scholarly journals Surgical Treatment Alternatives to Sacral Neuromodulation for Fecal Incontinence: Injectables, Sphincter Repair, and Colostomy

2021 ◽  
Vol 34 (01) ◽  
pp. 040-048
Author(s):  
Srinivas Joga Ivatury ◽  
Lauren R. Wilson ◽  
Ian M. Paquette
Keyword(s):  
Surgical Treatment ◽  
Fecal Incontinence ◽  
Health Problem ◽  
Sacral Neuromodulation ◽  
Treatment Options ◽  
Operative Management ◽  
Sphincter Repair ◽  
Healthy Women ◽  
Non Operative Management ◽  
Treatment Alternatives

AbstractFecal incontinence is a prevalent health problem that affects over 20% of healthy women. Many surgical treatment options exist for fecal incontinence after attempts at non-operative management. In this article, the authors discuss surgical treatment options for fecal incontinence other than sacral neuromodulation.

Paediatric obstructive sleep apnoea: is our operative management evidence-based?

2018 ◽  
Vol 132 (4) ◽  
pp. 293-298 ◽  
Author(s):  
L Pabla ◽  
J Duffin ◽  
L Flood ◽  
K Blackmore
Keyword(s):  
Surgical Treatment ◽  
Obstructive Sleep Apnoea ◽  
Treatment Options ◽  
Operative Management ◽  
Evidence Base ◽  
Sleep Apnoea ◽  
Surgical Correction ◽  
Operative Care ◽  
Obstructive Sleep ◽  
Objective Evidence

AbstractBackground:Despite the plethora of publications on the subject of paediatric obstructive sleep apnoea, there seems to be wide variability in the literature and in practice, regarding recourse to surgery, the operation chosen, the benefits gained and post-operative management. This may reflect a lack of high-level evidence.Methods:A systematic review of four significant controversies in paediatric ENT was conducted from the available literature: tonsillectomy versus tonsillotomy, focusing on the evidence base for each; anaesthetic considerations in paediatric obstructive sleep apnoea surgery; the objective evidence for the benefits of surgical treatment for obstructive sleep apnoea; and the medical treatment options for residual obstructive sleep apnoea after surgical treatment.Results and conclusion:There are many gaps in the evidence base for the surgical correction of obstructive sleep apnoea. There is emerging evidence favouring subtotal tonsillectomy. There is continuing uncertainty around the prediction of the level of post-operative care that any individual child might require. The long-term benefit of surgical correction is a particularly fertile ground for further research.

Fecal incontinence: an up-to-date critical overview of surgical treatment options

2005 ◽  
Vol 390 (6) ◽  
pp. 544-552 ◽  
Author(s):  
Christophe Müller ◽  
Orlin Belyaev ◽  
Thomas Deska ◽  
Ansgar Chromik ◽  
Dirk Weyhe ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fecal Incontinence ◽  
Treatment Options ◽  
Critical Overview

scholarly journals Impact of COVID-19 on orthopaedic care: a call for nonoperative management

2020 ◽  
Vol 12 ◽  
pp. 1759720X2093427 ◽  
Author(s):  
Mark R. Phillips ◽  
Yaping Chang ◽  
Robert D. Zura ◽  
Samir Mehta ◽  
Peter V. Giannoudis ◽  
...  
Keyword(s):  
Surgical Management ◽  
Operative Treatment ◽  
Surgical Procedures ◽  
Elective Surgery ◽  
Treatment Options ◽  
Operative Management ◽  
Management Options ◽  
Orthopaedic Care ◽  
Elective Surgical Procedures ◽  
Non Operative Management

Background: Surgical specialties face unique challenges caused by SARS-COV-2 (COVID-19). These disruptions will call on clinicians to have greater consideration for non-operative treatment options to help manage patient symptoms and provide therapeutic care in lieu of the traditional surgical management course of action. This study aimed to summarize the current guidance on elective surgery during the COVID-19 pandemic, assess how this guidance may impact orthopaedic care, and review any recommendations for non-operative management in light of elective surgery disruptions. Methods: A systematic search was conducted, and included guidance were categorized as either “Selective Postponement” or “Complete Postponement” of elective surgery. Selective postponement was considered as guidance that suggested elective cases should be evaluated on a case-by-case basis, whereas complete postponement suggested that all elective procedures be postponed until after the pandemic, with no case-by-case consideration. In addition, any statements regarding conservative/non-operative management were summarized when provided by included reports. Results: A total of 11 reports from nine different health organizations were included in this review. There were seven (63.6%) guidance reports that suggested a complete postponement of non-elective surgical procedures, whereas four (36.4%) reports suggested the use of selective postponement of these procedures. The guidance trends shifted from selective to complete elective surgery postponement occurred throughout the month of March. The general guidance provided by these reports was to have an increased consideration for non-operative treatment options whenever possible and safe. As elective surgery begins to re-open, non-operative management will play a key role in managing the surgical backlog caused by the elective surgery shutdown. Conclusion: Global guidance from major medical associations are in agreement that elective surgical procedures require postponement in order to minimize the risk of COVID-19 spread, as well as increase available hospital resources for managing the influx of COVID-19 patients. It is imperative that clinicians and patients consider non-operative, conservative treatment options in order to manage conditions and symptoms until surgical management options become available again, and to manage the increased surgical waitlists caused by the elective surgery shutdowns.

Osteoarthritis of the hand

2011 ◽  
Author(s):  
T.R.C. Davis ◽  
N.D. Downing
Keyword(s):  
Surgical Treatment ◽  
Operative Management ◽  
Hand Osteoarthritis ◽  
Failure Rates ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Non Operative Management

♦ Prevalence of hand osteoarthritis increases with age♦ Most hand osteoarthritis causes few symptoms♦ Non-operative management is sufficient for the majority of cases♦ Surgical treatment is sometimes required♦ Total joint replacements have significant failure rates.

scholarly journals Management of acute appendicitis during the COVID-19 pandemic: Views of two Brazilian surgical societies

2021 ◽  
Vol 48 ◽  
Author(s):  
JOSÉ GUSTAVO PARREIRA ◽  
LOUISIE GALANTINI LANA DE-GODOY ◽  
TERCIO DE-CAMPOS ◽  
PEDRO DE SOUZA LUCARELLI-ANTUNES ◽  
LUIZ GUSTAVO DE-OLIVEIRA-E-SILVA ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operative Management ◽  
Chest Ct ◽  
Therapeutic Options ◽  
Non Operative Management

ABSTRACT Acute appendicitis (AA) is a frequent cause of abdominal pain requiring surgical treatment. During the COVID-19 pandemic, surgical societies considered other therapeutic options due to uncertainties in the evolution of the disease. The purpose of this study is to assess the treatment of AA by members of two Brazilian surgical societies in this period. A common questionnaire was sent in 2020. There were 382 responses. Most surgeons had more than 15 years of profession (68.3%) and treated more than five cases per month (44.8%). About 72.5% would indicate chest CT to investigate COVID-19 in patients with AA. For those patients sustaining uncomplicated AA, without COVID-19, 60.2% would indicate laparoscopic appendectomy (VLA), followed by open appendectomy (OA) (31.7%) and non-operative management (NOM) (1.3%). For those with mild COVID-19, OA was suggested by 51.0%, followed by VLA (29.6%) and NOM (6.0%). For those with severe COVID-19, OA was proposed by 35.3%, followed by NOM (19.9%) and VLA (18.6%). For patients with periappendiceal abscesses, without COVID-19, VLA was suggested by 54.2%, followed by OA (33.2%) and NOM (4.4%). For those with mild COVID-19, OA was proposed in 49.5%, followed by VLA (29.3%) and NOM (8.9%). In those with severe COVID-19, OA was proposed in 36.6%, followed by NOM (25.1%) and VLA (17.3%). This information, based on two recognized Brazilian surgical societies, can help the surgeon to select the best approach individually.

One-stage wound healing of fingertip injuries induced by treatment of artificial dermis

2018 ◽  
Vol 50 (04) ◽  
pp. 269-275 ◽  
Author(s):  
Xianghong Lou ◽  
Haijun Zhu ◽  
Hang Xue ◽  
Yuxiong Weng ◽  
Jianghai Chen
Keyword(s):  
Wound Healing ◽  
Surgical Treatment ◽  
Operative Management ◽  
Good Alternative ◽  
One Stage ◽  
Type Iv ◽  
Artificial Dermis ◽  
Treat All ◽  
Almost All ◽  
Non Operative Management

Abstract Backround Fingertip injuries are common in both adults and children. Many operative and non-operative management techniques have been reported to restore the function and cosmetic shape of fingertips after injuries. Although these methods may be used for different indications in clinical settings, few of them can treat all kinds of fingertip injuries. In addition, there is controversy as to whether the surgical approach or the conservative approach is the optimal management for fingertip injuries. Methods Thirty-six fingers of 33 patients with fingertip injuries were included in the study. All wounds were treated with surgical debridement and artificial dermis coverage without further surgical treatment. Follow-up duration was 24.5 months on average. Results All injuries were categorised into four types – Allen’s classification of fingertip injury type II, type III, type IV, and transverse amputations proximal to the lunula and close to the level of the distal interphalangeal (DIP) joint – and 28 of them had bone exposure. The defects of all fingers were restored in one stage within an average of 8 weeks. Although the length and width of the new fingertips were less than those of the contralateral fingertips, almost all patients were satisfied with the functional and cosmetic outcomes of their regenerated fingers. Conclusions One-stage wound healing of fingertip injuries induced by artificial dermis treatment is an easy and effective approach to restoring defects after injury with excellent functional and cosmetic results. Nearly all kinds of fingertip injuries can be managed with this method without any further surgical treatment. Therefore, this is a good alternative for the management of fingertip injuries.

scholarly journals NON OPERATIVE MANAGEMENT OF ACUTE APPENDICITIS- A PROSPECTIVE STUDY.

2019 ◽  
pp. 1-3
Author(s):  
Rakesh Kumar Verma ◽  
Surit Majumdar
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Prospective Study ◽  
Success Rate ◽  
Operative Treatment ◽  
Operative Management ◽  
Oral Antibiotic ◽  
Lower Quadrant ◽  
Non Operative Management

BACKGROUND: Right lower quadrant abdominal pain is a common cause of Emergency department admission.Acute appendicitis is one of the commonest diagnosis in this setting.The natural history of acute appendicitis non-operatively treated with antibiotics remains unclear. In this prospective study, operative and non-operative management of acute appendicitis were evaluated regarding their safety and cost effectiveness. AIMS AND OBJECTIVE: The purpose of this study was to assess the feasibility, initial safety and efficacy, early and late success rate of non-operative treatment of confirmed acute uncomplicated appendicitis and to monitor the long-term follow-up of non-operated patients. METHODS AND MATERIALS: Selected Acute Appendicitis patients were enrolled in this prospective comparative study (Conservative or non-operative vs operative or surgical treatment).Conservative treatment was based on a brief gut rest (partial or complete) and antibiotic therapy (Initially parenteral and then followed up with oral antibiotic). 105 patients of AA were selected for study, as per inclusion criteria. They were offered the options of conservative and surgical treatment. 52 patients opted for and complied with conservative treatment; rest (53) declined and opted for surgery,so were operated (Laparoscopic/Open) and taken as controls.Enrolment in study was done from March 2015 to February 2017 and they were further followed up for a period of 2 plus years. Secondary outcomes include hospital length of stay and cost,days of missed works and return to normal activity at home;and these were compared in both the groups (conservative vs.operative). RESULT: In non-operative group (52 patients), 4 patients (7.69 %) failed to respond satisfactorily and managed by appendectomy. 2 patients (3.85 %) developed appendicular lump in the course and they were also operated with interval appendicectomy, so 6 patients were considered as early failures (11.54%) with early success rate of 88.46%. Four patients experienced recurrent attacks of acute appendicitis (AA);in them, repeat conservative approach was not tried and they were managed with appendectomy.This brought down the Late success rate to 80.76%.In appendectomy group, 2 patients complained of persistent discomfort in right lower abdomen, five patients developed wound or port site infection and one patient developed incisional hernia. In non-operative group, hospital stays were shorter with lesser hospital costs and days of missed work and also statistically significant as compared to appendectomy group. CONCLUSION:This study confirms the feasibility,safety and optimum success rate of non-operative treatment of early AA in selected patients.

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