Surgical treatment of relapsed megaesophagus

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.

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Duplex scanning as an alternative to computer tomography with contrast enhancement for the control of complications after endovascular aneurysm repair

Clinical Practice ◽

10.17816/clinpract09144-49 ◽

2018 ◽

Vol 9 (1) ◽

pp. 44-49

Author(s):

D. I. Korshunov ◽

R. I. Khabazov ◽

N. V. Ustiantseva ◽

A. V. Chupin ◽

S. V. Deryabin

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Early Detection ◽

Computer Tomography ◽

Postoperative Period ◽

Surgical Intervention ◽

Endovascular Aneurysm Repair ◽

Duplex Scanning ◽

Non Invasive ◽

Aneurysm Repair

EVAR (endovascular aneurism repair) is the preferred method for the surgical treatment of ananeurysm. The advantage of this type of surgical intervention is that a smaller number of postoperative complications will occur. The main diagnostic tasks for patients after EVAR are to determine the size of the aneurysmal sac, detection of an endoleak, detection of the endoprosthesis migration and the deformation of the stent graft itself. Conclusion: early detection of complications in the postoperative period remains the main problem for monitoring patients after EVAR. Duplex scanning is a safe, non-invasive and effective method of measuring the size of an aneurysmal sac and detecting possible complications after EVAR.

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Surgical Treatment of Prolapse of the Third Eyelid Gland in Dogs using Modified Morgan Pocket Technique

Indian Journal of Animal Research ◽

10.18805/ijar.b-1131 ◽

2019 ◽

Author(s):

R. Yaygingul ◽

Z. Bozkan ◽

Z. Bilgen ªen ◽

B. Kibar Kurt ◽

O. Bulut ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Clinical Outcome ◽

Success Rate ◽

Postoperative Period ◽

Clinical Problem ◽

The Third ◽

Unilateral Disease ◽

Percent Success ◽

The Right

The aim of this retrospective study was to evaluate the clinical outcome, complications, recurrence rate, and results of the pocket technique in the treatment of prolapse of the third eyelid gland, cherry eye namely. Thirty eyes of 26 dogs diagnosed with prolapse of the third eyelid gland were included the study. Conjunctivitis and ocular discharges were noticed in the affected eyes. The four cases were (15%) bilateral and twenty-two (85%) were unilateral. Of the dogs with unilateral disease, the affected eye was on the left side in 10 (45%) dogs and the right side in 12 (55%). Eighteen dogs were male and eight were female. Twenty-six dogs, 30 eyes with protrusion of the third eyelid gland were treated using Modified Morgan’s pocket technique. In the postoperative period, the dogs were controlled 3 times with 7 day intervals and no clinical problem was detected. Modified Morgan pocket technique was used with 96.1 percent success rate for the re-positioning of prolapsed gland of the third eyelid in dogs.

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Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

Journal of New Medical Technologies eJournal ◽

10.12737/6454 ◽

2014 ◽

Vol 8 (1) ◽

pp. 0-0

Author(s):

Антонов ◽

A. Antonov

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Postoperative Complications ◽

Cancer Patients ◽

Postoperative Period ◽

Bone Fractures ◽

Infectious Complications ◽

Lower Limbs ◽

Oncologic Patients

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

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Clinical case of surgical treatment of giant central anastomosis aneurysm after autovenous femoropopliteal bypass

Perm Medical Journal ◽

10.17816/pmj381144-150 ◽

2021 ◽

Vol 38 (1) ◽

pp. 144-150

Author(s):

Vladimir A. Samartsev ◽

Dmitry S. Vaganov ◽

Andrey Yu. Oparin ◽

Ilya A. Karasov ◽

Eugeny V. Kruglov ◽

...

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Efficient Method ◽

Postoperative Period ◽

Clinical Case ◽

Lower Extremities ◽

Femoropopliteal Bypass ◽

Proximal Anastomosis ◽

Surgical Revascularization ◽

Aneurysm Development

Ahterosclerosis of vessels of the lower extremities is widely distributed in the population. Open surgical revascularization is an efficient method for treatment of this pathology. One of the rare postoperative complications is an anastomosis aneurysm development. We report about a clinical case of a 74-year-old male with a giant (25 cm in diameter) aneurysm of the proximal anastomosis after femoropopliteal bypass. Open aneurysmectomy was performed, and the postoperative period was uneventful.

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Assessment of postoperative complications of transurethral contact pyelocalycоlithotripsy in patients with high-density stones according to the Clavien – Dindo classification

Urologicheskie vedomosti ◽

10.17816/uroved46150 ◽

2020 ◽

Vol 10 (4) ◽

pp. 309-316

Author(s):

Toirkhon Kh. Nazarov ◽

Anisjon I. Tursunov ◽

Ivan V. Rychkov ◽

Magomed A. Ahmedov ◽

Kseniya E. Trubnikova ◽

...

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Retrospective Analysis ◽

Kidney Stones ◽

Postoperative Period ◽

Topical Issue ◽

Unified Algorithm ◽

Cavity System ◽

Treatment Of Urolithiasis

Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access. Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy. Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated. Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien Dindо classification. Conclusion. The improved Clavien Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.

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Prevention of complications of transvesical adenomectomy with a blind suture of the urinary bladder

Kazan medical journal ◽

10.17816/kmj2146 ◽

2012 ◽

Vol 93 (1) ◽

pp. 56-61

Author(s):

E A Zubkov ◽

M E Sitdykova

Keyword(s):

Urinary Tract ◽

Surgical Treatment ◽

Postoperative Complications ◽

Urinary Bladder ◽

Postoperative Period ◽

Early Recovery ◽

One Stage ◽

Analysis Of Results ◽

Transvesical Adenomectomy ◽

Prostate Adenoma

Aim. To determine the frequency and develop methods for prevention of possible complications of transvesical adenomectomy. Methods. Conducted was an analysis of results of surgical treatment of 492 patients with prostate adenoma. One-stage suprapubic transvesical adenomectomy with a primary blind suture of the urinary bladder and hemostasis of the adenoma bed was performed in 347 patients. Results. In the postoperative period inflammatory complications of the urinary tract were observed in 5 (1.4%) out of 347 operated patients. It was established that the frequency and nature of both early and late pyo-inflammatory and obstructive postoperative complications of the suprapubic adenomectomy depend on the method of hemostasis of the bed of the adenoma and on the time of urination recovery. Conclusion. The main measures of prevention of complications during suprapubic adenomectomy are hemostasis of the bed of the adenoma by temporary retriganization with removable hemostatic ligatures, early recovery of urethral voiding (2-4 days) and application of antibiotics to the bed of the adenoma via the drainages of the deference ducts.

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APPENDICULAR PERITONITIS IN CHILDREN: AN EFFICIENT SURGICAL APPROACH AND INTENSIVE CARE

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2020-24-2-62-70 ◽

2020 ◽

Vol 24 (2) ◽

pp. 62-70

Author(s):

O. V. Karaseva ◽

Kseniia E. Utkina ◽

A. L. Gorelik ◽

A. V. Timofeeva ◽

D. E. Golikov ◽

...

Keyword(s):

Intensive Care ◽

Laparoscopic Surgery ◽

Surgical Treatment ◽

Postoperative Complications ◽

Intestinal Obstruction ◽

Postoperative Period ◽

Diffuse Peritonitis ◽

Surgical Tactics ◽

Adhesive Intestinal Obstruction ◽

Local Protocol

Introduction. Currently, there is no any unified approach to the treatment of complicated forms of acute appendicitis in children. The purpose of our study is to evaluate the effectiveness of the local Protocol for diagnostics and treatment of appendicular peritonitis (AP) in children. Material and methods. 149 children with AP, aged 2 - 17 (11 ± 3.5 ), were included into the study. All of them were treated at the Clinical and Research Institute Emergency Pediatric Surgery and Trauma (CRIEPST) in 2015-2018. In the gender structure, boys (104; 69.8%) prevailed over girls (45; 30.2%). The following parameters were evaluated: AP structure, surgical tactics, postoperative course (incidence of postoperative intestinal failure syndrome (IFS), postoperative complications, length of hospital stay). A tactics for surgical treatment and volume of intensive care in the postoperative period were defined depending on AP severity and according to the local Protocol. Laparoscopic appendectomy was performed in 145 (97.3%) patients. There were no intraoperative complications and conversions in the studied group. In case of periappendiular abscess (PA) 3 (2.7%), patients had puncture and abscess drainage under ultrasound control. Results. While analyzing the AP structure by forms , the following picture was shown: free and abscessed forms were approximately equal - 72 (48.3%) and 77 (51.7%), respectively (p > 0.05). Diffuse peritonitis - 31.5%; generalized - 16.8%; combined - 17.4%; periappendicular abscess (PA) stage 1-14.8%; PA 2-16.8%; PA 3-2.7%. Postoperative complications - 4 (2.7%): postoperative abdominal abscesses - 3 (2.0%); early adhesive intestinal obstruction - 1 (0.7%). In postoperative abscesses, puncture and drainage were performed under ultrasound control; in early adhesive intestinal obstruction - laparoscopic adhesiolysis. All the children recovered. Length of intensive care was 2.9 ± 1.8 days; hospitalization - 12.0 ± 5.2 days. Conclusion. The local Protocol developed by the researchers helps to define a surgical tactics and volume of intensive care in the postoperative period. Laparoscopic surgery, in the vast majority of cases, is an optimal and effective technique for AP surgical treatment in children. Contraindications to laparoscopic surgery are PA 3 and total abscessing peritonitis.

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Comparison of outcomes between medical and surgical treatment in dogs with prostatic adenocarcinoma: a retrospective study

BMC Veterinary Research ◽

10.1186/s12917-021-03103-5 ◽

2022 ◽

Vol 18 (1) ◽

Author(s):

Keigo Iizuka ◽

Kumiko Ishigaki ◽

Mamiko Seki ◽

Takahiro Nagumo ◽

Kei Tamura ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Postoperative Complications ◽

Survival Time ◽

Medical Management ◽

Prostatic Carcinoma ◽

Prostatic Adenocarcinoma ◽

Initial Evaluation ◽

Treatment Type ◽

Surgical Group

Abstract Background Prostatic cancer is uncommon in dogs. Dogs with prostatic carcinoma have been reported to have a poor prognosis. Information regarding prognosis with various surgery options as well as prognosis with surgical vs. medical treatment is lacking. This retrospective study compares the outcomes of medical management to surgical treatment in dogs with prostatic adenocarcinoma and assesses the surgical outcomes of patients who underwent total prostatectomy (TP) and prostatocystectomy (TPC). The medical records of 41 dogs with prostatic adenocarcinoma, between February 2008 and June 2019, were reviewed for information on signalment, clinical signs in the initial evaluation, preoperative diagnostic imaging findings, treatment type (non-surgical or surgical), surgery type, postoperative complications, adjunctive medical therapy, and survival time. The dogs were divided into non-surgical (n = 12) or surgical (n = 29) groups. The surgical group was subdivided into the TP (n = 20) and TPC (n = 9) subgroups. Results Age was not significantly different between the surgical (median 13.1 years [8.4–15.4] years) and the non-surgical groups (median 10.8 [7.7–15.3] years). Body weight (BW) was also not significantly different between the surgical (median 6.8 kg [2.4–34.5 kg]) and non-surgical groups (median 6.4 kg [3.7–9.12 kg]). The overall median survival time (MST) from the initial evaluation was significantly longer in the surgical than in the non-surgical group (337 vs. 90.5 days). The postoperative MST was significantly longer in the TP group than in the TPC subgroup (510 vs. 83 days). As TPC was performed in cases of tumor progression, its postoperative complications were severe, resulting in a shorter MST. Ten (50%) and 6 patients (30%) in the TP subgroup postoperatively showed mild and severe urinary incontinence, respectively, whereas all patients in TPC subgroup did show severe incontinence. Conclusion Results of the study suggest that surgical treatment of prostatic carcinoma results in longer survival times over medical management alone. In particular, TP might be recommended for improving survival time and quality of life in canine prostatic adenocarcinoma that does not infiltrate the bladder. Early detection is key for a survival advantage with surgical treatment.

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Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients

Ambulatory surgery hospital-replacing technologies ◽

10.21518/1995-14772018-1-2-64-71 ◽

2018 ◽

pp. 64-71

Author(s):

A. N. Shikhmetov ◽

L. A. Osin ◽

A. M. Zadikyan ◽

A. A. Pazichev

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Postoperative Period ◽

Early Postoperative Period ◽

Subsequent Treatment ◽

The Body ◽

Operating Table ◽

Operating Team ◽

Simultaneous Operations ◽

Repeated Surgery

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.

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Surgical Treatment of Objective Patellar Instability: Long-Term Results

Joints ◽

10.1055/s-0038-1636949 ◽

2018 ◽

Vol 06 (01) ◽

pp. 033-036 ◽

Cited By ~ 3

Author(s):

Massimo Berruto ◽

Francesco Uboldi ◽

Paolo Ferrua ◽

Giovanni Vergottini ◽

Andrea Manunta

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Surgical Procedures ◽

Surgical Procedure ◽

Patellar Instability ◽

Long Term Results ◽

Patellar Tilt ◽

Kujala Score ◽

Tegner Score

Purpose To evaluate the long-term results of classical “à la carte” surgical treatment of objective patellar instability as proposed by Dejour in 1987. Methods A multicentric retrospective study was conducted evaluating patients that underwent surgical procedure with a 10-year minimum follow-up (mean 12.7; range, 10–15). Surgical procedures were medial transfer of the tibial tubercle transfer according to Elmslie and Trillat et al in 38 cases, plasty of the vastus medialis obliquus according to Insall in 15 cases, open lateral retinacular release in 13 cases, capsuloplasty in 3 cases, and trochleoplasty in 1 case. Different combinations of surgical procedures were adopted according to the pathological features. Subjective outcome was assessed with the visual analog scale (VAS), Kujala score, subjective International Knee Documentation Committee (IKDC) score, Tegner score, and Crosby and Insall scale. Radiographic exams were used to assess the patellar tilt by the Laurin's angle and patellofemoral osteoarthritis (OA) according to the Iwano radiological OA scale. Results Forty patients were evaluated. Subjectively, 60% of patients achieved a result judged good, 34% sufficient, and 6% poor. There were only two cases of recurrence of instability. Mean score results were Kujala score 73.4 ± 9.9 (range, 55–95), VAS 4.5 ± 1.2 (range, 1–6), IKDC 64.8 ± 7.9 (range, 51–88), and Tegner score 4. Only nine patients returned to sports activities). Ten patients developed a grade I patellofemoral OA, 8 patients a grade II, and 22 patients a grade III. Average patellar tilt was 10° ± 3.9°. Conclusion This retrospective study showed that the traditional surgical procedure was successful for the treatment of patellar instability, but it did not prevent symptomatic patellofemoral OA. Level of Evidence Level IV, retrospective case series.

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