scholarly journals Laparoscopic management of cholecystoenteric fistula: A single-center experience

2017 ◽  
Vol 45 (3) ◽  
pp. 1090-1097 ◽  
Author(s):  
Xiang-yang Li ◽  
Xin Zhao ◽  
Peng Zheng ◽  
Xiao-Ming Kao ◽  
Xiao-Song Xiang ◽  
...  
Keyword(s):  
Postoperative Morbidity ◽  
Postoperative Recovery ◽  
Diagnostic Methods ◽  
Laparoscopic Management ◽  
Conversion To Open Surgery ◽  
Single Center Experience ◽  
Cholecystoenteric Fistula ◽  
Jinling Hospital ◽  
Cholecystocolonic Fistula

Aim To report our experience regarding management of cholecystoenteric fistula (CEF) and identify the most effective diagnostic methods and surgical treatment. Methods In total, 10,588 patients underwent laparoscopic cholecystectomy for cholecystolithiasis from January 2000 to December 2014 at the Research Institute of General Surgery, Jinling Hospital (Nanjing, China). Twenty-nine patients were diagnosed with CEF preoperatively or intraoperatively. Data were retrospectively collected on demographics, preoperative diagnostics, intraoperative findings, laparoscopic procedures, complications, and follow-up. Results Twenty-nine patients (female/male ratio, 2.2; mean age, 68.7 years) with CEF were evaluated. Twenty-three (79.3%) patients had a cholecystoduodenal fistula (CDF), four (13.8%) had a cholecystocolonic fistula (CCF), one (3.4%) had a cholecystogastric fistula, and one (3.4%) had a CDF combined with a CCF. Only nine (31.0%) patients obtained a preoperative diagnosis. All patients initially underwent laparoscopic treatment, but five (17.2%) underwent conversion to open surgery; three of these five developed postoperative morbidity or mortality, and the other two had an uneventful postoperative course. Among patients managed successfully by laparoscopy, the hospital stay ranged from 3 to 6 days (mean, 4 days). All patients were asymptomatic at a mean follow-up of 13 months (range, 3–21 months). Conclusion Ultrasound and computed tomography can provide valuable diagnostic clues for CEF. Laparoscopic management of CEF in experienced hands is safe, feasible, and associated with rapid postoperative recovery.

Ovarian Sparing Surgery in Mature Ovarian Teratomas in Children: A 20-Year Single-Center Experience

2020 ◽  
Author(s):  
Olga Szymon ◽  
Bartosz Bogusz ◽  
Anna Taczanowska-Niemczuk ◽  
Marcin Maślanka ◽  
Wojciech Górecki
Keyword(s):  
Postoperative Morbidity ◽  
Good Prognosis ◽  
Ovarian Teratoma ◽  
Single Center Experience ◽  
Complementary Approach ◽  
Tumor Transformation ◽  
Benign Nature ◽  
Chemical Peritonitis ◽  
Bilateral Lesions

Abstract Introduction Despite its benign nature, possible bilateral presentation, and a very good prognosis, ovarian sparing tumorectomy (OST) in mature ovarian teratoma (MOT) is not commonly performed. Unilateral oophorectomy has physiological consequences, while bilateral is devastating. The aim of this study is promotion of OST in MOT among children. Materials and Methods We reviewed 120 patients operated for MOT between August 1999 and 2019. Results Ovariectomy was performed in 15 patients (14 between 1999 and 2009 and 1 after 2010). In 105 girls, OST was possible including 32 with ovarian torsion. The approach was laparoscopy in 30 girls (11 conversions) and laparotomy in 94. Intra-abdominal spillage occurred in 30% of laparoscopic dissections. Postoperative morbidity was not associated with surgical approach (p = 0.613) or presence of adnexal torsion (p = 0,608). Follow-up was from 4 months to 9 years (median = 4 years) with access to 90% of patients. Bilateral lesions were observed in six (synchronous in five and metachronous in one) patients. Recurrence appeared in three patients operated via laparotomy and OST (after 12, 46, and 74 months). In one girl, asynchronous contralateral MOT was found 5 years after unilateral oophorectomy. Ovarian regeneration after torsion was observed in sonography in 84.4% of the patients. None of the patients experienced chemical peritonitis or malignant tumor transformation. Conclusion OST is safe and effective and should be the first-line procedure in children. Laparoscopy and laparotomy constitute a complementary approach to MOT. Ultrasound follow-up is necessary to monitor recurrence, contralateral disease, and ovarian regeneration.

scholarly journals Laparoscopic management of Hepatic cystic echinococcosis in Nepal: A single center experience

2020 ◽  
Vol 23 (1) ◽  
pp. 2-8
Author(s):  
Rabin Koirala ◽  
Ashish P. Rajbhandari ◽  
Shailesh Maharjan ◽  
Sashi Shekhar Adhikari
Keyword(s):  
Cystic Echinococcosis ◽  
Kidney Injury ◽  
Operation Time ◽  
Biliary Fistula ◽  
Laparoscopic Treatment ◽  
Recurrence Rates ◽  
Laparoscopic Management ◽  
Conversion To Open Surgery ◽  
Single Center Experience ◽  
The Mean

Introduction: Advances in laparoscopy has replaced many conventional open surgeries; hepatic cystic echinococcosis (CE) surgery is no exception. This study aims to evaluate the feasibility, postoperative outcomes including complications and recurrence rates after employing laparoscopic treatment for hepatic CE. Methods: This is a prospective study involving patients who underwent laparoscopic intervention for Hepatic CE at Nepal Medical College and Teaching Hospital from 1st July 2014 to 30th June 2019. Laparoscopic partial pericystectomy was done through the Palanivelu hydatid system and technique after pretreatment with albendazole (10mg/kg) for at least one week. Clavien-Dindo classification was used to classify postoperative complications. Results: Twenty-two patients were enrolled in the study with a mean age of 33.95±15.24 (18.0-75.0) years, 15 (68.18%) of them being female. Abdominal pain (77.3%) was the commonest complaint and a single cyst in the right lobe of the liver was the commonest pathology. The mean size of the cyst was 10.2±3.0 (5.0-15.0) cms. 40.9% of the cysts belonged to WHO-IWGE Grade CE3, while grade CE2 and CE1 consisted of 27.3% each. The mean operation time was 80.7 ± 19.7 (60-120) minutes. Out of the 22 patients, six (27.3%) had minor grades while four (18.2%) had major grades of Clavien-Dindo complications. Among the major complications, one (4.5%) patient each developed biliary fistula managed with ERCP and stenting, recurrence after three months, intraoperative bleeding requiring conversion to open surgery, and acute kidney injury managed with dialysis. There was no anaphylaxis or operative mortality. Conclusion: In selected patients, laparoscopic treatment for hepatic CE is feasible even in a resource-limited country like Nepal. With a low rate of conversion, recurrence and mortality, laparoscopic management can be safe, effective and encouraging treatment modality for the patients of hepatic CE.

scholarly journals Comparison between the draf IIc and standard draf IIb procedure for frontal sinus drainage: single center experience and comparison of outcomes

2020 ◽  
Vol 12 (5) ◽  
pp. 167-170
Author(s):  
Aigerim Kvarantan ◽  
Gorazd Poje ◽  
Livije Kalogjera
Keyword(s):  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Postoperative Recovery ◽  
Treatment Results ◽  
Related Data ◽  
Single Center Experience ◽  
Uneventful Postoperative Recovery ◽  
Sinus Drainage ◽  
Frontal Sinuses

Aims: Inadequate surgical frontal sinus drainage in chronic sinusitis cases refractory to conservative treatment results in a poor clinical response and is associated with recurrent frontal recess stenosis. Endonasal frontal sinus drainage procedures are classified according to Draf into three groups: DrafIIb enables unilateral orbit to septum drainage and the IIc is the extension of the IIb across the midline. The purpose of our report is to review chronic sinusitis cases treated at our Department using the standard (IIb) or modified (IIc) procedure and compare results. Methods: Patient- and surgery-related data were retrieved on patients operated between 2013 and 2016 for chronic frontal sinusitis using the standard/modified DrafIIb procedure.The modified IIb (i.e. IIc) procedure was performed so that both frontal sinus ostia were visualized by performing an intersinusseptectomy: the aim was to provide drainage to both frontal sinuses simultaneously. Results: In the observed period, 26 patients were treated: 12 using the modified DrafIIb (IIc) and 14 using the standard DrafIIb procedure. There were no significant differences between groups regarding age, sex, number of previous procedures or follow-up period. All patients had an uneventful postoperative recovery and there were no cases of re-stenosis observed in the DrafIIc group; there were seven cases of restenosis in the DrafIIb group.

scholarly journals ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR

2015 ◽  
Vol 174 (2) ◽  
pp. 25-29 ◽  
Author(s):  
D. N. Maistrenko ◽  
M. I. Generalov ◽  
P. G. Tarazov ◽  
F. K. Zherebtsov ◽  
V. V. Osovskikh ◽  
...  
Keyword(s):  
Open Surgery ◽  
Risk Group ◽  
First Year ◽  
Aortic Aneurism ◽  
Conversion To Open Surgery ◽  
Single Center Experience ◽  
Abdominal Aortic ◽  
Abdominal Aortic Aneurism ◽  
High Surgical Risk

The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stentgrafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn’t necessary to use a conversion to open surgery. The follow-up period consisted of 44,6±2,1 months. Control ultrasound and computer tomography studies hadn’t revealed an increase of aneurism sack sizes or «leakages». A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stentgraft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group.

scholarly journals Clinical outcomes in the surgical treatment of esophageal leiomyoma: A retrospective evaluation of 13 cases

2020 ◽  
Vol 28 (3) ◽  
pp. 505-513
Author(s):  
İrfan Yalçınkaya
Keyword(s):  
Open Surgery ◽  
Thoracoscopic Surgery ◽  
Diagnostic Methods ◽  
Esophageal Leiomyoma ◽  
Conversion To Open Surgery ◽  
Video Assisted ◽  
Study Results ◽  
Surgical Methods ◽  
Video Assisted Thoracoscopic Surgery

Background: In this study, we aimed to evaluate the surgical outcomes after enucleation of esophageal leiomyomas and present the feasibility of enucleation using video-assisted thoracoscopic surgery. Methods: The medical records of 13 patients (8 males, 5 females; mean age 45.9 years; range, 30 to 69 years) who underwent open or thoracoscopic surgery for an esophageal leiomyoma between April 2007 and June 2019 were retrospectively reviewed. The patients were evaluated with regard to age, sex, presenting symptoms, duration of symptoms, size and localization of tumors, diagnostic methods, surgical methods, conversion to open surgery, morbidity and mortality, discharge time, and follow-up period. Results: Of the patients, four were operated via thoracotomy and nine via video-assisted thoracoscopic surgery. Enucleation was successfully completed with thoracoscopy in five patients. Four patients required conversion to thoracotomy. In the early postoperative period, two of these four patients developed complications and underwent re-thoracotomy. A solitary leiomyoma was detected in all, but one patient (multiple). The mean size of the tumors was 68.4 mm. Complications were seen in only one patient during follow-up and no recurrence was observed in any patient. Conclusion: Our study results indicate that thoracoscopic enucleation of esophageal leiomyoma is a safe, feasible, and effective technique in selected patients and conversion to open surgery can be easily done for any reason during the procedure.

Post Discharge Clinically Overt Venous Thromboembolism in Orthopaedic Surgery Patients with Negative Venography -an Overview Analysis

1996 ◽  
Vol 76 (06) ◽  
pp. 0887-0892 ◽  
Author(s):  
Serena Ricotta ◽  
Alfonso lorio ◽  
Pasquale Parise ◽  
Giuseppe G Nenci ◽  
Giancarlo Agnelli
Keyword(s):  
Venous Thromboembolism ◽  
Orthopaedic Surgery ◽  
Diagnostic Methods ◽  
Future Research ◽  
Post Discharge ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Overview Analysis ◽  
Major Orthopaedic Surgery

SummaryA high incidence of post-discharge venous thromboembolism in orthopaedic surgery patients has been recently reported drawing further attention to the unresolved issue of the optimal duration of the pharmacological prophylaxis. We performed an overview analysis in order to evaluate the incidence of late occurring clinically overt venous thromboembolism in major orthopaedic surgery patients discharged from the hospital with a negative venography and without further pharmacological prophylaxis. We selected the studies published from January 1974 to December 1995 on the prophylaxis of venous thromboembolism after major orthopaedic surgery fulfilling the following criteria: 1) adoption of pharmacological prophylaxis, 2) performing of a bilateral venography before discharge, 3) interruption of pharmacological prophylaxis at discharge in patients with negative venography, and 4) post-discharge follow-up of the patients for at least four weeks. Out of 31 identified studies, 13 fulfilled the overview criteria. The total number of evaluated patients was 4120. An adequate venography was obtained in 3469 patients (84.1%). In the 2361 patients with negative venography (68.1%), 30 episodes of symptomatic venous thromboembolism after hospital discharge were reported with a resulting cumulative incidence of 1.27% (95% C.I. 0.82-1.72) and a weighted mean incidence of 1.52% (95% C.I. 1.05-1.95). Six cases of pulmonary embolism were reported. Our overview showed a low incidence of clinically overt venous thromboembolism at follow-up in major orthopaedic surgery patients discharged with negative venography. Extending pharmacological prophylaxis in these patients does not appear to be justified. Venous thrombi leading to hospital re-admission are likely to be present but asymptomatic at the time of discharge. Future research should be directed toward improving the accuracy of non invasive diagnostic methods in order to replace venography in the screening of asymptomatic post-operative deep vein thrombosis.

Holding it together � patients� perspectives on postoperative recovery when using an e-assessed follow-up

2018 ◽  
Author(s):  
Karuna Dahlberg ◽  
Maria Jaensson ◽  
Ulrica Nilsson ◽  
Mats Eriksson ◽  
Sigrid Odencrants
Keyword(s):  
Postoperative Recovery
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