scholarly journals Prophylaxis and treatment of intraoperative extrahepatic biliary ducts injury in laparoscopic cholecystectomy

2011 ◽  
Vol 2 (4) ◽  
pp. 23-28
Author(s):  
Yuri V. Ivanov ◽  
Dmitriy V. Sazonov ◽  
Dmitriy P. Lebedev ◽  
Olga E. Nechaeva
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Diagnostic Methods ◽  
Surgical Correction ◽  
Time Duration ◽  
Modern Classification ◽  
Biliary Ducts

The article presents the modern classification of extrahepatic biliary ducts injuries in laparoscopic cholecystectomy. Three groups of biliary ducts intraoperative injures risk factors are described. The basic methods of preoperative and intraoperative prophylaxis of the biliary ducts injury and diagnostic methods are offered. The variations of surgical correction according to the level of biliary ducts injury and time duration of injury are recommended.

Pathology of the urachus. History of the issue and current state of the problem

2021 ◽  
Vol 11 (2) ◽  
pp. 141-152
Author(s):  
Dmitriy N. Shchedrov ◽  
Igor S. Shormanov ◽  
Sergey V. Kotov ◽  
Eugene V. Morozov
Keyword(s):  
Laparoscopic Approach ◽  
Comparative Assessment ◽  
Diagnostic Methods ◽  
Malignant Neoplasms ◽  
Current State ◽  
Modern Classification ◽  
History Of ◽  
Adults And Children ◽  
Gender Aspect

Based on the analysis of literature sources, modern data are presented on the nosological structure of urachus diseases in adults and children, diagnostic methods, as well as treatment tactics for various anatomical variants of anomalies in the development of the urinary duct. A modern classification of urachal malformations caused by disorders of its obliteration is presented. Various modifications of the laparoscopic approach are considered for the most common types of this pathology. The reasons for the development of malignant neoplasms from the urachus tissue, including in the gender aspect, are described, and a comparative assessment of the methods of surgical treatment of urachus tumors is given.

scholarly journals Prognostication of complications in patients with diseases of gallbladder after laparoscopic cholecystectomy

2020 ◽  
Vol 87 (7-8) ◽  
pp. 10-14
Author(s):  
М. А. Каshtalyan ◽  
А. E. Тkachenko ◽  
О. А. Кvasnevskiy ◽  
А.О. Коlotvin
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Theoretical Substantiation ◽  
Scientific Practical ◽  
Premorbid State

Objective. To elaborate a prognostic classification of possibilities for occurrence of іntra- and postoperative complications, basing on determination of a premorbid state and the risk factors, concerning operative intervention in patients, suffering surgical diseases of gallbladder. Маterials and methods. Retrospective analysis of treatment of 911 patients, suffering cholelithiasis disease, оperated by the laparoscopic cholecystectomy procedure, was conducted, and factors of possibility of occurrence for іntra- and postoperative complications were determined with further establishment of their criteria. Results. The factors of risk for the complications occurrence after laparoscopic cholecystectomy in patients with diseases of gallbladder (n=911) were investigated. Prognostication pattern of the complications occurrence was built, taking into account the results of correlation-regression analysis conducted, and on its base the clinic-epidemiological groups of the complications risk were formatted with determination of their frequency of confidence intervals. Conclusion. Theoretical substantiation and scientific-practical decision of the task was presented, concerning raising of efficacy of miniinvasive operative interventions in patients with diseases of gallbladder, using elaborated methods of prophylaxis and surgical treatment of complications.

Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

2020 ◽  
Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  
Keyword(s):  
Risk Factors ◽  
International Classification Of Diseases ◽  
Opioid Use ◽  
Proximal Row Carpectomy ◽  
Use Patterns ◽  
Patient Demographics ◽  
Implant Complications ◽  
Increased Risk ◽  
Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

The Accuracy of ACR TI-RADS Classification of Neck Ultrasound as a First-Line Diagnostic Approach for Thyroid Neoplasms in Pediatric Patients: A Retrospective Study

2018 ◽  
Vol 5 (1) ◽  
pp. 13-23
Author(s):  
Nikolai S. Grachev ◽  
Elena V. Feoktistova ◽  
Igor N. Vorozhtsov ◽  
Natalia V. Babaskina ◽  
Ekaterina Yu. Iaremenko ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Pediatric Patients ◽  
Thyroid Neoplasms ◽  
Diagnostic Methods ◽  
Diagnostic Approach ◽  
First Line ◽  
Neck Ultrasound

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

Classification of Potential Risk Factors through HIRARC Method in Assessing Indoor Environment of Museums

2018 ◽  
Vol 10 (8) ◽  
Author(s):  
Syahrun Neizam Mohd Dzulkifli ◽  
◽  
Abd Halid Abdullah ◽  
Yee Yong Lee ◽  
Mohd Mahathir Suhaimi Shamsuri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Indoor Environment ◽  
Potential Risk Factors

scholarly journals The ‘wave sign’ in hip arthroscopy: a systematic review of epidemiological factors, current diagnostic methods and treatment options

2020 ◽  
Author(s):  
Jason Derry Onggo ◽  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Andrew Duong ◽  
Olufemi R Ayeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Protective Factor ◽  
Treatment Options ◽  
Arthroscopic Surgery ◽  
Classification Systems ◽  
Diagnostic Methods ◽  
Suture Repair ◽  
Significant Heterogeneity ◽  
Epidemiological Factors

ABSTRACT This study aims to present a systematic review and synthesized evidence on the epidemiological factors, diagnostic methods and treatment options available for this phenomenon. A multi-database search (OVID Medline, EMBASE and PubMed) was performed according to PRISMA guidelines on 18 June 2019. All studies of any study design discussing on the epidemiological factors, diagnostic methods, classification systems and treatment options of the wave sign were included. The Newcastle–Ottawa quality assessment tool was used to appraise articles. No quantitative analysis could be performed due to heterogeneous data reported; 11 studies with a total of 501 patients with the wave sign were included. Three studies examined risk factors for wave sign and concluded that cam lesions were most common. Other risk factors include alpha angle &gt;65° (OR=4.00, 95% CI: 1.26–12.71, P=0.02), male gender (OR 2.24, 95% CI: 1.09–4.62, P=0.03) and older age (OR=1.04, 95% CI: 1.01–1.07, P=0.03). Increased acetabular coverage in setting of concurrent cam lesions may be a protective factor. Wave signs most commonly occur at the anterior, superior and anterosuperior acetabulum. In terms of staging accuracy, the Haddad classification had the highest coefficients in intraclass correlation (k=0.81, 95% CI: 0.23–0.95, P=0.011), inter-observer reliability (k=0.88, 95% CI: 0.72–0.97, P&lt;0.001) and internal validity (k=0.89). One study investigated the utility of quantitative magnetic imaging for wave sign, concluding that significant heterogeneity in T1ρ and T2 values (P&lt;0.05) of acetabular cartilage is indicative of acetabular debonding. Four studies reported treatment techniques, including bridging suture repair, reverse microfracture with bubble decompression and microfracture with fibrin adhesive glue, with the latter reporting statistically significant improvements in modified Harris hip scores at 6-months (MD=19.2, P&lt;0.05), 12-months (MD=22.0, P&lt;0.05) and 28-months (MD=17.5, P&lt;0.001). No clinical studies were available for other treatment options. There is a scarcity of literature on the wave sign. Identifying at risk symptomatic patients is important to provide prompt diagnosis and treatment. Diagnostic techniques and operative options are still in early developmental stages. More research is needed to understand the natural history of wave sign lesions after arthroscopic surgery and whether intervention can improve long-term outcomes. Level IV, Systematic review of non-homogeneous studies.

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