Persistent foreign body sensation and pharyngeal pain due to retention of staples: an interesting sequelae of endoscopic stapling procedure

2001 ◽  
Vol 115 (5) ◽  
pp. 425-427 ◽  
Author(s):  
P. S. Arunachalam ◽  
D. S. Cameron

The surgical treatment of a pharyngeal pouch with endoscopic stapling diverticulotomy is a relatively new concept. Long-term results and complications are yet to be fully studied. We describe a patient who developed persistent pharyngeal pain and foreign body sensation due to retention of a clump of staples at the cricopharyngeal sphincter. This complication has not been reported before. This case highlights the need for repeat endoscopy rather than a barium swallow X-ray if the patients are symptomatic after stapling procedures.

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Mahmoud Elnaggar ◽  
Gunay Verdiyeva ◽  
Nisha Rajesh Thamaran ◽  
Oladapo Fafemi ◽  
Alexandru Munteanu

Abstract Aim Assessment of long term complications of self gripping mesh used in different types of hernia repair procedures more than 4 years ago aiming to compare the results with sutured prolene mesh with regards to safety and efficacy. Methods 70 patients (3 emergency & 67 elective) ventral hernia repair procedures, done in 2016 using self gripping mesh, were followed for recurrence and complications on the long term. Results There were 2 right (6.45%) and 1 left (3.44%) inguinal hernia recurrences. There were no cases of chronic groin pain or foreign body sensation. As compared to the meta-analysis of postoperative pain using non-sutured or sutured single-layer open mesh repair for inguinal hernia, where 19 studies including 4531 patients analysed recurrence, no significant difference was found in recurrence rates between the 2 mesh repair groups after 1 year of follow-up. With regards to the incidence of chronic pain at 12 months, there was no significant difference between Self gripping and suture fixation. Conclusions The self-gripping mesh in this study has better results as compared with a sutured mesh regarding the incidence of chronic postoperative inguinal pain and foreign body sensation. Recurrence rates are comparable to most studies, however, long-term results still are based on relatively small patients numbers.


2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia


2021 ◽  
pp. 40-49
Author(s):  
V. A. Gankov ◽  
E. A. Tseimakh ◽  
G. I. Bagdasaryan ◽  
A. R. Andreasyan ◽  
S. A. Maslikova

Relevance. Treatment of achalasia of the cardia (AС) is currently palliative, aimed at reducing the manifestation of clinical symptoms of the disease. Together with instrumental methods of examination of esophageal function, the Eckardt scale and the GIGLI questionnaire are convenient and simple tools for evaluating results in the long-term postoperative period.The aim of the study was to evaluate the long-term results of surgical treatment of patients with 2-4 stages of AС, after laparoscopic Нeller myotomy with anterior hemiesophagofundoplication by Dor to the results of special methods of esophageal examination and patient questionnaires using the Eckardt scale and the GIGLI questionnaire.Materials and methods. The work included the results of examinations of 103 patients who underwent video laparoscopic Нeller myotomy, with anterior hemiesophagofundoplication by Dor. The period of examination in the postoperative period was from 3 to 7 years. The results of X-ray examination of the esophagus and stomach, manometry of the esophageal and esophageal-gastric junction before and after surgery were studied , and patients were also surveyed according to the Eckardt scale and the GIGLI questionnaire.Results. The analysis of the results of instrumental methods of studying the function of the esophagus in the pre – and postoperative periods showed that the given manometry of the esophagus and esophageal-gastric junction, X-ray of the esophagus and stomach significantly improved in the postoperative period in patients with all stages of the disease. The results of patients of 4th stage AC compared with the results of 2nd and 3rd stages patients were worse(p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the results were better in patients with stage 2, worse in patients with stage 4 of AK (p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the 2nd stage patients results were better, 4th stage patients results were worse (p<0,05).Conclusions. After video-endoscopic Нeller myotomy with fundoplication by Dor, the indicators of esophageal manometry and esophageal and stomach radiography significantly improve, the results of the Eckardt scale and GIGLI questionnaire survey of patients show a significant decrease in the severity of clinical manifestations of AC in the balls. This method of surgical treatment can be recommended already at the 2nd stage of AC and as an organpreserving operation for 4th stage.


2021 ◽  
Vol 23 (3) ◽  
pp. 75-82
Author(s):  
Vadim B. Samedov ◽  
Pavel N. Romashchenko ◽  
Gennady O. Revin

Surgical treatment of patients with chronic slow-transit constipation leads to unsatisfactory results in almost a third of cases. It appears relevant to the search for the causes of unsatisfactory results of surgical interventions in such patients and the need to develop a rational diagnostic algorithm; its implementation will allow us to determine the indications for surgical treatment and justify the volume of colon resection. For this purpose, the results of the examination and treatment of 53 patients with constipation were analyzed. The median disease duration was 15 years, and the median duration of constipation was 6.2 1.6 days. Patients were divided into a group with a positive effect of conservative treatment and a group without the expected effect. The symptoms, results of laboratory tests of blood and feces, and instrumental studies of the colon were analyzed. A balloon expulsion test was used to exclude proctogenic constipation. The evacuation function of the colon was studied by X-ray examination, while the transit time of barium sulfate or X-ray contrast markers through the gastrointestinal tract was estimated. Twenty-four patients underwent surgery for chronic slow-transit constipation, while the sigmoid colon was removed in one patient, including 7-left-sided hemicolectomy and 16-subtotal resection of the colon. Long-term results were examined in the period from 3 to 6 months after surgery. In the total examination of the semiotics of chronic slow-transit constipation, the results did not show significant differences between the groups of patients and did not allow us to justify the stratification into severe and non-severe disease course by its specific symptoms. The use of X-ray contrast markers for the assessment of the state of the evacuation function of the colon makes it possible to quantify the severity of various motor disorders and justify the choice of the volume of its resection. The analysis of the long-term results of the treatment of patients with chronic slow-transit constipation allows us to conclude that segmental resections of the colon (left-sided hemicolectomy, resection of the sigmoid colon) have a good therapeutic effect if the preoperative examination revealed a segmental type of failure of the evacuation function of the colon, and subtotal resection of the colon is appropriate for the common type. The absence of negative results of surgical treatment of patients with chronic slow-transit constipation, in which the formation of a colonic anastomosis was performed with a short stump of the sigmoid colon, indicates the possibility of using this option to complete the surgical intervention.


Author(s):  
U.S. Fayzieva ◽  
◽  
M.D. Gulyamova ◽  
O.I. Ikramov ◽  
◽  
...  

Purpose. To study the clinical efficacy of the long-term results of a step-by-step method of surgical treatment of open eye trauma complicated by the presence of the intraocular foreign body (IFB) in the posterior segment, including primary surgical treatment (PST) and delayed vitreoretinal surgery with IFB extraction within 24 hours after PST. Material and methods. The clinical efficacy of delayed IFB removal within 2 years was studied in 32 eyes with open trauma of the eyeball complicated by the presence of IFB in the posterior segment. Concomitant traumatic complications included partial hemophthalmos (84.4%) and rhegmatogenous retinal detachment (RD) (59.4%). Results. By the end of 2 years of follow-up, the anatomical effect was observed in all examined 21 eyes, including 15 eyes (71.4%) with hemophthalmos and 13 eyes (61.9%) with traumatic retinal detachment. In this case, recurrence of RD occurred in 7 eyes, post-traumatic traction RD- in 3 eyes. Functional effect with improved visual acuity was in 12 eyes (57.1%). At the same time, the MCVA was 0.3±0.05 (0.15–0.5). Conclusion. The presented method made it possible to achieve a stable anatomical effect and stable functional results, even in the presence of severe trauma complicated by total hemophthalmos and retinal detachment, in the long term. Key words: open eyeball injury, intraocular foreign body, primary surgical treatment, transvitreal intraocular foreign body extraction, post-traumatic traction retinal detachment.


2016 ◽  
Vol 4 (1) ◽  
pp. 5-10
Author(s):  
Vadim V Kozhevnikov ◽  
Evgeny V Voronchikhin ◽  
Lyudmila G Grigoricheva ◽  
Zhanna N Radimova

Introduction: Congenital clubfoot is a complex orthopedic problem, and the frequency of recurrence or secondary deformities may reach up to 60% in some cases.Purpose: To determine indicators for the surgical treatment of recurrent foot deformity using the Ilizarov external fixator and to evaluate the effectiveness of this approach.Materials and Methods: The feet of 78 children with recurrent congenital clubfoot were analyzed using X-ray and ultrasound to investigate their clinical and functional characteristics. According to the characteristics of the deformity, we performed tenoligamentocapsulotomy combined with tarsal osteotomies and tendon plastics. Furthermore, we determined the indicators for the surgical treatment of foot deformity using the Ilizarov external fixator.Results: In total, 33 children (56 feet) were treated using a distraction external fixator combined with tenoligamentocapsulotomy. Following treatment, long term results were assessed using a three-point scale: good, satisfactory, and unsatisfactory. The number of children of 8 years of age whose treatment was graded as either good or satisfactory was higher than children who were over 9 years of age. Functional recovery was also better in the younger age group.Conclusion: By determining specific indications for different treatment methods, physicians are able to apply an individual approach for diagnosing and treating recurrent congenital clubfoot. Good and satisfactory long term results were obtained in approximately 90 % of cases.


2017 ◽  
Vol 176 (4) ◽  
pp. 96-99
Author(s):  
A. N. Tulupov ◽  
G. I. Sinenchenko ◽  
M. I. Safoev ◽  
A. V. Nikitin

OBJECTIVE. The study determined an optimal method of surgical treatment of Zenker-diverticulum. MATERIALS AND METHODS. The patients (12 men) were examined using X-ray contrasting of the esophagus and fibroesophagoscopy. The planned diverticulectomy from cervical access was performed on all patients. RESULTS. The treatment was without complications and the patients had favorable outcomes and good long-term results. CONCLUSIONS. The open diverticulectomy using cervical access is the operation of choice.


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