Observation on the Curative Effect of Microsurgery in 154 Children with Strabismus and Analysis of Its Influencing Factors

Strabismus is a common ophthalmic disease in the process of child body development, in which the two eyes cannot gaze at the target at the same time, and the incidence of this disease of children is higher. In children with esotropia, exotropia, and up and down strabismus and other typical symptoms, the cause is genetic, innerve, and refractive and regulated, and not receiving timely treatment may lead to stereo vision and diplopia and other phenomena, affecting their learning and life. Surgical treatment is the main treatment for strabismus at present. Traditional orthodontic surgery is performed by doctors under the naked eye, often due to improper operation or suture error and other factors, resulting in more postoperative complications, such as more tissue damage, conjunctival congestion, and muscle suture reaction, which seriously affect the clinical effect of surgical treatment. In recent years, with the continuous development of microsurgical technology, the correction of strabismus under a microscope has been widely carried out in clinic. The operation under the microscope makes the operation more delicate and accurate, overcomes the defects of traditional surgery, and highlights the advantages of minimally invasive surgery. The purpose of this study was to investigate the effect of microsurgical techniques in the treatment of strabismus in children and to analyze the factors influencing the outcome. The results showed that microsurgical strabismus correction in the treatment of strabismus children has short operation time, less intraoperative blood loss, short hospital stay, high efficiency, and less complications, which is worthy of popularization. Age, preoperative strabismus angle, refractive error, distance stereopsis injury, near stereoscopic injury, and duration of disease were all independent influencing factors of postoperative efficacy.

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MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00021 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0002

Author(s):

Brendon C. Mitchell ◽

Matthew Y. Siow ◽

Alyssa Carrol ◽

Andrew T. Pennock ◽

Eric W. Edmonds

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Shoulder Instability ◽

Surgical Intervention ◽

Operation Time ◽

Demographic Variables ◽

Return To Sports ◽

Suture Anchors ◽

Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

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Turbinoplasty of hypertrophied inferior turbinate by diode laser

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v16i1.5778 ◽

1970 ◽

Vol 16 (1) ◽

pp. 29-34

Author(s):

Md Rojibul Hoque ◽

Asaduzzaman Rasel ◽

Md Khalid Asad ◽

Moni Lal Aich

Keyword(s):

Diode Laser ◽

Local Anesthesia ◽

Operation Time ◽

Inferior Turbinate ◽

Complete Relief ◽

Clinical Experiences ◽

Short Operation Time ◽

The Mean ◽

Conventional Radiology

Background: Different laser types have been used for the treatment of hypertrophied inferiornasal turbinates. The clinical experiences of its treatment by means of a diode laser are presented.Methods: A total of 45 patients suffering from nasal obstruction due to hypertrophied inferiorturbinates (HIT) were treated with a continuous diode laser (14 W- 940 nm) in "contact" modeand under local anesthesia. Thirty patients (16 with allergic rhinitis and 14 with vasomotorrhinitis) were included into this clinical trial with a follow-up of 6 months. The study wasconducted by a questionnaire, photo documentation, conventional radiology of the paranasalsinuses, and histology.Results: The mean operation time took 8 min/turbinate, no nasal packing was necessary andno immediate complications (e.g., bleeding) were observed. Statistical analysis revealedsignificant subjective improvement (86%) of the nasal airflow and nasal cavity volume (photodocumentation) 6 months after laser surgery. In addition, complete relief of headache wasachieved in 32%. The remission rates of persistent rhinorrhoea and post-nasal dripping were,at about 88% and 64%, respectively. Atrophic change and synechiae had not been observed.Conclusions: Diode laser treatment of HIT is a useful procedure, which can be performed as anoutpatient surgery under local anesthesia, resulting in a controlled coagulation and ablation of thesoft tissue. The short operation time and the good results provide an excellent patient acceptance.Key words: Diode Laser; Hypertrophied Inferior Turbinate; Turbinoplasty.DOI: 10.3329/bjo.v16i1.5778Bangladesh J Otorhinolaryngol 2010; 16(1): 29-34

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POSSIBILITIES OF USING MINIINVASIVE CATHETER TECHNOLOGIES IN THE TREATMENT OF LUNG BLEEDING

EUREKA Health Sciences ◽

10.21303/2504-5679.2019.001087 ◽

2019 ◽

Vol 6 ◽

pp. 41-48

Author(s):

Kateryna Ponomarova

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Surgical Treatment ◽

Pulmonary Disease ◽

High Efficiency ◽

Bronchial Artery ◽

Pulmonary Hemorrhage ◽

Community Acquired Pneumonia ◽

Chronic Obstructive ◽

Bronchial Arteries ◽

Obstructive Pulmonary Disease

Aim – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. Materials and methods. Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. Results. As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. Conclusion. Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.

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The effectiveness and appropriateness of Interval Laparoscopic Appendectomy on adult appendiceal mass, a retrospective cohort

10.21203/rs.2.14168/v1 ◽

2019 ◽

Author(s):

Shiro Fujihata ◽

Hidehiko Kitagami ◽

Yosuke Kitayama ◽

Ayumi Suzuki ◽

Moritsugu Tanaka ◽

...

Keyword(s):

Surgical Treatment ◽

Laparoscopic Appendectomy ◽

Perioperative Complications ◽

Oral Intake ◽

Operation Time ◽

Appendiceal Mass ◽

Uncomplicated Appendicitis ◽

Objective Parameter ◽

Significant Difference ◽

Non Surgical Treatment

Abstract Background: Appendiceal mass sometimes requires extended resection and difficult to treat postoperative complications. Interval appendectomy has been performed mainly in the field of pediatric surgery to avoid them. Recently, there are a few reports on interval laparoscopic appendectomy (ILA). We examined not only the safety and effectiveness of ILA for adult appendiceal mass (AAM), but also the appropriateness of ILA for which cases should be treated non-surgically for ILA or converted to surgical treatment. Methods: Among 956 appendectomies performed between April 2012 and March 2018, there were 49 cases of AAM, of which 34 cases underwent ILA; ILA group. The safety and efficacy of ILA were examined by comparing with 477 cases of adult uncomplicated appendicitis underwent laparoscopic appendectomy (LA); LA group. The appropriateness of ILA was examined by comparing with the remaining 15 cases of AAM; non-ILA group. Results: The ILA group had a longer operation time than the LA group, but the postoperative hospital stay was shorter, and no significant difference were found in the bleeding volume, the days required for oral intake of solid food, and the perioperative complications. Examining the factors for failure of non-surgical treatment or relapse of inflammation during interval period, higher WBC day3 / day0 was found to be an independent risk factor. Conclusion: ILA against AAM was almost as safe and effective as LA for adult uncomplicated appendicitis. WBC day3 / day0 may be effective as an objective parameter for judging the termination of non-surgical treatment for ILA. This determination to convert ineffective non-surgical treatment to surgical treatment earlier may reduce the burden on the patient.

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Method of spleen reduction in laparoscopic splenectomy in children with hereditary autoimmune hemolytic anemia

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic710 ◽

2020 ◽

Vol 10 (4) ◽

pp. 429-433

Author(s):

Vyacheslav G. Svarich ◽

Ilya M. Kagantsov ◽

Violetta A. Svarich

Keyword(s):

Surgical Treatment ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Laparoscopic Splenectomy ◽

Surgical Intervention ◽

Abdominal Cavity ◽

Operation Time ◽

Spleen Tissue ◽

Surgical Department ◽

Large Size

Purpose. This study aimed to improve the results of surgical treatment of children with hereditary autoimmune hemolytic anemia by laparoscopic splenectomy. Materials and methods. In the period from 1991 to 2020, a total 47 patients with hereditary autoimmune hemolytic anemia were treated in the surgical department of the Republican Childrens Clinical Hospital of Syktyvkar. Splenectomy was performed by the open method in 25 children, and laparoscopic method in 22 patients. Since 2019, the method of spleen reduction during laparoscopic splenectomy has been used in 3 patients when the large size of the mobilized spleen does not correspond to the size of the endoscopic container. Results. On average, surgical intervention using the above-described method of spleen reduction lasted for 19 2 min lesser than with laparoscopic splenectomy without the above method, due to the possibility of removing a significantly smaller volume of spleen tissue from the endoscopic sac outside the abdominal cavity. However, the most important achievement was the almost complete elimination of the risk of getting free fragments of a pathologically altered spleen with its possible replantation and recurrence of the clinic of autoimmune hemolytic anemia. The postoperative period was smooth, and all patients were discharged at their place of residence 7 days after the laparoscopic splenectomy. Intra-abdominal complications and relapses of the disease associated with the above-described method of operation did not occur in any patient within 612 months postoperative. Conclusion. The proposed method of spleen reduction during laparoscopic splenectomy made it possible to avoid relapses of the disease, reduce the operation time, as a result, improved the results of surgical treatment in children with hereditary autoimmune hemolytic anemia.

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Method of surgical treatment of the saddle nose deformity

Russian otorhinolaryngology ◽

10.18692/1810-4800-2021-4-43-47 ◽

2021 ◽

Vol 20 (4) ◽

pp. 43-47

Author(s):

D. S. Pshennikov ◽

◽

Z. M. Abdulaev ◽

◽

Keyword(s):

Surgical Treatment ◽

Local Anesthesia ◽

Nasal Septum ◽

Soft Tissues ◽

Operation Time ◽

Functional Results ◽

Nasal Dorsum ◽

Superficial Musculoaponeurotic System ◽

Saddle Nose Deformity ◽

External Nose

Saddle deformity of the external nose, which is a consequence of trauma, is usually combined with a nasal septal deviation and is quite widespread in the population. The problem of surgical treatment of this group of patients lies not only in the technical complexity, trauma of the proposed methods but also in the need to carry out significant interventions under general anesthesia, which limits the use of available techniques by a wide number of ENT surgeons, increases the duration of the operation, recovery time and temporary disability of the patient. The invention aims to improve surgical treatment of patients with saddle nasal deformity by providing stable cosmetic and functional results. Materials and methods: The proposed method of surgical treatment of saddle deformity of nasal dorsum includes several stages. Cartilage autograft taken from nasal septum during septoplasty is milled to 0,5–1,0 mm, mixed with 0,5 ml of latex tissue glue (LTG) having hemostatic and antiseptic properties due to aminocaproic acid and dioxidine content, respectively. This mixture is kept for 5 minutes and delivered to the pocket formed under the SMAS (superficial musculoaponeurotic system) layer in the soft tissues of the dorsum of the external nose, after which the final shape of the nose is simulated and fixed with a plaster splint for a week. Results: Based on the department of otolaryngology of Semashko Ryazan Regional Clinical Hospital, for the period from 2012 to 2019, 17 patients were treated with a diagnosis: saddle deformity of the external nose and nasal septum deviation. All patients underwent rhinoseptoplasty under local anesthesia using LTG as described above. No complications were observed in the postoperative period. During follow-up from 7 to 24 months, patients retain constant functional and cosmetic results. Conclusions. This method is a simple, low-traumatic one of surgical treatment of saddle deformity of the nasal dorsum, which allows reducing the operation time, performing it under local anesthesia and obtaining good cosmetic and functional results. The technical simplicity and accessibility of the method make it possible to use it in hospitals engaged in the surgical treatment of nasal diseases.

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Combined supra/infratentorial approach to tentorial meningiomas

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000100010 ◽

2005 ◽

Vol 63 (1) ◽

pp. 50-54 ◽

Cited By ~ 4

Author(s):

Igor de Castro ◽

Daniel de Holanda Christoph ◽

José Alberto Landeiro

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Occipital Lobe ◽

Transverse Sinus ◽

Surgical Removal ◽

Tentorial Meningioma ◽

Operative Evaluation ◽

Unique Approach ◽

Microsurgical Techniques ◽

Brain Retraction

In spite of significant advancements in imaging technology, monitoring, and microsurgical techniques, complete and safe removal of tentorial meningiomas remains a challenge for most neurosurgeons. Classifications of tentorial meningiomas are revised. The combined supra/infratentorial approach to resects tentorial meningioma is discussed. This approach provides a wider exposure of the supra/infratentorial region with less brain retraction. With this approach the occipital lobe and the cerebellum are exposed along the tentorium. Two illustrative cases are presented. The patients were studied with computerized tomography, magnetic resonance and angiography. The anatomy of the transverse sinus and the confluence of the sinus could be appreciated with these studies. The operative technique is described stepwise. Emphasis is placed on pre-operative evaluation and surgical technique, leading to a total surgical removal of the lesion with margins of safety. The goal of surgical treatment of tentorial meningiomas is their complete and safe removal. With this unique approach we sought to confirm that it offers a safe means of resection not only the neoplasm but also the infiltrated dura.

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Threshold Determination for Sharing Bus Rapid Transit–Exclusive Lanes with Conventional Buses

Sustainability ◽

10.3390/su11174592 ◽

2019 ◽

Vol 11 (17) ◽

pp. 4592

Author(s):

Yue ◽

Chen ◽

Yang ◽

Keyword(s):

Influencing Factors ◽

Operation Time ◽

Analytical Models ◽

Bus Rapid Transit ◽

Utilization Rate ◽

Rapid Transit ◽

Multiple Perspectives ◽

The Road ◽

Road Section ◽

Stop Spacing

Sharing bus rapid transit (BRT) exclusive lanes with conventional buses is being considered to solve the problem of low utilization rate of BRT-exclusive lanes. However, the quantitative conditions and threshold that determine when to share need to be study. This paper took the common section of BRT and conventional bus lines as its research object. Practical investigation was conducted to analyze shared characteristics from multiple perspectives and explore influencing factors and mechanisms for sharing implementation. Based on the survey results, analytical models were established to quantify the influencing factors from three perspectives of road section, intersection, and bus stop. We selected departure volume of conventional buses as a threshold index and then summarized the constraints and the calculation process of sharing threshold. Finally, numerical examples of different scenarios were used to verify the feasibility and effectiveness of the method. The operation efficiency of the road section on exclusive lanes was the constraint on the lower limit of the shared threshold, while the upper limit was constrained by queuing probability or bus operation time under different intersections and stop spacing, which can provide reference for the shared setting of exclusive bus lanes.

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A novel model of acellular dermal matrix plug for anal fistula treatment. Report of a case and surgical consideration based on first utility in Poland

Polish Journal of Surgery ◽

10.5604/01.3001.0010.3912 ◽

2017 ◽

Vol 89 (4) ◽

pp. 52-55 ◽

Cited By ~ 1

Author(s):

Adam Bobkiewicz ◽

Łukasz Krokowicz ◽

Maciej Borejsza-Wysocki ◽

Tomasz Banasiewicz

Keyword(s):

Anal Fistula ◽

Operation Time ◽

Acellular Dermal Matrix ◽

Dermal Matrix ◽

Polish Experience ◽

Short Operation Time ◽

New Type ◽

Fistula Treatment ◽

Long Term Observation

Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from collagen material. We are presenting the first Polish experience with a new model of biomaterial plug for the treatment of anal fistula. We also point out key elements of the procedure (both preoperative and intraoperative) associated with this method. In the authors’ opinion, the method is simple, safe and reproducible. Innovative shape of the plug minimizes the risk of its migration and rotation. It also perfectly blends with and adapts to the course and shape of the fistula canal, allowing it to become incorporated and overgrown with tissue in the fistula canal. The relatively short operation time, minor postoperative pain and faster convalescence are with no doubt additional advantages of the method. Long-term observation involving more patients is essential for evaluation of the efficacy of the treatment of fistulas with the new type of plug.

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Surgical Treatment of the Tubal Infertility: Issues and Options

Journal of New Medical Technologies ◽

10.12737/3303 ◽

2014 ◽

Vol 21 (1) ◽

pp. 121-127 ◽

Cited By ~ 2

Author(s):

Яковлева ◽

Natalya Yakovleva

Keyword(s):

Surgical Treatment ◽

Surgical Management ◽

High Efficiency ◽

Assisted Reproductive Technologies ◽

Adhesion Formation ◽

Reproductive Technologies ◽

Postoperative Adhesion ◽

Fallopian Tubes ◽

Tubal Infertility ◽

Surgical Methods

There are two basic principles in the treatment of the tubal infertility: surgery and assisted reproductive technologies. The high efficiency of the surgical methods of the female reproductive functions recovery in comparison with in vitro fertilization is demonstrated in this paper. According to the literature review there are two effective basic surgical methods: microsurgery and endo-video-surgery in the treatment of the patients with tubal infertility. It was demonstrated that the unsuccessful results of the surgical treatment of the patients with tubal infertility are essentially connected to the fallopian tubes reocclusion and adhesive process recurrence in the small pelvis cavity. According to the new literature data, the different intra-operative and postoperative methods of the improvement of the effectiveness of the surgical management of this patient population were analyzed. However the further examinations are necessary, they will determine strict criteria for the treatment method choice of the patients with tubal infertility. The possible ways to increase the surgical management efficiency of the tubal infertility will be the surgical technique development and working out of the new methods of the rehabilitation therapy oriented to the prophylaxis of the fallopian tubes reocclusion, restoration of their functional activity, prophylaxis of the postoperative adhesion formation. The literature data review showed that surgical treatment and assisted reproductive technology must be considered as complement each other methods that may be used particularly and in combination.

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