Bilateral, simultaneous cochlear implantation in children: surgical considerations

2009 ◽  
Vol 123 (8) ◽  
pp. 837-839 ◽  
Author(s):  
L Migirov ◽  
J Kronenberg
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Clinical Care ◽  
Operation Time ◽  
Study Cohort ◽  
General Anaesthetic ◽  
Safe Procedure ◽  
Operative Complications ◽  
Post Operative Complications

AbstractProblem:The advantages of bilateral, simultaneous cochlear implantation include: the possibility to pre-empt cochlear calcification following meningitis; reduction of the intervention to only one procedure, general anaesthetic and course of clinical care (with obvious benefits for the patient); and greater cost-effectiveness. The disadvantages of such a procedure include: doubling the risk of associated complications; placing the patient on the implanted side during contralateral implantation; the possibility of vestibular alteration simultaneously in both ears; the need for precise planning of symmetrical incisions and implant sites; and longer surgery time.Methods:The study cohort included 10 children who underwent bilateral, simultaneous cochlear implantation using the suprameatal approach.Results:The overall operation time, inclusive of anaesthesia, was approximately three hours in all cases. None of the children had any intra- or post-operative complications.Conclusions:From a surgical perspective, bilateral, simultaneous cochlear implantation is a safe procedure. The use of a non-mastoidectomy approach is recommended.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

Post-operative complications of cochlear implantation in adults and children: five years' experience in Maastricht

2006 ◽  
Vol 121 (4) ◽  
pp. 318-323 ◽  
Author(s):  
J T F Postelmans ◽  
B Cleffken ◽  
R J Stokroos
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Retrospective Chart Review ◽  
Operative Complications ◽  
Ventilation Tubes ◽  
Adults And Children ◽  
Post Operative Complications

Although cochlear implantation is considered a safe method of rehabilitation for profoundly deaf individuals, a number of these patients suffer complications after surgery. To evaluate post-operative complications after cochlear implantation, a retrospective chart review was performed for 112 patients who had undergone implantation in the Maastricht Academic Hospital. Minor complications were defined as those that could be overcome by medical or audiological management. These occurred in 36 patients (32 per cent) and all were managed successfully. Major complications were defined as device extrusion and those requiring further surgery, and these were identified in four patients (3.6 per cent). These complications included wound infection and device failure mediated by middle-ear pathology. In cases of chronic otitis media, we recommend performance of cochlear implantation as a staged procedure. In order to reduce the post-operative incidence of acute otitis media, we recommend adenoidectomy, placement of ventilation tubes and early antibiotic treatment.

Laparoscopy for the treatment of ovarian remnant syndrome in four dogs and two cats

2016 ◽  
Vol 44 (02) ◽  
pp. 86-92 ◽  
Author(s):  
M. Brückner
Keyword(s):  
Clinical Relevance ◽  
Safe Procedure ◽  
Laparoscopic Treatment ◽  
Case Selection ◽  
Operative Complications ◽  
Open Laparotomy ◽  
Laparoscopic Removal ◽  
Portal Technique ◽  
Rule Out ◽  
Post Operative Complications

Summary Objective: To describe the clinical workup and laparoscopic treatment of ovarian remnant syndrome in dogs and cats. Material and methods: After confirming the diagnosis with some or all of the following tests – vaginoscopy with cytology, hormonal tests, and ultrasound – laparoscopic removal of the ovarian remnants was performed. A three-portal technique was used in the four dogs and a two-portal technique in the two cats. Results: All patients recovered well and were discharged the same day. No post-operative complications occurred in any patient. Conclusion and clinical relevance: Overall, in the hands of an experienced laparoscopic surgeon, laparoscopic removal of ovarian remnants appears to be a safe procedure in dogs and cats. In addition, laparoscopy offers the advantages of excellent visualization and a reduced morbidity for the patient. Careful case selection and complete pre-operative workup to rule out co-morbidities or underlying neoplasia are important. As with any laparoscopy the surgeon should always be prepared to convert to an open laparotomy if necessary.

scholarly journals COMPARISON OF OUTCOMES BETWEEN EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
Vol 71 (3) ◽  
pp. 796-800
Author(s):  
Muhammad Ismail ◽  
Nasir Mehmood Wattoo ◽  
Muhammad Qasim Butt ◽  
Fareeha Naz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operation Time ◽  
Acute Calculous Cholecystitis ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Calculous Cholecystitis ◽  
Post Operative Complications

Objective: To compare early versus delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of mean operative time, hospital stay, conversion rate to open surgery and post-operative complications. Study Design: Quasi experimental study. Place and Duration of Study: Army Liver Transplant Unit, Department of Surgery, Pak-Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Methodology: A total of 170 patients (85 in each group) diagnosed as a case of acute calculous cholecystitis who met the sample selection criteria were included. Group A patients underwent early laparoscopic cholecystectomy within 72 hours of admission while group B patients underwent conservative management followed by delayed laparoscopic cholecystectomy after 6 weeks. All patients were followed for operative time, hospital stay, per-operative difficulties encountered and post-operative complications. Results: Group A had a mean operation time of 43.9 ± 11.1 minutes, while group B had a mean operation time of 45.8 ± 10.1 minutes (p=0.83). The mean duration of hospitalization was 2.8 ± 1.1 days in group A and 5.3 ± 0.8 days in group B (p<0.001). Complications were measured at a frequency of 14.1% in group A and 5.9% in group B (p=0.07). Conclusion: Early laparoscopic cholecystectomy is better than delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of hospital stay and per-operative difficulties faced. The post-operative complications between the two groups are comparable.

scholarly journals 713 Wide-Awake Local Anaesthesia No Tourniquet (WALANT) Procedures During COVID-19: A Single Centre Experience

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Sutcliffe ◽  
B Khera ◽  
H Khashaba
Keyword(s):  
Patient Satisfaction ◽  
Plastic Surgery ◽  
Case Series ◽  
General Anaesthetic ◽  
Trauma Service ◽  
Single Centre Experience ◽  
Operative Complications ◽  
Operating Theatres ◽  
Block Data ◽  
Post Operative Complications

Abstract Aim WALANT procedures are becoming more popular and are particularly useful in the COVID-19 pandemic. Procedures can be performed without needing access to general theatres and anaesthetic support, minimising the number of patient-healthcare interactions and avoiding aerosolisation. Our unit has taken this approach and aim to present a case series that demonstrates the efficacy and safety of WALANT. Method A retrospective analysis of WALANT cases in a single plastic surgery centre during March-August 2020 was performed. All procedures using a WALANT approach were included, that would have otherwise required general anaesthetic or regional block. Data was collected on a number of variables, including patient satisfaction. Results 37 procedures were included in analysis. The majority of the injuries consisted of hand trauma. There were no cases of post-operative complications, although one required completion in main theatres due to technicality. No patients required additional anaesthetic during the procedure and all reported pain score as 0/10. Overall patient satisfaction was 10/10 for 26 patients, 9/10 for 10 patients and 7/10 for one patient. Conclusions Results show the use of WALANT can facilitate an effective plastic surgery trauma service during COVID-19. Most of the procedures were performed in the outpatient department setting, without the need for main operating theatres or anaesthetic support. All procedures were performed within 24 hours of initial presentation and were able to be discharged on the same day. In addition, patient satisfaction remained high and post-operative complications were minimal. We propose that the use of WALANT should continue and increase beyond the current pandemic.

scholarly journals Low-temperature radiofrequency coblation reduces treatment interval and post-operative pain of laryngotracheal recurrent respiratory papillomatosis

2020 ◽  
Vol 40 (5) ◽  
Author(s):  
Fang Hao ◽  
Liyan Yue ◽  
Xiaoyan Yin ◽  
Xiaotong Wang ◽  
Chunguang Shan
Keyword(s):  
Low Temperature ◽  
Blood Loss ◽  
Co2 Laser ◽  
Operation Time ◽  
Recurrent Respiratory Papillomatosis ◽  
High Recurrence Rate ◽  
Time Interval ◽  
Pain Scores ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Laryngeal papillomatosis is a benign disease in the larynx but with the potential to develop into significant complications as a result of its high recurrence rate. CO2 laser and radiofrequency controlled ablation (coblation) have been used to treat recurrent respiratory papillomatosis, but detailed comparisons of their respective treatment outcomes are not fully investigated. This retrospective study examines the procedure time, time interval between interventions, blood loss during operation, post-operative complications and pain scores among patients who received either CO2 laser or radiofrequency coblation interventions for laryngotracheal recurrent respiratory papillomatosis. Compared with CO2 laser intervention, radiofrequency coblation significantly reduced operation time, time interval between interventions, blood loss during operation and number of times bipolar electrocoagulation needed in each procedure. Post-operatively, pain scores after radiofrequency coblation were significantly lower than those after CO2 laser intervention. Incidence rates of post-operative complications, in terms of palate pharyngeal mucosa damage, bleeding and subcutaneous emphysema, were also significantly reduced after radiofrequency coblation. Low-temperature radiofrequency coblation is a superior intervention compared with CO2 laser against laryngotracheal recurrent respiratory papillomatosis.

scholarly journals Feasibility of Using the Epidural Space Detecting Device (EPI-DetectionTM) for Interlaminar Cervical Epidural Injection

2020 ◽  
Vol 9 (8) ◽  
pp. 2355
Author(s):  
Jiin Kang ◽  
Sam Sun Park ◽  
Chul Hwan Kim ◽  
Eui Chul Kim ◽  
Hyung Cheol Kim ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Epidural Space ◽  
Negative Pressure ◽  
Operation Time ◽  
Epidural Injection ◽  
Cervical Radiculopathy ◽  
Loss Of Resistance ◽  
Operative Complications ◽  
Post Operative Complications

Cervical epidural injection (CEI), which is widely used for the treatment of cervical radiculopathy, sometimes has been associated with post-operative complications. Recently, EPI-DetectionTM, which detects the negative pressure of the epidural space and notifies the proceduralist by flashing a light and producing a beeping sound, was introduced. We assumed that the newly developed device could be as safe and efficient as the conventional loss of resistance (LOR) method. Therefore, we aimed to evaluate the effectiveness of the EPI-DetectionTM and compare it to that of the conventional LOR method. We randomly assigned 57 patients to the LOR and EPI-Detection groups (29 and 28 patients, respectively). Subjects were treated with interlaminar CEI (ILCEI) using one of two methods. The measured parameters, i.e., operation time and radiation dose were lower in the EPI-DetectionTM group (4.6 ± 1.2 min vs. 6.9 ± 2.1 min; and 223.2 ± 206.7 mGy·cm2 vs. 380.3 ± 340.9 mGy·cm2, respectively; all p < 0.05) than in the LOR group. There were no complications noted in either group. Both the EPI-DetectionTM and LOR methods were safe and effective in detecting the epidural space, but the former was superior to the latter in terms of operation time and radiation exposure. The EPI-DetectionTM may help perform ILCEI safely.

scholarly journals The effectiveness of laparoscopic gastrectomy with totally intracorporeal reconstruction of gastrointestinal tract using unprecut method in management for gastric cancer

2019 ◽  
Vol 9 (3) ◽  
Author(s):  
Duy Long Võ ◽  
Keyword(s):  
Gastric Cancer ◽  
Gastrointestinal Tract ◽  
Total Gastrectomy ◽  
Laparoscopic Gastrectomy ◽  
Distal Gastrectomy ◽  
Gastrointestinal Surgery ◽  
Operation Time ◽  
Operative Complications ◽  
The Mean ◽  
Post Operative Complications

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi cắt dạ dày và nạo hạch mang lại nhiều lợi ích cho người bệnh. Phục hồi lưu thông ruột theo Roux - en -Y hoàn toàn bằng phẫu thuật nội soi (PTNS) theo phương pháp cắt dạ dày và ruột non trước tốn nhiều stapler, làm tăng chi phí điều trị. Mục tiêu của nghiên cứu này nhằm đưa ra kỹ thuật phục hồi lưu thông ruột hoàn toàn bằng PTNS mà không cắt ruột trước trong điều trị ung thư dạ dày. Phương pháp nghiên cứu: Đây là nghiên cứu tiền cứu, can thiệp lâm sàng. Từ tháng 6 năm 2015 đến tháng 8 năm 2016, tại khoa Ngoại Tiêu hóa, Bệnh viện Đại học Y Dược TP. HCM có 70 trường hợp ung thư dạ dày được phẫu thuật nội soi cắt dạ dày kèm nạo hạch D2 và phục hồi lưu thông ruột hoàn toàn trong ổ bụng theo Roux en Y bằng kỹ thuật không cắt ruột trước. Trong số này, có 40 trường hợp được cắt bán phần dưới dạ dày và 30 trường hợp cắt toàn bộ dạ dày. Các dữ kiện để đánh giá kết quả gồm: số lượng stapler dùng, thời gian mổ, biến chứng sau mổ và thời gian sống còn sau mổ. Kết quả: Tuổi trung bình 51,1. Thời gian mổ trung bình là 178 ± 28 phút. Số lượng stapler dùng cho 1 trường hợp cắt bán phần dưới hoặc toàn bộ dạ dày là 3, tối đa dùng 4 stapler. Tất cả trường hợp đều không còn tế bào ác tính ở bờ mặt cắt. Có 1 trường hợp (1,4%) nối lộn quai. Không có biến chứng xì, rò hay chảy máu miệng nối sau mổ. Thời gian sống còn chung sau mổ 1 và 3 năm lần lượt là 92% và 81%. Kết luận: Phục hồi lưu thông ruột theo phương pháp Roux - en -Y hoàn toàn qua PTNS cắt dạ dày và nạo hạch D2 mà không cắt ruột trước làm giảm số lượng stapler dùng và không tăng thêm biến chứng sau mổ. Thời gian sống còn sau mổ khả quan. Abstract Introduction: Gastrectomy associated with lymphadenectomy for patients with gastric cancer has great benefits. Totally intracorporeal Roux-en-Y anastomosis uses lot of staplers, and costs to patients. The aim of this study is to investigate on the effectiveness laparoscopic gastrectomy with totally intracorporeal reconstruction of gastrointestinal tract using unprecut method for gastric cancer. Material and Methods: This was a prospective interventional clinical research. From June 2015 to August 2016 at Gastrointestinal Surgery Department of UMC, 70 patients of gastric cancer were performed D2-gastrectomy with totally intracorporeal Roux-en-Y anastomosis using unprecut method. Among them, there were 40 cases of distal gastrectomy and 30 cases of total gastrectomy. The data collected were : number of staplers, operation time, post-operative complications, survival time. Results: The mean age was 51.1 years. The mean operation time was 178 +/- 28 minutes. The number of staplers per case for distal gastrectomy or total gastrectomy was 3 staplers, with maximum of 4 staplers. All cases had R0 margins. There was one case (1.4%) of misconstruction. There were no post-operative complications such as leakage or anastomotic fistular even bleeding. Overall 1-year and 3-year survival rates were 92% and 81%, respectively. Conclusion: Laparoscopic gastrectomy with totally intracorporeal reconstruction of gastrointestional tract using unprecut method for gastric cancer saved the number of staplers and not increased post-operative complications. The survival rate was satisfied. Keyword: Laparoscopic gastric

scholarly journals Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study

2020 ◽  
Author(s):  
Kirsten W. Slagter ◽  
Gerry M. Raghoebar ◽  
Inge Hamming ◽  
Jiska Meijer ◽  
Arjan Vissink
Keyword(s):  
Pain Score ◽  
Self Efficacy ◽  
Short Form ◽  
Safe Procedure ◽  
Inclusion Criteria ◽  
Operative Complications ◽  
Breastfeeding Problems ◽  
Prospective Longitudinal ◽  
Post Operative Complications

Abstract Objectives To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems. Materials and methods A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months’ post frenotomy. Results All 175 women completed the 1-month follow-up and 146 women the 6 months’ follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment. Conclusions Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems. Clinical relevance Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help. International trial register ISRCTN64428423

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