scholarly journals Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097521
Author(s):  
Xiao-fei Sun ◽  
Yuan Wang ◽  
Jing-chuan Sun ◽  
Xi-ming Xu ◽  
Qing-jie Kong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Consensus Statement ◽  
Clinical Symptoms ◽  
Posterior Longitudinal Ligament ◽  
Diagnosis And Treatment ◽  
Asia Pacific ◽  
Ct Reconstruction ◽  
Whole Process ◽  
Surgical Methods ◽  
Level Of Agreement

Purpose: The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL). Method: Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement. Results: Cervical OPLL can cause various degrees of neurological symptoms, an it’s thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article. Conclusion: In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.

scholarly journals Un caso de Síndrome de Wünderlich y revisión de la bibliografía / A case of Wünderlich syndrome and literature review

Ciencia Unemi ◽  
2016 ◽  
Vol 9 (19) ◽  
pp. 84
Author(s):  
Katiuska Mederos Mollineda ◽  
Yumy Fernandez Velez ◽  
Lilian Escariz Borrego ◽  
Victor Chavez Guerra ◽  
Jorge Diaz Rodriguez
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Rare Disease ◽  
Pelvic Pain ◽  
High Frequency ◽  
Congenital Malformations ◽  
Clinical Symptoms ◽  
Specific Treatment ◽  
Diagnosis And Treatment ◽  
Statistical Report

El diagnóstico y terapéutica de las malformaciones congénitas todavía hoy constituye una problemática universal. El presente trabajo corresponde al estudio de un caso de una adolescente de 14 años de edad, paciente del Hospital Oncológico Dr. Julio Villacreses Colmont de Manabí (SOLCA), Ecuador, que a partir del mes de septiembre de 2014 inicia con cuadro clínico de dolor pélvico mantenido, leucorrea persistente y fétida, sin menarquia y sin respuesta a tratamiento específico. Realizadas la Ecografía y Resonancia Magnética, se definen múltiples malformaciones congénitas, obteniéndose el diagnóstico del Síndrome de Wünderlich; una patología rara, con frecuencia de un 40%. El objetivo de este trabajo consiste en demostrar la elevada frecuencia de esta morbilidad para disminuir tratamientos quirúrgicos innecesarios (Histerectomía), un factor agravante para su eventual compromiso reproductivo. En Ecuador no reportan estadísticas del síndrome, o existe un subregistro de esta entidad. Abstract The diagnosis and treatment of congenital malformations is still a universal problem nowadays. The present work is a study of a case of a 14-year-old patient at the Cancer Hospital Dr. Julio Villacreces Colmont (SOLCA) in Manabí, Ecuador, that from September 2014 begins with clinical symptoms of steady pelvic pain, a persistent and fetid leukorrhea without menarche and response to a specific treatment. Once carried ultrasound and MRI, multiple congenital malformations are defined to give the diagnosis Wünderlich Syndrome; a rare disease, which is frequent at a 40%. The objective of this work is to demonstrate the high frequency of this disease to reduce unnecessary surgical treatment (hysterectomy), which is an aggravating factor for possible reproductive status. In Ecuador there is no statistical report of this syndrome, or there is underreporting of this disease.

scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
Paradoxical Movement ◽  
First Choice ◽  
Surgical Methods

Abstract Backgrounds This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration. Methods We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body weight1.99-28.5kg,median body weight 7.87±4.40kg) admitted to our hospital in recent 10years,　and statistically analyzed their clinical manifestations and surgical methods. Results 108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication.107 patients recovered well postoperatively, except for 1 patient died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.During follow-up, the location of the diaphragm was normal and no paradoxical movement was observed.Eleven of the 17 children who did not undergo surgical treatment did not see a decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated.Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration,but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of short operation time, less trauma, rapid recovery,　so it should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 2: Indications for Surgical Treatment, Arthroscopic or Open Debridement, and Reconstruction Techniques of Suture Button and Screw Fixation

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110210
Author(s):  
Hiroaki Kurokawa ◽  
Hongyun Li ◽  
Chayanin Angthong ◽  
Yasuhito Tanaka ◽  
Yujie Song ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sports Medicine ◽  
Consensus Statement ◽  
Screw Fixation ◽  
Asia Pacific ◽  
Suture Button ◽  
Syndesmosis Injury ◽  
Strong Consensus ◽  
International Experts ◽  
Open Debridement

Background: The indications for surgical treatment of chronic syndesmosis injury are challenging for many orthopaedic clinicians, as there is no international consensus on the optimal management of these injuries. Purpose: An international group of experts representing the field of sports injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 9 items with 17 clinical questions and statements were related to indications for surgical treatment, arthroscopic versus open debridement, and suture button versus screw fixation reconstruction techniques and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 17 questions and statements, 4 achieved unanimous support, 11 reached strong consensus, and 2 reached consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical indications and techniques for chronic syndesmosis injury.

scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Treatment Method ◽  
Diaphragmatic Eventration ◽  
Time To Peak ◽  
Surgical Methods ◽  
Better Than

Abstract Background:This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration.Methods: We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body mass1.99-28.5kg,median body mass 7.87±4.40kg) admitted to our hospital in recent 10years,and statistically analyzed their clinical manifestations and surgical methods. Results:108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic Plication.107 patients recovered well postoperatively, except for 1 patient with hiatal hernia died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.Eleven of the 17 children who did not undergo surgical treatment did not see a significant decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the lung function values of 13 children before operation and 3 year after operation was compared. The difference in percent of expiratory time to peak tidal time (tPTEF%tE) and percentage of tidal volume to peak tidal expiratory flow(VPEF%VE) was significant (P<0.05).In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions: Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated early. All kinds of surgical methods can achieve better results.The clinical symptoms of children after diaphragm Plication operation are better than those before operation.We believe that the continuous suture of barbed wire thread applied to thoracoscopy diaphragm Plication surgery has quick operation time, less trauma, and quick recovery should be the preferred treatment method for infants with congenital diaphragmatic eventration.

Consensus on the change of criteria for cure of acromegaly during the last decade

2011 ◽  
Vol 152 (18) ◽  
pp. 703-708 ◽  
Author(s):  
Gábor László Kovács ◽  
Judit Dénes ◽  
Erika Hubina ◽  
László Kovács ◽  
Sándor Czirják ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Disease Control ◽  
Short Communication ◽  
Consensus Statement ◽  
Diagnosis And Treatment ◽  
Clinical Aspects ◽  
Insulin Like Growth Factor ◽  
Criteria For Diagnosis ◽  
Definition Of

The Acromegaly Consensus Group redefined the consensus criteria for cure of acromegaly. 74 neurosurgeons and experienced endocrinologists summarized the latest results on diagnosis and treatment of acromegaly. In this consensus statement the reliable growth hormone and insulin-like growth factor-1 assays were established. Definition of disease control was discussed based on the available publications and evidence. This short communication summarizes the clinical aspects of consensus criteria for diagnosis and cure of acromegaly based on the original article. Orv. Hetil., 2011, 152, 703–708.

Síndrome da Anca de Ressalto

2018 ◽  
Vol 9 (1) ◽  
pp. 8
Author(s):  
Bernardo Almeida
Keyword(s):  
Surgical Treatment ◽  
Hip Joint ◽  
Scientific Literature ◽  
Therapeutic Targets ◽  
Clinical History ◽  
Disease Diagnosis ◽  
Diagnosis And Treatment ◽  
Snapping Hip ◽  
Predominant Symptom ◽  
Snapping Hip Syndrome

Snapping hip syndrome is a condition in which the predominant symptom is the snapping feelingaround the hip joint caused by a dynamic impingement between muscles or tendons and boneprominences. The etiology of the snapping hip types and consequently the therapeutic targets havebeen subjects of discussion and controversy along the years. A careful clinical history and physicalexamination is frequently enough for this disease diagnosis. Treatment is typically conservative,however when it is not successful surgical treatment is indicated, consisting on the snapping muscleor tendons lengthening. The authors review in this paper the current scientific literature about functionalanatomy, physiopathology, symptoms, diagnosis and treatment of snapping hip.

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

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