STANDARDIZED PROACTIVE ENDOSCOPIC AND SURGICAL INTERVENTIONS FOR MANAGEMENT OF PATIENTS WITH BOERHAAVE SYNDROM TO REDUCE MORTALITY: A RETROSPECTIVE ANALYSIS

Background: Venous thrombosis with and without pulmonary embolism is a frequent complication of malignancies and second among the causes of death in tumour patients. Its incidence is reported to be 10 to 15%. Since for methodological reasons, this rate can be assumed to be too low and to disregard asymptomatic venous thrombosis, a combined retrospective and prospective study was performed to examine the actual frequency of venous thrombosis in tumour patients. Patients and methods: The histories of 409 patients (175 women, 234 men, mean age 69 years [19 to 96 years]) with different tumours, consecutively enrolled in the order of their altogether 426 inpatient treatments, were checked in retrospect for the frequency of venous thrombosis and pulmonary embolism. Subsequently, 97 tumour inpatients (36 women, 61 men, mean age 70 years [42 to 90 years]) were systematically screened, by means of duplex sonography and/or venography, for venous thromboses in the veins of the pelvis and both legs. Results: In the retrospective analysis, where no systematic screening for thromboses was performed and only symptomatic thrombosis was recorded, venous thrombosis was found in 6.6% of all tumour patients, whereas in the prospective examination with systematic duplex sonography and / or venography of all patients, the percentage was 33%. In the prospective study, 31.3% of venous thromboses were symptomatic and 68.7% asymptomatic. In 39.3% of the cases in the retrospective analysis and 25% in the prospective analysis, venous thrombosis occurred during chemotherapy, surgery or radiation therapy. Venous thrombosis was most often seen in metastasizing tumours and in colorectal carcinoma (40%), haematological system diseases (28.6%), gastric cancer (30%), bronchial, pancreas and ovarian carcinoma (28.6%), and carcinoma of the prostate (16.7%). Conclusion: Regular screening for thrombosis is indicated even in asymptomatic tumour patients because asymptomatic venous thrombosis is frequent, can lead to pulmonary embolism and has to be treated like symptomatic venous thrombosis. This is particularly true for metastasization during chemotherapy, surgical interventions, or radiation.

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Retrospective analysis of risk factors for occurrence of pancreatic fistula in patients following pancreaticoduodenectomy

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(3)-07 ◽

2018 ◽

Vol 22 (3) ◽

pp. 436-441

Author(s):

K.G. Valikhnovska

Keyword(s):

Risk Factors ◽

Pancreatic Fistula ◽

Pancreatic Duct ◽

Retrospective Analysis ◽

Pancreatic Head ◽

Fistula Formation ◽

Surgical Interventions ◽

Periampullary Tumors ◽

Pancreatic Fistulas

Pancreaticoduodenectomy still is a “gold standard” in treatment of hepatopancreaticobiliary tumors. The causes of pancreatic fistula were analyzed in 414 patients aged from 22 to 81 following pancreaticoduodenectomy due to periampullary tumors. The said patients were operated on during the period from 2008 to 2017. The aim of this study is to improve outcomes of pancreatic resection based on a retrospective analysis of the causes of postoperative pancreatic fistulae and the development of a range of measures to prevent the above complication. Influence of risk factors of pancreatic fistula formation was evaluated by Pirson’s method (χ2). The factors contributing to the occurrence of pancreatic fistulas included type of resection (Whipple pancreaticoduodenectomy, pylorus preserving pancreaticoduodenectomy; χ2=8.616,1, p=0.0033, p<0.01), kind of pathology (cancer of the pancreatic head; χ2=7.658,1, p=0.0057, p<0.01), type of pancreaticojejunostomy (invaginative pancreatic duct-jejunostomy; χ2=17.83,1, p=0.0001, p<0.001) and technique for drainage of the major pancreatic duct (pancreaticojejunostomy on external drainage; χ2=16.40,1, p=0.0001, p<0.001). The detailed study of risk factors for the occurrence of pancreatic fistula is essential for improving the prognosis, prophylaxis and treatment of this pathology. The quality of the surgical intervention and the course of the postoperative period in patients with periampullary tumors depend on the choice of resection type, techniques for surgical interventions on the pancreas.

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LEARNING CURVE OF ROBOT-ASSISTED MYOMECTOMY

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.18821/2313-8726-2019-6-4-221-224 ◽

2019 ◽

Vol 6 (4) ◽

pp. 221-224

Author(s):

A. G Tyan ◽

Ekaterina V. Slukhanchuk

Keyword(s):

Blood Loss ◽

Learning Curve ◽

Retrospective Analysis ◽

Average Duration ◽

Reproductive Age ◽

Robot Assisted ◽

Extensive Experience ◽

Intracorporeal Suturing ◽

Surgical Interventions ◽

The City

Introduction. Robot-assisted myomectomy is the most modern types of surgical interventions for uterine myoma in patients of reproductive age. It benefit in simplicity of intracorporeal suturing and lack of laparoscopic myomectomy limitations. Of great scientific interest is the speed of mastering the method. We studied the learning curve of a robot-assisted myomectomy based on our own experience. Material and methods. A retrospective analysis of the results of 45 robot-assisted operations for uterine myomas from August 2016 to June 2017 was performed at the City Clinical Hospital named after S.I. Spasokukotskiy. All operations were performed by a single surgeon with extensive experience in laparoscopic surgery. The surgeon had no experience of robotic operations. Results. According to a retrospective analysis, there was stromg correlation between the acquired experience of robotic surgery and such indicators as the average duration of the operation, the time of thermal ischemia and the volume of blood loss. Conclusion. The learning curve of a robot-assisted myomectomy for an experienced laparoscopic surgeon improves to 15 operations. This experience is enough to perform operations with a minimum duration, volume of blood loss and complications.

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Takayasu's arteritis: the retrospective analysis of patients from the Ural population

Bulletin of Russian State Medical University ◽

10.24075/brsmu.2019.012 ◽

2019 ◽

pp. 93-101 ◽

Cited By ~ 1

Author(s):

IE Borodina ◽

AA Popov ◽

GG Salavatova ◽

LA Shardina

Keyword(s):

Retrospective Analysis ◽

Clinical Presentation ◽

Takayasu’S Arteritis ◽

Arterial Stenosis ◽

Major Adverse Cardiovascular Events ◽

Takayasu's Arteritis ◽

Female Ratio ◽

Surgical Interventions ◽

Geographical Regions ◽

Type V

Takayasu's arteritis (TA) is a rare disease that can be overlooked during the first visit to a GP, rheumatologist, or any other medical specialist due to a variety of its symptoms. The aim of this study was to describe the clinical presentation and the course of patients with TA residing in the Middle Ural. A retrospective analysis was conducted using the medical records of 183 patients treated at the Sverdlovsk Regional Clinical Hospital 1 from 1979 through 2018. The male to female ratio was 1:3. The mean age was 33.5 years for women and 35.2 for men. The most frequently involved arteries were subclavian (101 cases; 55%), carotid (98 cases; 53%) and renal (77 cases; 42%). Type V was the most common angiographic type. Arterial stenosis was present in 94 (51%) patients. Sixty-six patients received surgical interventions. Of all patients included in the analysis, 31 died. The observed 5-year survival was 92%, 10-year survival, 90% and 15-year survival, 80%. Seventy-two patients (39%) developed major adverse cardiovascular events (MACE), including myocardial infarction, ischemic stroke, and thrombosis of large arteries/veins. The clinical presentation of TA may vary in different geographical regions.

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Classical Versus Laparoscopic Approach in Retroperitoneal Lesions - Advantages and Limitations

Acta Medica Marisiensis ◽

10.2478/amma-2013-0042 ◽

2013 ◽

Vol 59 (4) ◽

pp. 182-186

Author(s):

Crăciun C ◽

Azamfirei L ◽

Coroș Mf ◽

Crăciun Rc

Keyword(s):

Laparoscopic Surgery ◽

Minimally Invasive ◽

Retrospective Analysis ◽

Medical Records ◽

Laparoscopic Approach ◽

Laparoscopic Technique ◽

Surgical Interventions ◽

Group I ◽

Vascular Factor ◽

Laparoscopic Intervention

Abstract Background: At present, the laparoscopic intervention in retroperitoneal primitive tumors, abscesses, haematomas and retroperitoneal effusions is still a challenge. The purpose of this paper is to identify the differences between laparoscopic and conventional surgical interventions in diseases of the retroperitoneum. Material and method: The study follows a retrospective analysis of various retroperitoneal interventions performed on 62 patients between 2010-2012 in the Surgery Clinic 1 of Mures County Hospital. We have chosen from the casuistry the cases with tumoral diseases or nontumoral and divided the patients into two groups: group I who had undergone classic interventions and group II who had undergone laparoscopic procedures. We studied the clinical medical records, surgical protocols and anatomopathological results. Results: For 2010 we extracted 23 cases (39,2% classical interventions), for 2011-21 patients (31,4% classic) and for 2012 -18 cases (29,4% classical interventions). According to the type of the disease, 30 classical interventions were performed for tumoral formations and 21 interventions for non-tumoral formations. Laparoscopic tumoral cases included three tumors and a retroperitoneal metastasis,while the non-tumoral were represented by 7 urohaematic effusions as a result of percutaneous nephrolithotomy procedures. Conclusions: Laparoscopic surgery of retroperitoneal lesions is minimally invasive, the postoperative evolution of patients is favorable, without major complications.. Classical intervention of retroperitoneal lesions is indicated in large haematomas, abscesses, and big invasive tumors with vascular factor which does not allow the use of laparoscopic technique

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ОСОБЛИВОСТІ ІМУНОЛОГІЧНИХ ЗМІН У ХВОРИХ ПІСЛЯ МАСТЕКТОМІЇ

World Science ◽

10.31435/rsglobal_ws/31052019/6517 ◽

2019 ◽

Vol 2 (5(45)) ◽

pp. 32-35

Author(s):

Макаров В. В. ◽

Камарчук В. В. ◽

Мельник Д. Ю. ◽

Доценко Д. Г.

Keyword(s):

Breast Cancer ◽

Retrospective Analysis ◽

Risk Prediction ◽

Postoperative Period ◽

Physiological Parameters ◽

Surgical Interventions ◽

Group I ◽

The Future ◽

Physiological Reserve ◽

Group Ii

Postoperative period after surgical interventions on the breast are determined by the level of physiological reserve and by the statement of immunоlogical and physiological parameters. The purpose of this research was to determine the risk prediction of postmastectomy lymphorrhea markers. A retrospective analysis of laboratories results of 78 patients with breast cancer after mastectomy during 2006 till 2011 years was made. Group I included patients without postoperative lymphorrhea. Group II included patients with prolongated postoperative lymphorrhea. Using advanced laboratory researches in patients with breast cancer to determine the risk prediction of markers of postmastectomy lymphorrhea allows the use of additional preventive and curative interventions in the future.

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Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00110 ◽

2020 ◽

pp. 1-16

Author(s):

Julie L. Wambaugh ◽

Lydia Kallhoff ◽

Christina Nessler

Keyword(s):

Retrospective Analysis ◽

Sound Production ◽

Apraxia Of Speech ◽

Practice Schedule ◽

Practice Schedules ◽

Baseline Performance ◽

The Mean ◽

Number Of Treatment ◽

The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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