scholarly journals Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Operation Time ◽  
Neurological Deficits ◽  
Thoracolumbar Junction ◽  
Surgical Approaches ◽  
Instrumented Fusion ◽  
Group A ◽  
Group B ◽  
Multicentre Retrospective Study

Abstract Background The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. Forty-five patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals. Results All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2 ± 45.4 min, 408.0 ± 54.3 min, 227.9 ± 58.5 min, and the blood loss was 744.0 ± 193.8 ml, 1134.6 ± 328.2 ml, 349.8 ± 289.4 ml in groups A, B and C respectively. The average loss of correction was 5.5 ± 3.7° in group A, 1.6 ± 1.9° in group B, 1.7 ± 2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.

scholarly journals Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Operation Time ◽  
Neurological Deficits ◽  
Thoracolumbar Junction ◽  
Surgical Approaches ◽  
Instrumented Fusion ◽  
Group A ◽  
Group B ◽  
Multicentre Retrospective Study

Abstract Background: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study. Methods: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. 45 patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals. Results: All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2±45.4min, 408.0±54.3min, 227.9±58.5min, and the blood loss was 744.0±193.8ml, 1134.6±328.2ml, 349.8±289.4ml in groups A, B and C respectively. The average loss of correction was 5.5±3.7° in group A, 1.6±1.9° in group B, 1.7±2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). Conclusions: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.

scholarly journals Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Operation Time ◽  
Neurological Deficits ◽  
Thoracolumbar Junction ◽  
Surgical Approaches ◽  
Instrumented Fusion ◽  
Group A ◽  
Group B ◽  
Multicentre Retrospective Study

Abstract Background: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study. Methods: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. 45 patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals. Results: All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2±45.4min, 408.0±54.3min, 227.9±58.5min, and the blood loss was 744.0±193.8ml, 1134.6±328.2ml, 349.8±289.4ml in groups A, B and C respectively. The average loss of correction was 5.5±3.7° in group A, 1.6±1.9° in group B, 1.7±2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). Conclusions: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.

scholarly journals Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Spinal Tuberculosis ◽  
Thoracolumbar Junction ◽  
Surgical Approaches ◽  
Instrumented Fusion ◽  
Group A ◽  
Group B ◽  
Posterior Debridement ◽  
Multicentre Retrospective Study

Abstract Background: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three surgical approaches through a multicentre retrospective study. Methods: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. 45 patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion in a single- or two-stage procedure (Group B) and 80 underwent posterior debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Operations at each centre were performed by the same senior medical team in each centre. Results: All three surgical approaches achieved bone fusion and pain relief. All patients with neurological deficits had different degrees of recovery after surgery. The operative time was 330.2±45.4min, 408.0±54.3min, 227.9±58.5min, and the blood loss was 744.0±193.8ml, 1134.6±328.2ml, 349.8±289.4ml in groups A, B and C respectively. The mean loss of correction was 5.5±3.7° in group A, 1.6±1.9° in group B, 1.7±2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). Conclusions: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is superior to the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as the anterior-only or combined procedure but with shorter operation times, less trauma and less blood loss. Keywords: Spinal tuberculosis; Thoracolumbar junction lesion; Surgical treatment; Outcome.

scholarly journals Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Thoracolumbar Junction ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

scholarly journals Thoracoscopy Assisted Minimally Surgery (NUSS procedure) for Pectus Excavatum vs. Novel Modified NUSS procedure - A Single-Center Retrospective Study

2018 ◽  
Vol 21 (5) ◽  
pp. E404-E408
Author(s):  
Lifei Meng ◽  
Mingsong Wang
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Pectus Excavatum ◽  
Operation Time ◽  
Nuss Procedure ◽  
School Of Medicine ◽  
Hospitalization Time ◽  
Group A ◽  
Reducing Costs ◽  
Group B

Objective: The purpose of this article is to evaluate the efficacy of thoracoscopy assisted minimally surgery (NUSS procedure) for pectus excavatum and novel modified NUSS procedure by comparing the data of patients of pectus excavatum who had undergone novel modified NUSS Procedure or NUSS procedure. Methods: A retrospective study was performed, involving 132 cases of patients with pectus excavatum collected from Shanghai Jiaotong University School of Medicine Xinhua Hospital cardio-thoracic surgery between Jan. 2009 and Jan. 2012. The 132 patients were strictly divided into two groups: Group A included 76 cases that underwent a novel modified NUSS procedure; Group B included 56 cases that underwent NUSS procedure. Compared data included gender, age, operative time, blood loss, postoperative hospital staying and clinical variables and demographic were compared with univariable analysis. Results: No statistically significant correlations were observed in the two groups, such as age (12.67±4.793 years vs. 12.20± 6.423 years), sex, and other clinical data (P > 0.05). In Group A, postoperative hospitalization time (3.95±0.487 days vs. 6.07±1.412 days), operation time (46.28±12.218 minutes vs. 72.23±24.270 minutes), and blood loss (7.37±4.863 ml vs. 16.93±14.002 ml) were significantly better than those in Group B (P < 0.05), shortening hospitalization time, reducing costs, meaning statistically significant differences. There was no recurrence in Group A and Group B after operation. Conclusion: The study demonstrated that novel modified NUSS procedure is less invasive, having rapid recovery, shortening the time of hospital stay, and reducing hospital cost. Thus, it is safe, worth promoting, and is widely being used.

scholarly journals COMPARISON OF HEMODYNAMIC STATUS AND COMPLICATIONS BETWEEN TWO DIFFERENT DOSES OF INTRAMYOMETRIAL VASOPRESSIN DURING LAPAROSCOPIC MYOMECTOMY: A RETROSPECTIVE STUDY, THE LESSER THE BETTER

2021 ◽  
pp. 111-113
Author(s):  
NUPUR MODA ◽  
SUSHREE DAS ◽  
MADHUSMITA PATRO ◽  
PRERNA BISWAL
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Blood Loss ◽  
Normal Saline ◽  
Airway Pressure ◽  
Laparoscopic Myomectomy ◽  
Hemodynamic Status ◽  
Group A ◽  
Group B ◽  
Different Doses

Objective: Our aim is comparison of hemodynamic status and complications between two different doses of intramyometrial vasopressin during laparoscopic myomectomy. Methods: We did a retrospective analysis of hemodynamic status and its anesthetic concerns in patients who received two different doses of intramyometrial vasopressin. Eighty patients undergoing laparoscopic myomectomy under general anesthesia were divided into two groups of 40 patients in each group. In Group A (n=40), 10 units of intramyometrial vasopressin in 200 ml of normal saline were given and, in Group B, 20 units of intramyometrial vasopressin in 200 ml of NS were given intraoperatively by surgeon. Results: 20 units intramyometrial vasopressin used dogmatically by surgeons drops blood loss but it is connected with cardiovascular impediments. Hence, 10 units of intramyometrial vasopressin as compared to 20 units which are used by some surgeons are associated with similar blood loss and lesser side effects such as bradycardia, pulmonary edema, hypotension, blood loss, and increased airway pressure. Conclusion: Hence, anesthesiologists and gynecologists must take the precautions to escape and minimize the frequency of impediments with intramyometrial vasopressin by selecting the appropriate dosage of vasopressin.

scholarly journals TONSILLECTOMY IN PAEDIATRIC POPULATION

2016 ◽  
Vol 23 (04) ◽  
pp. 499-503
Author(s):  
Raheel Ahmad ◽  
Farhan Salam ◽  
Abdul Saeed Khan ◽  
Faisal Bashir ◽  
Atif Rafique
Keyword(s):  
Standard Deviation ◽  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Group A ◽  
Group B ◽  
Cold Steel Dissection ◽  
Cold Dissection ◽  
Dissection Method

Objectives: To compare mean operative time and Intra operative blood lossbetween bipolar electro dissection and cold dissection tonsillectomy in paediatric population.Study Design: Randomized controlled trial. Place and Duration: Department of ENT and Headand Neck Surgery, Continental Medical College, Hospital Lahore, from 1 January 2015 to 30September 2015. Materials and Methods: This study included 164 patients of age group 4 to12 years of either gender undergoing tonsillectomy. The patients were divided into two equalgroups designated as A and B each having 82 patients using simple random sampling. Patientsin group A were operated for tonsillectomy by bipolar electrocautry while group B underwenttonsillectomy by cold steel dissection method. All patients in both groups were assessed foroperating time and intra-operative blood loss. Results: Out of 82 cases of Bipolar DissectionGroup 49(60%) patients were male and 33(40%) patients were female. Whereas in 82 casesof Cold Dissection Group 51(62%) patients were male and 31(38%) patients were female.Mean age of patients was 7.2(SD ± 1.97) years. Mean operation time was 15 minutes withstandard deviation ± 1.21 in group A as compared to group B where mean operation time was20 minutes with standard deviation ± 1.87. Mean blood loss was 7 ml with standard deviation± 2.53 in patients of group A as compared to Patients in group B who mean blood loss of 30ml with standard deviation ± 3.46. Group A had statistically significant lower operative time andblood loss than group B. Conclusion: Tonsillectomy with bipolar electro dissection method ismuch better than cold steel dissection method. It has an advantage of less blood loss duringsurgery. It significantly reduces intra operative time.

scholarly journals Managing Sacral Giant Cell Tumor with Surgery and Various Adjuvant Therapies

2020 ◽  
Author(s):  
Yushen Zhang ◽  
Jun Fu ◽  
Yingsen Xue ◽  
Zheng Guo ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Operation Time ◽  
Arterial Embolization ◽  
Cell Tumor ◽  
Adjuvant Therapies ◽  
Group A ◽  
Group B

Abstract Background and purpose: There is no consensus regarding the appropriate treatment of sacral giant cell tumor (SGCT). This study is to compare oncological and neurological outcomes of SGCT managed by surgery and various adjunctive therapies.Methods: A total of 31 patients with SGCT were retrospectively studied. They were divided into two Groups. A: 13 patients underwent surgery plus SAE and radiotherapy; Group B: 18 patients underwent surgery plus one arterial embolization and denosumab. The postoperative functional outcomes, recurrence, mortality, and complications were compared.Results: The mean operation time (231±49min) and blood loss (3167±856mL) of group B were significantly less than those of group A (283±41min, 5054±689mL) (p<0.05). The average follow-up was 68.5 months. The neurologic function scores showed no significant difference. The recurrence rate of group B (11.2%) was much lower than that of group A (30.7%, p=0.17). The cumulative survival rate of group B was higher than that of group A (p=0.133).Conclusions: In comparison to other adjuvant therapies, one arterial embolization plus denosumab can reduce the intra-operative blood loss, shorten the operation time, and decrease the recurrence rate in patients with SGCT.

Outcomes of Thoracolumbar Burst Fracture in Patients With Osteoporosis Without Neurologic Symptoms: Analysis of Three Different Surgical Approaches

2019 ◽  
Vol 9 (8) ◽  
pp. 1052-1057
Author(s):  
Tao Li ◽  
Yonghong Zheng ◽  
Zhengwei Xu ◽  
Dingjun Hao ◽  
Lixiong Qian
Keyword(s):  
Blood Loss ◽  
Internal Fixation ◽  
Hospital Stay ◽  
Burst Fracture ◽  
Surgical Approaches ◽  
Intraoperative Blood Loss ◽  
Thoracolumbar Burst Fracture ◽  
Neurologic Symptoms ◽  
Group A ◽  
Group B

This study aimed to compare the outcomes of thoracolumbar burst fractures in patients with osteoporosis without neurologic symptoms according to the surgical approach. The patients in group A underwent percutaneous balloon kyphoplasty, those in group B underwent minimally invasive percutaneous reduction and internal fixation, and those in group C underwent open reduction with bone graft fusion and internal fixation. Fracture reduction was assessed by X-ray. The operative time in group A was shorter than that in groups B and C, with less intraoperative blood loss and shorter hospital stay. The intraoperative blood loss was less in group B than in group C, with shorter hospital stay. The postoperative visual analog scale scores were lower than the preoperative scores in each group. Cobb's angle of the injured vertebra in the last follow-up was larger in group A than in groups B and C. Regarding complications, in group A, nine patients developed postoperative bone cement leakage that required no specific treatment. In group B, one patient developed subcutaneous hematoma that healed well after treatment. The screw channel was loosened in two patients without symptoms; the screws were removed 1 year later. In group C, delayed incision healing was found in five patients. All three surgical approaches safely and effectively relieved the lower back pain in patients with thoracolumbar burst fracture with osteoporosis but without neurologic symptoms.

The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not

2020 ◽  
Vol 134 (9) ◽  
pp. 779-783
Author(s):  
D Wang ◽  
W Wang
Keyword(s):  
Blood Loss ◽  
Tympanic Membrane ◽  
Operation Time ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Membrane Repair ◽  
Group A ◽  
Endoscopic Myringoplasty ◽  
Group B ◽  
Approach Group

AbstractObjectiveThe aim of this study was to compare the differences between the no tympanomeatal flap approach and the tympanomeatal flap approach in endoscopic myringoplasty.MethodA total of 132 patients with tympanic membrane perforation were randomly divided into two groups: the no tympanomeatal flap approach group (group A, 56 ears) and the tympanomeatal flap approach group (group B, 76 ears). A comparison between the two groups was made.ResultsThe average operation time of group A was 36.00 ± 5.24 minutes, which was significantly shorter than that of group B, which was 43.89 ± 4.57 minutes (p = 0.002). The blood loss of group A was 5.08 ± 1.83 ml, which was significantly less than that of group B (9.67 ± 2.29 ml; p < 0.001). There were no differences in the degree of hearing improvement, the rate of hearing improvement, the dry ear time (when the external auditory canal and the operating cavity were dry) after operation and the success rate of tympanic membrane repair when compared between the two groups.ConclusionCompared with group B, group A (no tympanomeatal flap approach) can achieve the same effect but has the advantages of a shorter operation time and less blood loss during the operation.

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