scholarly journals The choice of feminizing genitoplasty tactic in girls with congenital adrenal hyperplasya

2021 ◽  
Vol 14 (4) ◽  
pp. 30-35
Author(s):  
Alexander V. Anikiev
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Two Stage ◽  
Extensive Experience ◽  
Multidisciplinary Study ◽  
Increased Risk ◽  
Long Time ◽  
Feminizing Genitoplasty

The choice of tactics for feminizing plastic surgery (one- or two-stage) remains an actually issue. To operate early, in the first months of a child’s life, when endocrinological stabilization is achieved, or to postpone the intervention until puberty? Despite the large number of approaches to surgical treatment, still not all results can be recognized as positive. There are complications that affect the quality of life of patients, not only of a surgical but also of a psychological nature. The advantages of one or another approach are currently impossible to prove, since this will require a prospective multicenter multidisciplinary study of long-term results with each of the approaches. Therefore, pediatric surgeons for a long time in the choice of tactics will be based on accumulated experience and logical reasoning. Given the extensive experience of multidisciplinary rehabilitation, the positive long-term results of two-stage feminization remains the preferred tactic for surgical treatment of girls with CAH. The increased risk of complications from the genitourinary system in the form of infections of the urinary tract, hematocolpos and hematometra in girls with a narrow common urogenital canal, which is inherent in virilization of 3, 4 and 5 degrees according to Prader, can be considered as a reason for an early one-stage feminizing plasty.

scholarly journals Efficacy of the trans‑obturator and retropubic mid‑urethral slings for stress urinary incontinence

2019 ◽  
Vol 88 (3-4) ◽  
pp. 115-124
Author(s):  
Matej Keršič ◽  
Maruša Keršič ◽  
Tina Kunič ◽  
Matija Barbič ◽  
Ivan Verdenik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Short Form ◽  
Long Term Results ◽  
Efficacy And Safety ◽  
Severity Scale ◽  
Exclusion Criteria

Background: The aim of our study was to report the extended long-term results of the use of tension-free vaginal tape (TVT) and trans-obturator tape (TOT) for the treatment of female urinary stress incontinence (SUI) at the Division of Gynaecology and Obstetrics / UMC Ljubljana. There are few data on this topic in the literature. Our aim was to find out whether and how the procedure improved the patients’ quality of life and for how long, whether the patients had complications after the procedure, and how this type of procedure affected the long-term results.Methods: A retrospective clinical trial comparing the use of TVT and TOT was carried out from January to August 2017 and included all the patients operated on at the Division of Gynaecology and Obstetrics / UMC Ljubljana with TVT or TOT procedure for stress or mixed urinary incontinence (UI) associated with urethral hyper mobility (the stress component was clinically predominant). The exclusion criteria were more than 10 years from procedure, age more than 80 years in 2016, previous anti-incontinence surgery and/or pelvic organ prolapse more than stage I on POP–q in any vaginal compartment. After inclusion and exclusion criteria, 1104 patients were sent quality-of-life questionnaires (PGI-S, PGI-I, SANDVIK SEVERITY SCALE, UDI-6, IIQ-7, ICIQ-UI Short Form (Slovenian)) with questions about the diagnosis, procedures, complications, reoperations, post-operative results, and satisfaction with the procedure. Till August 2017 (6 months after sending) we received 466 questionnaires (42.2 % response rate). After 225 questionnaires were excluded due to incomplete data, 241 questionnaires were analysed.Results: In the analysed group of patients (N = 241), 189 (78 %) had TOT and 52 (22 %) had TVT. Our retrospective study has confirmed that the efficacy and safety of TOT and TVT in the surgical treatment of SUI are comparable. The TOT and TVT groups did not differ significantly from each other in PGI-S, PGI-I, SANDVIK SEVERITY SCALE, UDI-6, IIQ-7, and ICIQ-UI Short Form or in postoperative complication rate. Repeat surgery was needed in 25/189 (13.2 %) TOT patients and 12/52 (23.1 %) TVT patients; p = 0.082. Urinary retention appeared in 18/189 (9.5 %) TOT patients and 7/52 (13.5 %) TVT patients; p = 0.411. Mesh erosion/inflammation appeared in 12/189 (6.3 %) TOT patients and 2/52 (38 %) TVT patients; p = 0495.Conclusion: We can conclude that the efficacy and safety of TOT and TVT in the surgical treatment of SUI are comparable. The choice of the technique should be based on the relative pros and cons of techniques and the surgeon’s experience.

scholarly journals Complex treatment of patients with achalasia of cardia and cardiospasm subject to psychosomatic disorders.

2018 ◽  
Vol 96 (5) ◽  
pp. 419-426
Author(s):  
A. F. Chernousov ◽  
T. V. Khorobrykh ◽  
F. P. Vetshev ◽  
L. V. Romasenko ◽  
V. A. Dulova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Gastrointestinal Tract ◽  
Neuromuscular Diseases ◽  
Long Term Results ◽  
Complex Treatment ◽  
Psychosomatic Disorders ◽  
Main Method ◽  
All Diseases

Achalasia of cardia and cardiospasm are neuromuscular diseases characterized by functional disorders of the permeability of the esophageal-gastric junction, their prevalence is up to 22% of all diseases of the esophagus. The article presents a series of clinical studies of 114 patients with achalasia of cardia and cardiospasm since 2006. A modified algorithm for the examination and treatment ofpatients with different stages of the disease is presented. The balloon cardiodilation, as the main method of treatment, was carried out by 76 patients. Surgical treatment was performed in 36 patients: 17 patients with stage III performed esophagocardiomyotomy with incomplete fundoplication in the modification of A.F. Chernousov, 19 - with the IV stage transhiatal extirpation of the esophagus with gastroplasty was performed. A group of 26 patients with psychosomatic disorders was selected, who, in addition to traditional surgical treatment, underwent psychotropic therapy. Good immediate and long-term results of complex treatment were obtained. Substantially faster relief of symptoms of dysphagia and other complaintsfrom the gastrointestinal tract was noted, a more persistent and prolonged effect of dilation sessions and a significant improvement in the quality of life compared with patients who did not receive psychotropic drugs. In this group of patients, we did not observe any recurrence of the disease after the dilatation sessions. The control examination (endoscopic and X-ray examination of the upper gastrointestinal tract, manometry) revealed no signs of dysphagia or gastroesophageal reflux in any patient, including among the operated.

scholarly journals Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results

2014 ◽  
Vol 89 (4) ◽  
pp. 594-598 ◽  
Author(s):  
Paula Curitiba Maciel ◽  
Joel Veiga-Filho ◽  
Marcelo Prado de Carvalho ◽  
Fernando Elias Martins Fonseca ◽  
Lydia Masako Ferreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Self Esteem ◽  
Long Term Results

Long-Term Results of Surgically Treated Radial Polydactyly – An Outcome Correlation Study

2019 ◽  
Vol 24 (03) ◽  
pp. 264-269
Author(s):  
Ching Man Yeung ◽  
Alexander Kai Yiu Choi ◽  
Jennifer Wing Sze Tong ◽  
Winnie Fok ◽  
Yat Fai Chan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Well Being ◽  
Structure And Function ◽  
Long Term Results ◽  
Activity Restriction ◽  
Patient Reported ◽  
And Function

Background: Thumb polydactyly is one of the commonest congenital hand differences. Traditional surgeon-based outcome scores capture outcomes mainly on bodily structure and function. Outcomes on the long-term well-being of the patients in the domains of activity and participation are not fully studied. Methods: Forty-eight thumbs in forty-five Chinese patients with radial polydactyly underwent surgical treatment at or before 3 years old were recruited. Mean follow-up was 11.6 years. Surgical outcomes were collected and compared to the normal opposite thumb. The results were compiled into the Japanese Society for Surgery of the Hand (JSSH) score, Cheng score and Tada score. Patients’ activity involving hands were assessed by both objective tools and patient-reported outcome measure while their health-related quality of life (HRQoL) was assessed by Patient- and Parent-reported Pediatric Quality of Life Inventory (PedsQL). Correlations between outcomes were analysed. Results: Overall, both parents and patients themselves reported good quality of life with mean score of 86.6% and 92.1% respectively in PedsQL. The combined surgical scores ranged from 52% good or excellent results using JSSH score to 100% good result using Cheng score. None of the outcomes on bodily structure and function showed positive correlation with patient’s well-being. Negative correlation was noted in total passive range of movement, active movement and Cheng score. All patients reported no activity restriction. Writing test did not show significant slowing. The operated hands had significantly poorer fine motor dexterity than normal. No significant correlation is noted between activity outcomes and PedsQL. Conclusions: Outcomes on bodily structure, function and activity showed little correlation with patients’ well-being after thumb polydactyly correction. It should be careful in using or analysing patient/parent-reported outcome measures on HRQoL as outcome assessment of surgical treatment of radial polydactyly.

Quality of life after surgical treatment of children with obstructive sleep apnea: Long-term results

2006 ◽  
Vol 70 (9) ◽  
pp. 1575-1579 ◽  
Author(s):  
Alberto Díez-Montiel ◽  
Juan I. de Diego ◽  
Maria P. Prim ◽  
Maria A. Martín-Martínez ◽  
Elia Pérez-Fernández ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Surgical Treatment ◽  
Sleep Apnea ◽  
Long Term Results ◽  
Obstructive Sleep

scholarly journals Long-term results of surgical treatment of calculous cholecystitis with the use of mini-access

2014 ◽  
Vol 21 (1) ◽  
pp. 67-69
Author(s):  
R. A. Sopiya ◽  
A. A. Popov ◽  
A. J. Korobov ◽  
E. R. Sopiya
Keyword(s):  
Surgical Treatment ◽  
Clinical Laboratory ◽  
Long Term Results ◽  
Acute Calculous Cholecystitis ◽  
Sf 36 ◽  
Instrumental Methods ◽  
Calculous Cholecystitis

The paper presents the follow-up results of the mini-access surgery for chronic calculous cholecystitis (72 patients) and for calculous cholecystitis (133 patients) performed 3-6 years ago. The long-term results were estimated on two international questionnaires of quality of life (SF-36, GSRS), and on the data of clinical, laboratory and instrumental methods of investigation. All patients operated on for chronic calculous cholecystitis had good long-term results. 99.3 % of the patients with acute calculous cholecystitis had good and satisfactory results of surgical treatment. Only 1 (0.7 %) patient had an unfavourable result, because of choledocholithiasis, identified 2 years after surgery.

scholarly journals LONG-TERM RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH FOLLICULAR TUMORS OF THE THYROID

2015 ◽  
Vol 174 (5) ◽  
pp. 32-34
Author(s):  
I. N. Zubarovskiy ◽  
M. V. Mikhailova ◽  
S. K. Osipenko
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Replacement Therapy ◽  
Postoperative Period ◽  
Long Term Results ◽  
Follicular Tumors

The article analyzed an experience of treatment of 51 patients with follicular tumors. It was proved, that there weren’t any complications and recurrences in case of typically performed operation and adequate replacement therapy in postoperative period. It was noted a good quality of life from 2 to 5 years.

Sign in / Sign up

Export Citation Format

Share Document