The application of long frame draining of pancreatoejunoanastomosis in patient after gastropancreatoduodeonal resection

Objective. To demonstrate the possibilities of early diagnosis of pancreatoejunonastomosis failure and options for surgical treatment of patients with pancreatic fistula after gastropancreatoduodenal resection using long-term frame drainage of pancreatojejunonastomosis. Materials and methods. The results of combined treatment of a patient of the Department of General Surgery of S. M. Kirov Military Medical Academy with a intraductal papillary mucinous neoplasms. Pancreatoejunonastomosis failure was diagnosed based on the criteria of the International Research Group for the Study of Pancreatic Fistulas. Results of the study. Patient B., 61 years old. In January 2019, computer tomography revealed a cystic cavity in the head of the pancreas. An controlled endoscopic ultrasound sonography biopsy was performed. Morphological examination verified the signs of intraductal papillary mucinous neoplasm. On March 11, 2019, the patient underwent gastropancreatoduodenal resection with decompression of pancreatoejunoanastomosis using long-term frame drainage of the main pancreatic duct. On the third day of the postoperative period, x-ray contrast fistulography was used to diagnose the failure of the pancreatoejunonastomosis with the formation of a B type fistula. On the 23d day after gastropancreatoduodenal resection, puncture drainage of the non-drained acute fluid collection was performed under ultrasonographic control. On the 36th day of the postoperative period the frame and puncture drains were removed. Conclusion. The use of long-term frame drainage for decompression of the duct system with staged fistulography, early diagnosis of complications of gastropancreatoduodenal resection in the form of the formation of type B pancreatic fistula, provided the effectiveness of conservative and minimally invasive measures for the treatment of postoperative complications (8 figs, bibliography: 7 refs).

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Tumor-like formations and tumors of the ovaries in girls and girls

Kazan medical journal ◽

10.17816/kazmj64376 ◽

1980 ◽

Vol 61 (6) ◽

pp. 15-18

Author(s):

A. Z. Urazaev ◽

N. L. Kapelushnik

Keyword(s):

Early Diagnosis ◽

Clinical Course ◽

Combined Treatment ◽

Ovarian Tumors ◽

Long Term Results ◽

Methods Of Treatment ◽

Practical Recommendations

The analysis of the clinical course of tumor-like formations and ovarian tumors in 40 girls and adolescents aged 6 to 17 years is presented. More frequent development of proliferating tumors was noted. The immediate and long-term results of surgical and combined treatment of these patients have been studied. Practical recommendations for early diagnosis of ovarian tumors and methods of treatment are given.

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Analysis long-term results of combined treatment pellucid marginal degeneration

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2020-4-63-64 ◽

2020 ◽

pp. 63-64

Author(s):

I.V. Vasilieva ◽

◽

V.V. Egorov ◽

S.V. Kostenev ◽

A.V. Vasiliev ◽

...

Keyword(s):

Combined Treatment ◽

Long Term Results

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Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

Revista de Chimie ◽

10.37358/rc.17.12.5997 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2875-2878

Author(s):

Delia Rusu Andriesi ◽

Ana Maria Trofin ◽

Irene Alexandra Cianga Spiridon ◽

Corina Lupascu Ursulescu ◽

Cristian Lupascu

Keyword(s):

Risk Factors ◽

Pancreatic Fistula ◽

Pancreatic Surgery ◽

Postoperative Pancreatic Fistula ◽

University Center ◽

Preoperative Hemoglobin ◽

Term Administration ◽

Postoperative Administration

Pancreatic fistula is the most frecquent and severe postoperative complication after pancreatic surgery, with impressive implications for the quality of life and vital prognosis of the patient and for these reasons it is essential to identify risk factors. In the current study, who included 109 patient admitted to a single university center and who underwent pancreatic resection for malignant pathology, we assessed the following factors as risk factors: age, sex, preoperative hemoglobin value, preoperative total protein value, obesity and postoperative administration of sandostatin. Of the analyzed factors, it appears that only obesity and long-term administration of sandostatin influences the occurrence of pancreatic fistula.

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Gingival Health of Porcelain Laminate Veneered Teeth: A Retrospective Assessment

Operative Dentistry ◽

10.2341/18-088-c ◽

2019 ◽

Vol 44 (5) ◽

pp. 452-458 ◽

Cited By ~ 1

Author(s):

R Arif ◽

JB Dennison ◽

D Garcia ◽

P Yaman

Keyword(s):

Repeated Measures ◽

Gingival Crevicular Fluid ◽

Statistical Significance ◽

Fluid Collection ◽

Gingival Recession ◽

Gingival Health ◽

Long Term Effect ◽

The Mean ◽

Crevicular Fluid

SUMMARY Statement of Problem: The long-term effect of the presence of porcelain laminate veneers (PLVs) on the health of the surrounding gingival issues is not available in the restorative literature. Purpose: To assess the long-term effect of PLVs on the health of the surrounding gingival tissues. A secondary aim was to correlate gingival crevicular fluid (GCF) scores with clinical parameters used for gingival health assessment in teeth treated with PLVs. Methods and Materials: Patients who received PLVs placed at the Graduate Restorative Clinic within a seven- to 14-year period were recalled for clinical evaluations. Periodontal measurements including gingival index (GI), periodontal pocket depth (PPD), gingival recession (GR), and clinical attachment level (CAL) were measured using a standard probe and indices. Gingival Crevicular Fluid (GCF) was measured with a Periotron machine (Periotron 8000, Oraflow Inc), using Periopaper (Periopaper Gingival Fluid Collection Strip, Oraflow Inc.) for fluid collection. Photographs of any observed clinical defect were taken. Data were tabulated using Excel 2010 (Microsoft Corp). Statistical analysis for all descriptive statistics was performed using SPSS 21 (SPSS Software, IBM Corp.) and Stata SE 13 (Stata Software, StataCorp). Repeated-measures analysis of variance (ANOVA) was done to test for statistical significance of the mean pocket depths between the restored and unrestored surfaces of the veneered teeth. The significance level for all tests was p<0.05. Pearson's correlation coefficient was performed for testing statistical significance between GCF and GI and between GCF and PPD. Results: The frequency distribution of the GI included 47 PLVs (43%) with normal gingiva, 16 (15%) with mild inflammation, and 46 (42%) with moderate inflammation and bleeding on probing. The average PPD on the facial surface of the maxillary and mandibular PLVs was 2.17 mm and 2.16 mm, respectively. On the lingual surface, the average PPD was 2.10 mm for maxillary and 2.22 mm for mandibular PLVs. Gingival recession was seen in 27% of the evaluated PLVs. The repeated-measures ANOVA revealed p≥0.136, showing no statistical difference in the mean pocket depths between restored facial and unrestored lingual surfaces of the veneered teeth. A moderate correlation (r=0.407) was found between GCF and GI, which was significant at p<0.001. No correlation (r=0.124) was found between GCF and PPD, which was not significant at p=0.197. Conclusions: Gingival response to the evaluated PLVs was in the satisfactory range, with overall GI scores ranging between normal and moderate inflammation, pocket depths ranging from 1 to 2 mm, and recession present in 27% of the evaluated PLVs. No statistically significant difference was found between the mean pocket depths of the restored and unrestored surfaces of veneered teeth (p≥0.136). A moderate correlation was found between GCF and GI.

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Wrapping the pancreas with a polyglycolic acid sheet before stapling reduces the risk of fluid collection on the pancreatic stump after distal pancreatectomy

Surgical Endoscopy ◽

10.1007/s00464-021-08387-0 ◽

2021 ◽

Author(s):

Ji Su Kim ◽

Seoung Yoon Rho ◽

Dong Min Shin ◽

Munseok Choi ◽

Chang Moo Kang ◽

...

Keyword(s):

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Fluid Collection ◽

International Study ◽

Polyglycolic Acid ◽

Previous Method ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Pancreatic Stump ◽

Resection Line

Abstract Background Postoperative pancreatic fistula (POPF) and postoperative fluid collection (POFC) are common complications after distal pancreatectomy (DP). The previous method of reducing the risk of POPF was the application of a polyglycolic acid (PGA) sheet to the pancreatic stump after cutting the pancreas with a stapler (After-stapling); the new method involves wrapping the pancreatic resection line with a PGA sheet before stapling (Before-stapling). The study aimed to compare the incidence of POPF and POFC between two methods. Methods Data of patients who underwent open or laparoscopic DPs by a single surgeon from October 2010 to February 2020 in a tertiary referral hospital were retrospectively analyzed. POPF was defined according to the updated International Study Group of Pancreatic Fistula criteria. POFC was measured by postoperative computed tomography (CT). Results Altogether, 182 patients were enrolled (After-stapling group, n = 138; Before-stapling group, n = 44). Clinicopathologic and intraoperative findings between the two groups were similar. Clinically relevant POPF rates were similar between both groups (4.3% vs. 4.5%, p = 0.989). POFC was significantly lesser in the Before-stapling group on postoperative day 7 (p < 0.001). Conclusions Wrapping the pancreas with PGA sheet before stapling was a simple and effective way to reduce POFC.

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Impact of Hybrid Operating Rooms on Long-Term Clinical Outcomes Following Fenestrated and Branched Endovascular Aortic Repair

Journal of Endovascular Therapy ◽

10.1177/1526602821996725 ◽

2021 ◽

pp. 152660282199672

Author(s):

Giovanni Tinelli ◽

Marie Bonnet ◽

Adrien Hertault ◽

Simona Sica ◽

Gian Luca Di Tanna ◽

...

Keyword(s):

Operating Room ◽

Clinical Outcomes ◽

Cox Regression ◽

Statistical Significance ◽

Aortic Aneurysms ◽

Study Patient ◽

Cox Regression Analysis ◽

Significant Difference ◽

The Impact

Purpose: Evaluate the impact of hybrid operating room (HOR) guidance on the long-term clinical outcomes following fenestrated and branched endovascular repair (F-BEVAR) for complex aortic aneurysms. Materials and Methods: Prospectively collected registry data were retrospectively analyzed to compare the procedural, short- and long-term outcomes of consecutive F-BEVAR performed from January 2010 to December 2014 under standard mobile C-arm versus hybrid room guidance in a high-volume aortic center. Results: A total of 262 consecutive patients, including 133 patients treated with a mobile C-arm equipped operating room and 129 with a HOR guidance, were enrolled in this study. Patient radiation exposure and contrast media volume were significantly reduced in the HOR group. Short-term clinical outcomes were improved despite higher case complexity in the HOR group, with no statistical significance. At a median follow-up of 63.3 months (Q1 33.4, Q3 75.9) in the C-arm group, and 44.9 months (Q1 25.1, Q3 53.5, p=0.53) in the HOR group, there was no statistically significant difference in terms of target vessel occlusion and limb occlusion. When the endograft involved 3 or more fenestrations and/or branches (complex F-BEVAR), graft instability (36% vs 25%, p=0.035), reintervention on target vessels (20% vs 11%, p=0.019) and total reintervention rates (24% vs 15%, p=0.032) were significantly reduced in the HOR group. The multivariable Cox regression analysis did not show statistically significant differences for long-term death and aortic-related death between the 2 groups. Conclusion: Our study suggests that better long-term clinical outcomes could be observed when performing complex F-BEVAR in the latest generation HOR.

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Long-term postoperative opioid prescription after cholecystectomy or gastric by-pass surgery: a retrospective observational study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0150 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Viktoria Larsson ◽

Cecilia Nordenson ◽

Pontus Karling

Keyword(s):

Observational Study ◽

Postoperative Period ◽

Medical Records ◽

Early Postoperative Period ◽

Retrospective Observational Study ◽

Opioid Use ◽

Opioid Prescription ◽

Post Surgery ◽

Gastric By Pass

Abstract Objectives Opioids are commonly prescribed post-surgery. We investigated the proportion of patients who were prescribed any opioids 6–12 months after two common surgeries – laparoscopic cholecystectomy and gastric by-pass (GBP) surgery. A secondary aim was to examine risk factors prior to surgery associated with the prescription of any opioids after surgery. Methods We performed a retrospective observational study on data from medical records from patients who underwent cholecystectomy (n=297) or GBP (n=93) in 2018 in the Region of Västerbotten, Sweden. Data on prescriptions for opioids and other drugs were collected from the patients` medical records. Results There were 109 patients (28%) who were prescribed opioids after discharge from surgery but only 20 patients (5%) who still received opioid prescriptions 6–12 months after surgery. All 20 of these patients had also been prescribed opioids within three months before surgery, most commonly for back and joint pain. Only 1 out of 56 patients who were prescribed opioids preoperatively due to gallbladder pain still received prescriptions for opioids 6–12 months after surgery. Although opioid use in the early postoperative period was more common among patients who underwent cholecystectomy, the patients who underwent GBP were more prone to be “long-term” users of opioids. In the patients who were prescribed opioids within three months prior to surgery, 8 out of 13 patients who underwent GBP and 12 of the 96 patients who underwent cholecystectomy were still prescribed opioids 6–12 months after surgery (OR 11.2; 95% CI 3.1–39.9, p=0,0002). Affective disorders were common among “long-term” users of opioids and prior benzodiazepine and amitriptyline use were significantly associated with “long-term” opioid use. Conclusions The proportion of patients that used opioids 6–12 months after cholecystectomy or GBP was low. Patients with preoperative opioid-use experienced a significantly higher risk of “long-term” opioid use when undergoing GBP compared to cholecystectomy. The indication for being prescribed opioids in the “long-term” were mostly unrelated to surgery. No patient who was naïve to opioids prior surgery was prescribed opioids 6–12 months after surgery. Although opioids are commonly prescribed in the preoperative and in the early postoperative period to patients with gallbladder disease, there is a low risk that these prescriptions will lead to long-term opioid use. The reasons for being prescribed opioids in the long-term are often due to causes not related to surgery.

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The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽

10.1136/bmjopen-2017-016667 ◽

2017 ◽

Vol 7 (11) ◽

pp. e016667 ◽

Cited By ~ 3

Author(s):

Herng-Ching Lin ◽

Sudha Xirasagar ◽

Cha-Ze Lee ◽

Chung-Chien Huang ◽

Chao-Hung Chen

Keyword(s):

Rheumatoid Arthritis ◽

Early Diagnosis ◽

Reflux Disease ◽

Treatment Guidelines ◽

Population Based ◽

Oesophageal Reflux ◽

Study Patient ◽

Oesophageal Reflux Disease ◽

Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

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A Randomized Trial of the Long-term Effects of Digital Ocular Compression in the Late Postoperative Period

Journal of Glaucoma ◽

10.1097/00061198-200108000-00004 ◽

2001 ◽

Vol 10 (4) ◽

pp. 266-270 ◽

Cited By ~ 7

Author(s):

Jeffrey D. Henderer ◽

Michael C. Heeg ◽

George L. Spaeth ◽

Marlene R. Moster ◽

Jonathan S. Myers ◽

...

Keyword(s):

Randomized Trial ◽

Postoperative Period ◽

Long Term Effects ◽

Late Postoperative Period

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Tubocutaneous Fistula

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/104360 ◽

2015 ◽

Vol 2015 ◽

pp. 1-2

Author(s):

Krishnaveni Nayini ◽

Clive Gie

Keyword(s):

Early Diagnosis ◽

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Fistulous Tract ◽

Rare Condition ◽

Diagnosis And Treatment ◽

Case Presentation ◽

Child Birth ◽

The Right

Introduction. Tubocutaneous fistula is a very rare condition; most cases described in the literature are secondary to endometriosis, tuberculosis, and complications of child birth and gynecological operations.Case Presentation. We report a case of 40-year-old woman who presented with tubocutaneous fistula secondary to pelvic inflammatory disease which was diagnosed in the setting of persistent discharging wound in the right groin.Conclusion. Tubocutaneous fistula is a rare condition. Salpingectomy and resection of fistulous tract is the treatment of choice as is treating the underlying cause. Early diagnosis and treatment of these patients are essential for avoiding long term complications.

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