scholarly journals Multimodality Surgical Approach in Management of Laryngotracheal Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Ashfaque Ansari ◽  
Annju Thomas
Keyword(s):  
Primary Anastomosis ◽  
Delayed Diagnosis ◽  
Subglottic Stenosis ◽  
Long Term Results ◽  
Laryngotracheal Stenosis ◽  
Surgical Anastomosis ◽  
Suture Tension ◽  
Multiple Treatments ◽  
Almost All

Introduction. Postintubation laryngotracheal stenosis requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. This report presents surgically treated cases of laryngotracheal stenosis secondary to long-term intubation/tracheostomy with review of the literature. Materials and Methods. In this retrospective study, we present 5 cases (a 23-year-old male, 13-year-old male, 22-year-old male, 19-year-old male, and 33-year-old female) of postintubation/tracheostomy laryngotracheal (glottic/subglottic) stenosis in the years 2016 and 2017. Each patient was managed differently. Intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded. Results. The site of stenosis was in the subglottis in 4 patients and glottis in 1 patient. The mean length of the stenosis was greater in the postintubation group. Postintubation stenosis had a mean duration of intubation of 6.8 days, compared to 206.25 days of cannulation following tracheostomies. Each patient underwent an average of 2 procedures during their treatment course. One patient underwent open surgical anastomosis because of recurrent subglottic stenosis after multiple treatments. Phonation improved immediately in almost all except in the patient who underwent only endoscopic dilatation. Discussion. The reasons for laryngeal stenosis and its delayed diagnosis have been reviewed from the literature. Suture tension should be appropriate, and placement of the suture knot outside the trachea minimizes formation of granulation tissue. The published reports suggest that resection by endoscopy with laser and open technique resection and primary anastomosis are the best treatment modality so far as the long-term results are concerned. Conclusion. Resection of stenotic segment by open surgical anastomosis and laser-assisted resection is a safe option for the treatment of subglottic stenosis following intubation without the need for repeated dilation. Endoscopic dilation can be reserved for unfit patients.

Long-term results of delayed primary anastomosis for pure oesophageal atresia: a 27-year follow up

2007 ◽  
Vol 23 (7) ◽  
pp. 647-651 ◽  
Author(s):  
Thambipillai Sri Paran ◽  
Diane Decaluwe ◽  
Martin Corbally ◽  
Prem Puri
Keyword(s):  
Oesophageal Atresia ◽  
Primary Anastomosis ◽  
Long Term Results

An Eight-year Follow-up to a Randomized Clinical Trial of Participant Satisfaction with Three Types of Mandibular Implant-retained Overdentures

2004 ◽  
Vol 83 (8) ◽  
pp. 630-633 ◽  
Author(s):  
R. Timmerman ◽  
G.T. Stoker ◽  
D. Wismeijer ◽  
P. Oosterveld ◽  
J.I.J.F. Vermeeren ◽  
...  
Keyword(s):  
Positive Impact ◽  
Controlled Trial ◽  
Long Term Results ◽  
Participant Satisfaction ◽  
Chewing Ability ◽  
Almost All ◽  
Mandibular Overdenture

Studies have shown that mandibular implant overdentures significantly increase satisfaction and quality of life of edentulous elders. Improved chewing ability appears to have a positive impact on nutritional state. Therefore, it is important to determine the best design of this prosthesis over the long term. In this randomized controlled trial, three groups of edentulous participants with atrophic mandibles wore 3 types of implant overdentures. During an eight-year follow-up, only seven of the 110 participants had dropped out of this study. Almost all participants were still satisfied with their overdentures. Participant satisfaction concerning retention and stability of the mandibular overdenture had decreased significantly in the two-implant ball attachment group, whereas the opinion of participants in the single- and triple-bar groups was still at the same level. The long-term results suggest that a mandibular overdenture retained by 2 implants with a single bar may be the best treatment strategy for edentulous people with atrophic ridges.

The long-term results of hyoid-sternohyoid grafts in the correction of subglottic stenosis

1986 ◽  
Vol 100 (6) ◽  
pp. 665-674 ◽  
Author(s):  
A. P. Freeland
Keyword(s):  
Granulation Tissue ◽  
Major Complication ◽  
Subglottic Stenosis ◽  
Long Term Results ◽  
Repair Site ◽  
Long Term Follow Up

AbstractThe long-term follow-up of eight patients with established subglottic stenosis managed with a composite hyoid-sternohyoid graft is reported. Four of these patients were children. All but one of the patients were extubated within four months of surgery. The reconstructed airway is shown to grow with age and re-stenosis has not occurred. Apart from post-operative granulation tissue at the repair site, the major complication has been a breathy voice in two children due to overwidening of the larynx.

535 EVALUATION OF THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER FROM 650 CASES IN A SINGLE INSTITUTE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Takashi Kamei ◽  
Yusuke Taniyama ◽  
Hiroshi Okamto
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Treatment ◽  
Thoracoscopic Esophagectomy ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
Almost All

Abstract   Minimally invasive surgery (MIS) for esophageal cancer has been wide-spreading in worldwide since the first report in 1992. In Japan, we firstly introduced thoracoscopic esophagectomy as a MIS for esophageal cancer in 1994 and performed more than 650 cases over the last two decades. The aim of the present study is to evaluate an oncological feasibility and less invasiveness of this operation from short and long term results. Methods Thoracoscopic esophagectomy was performed in almost all resectable thoracic esophageal cancer patient, briefly indication for this operation is cT1-T3 tumors and lymph node involvement within the regional lesion. We performed thoracoscopic esophagectomy with one lung ventilation in left lateral decubitus position (Group L) up to 2011. From 2012, prone thoracoscopic esophagectomy with bilateral ventilation and artificial pneumothorax (Group P) has been undergone. We analyzed the long-term outcome in all patients who received thoracoscopic esophagectomy with or without neoadjuvant treatment. Furthermore, we evaluated the less invasiveness from the results of short-term outcome and operation-related morbidity between Group L and Group P. Results The 5-year survival rates in no treatment before surgery cases were 61.9% overall, and 86.9%, 71.5%, 68.1%, 40.9%, 37.4% for pathological stages I, IIA, IIB, III and IVa, respectively (TNM classification 6th edition). 30 days mortality in this series was 0.6%. 5-year survival in cStage II and III with neoadjuvant chemotherapy was 65.7%. 3-year survival in salvage esophagectomy after failure of definitive chemoradiotherapy with R0 resection was 43.0%. Total amount of blood loss, rate of postoperative pulmonary complications and the postoperative inflammatory response were significantly lower in Group P than in Group L. Conclusion Thoracoscopic esophagectomy is safety and oncologically feasible. From the view point of less invasiveness benefits, prone esophagectomy has advantages than lateral decubitus procedure and this operation is recommended in almost all patients with a resectable esophageal cancer.

scholarly journals Current Status of the Self-Expandable Metal Stent as a Bridge to Surgery Versus Emergency Surgery in Colorectal Cancer: Results from an Updated Systematic Review and Meta-Analysis of the Literature

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 268
Author(s):  
Roberto Cirocchi ◽  
Alberto Arezzo ◽  
Paolo Sapienza ◽  
Daniele Crocetti ◽  
Davide Cavaliere ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Surgery ◽  
Primary Anastomosis ◽  
Meta Analysis ◽  
Long Term Results ◽  
Bridge To Surgery ◽  
Metal Stent ◽  
Sems Group ◽  
Short And Long Term

Background: The current use of endoscopic stenting as a bridge to surgery is not always accepted in standard clinical practice to treat neoplastic colonic obstructions. Objectives: The role of colonic self-expandable metal stent (SEMS) positioning as a bridge to resective surgery versus emergency surgery (ES) for malignant obstruction, using all new data and available variables, was studied and we focused on short- and long-term results. Materials and Methods: A systematic review with meta-analysis was performed. PubMed, SCOPUS and Web of Science databases were included. The search comprised only randomized controlled trials (RCTs) investigating the interventions that included SEMS positioning versus ES. The primary outcomes were the rates of overall postoperative mortality, clinical and technical success. The secondary outcomes were the short- and long-term results. Results: A total of 12 studies were eligible for further analyses. A laparoscopic colectomy was the most common operation performed in the SEMS group, whereas the traditional open approach was commonly used in the ES group. Intraoperative colonic lavage was seldomly performed during ES. There were no differences in mortality rates between the two groups (RR 1.06, 95% CI 0.55 to 2.04; I2 = 0%). In the SEMS group, the rate of successful primary anastomosis was significantly higher in of SEMS (69.75%) than in the ES (55.07%) (RR 1.26, 95% 245 CI 1.01 to 1.57; I2 = 86%). Conversely, the upfront Hartmann procedure was performed more frequently in the ES (39.1%) as compared to the SEMS group (23.4%) (RR 0.61, 95% CI 0.45 to 0.85; I2 = 23%). The overall postoperative complications rate was significantly lower in the SEMS group (32.74%) than in the ES group (48.25%) (RR 0.61, 95% CI 0.41 to 0.91; I2 = 65%). Conclusions: In the presence of malignant colorectal obstruction, SEMS is safe and associated with the same mortality and significantly lower morbidity than the ES group. The rate of successful primary anastomosis was significantly higher than the ES group. Nevertheless, recurrence and survival outcomes are not significantly different between the two groups. The analysis of short- and long-term results can suggest the use of SEMS as a bridge to resective surgery when it is performed by an endoscopist with adequate expertise in both colonoscopy and fluoroscopic techniques and who performed commonly colonic stenting.

Laparoscopic posterior sectoral bile duct injury: the emerging role of nonoperative management with improved long-term results after delayed diagnosis

2011 ◽  
Vol 25 (8) ◽  
pp. 2684-2691 ◽  
Author(s):  
M. T. P. R. Perera ◽  
A. Monaco ◽  
M. A. Silva ◽  
S. R. Bramhall ◽  
A. D. Mayer ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Nonoperative Management ◽  
Delayed Diagnosis ◽  
Long Term Results

scholarly journals Failure of Colorectal Anastomosis: Risk Factors, Prevention, Diagnosis, Therapeutic Tactics

2019 ◽  
Vol 29 (2) ◽  
pp. 27-34 ◽  
Author(s):  
M. F. Cherkasov ◽  
A. V. Dmitriev ◽  
V. S. Groshilin ◽  
S. V. Pereskokov ◽  
M. A. Kozyrevskiy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anastomotic Leakage ◽  
Rectal Resection ◽  
Intestinal Anastomosis ◽  
Colorectal Anastomosis ◽  
Long Term Results ◽  
Individual Consideration ◽  
Independent Risk Factors ◽  
Almost All

Aim. To analyse and generalize available literature data on the problem of colorectal anastomotic leakage after rectal resection. Key findings. Over the last decade, there has been an increasing trend towards sphincter-preserving operations in modern colorectal surgery. The widespread use of suturing devices of various diameters allows the formation of ultra-low anastomoses (at the level of the pelvic floor). One of the menacing complications after rectal resection is anastomotic leakage, which frequency can reach 21%. The mortality from anastomotic leakage can reach 40%. The analysed literature sources discuss a variety of risk factors, both preoperative and intraoperative, affecting the healing of the inter-intestinal anastomosis. In almost all studies, the height of the tumour and the anastomosis from the anus, preoperative radiotherapy and male sex are independent risk factors for the development of colorectal anastomotic leakage. Concerning other factors, there are conflicting opinions. The timely use of preventive measures and early diagnosis of colorectal anastomotic leakage can reduce the number and severity of postoperative complications.Conclusion. Individual consideration of risk factors and their adequate assessment in terms of possible complications are decisive in the choice of the extent of surgical intervention, which will undoubtedly improve the immediate and long-term results of the surgical treatment of colorectal cancer. 

Best Treatment of Saphenous Vein Graft Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 46 ◽  
Author(s):  
Paolo Sbarzaglia ◽  
Salvatore Notaristefano ◽  
Claudio Cavallini ◽  
◽  
◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Long Term Results ◽  
Attractive Alternative ◽  
Late Restenosis ◽  
Almost All

When used as conduits for coronary artery bypass surgery, saphenous vein grafts (SVG) develop atherosclerotic disease that may result in stenosis or occlusion in 50% of patients by 10 years. SVG intervention has become an attractive alternative to reoperation in these patients, but is associated with less favourable acute and long-term outcomes compared with percutaneous coronary intervention (PCI) of native vessels due to a higher incidence of periprocedural micro-embolisation and of late restenosis. The role of protection devices that reduce distal embolisation and no-reflow phenomenon has been well established, and they now represent a ‘must’ for almost all of the procedures of PCI in SVG. The potential role of drug-eluting stents (DES) in improving long-term results of SVG intervention is still debated and, to date, there is no clear evidence of their benefit in relevant clinical end-point. The aim of this article is to examine the best available therapeutic options for patients undergoing PCI of SVG lesions.

Successful Treatment of Idiopathic Laryngotracheal Stenosis by Resection and Primary Anastomosis

2003 ◽  
Vol 112 (9) ◽  
pp. 798-800 ◽  
Author(s):  
Hermes C. Grillo ◽  
Douglas J. Mathisen ◽  
Cameron D. Wright ◽  
Simon K. Ashiku ◽  
John C. Wain
Keyword(s):  
Surgical Treatment ◽  
Successful Treatment ◽  
Primary Anastomosis ◽  
Tracheal Resection ◽  
Laryngotracheal Stenosis ◽  
Term Response

We studied the early and long-term response of idiopathic laryngotracheal stenosis (ILTS) to treatment by 1-stage laryngotracheal or tracheal resection and reconstruction in 73 patients. Nineteen of the 72 (26%) noted no difference in their voices or any difficulty in breathing after reconstruction. Forty-seven (64%) described loss of ability to project their voices as loudly as before or noted some difficulty in singing as well as they did before. Five (7%) had various degrees of dyspnea or stridor on effort. One needed continued dilation. The median follow-up was 8 years. Surgical treatment gave good or excellent results in 90% of these patients with ILTS. Recurrence or progression of stenosis was not evident.

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