Revision cricotracheal resection: our experience

2021 ◽  
Vol 135 (1) ◽  
pp. 57-63
Author(s):  
H A Ebada ◽  
A M A El-Fattah ◽  
A Tawfik
Keyword(s):  
Operative Technique ◽  
Curative Treatment ◽  
Success Rates ◽  
University Hospitals ◽  
Recurrent Stenosis ◽  
Cricotracheal Resection ◽  
Major Complications ◽  
Operative Complications ◽  
Surgical Emphysema ◽  
Operative Assessment

AbstractObjectiveThe incidence of recurrent stenosis after cricotracheal resection is 3–9.5 per cent. Management of such patients is challenging. This study aimed to review our experience in revision cricotracheal resection.MethodsThe study was conducted in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, on nine patients with recurrent stenosis following cricotracheal resection. Revision cricotracheal resection was performed in all patients. Surgiflo was applied on the site of anastomosis to enhance healing.ResultsNo intra-operative complications were recorded. Minor post-operative complications occurred in two patients (surgical emphysema and temporary choking); no major complications were reported. Re-stenosis occurred in one patient. Successful decannulation was achieved in eight of the nine patients.ConclusionRevision cricotracheal resection is the definitive curative treatment for recurrent stenosis after previous unsuccessful resection. It has high success rates, provided that careful pre-operative assessment and meticulous operative technique are performed.

Evaluation of post-operative complications after Milligan- Morgan haemorrhoidectomy versus Stapled Haemorrhoidopexy techniques

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adel Darweish ◽  
Dr.Ibrahim Maged Abed El Maksod ◽  
Atef Abed El Tawab Nafea
Keyword(s):  
Surgical Intervention ◽  
Anal Stenosis ◽  
Stapled Haemorrhoidopexy ◽  
Success Rates ◽  
University Hospitals ◽  
Haemorrhoidal Disease ◽  
Post Operative Pain ◽  
Conventional Hemorrhoidectomy ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background Haemorrhoidal disease is one of the oldest illnesses known to mankind. It leads to significant pain, discomfort and poor quality of life. It is one of the common diseases which affect mankind but it is difficult to give an accurate figure of the prevalence because although many patients present with symptoms, many do not and some never bring it to notice of clinicians. The word hemorrhoids means flow of blood, the word pile means a ball, indicating two cardinal symptoms of this disease; bleeding per rectum and mass per anus. Aim of the work Aim of the work is to detect and compare the post-operative complications (Pain, Bleeding and anal stenosis) after 2 of the most commonly used techniques for management of the clinically diagnosed third and fourth stage hemorrhoids: Milligan-Morgan hemorrhoidectomy and stapler hemorrhoidopexy. Patient and Methods After obtaining approval from The College Ethical Committee, the study entitled "Evaluation of Postoperative Complications after Open MM Hemorrhidectomy versus Stapled Hemorrhoidopexy" was conducted on a total of 30 patients with hemorrhoids undergoing either conventional hemorrhoidectomy by Milligan Morgan (MM) technique or stapler hemorrhoidopexy. The patients were selected randomly after fulfilling the inclusion criteria in the department of general surgery, Ain Shams University hospitals over a period of 4 months starting from 1 August 2019 to 1 December 2019. Patients were admitted via surgical outpatient clinic. Patients were randomly distributed to 2 groups (A & B), each group containing 15 patients. Results A total of 30 patients who underwent either conventional hemorrhoidectomy (CH) or stapler hemorrhoidopexy (SH) in The Department of Surgery, Faculty of Medicine, Ain Shams University included in this study for 4 months started from 1/8/2019 and ended in 1/12/2019 and the following results are obtained. Conclusion Haemorrhoidal disease is considered as one of the commonest ano-rectal diseases. Non-surgical measures whatever drug therapy or office procedures, can be presented to the patients with stage 1 and stage 2 haemorrhoids. However, when these measures fail, surgical intervention must be thought for the patients with stage 3 and stage 4 haemorrhoids. Surgical intervention should be tailored to each patient in accordance to the seriousness of symptoms, the magnitude of the external anorectal element and the presence of any concurrent ano-rectal morbidity. At present, there are many surgical interventions obtainable for treatment of prolapsing piles disease and most of them yielding acceptable success rates. Conventional Haemorrhoidectomy (CH) whatever open (Milligan Morgan) or closed (Ferguson) is considered the gold standard for surgical intervention of piles but due to the severe associated post-operative pain, especially with defecation, Stapled Haemorrhoidopexy (SH) seems to present shorter operative time, less post-operative pain, less bleeding and anal stricture and also less time off work in comparison with CH. Although rare but horrible complications have been noted with SH, which dictate that SH should be performed only by experienced surgeons. Eventually we strongly recommend the use of stapler devices for haemorrhoidectomy when and where possible especially for high grade and prolapsing haemorrhoids although more research and study should be made in this concern for more confirmation of our results due to decreased specimen size and short post-operative follow up period in our study.

scholarly journals Cervical tracheal resection with cricotracheal anastomosis: experience in adults with grade III–IV tracheal stenosis

2010 ◽  
Vol 125 (6) ◽  
pp. 614-619 ◽  
Author(s):  
A M A El-Fattah ◽  
E Kamal ◽  
H E Amer ◽  
M Fouda ◽  
A E M A Elwahab ◽  
...  
Keyword(s):  
Tracheal Stenosis ◽  
Orotracheal Intubation ◽  
Difficult Problem ◽  
Tracheal Resection ◽  
Success Rates ◽  
University Hospitals ◽  
Surgical Emphysema ◽  
Male Patients ◽  
Lost To Follow Up ◽  
Grade Iii

AbstractIntroduction:Laryngotracheal stenosis is currently one of the most common complications associated with nasal and orotracheal intubation and tracheotomy. Once established, tracheal stenosis can be a complex and difficult problem to manage.Patients and methods:We retrospectively analysed 2004–2010 data for 12 male patients with postintubation cervical tracheal stenosis (grade III–IV) treated in the otolaryngology department, Mansoura University Hospitals. All patients had a tracheostomy at presentation, and all underwent tracheal resection with primary cricotracheal anastomosis and suprahyoid release.Results:Grade III stenosis was present in five patients (41.7 per cent) and grade IV stenosis in seven patients (58.3 per cent). The length of trachea resected ranged from 2 to 4 cm, representing one to four tracheal rings. In all 12 patients, the procedure allowed successful tracheotomy decannulation. Minor complications comprised surgical emphysema (n = 2) and wound infection (n = 1), and were managed conservatively. Major complications consisted of restenosis (n = 3), managed in two patients by repeated dilatation; one patient was lost to follow up.Conclusion:Segmental tracheal resection with cricotracheal anastomosis was successful in 11/12 (92 per cent) patients with severe cervical tracheal stenosis. The strategy for treatment of airway stenosis is now well established and success rates are high, with minimal or no sequelae.

scholarly journals Tehnika splenektomije

2002 ◽  
Vol 49 (3) ◽  
pp. 45-50 ◽  
Author(s):  
Radoje Colovic
Keyword(s):  
Operative Technique ◽  
Splenic Artery ◽  
Benign Lesions ◽  
Operative Complications ◽  
Short Gastric Vessels ◽  
Gastrosplenic Ligament ◽  
Accessory Spleens

Splenectomy has been performed in trauma in a number of benign lesions of the spleen and in a certain haematological diseases. When performed for trauma a luxation technique of splenectomy is applied since it allows quick haemostasis. When performed in other indications, the spleen is usually enlarged. In those patients "splenectomy in situ" is recommended. That means, first, division of the short gastric vessels and gastrosplenic ligament, second, ligation of the splenic artery and finally division of the hilar vessels after which the spleen may be simply removed. Details of operative technique, management of accessory spleens and prevention of operative complications are described.

Post-operative complications

2016 ◽  
Author(s):  
Claire Perkins
Keyword(s):  
At Risk ◽  
Surgical Patients ◽  
Good Knowledge ◽  
Appropriate Care ◽  
Post Operative Period ◽  
Care Treatment ◽  
Operative Complications ◽  
Treatment Plans ◽  
Operative Assessment ◽  
Post Operative Complications

Surgical patients are at risk of post-operative complications. A thorough pre-operative assessment and the implementation of appropriate care/treatment plans will reduce the likelihood of complications occurring. The surgical nurse should have a good knowledge and understanding of recognizing, preventing, and treating post-operative complications. The ABCDE approach should be used in the immediate post-operative period and if the patient becomes acutely unwell. This chapter uses body systems and the ABCDE approach to review post-operative complications.

Comparative study of management of inferior turbinate hypertrophy using turbinoplasty assisted by microdebrider or 980 nm diode laser

2012 ◽  
Vol 126 (12) ◽  
pp. 1231-1237 ◽  
Author(s):  
A N Kassab ◽  
M Rifaat ◽  
Y Madian
Keyword(s):  
Diode Laser ◽  
Operative Time ◽  
Inferior Turbinate ◽  
The Other ◽  
Success Rates ◽  
Non Invasive ◽  
Turbinate Hypertrophy ◽  
Operative Complications ◽  
Laser Group ◽  
Inferior Turbinate Hypertrophy

AbstractObjective:This study aimed to compare the outcomes of turbinoplasty assisted by microdebrider and by diode laser (980 nm wavelength).Methods:Forty patients suffering from bilateral nasal obstruction were randomly divided into two equal groups. One group was managed with microdebrider-assisted turbinoplasty and the other with diode laser assisted turbinoplasty. The patients were followed up for six months post-operatively.Results:After six months, total success rates were 90 per cent for the microdebrider group and 85 per cent for the diode laser group. There were no significant differences between the two groups regarding success rate, post-operative complications or operative time.Conclusion:These two techniques are equally safe, reliable, successful and non-invasive.

scholarly journals Complications of cochlear implantation surgery in Zagazig University Hospitals

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Alaa Eldin M. Elfeky ◽  
Adly A. Tantawy ◽  
Asmaa M. Ibrahim ◽  
Ibrahim M. Saber ◽  
Said Abdel-Monem
Keyword(s):  
Facial Nerve ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Csf Leak ◽  
Facial Nerve Paralysis ◽  
Complication Rates ◽  
Chorda Tympani Nerve ◽  
University Hospitals ◽  
Nerve Paralysis ◽  
Major Complications

Abstract Background Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon’s skill and clinical expertise in managing various cochlear implant cases improve with years of experience, the complication rates ideally come down over time. This article is intended to describe the most common surgical complications of cochlear implantation in Zagazig University Hospitals. This retrospective study included 130 patients who underwent cochlear implantation in Zagazig University Hospitals from 2016 to 2018. The patients were 61 males and 69 females; their ages ranged between 2 and 6 years old with a mean age of 4.3. This study aims to provide feedback on the common complications of CI surgery at our institution to help the reduction of its incidence in the future. Results One hundred thirty cases of cochlear implants were performed in our department between 2016 and 2018. Sixty complications were recorded, including 27 cases of minor and 21 cases of major complications. Minor complications were flap wound infection in 4 cases (3.1%), chorda tympani nerve injury in 7 cases (5.4%), postoperative vertigo and vomiting in 3 cases (2.3%), injury of EAC in 7 cases (5.4%), wound seroma/hematoma in 4 cases (3.1%), and facial nerve twitching in 2 cases (1.5%). Major complications were electrode extrusion in 2 cases (1.5%), CSOM in 1 case (0.8%), CSF leak in 8 cases (6.1%), magnet migration in 3 cases (2.3%), total facial nerve paralysis in 5 cases (3.8%), and device failure in 2 cases (1.5%). Conclusion The overall incidence of major complications is low. The majority of minor complications can be effectively managed with conservative measures. Cochlear implantation remains a safe and effective surgical procedure.

scholarly journals Predictors of success for combined endoscopic third ventriculostomy and choroid plexus cauterization in a North American setting: a Hydrocephalus Clinical Research Network study

2019 ◽  
Vol 24 (2) ◽  
pp. 128-138
Author(s):  
Jay Riva-Cambrin ◽  
John R. W. Kestle ◽  
Curtis J. Rozzelle ◽  
Robert P. Naftel ◽  
Jessica S. Alvey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Research ◽  
Choroid Plexus ◽  
Patient Selection ◽  
Operative Technique ◽  
Intraventricular Hemorrhage ◽  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Success Rates ◽  
Choroid Plexus Cauterization

OBJECTIVEEndoscopic third ventriculostomy combined with choroid plexus cauterization (ETV+CPC) has been adopted by many pediatric neurosurgeons as an alternative to placing shunts in infants with hydrocephalus. However, reported success rates have been highly variable, which may be secondary to patient selection, operative technique, and/or surgeon training. The objective of this prospective multicenter cohort study was to identify independent patient selection, operative technique, or surgical training predictors of ETV+CPC success in infants.METHODSThis was a prospective cohort study nested within the Hydrocephalus Clinical Research Network’s (HCRN) Core Data Project (registry). All infants under the age of 2 years who underwent a first ETV+CPC between June 2006 and March 2015 from 8 HCRN centers were included. Each patient had a minimum of 6 months of follow-up unless censored by an ETV+CPC failure. Patient and operative risk factors of failure were examined, as well as formal ETV+CPC training, which was defined as traveling to and working with the experienced surgeons at CURE Children’s Hospital of Uganda. ETV+CPC failure was defined as the need for repeat ETV, shunting, or death.RESULTSThe study contained 191 patients with a primary ETV+CPC conducted by 17 pediatric neurosurgeons within the HCRN. Infants under 6 months corrected age at the time of ETV+CPC represented 79% of the cohort. Myelomeningocele (26%), intraventricular hemorrhage associated with prematurity (24%), and aqueductal stenosis (17%) were the most common etiologies. A total of 115 (60%) of the ETV+CPCs were conducted by surgeons after formal training. Overall, ETV+CPC was successful in 48%, 46%, and 45% of infants at 6 months, 1 year, and 18 months, respectively. Young age (< 1 month) (adjusted hazard ratio [aHR] 1.9, 95% CI 1.0–3.6) and an etiology of post–intraventricular hemorrhage secondary to prematurity (aHR 2.0, 95% CI 1.1–3.6) were the only two independent predictors of ETV+CPC failure. Specific subgroups of ages within etiology categories were identified as having higher ETV+CPC success rates. Although training led to more frequent use of the flexible scope (p < 0.001) and higher rates of complete (> 90%) CPC (p < 0.001), training itself was not independently associated (aHR 1.1, 95% CI 0.7–1.8; p = 0.63) with ETV+CPC success.CONCLUSIONSThis is the largest prospective multicenter North American study to date examining ETV+CPC. Formal ETV+CPC training was not found to be associated with improved procedure outcomes. Specific subgroups of ages within specific hydrocephalus etiologies were identified that may preferentially benefit from ETV+CPC.

Comparative Study between Percutaneous Approach and Transurethral Approach for Treatment of Urinary Bladder Stones

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Taema ◽  
Hossam Mohammed El Awady ◽  
Mahmoud Mohammed El Shahawy
Keyword(s):  
Urinary Bladder ◽  
Safe Procedure ◽  
University Hospitals ◽  
Percutaneous Approach ◽  
Bladder Stones ◽  
Operative Complications ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Purpose The aim of this study is to compare outcome of percutaneous cystolithotripsy approach (pccl) vs transurethral cystolithotripsy approach (tucl) in treatment of large urinary bladder stones regarding efficacy, safety and peri-operative complications. Methods This study included 60 patients who had urinary bladder stone, treated at Ain Shams University hospitals in Egypt from March 2019 to March 2020 and randomly assigned into two groups: group A: percutaneous cystolithotripsy (PCCL) and group B: transurethral using nephroscope combined with meurmayer stone punch (tucl). Baseline and perioperative data were recorded and compared between two groups. Results Baseline parameters and the peri-operative complications (fever, transient haematuria, urinary bladder perforation, suprapubic wound infection and persistent leakage from suprapubic site) were compared between the two groups. Complete stone clearance was achieved in all the patients. The mean operative time in pccl group and tucl group was (30±7 min and 32±7 min) respectively. Urinary catheter duration in Pccl group was significantly more than Tucl group. Till the last follow-up, 6.6% patients (n = 2) developed urethral stricture in Tucl group. Conclusions PCCL is a safe procedure with acceptable morbidity and can be used as an alternative to tucl in treating (2-4 cm) urinary bladder stones.

scholarly journals Successful Smoking Cessation in COPD: Association with Comorbidities and Mortality

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
H. Kupiainen ◽  
V. L. Kinnula ◽  
A. Lindqvist ◽  
D. S. Postma ◽  
H. M. Boezen ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Alcohol Abuse ◽  
Success Rates ◽  
University Hospitals ◽  
Quit Smoking ◽  
Copd Patients ◽  
Nicotine Dependency ◽  
Psychiatric Conditions ◽  
Enrollment Data ◽  
First Time

Smoking cessation is the cornerstone of COPD management, but difficult to achieve in clinical practice. The effect of comorbidities on smoking cessation and risk factors for mortality were studied in a cohort of 739 COPD patients recruited in two Finnish University Hospitals. The diagnosis of COPD was done for the first time on average 5.5 years prior to the enrollment. Data from the medical records and followup questionnaires (years 0, 1, 2, and 4) have been analyzed. The patients’ lung function varied greatly; mean FEV158% of predicted. A total of 60.2% of men and 55.6% of women had been able to quit smoking. Alcohol abuse (OR 2.1, 95% CI 1.4–3.3) and psychiatric conditions (OR 1.8, 95% CI 1.2–2.7) were strongly related to low success rates of quitting. Among current smokers high nicotine dependency was again explained by alcohol abuse and psychiatric conditions. Non-quitters were younger than quitters, but their mortality rates remained significantly higher even when the model was adjusted for impairment of lung functions and comorbidities. In conclusion, co-existing addiction and psychiatric diseases significantly decreased the success rates in smoking cessation and increased mortality among the patients.

scholarly journals Endotracheal Intubation Success Rate in an Urban, Supervised, Resident-Staffed Emergency Mobile System: An 11-Year Retrospective Cohort Study

2020 ◽  
Vol 9 (1) ◽  
pp. 238 ◽  
Author(s):  
Michèle Chan ◽  
Christophe A. Fehlmann ◽  
Mathieu Pasquier ◽  
Laurent Suppan ◽  
Georges L. Savoldelli
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Life Support ◽  
Advanced Life Support ◽  
Resident Physician ◽  
Success Rates ◽  
University Hospitals ◽  
Specialist Physician ◽  
Intubation Success Rate ◽  
Training Background

Objectives: In the prehospital setting, endotracheal intubation (ETI) is sometimes required to secure a patient’s airways. Emergency ETI in the field can be particularly challenging, and success rates differ widely depending on the provider’s training, background, and experience. Our aim was to evaluate the ETI success rate in a resident-staffed and specialist-physician-supervised emergency prehospital system. Methods: This retrospective study was conducted on data extracted from the Geneva University Hospitals’ institutional database. In this city, the prehospital emergency response system has three levels of expertise: the first is an advanced life-support ambulance staffed by two paramedics, the second is a mobile unit staffed by an advanced paramedic and a resident physician, and the third is a senior emergency physician acting as a supervisor, who can be dispatched either as backup for the resident physician or when a regular Mobile Emergency and Resuscitation unit (Service Mobile d’Urgence et de Réanimation, SMUR) is not available. For this study, records of all adult patients taken care of by a second- and/or third-level prehospital medical team between 2008 and 2018 were screened for intubation attempts. The primary outcome was the success rate of the ETI attempts. The secondary outcomes were the number of ETI attempts, the rate of ETI success at the first attempt, and the rate of ETIs performed by a supervisor. Results: A total of 3275 patients were included in the study, 55.1% of whom were in cardiac arrest. The overall ETI success rate was 96.8%, with 74.4% success at the first attempt. Supervisors oversaw 1167 ETI procedures onsite (35.6%) and performed the ETI themselves in only 488 cases (14.9%). Conclusion: A resident-staffed and specialist-physician-supervised urban emergency prehospital system can reach ETI success rates similar to those reported for a specialist-staffed system.

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