽  
Surgical Techniques ◽  
Postoperative Management ◽  
Postoperative Surveillance ◽  
Feeding Tubes ◽  
Term Evolution ◽  
Long Run ◽  
Nursing Services ◽  
Limited Period

Aim. The paper aims, thanks to the long-standing practice, to synthesize the clinical experience gained during the surgery for feeding tubes management and highlight the details we had to deal with in order to overcome the local and general difficulties. Materials and method. A retrospective study was carried out over a period of 20 years (1996-2016), on the patients who underwent surgery for placing feeding tubes in our clinic. They were analyzed: the techniques used, the long-term evolution, the complications and the incidents and the way they were solved. Results. A total of 329 patients were enrolled in the study. The surgical techniques used were: classic surgical solutions (300 cases) and percutaneous endoscopic gatrostomy (PEG, 29 cases). For classical interventions, post-operative evolution was good in 219 patients (73%) and was complicated by various accidents and incidents in 81 cases (23%). The study presents the causes that may lead to these complications, the local and general, clinical and paraclinical consequences and the correct surgical attitude, as well as particular cases that required the adaptation of the surgical techniques to local anatomical and functional polymorphism. In the long run, the jejunostomy appears to be relatively inferior to gastrostomy, in terms of toland efficiency. PEG complications were minor and transient, but the reduced number of cases and the limited period of postoperative surveillance did not allow statistically significant conclusions to be drawn. Conclusions. The postoperative management of surgical feeding solutions requires permanent collaboration between surgeon, patient and outpatient nursing services at home and requires knowing and observing of a specific nursing protocol to avoid disturbing the nutrient balance of the patient.

Brain Tumors

2020 ◽  
pp. 23-42
Author(s):  
Angela M. Bohnen ◽  
Kaisorn L. Chaichana ◽  
Alfredo Quinones-Hinojosa
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumors ◽  
Demyelinating Disease ◽  
Intraoperative Complications ◽  
Postoperative Management ◽  
Treatment Modalities ◽  
Adjuvant Radiation ◽  
Term Care ◽  
Metastatic Lesions

Having a general understanding of brain tumors is integral to mastering the oral board examination. For the general session, examinees should be able to identify both intra-axial and extra-axial tumors and provide a comprehensive understanding of the differential diagnosis and plan regarding treatment, while also verbalizing concepts behind the treatment modalities and articulating to a patient and family the alternative approaches as well as the complications related to management. Pathologies to familiarize oneself with include gliomas, meningiomas, metastatic lesions, and pituitary lesions. For subspecialty examinees, complex cases such as endonasal, endoscopic, keyhole, and skull base approaches should be mastered. For each case, a broad differential diagnosis should include infection, hematoma, infarction, thrombosed aneurysm, inflammation, and/or demyelinating disease. Discuss the preoperative workup the indications for surgery and surgical approach. Interpret the preoperative and postoperative imaging critically. Be prepared for potential intraoperative complications and discussion of postoperative management including adjuvant radiation and chemotherapy and long-term care.

Termination of pregnancy

2018 ◽  
Vol 11 (11) ◽  
pp. 620-625
Author(s):  
Catherine Stace
Keyword(s):  
Secondary Care ◽  
Surgical Procedure ◽  
Termination Of Pregnancy ◽  
Limited Evidence ◽  
Psychological Sequelae ◽  
Common Procedure ◽  
Care And Support ◽  
Ongoing Care

Termination of pregnancy (TOP) refers to a medical or surgical procedure to end a pregnancy. It is a safe and well-tolerated procedure with limited evidence to suggest any long-term psychological sequelae. It is also a common procedure, and given the number of women who will undergo a TOP, it is crucial that GPs understand the procedure and the care of women requesting it. This article aims to outline referral processes, legislation, and ongoing care and support of women. It will not consider TOP after 24 weeks gestation, or in emergencies, as these are arranged within secondary care.

Complications of Classical Tracheostomy and Management

2003 ◽  
Vol 33 (3) ◽  
pp. 148-150 ◽  
Author(s):  
P A Onakoya ◽  
O G B Nwaorgu ◽  
L A Adebusoye
Keyword(s):  
Mortality Rate ◽  
Home Care ◽  
Retrospective Review ◽  
Postoperative Management ◽  
College Hospital ◽  
Airway Diseases ◽  
Complications And Mortality ◽  
Overall Mortality

Tracheostomy can prevent many deaths in otherwise fatal airway diseases and problems but has numerous complications that are mostly avoidable if the procedure is carefully performed together with strict postoperative management. This is a retrospective review of tracheostomy complications over a 10 year period (1991–2002) in the Department of Otorhinolaryngology (ORL), University College Hospital, Ibadan. A total of 179 tracheostomies performed on 168 patients with 69 complications (38.6%) were documented. There was a significantly greater number of complications in the 43 emergency cases (54%) than in the 26 elective cases [(46%), P=0.0002]. The overall mortality rate was 2.2%. The most common complications of tracheostomy were infective in origin, representing 43% of all complications. This study highlights the complications and mortality and gives details of management that will prevent or minimize their occurrences. Those who require long-term tracheostomy must be on regular follow-up and taught home-care of the tracheostomy before discharge from the hospital.

The oncologic impact of pancreatic fistula after pancreatectomy in patients with pancreatic cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 426-426
Author(s):  
Manabu Kawai ◽  
Yoshiaki Murakami ◽  
Seiko Hirono ◽  
Ken-Ichi Okada ◽  
Fuyuhiko Motoi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Fistula ◽  
Hazard Analysis ◽  
High Volume ◽  
Postoperative Management ◽  
Proportional Hazard ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Proportional Hazard

426 Background: There is a few reports that evaluates the association between pancreatic and long-term survival after pancreatectomy in patients with pancreatic cancer. The aim of this study was to elucidate the oncological impact of pancreatic fistula (PF) on long-term survival after pancreatectomy in patients with pancreatic cancer by performing a survey of high volume centers for pancreatic resection in Japan. Methods: Between January 2001 and December 2012, 1,369 patients who underwent pancreatectomy for pancreatic cancer at 7 high-volume centers in Japan were retrospectively reviewed. Results: Pancreatic fistula(PF) occurred in 320 of 1,369 patients (23.5%), and these were classified based ISGPF as follows; grade A in 10.2%, grade B in 10.7%, and grade C in 2.6% of the patients. Median survival time (MST) in no fistula/grade A, grade B and grade C were 24.0, 26.3 and 11.0 months, respectively. MST in grade B PF was similar with that in no fistula/grade A. However, patients with grade C PF had a significantly poorer survival than those without (P<0.001). In the multivariate cox proportional hazard analysis, grade C PF was detected as an independent prognostic factor after pancreatectomy for pancreatic cancer (hazard ratio (HR) 2.15; 95% confidence interval (CI) 1.40-3.29; P< 0.001). Conclusions: Grade C PF adversely affects long-term survival of patients with pancreatic cancer undergoing pancreatectomy, although patients with grade B PF have similar prognosis with no fistula/grade A. Postoperative management to prevent grade C PF is important to improve prognosis in patients with pancreatic cancer undergoing pancreatectomy.

Glaucoma laser and surgical procedure rates in Canada: a long-term profile

2008 ◽  
Vol 43 (4) ◽  
pp. 449-453 ◽  
Author(s):  
Robert J. Campbell ◽  
Graham E. Trope ◽  
Rony Rachmiel ◽  
Yvonne M. Buys
Keyword(s):  
Surgical Procedure

scholarly journals Ill Effects of Smoking: Baseline Knowledge among School Children and Implementation of the “AntE Tobacco” Project

2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
Salim Surani ◽  
Raghu Reddy ◽  
Amy E. Houlihan ◽  
Brenda Parrish ◽  
Gina L. Evans-Hudnall ◽  
...  
Keyword(s):  
Educational Program ◽  
Short Term ◽  
Educational Objectives ◽  
Item Questionnaire ◽  
Term Retention ◽  
Baseline Knowledge ◽  
Long Term Retention ◽  
Tobacco Education

Introduction. Cigarette smoking contributes to the deaths of more than 400,000 Americans annually. Each day >3,000 children and adolescents become regular smokers. This paper details a new antitobacco educational program titled “AntE Tobacco”Method. Children in grades 1–3 were administered a 10-item questionnaire to ascertain their baseline knowledge about the ill effects of smoking, shown an educational cartoon video depicting the ill effects of tobacco, and given a story book based on the video. At the end of video, children were administered a questionnaire to determine short-term recall of the antitobacco educational objectives of the program. Four to 6 weeks later, the children were then administered a follow-up survey to determine long-term retention of the anti tobacco educational program.Result. Eighty two percent of the children answered the outcome questions correctly immediately following the video. At follow-up, 4–6 weeks later, 83% of children answered all questions correctly.Conclusion. The anti tobacco education program used in this study effectively conveyed most of the educational objectives. The results of this study indicate that a multimedia (i.e., video and book) educational program can be used to educate and reinforce anti tobacco messages. This program may be very useful as a part of a comprehensive anti tobacco curriculum in school systems.

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