scholarly journals Ultrasound evaluation of the renal pelvis in cats with ureteral obstruction treated with a subcutaneous ureteral bypass: a retrospective study of 27 cases (2010–2015)

2017 ◽  
Vol 20 (10) ◽  
pp. 875-883 ◽  
Author(s):  
Julien Fages ◽  
Marilyn Dunn ◽  
Swan Specchi ◽  
Pascaline Pey

Objectives The objective of the study was to measure the preoperative and postoperative renal pelvic size and describe the ultrasound findings following successful decompression of a ureteral obstruction using the subcutaneous ureteral bypass (SUB) device in cats. Methods This retrospective study assessed the measurement of the renal pelvis of 27 cats with unilateral (n = 21) or bilateral (n = 6) ureteral obstruction before (pre-t0) and after placement of a SUB during short- (before t0 + 3 months) and long-term (after t0 + 3 months) follow-up. Several qualitative ultrasound parameters were recorded for each cat. At both intervals, the last ultrasound examination was used for qualitative criteria and the mean pelvic size was recorded. The complications observed during follow-up were divided into obstructive and non-obstructive. Results No qualitative ultrasound parameter was statistically significant. The presence of retroperitoneal or peritoneal effusion was rarely seen (n = 4/25 during the short term and n = 1/14 during the long term). Hyperechogenicity of the perirenal adipose tissue decreased in the long term. A statistically significant decrease in the width of the renal pelvis was noted in the short- (2.4 mm, range 0–7.0 mm) and long-term (1.7 mm, range 0–3.5 mm) follow-ups compared with the preoperative value (11.7 mm, range 0.9–41 mm). Three months following SUB placement, each cat without an obstructive complication had a pelvic width ⩽3.5 mm. Conclusions and relevance Renal pelvic distension is at least partially reversible when ureteral obstruction is treated by placement of a SUB. Ultrasound monitoring is a useful tool to detect obstructive complications.

Author(s):  
Rafique Umer Harvitkar ◽  
Abhijit Joshi

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.


2020 ◽  
Vol 106 (8) ◽  
pp. 1589-1595
Author(s):  
Charles Bijon ◽  
Marc Saab ◽  
Thomas Amouyel ◽  
Nadine Sturbois-Nachef ◽  
Elvire Guerre ◽  
...  

Endocrine ◽  
2019 ◽  
Vol 66 (2) ◽  
pp. 310-318 ◽  
Author(s):  
Liang Lv ◽  
Yong Jiang ◽  
Senlin Yin ◽  
Yu Hu ◽  
Cheng Chen ◽  
...  

2020 ◽  
pp. 153857442096925
Author(s):  
Chen-Ting Cheng ◽  
Yuan-Chen Chang ◽  
Ka-Wai Tam ◽  
Yu-Chun Yen ◽  
Yu-Chen Ko

Background: Creating and maintaining a functioning arteriovenous access is essential for long-term hemodialysis patients. Transposed brachiobasilic fistula (BBF) or arteriovenous graft (AVG) becomes an option when radiocephalic or brachiocephalic fistula cannot be created or fails. This study compared the patency and complications between BBFs and AVGs among patients on hemodialysis. Methods: A retrospective study was performed in Shuang Ho Hospital, Taiwan, from November 2015 to May 2020. All the operations were done by a single surgeon. Primary outcomes were primary patency, primary-assisted patency, and secondary patency of the BBF and AVG groups. Secondary outcomes were incidence of complications and reinterventions. Results: Of the 144 consecutive patients, 20 and 124 patients underwent BBF and AVG creation, respectively. Median follow-up time was 19.2 months. Primary patency at 1 and 2 years were 67% and 19% in the BBF group and 44% and 16% in the AVG group (P = 0.126). Primary-assisted patency at 1 and 2 years were 82% and 54% in the BBF group and 54% and 30% in the AVG group (P = 0.012). Secondary patency at 1 and 2 years were 100% and 82% in the BBF group and 81% and 67% in the AVG group (P = 0.078). The incidence of complication was significantly higher in the AVG than in the BBF group (1.7 per patient-year vs 0.93, P < 0.001). Conclusion: Compared with the AVG group, BBF group showed better primary-assisted patency, less complication and intervention rates. Therefore, BBF is a reliable option for patients with exhausted cephalic veins if basilic vein is available for reconstruction.


Sign in / Sign up

Export Citation Format

Share Document