scholarly journals Operative Outcomes for Cervical Myelopathy and Radiculopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
J. G. Galbraith ◽  
J. S. Butler ◽  
A. M. Dolan ◽  
J. M. O'Byrne
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Intractable Pain ◽  
Spinal Stability ◽  
Nerve Roots ◽  
Operative Outcomes ◽  
Anterior Posterior

Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

scholarly journals Surgical treatment of hemorrhoids: a critical appraisal of the current options

2014 ◽  
Vol 27 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Marlise Mello CERATO ◽  
Nilo Luiz CERATO ◽  
Patrícia PASSOS ◽  
Alberto TREIGUE ◽  
Daniel C. DAMIN
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Postoperative Recurrence ◽  
Long Term Results ◽  
Published Data ◽  
Complication Rates ◽  
Recurrence Rates

Introduction : Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim : To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods : A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results : Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion : Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

Different surgical treatments for nasal septal perforation and their outcomes

2007 ◽  
Vol 121 (5) ◽  
pp. 419-426 ◽  
Author(s):  
A Y Goh ◽  
S S M Hussain
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Journal Club ◽  
Treatment Options ◽  
Surgical Approaches ◽  
Septal Perforation ◽  
Inclusion Criteria ◽  
Hand Search ◽  
Nasal Septal Perforation ◽  
The Subject

Objective: To critically evaluate the literature on surgical treatment options for nasal septal perforations and to analyse the outcomes of these treatment options.Design: A systematic review of studies of nasal septal perforation closure using surgical intervention, published from January 1975 to March 2006.Data sources: Forty-nine papers were identified from electronic databases (all Evidence Based Medicine reviews (Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effectiveness and Cochrane Controlled Trials Register), EMBASE, Ovid (Medline) and British Medical Journal publications) and from a hand search of the reference lists of retrieved papers. Textbooks pertinent to the subject were referred to for background reading. Twenty-three studies met the inclusion criteria.Main outcome measure: Effectiveness of the surgical intervention to completely close the perforation.Results: Five studies examined the sole use of intranasal mucosal flaps to close the perforation, i.e. inferior turbinate flaps, quadrangular cartilage flap and mucoperiosteal flap. Eighteen studies reported the use of a combination of intranasal mucosal flap and interposition graft. Graft materials included temporalis fascia, mastoid periosteum, nasal septal material, acellular human dermal graft, conchal cartilage and porcine small intestine mucosa. Studies utilising interposition grafts generally produced higher closure rates. The surgical approaches documented include closed endonasal, unilateral hemitransfixion, external rhinoplasty and midfacial degloving techniques. A range of surgical treatment methods was reported in the literature, but some papers were excluded from this review as they did not meet the inclusion criteria. It was difficult to infer the true effectiveness of each study as the subject numbers were small, patient selection criteria were often unspecified and the follow-up period was brief. However, factors leading to an increased chance of success were identified.Conclusion: The review found an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. It is difficult to be categorical about the effectiveness of a surgical treatment method; nonetheless, each technique has its own advantages and drawbacks.

Surgical treatment of single-suture craniosynostosis: an argument for quantitative methods to evaluate cosmetic outcomes

2010 ◽  
Vol 6 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Todd C. Hankinson ◽  
Elizabeth J. Fontana ◽  
Richard C. E. Anderson ◽  
Neil A. Feldstein
Keyword(s):  
Surgical Treatment ◽  
Intracranial Hypertension ◽  
Quantitative Methods ◽  
Surgical Techniques ◽  
Neurocognitive Deficits ◽  
External Compression ◽  
Operative Outcomes ◽  
History Of ◽  
Considerable Work ◽  
Single Suture

The traditional reasons for surgical intervention in children with single-suture craniosynostosis (SSC) are cosmetic improvement and the avoidance/treatment of intracranial hypertension, which has been thought to contribute to neurocognitive deficits. Despite considerable work on the topic, the exact prevalence of intracranial hypertension in the population of patients with SSC is unknown, although it appears to be present in only a minority. Additionally, recent neuropsychological and anatomical literature suggests that the subtle neurocognitive deficits identified in children with a history of SSC may not result from external compression. They may instead reflect an underlying developmental condition that includes disordered primary CNS development and early suture fusion. This implies that current surgical techniques are unlikely to prevent neurocognitive deficits in patients with SSC. As such, the most common indication for surgical treatment in SSC is cosmetic, and most patients benefit from considerable subjective cosmetic normalization following surgery. Pediatric craniofacial surgeons have not, however, agreed upon objective means to assess postoperative cranial morphological improvement. We should therefore endeavor to agree upon objective craniometric tools for the assessment of operative outcomes, allowing us to accurately compare the various surgical techniques that are currently available.

scholarly journals COMPARATIVE STUDY OF POSTOPERATIVE PAIN BETWEEN THE LICHTENSTEIN AND LAPAROSCOPY SURGICAL TECHNIQUES FOR THE TREATMENT OF UNILATERAL PRIMARY INGUINAL HERNIA

2017 ◽  
Vol 30 (3) ◽  
pp. 173-176 ◽  
Author(s):  
Leandro Mendonça PEDROSO ◽  
Renato Miranda DE-MELO ◽  
Nelson Jorge DA-SILVA-JR
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Data Analysis ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Lichtenstein Technique ◽  
Primary Inguinal Hernia ◽  
Lichtenstein Procedure

ABSTRACT Background: There are several surgical treatment options for inguinal hernia; however, there is no consensus on the literature identifying which surgical technique promotes less postoperative pain. Aim: To compare the intensity of postoperative pain between the surgical techniques Lichtenstein and transabdominal pre-peritoneal laparoscopy for the treatment of unilateral primary inguinal hernia. Methods: Were included 60 patients, of which 30 were operated through the Lichtenstein technique and 30 patients through the transabdominal pre-peritoneal laparoscopy. The pain levels were evaluated through the analogue visual scale for 2, 10 and 30 days after the surgery. Additionally, the recurrence rate and the presence of chronic pain and paresthesia were evaluated 12 months after the surgery. Results: Overall, the data analysis showed significant differences on pain levels between the surgical techniques. There were no significant differences between the pain levels for day 2. However, for 10 and 30 days after the surgery, the pain levels were significantly lower for the patients operated through the transabdominal pre-peritoneal laparoscopy technique compared to the Lichtenstein technique. Furthermore, despite no recurrent hernias for both surgical techniques, 32 % of patients operated through the Lichtenstein technique reported chronic pain and paresthesia 12 months after the surgery, compared with 3,6% of patients operated through the transabdominal pre-peritoneal laparoscopy technique. Conclusion: There are differences between the surgical techniques, with the transabdominal pre-peritoneal laparoscopy procedure promoting significantly lower postoperative pain (10 and 30 days) and chronic pain (12 months) compared to the Lichtenstein procedure.

scholarly journals Spondylodiscitis Caused by Aspergillus Species

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1899
Author(s):  
Christos Koutserimpas ◽  
Ifigeneia Chamakioti ◽  
Symeon Naoum ◽  
Konstantinos Raptis ◽  
Kalliopi Alpantaki ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Standard Of Care ◽  
Clinical Challenge ◽  
Life Threatening ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Mean Time

Background: Spondylodiscitis caused by Aspergillus spp. is a rare but life-threatening clinical entity. However, a consensus on diagnostic criteria and most effective medical management is still missing. The present study is a review of all published cases of spondylodiscitis caused by Aspergillus spp., in an effort to elucidate epidemiology, patients’ characteristics, andand the medical and surgical treatment options and their effectiveness. Methods: A thorough review of all existing spondylodiscitis cases caused by Aspergillus was performed. Data regarding demographics, responsible fungus, time between symptoms’ onset and firm diagnosis, antifungal treatment (AFT), surgical intervention, andand the infection’s outcome were investigated. Results: A total of 118 Aspergillus spondylodiscitis cases, yielding 119 Aspergillus spp. isolates, were identified in the literature. The patients’ mean age was 40.6 years. Magnetic resonance imaging (MRI) (after its introduction) indicated the diagnosis in most cases (66.7%), while definite diagnosis was established through cultures in the majority of cases (73.7%). Aspergillus fumigatus was isolated in most cases (73; 61.3%), followed by Aspergillus flavus (15; 12.6%) andand Aspergillus nidulans and terreus (7; 5.9%, each). The mean time between symptoms’ onset and diagnosis was 5.7 months. Amphotericin B was the preferred antifungal regiment (84 cases; 71.2%), followed by voriconazole (31; 26.3%), and the mean AFT duration was 6.1 months. The final outcome was successful in 93 cases (78.8%). Furthermore, 77 patients (65.3%) underwent surgery. Conclusions: Spondylodiscitis caused by Aspergillus spp. represents a clinical challenge, requiring a multidisciplinary approach. The present review has shown that prolonged AFT has been the standard of care of the studied cases, while surgical treatment seems to play an important role in selected patents.

Association of ≥ 12 months of delayed surgical treatment for cervical myelopathy with worsened postoperative outcomes: a multicenter analysis of the Quality Outcomes Database

2021 ◽  
pp. 1-7
Author(s):  
David T. Asuzu ◽  
Jonathan J. Yun ◽  
Mohammed Ali Alvi ◽  
Andrew K. Chan ◽  
Cheerag D. Upadhyaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Postoperative Outcomes ◽  
Symptom Duration ◽  
Initial Symptom ◽  
Delayed Presentation ◽  
Quality Outcomes ◽  
Duration Of Symptoms

OBJECTIVE Degenerative cervical myelopathy (DCM) results in significant morbidity. The duration of symptoms prior to surgical intervention may be associated with postoperative surgical outcomes and functional recovery. The authors’ objective was to investigate whether delayed surgical treatment for DCM is associated with worsened postoperative outcomes. METHODS Data from 1036 patients across 14 surgical centers in the Quality Outcomes Database were analyzed. Baseline demographic characteristics and findings of preoperative and postoperative symptom evaluations, including duration of symptoms, were assessed. Postoperative functional outcomes were measured using the Neck Disability Index (NDI) and modified Japanese Orthopaedic Association (mJOA) scale. Symptom duration was classified as either less than 12 months or 12 months or greater. Univariable and multivariable regression were used to evaluate for the associations between symptom duration and postoperative outcomes. RESULTS In this study, 513 patients (49.5%) presented with symptom duration < 12 months, and 523 (50.5%) had symptoms for 12 months or longer. Patients with longer symptom duration had higher BMI and higher prevalence of anxiety and diabetes (all p < 0.05). Symptom duration ≥ 12 months was associated with higher average baseline NDI score (41 vs 36, p < 0.01). However, improvements in NDI scores from baseline were not significantly different between groups at 3 months (p = 0.77) or 12 months (p = 0.51). Likewise, the authors found no significant differences between groups in changes in mJOA scores from baseline to 3 months or 12 months (both p > 0.05). CONCLUSIONS Surgical intervention resulted in improved mJOA and NDI scores at 3 months, and this improvement was sustained in both patients with short and longer initial symptom duration. Patients with DCM can still undergo successful surgical management despite delayed presentation.

scholarly journals Surgical Treatment with Locoregional Flaps for the Eyelid: A Review

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Federico Lo Torto ◽  
Luigi Losco ◽  
Nicoletta Bernardini ◽  
Manfredi Greco ◽  
Gianluca Scuderi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Social Relationship ◽  
Surgical Planning ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Full Thickness ◽  
Eyelid Reconstruction ◽  
Colour Match ◽  
Full Thickness Excision ◽  
Anatomy Knowledge

Reconstruction of the eyelids after skin cancer excision can be challenging. Surgical treatment options are multiple; deep anatomy knowledge of lamellar components is mandatory to choose the most adequate surgical planning. Eyelids’ role in vision and social relationship is critical; both function and aesthetics are tough to restore. Using a flap provides a satisfying texture and colour match with adjacent tissues and ensures short contraction during healing; furthermore, grafts are sometimes necessary to achieve pleasing results. Hundreds of surgical techniques have been described aiming for eyelid reconstruction; in our paper, we want to provide for our audience the most reliable and useful procedures for subtotal and total eyelid reconstruction following NMSC full-thickness excision.

The role of the surgical method in the complex treatment of laryngeal cancer

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Cristina Albul ◽  
◽  
Gheorghe Tibirna ◽  
Nikolay Gorshkov ◽  
Andrei Tibirna ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Life Expectancy ◽  
Laryngeal Cancer ◽  
Surgical Intervention ◽  
Locally Advanced ◽  
Complex Treatment ◽  
Republic Of Moldova ◽  
The Republic ◽  
Anterior Posterior

As a result of studying the dynamics of the incidence of laryngeal cancer in the Republic of Moldova, in the period from 1980 to 2020. It was found that annually, a malignant tumor of the larynx, on average, about 120 patients fall ill. Over the course of 40 years, 874 patients were identified, of which more than 80% were admitted for treatment at stages 3-4 of the disease. This article studied the results of surgical treatment of 258 patients with locally advanced laryngeal cancer. Based on the characteristics of the spread of laryngeal cancer to neighboring organs and tissues, they gave us the basis to distinguish five main types of surgical intervention: upper, lower, anterior, posterior and lateral. The justification of these operations is proved by the patient’s life expectancy, which is 53.6%.

scholarly journals Surgical treatment options and management strategies of metastatic renal cell carcinoma to the lumbar spinal nerve roots

2013 ◽  
Vol 20 (11) ◽  
pp. 1546-1549 ◽  
Author(s):  
Christian Strong ◽  
Vijay Yanamadala ◽  
Arjun Khanna ◽  
Brian P. Walcott ◽  
Brian V. Nahed ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Treatment Options ◽  
Management Strategies ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Lumbar Spinal

scholarly journals Laser surgical treatment options for diseases of the upper respiratory tract in horses – An overview

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Bernhard Ohnesorge ◽  
Anna Rötting
Keyword(s):  
Surgical Treatment ◽  
Respiratory Tract ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Minimal Invasive ◽  
Surgical Approaches ◽  
Upper Respiratory Tract ◽  
Common Diseases ◽  
Life Threatening ◽  
Upper Respiratory

AbstractDiseases of the upper respiratory tract in horses can be life-threatening, or more frequently, limit the ability of the equine athlete to perform. Traditional surgical approaches are often invasive and are limited due to anatomic considerations. This article summarizes minimal invasive surgical techniques and in particular, laser surgical techniques useful for treatment of common diseases of the upper respiratory tract in horses.

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