Dependence of the effectiveness of antiglaucomatous operations on the method of forming the conjunctival flap

1995 ◽  
Vol 76 (1) ◽  
pp. 61-61
Author(s):  
N. H. Khasanova ◽  
Z. G. Kamalov ◽  
F. S. Amirova ◽  
R. F. Akhmetshin

The influence of two methods of forming a conjunctival flap on the hypotensive efficiency of operations and the outflow of intraocular fluid in the long-term follow-up was studied. Operated on 2 groups of patients - 150 people (150 eyes). In group 1 (76 patients), operations were performed with an incision of the conjunctiva at the site of its attachment along the limbus for 5 - 6 mm, followed by its separation by 3 - 4 mm upward.

Author(s):  
A.P. Voznyuk ◽  
◽  
S.I. Anisimov ◽  
S.Y. Anisimova ◽  
L.L. Arutyunyan ◽  
...  

Purpose. To evaluate the efficacy and safety of femtolaser-assisted phacoemulsification in glaucomatous eyes in the long-term follow-up. Materials and methods. A retrospective analysis of the results of the surgical treatment of patients with combined cataract and glaucoma pathology was analyzed. The patients were divided into groups depending on the method of surgical intervention: 1) phacoemulsification with femtolaser support (26 eyes, 23 patients); 2) phacoemulsification (36 eyes, 30 patients); Results. Before surgery, there were no statistically significant differences in IOP and corneal hysteresis (СН) between groups 1 and 2. The mean values of IOP cc, IOP g and СН of group 1 before surgery were 22.7±6.1 mm Hg, 20.9±6.9 mm Hg, 8.5±1.6 mm Hg; 2 group – 22.9±8.7 mm Hg, 21.6±8.9 mm Hg, 8.9±1.6 mm Hg respectively. Average values of IOP cc, IOP g and CН 5 years after the surgical treatment in group 1 were 15.3±1.2 mm Hg, 14.4±3.4 mm Hg, 9.6±4.2 mm Hg; in group 2 – 18.0±4.2 mm Hg, 16.1±4.2 mm Hg, 8.8±2.2 mm Hg respectively. In both groups, stabilization of IOP and CH indices was noted, which remained throughout the entire observation period, which shows the normalization of the biomechanical properties of the corneoscleral membrane of the eye in the long-term postoperative period. Conclusion. Femtolaser accompaniment of phacoemulsification is an effective and safe method of cataract surgery for combined pathology. Key words: femtolaser, cataract, glaucoma, phacoemulsification.


BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheng-Qiang Fu ◽  
Chang-Shui Zhuang ◽  
Xiao-Rong Yang ◽  
Wen-Jie Xie ◽  
Bin-Bin Gong ◽  
...  

Abstract Background To evaluate the feasibility and safety of robot-assisted retroperitoneal laparoscopic adrenalectomy (RARLA) for large pheochromocytomas (PHEOs; size≥6 cm) compared with retroperitoneal laparoscopic adrenalectomy (RLA). Methods Fifty-one patients who underwent adrenalectomy for large PHEOs between March 2016 and January 2019 were enrolled and divided into two groups, including 32 RLA cases and 19 RARLA cases. We compared the perioperative efficacy and long-term follow-up results between the two groups. Results Preoperative data, including demographics, comorbidities and tumour characteristics, were similar between the groups. Intraoperatively, the RARLA group had a lower incidence of haemodynamic instability (26.3% vs. 56.2%, P = 0.038) and less intraoperative blood loss (100 ml vs. Two hundred milliliter, P = 0.042) than the RLA group. The groups showed no significant differences in operative time or transfusion rates. Postoperatively, the time to diet resumption, time to ambulation, time to drainage removal and postoperative hospital stay were shorter in the RARLA group than in the RLA group (1 d vs. 2 d, P = 0.027; 1 d vs. 2 d, P = 0.034; 3 d vs. 5 d, P = 0.002; 5 d vs. 6 d, P = 0.02, respectively). The groups exhibited no significant differences in the duration of anaesthetic use, complications, or long-term follow-up results for the blood pressure (BP) improvement rate. Conclusions Compared with RLA, RARLA is a safe, feasible and even optimized procedure for large PHEOs.


2003 ◽  
Vol 11 (2) ◽  
pp. 131-134 ◽  
Author(s):  
Jai Raman ◽  
Pallav Shah ◽  
Siven Seevanayagam ◽  
John Cheung ◽  
Brian Buxton

Mitral regurgitation due to bileaflet prolapse and ischemic causes can be difficult to repair. Midterm experience of the Alfieri edge-to-edge repair as an alternative to valve replacement is reported. Twenty-six patients with severe mitral regurgitation underwent the Alfieri repair between January 1998 and December 2000 (group 1); 15 cases were due to bileaflet prolapse and 7 were of ischemic origin. During the same period, valve replacement was performed in 36 patients (group 2), 20 of whom had similar indications. Follow-up was complete to a mean of 15 months (range, 1–28 months). There was no early death in either group. During follow-up, there was no reoperation in group 1, while 2 patients in group 2 required reoperations due to prosthetic valve endocarditis. There were 4 major thromboembolic or bleeding events in group 2, and none in group 1. All patients in group 1 had trivial to mild mitral regurgitation on follow-up echocardiography. The mean mitral valve gradient was significantly higher in group 2 compared to group 1 (7.2 versus 3.2 mm Hg, p = 0.001). The edge-to-edge repair is associated with good early and midterm results. Long-term follow-up is required to evaluate the durability of this technique.


2021 ◽  
Vol 8 (3) ◽  
pp. 181-186
Author(s):  
Didem Dereli Akdeniz ◽  
Gürkan Avcı

Objective: Multinodular goiter is a common surgical disease. There is no common consensus regarding the extent of thyroidectomy for multinodular goiter. This  study aims to present personal experience on treating patients with multinodular goiter and to compare complication rates and results of total and partial thyroidectomy for multinodular goiter. Material and Method: Three hundred fifty patients underwent thyroidectomy for multinodular goiter between May 2003 and October 2010. All patients were diagnosed as multinodular goiter and were referred to surgery by one endocrinologist. All operations were also performed by one surgeon using microsurgical techniques. Partial thyroidectomy (bilateral subtotal or unilateral total thyroidectomy and contralateral subtotal thyroidectomy) was performed in 65 patients (Group-1) and extracapsular total thyroidectomy was performed in 285 patients (Group-2). All patients are being followed followed from the day they were diagnosed until now by the same endocrinologist. Fisher exact test was used for statistical analysis. Results: In Group-1, one patient had transient vocal-cord palsy and but none had hypoparathyroidism. On the other hand, in Group-2, two patients had transient vocal-cord palsy, five had hypocalcemia (one was permanent), and one had a hematoma. Mortality and wound infection were absent in both groups. The histopathological studies showed that 40 incidental thyroid carcinomas occurred among Group-2 patients. During long-term follow-up, 13 patients had goiter recurrence (n = 65, 20%) in Group-1, whereas none had goiter recurrence in Group-2. Conclusion: There were no statistically significant differences in the complication rate between subtotal and total thyroidectomy groups (p>0.05). However, the recurrence rate was higher (statistically significant) after subtotal thyroidectomy than after total thyroidectomy (p<0.05). Total thyroidectomy eliminated future recurrence of the disease and is also curative in incidental thyroid carcinomas. In addition, it can be safely performed using microsurgical techniques.


Author(s):  
Ersan Cetınkaya ◽  
Sibel Inan ◽  
Kenan Yıgıt ◽  
Mehmet Cem Sabaner ◽  
Ümit Übeyt Inan

Objective: To investigate the changes in macular retinal layers and panretinal neuroretinal functions in the long-term follow-up of patients with primary open-angle glaucoma. Materials and Methods: Forty-one patients diagnosed with primary open-angle glaucoma were followed up for 12 months. According to their mean deviation (MD) values), the patients were put into two groups as Group 1 with early stage glaucoma (MD≥-6) and Group 2 with middle-advanced stage glaucoma (MD<-6). Optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were performed at the baseline and at the sixth- and 12th-month evaluations. The OCT, retinal layer and mfERG findings were compared between the two groups. Results: There was no statistically significant difference between the groups in terms of gender and age In Group 2, the mean baseline macula Retina Nerve Fiber Layer, Ganglion Cell Layer and Inner Pleksiform Layer measurements were lower in each quadrant compared to Group 1. Concerning progression in OCT measurements, there was no significant difference between the two groups. However, it was noteworthy that in Group 2, there was a decrease especially in the first and second ring amplitudes of the P1 and N2 waves and prolongation of the implicit time. At the 12-month evaluation, there was prolongation of the implicit time of the N1 wave and a decrease in the P1 wave amplitude in Group 1. Conclusion: Retinal layers are affected in patients with intermediate and advanced stage glaucoma. In the follow-up of early stage glaucoma patients, mfERG measurements can show damage that may occur.


2020 ◽  
Vol 7 (3) ◽  
pp. 33-42
Author(s):  
A. N. Kazantsev ◽  
K. P. Chernykh ◽  
N. E. Zarkua ◽  
R. Yu. Leader ◽  
K. G. Kubachev ◽  
...  

Purpose of the study. Comparison of hospital and long-term results of autoarterial reconstruction of carotid artery bifurcation and the formation of a new bifurcation with an extended atherosclerotic lesion of the internal carotid artery (ICA). Materials and methods. In the period from January 2018 to May 2020, this cohort, comparative, prospective, open-label study included 279 patients with an extended atherosclerotic lesion of the ICA operated on in the Alexandr Hospital. Depending on the implemented strategy of surgical correction, all patients were divided into two groups: group 1 (n=132) — autoarterial reconstruction of bifurcation of the carotid arteries; Group 2 (n=147) — the formation of a new bifurcation. Complications were recorded in the hospital and long-term postoperative periods. The total follow-up period was 16.4±9.3 months. The endpoints of the study were such adverse cardiovascular events as death, myocardial infarction (MI), stroke, thrombosis / restenosis of the anastomosis zone, combined endpoint (death from stroke / IM + IM + stroke). Results. The ICA clamping time in group 1 was 32.6±3.3 minutes, in group 2 – 31.7±3.5 minutes, which did not receive statistically significant differences (р=0.81). In the hospital postoperative period, adverse cardiovascular events were not recorded. In the long-term follow-up, the groups were comparable in the frequency of all complications. Identified lethal outcomes developed as a result of the formation of MI in patients with multiple lesions of the coronary arteries and a history of myocardial revascularization. The likely cause was shunt / stent thrombosis with subsequent coronary insufficiency and an increase in ischemic heart damage. The causes of stroke, recorded in each group in isolated cases, were the presence of atrial fibrillation. Patients did not comply with the recommended regimen of anticoagulant therapy, which provoked the development of cerebral catastrophe. In turn, the identified restenoses of the reconstruction zone were asymptomatic and were also observed in isolated cases in each group in the period 12 months after CEE. Conclusion. Autoarterial reconstruction of carotid bifurcation and the formation of a new bifurcation are comparable in safety and effectiveness methods of surgical treatment of an extended atherosclerotic lesion of the ICA. Operation techniques differ in the choice of an artery that is cut off from bifurcation — the external carotid artery or ICA. Further, the reconstruction progress is absolutely identical. Hospital and long-term follow-up results showed minimal indicators of the development of cardiovascular and hemodynamic changes due to the type of operation. Thus, both reconstruction techniques can be the operation of choice for an extended ICA lesion.


2021 ◽  
Vol 26 (12) ◽  
pp. 4742
Author(s):  
Yu. V. Belov ◽  
A. N. Kazantsev ◽  
R. A. Vinogradov ◽  
A. V. Korotkikh ◽  
V. V. Matusevich ◽  
...  

Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5217-5217
Author(s):  
A.M. Carella ◽  
Maria T. Corsetti ◽  
Germana Beltrami ◽  
Carlo Bodenizza ◽  
Marina Cavaliere

Abstract Residual diploid hematopoietic progenitor cells (HPC) represent a quantitatively useful reservoir from a therapeutic standpoint, particularly early in the course of the disease. Clinical evidence for the persistence of diploid HPC in CML has been provided by the fact that Ph-negative cells are mobilized into the blood of patients treated with chemotherapy/G-CSF, IFN-a and, more recently, with Imatinib. In this report, we update our experience in 50 patients with early chronic phase not previously treated with IFN-a. All patients completed the mobilization protocol (ICE/mini-ICE) and diploid or prevalently diplod HPC were mobilized in peripheral blood after G-CSF. High-dose therapy consisted of Busulfan (4 mg/kg/d x 4 days) (44 patients) or TBI-containing regimen (6 patients). No patient died of the procedure. After engraftment, all patients were treated with IFN-a (3–5 MU/d three times weekly). The median follow-up of 50 patients is 77 months (range, 8 to 142 months). At present (July 31, 2004), 39 patients (78%) are alive at a median follow-up of 89 months (range, 43 –142) from autografting: 15/39 patients maintain major cytogenetic remission (MCyR) under IFN-a (1 patient received MUD in MCyR;) 23 patients (22 in CP and 1 in AP), who relapsed cytogenetically received Imatinib. Sixteen out of 23 pts on Imatinib achieved MCyR (2 patients) or complete cytogenetic remission (CCyR) (14 patients). Eleven out of 50 patients died at a median of 35 months (range, 8 to 106 months): 9 patients of blastic transformation (2 in the Imatinib group), 1 patient of fulminant hepatitis and 1 of cardiac arrest under Imatinib treatment. In conclusion, intensive treatment with autografting/IFN-a ± Imatinib was able to control the disease in 39/50 patients of whom 31 patients are still in major/complete cytogenetic remission.


Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 310
Author(s):  
Maurizio De Pellegrin ◽  
Lorenzo Marcucci ◽  
Lorenzo Brogioni ◽  
Giovanni Prati

Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we collected data of 11 MS patients with unilateral (n = 5) or bilateral (n = 6) CF, for a total of 17 feet (9R,8L). Six patients (3M,3F) for a total of 10 feet (6R,4L) were treated elsewhere, performing first surgery at an average age of nine months, and in our hospital for relapse surgery at an average age of 4.5 years (Group 1). Five patients (3M, 2F), for a total of seven feet (3R,4L), were primarily treated in our hospital with a peritalar release according to McKay at an average age of 9.4 months (Group 2). Diméglio score was used to assess CF severity. Three questionnaires were submitted for evaluation of subjective and functional results: American Orthopedics Foot and Ankle Society for Hindfoot (AOFAS), Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Average AOFAS/FAOS/FAMM scores were 82.8, 84.8, and 82.3 for Group 1, and 93.2, 94.7, and 95.1 for Group 2 at an average follow-up of 16.9 and 13.3 years, respectively. The average Diméglio score improved from 15.5 to 4.8 in the long-term follow-up in Group 1 and from 14.6 to 3.8 in Group 2. The comparison between the groups showed better results for AOFAS, FAOS, and FAAM scores for Group 2, particularly for pain, function, and foot alignment and for the post-surgical Diméglio score. CF in MS is more severe and presented a higher relapse rate (58.8%) than idiopathic CF. Peritalar release showed no relapse and better subjective and functional results in the long-term follow-up compared to other surgical techniques


Author(s):  
A. N. Kazantsev ◽  
M. A. Chernyavsky ◽  
R. A. Vinogradov ◽  
V. N. Kravchuk ◽  
D. V. Shmatov ◽  
...  

Objective: to analyze the in-hospital and long-term outcomes of classical carotid endarterectomy (CEE) in extended atherosclerotic lesions in comparison with the outcomes of this operation in local atherosclerotic plaque (AP). Materials and Methods. This study, which lasted from January 2010 to December 2020, included 148 patients with extended AP and hemodynamically significant internal carotid artery (ICA) stenosis. The term “extended” was understood as a hemodynamically significant lesion ≥ 5 cm long. These patients made up Group 1. Group 2 was formed over the same period of time from 632 patients with hemodynamically significant stenosis <5 cm long. In both cohorts, CEE with repair of the reconstruction zone with a diepoxide-treated xenopericardial patch was performed. Long-term follow-up was 71.4 ± 45.6 months. Results. The groups were comparable in terms of frequency of in-hospital complications: death (group 1: 0.67%, n = 1; group 2: 0.5%, n = 3; p = 0.74; OR = 1.42; 95% Cl 0.14-13.6), myocardial infarction (MI) (group 1: 0.67%, n = 1; group 2: 0.5%, n = 3; p = 0.74; OR = 1.42; 95% CI 0.14-13.6), ischemic stroke (group 1: 0%; group 2: 0.5%, n = 3; p = 0.91; OR = 0.6; 95% CI 0.03-11.8), combined endpoint (death + MI + stroke) (group 1: 1.35%, n = 2; group 2: 1.4%, n = 9; p = 0.74; OR = 0.94; 95% CI 0.2-4.43). The groups were also comparable in terms of frequency of long-term complications: death (group 1: 2.0%, n = 3; group 2: 2.05%, n = 13; p = 0.76; OR = 0.98; 95% CI 0.27-3.5), MI (group 1: 2.7%, n = 4; group 2: 2.4%, n = 15; p = 0.95; OR = 1.14; 95% CI 0.37-3.49), ischemic stroke (group 1: 5.4%, n = 8; group 2: 5.2%, n = 33; p = 0.9; OR = 1.03; 95% CI 0.46-2.29), ICA occlusion and restenosis (group 1: 12.8%, n = 19; group 2: 13.3%, n = 84; p = 0.99; OR = 0.96; 95% CI 0.56-1.63), combined endpoint (death + MI + stroke) (group 1: 10.1%, n = 15; group 2: 9.6%, n = 61; p = 0.98; OR = 1.05; 95% CI 0.58-1.91). Analysis of survival graphs revealed no significant intergroup differences for all types of complications (lethal outcome: p = 0.56; MI: p = 0.73; stroke/mini-stroke: p = 0.89; ICA restenosis/occlusion: p = 0.82; combined end point: p = 0.71). Their increase was uniform in both groups. However, more than half of all ICA restenoses and occlusions were visualized in the first 6 months after CEE. Conclusion. Implantation of a long patch (≥ 5 cm) is not characterized by increased incidence of restenosis and all adverse cardiovascular events during in-hospital and long-term follow-up.


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