scholarly journals Atípusos aortacoarctatiók sebészi kezelésének hosszú távú eredményei

2016 ◽  
Vol 157 (26) ◽  
pp. 1043-1051
Author(s):  
Csaba Dzsinich ◽  
László Entz ◽  
Péter Berek ◽  
Gábor Vallus ◽  
László Barta ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Severe Hypertension ◽  
Somatic Growth ◽  
Cardiovascular Disorder ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Time Period ◽  
Surgical Methods ◽  
Atypical Aortic Coarctation

Introduction: Aortic coarctation is a frequent congenital cardiovascular disorder representing 5–8% of all cases. It is typically localized in the isthmic region. However, in about 1% of cases coarctation may develop in atypical sites of the aorta and it is frequently complicated with severe hypertension. Aim: The aim of the authors was to present diagnostic and surgical methods used in 27 patients with atypical aortic coarctation during the last 35 years with special interest on long-term results. Method: There was a great advance in diagnostic and surgical treatment methods during the time period analyzed in this study. Nowadays morphologic diagnosis is most commonly obtained using computed tomography angiography and magnetic resonance angiography. Some cases were treated with endovascular techniques, but the authors used also a wide variety of surgical approaches in these patients with atypical aortic coarctation. Results: No patient died after surgery and hypertension was reduced in all patients, too. Reintervention was necessary in patients operated in childhood due to change of body measures. Conclusions: Atypical aortic coarctation can be treated surgically with good early and late outcomes. Somatic growth of children may indicate surgical revision. Orv. Hetil., 2016, 157(26), 1043–1051.

scholarly journals 307 Long term results of chirurgical repair of aortic coarctation in Tunisia

2011 ◽  
Vol 3 (1) ◽  
pp. 101
Author(s):  
Sana Ouali ◽  
Sami Hammas ◽  
Rim Gribaa ◽  
Slim Kacem ◽  
Elyes Neffeti ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Long Term Results

scholarly journals Standard Surgical Approaches to Primary Choledocholithiasis — Definitive Versus Temporary Decompression

HPB Surgery ◽  
1992 ◽  
Vol 6 (1) ◽  
pp. 35-49
Author(s):  
António Castro Mendes de Almeida ◽  
Fernando José Aldeia ◽  
Noel Medina dos Santos ◽  
Caetano Winston Gracias
Keyword(s):  
Revisional Surgery ◽  
Imaging Techniques ◽  
Intraoperative Imaging ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Anastomotic Complications ◽  
T Tube ◽  
Group A ◽  
Group B

The occurrence of retained/recurrent calculi after primary CBDE followed by temporary T-tube decompression, have remained at rates varying from 5.4% to 20.9% over the last 10 years in spite of sophisticated pre and intraoperative imaging techniques. It is postulated that a functional obstruction, due to dysmotility of the SO, lies behind most stone-containing ducts. Thus it seems logical to us that a permanent “fenestration” should be the management of most such ducts.We prospectively followed-up, for one to 10 years, two groups of patients submitted to primary CBDE aiming to assess the short and long-term results of two different surgical approaches to duct lithiasis. In one (Group A) 162 CBDE's were performed, out of 680 CHE's (24%), with a “positivity” of 68% and in the other (Group B) 80 CBDE's, out of 438 CHE's (18%), with a “positivity” of 70%. In Group A a T-tube decompression was used in 79(49%) and a definitive drainage in 83(51%) whereas in Group B the T-tube was employed in only 3(4%) and some form of permanent “fenestration” in 77(96%). There were no significant differences between the operative mortality rates, which were 2.5% in Group A (1 death post T-tube, 3 post CDJ) and 1.3% in Group B (1 death post CDD). The long-term results, though, were significantly worse among patients of Group A whose ducts were temporarily decompressed: 10/79 (12.7%) required further aggressive interventional therapy for retained/recurrent stones while only 3.8% (3/80) in Group A and 1.3% (1/76) in Group B required revisional surgery for bilio-digestive anastomotic complications with cholangitis.It is concluded that it is against the long-term efficiency of the approach utilized in Group B that the new laparoscopic techniques should be compared.

scholarly journals Effectiveness of Repair of Aortic Coarctation in Neonates: A Long-Term experience

2021 ◽  
Author(s):  
Chiara Minotti ◽  
Manuela Scioni ◽  
Biagio Castaldi ◽  
Alvise Guariento ◽  
Roberta Biffanti ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Nyha Class ◽  
Long Term Results ◽  
Relative Risk Ratio ◽  
Hypoplastic Aortic Arch ◽  
Long Term Experience

AbstractTo evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neonates. This is a retrospective clinical review of neonates with CoAo, who underwent surgery between 1995 and 2019. Data were retrieved from our institutional database, to identify preoperative and postoperative characteristics. Statistical analysis was performed by means of relative risk ratio and Cox and logistic multivariate analysis. 218 consecutive neonates (M/F: 129/89, median age 11 days, IQR 7–17 days) were included; 202 (92.7%) had a left thoracotomy; 178 underwent extended end-to-end anastomosis (EEEA, 81.6%). Hypoplastic aortic arch (HAA) was present in 102 patients (46.8%); complex cardiac anomalies in 85 (39%). Significant postoperative complications occurred in 20 (9.2%). Thirty-day mortality was 2.3% (most in complex types). At a median follow-up of 10.4 years (IQR 5.6–15.0 years; FU completeness 95.9%), there were 8 late deaths (3.7%), all associated to complex CoAo. Among 196 survivors, 177 (93.2%) were in NYHA class I; re-interventions on aortic arch occurred in 9.2% (2.0% were surgical). Freedom from mortality and re-intervention on aorta at 10 years were 94.3% and 96.7%, respectively. Surgical repair of CoAo in newborns without CPB in our series was safe and low-risk, with excellent early and late outcomes.

scholarly journals The effectiveness of surgical and non-surgical techniques in orthodontic practice in closing post-extraction spaces: a systematic review

2021 ◽  
Vol 19 (1) ◽  
pp. 31-38
Author(s):  
Z. S. Khabadze ◽  
M. E. Balashova
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Side Effects ◽  
Orthodontic Treatment ◽  
Surgical Techniques ◽  
Long Term Results ◽  
Publication Date ◽  
Controlled Clinical Trials ◽  
Surgical Methods

Reducing the orthodontic treatment duration is an important issue, especially for adult patients who want to complete treatment faster due to social or aesthetic reasons. In addition, an increase in the duration of orthodontic treatment has a number of side effects, therefore, orthodontists and patients are interested in the use of techniques that can accelerate the movement of teeth. Shorter treatment times can be achieved through a combination of orthodontic and surgical or non-surgical techniques.Aim. To systematically evaluate scientific data on the effectiveness and side effects of surgical and non-surgical methods in accelerating orthodontic treatment in situations with the removal of premolars and subsequent closure of the post-extraction spaces.Materials and methods. Electronic search of articles was carried out using search engines and databases: Cyberleninka, eLIBRARY, Google Scholar, Pub Med, SCOPUS. The publication date criterion was selected from January 2010 to January 2021. Articles included in the systematic review had to meet the following inclusion criteria: controlled clinical trials and randomized controlled clinical trials conducted in humans and published in the last 11 years in English language. The systematic review included and analyzed 15 full-text articles.Result. According to the systematic review, the speed of movement of teeth increases 2 times with corticotomy, and 1.5 times with piezocorticotomy, which is consistent with the data of other studies. At the same time, the effectiveness of the movement remains for no more than 2 months after the intervention.Conclusions. The corticotomy procedure reduces the treatment time in comparison with traditional methods by 30-50% (6-8 months). The investigated techniques did not have a significant effect on the depth of probing, the level of attachment, on the density of bone tissue, rotation and inclination of the moved teeth. Since no complications were identified for 2-4 months of observation, further studies are required to assess long-term results in the long term.

Long-term survival between total colectomy versus proctocolectomy in patients with FAP: a registry-based, observational cohort study

2019 ◽  
Vol 106 (2) ◽  
pp. 139-148 ◽  
Author(s):  
Ilaria Ardoino ◽  
Stefano Signoroni ◽  
Enzo Malvicini ◽  
Maria Teresa Ricci ◽  
Elia M. Biganzoli ◽  
...  
Keyword(s):  
Propensity Scores ◽  
Cox Regression ◽  
Total Colectomy ◽  
Multivariable Analysis ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Term Survival ◽  
Observational Cohort ◽  
Pros And Cons

Background: The best surgical choice for patients with familial adenomatous polyposis (FAP) is still debated. No prospective trials have been carried out to evaluate the pros and cons of the recommended procedures: total colectomy (ileorectal anastomosis [IRA]) vs restorative proctocolectomy (ileal pouch–anal anastomosis [IPAA]). The aim of this study was to provide a basis for tailored precision surgery in patients with FAP. Methods: We conducted a retrospective review of patients with FAP who underwent surgery and were registered in a dedicated database in Milan, Italy. Twenty-year survival related to surgical approach and prognostic factors were investigated using a Cox regression model. Results: A total of 925 patients underwent surgery between 1947 and 2015: 340 (36.8%) IPAA and 585 (63.2%) IRA. Colorectal cancer (CRC) at surgery was diagnosed in 28.6% of patients and a pathogenic APC variant was identified in 88%. During a median follow-up of 129 months, 150 patients died. The survival probability was significantly higher in the IRA than the IPAA group: 0.82 vs 0.75 (hazard ratio [HR] 0.6, 95% confidence interval [CI] 0.42–0.84). Multivariable regression modeling adjusted for propensity scores showed a similar difference, although no longer significant. Multivariable analysis indicated as independent risk factors CRC (HR 4.68, 95% CI 3.04–7.20) and age at surgery (HR 1.03, 95% CI 1.02–1.06). Among patients without cancer, the main risk factor for shorter survival was older age (HR 1.06, 95% CI 1.04–1.09). Conclusion: The study confirms excellent long-term results of surgical approaches with IRA and IPAA, suggesting that the best surgical choice may be an individually and clinically tailored approach, preferably at a young age.

Robotic surgery in gynecology

2012 ◽  
Vol 153 (25) ◽  
pp. 967-972
Author(s):  
Roland Csorba
Keyword(s):  
Robotic Surgery ◽  
Gynecologic Oncology ◽  
Surgical Approaches ◽  
Long Term Outcomes ◽  
Post Operative Pain ◽  
Surgical Methods ◽  
Adnexal Surgery ◽  
The Right ◽  
Oncologic Diseases

Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods. Orv. Hetil., 2012, 153, 967–972.

Use of Fresh Osteochondral Allografts in the Patellofemoral Joint

2017 ◽  
Vol 31 (03) ◽  
pp. 227-230 ◽  
Author(s):  
Victor Kremser ◽  
Burak Altintas ◽  
Christian Lattermann
Keyword(s):  
State Of The Art ◽  
Long Term Results ◽  
Osteochondral Allograft ◽  
Surgical Approaches ◽  
High Survival ◽  
Survival Times ◽  
Chondral Defects ◽  
Current State ◽  
Fresh Osteochondral Allograft

AbstractFresh osteochondral allograft (OCA) transplantation has become a mainstay for the treatment of osteochondral defects in the tibiofemoral joint. With excellent outcomes and high survival times, this technology has recently become more interesting for use in the patellofemoral (PF) joint. This review article will point out the historical difficulties that the use of fresh OCA poses. With newer surgical approaches and a better understanding of the mechanical requirements of the PF joint, the use of OCA transplantation has shown increasingly better results. Illustrating the technique for the preparation and implantation of single plug allografts and bulk allografts to the trochlea and patella as well as the analysis of the available literature, we point out the current state of the art as well as potentially achievable long-term results. Finally, we will point out emerging technology seeking to further develop the use of allograft technology in patellofemoral chondral defects.

scholarly journals Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Surgical Methods

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Pilar Valderrama ◽  
Thomas G. Wilson Jr
Keyword(s):  
In Vivo Studies ◽  
Surgical Approaches ◽  
Validity And Reliability ◽  
Implant Surface ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Term Evaluation

Purpose. Peri-implantitis is one of the major causes of implant failure. The detoxification of the implant surface is necessary to obtain reosseointegration. The aim of this review was to summarize in vitro and in vivo studies as well as clinical trials that have evaluated surgical approaches for detoxification of the implant body surfaces.Materials and Methods. A literature search was conducted using MEDLINE (PubMed) from 1966 to 2013. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters, radiographic bone fill, and histological reosseointegration.Results. From 574 articles found, 76 were analyzed. The findings, advantages, and disadvantages of using mechanical, chemical methods and lasers are discussed.Conclusions. Complete elimination of the biofilms is difficult to achieve. All therapies induce changes of the chemical and physical properties of the implant surface. Partial reosseointegration after detoxification has been reported in animals. Combination protocols for surgical treatment of peri-implantitis in humans have shown some positive clinical and radiographic results, but long-term evaluation to evaluate the validity and reliability of the techniques is needed.

scholarly journals Robotic Surgery in Gynecology: An Updated Systematic Review

2011 ◽  
Vol 2011 ◽  
pp. 1-29 ◽  
Author(s):  
Lori Weinberg ◽  
Sanjay Rao ◽  
Pedro F. Escobar
Keyword(s):  
Robotic Surgery ◽  
Observational Studies ◽  
Gynecologic Oncology ◽  
Surgical Approaches ◽  
Post Operative Pain ◽  
Surgical Methods ◽  
Adnexal Surgery ◽  
The Right ◽  
Oncologic Diseases

The introduction of da Vinci Robotic Surgery to the field of Gynecology has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. In general gynecology and reproductive gynecology, the robot is being increasingly used for procedures such as hysterectomies, myomectomies, adnexal surgery, and tubal anastomosis. Among urogynecology the robot is being utilized for sacrocolopexies. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomies and lymphadenectomies in oncologic diseases. Despite the rapid and widespread adoption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. Our aim is to update previously published reviews with a focus on only comparative observational studies. We determined that, with the right amount of training and skill, along with appropriate patient selection, robotic surgery can be highly advantageous. Patients will likely have less blood loss, less post-operative pain, faster recoveries, and fewer complications compared to open surgery and potentially even laparoscopy. However, until larger, well-designed observational studies or randomized control trials are completed which report long-term outcomes, we cannot definitively state the superiority of robotic surgery over other surgical methods.

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