scholarly journals IMAGE-GUIDED SURGERY IN THE SPINE: NEURONAVIGATION VS. FLUOROSCOPY

2015 ◽  
Vol 14 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Vinícius de Paula Guedes ◽  
Elisangela Ferrretti Manffra ◽  
Luiz Roberto Aguiar
Keyword(s):  
Blood Transfusion ◽  
Pedicle Screws ◽  
Operation Time ◽  
Computer Assisted Surgery ◽  
Accurate Method ◽  
Implantation Technique ◽  
Computer Assisted ◽  
Group I ◽  
Operative Complications ◽  
Group Ii

Objectives:To evaluate the accuracy and the operative complications of implanting pedicle screws in the thoracic and lumbar spine, using computer-assisted surgery compared to the implantation technique using fluoroscopy.Methods:A retrospective study was conducted at the Hospital Universitário Cajuru PUC-PR from January 2000 to January 2009. Two groups of patients undergoing implant pedicle screws were analyzed (n=80). Group I received implant pedicle screws through fluoroscopy technique and group II, through neuronavigation technique. The accuracy of positioning of pedicle screws was evaluated using rating scales.Results:The accuracy was higher in group II, where 77.5% of the screws were correctly positioned, whereas there were only 28.5% in group I (p=0.001). There was a reduction of 95% (CI: 80-97%) in the risk of screws misplacement in group II. The average operation time was 312.2±78.1 minutes in group I and 270.3±41.4 in group II (p=0.004). Blood transfusion was needed in 28 patients in group I and 10 patients in group II (p=0.005), resulting in 64% risk reduction of blood transfusion in group II. Eight patients in group I underwent revision surgery whereas only one patient in the group II, that is, 75% of surgical revision risk reduction.Conclusion:The implantation technique of pedicle screws using neuronavigation is a more accurate method and has less operative complications compared with the technique that uses fluoroscopy.

scholarly journals Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Henriette L. Möllmann ◽  
Laura Apeltrath ◽  
Nadia Karnatz ◽  
Max Wilkat ◽  
Erik Riedel ◽  
...  
Keyword(s):  
Computer Assisted Surgery ◽  
Reference Points ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Advantages And Disadvantages ◽  
Patient Specific Implants ◽  
Operative Complications ◽  
The Difference ◽  
And Training

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

Efficacy of Computer-Assisted Management of Respiratory Failure in Neonates

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 139-143 ◽  
Author(s):  
Waldemar A. Carlo ◽  
Lucia Pacifico ◽  
Robert L. Chatburn ◽  
Avroy A. Fanaroff
Keyword(s):  
Respiratory Failure ◽  
Computer Program ◽  
Computer Assisted ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Group Iii ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii ◽  
Assisted Management

We modified an algorithm for mechanical ventilation of infants with respiratory distress syndrome to create an interactive user-friendly computer program. To determine the effectiveness of this computer program, we evaluated the correction of deranged arterial blood gases in three groups of neonates: group I, treated before the introduction of the computer into the nursery; group II, managed by pediatric residents with the guidance of the computer program; group III, treated after the introduction of the computer into the nursery but managed without consideration of the computer output. Arterial blood gas values improved more frequently in the neonates managed with computer consultation (group II, 65/75, 87%) than in both control groups (group I, 37/57, 65%, P < .005; and group III, 46/63, 73%, P < .05). Furthermore, increases in ventilatory support in the presence of normal arterial blood gas values occurred only in patients managed without computer guidance. In a teaching institution, more effective care of neonates with respiratory failure may be facilitated by computer-assisted management of mechanical ventilators.

Echocardiographic assessment of LV mass in rabbits: models of pressure and volume overload hypertrophy

1993 ◽  
Vol 265 (6) ◽  
pp. H2066-H2072 ◽  
Author(s):  
J. F. Plehn ◽  
E. Foster ◽  
W. N. Grice ◽  
M. Huntington-Coats ◽  
C. S. Apstein
Keyword(s):  
Pressure Overload ◽  
Volume Overload ◽  
Accurate Method ◽  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Group I ◽  
Lv Mass ◽  
Wet Weight ◽  
Group Ii

We describe a method for the noninvasive measurement of left ventricular mass in small animals using two-dimensionally guided M-mode echocardiography. We compared echocardiographic cross-sectional area (CSA) and cubed-based volumetric indexes of left ventricular (LV) mass with postmortem wet weight in renovascular hypertension-induced pressure overload (group I) and acute aortic insufficiency-induced volume overload (group II) models of ventricular hypertrophy. CSA and cubed echocardiographic indexes correlated well with wet weight from a combination of group I and II animals and their controls (r = 0.89, P < 0.001 for both groups). Separate analyses of groups I and II also demonstrated significant relationships between mass indexes and wet weight using CSA and cubed formulas, respectively, in both pressure (r = 0.57, P = 0.01 and r = 0.71, P < 0.001) and volume (r = 0.90 and r = 0.89, P < 0.001) overload models. Echocardiographically predicted LV mass derived from cubed and CSA regression formulas was 89 and 56% sensitive for pressure overload hypertrophy in group I and 100% sensitive (both cubed and CSA methods) for volume overload hypertrophy in group II. Cubed and CSA mass regression formulas were 60 and 80% specific for hypertrophy in group I and 100 and 90% specific in group II. Normalization of predicted LV mass for body weight added little to the overall technique accuracy with measured sensitivities of 83 and 75% and specificities of 92 and 77%, respectively, for cubed and CSA methods. Two-dimensionally guided M-mode echocardiography provides a reasonably accurate method of LV mass determination in rabbits with pressure- or volume-overloaded ventricles.

scholarly journals Fistulotomy with or without marsupialisation of wound edges in treatment of simple anal fistula: a randomised controlled trial

2019 ◽  
Vol 101 (7) ◽  
pp. 472-478 ◽  
Author(s):  
M Anan ◽  
SH Emile ◽  
H Elgendy ◽  
M Shalaby ◽  
A Elshobaky ◽  
...  
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Anal Fistula ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Operation Time ◽  
Complication Rates ◽  
Group I ◽  
Group Ii ◽  
Fistula Track

Background Promotion of healing of the anal wound after fistulotomy may help accelerate recovery and return to work. The present study aimed to assess the effect of marsupialisation of the edges of the laid open fistula track on wound healing after anal fistulotomy for simple anal fistula. Methods This was a prospective randomised trial on patients with simple anal fistula. Patients were randomly assigned to one of two groups; group I underwent anal fistulotomy and group II underwent anal fistulotomy and marsupialisation of the edges of the laid open track. Outcomes of the study were time to achieve complete wound healing, operation time, postoperative pain and complications. Results Sixty patients of mean age of 40.8 years with simple anal fistula were randomly divided into two equal groups. No significant differences between the two groups regarding operation time (16.8 vs 18.4 minutes; P = 0.054), postoperative pain score (1.6 vs 1.2; P = 0.22), and complication rates were recorded. Group II achieved complete healing in a significantly shorter duration than group I (5.1 vs 6.7 weeks; P < 0.0001). Conclusion Marsupialisation of the edges of the laid open fistula track after fistulotomy resulted in quicker wound healing with similar complication and recurrence rates to lay open fistulotomy alone.

scholarly journals Skin Staples: A Safe Technique for Securing Mesh in Lichtensteins Hernioplasty as Compared to Suture

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Anand Munghate ◽  
Sushil Mittal ◽  
Harnam Singh ◽  
Gurpreet Singh ◽  
Manish Yadav
Keyword(s):  
Mesh Fixation ◽  
Operating Time ◽  
Operation Time ◽  
Skin Closure ◽  
Skin Staples ◽  
Group I ◽  
Lichtenstein Hernia Repair ◽  
Duration Of Surgery ◽  
Group Ii ◽  
Polypropylene Sutures

Background.Lichtenstein tension free repair is the most commonly used technique due to cost effectiveness, low recurrence rate, and better patient satisfaction. This study was done to compare the duration of surgery and postoperative outcome of securing mesh with skin staples versus polypropylene sutures in Lichtenstein hernia repair.Materials and Methods.A total of 96 patients with inguinal hernia undergoing Lichtenstein mesh repair were randomly assigned into two groups. The mesh was secured either by using skin staples (group I) or polypropylene sutures (group II).Results.The operation time was significantly reduced from mesh insertion to completion of skin closure in group I (mean 20.7 min) as compared to group II (mean 32.7 min) with significantPvalue(P<0.0001)and less complication rate in group I as compared to group II.Conclusion.Mesh fixation with skin staples is as effective as conventional sutures with added advantage of significant reduction in the operating time and complications or recurrence. The staples can be applied much more quickly than sutures for fixing the mesh, thus saving the operating time. Infection rate is significantly decreased with staples.

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

scholarly journals Evaluation of Closure versus Non-closure of Vaginal Vault after Non-descent Vaginal Hysterectomy

2021 ◽  
Vol 12 (1) ◽  
pp. 45-49
Author(s):  
Mousumi Saha ◽  
Ratu Rumana Binte Rahman ◽  
Gulshan Ara ◽  
Florida Rahman ◽  
Raunak Jahan
Keyword(s):  
Blood Transfusion ◽  
Vaginal Hysterectomy ◽  
Computer Software ◽  
Pelvic Abscess ◽  
Vaginal Vault ◽  
Gynecological Disorders ◽  
Abdominal Approach ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Introduction: Non-descent vaginal hysterectomy has been considered a valid alternative to the abdominal approach and is also preferred for benign uterine diseases without descent of uterus because it is associated with fewer complications. Vaginal vault is the enlargement of the internal end of the vagina which is usually closed during vaginal hysterectomy. This study was done to see the outcome of vault closure versus non-closure in non-descent vaginal hysterectomy in non-prolapsed uterus. Methods: This prospective study was done in Obstetrics and Gynae Department, Sir Salimullah Medical College and Mitford Hospital during the period of July 2011 to December 2011. A total number of 50 patients with benign gynecological disorders without descent of uterus who admitted for hysterectomy were enrolled in this study. Among them, 25 patients had the vault close (group I) whereas 25 patients had an open vault(group11). Indication for hysterectomy, complications, blood transfusion, hospital stay (day) and histopathological findings were assessed for both groups. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20). Results: Majority of the patients was found in the age group of 41-45 years in both groups, which was 12(48.0%) in Group I and 18(72.0%) patients in Group II. Blood transfusion was needed in 5(20.0%) and in 6(24.0%) in Group I and Group II respectively. Post operative complications after 15 days of follow-up, pelvic abscess was found 4.0% in Group I & not found in Group II. UTI was not found in Group I but 4.0% found in Group II. Conclusion: Outcomes were almost similar in both procedure. Ultimately the study did not show any significant difference between either group. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 45-49

scholarly journals Treatment of pediatric patients with lower leg deformities associated with physeal arrest: analysis of 28 cases

2017 ◽  
Vol 5 (4) ◽  
pp. 38-47
Author(s):  
Viktor A. Vilensky ◽  
Andrey A. Pozdeev ◽  
Timur F. Zubairov ◽  
Ekaterina A. Zakharyan
Keyword(s):  
External Fixation ◽  
Growth Plate ◽  
Deformity Correction ◽  
Limb Length Discrepancy ◽  
Lower Leg ◽  
Computer Assisted ◽  
Mechanical Axis Deviation ◽  
Group I ◽  
Group Ii ◽  
Healthy Part

Aim. To retrospectively analyze the results of two treatment methods for lower leg deformities associated with partial growth arrest. Materials and methods. Group I comprised 15 children who underwent osteotomy, acute overcorrection, and external fixation by Ilizarov with subsequent lengthening of the segment. Group II comprised 13 patients who underwent epiphysiodesis of the healthy part of the growth plate by drilling, osteotomy with external fixation by use of an Ortho-SUV Frame, and subsequent gradual deformity correction and lengthening. Results. In group I, overcorrection of varus deformities by mechanical axis deviation (MAD) was 18.28 ± 5.25 mm, overcorrection by mechanical medial proximal tibial angle (mMPTA) was 14.86 ± 4.45°, and overcorrection by mechanical lateral distal tibial angle (mLDTA) was 12.85 ± 3.02°. Overcorrection of valgus deformities according to MAD was 15.12 ± 8.28 mm, overcorrection by mMPTA was 10.38 ± 2.77°, and overcorrection by mLDTA was 7.5 ± 3.9°. Recurrence of the deformity was observed in 11 (73%) cases (range, 5–16 months). In group II, the accuracy of correction (AC) in varus deformities for MAD was 98% and 94% for mMPTA and mLDTA. For valgus deformities, AC for MAD was 90% and 96% for mMPTA and mLDTA. The AC for anatomical proximal posterior tibial angle and anatomical anterior distal tibial angle was 96% for procurvation deformities and that for recurvation deformities was 92%. Deformity recurrence was observed in only one case within 6 months after frame removal. In 2 cases, repeat limb length discrepancy correction surgeries were performed. Conclusion. Use of epiphysiodesis of the healthy portion of the growth plate in combination with osteotomy, computer-assisted external fixation with subsequent gradual deformity correction, and lengthening in patients with deformities associated with partial physeal arrest significantly decreased the number of deformity recurrences.

scholarly journals Acute hypervolemic hemodilution combined with controlled hypotension to minimize blood loss during operations of spine fusion: remifentanil versus magnesium sulfate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Khaled Mohammed Elnaghy ◽  
Ibrahimabd-Elsalam Nasr ◽  
Eman Mohamed Kamal
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Magnesium Sulfate ◽  
Spine Fusion ◽  
Controlled Hypotension ◽  
Group Iii ◽  
Group I ◽  
Estimated Blood Loss ◽  
Hypervolemic Hemodilution ◽  
Group Ii

Abstract Background Blood loss is one of the major problems during operations of spine fusion. Several blood-conservative measures were applied to reduce the incidence of blood loss—among them, acute hypervolemic hemodilution (AHH) and controlled hypotension (CH). This study was designed to detect the effect of combination of AHH with CH induced by remifentanil versus magnesium sulfate on the volume of blood loss, allogeneic blood transfusion, hemodynamics, coagulation, and electrolytes during operations for spine fusion which are risky operations with high incidence of blood loss and blood transfusion. Sixty patients scheduled for posterior fusion of the spine were randomly allocated into three groups of 20 patients each (group I (AHH), group II (AHH combined with remifentanil-based CH), and group III (AHH combined with magnesium sulfate-based CH)). Estimated blood loss and total volume of packed red blood cells (PRBCS) transfused were recorded. Arterial blood pressure (ABP) and heart rate (HR) measures were recorded. Blood samples were obtained for the detection of hemoglobin (Hb) and hematocrit (HCT). Results Estimated blood loss, percentage blood loss, and intraoperative RBC transfusion units were significantly high in group I in relation to group II and group III (Table 2). Cardiac output was significantly higher in group I in relation to group II and group III at 10, 15, 30, 45, and 60 min after start of AHH. MBP and HR results were significantly high in group I in comparison with group II and group III at 30, 45, 60, and 90 min and 2 and 3 h after start of study drugs. CVP results were significantly high in group I in relation to group II and group III at 15, 30, 45, 60, and 90 min after start of AHH. PTT was significantly increased in the three study groups in comparison with baseline inside each group after AHH. Conclusion Combination of AHH with CH induced by remifentanil or magnesium sulfate was associated with reduction in estimated blood loss, and total volume of PRBCS transfused. There was no significant difference between hemodynamic parameters with the use of remifentanil or magnesium sulfate except that SBP, DBP, and MBP results were significantly high with magnesium sulfate at 15 min after drug infusion. There was significant increase in PT and PTT after AHH that was not reflected by significant blood oozing from the operative field, or by difficulty in hemostasis.

Low density lipoprotein on poor quality mithun (Bos frontalis) semen preservation

2016 ◽  
Author(s):  
P. Perumal ◽  
S. K. Srivastava ◽  
K. K. Baruah ◽  
J. S. Rajoriya ◽  
N. Srivastava
Keyword(s):  
Density Lipoprotein ◽  
Egg Yolk ◽  
Cholesterol Content ◽  
Poor Quality ◽  
Computer Assisted ◽  
Low Density ◽  
Liquid Storage ◽  
Group I ◽  
Intracellular Enzymes ◽  
Group Ii

Low density lipoproteins (LDL) extracted from hens egg yolk (EY) has been studied over EY based extender for liquid storage of mithun semen with the objective to explore the use of LDL in place of EY. Physio-morphological attributes (PMAs) and mobility and velocity parameters were measured by computer assisted sperm analyser (CASA). Leakage of intracellular enzymes, activity of total antioxidants and lipid peroxidation following liquid storage (5oC) of mithun semen were studied. Fifty ejaculates were collected through transrectal massage method from matured mithun bulls and based on the mass activity and individual motility; the semen samples were splited into good and poor quality and diluted with the tris citrate glycerol (TCG) extender and were splited into three equal aliquots: Group I: Control, EY; Group II and Group III contained 8 and 10% LDL (w/v), respectively. PMAs, intracellular enzymatic leakage and biochemical profiles were evaluated at 5°C following 10hrs incubation. Result revealed a significant (p less than 0.05) improvement in PMAs, CASA parameters and cholesterol content of spermatozoa as well as reduction in leakage of intracellular enzymes, oxidative stress in Group II than control and other treatment group. It was concluded that addition of 8% LDL holds a clear advantage over EY or 10% LDL in liquid preservation of mithun semen.

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