Optimization of surgical tactics in hepatic echinococcosis

Author(s):  
S. E. Voskanyan ◽  
E. V. Naidenov ◽  
A. N. Bashkov ◽  
S. V. Cholakyan

Aim. Optimization of the surgical tactics in hepatic echinococcosis.Material and methods. From 2009 to 2021, 56 patients with hepatic echinococcosis have been operated: 6 patients underwent PAIR, 7 – open echinococcectomy, 18 – pericystectomy (“ideal echinococcectomy”) and 16 – anatomical hepatectomy (S2/3, S6/7 bisegmentectomy) or atypical resection. In 7 cases hemigepatectomy has been performed, in 2 – combined interventions have been performed for echinococcosis relapse of the abdominal cavity.Results. The duration of minor hepatic resection was shorter than pericystectomy and major hepatic resection. The smallest blood loss was noted in patients who underwent open echinococcectomy, anatomical and atypical hepatectomy. No complications after PAIR were noticed. The lowest incidence of postoperative complications, including biliary complications, was found after hepatic resection interventions. The lenths of hospital stay after hepatic resections was significantly shorter compared to ecinococcectomy and pericystectomy. The reccurence of hepatic echinococcosis relapse was detected in 4 (66.7%) patients after PAIR and 2 (28.6%) patients after ecinococcectomy.Conclusion. Organ-preserving techniques should be a priority in the surgical treatment of hepatic echinococcosis. The best results in terms of the early postoperative complications frequency in the hepatic echinococcosis treatment were demonstrated by minor hepatic resections. Open echinococcectomy should be performed only for central location of large cysts and (or) their massive contact with the liver vessels. Minimally invasive resection technologies demonstrate optimal short- and long-term results. Major hepatectomy should be performed very selectively and only in those cases when they have advantages over other methods, and their implementation does not lead to a loss of more than 20% of healthy hepatic parenchyma. The best long-term results showed pericystectomy and hepatectomy in comparison with echinococcectomy.

2001 ◽  
Vol 110 (10) ◽  
pp. 907-911 ◽  
Author(s):  
Maria Izabel Kos ◽  
Pierre B. Montandon ◽  
Jean-Philippe Guyot

We analyzed the results of 604 cases of primary stapes surgery performed between 1974 and 1997 with replacement of the stapes by a 0.6- or 0.8-mm Schuknecht Teflon-wire piston. At long-term follow-up (1 to 21 years; mean, 7 years), the residual air-bone gap was 10 dB or less in 79% of the cases. The hearing results and postoperative complications were comparable to those reported by authors who used the same evaluation criteria. Although the aim of the surgery was to perform a small stapedotomy with a narrow footplate perforation (0.8 mm), a large stapedotomy or a stapedectomy was performed in 134 cases (22.2%) because of surgical or anatomic conditions. Our results show that the larger footplate perforations allowed a better correction of the air-bone gap at the lower frequencies. The ears with larger perforations did not show a higher incidence of sensorineural hearing loss.


Author(s):  
M. G. Efanov ◽  
N. I. Pronina ◽  
R. B. Alikhanov ◽  
O. V. Melekhina ◽  
Y. V. Kulezneva ◽  
...  

Aim: to evaluate the short- and long-term outcomes of laparoscopic and open operations in the treatment of hepatic echinococcosis.Materials and methods. The results of laparoscopic and open echinococcectomies performed from 2013 to 2020 were retrospectively studied. Laparoscopic operations were considered the method of choice. Open operations were performed in cases with contraindications to the laparoscopic approach.Results. In total, 57 patients were operated: 47 laparoscopically (including robotic approach in 4 cases), 9 patients underwent open surgery. Radical procedures prevailed among laparoscopic cystectomies: 46 (98%). In the groups of laparoscopic/open cystectomies, partial pericystectomy was performed in 1/3 of patients, subtotal – in 24/4, total – in 13/0, and liver resection – in 9/2 patients, respectively. Laparoscopic procedures were performed mainly for types 1 and 3 of cysts, open procedures – for type 2 (WHO), recurrent and extrahepatic abdominal cysts were indication for open surgery. The frequency of severe complications did not differ between the groups. In the laparoscopic group, 1 (2%) patient died. After laparoscopic cystectomies, the mean (median) hospital stay (8 vs 10 days) and duration of abdominal drainage (10 vs 12 days) were significantly shorter. Relapse occurred only after conservative cystectomies, in one patient in each group.Conclusion. Laparoscopic radical surgery for liver hydatid cysts may be the method of choice if performed in a specialized HPB center. Patient selection criteria should be based on the center's experience in laparoscopic liver surgery.


Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.


Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Boštjan Lanišnik ◽  
Vojko Didanovič ◽  
Bogdan Čizmarevič

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>


Author(s):  
N Bobrova ◽  
N Trofimova

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.


1995 ◽  
Vol 46 (5) ◽  
pp. 853 ◽  
Author(s):  
NS Barrett

Movement patterns were studied on a 1-ha isolated reef surrounding Arch Rock in southern Tasmania. Short-term movements were identified from diver observations, and interpretation of long-term movements involved multiple recaptures of tagged individuals. Visual observations indicated that the sex-changing labrids Notolabrus tetricus, Pictilabrus laticlavius and Pseudolabrus psittaculus were all site-attached, with females having overlapping home ranges and males being territorial. In the non-sex-changing labrid Notolabrus fucicola and in the monacanthids Penicipelta vittiger and Meuschenia australis, there was no evidence of territorial behaviour and 1-h movements were in excess of the scale of the study. The long-term results indicated that all species were permanent reef residents, with most individuals of all species except M. australis always being recaptured within a home range of 100 m × 25 m or less. Only 15% of individuals of M. australis were always recaptured within this range category. The natural habitat boundary of open sand between the Arch Rock reef and adjacent reefs appeared to be an effective deterrent to emigration. The use of natural boundaries should be an important consideration in the design of marine reserves where the aim is to minimize the loss of protected species to adjacent fished areas.


2019 ◽  
Vol 29 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Giuseppe Portale ◽  
Alessandro Valdegamberi ◽  
Francesco Cavallin ◽  
Flavio Frigo ◽  
Valentino Fiscon

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