scholarly journals Open Surgical Excision Versus Endoscopic Radiofrequency Ablation for Piriform Fossa Fistula

2020 ◽  
pp. 014556131989894
Author(s):  
Shilei Pu ◽  
Wanpeng Li ◽  
Hongming Xu ◽  
Liming Zhao ◽  
Xiaojun Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Surgical Excision ◽  
Neck Surgery ◽  
Curative Effect ◽  
Advantages And Disadvantages ◽  
Endoscopic Radiofrequency Ablation ◽  
The Mean

Objectives: The purpose of this study is to explore the curative effect of open surgical excision and endoscopic radiofrequency ablation (RA) in the treatment of piriform fossa fistula (PSF). Methods: Retrospective study of 80 cases of PSF in the Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, from June 2009 to June 2017. Results: In this series, there were 43 males and 37 females, and the mean age was 5.2 years (17 days to 12 years). Surgical excision was performed for 62 patients. Radiofrequency ablation was performed for 18 patients. Six cases of postoperative temporary hoarseness occurred, and the hoarseness rates were not significantly different between the excision and RA groups (6.4% vs 11.1%, respectively, P = .88). Two cases of temporary neck abscess occurred in the RA group. After the mean follow-up period of 3.1 years (1-8 years), no recurrence was found between the excision and RA groups. Conclusions: The curative effect of excision and RA for PSF is not significantly different; each of the 2 methods has its advantages and disadvantages. However, RA for PSF has the merit of being minimally invasive, easy to operate, and safe; this procedure seems to be more suitable in the clinic.

Kirschner Pin Migration Associated with the Sliding Genioplasty

1993 ◽  
Vol 10 (1) ◽  
pp. 15-19
Author(s):  
David J. Gingrass
Keyword(s):  
Retrospective Study ◽  
Bone Plates ◽  
Surgical Indications ◽  
Common Procedure ◽  
Vertical Movements ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Fixation Techniques ◽  
The Mean

The sliding genioplasty for cosmetic augmentation of microgenia is a common procedure performed by maxillofacial and cosmetic surgeons. There are multiple designs for this osteotomy, and multiple fixation techniques proposed, among which include wires, screws, bone plates, and pins. Likewise, there are many advantages and disadvantages to each of the designs and the fixation techniques that will be utilized according to the surgical indications and the surgeon's preference. A techique used at the Medical College of Wisconsin in Milwaukee involves fixation of the osteotomy segments with Kirschner pins placed at multiple divergent angles. This technique allows for placement of the free segments in virtually any location, and provides for a type of rigid stabilization, particularly in large anterior and vertical movements. One criticism that has been suggested with the use of Kirschner pins is the possibility of migration. This retrospective study evaluates 13 patients who underwent augmentation genioplasty, rigidly fixated with Kirschner pins. Twenty-eight total Kirschner pins were placed, with one being removed. The mean postoperative follow-up was 32 months, and the average number of pins placed was 2.15 per patient. It would appear then, from this study, that migration of Kirschner pins when used with the sliding genioplasty, is not a significant postoperative concern.

Ocular dermoids in 13 cats: a multicentre retrospective study

2021 ◽  
pp. 1098612X2110438
Author(s):  
Anaïs Cathelin ◽  
Anne-Sandrine Augsburger ◽  
Jennifer Anne ◽  
Sylvain Medan ◽  
Julien Michel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ocular Surface ◽  
Rare Condition ◽  
Surgical Excision ◽  
Genetic Transmission ◽  
Study Population ◽  
The Mean ◽  
Lost To Follow Up ◽  
Multicentre Retrospective Study

Objectives The aim of this multicentre retrospective study was to review the clinical data, outcomes and histopathological features of cats that had been treated for ocular surface dermoids. Methods Thirteen cats from various private practices in France with a clinical diagnosis of ocular surface dermoid were included in the study. Results The mean age of the study population at the time of diagnosis was 5 months. There were nine males and four females. Three different breeds were, including: domestic shorthair (n = 7), Birman (n = 4) and Havana Brown (n = 2). Two of the four Birmans were related (same sire). The two Havana Browns were also related (same sire). All of the dermoids were unilateral. Five of the dermoids were strictly conjunctival. Four affected both the conjunctiva and the cornea. Three affected both the conjunctiva and the eyelid, and one was strictly corneal. They were located in various positions: temporal (n = 9), inferonasal (n = 1), dorsonasal (n = 1) and dorsotemporal (n = 1). The last dermoid was heterogeneous and involved the nasal, dorsal and temporal quadrants. Concurrent eye diseases were observed in five patients: four cats exhibited associated eyelid agenesis and one cat exhibited persistent iris-to-iris pupillary membranes. Ten dermoids were surgically excised with no recurrences. Surgery was not performed for three cats: one cat died a few days after diagnosis and two cats were lost to follow-up after initial presentation. Conclusions and relevance Ocular surface dermoids are a rare condition in cats that can be treated successfully by surgical excision. Although our study reports only a small number of cases, the observation of ocular surface dermoids in two related cats in two different breeds indicates that genetic transmission is likely.

scholarly journals Minimally invasive chevron/akin osteotomy: radiographic outcomes

2021 ◽  
Vol 15 (2) ◽  
pp. 110-114
Author(s):  
Kepler Alencar Mendes de Carvalho ◽  
Fernando Garnica Torrico ◽  
David Satiro Borges Pereira de Oliveira ◽  
André Donato Baptista
Keyword(s):  
Retrospective Study ◽  
Minimally Invasive ◽  
Hallux Valgus ◽  
Level Of Evidence ◽  
Radiographic Outcomes ◽  
Statistical Relevance ◽  
Akin Osteotomy ◽  
The Mean

Objective: To evaluate radiographic outcomes in patients undergoing minimally invasive Chevron/Akin osteotomy (MICA) for hallux valgus correction. Methods: We have treated 31 patients (40 feet). Preoperative and postoperative hallux metatarsophalangeal angles (hallux valgus angles, HVA), intermetatarsal angles (IMA) between the first and second metatarsals, and distal metatarsal articular angles (DMAA) were followed up for 12 months. Results: The mean age of the patients was 53.2 years. Mean preoperative HVA, IMA, and DMAA values were 28.85°, 15.38°, and 14.35°, respectively. The mean postoperative angles measured after 1 year were 10.60°, 7.95°, and 7.48°. Improvements in HVA, IMA, and DMAA values showed statistical relevance. There were no losses in angular parameters during follow-up. Conclusion: The radiographic outcomes in patients undergoing MICA osteotomy for hallux valgus correction followed up for 12 months showed significant improvements and no recurrence of the deformity. Our results suggest that this technique is effective for correcting hallux valgus. Level of Evidence III; Therapeutic Studies; Comparative Retrospective Study.

scholarly journals Surgical excision of wrist ganglia; literature review and nine-year retrospective study of recurrence and patient satisfaction

2009 ◽  
Vol 1 (1) ◽  
pp. 5 ◽  
Author(s):  
Surjit Lidder
Keyword(s):  
Retrospective Study ◽  
Hand Surgery ◽  
Surgical Excision ◽  
Consecutive Series ◽  
Single Institution ◽  
Recurrence Rates ◽  
The Mean ◽  
Open Excision

The main options for the treatment of wrist ganglia are reassurance, aspiration, arthroscopic resection and open excision. Variations within each option have been described and the literature is clouded by widespread variability in the results reported. We present the results of our own long-term retrospective study, review the literature and question the surgical risks and demands placed on healthcare resources. A retrospective review of the surgical results of dorsal and volar wrist ganglia excision between January 1998 and March 2005 was undertaken at a single institution. Of the 152 patients in this consecutive series, 117 (77%) patients responded to a telephone questionnaire. The mean length of follow-up in this series of 117 patients was 4.2 years (range 1.5-8.7 years). The overall recurrence rate following excision of all wrist ganglia in this series was 41.8 %. When looking just at volar ganglia, the risk of recurrence is higher at 46.8%. Should the ganglion recur, the risk of developing a moderate to severely tender scar is 34.6% and the risk of developing an unsightly scar is 8.2%. This study questions the effectiveness of surgical excision in the treatment of wrist ganglia when performed by a mixture of surgeons in that the recurrence rates are very similar to the rates seen in studies that merely observe or aspirate wrist ganglia. We propose that for symptomatic ganglia, specialists in hand surgery may be more appropriate at treating such a pathology.

scholarly journals Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Won-Suh Choi ◽  
Jin-Sung Kim ◽  
Kyeong-Sik Ryu ◽  
Jung-Woo Hur ◽  
Ji-Hoon Seong ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Sacroiliac Joint ◽  
Invasive Technique ◽  
Bipolar Radiofrequency ◽  
Endoscopic Radiofrequency Ablation ◽  
The Mean ◽  
Preliminary Study ◽  
Lateral Branches ◽  
Duration Of Operation

Background. Radiofrequency ablation (RFA) is a less invasive technique for treatment of sacroiliac joint (SIJ) pain. Objective. To evaluate the feasibility and efficacy of endoscope-guided RFA for the treatment of CLBP from the SIJ complex. Methods. In this retrospective study, the medical records of 17 patients who underwent endoscope-guided RFA of the SIJ complex were reviewed. A bipolar radiofrequency probe was used to lesion the posterior capsule of the SIJ as well as the lateral branches of S1, S2, S3, and the L5 dorsal ramus in multiple locations. We visualized the ablation area using endoscope. We assessed visual analogue scale (VAS) and the Oswestry disability index (ODI) preoperatively, immediately postop, and at 1-, 3-, and 6-month postop outpatient clinic visits. Patient satisfaction of the procedure was assessed in percentages. Results. The mean duration of operation was 20 to 50 minutes. The mean VAS and the ODI scores decreased significantly immediately after the procedure and were kept significantly lower than baseline levels during the follow-up periods. No complications occurred perioperatively and during the follow-up periods. 88.6% of patients were satisfied with the procedure. Conclusions. Our preliminary results suggest that endoscope-guided RFA may be alternative option to treat CLBP secondary to SIJ complex.

Minimally Invasive Transaortic Repair of the Mitral Valve

2011 ◽  
Vol 14 (4) ◽  
pp. 232 ◽  
Author(s):  
Orlando Santana ◽  
Joseph Lamelas
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Operative Mortality ◽  
The Mean ◽  
Transaortic Approach

<p><b>Objective:</b> We retrospectively evaluated the results of an edge-to-edge repair (Alfieri stitch) of the mitral valve performed via a transaortic approach in patients who were undergoing minimally invasive aortic valve replacement.</p><p><b>Methods:</b> From January 2010 to September 2010, 6 patients underwent minimally invasive edge-to-edge repair of the mitral valve via a transaortic approach with concomitant aortic valve replacement. The patients were considered to be candidates for this procedure if they were deemed by the surgeon to be high-risk for a double valve procedure and if on preoperative transesophageal echocardiogram the mitral regurgitation jet originated from the middle portion (A2/P2 segments) of the mitral valve.</p><p><b>Results:</b> There was no operative mortality. Mean cardiopulmonary bypass time was 137 minutes, and mean cross-clamp time was 111 minutes. There was a significant improvement in the mean mitral regurgitation grade, with a mean of 3.8 preoperatively and 0.8 postoperatively. The ejection fraction remained stable, with mean preoperative and postoperative ejection fractions of 43.3% and 47.5%, respectively. Follow-up transthoracic echocardiograms obtained at a mean of 33 days postoperatively (range, 8-108 days) showed no significant worsening of mitral regurgitation.</p><p><b>Conclusion:</b> Transaortic repair of the mitral valve is feasible in patients undergoing minimally invasive aortic valve replacement.</p>

scholarly journals Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lin Yan ◽  
Mingbo Zhang ◽  
Fang Xie ◽  
Jun Ma ◽  
Jing Xiao ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Symptom Score ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Efficacy And Safety ◽  
Thyroid Lobectomy ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

scholarly journals Minimal Invasive Surgery for Gastroesophageal Reflux Disease and Hiatus Hernia—Our Experience: A Case Series with Review of Literature

2021 ◽  
Author(s):  
Rafique Umer Harvitkar ◽  
Abhijit Joshi
Keyword(s):  
Retrospective Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Operating Time ◽  
Type I ◽  
Type Ii ◽  
The Mean ◽  
Gerd Symptoms

Abstract Introduction Laparoscopic fundoplication (LF) has almost completely replaced the open procedure performed for gastroesophageal reflux disease (GERD) and hiatus hernia (HH). Several studies have suggested that long-term results with surgery for GERD are better than a medical line of management. In this retrospective study, we outline our experience with LF over 10 years. Also, we analyze the factors that would help us in better patient selection, thereby positively affecting the outcomes of surgery. Patients and Methods In this retrospective study, we identified 27 patients (14 females and 13 males) operated upon by a single surgeon from 2010 to 2020 at our institution. Out of these, 25 patients (12 females and 13 males) had GERD with type I HH and 2 (both females) had type II HH without GERD. The age range was 24 to 75 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy). A total of 25 patients had various degrees of esophagitis. Two patients had no esophagitis. These patients were analyzed for age, sex, symptoms, preoperative evaluation, exact procedure performed (Nissen’s vs. Toupet’s vs. cruroplasty + gastropexy), morbidity/mortality, and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications, and recurrent symptoms on follow-up. Symptoms were assessed objectively with a score for six classical GERD symptoms preoperatively and on follow-up at 1-, 4- and 6-weeks postsurgery. Further evaluation was performed after 6 months and then annually for 2 years. Results 14 females (53%) and 13 males (48%) with a diagnosis of GERD (with type I HH) and type II HH were operated upon. The mean age was 46 years (24–75 years) and the mean body mass index (BMI) was 27 (18–32). The range of duration of the preoperative symptoms was 6 months to 2 years. The average operating time dropped from 130 minutes for the first 12 cases to 90 minutes for the last 15 cases. The mean hospital stay was 3 days (range: 2–4 days). In the immediate postoperative period, 72% (n = 18) of the patients reported improvement in the GERD symptoms, while 2 (8%) patients described heartburn (grade I, mild, daily) and 1 (4%) patient described bloating (grade I, daily). A total of 5 patients (20%) reported mild dysphagia to solids in the first 2 postoperative weeks. These symptoms settled down after 2 to 5 weeks of postoperative proton-pump inhibitor (PPI) therapy and by adjusting consistency of oral feeds. There was no conversion to open, and we observed no perioperative mortality. There were no patients who underwent redo surgeries in the series. Conclusion LF is a safe and highly effective procedure for a patient with symptoms of GERD, and it gives long-term relief from the symptoms. Stringent selection criteria are necessary to optimize the results of surgery. Experience is associated with a significant reduction of operating time.

scholarly journals 689 Silac (Sinus Laser-Assisted Closure) For Pilonidal Sinus: Our NHS Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kalaskar ◽  
J Adamek
Keyword(s):  
Minimally Invasive ◽  
Success Rate ◽  
Pilonidal Disease ◽  
Surgical Excision ◽  
Pilot Project ◽  
Invasive Technique ◽  
Recurrence Rates ◽  
Pilonidal Cyst ◽  
Primary Wound Closure

Abstract Introduction The accepted treatment of pilonidal disease still consists of surgical excision with primary wound closure. This treatment has complications such as excessive pain, delayed wound healing, and recurrence. We introduced this technique using a radial laser probe (SiLaCTM, Biolitec, Germany). Previous studies have shown encouraging results with respect to safety, patient satisfaction, and minimal recurrence rates. Method The pilot project was planned with the objectives to assess postoperative complications and reoperation rates. All operations were performed as day case procedures under general anaesthesia. We studied the data of our first 25patients operated with this technique between January 2019 and December 2019 using a prospective database and outpatient clinic follow up. Results The median follow up duration was 13 months. The initial success rate was 64%(16/25), reoperation was required in 32%(8/25) and one patient was lost to follow up. one patient returned with abscess formation in the postoperative period. Conclusions SiLaC is a safe and minimally invasive technique for the destruction of the pilonidal cyst and sinus. The success rate is modest, making this new therapy a minimally invasive option for the majority of the patients with pilonidal disease but it should be offered with caution.

Endoscopy-Assisted Achilles Tendon Reconstruction With a Central Turndown Flap and Semitendinosus Augmentation

2016 ◽  
Vol 37 (12) ◽  
pp. 1333-1342 ◽  
Author(s):  
Prashant N. Gedam ◽  
Faizaan M. Rushnaiwala
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Wound Complication ◽  
Reconstruction Technique ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Perioperative Morbidity ◽  
The Mean

Background: The objective of this study was to report the results of a new minimally invasive Achilles reconstruction technique and to assess the perioperative morbidity, medium- to long-term outcomes, and functional results. Methods: Our series was comprised 14 patients (11 men and 3 women), with a mean age of 45.6 years at surgery. Each patient had a chronic Achilles tendon rupture. The mean interval from rupture to surgery was 5.5 months (range, 2-10). The mean total follow-up was 30.1 months (range, 12-78). All patients were operated with a central turndown flap augmented with free semitendinosus tendon graft and percutaneous sutures in a minimally invasive approach assisted by endoscopy. The patients underwent retrospective assessment by clinical examination, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot score, and the Achilles Tendon Total Rupture Score (ATRS). Paired t tests were used to assess the preoperative and postoperative AOFAS scores, ATRS scores, and ankle range of motion. Results: The length of the defect ranged from 3 to 8 cm (mean, 5.1), while the length of the turndown flap ranged from 8 to 13 cm (mean, 10.1). The mean AOFAS score improved from 64.5 points preoperatively to 96.9 points at last follow-up. The mean ATRS score improved from 49.4 preoperatively to 91.4 points at last follow-up. None of the patients developed a wound complication. No patient had a rerupture or sural nerve damage. Conclusion: All patients in our study had a favorable outcome with no complications. We believe that with this triple-repair technique, one can achieve a strong and robust repair such as in open surgery while at the same time reducing the incidence of complications. Level of Evidence: Level III, retrospective comparative study.

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