scholarly journals Experience of Laparoscopic Exploration and Gonadectomy in lntersex Children

1998 ◽  
Vol 4 (3) ◽  
pp. 127-133 ◽  
Author(s):  
Ken Morita ◽  
Katsuya Nonomura ◽  
Kaname Ameda ◽  
Hidehiro Kakizaki ◽  
Toshiki Koyama ◽  
...  
Keyword(s):  
Time Use ◽  
Gonadal Dysgenesis ◽  
Operation Time ◽  
Laparoscopic Technique ◽  
Laparoscopic Exploration ◽  
Cosmetic Appearance ◽  
Xy Gonadal Dysgenesis ◽  
Abdominal Exploration ◽  
Group 2 ◽  
Group 1

The use of laparoscopic technique to diagnose and treat intersex children is gradually introduced in clinical urology. From 1985 to 1996, abdominal exploration and gonadectomy were performed in 11 intersex children together with urogenital endoscopy and genitoplastic surgery in our institutes. Their median age was 6.0 (range 0–15) years old and initial gender sex was female in 8 and male in 3. The initial 4 cases (group 1) underwent open abdominal exploration together with gonadectomy, while the latter 7 cases (group 2) underwent laparoscopic exploration simultaneously with 3 laparoscopic gonadectomy and 1 open one via a inguinal incision. Their final diagnoses were male pseudohermaphroditism in 4 cases, mixed gonadal dysgenesis in 3, true hermaphroditism in 2, XX gonadal dysgenesis in 1, and XY gonadal dysgenesis in 1. Consequently, 2 of initial male were reared as a female. Operation time, use of analgesics, postoperative hospital stay and postoperative complications were not significantly different between the two groups, however, postoperative abdominal wound appearance was more acceptable in group 2. The most significant advantage of laparoscopic surgery in intersex children is cosmetic appearance especially when social gender is determined as female irrespective types of intersexuality.

scholarly journals Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

2018 ◽  
pp. 1
Author(s):  
Baris Buke ◽  
Hatice Akkaya ◽  
Cigdem Karakukcu
Keyword(s):  
Cesarean Section ◽  
Inflammatory Reaction ◽  
Operation Time ◽  
Blood Samples ◽  
Inflammatory Reactions ◽  
Tnf Α ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Group 1

<p><strong>Objectives:</strong> There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels.<br />To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.</p><p><strong>Study Desıgn:</strong> The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.</p><p><strong>Results:</strong> There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).</p><p><strong>Conclusions:</strong> The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.</p>

scholarly journals Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877089 ◽  
Author(s):  
Cen Tao Liu ◽  
Heng an Ge ◽  
Rui Hu ◽  
Jing Biao Huang ◽  
Yi Chao Cheng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Pain Score ◽  
Operation Time ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Single Row ◽  
Repair Technique ◽  
Randomized Controlled Studies ◽  
Group 2 ◽  
Group 1

Background: The comparison of clinical outcomes of arthroscopic footprint-preserving knotless single-row repair with the tear completion repair technique for articular-sided partial-thickness rotator cuff tears (PTRCTs) remains unclear. Methods: A total of 68 patients diagnosed with articular-sided PTRCTs who underwent rotator cuff repair between December 2014 and June 2015 were included. Of the 68 patients, 30 received footprint-preserving knotless single-row repair (group 1) and 38 received the tear completion repair technique (group 2). Preoperative and postoperative assessments were compared. Results: Both groups had significantly improved American Shoulder and Elbow Surgeons (ASES) scores (group 1: 48.2 preoperatively to 81.9 postoperatively, p < 0.001; group 2: 47.1 preoperatively to 84.9 postoperatively, p < 0.001) and visual analog scale (VAS) pain score (group 1: 6.0 preoperatively to 0.93 postoperatively, p < 0.001; group 2: 6.1 preoperatively to 1.1 postoperatively, p < 0.001), showing that the two procedures significantly improved postoperative shoulder function. No significant differences were shown in ASES score or VAS pain score between the two groups ( p > 0.05). The mean operation time was significantly shorter in group 1 with an average of 48.1 min than in group 2 with an average of 60.4 min ( p < 0.001). Conclusions: Footprint-preserving knotless single-row repair obtains similar clinical results compared to tear completion repair in the treatment of articular-sided PTRCTs. Footprint-preserving knotless single-row repair may be a convenient choice for the treatment of articular-sided PTRCTs. Randomized controlled studies are needed to investigate whether the footprint-preserving knotless single-row repair yields better long-term outcomes through the protection of the bursal cuff and restoration of the healthy footprint.

scholarly journals Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

2014 ◽  
Vol 8 (9-10) ◽  
pp. 595 ◽  
Author(s):  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Aslan Demir ◽  
Ramazan Kocaaslan ◽  
Fatih Altunrende
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Statistical Difference ◽  
Preoperative Evaluation ◽  
Operation Time ◽  
Maximum Flow ◽  
Prostatic Hyperplasia ◽  
Group 2 ◽  
Hemoglobin Drop ◽  
Group 1

Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.

scholarly journals Incidence of Meniscal Tears Accompanying ACL Ruptures

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Mehmet Hasan Tatari ◽  
Vugar Guliyev
Keyword(s):  
Statistical Difference ◽  
Meniscal Tear ◽  
Operation Time ◽  
Variance Analysis ◽  
Meniscal Tears ◽  
Chi Square ◽  
Group 3 ◽  
Group 2 ◽  
Bucket Handle ◽  
Group 1

Objectives: Anterior cruciate ligament (ACL) injury is a common disorder in athletes and in most cases, meniscal tears accompany. These meniscal tears can be the result of the initial trauma or the consecutive injuries in the unoperated patients. The aim of the study was to compare the incidence of meniscal tears in the patients operated because of ACL defficiency in the early or late period after the initial trauma. The age of the patient and meniscal tear pattern were the other subjects compared. Methods: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236). Results: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236) Conclusion: We can say that the incidence of meniscal tears can be decreased if the patients with ACL injury are operated early after the initial trauma. Earlier ACL reconstruction means less meniscal tear.

scholarly journals Adrenal Incidentalomas: Should We Operate on Small Tumors in the Era of Laparoscopy?

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Michał Pędziwiatr ◽  
Michał Natkaniec ◽  
Mikhail Kisialeuski ◽  
Piotr Major ◽  
Maciej Matłok ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Operation Time ◽  
Adrenal Tumors ◽  
Estimated Blood Loss ◽  
Important Argument ◽  
Risk Of Malignancy ◽  
Potentially Malignant ◽  
Group 2 ◽  
Histopathological Results ◽  
Group 1

Tumor size smaller than 4 cm as an indication for surgical treatment of incidentaloma is still a subject of discussion. Our aim was the estimation of the incidence of malignancy and analysis of treatment outcomes in patients with incidentaloma smaller than 4 cm in comparison to bigger lesions. 132 patients who underwent laparoscopic adrenalectomy for nonsecreting tumors were divided into two groups: group 1 (55 pts., size < = 40 mm) and group 2 (77 pts., size > 40 mm). Operation parameters and histopathological results were analyzed. No differences in group characteristics, mean operation time, and estimated blood loss were noted. Complications in groups 1 and 2 occurred in 3.6% and 5.2% of patients, respectively (P=0.67). Malignancy in groups 1 and 2 was present in 1 and 6 patients, respectively (P=0.13). Potentially malignant lesions were identified in 4 patients in group 1 and 4 patients in group 2 (P=0.39). The results do not allow for straightforward recommendations for surgical treatment of smaller adrenal tumors. The safety of laparoscopy and minimal, but impossible to omit, risk of malignancy support decisions for surgery. On the other hand, the risk of malignancy in smaller adrenal tumors is lower than surgical complications, which provides an important argument against surgery.

Percutaneous-Based Management of Staghorn Calculi in Solitary Kidney: Combined Mini Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery

2014 ◽  
Vol 94 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Wen Zhong ◽  
Zhijian Zhao ◽  
Liang Wang ◽  
Sunil Swami ◽  
Guohua Zeng
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Solitary Kidney ◽  
Retrograde Intrarenal Surgery ◽  
Staghorn Calculi ◽  
Combined Use ◽  
Stone Free Rate ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

Introduction: Mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are well-established techniques with little morbidity. The combined use of standard PCNL and the mini-PCNL or the RIRS technique was evaluated and compared to investigate their own role in the management of staghorn calculi in solitary kidney. Materials and Methods: 23 patients received combined standard PCNL and mini-PCNL (group 1), and 22 patients received combined standard PCNL and RIRS (group 2). The treatment results and complications were evaluated and compared. Results: The mean operation time was 128.8 ± 9.1 min in group 1 and 109.8 ± 10.7 min in group 2 (p < 0.001). The decrease in hemoglobin level in group 1 was significantly higher than that in group 2 (3.5 ± 0.6 vs. 2.1 ± 0.5 g/dl, p < 0.001). The final stone-free rate was significantly higher (p = 0.038) in group 2 (90.9%) than in group 1 (65.2%). Conclusions: Combined standard PCNL and RIRS technique can extract the majority of staghorn calculi quickly by PCNL with EMS Lithoclast, and RIRS used simultaneously can reduce the need for multiple tracts and therefore reduce blood loss and potential morbidity related to multiple tracts, shorten the operation time and achieve a high stone-free rate.

scholarly journals Which factors affect the success of pediatric PCNL? Single center experience over 20 years

2020 ◽  
Vol 92 (4) ◽  
Author(s):  
Volkan Izol ◽  
Nihat Satar ◽  
Yıldırım Bayazit ◽  
Fatih Gokalp ◽  
Nebil Akdogan ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Pediatric Patients ◽  
Operation Time ◽  
Fluoroscopy Time ◽  
Postoperative Blood Transfusion ◽  
Group 2 ◽  
Group 1

Objective: We aimed to investigate the impact of surgeons’ experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. Materials and methods: Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. Results: Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). Conclusions: The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.

scholarly journals Is routine ureteral stenting really necessary after retrograde intrarenal surgery?

2015 ◽  
Vol 87 (1) ◽  
pp. 72 ◽  
Author(s):  
Ekrem Ozyuvali ◽  
Berkan Resorlu ◽  
Ural Oguz ◽  
Yildiray Yildiz ◽  
Tolga Sahin ◽  
...  
Keyword(s):  
Renal Colic ◽  
Operation Time ◽  
Stent Insertion ◽  
Dimension Stone ◽  
Retrograde Intrarenal Surgery ◽  
Residual Stone ◽  
Double J Stent ◽  
Group 2 ◽  
Free Status ◽  
Group 1

Objectives: To investigate the situations in which ureteral double-J stent should be used after retrograde intrarenal surgery (RIRS). Patients and Methods: Patients with no ureteral double-J stent after RIRS constituted Group 1, and those with double- J stent after RIRS constituted Group 2. Patients’ age and gender, renal stone characteristics (location and dimension), stone-free status, VAS score 8 hours after surgery, post-procedural renal colic attacks, length of hospitalization, requirement for re-hospitalization, time to rehospitalization and secondary procedure requirements were analyzed. Results: RIRS was performed on 162 renal units. Double-J stent was used in 121 (74.6%) of these after RIRS, but not in the other 41 (25.4%). At radiological monitoring at the first month postoperatively after RIRS, complete stone-free status was determined in 122 (75.3%) renal units, while residual stone was present in 40 (24.6%). No significant differences were observed between the groups in terms of duration of fluoroscopy (p = 0.142), operation (p = 0.108) or hospitalization times (p = 0.798). VAS values determined routinely on the evening of surgery were significantly higher in Group 1 than in Group 2 (p = 0.025). Twenty-eight (17.2%) presentations were made to the emergency clinic due to renal colic within 1 month after surgery. Double-J catheter was present in 24 (85.7%) of these patients. Conclusions: Routine double-J stent insertion after RIRS is not essential since it increases costs, morbidity and operation time.

scholarly journals Salvage Holmium laser enucleation of prostate to treat recurring benign prostatic hyperplasia

2014 ◽  
Vol 8 (3-4) ◽  
pp. 235 ◽  
Author(s):  
Jin Kyu Oh ◽  
Jungbum Bae ◽  
Chang Wook Jeong ◽  
Jae-Seung Paick ◽  
Seung-June Oh
Keyword(s):  
Operation Time ◽  
Holmium Laser ◽  
Time Duration ◽  
Prostate Hyperplasia ◽  
Laser Enucleation ◽  
Group 2 ◽  
Benign Prostate ◽  
Holmium Laser Enucleation ◽  
Anatomical Plane ◽  
Group 1

Introduction: The Holmium laser enucleation of the prostate (HoLEP) technique to remove residual adenoma has not been reported. Salvage HoLEP enables anatomical enucleation of residual adenoma in patients who have previously undergone surgical treatment. We describe not only anatomical insights into the frequent location of adenoma recurrence, but also the feasibility of the salvage HoLEP technique.Methods: We retrospectively reviewed a database containing HoLEP video records for 35 patients out of a total of 535 individuals on whom HoLEP was performed by 2 surgeons (SJO & JSP) between July 2008 and June 2011. Group 1 consisted of patients who underwent salvage HoLEP due to recurring adenoma and Group 2 of patients who underwent HoLEP as an initially surgical management to treat benign prostate hyperplasia (BPH). We compared the dataset of pre-, intra- and postoperative parameters between Groups 1 and 2.Results: In the analysis of the video records of Group 1 (n = 35), there was significant remnant tissue around the verumontanum and the lateral lobes were also incompletely removed by previous conventional procedures. When we compared pre-, intra- and postoperative parameters between the 2 groups, there were no significant differences, including operation time, duration of hospital stay. However, the duration of the catheterization of Group 1 was shorter than that of Group 2 (1.38 ± 0.55 vs. 1.90 ± 1.81 days, p < 0.001).Conclusions: Even for cases of residual BPH, salvage HoLEP is a feasible and effective procedure for treating residual adenoma along the anatomical plane.

Sign in / Sign up

Export Citation Format

Share Document