scholarly journals Video-Assisted Thyroidectomy Using a Surgical Energy Device: Initial Experience in a Japanese Single-Center Cohort

2021 ◽  
pp. 153-157
Author(s):  
Jun-ichi Ohkubo ◽  
Tetsuro Wakasugi ◽  
Shoko Takeuchi ◽  
Shoichi Hasegawa ◽  
Azusa Takahashi ◽  
...  
Keyword(s):  
Demographic Data ◽  
Operation Time ◽  
Time Range ◽  
Initial Experience ◽  
Energy Devices ◽  
Parathyroid Tumors ◽  
Video Assisted ◽  
Hospitalization Period ◽  
Indwelling Time ◽  
Surgical Energy

<b><i>Objective:</i></b> Video-assisted thyroidectomy (VAT) was approved for coverage under the Japanese public health insurance system in 2016. In our department, we introduced VAT in 2018, and we have since been performing the procedure with the assistance of surgical energy devices. We herein summarize our cases undergoing VAT, including a review of points to consider when introducing the procedure, and characteristics of the surgical energy devices. <b><i>Methods:</i></b> We enrolled 24 patients (14 women and 10 men; age: 24–83 years; mean: 59.0 years) with thyroid/parathyroid tumors who underwent VAT between January 2018 and March 2021 at our department. The medical records of the patients were reviewed, and demographic data, clinical characteristics, histological type, treatment outcomes, and complications were analyzed. <b><i>Results:</i></b> The surgical energy devices used were LigaSure® in the first 4 cases, Acrosurg®. Scissors S17 in the next 13 cases, and Acrosurg®. Revo S15 in the latest 7 cases. The operation time (range: 72–250 min; mean: 147 min), intraoperative blood loss (range: 5–370 mL; mean: 33 mL), indwelling time of wound drain (range: 2–6 days; mean: 3.5 days), and hospitalization period (range: 3–8 days; mean: 5.5 days) were within acceptable ranges. In this study, it is suggested that Acrosurg®. Revo S15 can shorten the indwelling time and the hospitalization period. There were no serious complications, but 1 patient developed transient vocal cord paralysis, which improved 3 months after surgery. It was suggested that the microwave energy devices, Acrosurg®. Scissors S17 and Acrosurg®. Revo S15, may be more effective with respect to sealing/hemostasis/coagulation capacity and controllability than the high-frequency electrosurgical device, LigaSure®. <b><i>Conclusion:</i></b> Based on this initial experience, VAT using surgical energy devices appeared to be a safe, effective, and minimally invasive procedure for the treatment of thyroid/parathyroid tumors. Further studies confirming these early findings are needed.

Initial experience with video-assisted thoracoscopic lobectomy

1993 ◽  
Vol 56 (6) ◽  
pp. 1248-1253 ◽  
Author(s):  
Thomas J. Kirby ◽  
Michael J. Mack ◽  
Rodney J. Landreneau ◽  
Thomas W. Rice
Keyword(s):  
Initial Experience ◽  
Video Assisted ◽  
Thoracoscopic Lobectomy

Video-assisted central compartment lymphadenectomy in a patient with a positive RET oncogene: initial experience

2006 ◽  
Vol 21 (1) ◽  
pp. 120-123 ◽  
Author(s):  
P. Miccoli ◽  
R. Elisei ◽  
G. Donatini ◽  
G. Materazzi ◽  
P. Berti
Keyword(s):  
Central Compartment ◽  
Initial Experience ◽  
Video Assisted ◽  
Ret Oncogene

Analysis of Risk Factors of Intracranial Infection After Traumatic Brain Injury Surgery

2021 ◽  
Vol 7 (5) ◽  
pp. 3161-3167
Author(s):  
JiNan Li ◽  
XinLi Zhang ◽  
Hang SU ◽  
YaNan Qu ◽  
MeiXuan Piao
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Cerebrospinal Fluid ◽  
Brain Injury ◽  
Operation Time ◽  
Cerebrospinal Fluid Leakage ◽  
Infection Group ◽  
Intracranial Infection ◽  
Indwelling Time

Background: Craniocerebral operation is the main method for the treatment of traumatic brain injury. However, it is very easy to be complicated with intracranial infection after operation, which affects the surgical efficacy and patient’s prognosis. It is also the main cause of surgical failure. It may also cause patient’s death for some patients with serious diseases. It is found that the infection after craniocerebral operation is often accompanied with abnormal changes of body-related treatment, in which the changes of serological indicators are more significant. Therefore, it is helpful to provide guidance for the prevention and judgment of patient’s postoperative infection by analyzing the patient’s serological indicators. Objective: To investigate the risk factors of intracranial infection and the levels of serum procalcitonin (PCT) and endothelin-1 (ET-1) in patients after traumatic brain injury. Methods: From January 2018 to January 2021, 58 patients with intracranial infection after traumatic brain injury (infection group) were selected, and 116 patients without intracranial infection after traumatic brain injury (non-infection group) were selected. The difference of clinical data between the two groups was analyzed. Serum PCT and ET-1 levels were measured in the two groups. Results: In the infection group, admission GCS scoring <8 points, operation time ≥4h, indwelling time of drainage tube ≥ 2d, preoperative ALB <35g/ L, mechanical ventilation and cerebrospinal fluid leakage were 63.79%, 72.41%, 43.10%, 68.97%, 32.76% and 68.97% respectively, which were obviously higher than those in the non-infection group (P<0.05). Logistic regression analysis results showed that admission GCS scoring, operation time, indwelling time of drainage tube, preoperative ALB, mechanical ventilation and cerebrospinal fluid leakage were the influencing factors of intracranial infection after traumatic brain injury (OR = 0.712,1.556,1.451,0.641,1.954 and 1.667, P<0.05); serum PCT and ET-1 in the infection group were (0.83 ± 0.20) mg/L and (0.87 ± 0.23) ng/L, respectively, which were significantly higher than those in the non-infection group (P<0.05); serum PCT and ET-1 in patients with different sex, age and pathogen had no significant difference (P>0.05); serum PCT and ET-1 area under ROC curve were 0.828 and 0.751, respectively P<0.05. Conclusion: The intracranial infection of patients with traumatic brain injury are affected by many factors including, admission GCS scoring, operation time, and so on, the levels of serum PCT and ET-1 in patients with intracranial infection are increased, which may be useful in predicting intracranial infection.

Epidemiology and Pattern of Thromboembolism in Aseer Central Hospital, a Multispecialty Hospital in Aseer Region, Abha in Southern Saudi Arabia

2020 ◽  
Author(s):  
Aziz S
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Demographic Data ◽  
Venous Blood ◽  
Pulmonary Veins ◽  
Lower Limbs ◽  
Central Hospital ◽  
Vein Thrombosis ◽  
Hospitalization Period ◽  
Deep Vein

Background: Venous Thromboembolism (VTE) is a clinical disorder characterized by the pathological occurrence of single or many thrombi developing mainly in the deep veins of the lower limbs and pulmonary veins but also other parts of the venous circulation, albeit less. A frequently occurring venous thrombosis is a deep vein thrombosis (DVT), which is the presence of thrombus in deep veins of the lower extremity. Once this clot fragment is swept off (embolism), it moves along with the venous blood and flows to the pulmonary vessels, where it may result in a clinically significant disorder called pulmonary thromboembolism (PTE). Thrombosis occurring in the superficial veins would only cause discomfort but generally with insignificant consequences. Aim: This study aimed to assess patterns and risk factors of venous thromboembolism (VTE) among patients in the Aseer region. Methodology: A record-based descriptive analysis (retrospective) was used in this study. The clinical study targeted the patients with venous thromboembolism (VTE including PE & DVT) either admitted with the diagnosis or complicated during the hospitalization period in Aseer Central Hospital during the period from January 2010 to June 2019. Data extracted using pre-structured data collection sheet. The extracted data were patients' bio-demographic data, VTE related data, treatment received and relevant complications of treatment, and patient’s follow-up history. Results: The study included total of 207 patients with thromboembolism. The age of patients was between 15 - 100 years old with the average age being 57.3+12.9 years. Approximately 58% of the patients were female. Deep vein thrombosis (DVT) was recorded in 60.4% of the cases and 27.5% of them were diagnosed with pulmonary embolism (PE) while 12.1% had both PE and DVT. Exact of 59.6% of cases with PE had immobilization history for 24 to 72 hours as compared to 31.2% of DVT and 44% of patients with mixed thromboembolism. DM was recorded among 14% of PE cases and 21.6% of DVT. Warfarin with Enoxaparin was the most frequently given treatment in total (23.2%). Heparin followed by Warfarin was the second most common treatment. Conclusions and recommendation: The study revealed that VTE was commonly reported especially DVT and PE among the recorded cases and it was bilateral in a considerable number of cases. Immobilization with chronic disease and morbid obesity was noted as the most significant predictor for VTE.

Predictive Value of Charlson Comorbidity Index and Cofactors on 2-Year Mortality in Older Patients With Intertrochanteric Fractures: A Retrospective Analysis

2021 ◽  
Author(s):  
Jianda Xu ◽  
Homma Yasuhiro ◽  
Yuta Jinnai ◽  
Tomonori Baba ◽  
Zhuang Xu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Older Patients ◽  
Demographic Data ◽  
Survival Rates ◽  
Operation Time ◽  
Intertrochanteric Fractures ◽  
Time Out ◽  
Time Operation ◽  
Significant Difference ◽  
First Time

Abstract The aim of this study was to evaluate the role of Charlson comorbidities index (CCI) and cofactors on 2-year mortality in older patients with intertrochanteric fractures. 60 cases with unilateral intertrochanteric fracture were retrospectively analyzed and divided into Low-CCI group (CCI: 1-4) or high-CCI groups (CCI: 5-6). All the patients’ electronic hospital records were reviewed. The preoperative situations (demographic data, comorbidities and fracture conditions), perioperative situations (wait time, operation time, implant choice, blood loss, transfusion or not) and postoperative situations (complications, first time out of bed, function about 1-/2- week and 2-year mortality) were recorded. 51.67% were in low-CCI group and 48.33% in high-CCI group. The survival rates in low- and high-CCI group were 93.5% and 86.2 % respectively. According to the functional results of 1- or 2- week after operation, no significant difference was found (P=0.955, 0.140). Log-rank analysis showed that the main prognostic factors were blood loss, first time out of bed and complication (P<0.05). Multivariate analysis confirmed that complication and first time out of bed were significant factor on survival rate (P=0.029, 0.010). Charlson comorbidities index maybe not the indicator of 2-year mortality in older patients with intertrochanteric fractures. In order to improve the prognosis, more attentions should be paid to reduce the complications and encourage postoperative earlier excise out of bed.

scholarly journals Effect of pre-administration with aminophylline on the occurrence of post-dural puncture headache in women undergoing caesarean section by combined spinal-epidural anaesthesia

2018 ◽  
Vol 47 (1) ◽  
pp. 420-426
Author(s):  
Chao-Jie Yang ◽  
Tao Chen ◽  
Xin Ni ◽  
Wan-You Yu ◽  
Wei Wang
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Dural Puncture ◽  
Demographic Data ◽  
Operation Time ◽  
Post Dural Puncture Headache ◽  
Combined Spinal Epidural ◽  
Group A ◽  
Spinal Epidural

Objective To investigate the effect of the pre-administration with aminophylline on the occurrence of post-dural puncture headache (PDPH) in women undergoing caesarean section by combined spinal-epidural anaesthesia (CSEA). Methods The study enrolled women undergoing elective caesarean sections with CSEA and randomly allocated them into two groups; for 30 min immediately after the infant was delivered, group A received 250 mg aminophylline intravenously and group B received an equal volume of normal saline. Demographic data, operation time, intraoperative blood loss, intraoperative transfusion volume and the occurrence of PDPH during the first 7 days after the operation were recorded. Side-effects such as hypersensitivity, convulsion and arrhythmia were also recorded in the patients and infants in group A within 24 h after aminophylline administration. Results A total of 120 patients aged 24–38 years (pregnancy range, 38–42 weeks) were randomly allocated into two groups ( n = 60). The incidence of PDPH in group A was significantly lower than group C (two of 59 [3.4%] versus 10 of 58 [17.2%], respectively). There were no related side-effects within 24 h after aminophylline administration in group A. Conclusions Intraoperative intravenous infusion of 250 mg aminophylline reduced the incidence of PDPH after caesarean section under CSEA with no side-effects.

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