Long-term outcomes after corrective cartilaginous joint resection based on arthrographic findings of duplicated thumbs

2021 ◽  
Vol 46 (4) ◽  
pp. 367-372
Author(s):  
Kousuke Iba ◽  
Akira Saito ◽  
Megumi Hanaka ◽  
Toshihiko Yamashita
Keyword(s):  
Growth Period ◽  
Joint Space ◽  
Type Ii ◽  
Scoring Method ◽  
Joint Congruency ◽  
Thumb Duplication ◽  
Age At Surgery ◽  
Joint Connection

We report greater than 10-year outcomes in duplicated thumbs following corrective cartilaginous resection during the growth period. We have undertaken corrective resection of cartilaginous joint connections based on intraoperative arthrographic findings to reconstruct favourable alignment in six Wassel Type II and IV thumb duplication in six patients. The age at surgery was 13 months (range 10–15), and the average post-surgical follow-up was 134 months (range 120–160). We observed five excellent and one good outcome using the Japanese Society for Surgery of the Hand scoring method. Favourable joint congruency and alignment were preserved, and no growth plate arrest or joint space narrowing was present more than 10 years after surgery. We conclude that corrective resection of the cartilaginous joint based on intraoperative arthrographic findings has long-term reliability for duplicated thumbs, especially those of Wassel Type II and IV, which have a cartilaginous joint connection. Levels of evidence: IV

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.

Long-Term Effects of Bariatric Surgery on Type II Diabetes, Hypertension and Hyperlipidemia: A Meta-Analysis and Meta-Regression Study with 5-Year Follow-Up

2014 ◽  
Vol 25 (3) ◽  
pp. 397-405 ◽  
Author(s):  
Cristian Ricci ◽  
Maddalena Gaeta ◽  
Emanuele Rausa ◽  
Emanuele Asti ◽  
Francesco Bandera ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Type Ii Diabetes ◽  
Meta Analysis ◽  
Type Ii ◽  
Long Term Effects ◽  
Meta Regression

scholarly journals Tubularized proximally-incised plate in distal/midshaft hypospadias repair

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Antonio Marte ◽  
Lucia Pintozzi
Keyword(s):  
Perioperative Complications ◽  
Foley Catheter ◽  
Case Series ◽  
Functional Results ◽  
Inclusion Criteria ◽  
Urethral Plate ◽  
Age At Surgery ◽  
Long Term Follow Up

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25<sup>th</sup> percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

scholarly journals AROHANA KRAMA MATRA BASTI IN JANU SANDHIGATA VATA: A CASE STUDY

2021 ◽  
Vol 12 (10) ◽  
pp. 1-6
Author(s):  
Deeya Baboo ◽  
Prajwal Narayan ◽  
Ganesh Puttur
Keyword(s):  
Modern Science ◽  
Joint Space ◽  
Knee Joints ◽  
Long Term Effect ◽  
Walking Time ◽  
Marked Relief ◽  
Flexion And Extension

Ayurveda (Science of life) has explained about the pathogenesis and the treatment of various disorders, the incidence of some of which have increased in the present scenario due to altered diet habits and lifestyle. Janu Sandhigata Vata is one among the Vata Vyadhi which causes a lot of inconvenience and disability in day-to-day activities. It is compared to Osteoarthritis of knee in modern Science. In this case study, a female aged about 57 years presented in the OPD of SSCASRH, Bengaluru was diagnosed with Janu Sandhigata Vata of both the knee joints. Arohana Krama Matra Basti with Prasarini taila was planned as per Sharangadhara’s reference. There was significant improvement in the patient and was evaluated after treatment and also during follow up. There was marked relief with respect to her subjective complaints like pain, improved joint space, walking time, degree of flexion and extension & X ray. This type of Arohana Krama Matra Basti can be adopted in future for planning treatment in Janu Sandhigata Vata and also taken up in a larger group study to check for better relief, long term effect and reduced side effects. The case is further elaborated in the article

scholarly journals Long-Term Bowel Function and Fate of the Ileal Pouch After Restorative Proctocolectomy in Patients With Crohn’s Disease: A Systematic Review With Meta-Analysis and Metaregression

2019 ◽  
Vol 14 (3) ◽  
pp. 418-427 ◽  
Author(s):  
Gianluca Pellino ◽  
Danilo Vinci ◽  
Giuseppe Signoriello ◽  
Christos Kontovounisios ◽  
Silvestro Canonico ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileal Pouch ◽  
Meta Analysis ◽  
Bowel Function ◽  
Age At Surgery ◽  
Secondary Endpoints ◽  
Grade Failure

Abstract Background and Aims Debate exists on whether ileal pouch anal anastomosis [IPAA] can be safely offered to patients diagnosed with Crohn’s disease [CD]. Our aim was to assess the outcome of IPAA for CD vs ulcerative colitis [UC]. Methods We used a PRISMA/MOOSE-compliant meta-analysis. Studies published between 1993 and 2018 were retrieved. Primary end points included complications. Secondary endpoints included functional outcome. The time of CD diagnosis was considered [intentional vs incidental IPAA]. Results Eleven studies comprising 6770 patients [CD = 352, UC = 6418] were included, with 44–120 months of follow-up. Pouch fistulae were more common in CD (CD vs UC; odds ratio (OR) 6.08; p = 0.0003, GRADE+++), as were strictures [OR 1.82; p = 0.02, GRADE+++] and failure [OR 5.27; p &lt; 0.0001, GRADE++++]. Compared with UC, postoperative CD diagnosis was associated with a much higher risk of fistulae [OR 6.23; p = 0.006, GRADE+++] and failure [OR 8.53; p &lt; 0.0001, GRADE++++] than intentional IPAA in CD [fistula: OR 4.17; p = 0.04, GRADE+++; failure: OR 2.48; p = 0.009, GRADE++++]. Age at surgery was positively associated with failure in CD [p = 0.007]. Obstruction was more common after intentional IPAA for CD. The risk of pouchitis did not differ between CD and UC [OR 1.07, p = 0.76, GRADE+++]. CD patients were at a higher risk of seepage [OR 2.27; p = 0.010, GRADE++]. Conclusions Patients with CD have 5-fold higher risk of failure, and a 2-fold risk of strictures after IPAA compared with UC. The risk is much higher if diagnosis is performed after IPAA. Function in those who retain the pouch seemed similar to that of patients with UC. CD does not increase the risk of pouchitis. IPAA could be offered to a selected population of CD patients after proper preoperative counselling. [PROSPERO registry 116811]

scholarly journals Choledochal cyst of the proximal cystic duct: a taxonomical and therapeutic conundrum

2018 ◽  
Vol 100 (2) ◽  
pp. e34-e37 ◽  
Author(s):  
R Kilambi ◽  
AN Singh ◽  
KS Madhusudhan ◽  
P Das ◽  
S Pal
Keyword(s):  
Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Frozen Section ◽  
Type Ii ◽  
Choledochal Cysts ◽  
Duct Excision ◽  
Term Data

Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct–bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision. In addition, given the rarity of this condition and the paucity of long-term data, we recommend meticulous follow-up for development of any malignancy.

Topical Review: MACI as an Emerging Technology for the Treatment of Talar Osteochondral Lesions

2017 ◽  
Vol 38 (9) ◽  
pp. 1045-1048 ◽  
Author(s):  
Travis J. Dekker ◽  
Brandon Erickson ◽  
Samuel B. Adams ◽  
Christopher E. Gross
Keyword(s):  
Osteochondral Lesions ◽  
Type Ii ◽  
Short Term ◽  
Rates Of Return ◽  
Level Of Evidence ◽  
High Functioning ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Matrix-induced autologous chondrocyte implantation (MACI) is a viable procedure that can be used as both a primary or revision cartilage regenerative procedure in high-functioning individuals without tibiotalar arthritis. Both short-term and midterm follow-up results demonstrate clinical, radiographic, and functional improvements with high rates of return to full activities. Cost remains a chief concern with the use of this technique, but theoretical improvements in the durability of repair with type II cartilage replacement may offer long-term benefits. Level of Evidence: Level V, expert opinion.

Sign in / Sign up

Export Citation Format

Share Document