scholarly journals A study on surgical management of undescended testis

2018 ◽  
Vol 6 (9) ◽  
pp. 3105
Author(s):  
Mallikarjuna M. ◽  
Mahesh Dhotre ◽  
Shanmukhappa S.
Keyword(s):  
Surgical Management ◽  
Undescended Testis ◽  
Early Age ◽  
Undescended Testes ◽  
Exclusion Criteria ◽  
Common Procedure ◽  
Common Complaint ◽  
Operative Complications ◽  
And Function ◽  
Laparoscopic Orchidopexy

Background: Cryptorchidism which is synonymous with Undescended testes. It is one of the most common congenital anomalies found in children. The aim is to study the surgical management of undescended testis in relation to age, position, side, symptoms, complications and management of undescended testis. This study will present an overview of the current understanding of this challenging problem, mainly concentrating on surgical management.Methods: About 30 cases of undescended testis were included in the study, which were diagnosed with regards to age of presentation, clinical features, inclusion and exclusion criteria and relevant investigations like ultrasonography, diagnostic laparoscopy, CT whereever required. Cases were managed accordingly in the course of study and sampling of cases was taken from Bapuji Hospital and C.G. Hospital, Davangere during the study period.Results: Undescended testis was found more common on right side and most of them presented with the age group of 1-15 years with absence of testis in the scrotum being the most common complaint and hernia was found to be most commonly associated with undescended testis. Most common position of undescended testis was found to be intra-canalicular with most of them being palpable. The only one case had torsion and few of the cases had post operative complications like, wound infection haematoma. Open and laparoscopic orchidopexy can be used as most common procedure in early age group.Conclusions: Undescended testes is eminently treatable in today’s practice with the surgical procedures, an early diagnosis, informed counselling of parents and optimal surgical management offer optimised opportunities for successful placement and function of the testes which lessen the burden of complications.

scholarly journals Cholelithiasis: causative factors, clinical manifestations and management

2019 ◽  
Vol 6 (6) ◽  
pp. 2133
Author(s):  
Renu Pimpale ◽  
Pradeep Katakwar ◽  
Murtaza Akhtar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Management ◽  
Open Cholecystectomy ◽  
Clinical Manifestations ◽  
Gastrointestinal Disorder ◽  
Xanthogranulomatous Cholecystitis ◽  
Biliary Leak ◽  
Common Complaint ◽  
Causative Factors ◽  
Operative Complications

Background: Cholelithiasis is a common gastrointestinal disorder with an overall prevalence of 2-29%. This study aims to evaluate the evolution of demographic and etiological factors, the clinical manifestations of Cholelithiasis, the surgical management with its post-operative complications and the histopathological findings of the post-cholecystectomy specimen of gallbladder, in central India.Methods: Patients symptomatic or asymptomatic diagnosed ultrasonically as cholelithiasis were included in the study and patients with primary choledocholithiasis were excluded.Results: A total of 92 patients were enrolled, of which 62 (68.89%) were female, with mean age of 45.03yrs ± 13.59. Fifty four patients (58.69%) were having BMI >25. Pain was most common complaint seen in all patients. Jaundice was observed in 13 patients (14.13%) who had associated CBD calculus. Sickling was positive in 8.69% of patients. Lap cholecystectomy was done in 71 (77.17%) patients with a conversion rate of 6.57%. Nineteen (20.65%) were open cholecystectomy with or without CBD exploration and 2 underwent Lap cholecystostomy. Post operatively, surgical site infection was seen in 3 patients (4.22%) of laparoscopic cholecystectomy, 5 patients (26.31%) of open cholecystectomy and biliary leak was seen in 3 patients (15.78%) of open cholecystectomy. Histopathology of gallbladder was chronic cholecystitis in 70 patients (77.77%), malignancy was detected in 5 patients (5.55%) and Xanthogranulomatous cholecystitis in 2 patients (2.22%).Conclusions: Cholelithiasis is commonly seen in females in 4th and 5th decade mainly presenting with abdominal pain and dyspepsia. Laparoscopic cholecystectomy offers best surgical management with lesser complications.

scholarly journals Management of Undescended testis : Our experience

1970 ◽  
pp. 21-25
Author(s):  
Faryal Matin ◽  
AF Masud ◽  
Arifur Rahman
Keyword(s):  
Child Health ◽  
Surgical Management ◽  
Diagnostic Laparoscopy ◽  
Undescended Testis ◽  
Endocrine Function ◽  
Safe Procedure ◽  
Undescended Testes ◽  
Management Planning ◽  
Impalpable Testis ◽  
Back Ground

Back Ground: In the past, it was believed that the undescended testis suffered no adverse changes until after puberty and surgical intervention was not necessary until 12 to 15 years of age. In the recent past, orchiopexy has been recommended in the second year of life, but now orchiopexy is recommended at 6 month of age. This is because the first sign of damage to the testes are identified at about 6 month of age. Treatment of undescended testes improves fertility and endocrine function, reduces the risk of torsion & trauma, facilitates examination of testis and creates a normalappearing scrotum. The mainstay of therapy for the palpable undescended testes is surgical orchiopexy with creation of a subdartos pouch. When the testis is nonpalpable diagnostic laparoscopy is useful for management planning Aim: The aim of this study was to ascertain the experience of management of undescended testis in this hospital. Methods: The study was conducted at Institute of Child Health & Shishu Sasthya Foundation Hospital. Case notes of 57 patients who had undergone surgical management for undescended testis between December 1999 and November 20007 were reviewed. The patients were separated into 2 groups: patients with palpable undescended testis and patients with impalpable testis. Surgical management was not done before 6 month of age. Open orchiopexy was performed in palpable group. For impalpable group, diagnostic laparoscopy was done and managed accordingly. Results: The median age at operation was 7.2 years (range 06 month to 14 years). Orchiopexy was done at the age of 6 month in 2 patients. Among 57 cases, thirty-six patients had palpable testes and twenty-one patients had impalpable testis. Twenty patients had right sided undescended testis and four had bilateral. Clinical inguinal hernia was present in 2 cases with right sided palpable undescended testis. Hypospadias was present in 1 patient with right sided palpable undescended testis. Open orchiopexy was performed in 36 patients (palpable group). Laparoscopy was done 21 patients (impalpable group). In impalpable group (21) ultra-sonogram found testis in 7 cases and was doubtful in 2 cases. On diagnostic laparoscopy only 2 vanishing testes were found. Lap assisted single stage orchiopexy was performed in 1 patients. First stage of Fowler-Stephen was done laparoscopically in 18 cases. Second stage of this procedure was done in open method in 2 patients. There was no postoperative complication. Conclusions: Orchiopexy is a safe procedure for the children even at the age of 6 months. With laparoscopy impalpable testis can be safely diagnosed and managed. DOI: 10.3329/bjch.v31i1.6069 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 16-21

scholarly journals Surgical management of umbilical and paraumbilical hernias

2017 ◽  
Vol 4 (8) ◽  
pp. 2507
Author(s):  
Purushotham G. ◽  
Revanth K. ◽  
Aishwarya M.
Keyword(s):  
Wound Infection ◽  
Surgical Management ◽  
Surgical Procedures ◽  
Mesh Repair ◽  
Surgical Repair ◽  
Age Groups ◽  
Prolene Mesh ◽  
Tension Free ◽  
Common Complaint ◽  
Operative Complications

Background: To evaluate several types of surgical repair and their morbidity and post-operative complications.Methods: This was a prospective observational surgical study conducted in 50 cases of umbilical and paraumbilical hernias were included, the study was carried out by history, clinical examination, and appropriate investigations for operation were conducted. The patients were treated by either of the two surgical procedures Mayo’s repair or tension free repair using prolene mesh (mesh repair).Results: Umbilical and paraumbilical hernias were more common in females. Highest incidence was noted in 30-40 and 50-60 years age groups. Abdominal swelling was the most common complaint followed by pain. Post-operative complications like wound infection and seroma were noted in both the procedures. These hernias were operated by Mayo’s anatomical repair and tension free hernioplasty (mesh repair). Two recurrences were noted in patients operated by Mayo’s repair. There was no recurrence following mesh repair.Conclusions: Surgery was the main modality of treatment. Fewer complications like wound infection and seroma formation which can be managed conservatively by antibiotics, drainage of the seroma and pus with regular dressings were done. Study emphasizes tension free hernioplasty (mesh repair) to be the procedure of choice for the treatment of umbilical and paraumbilical hernias.

Recurrent Abdominal Pain in Childhood

1982 ◽  
Vol 4 (1) ◽  
pp. 29-34
Author(s):  
Giulio J. Barbero
Keyword(s):  
Abdominal Pain ◽  
Preschool Children ◽  
Early Adolescence ◽  
Recurrent Abdominal Pain ◽  
Practical Approach ◽  
Gastrointestinal Function ◽  
Organic Disease ◽  
Common Complaint ◽  
Aged Child ◽  
And Function

Recurrent abdominal pain (RAP) in childhood is a common complaint that may be difficult to diagnose and manage. Apley has reported that 10% of children have three or more episodes severe enough to impair activity and function over at least a three-month period. RAP appears less often in preschool children and, when present at earlier ages, it usually occurs in brief episodes rather than the more frequent and intense pattern that is characteristic of the school-aged child. RAP is more frequent in girls and is particularly prominent as a symptom in early adolescence. Occasional abdominal pain is a universal symptom in childhood and its significance is often difficult to assess. A practical approach is to determine the frequency, severity, and limitations produced by the pain before further exploration of its cause. DIAGNOSIS Recurrent abdominal pain in childhood can be divided into disturbances of gastrointestinal functions and a variety of pathologic disease or organic categories. A combination of the disturbance of function and other organic disease can also be present as the basis for the pain. Fewer than 10% to 15% of referred children reported in various studies have been found to have pain of organic origin. It is important to recognize that many patients and their parents are fearful of the pain as a symptom and are not easily able to incorporate a concept of disorder of a gastrointestinal function at the onset.

scholarly journals Seminoma in Undescended Intra Abdominal Testis: A Case Report

1970 ◽  
Vol 18 (2) ◽  
pp. 131-133 ◽  
Author(s):  
MM Haque ◽  
AB Siddique ◽  
ABMG Rabbani ◽  
MA Quasem ◽  
AKMG Rahman ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Testicular Tumor ◽  
Early Age ◽  
Sexually Active ◽  
Lower Abdomen ◽  
Undescended Testes ◽  
Cryptorchid Testis ◽  
Risk Of Cancer ◽  
Abdominal Testis

A mass in the lower abdomen in a sexually active man with a cryptorchid testis strongly points towards the diagnosis of malignancy in the abdominal testis.1 The incidence of testicular tumor is 11 times more in inguinal testes and 50 times more in intra abdominal testes. 2 Normally, the testes, which are inside the abdomen during gestation, migrate into the scrotum by the time of birth. Occasionally, boys are born with testes that are still in the abdomen or in the groin, not having completed their journey to the scrotum. These undescended testes are at high risk of cancer and should be moved into the scrotum at an early age or removed entirely.   doi: 10.3329/taj.v18i2.3194 TAJ 2005; 18(2): 131-133

scholarly journals Accuracy of ultrasound in pediatric undescended testes

2010 ◽  
Vol 4 (6) ◽  
pp. 983-986
Author(s):  
Teerasak Phewplung ◽  
Atchara Mahayosnond ◽  
Panruethai Trinavarat
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Surgical Procedures ◽  
Predictive Value ◽  
Undescended Testis ◽  
Clinical Implications ◽  
Common Condition ◽  
Undescended Testes ◽  
Ultrasonographic Diagnosis ◽  
Operative Findings

Abstract Background: The undescended testis represents a common condition affecting male infants with significant clinical implications such as infertility and testicular malignancy. There is controversy as to the diagnosis when a clinical examination fails to identify a testis. Objective: Investigate the value of ultrasound in the diagnosis of undescended testis, and evaluate the correlation between the preoperative ultrasonographic data and operative findings. Material and method: Thirty-nine boys (age: 3months -12 years) with undescended testes were examined between January 2003 and December 2007. All the boys had undergone a sonogram performed for localizing the undescended testes. Only 20 boys were sent for inguinal exploration, or other surgical procedures for localizing the undescended testes. We calculated specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and the accuracy of ultrasonographic diagnosis in boys with undescended testes. Results: Twenty-nine undescended testes were included in this study. Ultrasonography had a sensitivity of 82%, a specificity of 0%, PPV of 96%, NPV of 0%, and accuracy of 79% in the diagnosis of the undescended testis. Conclusions: The sensitivity and specificity including NPV of uetrasound had the unsatisfactory outcomes.

scholarly journals Trans-septal quilting suture versus intranasal silicone splint for preventing complications post endoscopic septoplasty

2021 ◽  
Vol 7 (9) ◽  
pp. 1415
Author(s):  
Rana F. Al Muslem ◽  
Mohammad R. Al Eid ◽  
Hussain A. Al Baharna
Keyword(s):  
Medical Records ◽  
Retrospective Cohort ◽  
Simple Technique ◽  
Common Procedure ◽  
Endoscopic Septoplasty ◽  
Video Recordings ◽  
Endoscopic Video ◽  
Operative Complications ◽  
The Difference ◽  
Quilting Suture

<p class="abstract"><strong>Background:</strong> Septoplasty is a common procedure in the field of otolaryngology for treatment of septal deviations. Intranasal splints and trans-septal quilting suture are commonly utilized to prevent post-operative complications. The silicone splint is a quick and simple technique to aid in cartilage support; however, it can cause discomfort. Trans-septal quilting suture is more available, well-tolerated and can help in mucosal tear closure, though is time-consuming. This study aimed to compare the efficacy of intranasal silicone splints versus quilting suture in the prevention of post endoscopic septoplasty complications.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective COHORT study comprised of patients who underwent endoscopic septoplasty between January 2017 and December 2019 at Qatif central hospital. The patients were assigned into two groups: group S, who received intranasal splints and group Q, who received trans-septal quilting suturing. Patients’ medical records were reviewed for evaluation of post-operative visits and post-operative nasal endoscopic video recordings from the image archive software were evaluated to document complications. Statistical analysis was conducted using SPSS 23.0 software.</p><p class="abstract"><strong>Results:</strong> The study included 65 patients, of whom 41 were in group S and 24 were in group Q. None of the patients had major bleeding, local infection or mucosal synechia. There was a higher complication rate in terms of mucosal crustation, septal hematoma and perforation among group S; however, the difference was not statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that trans-septal quilting suture and intranasal silicone splints are both equally effective in preventing complications following septoplasty.</p>

scholarly journals A study on assessment of postoperative complications among major abdominal surgeries using Clavien-Dindo classification

2020 ◽  
Vol 7 (6) ◽  
pp. 1788
Author(s):  
Rohit Reddy Rapaka ◽  
Venkata Reddy M.
Keyword(s):  
Abdominal Surgery ◽  
Age Group ◽  
Clinical Value ◽  
Exclusion Criteria ◽  
Standard Clinical Practice ◽  
Operative Complications ◽  
Postsurgical Complication ◽  
Low Incidence ◽  
Case Number ◽  
Definite Statement

Background: Surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation. Clavien-Dindo (CD) classification is the simplest way of reporting all complications. The main aim of this study was to test the usefulness of Clavien-Dindo classification in patients undergoing the abdominal surgery. In this study Clavien-Dindo classification has been used for assessment of postsurgical complications after major abdominal surgery.Methods: A total of 50 patients admitted to surgical wards for major abdominal surgery were evaluated through history, co-morbid condition and thorough clinical examination based on inclusion and exclusion criteria along with necessary investigations. Post-operative complications and management were recorded, and then postsurgical complication was classified based on Clavien-Dindo classification and assessed.Results: Most of the patients who developed complications were in the age group of 40-50 years. Most of the patients (32%) belonged to grade 2 complications. Serum creatinine, blood urea and post-operative stay were found to have direct relation with Clavien-Dindo grade of complications.Conclusions: The Clavien-Dindo classification represents an objective and simple way of reporting all complications in patients undergoing major abdominal surgeries and comparing the various complications between different surgeries. However, a definite statement on the clinical value of this classification system is not yet possible due to the small case number in this study, but the promising results should encourage further evaluation in larger cohort with the goal to possibly establish its validity as a standard clinical practice. 

Reductio Ad Absurdum: Examining the Validity of the 500-gram Rule in Reduction Mammaplasty

2020 ◽  
Author(s):  
Minji Kim ◽  
Mahmood J Al Bayati ◽  
Prakash J Mathew ◽  
Seth R Thaller
Keyword(s):  
Patient Satisfaction ◽  
Reduction Mammaplasty ◽  
Symptomatic Relief ◽  
Reduction Mammoplasty ◽  
Insurance Companies ◽  
Cochrane Central Register ◽  
Common Procedure ◽  
Form And Function ◽  
Hard Evidence ◽  
And Function

Abstract Background Reduction mammoplasty is a common procedure associated with a very high patient satisfaction rate. It has been shown to alleviate symptoms related to macromastia, such as back, neck, and shoulder pain, poor posture, bra strap grooving, paresthesia, and rashes. Despite the manifold benefits of reduction mammaplasty, some insurance companies require minimum resection weights of at least 500-grams per breast in order to distinguish between a reconstructive and aesthetic procedure. Objective The aim of this study is to assess the origins of the 500-gram rule used in reduction mammaplasty. Methods A comprehensive literature search of the MEDLINE, PubMed, Google Scholar, EMBASE, and Cochrane Central Register of Controlled Trials was conducted for studies published through July 2020 with multiple search terms related to resection weight criteria for breast reduction. Data on criteria, outcomes, and patient satisfaction were collected. Results A total of 14 articles were selected from the 27 articles that were identified. 500-gram rule appears to be arbitrary. It appears that it is not based on any available hard evidence. However, numerous studies show that patients who have less than 500-grams of tissue removed from each breast still experience significant symptomatic relief from reduction mammaplasty with a marked improvement in quality of life. Conclusion The 500-gram rule should be re-evaluated as criterion for pre-authorization reduction mammaplasty for insurance companies. It may influence surgeons to choose between form and function. Many additional patients might then benefit from this procedure with significant benefits.

Undescended testis and inguinoscrotal conditions in children

2017 ◽  
Author(s):  
David F.M Thomas
Keyword(s):  
Testicular Torsion ◽  
Undescended Testis ◽  
Cell Maturation ◽  
Age Group ◽  
Third Trimester ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Surgical Exploration ◽  
The Third ◽  
Inguinal Hernias

The testis descends in response to androgen stimulation in the third trimester of pregnancy. Germ cell maturation which normally occurs in early childhood is impaired or absent in undescended testes. The well-documented phenomenon of secondary ascent is now thought to account for a sizeable proportion of boys undergoing orchidopexy in later childhood. Inguinal hernias and communicating hydroceles are caused by persistence of a patent processus vaginalis. Surgery is always indicated for inguinal hernias but the majority of communicating hydroceles resolve spontaneously. Testicular torsion accounts for 90% acute scrotal symptoms in adolescents, in whom urgent surgical exploration is mandatory unless there is compelling evidence of an alternative diagnosis. Treatment is rarely justified for asymptomatic varicoceles in this age group.

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