ENDOSCOPIC TREATMENT OF LARGE CHOLEDOCHAL STONES AND CHOLEDOCHAL STONING: SUCCESS RATE, COMPLICATIONS AND ASSOCIATED FACTORS

OBJECTIVE At present, endoscopic treatment is advised as the first procedure in cases of suprasellar arachnoid cysts (SSCs) with hydrocephalus. However, the appropriate therapy for SSCs without hydrocephalus has not been fully determined yet because such cases are very rare and because it is usually difficult to perform the neuroendoscopic procedure in patients without ventriculomegaly given difficulties with ventricular cannulation and the narrow foramen of Monro. The purpose of this study was to find out the value of navigation-guided neuroendoscopic ventriculocystocisternostomy (VCC) for SSCs without lateral ventriculomegaly. METHODS Five consecutive patients with SSC without hydrocephalus were surgically treated using endoscopic fenestration (VCC) guided by navigation between March 2014 and November 2015. The surgical technique, success rate, and patient outcomes were assessed and compared with those from hydrocephalic patients managed in a similar fashion. RESULTS The small ventricles were successfully cannulated using navigational tracking, and the VCC was accomplished in all patients. There were no operative complications related to the endoscopic procedure. In all patients the SSC decreased in size and symptoms improved postoperatively (mean follow-up 10.4 months). CONCLUSIONS Endoscopic VCC can be performed as an effective, safe, and simple treatment option by using intraoperative image-based neuronavigation in SSC patients without hydrocephalus. The image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of hydrocephalus in patients with SSC may not be a contraindication to endoscopic treatment.

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Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy

Journal of Clinical Medicine ◽

10.3390/jcm8091279 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1279 ◽

Cited By ~ 2

Author(s):

Lee ◽

Jeon ◽

Kim ◽

Sung ◽

Chung ◽

...

Keyword(s):

Success Rate ◽

Associated Factors ◽

Clinical Characteristics ◽

Clinical Results ◽

Thyroid Stimulating Hormone ◽

Low Risk ◽

Maintenance Period ◽

Papillary Thyroid ◽

Clinical Factors ◽

Factors Associated

Background: This study aimed to identify the clinical results after thyrotropin suppression therapy (TST) cessation and evaluated clinical factors associated with successful TST cessation. Methods: Patients who underwent lobectomy due to low-risk papillary thyroid carcinoma (PTC) were included in this study. We compared clinical characteristics and outcomes between patients who succeeded to stop TST and failed to stop TST. Results: A total of 363 patients were included in the study. One hundred and ninety-three patients (53.2%, 193/363) succeeded to stop TST. The independent associated factors for successful TST cessation were the preoperative thyroid-stimulating hormone (TSH) level and the maintenance period of TST. Patients with low TSH level showed a higher success rate for levothyroxine (LT4) cessation than patients with high TSH level (1.79 ± 1.08 and 2.76 ± 1.82 mU/L, p < 0.001). Patients who failed to discontinue TST showed a longer maintenance period of TST than patients who succeeded to discontinue TST (54.09 ± 17.44 and 37.58 ± 17.68 months, p < 0.001). Conclusions: Preoperative TSH level and maintenance period of TST are important factors for successful cessation of TST. If TST cessation is planned for patients who are taking LT4 after lobectomy, a higher success rate of TST cessation is expected with low preoperative TSH level and early cessation of LT4.

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The Initial Success Rate of Cardiopulmonary Resuscitation and Its Associated Factors among Intensive Care Unit Patients in a Tertiary Hospital in Saudi Arabia

Journal of Intensive and Critical Care ◽

10.21767/2471-8505.100037 ◽

2016 ◽

Vol 02 (03) ◽

Cited By ~ 1

Author(s):

Akram Mohammad Rasheed ◽

Mohammad Faisal Amera ◽

PJ Parameaswari ◽

Owais Sabri Numan ◽

Ahmed Mohd Elhaj ◽

...

Keyword(s):

Intensive Care Unit ◽

Saudi Arabia ◽

Intensive Care ◽

Cardiopulmonary Resuscitation ◽

Success Rate ◽

Associated Factors ◽

Tertiary Hospital ◽

Initial Success Rate

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Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection

Advances in Urology ◽

10.1155/2011/352716 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Boris Chertin ◽

Ksenia Prosolovich ◽

Sagiv Aharon ◽

Ofer Nativ ◽

Sarel Halachmi

Keyword(s):

Success Rate ◽

Vesicoureteral Reflux ◽

Endoscopic Treatment ◽

Endoscopic Procedure ◽

Ureteral Reimplantation ◽

Endoscopic Injection ◽

Stable Function ◽

Renal Scan

Purpose. In recent years, endoscopic injection became the procedure of choice for the correction of vesicoureteral reflux in the majority of the centers. Unfortunately, endoscopic treatment is not always successful and sometimes requires more than one trial to achieve similar results to that of an open reimplantation surgery. Our aim of this study is to evaluate the feasibility and success rate of open ureteral reimplantation following failed endoscopic procedure.Patients and Methods. During 2004–2010, we evaluated 16 patients with persistent vesicoureteral reflux (grades II–IV) following failed endoscopic treatment. All patients underwent open ureteral reimplantation. All patients were followed with an ultrasound 6 weeks following surgery and every 6 months thereafter for an average of 22 months. Voiding cystography was performed at 3 months after surgery.Results. During unilateral open ureteral reimplantation, the implanted deposit from previous procedures was either excised, drained, or incorporated into the neotunnel with the ureter. Vesicoureteral reflux was resolved in all patients with 100% success rate. No new hydronephrosis or signs of obstruction developed in any of the patients. qDMSA renal scan was available in 8 patients showing improvement of function in 5 and stable function in 3, and no new scars were identified.Conclusions. Open ureteral reimplantation is an excellent choice for the correction of failed endoscopic treatment in children with vesicoureteral reflux.

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High success rate with new modified endoscopic treatment for high-grade VUR: A pilot study with preliminary report

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2015.07.013 ◽

2016 ◽

Vol 12 (2) ◽

pp. 100.e1-100.e4 ◽

Cited By ~ 2

Author(s):

S.A. Asgari ◽

A.S. Asl ◽

M.R. Safarinejad ◽

M.M. Ghanaei

Keyword(s):

Pilot Study ◽

Success Rate ◽

Endoscopic Treatment ◽

Preliminary Report ◽

High Success Rate ◽

High Grade

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A Comparison of Calcium Hydroxyapatite and Dextranomer/Hyaluronic Acid for the Endoscopic Treatment of Vesicoureteral Reflux

Advances in Urology ◽

10.1155/2013/263602 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Tin C. Ngo ◽

Ilene Yi-Zhen Wong ◽

William A. Kennedy

Keyword(s):

Hyaluronic Acid ◽

Learning Curve ◽

Success Rate ◽

Endoscopic Treatment ◽

Single Injection ◽

Statistical Significance ◽

Case Series ◽

Calcium Hydroxyapatite ◽

Success Rates ◽

Single User

Purpose. Minimal data exists comparing dextranomer/hyaluronic acid (Dx/HA) and calcium hydroxyapatite (CaHA) for the endoscopic treatment of VUR in the hands of a single user.Materials and Methods. We reviewed our consecutive single-user case series of 27 children (42 ureters) receiving endoscopic treatment with CaHA and 21 children (33 ureters) who received Dx/HA injection. Children receiving CaHA injections were divided into two groups of 13 and 14 patients (Coaptite I and II) to assess the learning curve effects. Postoperatively, RBUS and VCUG were performed. Multiple regression analysis was performed to assess statistical significance of success rates.Results. The total CaHA group had a per-ureter success rate (Grade 0) of 52% after one injection. When separated into two cohorts, the single injection per-ureter success rates were 43% for Coaptite I and 62% for Coaptite II. In contrast, the Dx/HA series had a single injection per-ureter success rate (Grade 0) of 78%.Conclusions. Our consecutive case experience shows improved results for Dx/HA compared to CaHA, though the learning curve effects and evolution of injection technique likely played a role in the improved outcomes in the Dx/HA cohort. A randomized controlled multicenter trial would provide the most accurate data comparing these two agents.

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Factores asociados a la eficacia de gol en waterpolo (Factors associated with shooting efficacy in water polo)

Retos ◽

10.47197/retos.v0i29.35220 ◽

2015 ◽

pp. 105-108

Author(s):

Francisco Manuel Argudo Iturriaga ◽

Laura Garcia Cervantes ◽

Encarnación Ruiz Lara

Keyword(s):

Success Rate ◽

Associated Factors ◽

Central Area ◽

Male And Female ◽

Factors Associated ◽

Water Polo ◽

European Water ◽

The World ◽

The Relationship ◽

Shooting Distance

Resumen. El objetivo del estudio fue analizar la relación entre la eficacia de gol en waterpolo y otros factores asociados como la microsituación de juego, la distancia de lanzamiento y el ángulo de lanzamiento. La muestra se compuso de 7215 lanzamientos pertenecientes al Campeonato de Europa de waterpolo (Málaga, 2008) y al Campeonato del Mundo de waterpolo (Roma, 2009). Los datos fueron analizados mediante el software Polo Análisis Directo v.1.0. Tanto en categoría femenina como masculina, la eficacia de gol de los lanzamientos de penalti fue mayor que en el resto de lanzamientos (p <.001). En waterpolo femenino se identificó un modelo con capacidad para predecir el 63% de los goles, donde se observó mayor posibilidad de gol en los lanzamientos llevados a cabo en jugadas de desigualdad numérica (OR=2.65) y de transición (OR=2.04). En waterpolo masculino el modelo tuvo capacidad para explicar el 65% de los goles, observándose mayor posibilidad de gol en las jugadas de desigualdad numérica (OR=2.59), en las jugadas de transición (OR=2.00) y en los lanzamientos efectuados desde la zona central o frontal a la portería (OR=1.33). Extrapolando los resultados al entrenamiento, deberíamos atender a dos directrices principalmente: la precisión de los lanzamientos realizados a una distancia inferior a 5 metros en las micro-situaciones de desigualdad numérica y de transición, y la eficacia de los lanzamientos en igualdad numérica a una distancia superior a 5 metros y desde posiciones laterales.Abstract. The aim of the study was to analyze the relationship between scoring and missing a goal in water polo and other associated factors such as the game micro-situation, shooting distance and shooting angle. The sample was composed of 7215 shots from the European Water Polo Championship (Malaga, 2008) and the World Water Polo Championship (Rome, 2009). The data were analyzed with Polo Analisis Directo v.1.0 software. The goal success rate of penalty shots was greater in both male and female categories than for non-penalty shots (p < .001). A model was identified in woman’s water polo that was able to predict 63% of the goals, in which the highest possibility of goal success was observed for shots taken during man-up situations (OR = 2.65) and transitions (OR = 2.04). The model applied to male water polo was able to predict 65% of the goals, showing that the highest possibility of scoring a goal corresponded to shots taken during man-up situations (OR = 2.59), in transitions (OR = 2.00) and those thrown from a central area (OR = 1.33). Extrapolating the results to apply to training, two main guiding principles should be adhered to: the precision of shots taken from less than 5 meters during man-up and transition micro-situations; and the efficacy of shots in numeric equality situations from over 5 meters and in lateral positions.

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Endoscopic treatment of Zenkerʼs diverticulum by complete septotomy: initial experience in 19 patients

Endoscopy International Open ◽

10.1055/a-1153-8985 ◽

2020 ◽

Vol 08 (07) ◽

pp. E885-E890

Author(s):

Charlotte Juin ◽

Maximilien Barret ◽

Arthur Belle ◽

Einas Abouali ◽

Sarah Leblanc ◽

...

Keyword(s):

Success Rate ◽

Endoscopic Treatment ◽

Clinical Success ◽

Muscularis Propria ◽

Clinical Success Rate ◽

Therapeutic Modality ◽

Complete Regression ◽

Muscle Sparing ◽

Lost To Follow Up

Abstract Background and study aims Endoscopic treatment of Zenker’s Diverticulum (ZD) using a flexible endoscope and a diverticuloscope consists of myotomy of the cricopharyngeus muscle, sparing the lower part of the diverticular septum. However, recurrence occurs in up to 54 % of patients at 4 years. We assessed the feasibility and safety of a complete septotomy in endoscopic treatment of ZD. Patients and methods We conducted a retrospective analysis of a prospectively collected database at a single referral center. All consecutive patients treated by complete resection of the diverticular wall were included. The endoscopic technique used a distal attachment cap and division of the ZD septum using a Dual Knife or a Triangle Tip knife in endocut mode, until the esophageal muscularis propria was seen and no residual diverticulum remained. Symptoms were evaluated using the Augsburger questionnaire. Results Nineteen patients, 10 of whom were men with mean age 79 ± 12 years, were treated by complete septotomy for a symptomatic ZD with a median size of 2.5 cm (range 1–5 cm). The clinical success rate was 100 % and the complication rate was 10 % (one pneumonia and one atrial fibrillation). Median hospital stay was 2 days (range 1–3 days). On Day 1 esophagogram, no extraesophageal contrast leakage was seen, periesophageal CO2 was still visible in two patients, and complete ZD regression was seen in 63 % of patients. The 6-month clinical success rate was 100 %, with two patients lost to follow-up, and a median symptom score of 0 (range 0–4). After a mean ± SD follow-up of 9 ± 5 months, the clinical success rate was 94 % (16/17). Conclusion Complete endoscopic septotomy is a feasible and safe therapeutic modality in patients with symptomatic ZD that does not require use of a diverticuloscope, and with good short-term efficacy. The complete regression of the diverticulum observed on Day 1 in 63 % of patients could be a marker of long-term clinical success.

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