scholarly journals The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Demetrios Moris ◽  
Alexandros Papalampros ◽  
Michail Vailas ◽  
Athanasios Petrou ◽  
Michael Kontos ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Technical Analysis ◽  
Definitive Treatment ◽  
Technological Evolution ◽  
Tips And Tricks ◽  
Robotic Approach ◽  
Bile Duct Injuries ◽  
Biliary Diversion ◽  
Anastomotic Strictures

Roux-en-Y hepaticojejunostomy (RYHJ) is currently considered as the definitive treatment for iatrogenic bile duct injuries and the principal representative of biliary diversion procedures. This technique has met many milestones of extensive evolution, particularly the last years of concomitant technological evolution (laparoscopic/robotic approach). Anastomotic strictures and leaks, which may have deleterious effects on the survival and quality of life of a patient with biliary obstruction of any cause, made the need of the development of a safe and efficient RYHJ compulsory. The aim of this technical analysis and the juxtaposed discussions is to elucidate with the most important milestones and technical tips and tricks all aspects of a feasible and reliable RYHJ technique that is performed in our center for the last 25 years in around 400 patients.

scholarly journals Quality of Life following Chemoradiotherapy for Localized Muscle Invasive Bladder Carcinoma: A Systematic Review

2021 ◽  
pp. 1-13
Author(s):  
Ben-Max De Ruiter ◽  
Abel N. Keijzer ◽  
Maarten C.C.M. Hulshof ◽  
Adriaan D. Bins ◽  
Theo M. de Reijke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Bladder Carcinoma ◽  
Bowel Function ◽  
Definitive Treatment ◽  
Cochrane Library ◽  
Social And Emotional ◽  
Muscle Invasive ◽  
The Impact

BACKGROUND: Health related Quality of Life (HRQoL) is an important factor regarding treatment for localized Muscle Invasive Bladder Carcinoma (MIBC), as it may affect choice of treatment. The impact of chemoradiotherapy (CRT) for MIBC on HRQoL has not yet been well-established. OBJECTIVE: To systematically evaluate evidence regarding HRQoL as assessed by validated questionnaires after definitive treatment with CRT for localized MIBC. METHODS: We performed a critical review of PubMed/MEDLINE, EMBASE, and the Cochrane Library in October 2020. Two reviewers independently screened articles for eligibility and assessed the methodological quality of the included articles using Joanna Briggs Institute critical appraisal tools. A narrative synthesis was undertaken. RESULTS: Of 579 articles identified, 11 studies were eligible for inclusion, including three RCTs and 8 non-randomized studies, reporting on HRQoL data for 606 CRT patients. Global health declined at End of treatment (EoT), and recovered 3 months following treatment. Physical function declined from baseline at EoT and recovered between 3 and 24 months and was maintained at 5 years follow up. CRT had little effect on social and emotional function in the short-term, but HRQoL results in the long-term were lower compared to the general population. Urinary function declined from baseline at EoT, but returned to baseline at 6 months following CRT. After initial decline in bowel function, a complete return to baseline occurred 4 years following treatment. The majority of studies assessing sexual function showed no to little effect on sexual function. CONCLUSIONS: HRQoL recovers to baseline within 3 months to 2 years in almost all domains. The amount of available evidence regarding HRQoL following CRT for MIBC is limited and the quality of evidence is low.

Quality-of-life assessment in the treatment of iatrogenic bile duct injuries: hepaticojejunostomy versus end-to-end biliary reconstructions

2012 ◽  
Vol 82 (12) ◽  
pp. 923-927 ◽  
Author(s):  
Beata Jabłońska ◽  
Marek Olakowski ◽  
Paweł Lampe ◽  
Zygmunt Górka ◽  
Łukasz Bułdak
Keyword(s):  
Quality Of Life ◽  
Bile Duct ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Bile Duct Injuries ◽  
End To End

Study on Mechanism of Molybdenum Concentrate Carbon-Free Roasting

2012 ◽  
Vol 588-589 ◽  
pp. 1685-1688 ◽  
Author(s):  
Lian Yong Wang ◽  
Jing Fan Zhang ◽  
Lei Dai ◽  
Jiu Ju Cai
Keyword(s):  
Technical Analysis ◽  
Economic Benefits ◽  
Thermal Balance ◽  
Environmental Benefits ◽  
Heat Of Reaction ◽  
Balance Test ◽  
Operating Process ◽  
Output Quality ◽  
Molybdenum Concentrate

Technical analysis was used to analyze the roasting of molybdenum concentrate on the basis of thermal balance test of rotary furnaces used for Roasting, and the results indicate that, on the condition of commercial production, the Roasting of MoS2 can occur spontaneously because the heat of reaction is so much that proper cooling measures should be adopted in case overheating happens. According to above analysis, carbon-free roasting technology of molybdenum concentrate was proposed in this paper. The results, which come from thermal balance test and technical analysis of rotary furnaces used for carbon-free roasting of molybdenum concentrate, indicate that outer heat source used in traditional Roasting technology is not needed in carbon-free roasting technology, because enough heat is generated during Roasting to ensure spontaneous reaction. In fact, heating is not needed in operating process except at the beginning, to make molybdenum concentrate catching fire, and when reaction completing, to remove residual sulphur. The technology in this paper is obviously advantageous in aspects of energy saving, output, quality of production, heat loss, the concentration of SO2 in flue gas, etc. and will have remarkable environmental benefits, economic benefits and social benefits.

scholarly journals Ivor–Lewis oesophagogastrectomy with Roux-en-Y duodenal bypass

2016 ◽  
Vol 98 (2) ◽  
pp. 116-120
Author(s):  
J Cartwright ◽  
E Forbat ◽  
A Botha
Keyword(s):  
Gastric Tube ◽  
Case Series ◽  
Poor Quality ◽  
Benign Disease ◽  
Ivor Lewis ◽  
Biliary Diversion ◽  
Complex Reconstruction ◽  
Long Term Result

Oesophagectomies and gastrectomies are performed predominantly for the treatment of malignant disease. However, in this case series, we describe three patients with benign disease who had a laparoscopic oesophagogastrectomy with gastroduodenal detachment and Roux-en-Y biliary diversion, and discuss the operative feasibility and consequent patient outcomes. Our aim was to modify the procedure using an established reconstruction already practised in gastric and bariatric surgery, thereby preventing operative sequelae that lead to a poor quality of life (eg reflux oesophagitis and vomiting). During the first postoperative year, our first two patients experienced weight loss, indigestion and lower bowel symptoms with no apparent improvement in gastric function compared with a standard gastric tube pull-up reconstruction. In the longer term, in both patients, the gastric tube interpositions appeared to function well and there was no evidence of gastro-oesophageal reflux disease, delayed gastric emptying or troublesome indigestion. Our third patient, who had lifelong severe reflux symptoms, was eating normally three months after the operation with no need for antacid medication. We therefore conclude that laparoscopic Ivor–Lewis oesophagogastrectomy with Roux-en-Y bypass is a more complex reconstruction with added risks but may in the long term result in better overall outcomes and satisfaction for patients, particularly those with benign disease.

The impact of Radiotherapy on Swallowing and Speech in Patients who Undergo total Laryngectomy

2008 ◽  
Vol 139 (6) ◽  
pp. 792-797 ◽  
Author(s):  
Carmen de Casso ◽  
Nicholas J. Slevin ◽  
Jarrod J. Homer
Keyword(s):  
Total Laryngectomy ◽  
Chart Review ◽  
Detrimental Effect ◽  
Definitive Treatment ◽  
Soft Diet ◽  
Carcinoma Of The Larynx ◽  
Voice Development ◽  
The Impact ◽  
Single Modality

Objectives Quality of life studies have shown no detrimental effect with radiotherapy (RT) in patients who have a total laryngectomy. We wished to determine the effect of RT (initial or postoperative) specifically on the swallowing and voice function in patients treated by total laryngectomy (TL) for carcinoma of the larynx. Design Multicenter chart review. Setting Multicenter study in the Greater Manchester and Lancashire area. Participants A total of 121 postlaryngectomy patients all of whom had completed definitive treatment at least 6 months before this study. Twenty-six patients had total laryngectomy as a single modality treatment and 95 had total laryngectomy and radiotherapy. Main Outcome Measures Swallowing (solid food, soft diet or fluid/PEG) and voice development. Results Swallowing was better in the group who had no radiotherapy ( P = 0.0037). There was no difference in voice function between the two groups. We also demonstrated that females had a worse swallowing outcome ( P = 0.0101), as did advanced nodal stage ( P = 0.001). Conclusions RT adversely affects the swallowing results but not the speech results after TL when given either as initial treatment or postoperatively. This should be kept in mind in the decision-making process in the treatment of patients with carcinoma of the larynx.

scholarly journals Social isolation and quarantine in the COVID-19 pandemic: impacts on mental health and quality of population life

2021 ◽  
Vol 10 (2) ◽  
pp. e30510212535
Author(s):  
Gabriel Kiaro Leite Nunes ◽  
Karinne Alice Santos de Araújo ◽  
Thais Ranielle Souza de Oliveira ◽  
Marcelina da Conceição Botelho Teixeira ◽  
Ieler Ferreira Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Isolation ◽  
Negative Impact ◽  
Definitive Treatment ◽  
World Population ◽  
The World ◽  
The Face ◽  
The Impact

The COVID-19 pandemic brought about major changes in the lifestyle of the world population. Due to the lack of vaccines or a definitive treatment for disease, governments around the world have adopted social isolation and quarantine as methods to control the spread of the virus. Objective: Thus, the objective of this study was to discuss how social isolation and quarantine periods affected people's mental health and quality of life during the COVID-19 pandemic. Methods: An integrative literature review was carried out during the COVID-19 pandemic between March and September 2020, establishing the following guiding question: How did social isolation and quarantine affect the mental health and quality of life of the population in the COVID-19 pandemic? Results: The final sample consisted of nineteen (19) articles, two (2) addressed depression during the pandemic period, three (3) presented the pandemic and the relationship with sociodemographic aspects, five (5) analyzed mental health in the pandemic, four (4) reported the impact of COVID-19 on the population's style and quality of life and the last five (5) demonstrated the quality of human relationships and emotional aspects in the face of the pandemic. Conclusion: It was demonstrated that isolation and the quarantine period had a negative impact on the population's quality of life and long-term mental health.

scholarly journals Assessment of Septoplasty Outcome using Nasal Obstruction Symptom Evaluation Scale

2019 ◽  
Vol 21 (2) ◽  
pp. 142-146
Author(s):  
Kundan Kumar Shrestha ◽  
R.R. Joshi ◽  
A.S. Rijal ◽  
A. Dhungana ◽  
S. Maharjan
Keyword(s):  
Quality Of Life ◽  
Nasal Obstruction ◽  
Septal Deviation ◽  
Definitive Treatment ◽  
Nose Scale ◽  
Outcome Instrument ◽  
Symptom Evaluation ◽  
The Mean ◽  
Nasal Septoplasty

 Nasal obstruction, the most common presenting symptom in nasal and sinus disease, is defined as patient discomfort manifested as a sensation of insufficient airflow through the nose. Nasal septal deviation is the most common anatomical cause of nasal obstruction. Surgical correction of a deviated septum, nasal septoplasty, is the definitive treatment for septal deviation. Many studies have discussed about outcomes of septoplasty. However, there is limited published literature on nasal septoplasty and its outcome in Nepal. The aim of this study is to evaluate the outcome of septoplasty using Nasal Obstruction Symptom Evaluation (NOSE) scale, a validated outcome instrument assessing quality of life (QoL) related to nasal obstruction. A total of 52 patients aged 18 years and above, with nasal obstruction at least for 3 months, undergoing septoplasty alone were included in the study. Baseline NOSE score was calculated a week before surgery. The patients were followed up after 3 months to record postoperative NOSE score. On statistical analysis, the mean NOSE scores before and 3 months after septoplasty were 45.58±21.38 and 8.46±8.37 respectively. The mean difference was 37.11± 21.22 and p value on paired t test was less than 0.001(highly significant). The mean differences of each component of the NOSE scale questionnaire were also found to be highly significant statistically with p values less than 0.001. Gender and age did not seem to affect the outcomes. In conclusion, NOSE scale is a valid, reliable and responsive instrument that is brief and easy to complete and has potential use for outcome studies in adults with nasal obstruction. This instrument showed that septoplasty, if done in properly selected patients, results in significant improvement in nasal obstruction and disease specific quality of life with high patient satisfaction.

scholarly journals The Role of the Stem Cells Therapy in the Peripheral Artery Disease

2019 ◽  
Vol 20 (9) ◽  
pp. 2233 ◽  
Author(s):  
Federico Biscetti ◽  
Nicola Bonadia ◽  
Elisabetta Nardella ◽  
Andrea Leonardo Cecchini ◽  
Raffaele Landolfi ◽  
...  
Keyword(s):  
Stem Cells ◽  
Vascular Complications ◽  
Arterial Disease ◽  
Definitive Treatment ◽  
Stem Cells Therapy ◽  
Artery Disease ◽  
The Moment ◽  
Peripheral Arterial

Vascular complications of diabetes mellitus are an important issue for all clinicians involved in the management of this complex pathology. Although many therapeutic advances have been reached, peripheral arterial disease is still an unsolved problem that each year compromises the quality of life and life span of affected patients. Oftentimes, patients, after ineffective attempts of revascularization, undergo greater amputations. At the moment, there is no effective and definitive treatment available. In this scenario, the therapeutic use of stem cells could be an interesting option. The aim of the present review is to gather all the best available evidence in this regard and to define a new role of the stem cells therapy in this field, from biomarker to possible therapeutic target.

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

Bile Duct Injuries during Laparoscopic Cholecystectomy: Management and Outcome

2005 ◽  
Vol 71 (12) ◽  
pp. 1060-1065 ◽  
Author(s):  
Kostas Tsalis ◽  
Emmanouil Zacharakis ◽  
Konstantinos Vasiliadis ◽  
Stavros Kalfadis ◽  
Orestis Vergos ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Definitive Treatment ◽  
Biliary Disease ◽  
Adequate Treatment ◽  
Bile Duct Injuries ◽  
Duct Ligation ◽  
Duct Of Luschka ◽  
Minor Injuries

The aim of this study is to analyze our experience with the management of bile duct injuries (BDIs) following laparoscopic cholecystectomy (LC). From 1996 to 2004, 21 patients with BDI after LC were treated in our department. The BDIs were graded according to the classification of Strasberg. Ten patients had minor BDI. Minor injuries were classified as A in six and D in four patients. In three patients, endoscopic retrograde cholangiopancreatography sphincterotomy and stent placement was adequate treatment. Six patients required laparotomy and bile duct ligation or suturing, and one patient underwent laparoscopy with additional ligation of a duct of Luschka. Eleven patients had major BDIs. These injuries were classified as E1 in two, E2 in three, E3 in four, and E4 in two patients. Among the patients with a major BDI, Roux- en-Y hepaticojejunostomy was performed. After a median follow-up of 69.45 months, no evidence of biliary disease has been detected among our patients. BDIs should be managed in a specialist unit where surgeons skilled to perform such repairs should undertake definitive treatment. Roux- en-Y hepaticojejunostomy is the procedure of choice in the management of major BDIs as it is accompanied by satisfactory results.

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