scholarly journals P-L08 Novel surgical technique for the management of biliary-enteric anastomotic strictures

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Tariq Tariq Al-Munaizel ◽  
Obada Abu Jarad
Keyword(s):  
Retrospective Study ◽  
Surgical Technique ◽  
Success Rate ◽  
Surgical Approach ◽  
New Technique ◽  
Site Infection ◽  
Wound Site ◽  
Anastomotic Strictures ◽  
Stricture Recurrence

Abstract Background This study presents an invented surgical technique for dealing with biliary-enteric anastomotic strictures with the potential to replace currently used methods in certain cases. Methods In this retrospective study, a novel surgical technique was introduced in the management of eight patients with bilioenteric strictures between January 2016 and May 2018. Results Our new technique was associated with a 100% success rate where patency of anastomosis was achieved in all patients along the 28 month follow-up period. Only two of the patients developed a complication including wound-site infection, and cholangitis at the 17th month follow-up. None of the patients developed intrahepatic biliary dilation or stricture recurrence. Conclusions This novel surgical approach may reduce recurrent medical and radiological interventions and the need for anastomosis revision. It may also lessen the rate of complications. However, larger scale studies are needed to confirm such findings.

scholarly journals A New Surgical Approach for the Treatment of Conjunctivochalasis: Reduction of the Conjunctival Fold with Bipolar Electrocautery Forceps

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Eduardo Arenas ◽  
Diana Muñoz
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Medical Records ◽  
Good Alternative ◽  
New Technique ◽  
Complete Reduction ◽  
New Surgical Technique

Aim. To report a new surgical technique for the treatment of conjunctivochalasis.Methods. A new surgical technique in which specially designed bipolar electrocautery forceps facilitate the complete reduction of the conjunctival folds without creating lesions near the corneoscleral limbus was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2011 and 2013 was made, and eighteen eyes of sixteen patients with conjunctivochalasis treated with this new technique were included.Results.All the eyes treated showed a significant improvement with no evidence of scar lesions after a mean follow-up time of 10 months.Conclusions. The surgical technique presented here could be a good alternative for the management of conjunctivochalasis.

Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing

2006 ◽  
Vol 121 (4) ◽  
pp. 329-332 ◽  
Author(s):  
V Nakhla ◽  
Y M Takwoingi ◽  
A Sinha
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Approach ◽  
Suitable Alternative ◽  
Significant Difference ◽  
Study Population ◽  
The Mean ◽  
Gauze Pack

Objectives: To assess the myringoplasty graft take rate, comparing two methods of post-operative ear packing: bismuth iodoform paraffin paste (BIPP) gauze versus tri-adcortyl ointment (TAO).Methods: A retrospective study of patients who had undergone myringoplasty at our department within a three-year period was undertaken. Data, including age, site and size of perforation, grade of surgeon, surgical approach, use of post-operative ear dressings, complications, and audiometric outcome, were collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at six months) was noted.Results: One hundred and seventy myringoplasties were performed over the study period, but data were complete on 154 patients and these constituted the study population. Age ranged from nine to 71 years (mean age 34 years) and the mean follow-up period was seven months. Consultants performed 62 per cent of the operations, with an 85 per cent success rate, whereas trainees performed the remaining 38 per cent, with a success rate of 73 per cent (p=0.059). The overall success rate was 80 per cent; 79 per cent for BIPP and 83 per cent for TAO (p=0.55), and 87 per cent for small perforations and 75 per cent for subtotal perforations (p=0.22). There was audiometric improvement in 74 per cent of cases.Conclusion: We found no significant difference in outcome between patients packed with TAO and BIPP. Packing with TAO is therefore a suitable alternative to BIPP gauze ear dressing following myringoplasty.

scholarly journals Outcome of OMG Urethroplasty by Asopa, Barbagli and Kulkarni Technique for Management of Anterior Urethral Stricture : Are Results Affected by the Surgical Technique?

2020 ◽  
Vol 19 (1) ◽  
pp. 23-27
Author(s):  
Md Shariful Islam ◽  
Md Asaduzzamman ◽  
Md Ruhul Quddus ◽  
Waliul Islam ◽  
Pranashis Saha
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Urethral Stricture ◽  
Significant Variation ◽  
Operative Procedure ◽  
Lichen Sclerosus ◽  
Team Approach ◽  
Anastomotic Site ◽  
Stricture Recurrence

Objective: To determine outcome of OMG urethroplasty by different surgical technique comparing ASOPA, BARBAGLI and KULKARNI TECHNIQUE in the management of anterior urethral stricture. Materials and Methods: A total of 62 patients with an average age of 42 yr(21-55) underwent OMG urethroplasty between 2008 to 2015 for anterior urethral stricture of different etiology. 2 patient lost durig follow up patient with lichen sclerosus and failed hypospadias were not included. OMG was always harvested from cheek using 2 team approach graft were placed using surgical technique of ASOPA, BARBAGLI and KULKARNI technique in 21,27 and 12 patients respectively clinical outcome was considered success or failure at the time any post operative procedure needed mean follow up was 45 month (6-95) Results: Out of 60 cases 51(85%) considered success and 9(15%) were considered failure. success rate were 85.7%,85%,and 83.5% in ASOPA, BARBAGLI and KULKARNI Technique and failure rate were 14.3%,15% and 16.7% respectively. Failure involve in the anastomotic site (2 in distal and 3 in proximal) were managed by OIU and involving whole length in 3 patient managed with staged urethropllasty. Conclusion: In our series, success rate of ASOPA, BARBAGLI and KULKARNI technique has no statistically significant variation. more over stricture recurrence was uniformly distributed in all group. so the outcome is not significantly affected by different technique used in OMG urethroplasty for anterior urethral stricture. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.23-27

scholarly journals Endoscopic treatment of suprasellar cysts without hydrocephalus

2016 ◽  
Vol 18 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Song-Bai Gui ◽  
Sheng-Yuan Yu ◽  
Lei Cao ◽  
Ji-wei Bai ◽  
Xin-Sheng Wang ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Patient Outcomes ◽  
Endoscopic Treatment ◽  
Foramen Of Monro ◽  
Image Guided ◽  
Operative Complications ◽  
Appropriate Therapy ◽  
Endoscopic Fenestration

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.

Regrowth of the adenoids after adenoidectomy down to the pharyngobasilar fascial surface

2015 ◽  
Vol 129 (7) ◽  
pp. 662-665 ◽  
Author(s):  
L Wei ◽  
M Wang ◽  
N Hua ◽  
K Tong ◽  
L Zhai ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Blood Loss ◽  
Success Rate ◽  
Operation Time ◽  
Early Complications ◽  
Estimated Blood Loss ◽  
Endoscopic Guidance ◽  
Pharyngobasilar Fascia

AbstractObjectives:This study aimed to explore adenoid regrowth after transoral power-assisted adenoidectomy down to the pharyngobasilar fascial surface.Methods:Transoral adenoidectomy down to the pharyngobasilar fascia surface was performed on 39 patients under endoscopic guidance, using a power-assisted system. The operation time, amount of blood loss and iatrogenic injury, presence of complications, and success and regrowth rates were recorded to assess the feasibility, safety and effectiveness of our surgical technique.Results:In this adenoidectomy procedure, the pharyngobasilar fascia was left intact. The estimated blood loss was 5–50 ml (mean 15 ml), and the success rate was 97.3 per cent. Early complications occurred in 2.3 per cent of patients, while no long-term complications occurred in the cohort. No regrowth was found in the follow-up assessments, which were performed for 18–36 months after surgery.Conclusion:Adenoid regrowth was rare after adenoidectomy down to the pharyngobasilar fascial surface. The pharyngobasilar fascia can therefore be considered a surgical boundary for adenoidectomy.

scholarly journals A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ben Warner ◽  
Phillip Harrison ◽  
Muhammad Farman ◽  
John Devlin ◽  
David Reffitt ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Liver Function Tests ◽  
Stent Insertion ◽  
Complication Rates ◽  
Metal Stent ◽  
Unique Type ◽  
Anastomotic Strictures ◽  
Stricture Recurrence

Abstract Background We report our experience of treating anastomotic strictures using a novel type of fully covered metal stent (FCSEMS). This stent, known as the Kaffes Stent, is short-length with an antimigration waist and is easily removable due to long retrieval wires deployed within the duodenum. Methods Sixty-two patients underwent ERCP and Kaffes stent insertion for post-transplant anastomotic strictures following confirmation of a stricture on MRCP. These patients were retrospectively analysed for immediate and long-term stricture resolution, improvement in symptoms and liver function tests (LFTs), stricture recurrence and complication rates. Results Of the 56 patients who had their stent removed at the time of analysis, 54 (96%) had immediate stricture resolution and 42 continued to have long-term resolution (mean follow-up period was 548 days). Of the 16 patients with symptoms of biliary obstruction, 13 had resolution of their symptoms. Overall, there was a significant improvement in LFTs after stent removal compared to before stent insertion. Complication rates were 15% with only one patient requiring biliary reconstruction. Conclusions The Kaffes stent is effective and safe at resolving post liver transplant biliary anastomotic strictures.

Implants Placed in the Nasopalatine Canal to Rehabilitate Severely Atrophic Maxillae: A Retrospective Study With Long Follow-up

2014 ◽  
Vol 40 (6) ◽  
pp. 699-706 ◽  
Author(s):  
David Peñarrocha ◽  
Eugenia Candel ◽  
Jose Luis Calvo Guirado ◽  
Luigi Canullo ◽  
Maria Peñarrocha
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Success Rate ◽  
Class V ◽  
Nasopalatine Canal ◽  
Level Of Satisfaction ◽  
Early Failures ◽  
Analogue Scales ◽  
Discrimination Method

To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell's class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prostheses.

Hepaticojejunostomy for Benign Disease: Long-Term Stricture Rate and Management

2019 ◽  
Vol 85 (12) ◽  
pp. 1350-1353 ◽  
Author(s):  
Shannon M. Zielsdorf ◽  
John J. Klein ◽  
Vidya A. Fleetwood ◽  
Martin Hertl ◽  
Edie Y. Chan
Keyword(s):  
Success Rate ◽  
Benign Disease ◽  
Success Rates ◽  
Transplant Patients ◽  
Stricture Rate ◽  
Anastomotic Strictures ◽  
The Mean ◽  
Radiological Intervention

The objective of the study was to determine the long-term stricture rate of hepaticojejunostiomy (HJ) performed for benign disease, to compare stricture rates for transplant patients and non-transplant patients, and to compare the success rates of procedural and surgical treatment options. Hospital charts of 135 consecutive patients undergoing HJ between 1998 and 2016 were analyzed retrospectively. The primary outcome was stricture formation. Secondary outcomes were time to stricture diagnosis and success rates of various interventions. The anastomotic stricture rate was 13.3 per cent (18). The mean follow-up period was 4.3 years. The mean time to stricture diagnosis was 2.3 years. Stricture rates were similar between the transplant (19.2%) and nontransplant, non-Whipple group (13%). Strictures were treated with radiological intervention with a 44.4 per cent success rate; each required multiple interventions. Mortality from liver disease after failure of nonoperative management of HJ strictures reached 30 per cent (3). Five of ten patients who failed radiological intervention underwent HJ revision; the success rate was 80 per cent. Anastomotic strictures of HJ performed for benign disease occur in 13 per cent of patients and typically develop within 2.5 years postoperatively. Yet, given the dangerous sequelae of chronic biliary obstruction and potential delay in presentation, a follow-up is recommended for up to 10 years. When strictures occur, HJ revision should be considered early, after two failed radiological interventions.

scholarly journals Periareolar augmentation mastopexy: A new approach dealing with the cases as tuberous breasts

2016 ◽  
Vol 49 (02) ◽  
pp. 172-177 ◽  
Author(s):  
Roberto Moltó-García ◽  
María Eloísa Villaverde-Doménech ◽  
Virina González-Alonso ◽  
Francisco Ripoll-Orts ◽  
Eduardo Simon-Sanz
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Techniques ◽  
Inferior Pole ◽  
Malpractice Claims ◽  
One Year ◽  
Periareolar Mastopexy ◽  
Augmentation Mastopexy ◽  
New Surgical Technique

ABSTRACTBackground: Periareolar augmentation mastopexy is one of the most demanded operations at Plastic Surgery clinics. Nevertheless, it is one of the leads of malpractice claims in United States caused by the high patient expectations and the standard surgical techniques which may result in common complications. The aim of this report is to present a new surgical approach to solve these complications. Methods: After establishing a working hypothesis, we performed a revision study of our patients and we came to the following conclusion: in order to perform a periareolar mastopexy for ptosis correction, breast has to be tuberous at any level and to have abnormally short inferior pole. These findings may explain the main complications from periareolar augmentation mastopexy with the standard surgical techniques. Consequently, we started a prospective observational study including 56 patients following a new surgical technique which deals the cases as tuberous breasts. Results: During three years, fifty-six periareolar mastopexies were performed with this new surgical approach with one year follow-up. No major complications were observed and 40 of the patients (71%) described the results as very positive. Conclusion: “If a periareolar mastopexy can be performed, then it must be a tuberous breast”. According to this, a new surgical technique for periareolar augmentation mastopexy has been developed obtaining an improvement in our surgical results and achieving a totally different view on this pathology, which has not been reported in literature yet.

Resection of Vascular Malformations

1993 ◽  
Vol 18 (1) ◽  
pp. 17-21 ◽  
Author(s):  
R. A. HILL ◽  
R. W. H. PHO ◽  
V. P. KUMAR
Keyword(s):  
Retrospective Study ◽  
Upper Limb ◽  
Surgical Approach ◽  
Vascular Malformations ◽  
Diffuse Type

A retrospective study was undertaken of 15 cases of congenital vascular malformations of the upper limb with a mean follow-up of 5.6 years. Malformations were classified on the basis of tissue involvement into local and diffuse types and the outcome of a radical surgical approach was assessed. There were seven cases of recurrence (47%). Recurrence was more frequent in the diffuse type and when excision was considered incomplete.

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