scholarly journals Management of Recurrent Rectourethral Fistula by York Mason Posterior Transrectal Transsphincteric Approach

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Fahri Yetişir ◽  
A. Ebru Şarer ◽  
H. Zafer Acar ◽  
Omer Parlak ◽  
Gokhan Osmanoglu ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Surgical Techniques ◽  
Digital Rectal Examination ◽  
Rectourethral Fistula ◽  
Transurethral Resection Of Prostate ◽  
Urinary Drainage ◽  
Transsphincteric Approach ◽  
Patient Will ◽  
Few Data ◽  
Supportive Management

Rectourethral fistula (RUF) may develop after ureterovesical and rectal intervention or radiation therapy (RT) rarely, but it is associated with significant morbidity and mortality. The patient will typically present with pneumaturia, faecaluria, and urinary drainage from the rectum. Diagnosis can be easily done with digital rectal examination, cystography, and urethrocystoscopy. Conservative supportive management of RUF does not appear to be successful in most patients, and management with surgical intervention remains the best treatment option. Several surgical techniques have been described including transabdominal, transanal, transperineal, combined abdominoperineal, anterior and posterior transsphincteric, transsacral, laparoscopic, robotic, and endoscopic minimally invasive approaches. There have been very few data about treatment of recurrent RUF. We would like to report the management of recurrent RUF following transurethral resection of prostate and RT for prostate carcinoma in an immunosuppressed, 75-year-old patient by York Mason posterior transrectal transsphincteric approach.

Thrombolysis in Arterial Occlusion

1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe
Keyword(s):  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
Arterial Occlusion ◽  
Second Step ◽  
Severe Bleeding ◽  
Initial Management

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.

Endoscopic sphenoidotomy

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 34-36
Author(s):  
I. Bulescu ◽  
C. Ioniţă ◽  
A. Coman ◽  
A. Panfiloiu ◽  
Andreea Nicoleta Costache ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Surgical Techniques ◽  
Endoscopic Technique ◽  
Detailed Knowledge

Given the progress of endoscopic surgical techniques detailed knowledge of nasosinusal local anatomy is an essential clinical request for surgeons. In this paper, the aim of the authors is to illustrate the surgical endoscopic technique of sphenoidotomy and to provide a step-by-step description of the main stages  of the surgical intervention.  

scholarly journals AngelChik Device Removal and Revisional Fundoplication

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Hannah Chase ◽  
Sotiris Mastoridis ◽  
Nicholas Maynard
Keyword(s):  
Surgical Intervention ◽  
Clinical Care ◽  
Surgical Techniques ◽  
Developed Countries ◽  
Late Complications ◽  
Biliary Leak ◽  
Proactive Approach ◽  
Uncertain Evidence ◽  
Lower Oesophagus ◽  
The Uk

Gastro-oesophageal reflux disease (GORD) is a common condition in developed countries with an increasing incidence in the UK, currently estimated at 5 per 1000 person-years. Risk factors for GORD include Helicobacter pylori infection, obesity, alcohol consumption, smoking and genetic predisposition.  Surgical management is performed in chronic, severe cases of GORD, refractory to medical management. There are a variety of interventional surgical techniques available and the patient in this case had placement of an AngelChik Device (AD) 30 years ago. This is now a historic device due to associated complications and this patient had it removed with revisional treatment of the patient’s GORD with Nissen Fundoplication. The patient experienced multiple post-surgical complications, namely biliary leak from the central port, pulmonary embolism and pneumonia. Following description of the case, this report will discuss the increasing incidence of late complications of AD and propose a proactive approach to these patients going forwards. It will also discuss the current uncertain evidence of a new surgical intervention called magnetic sphincter augmentation (MSA) of the lower oesophagus that has similar principles to the mechanism of an AD. From this it will emphasise that more stringent and worldwide collaboration is required when bringing a new medical device into clinical care.

Urinary miR-183 and miR-205 do not surpass PCA3 in urine as predictive markers for prostate biopsy outcome despite their highly dysregulated expression in prostate cancer tissue

2015 ◽  
Vol 53 (7) ◽  
Author(s):  
Carsten Stephan ◽  
Monika Jung ◽  
Silke Rabenhorst ◽  
Ergin Kilic ◽  
Klaus Jung
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Critical Evaluation ◽  
Sample Size Calculation ◽  
Digital Rectal Examination ◽  
Predictive Marker ◽  
Testing Procedure ◽  
Cancer Tissue ◽  
Few Data

AbstractMicroRNAs (miRNAs) have shown to be promising novel biomarkers in various cancers. We aimed to translate the results of an own previous tissue-based miRNA profile of prostate carcinoma (PCa) with upregulated miR-183 and downregulated miR-205 into a urine-based testing procedure for diagnosis of PCa.Urine sediments were prepared from urine samples collected after a standardized digital-rectal examination (DRE) of patients undergoing prostate biopsy with PSA (prostate-specific antigen) values <20 μg/L in consecutive order. According to the sample-size calculation (α=0.05, power=0.95), 38 patients each with PCa and without PCa were randomly enrolled in this study. PCA3 (prostate cancer associated 3) in urine as Food and Drug Administration-approved assay was determined as reference standard for comparison. The miRNAs were measured by RT-qPCR using TaqMan assays and normalized using different approaches.Both miRNAs were correlated to the mRNA PSA concentrations in the sediments indicating a relationship to the released prostate cells after DRE. However, they had no discriminating capacity between patients with and without PCa. In contrast, PCA3 clearly differentiated between these two patients groups. There was also no significant correlation between miRNAs and standard clinicopathologic variables like Gleason score and serum PSA.The data of our study show that miR-183 and miR-205 failed to detect early and aggressive PCa despite their highly dysregulated expression in cancer tissue. Our results and the critical evaluation of the few data of other studies raise serious doubts concerning the capability of urinary miRNAs to replace or improve PCA3 as predictive marker for prostate biopsy outcome.

scholarly journals Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Chiara De Giacinto ◽  
Marco R. Pastore ◽  
Gabriella Cirigliano ◽  
Daniele Tognetto
Keyword(s):  
Macular Hole ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Current Knowledge ◽  
Surgical Techniques ◽  
Retinal Disease ◽  
Narrative Review ◽  
Vitreomacular Interface ◽  
Tractional Forces

Macular hole (MH) in myopic eyes is a disease arising from complex tractional forces exerted by vitreomacular interface, epiretinal tissue, and progressive scleral ectasia of the posterior ocular globe wall. This retinal disease requires vitreoretinal treatment for its repair, and the surgical intervention remains a challenge also for experienced surgeons. The aim of this review is to describe the current knowledge regarding the pathogenesis of MH in myopic eyes and to detail novel surgical techniques and technological advancements in its surgical management.

Results of surgery to the damaged facial nerve

1989 ◽  
Vol 103 (6) ◽  
pp. 567-571 ◽  
Author(s):  
P. A. Fagan ◽  
K. K. Loh
Keyword(s):  
Facial Nerve ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Neurological Surgery ◽  
Early Surgical Intervention ◽  
Results Of Surgery ◽  
Facial Function

AbstractNeurological surgery of the paralysed face can be rewarding if performed early using appropriate surgical techniques. The results of 32 operations are analyzed. Excellent restoration of facial function is achieved with early surgical intervention but some results are poor. The reasons for failure are analyzed.

Study on spontaneous cerebrospinal fluid rhinorrhoea: its aetiology and management

2005 ◽  
Vol 119 (1) ◽  
pp. 12-15 ◽  
Author(s):  
C J Dunn ◽  
A Alaani ◽  
A P Johnson
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Queen Elizabeth Hospital ◽  
Study Group ◽  
Common Features ◽  
Csf Rhinorrhoea ◽  
The Common ◽  
Csf Leaks

The aim of this study was to identify the common features in a study group of patients with spontaneous cerebrospinal fluid (CSF) rhinorrhoea, to develop a hypothesis to explain the cause of this condition and to investigate the outcome of surgical techniques adopted to repair the leak. In this retrospective study the authors have reviewed all the cases of spontaneous CSF leaks attending and receiving treatment from the otolaryngology department of Queen Elizabeth Hospital, Birmingham, from 1992 to 2002.Of 34 patients with CSF leaks, 15 were spontaneous in nature and formed the study group. Of these 15 patients, 14 were female; with ages ranging from 37 to 70 years and a median age of 50 years. All the female patients were overweight with a body mass index (BMI) >24.9 and, of these, nine were considered obese with a BMI >30. It was attempted to identify common factors in the study group and it was evident that female sex, obesity and age played a key role in this condition.The follow-up period ranged from two to 98 months. Thirteen patients were asymptomatic but two patients remained symptomatic, one of these despite repeated surgical intervention.

scholarly journals Effect of different manipulations on serum PSA in patients with benign prostatic hyperplasia.

2021 ◽  
Vol 28 (06) ◽  
pp. 866-871
Author(s):  
Muhammad Iqbal ◽  
M. Adil Khurshid ◽  
Sohail Hassan ◽  
Manzoor Ahmad Naeem ◽  
Shahid Niaz ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Digital Rectal Examination ◽  
Management Plan ◽  
Significant Rise ◽  
Prostatic Hyperplasia ◽  
Transurethral Resection Of Prostate ◽  
Ultrasound Guided ◽  
Prostatic Biopsy ◽  
Rectal Examination ◽  
Rectal Ultrasound

Objectives: To evaluate the effect of different urological manipulations on the serum PSA level in patients with benign prostatic hyperplasia. Study Design: Quasi-experimental study. Setting: Department of Urology, Nawaz Sharif Social Security Hospital, Lahore. Period: January 2018 to December 2018. Material & Methods: A series of 60 patients were included in the study who fulfill the inclusion criteria. All the patients were above 50 years of age and presented with symptoms of benign prostatic hyperplasia. These patients were divided into four groups equally. In group A digital rectal examination, in group B transurethral resection of prostate, in group C Foley’s catheterization and in group D Trans rectal ultrasound guided prostatic biopsy was done. Pre-manipulation and post-manipulation blood samples for serum PSA were taken after 30 minutes, 72 hours and one week. Results: Trans urethral resection of prostate, Foley's catheterization and trans rectal ultrasound guided prostatic biopsy caused a statistically significant rise in serum PSA level (p < 0.05) while digital rectal examination did not raise serum PSA level significantly. Conclusion: Different manipulations do cause alteration in the serum PSA level which may change the management plan.

scholarly journals MINI-INVASIVE PERCUTANEOUS USP-CONTROLLED DRAINING OF PSEUDOCYSTS OF THE PANCREAS, SUPPLEMENTED WITH LASER VAPORIZATION

2020 ◽  
pp. 32-36
Author(s):  
Ya. V. Naboychenko ◽  
R. S. Shevchenko
Keyword(s):  
Minimally Invasive ◽  
Research Methods ◽  
Surgical Intervention ◽  
Average Length ◽  
Abdominal Cavity ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Laser Vaporization ◽  
Pancreatic Pseudocysts ◽  
Surgical Methods

Summary. Aim. The aim of this study was to evaluate the results of percutaneous minimally invasive ultrasound-controlled drainage of pancreatic pseudocysts, supplemented by laser vaporization, compared with classical surgical methods of treatment. Materials and research methods. This work is based on the results of examination and surgical treatment of 51 patients with PCPD, which were divided into two clinical groups. To optimize the choice of the method of surgical intervention, instrumental research methods were used: ultrasound (PHILIPS HD 11 XE apparatus (Austria), EGDS, ERCP, CT of the pancreas, ECG, X-ray examination of the chest and abdominal cavity, laparoscopy. Research results. The paper establishes options for choosing a puncture point for a pancreatic pseudocyst with minimal traumatic effect, as a result of which damage to neighboring organs is excluded. Selected the most effective methods of intraoperative use of laser radiation, depending on the formation of the pseudocyst wall and the type of complication. The main surgical techniques for intraoperative use of percutaneous puncture laser vaporization of the pseudocyst wall, with external and internal drainage, are presented. Conclusions. When comparing minimally invasive methods of surgical intervention with laparotomic ones, the effectiveness of the former is evidence-based, while the proportion of complications in the early postoperative period and the average length of hospital stay when using minimally invasive interventions are much less. The use of laser irradiation for the purpose of debridement and vaporization (for percutaneous minimally invasive interventions) made it possible to reduce the number of external drainage operations to 41.0 %, and to increase the number of internal digestive drainage operations to 48.7 %. In the long-term period, there was a decrease in the recurrence of pseudocysts to 12.5 %. The proposed method of treating patients with PCPD can be used as an operation of choice in the presence of clinical conditions and technical support.

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