scholarly journals Short term outcomes of snodgrass urethroplasty in distal and mid penile hypospadias

2018 ◽  
Vol 5 (5) ◽  
pp. 1878
Author(s):  
Pramod S. ◽  
Anukethan J.
Keyword(s):  
Demographic Data ◽  
Urethrocutaneous Fistula ◽  
Short Term ◽  
Urethral Plate ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Congenital Condition ◽  
The Mean ◽  
Complications Rate ◽  
Hypospadias Surgery

Background: Hypospadias is common congenital condition. First attempted hypospadias surgery was done during first century A.D. Since then more than 300 techniques have been explained in the surgery for Hypospadias. The goal of surgery is focused on functional and cosmetic outcomes. In 1994 Snodgrass popularized the technique of urethral plate incision, tubularization and secondary dorsal healing for hypospadias repair. Aim of the study was to evaluate the short term outcomes of Snodgrass urethroplasty.Methods: This was a retrospective study conducted by the department of Pediatric Surgery, Kempegowda Institute of medical sciences (KIMS) hospital, Bangalore from 2014 to 2017. Children with mid penile and distal hypospadias who had undergone Snodgrass urethroplasty were enrolled in the study. Children with previous surgery were excluded. The demographic data, duration of surgery, post operative requirement of anticholinergics, duration of catheterization and post operative stay were tabulated. Children were followed up for duration of 6 months to 3 years. Post operative complications were tabulated. Results: 40 children were included in the study. Age ranges of children were between 9 months to 14 years. In most of the children hypospadias was diagnosed at birth. The mean duration of surgery was 97.25 minutes. The mean duration of hospitalization was12.2 day. The overall complications rate was 20%. The most common complication was urethrocutaneous fistula. Out of the 40 children included in the study 4(10%) children required resurgery (urethrocutaneous fistula closure).Conclusions: Snodgrass urethroplasty is a simple and effective technique. It is easy to learn and can be applied as a single stage procedure. The most common complications are urethrocutaneous fistula and meatal stenosis.

scholarly journals Using prepucial mucous to cover neourethra in TIP urethroplasty: 4 years experience in a tertiary paediatric hospital of Bangladesh

2020 ◽  
pp. 37-40
Author(s):  
Sabbir Karim ◽  
◽  
Monoarul Islam Talukder ◽  
Sultana Parvin ◽  
◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Wide Spectrum ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Paediatric Hospital ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Key Words Hypospadias ◽  
The Mean ◽  
Different Tissues

Background. Hypospadias has a wide spectrum of penile abnormality requiring surgical correction. Most of the cases are of anterior variety and the surgical technique depends on constructing a neo urethra. Snodgrass or Tubularized Incised Plate (TIP) urethroplasty is one of the most popular techniques of urethroplasty which depends on the existing healthy, adequate and intact urethral plate. Different tissues have been described to cover the neourethra as second layer in literature. In this study we modified the TIP urethroplasty by covering the neourethra with 2 layers of pedicled prepucial mucosa or Dartos flap. Objective. To see the outcome of modified Snodgrass or TIP urethroplasty in anterior mid and proximal penile hypospadias. Materials and method. Total 88 patients were operated by modified Snodgrass technique or modified TIP urethroplasty from January 2012 to July 2016. Coronal, subcoronal, distal penile, mid penile and proximal penile hypospadias were included in the study. Every patient underwent modified TIP urethroplasty and outcomes were assessed. Results. The mean age of the patients were 28.34±14.98 months, ranges from 6.5 to 65 months. 9 (10.2%) patients of our series develop urethrocutaneous fistula, 5 (5.68%) patients develop meatal stenosis and 1 (1.1%) patient developed neourethral stricture. Conclusion. TIP urethroplasty is a versatile method to correct penile hypospadias. Covering of the neourethra with prepucial mucosa secure the neourethral anastomosis. The author declares that there is no conflict of interest. Key words: Hypospadias, TIP urethroplasty, Prepucial mucosa.

Anesthesia Management in Endovascular Aortic Repair

2021 ◽  
Author(s):  
Arzu Karaveli
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Demographic Data ◽  
Patient Characteristics ◽  
Endovascular Aortic Repair ◽  
Lengths Of Stay ◽  
Aortic Repair ◽  
Aortic Pathology ◽  
Duration Of Surgery ◽  
The Mean

Objective: Our study aimed to examine retrospectively the anesthesia techniques and their results applied to patients who underwent endovascular aortic repair due to aortic pathology. Methods: This retrospective and observational study included patients who underwent EVAR or TEVAR for abdominal and/or thoracic aortic aneurysm between 2015-2021. Patients’ demographic data, type of surgery and anesthesia, duration of surgery and anesthesia, amount of blood transfusion, lengths of stay in ICU and of hospital were recorded. Results: The data of 206 patients who underwent EVAR and TEVAR for abdominal and/or thoracic aortic aneurysm were obtained. TEVAR was applied to 63 patients and EVAR was applied to 143 patients. The procedure was performed under general anesthesia (GA) in all 63 patients who underwent TEVAR, while 15 patients who underwent EVAR were operated under GA and 128 patients under regional anesthesia (RA). The mean anesthesia and surgery times were found 136.1±72.0 min. and 112.2±71.3 min. in GA patients and it was 112.2±71.3 min. and 96.5±32.1 min. in RA patients. The mean length of ICU and hospital stays were determined as 1.6±2.1 days and 3.1±2.7 days in GA patients, and 1.2±0.6 days and 3.1±2.5 days in RA patients. Conclusion: GA or RA methods are preferred as anesthesia techniques in patients undergoing EVAR due to aortic aneurysm. Although RA has advantages compared to GA, such as shorting the lenght of hospital and ICU stays, reducing the blood product requirements, shorting both anesthesia and surgery times, patient characteristics should also be considered in the selection of anesthesia techniques.

scholarly journals Outcomes after Carotid Angioplasty and Stenting in Symptomatic Octogenarians

2011 ◽  
Vol 38 (3) ◽  
pp. 446-451 ◽  
Author(s):  
M. A. Almekhlafi ◽  
P. L. Couillard ◽  
A. Pandya ◽  
N. Shobha ◽  
W. F. Morrish ◽  
...  
Keyword(s):  
The Elderly ◽  
Carotid Stenting ◽  
Complication Rates ◽  
Carotid Angioplasty ◽  
Short Term ◽  
The Mean ◽  
Complications Rate ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
Length Of Hospitalization

Objective:Octogenarians were excluded from participation in many carotid endarterectomy trials due to the high complication rates observed in past studies. However, stroke resulting from carotid stenosis is expected to increase with the aging population. Moreover, advances in Carotid Angioplasty and Stenting (CAS) techniques have resulted in perceived improved safety of this procedure. We sought to review our experience with carotid stenting in symptomatic octogenarians with an emphasis on short-term outcomes and complications.Methods:This is a retrospective longitudinal cohort study of all symptomatic patients who underwent CAS in our center between 1997 and 2007. Thirty-day stroke and death rates, and length of hospitalization were compared between the symptomatic octogenarians and non-octogenarians.Results:A total of 214 procedures were performed on 211 symptomatic patients (56 females). Fifty-nine patients (14 females) were octogenarians. The median (interquartile range) age on procedure date for the octogenarian cohort was 83 (4) years. Periprocedural death occurred in two (3.4%) octogenarians and five (3.3%) non-octogenarians (p = 0.97). At 30 days from the procedure, stroke occurred in four (6.8%) octogenarians and seven (4.6%) non-octogenarians (p= 0.52). The mean hospital stay (4.8 days) was not different between the two cohorts. Age was not a predictor of the 30-day risk of composite stroke or death.Conclusion:The complications rate observed in octogenarians was not significantly higher than non-octogenarians. Our findings suggest that octogenarians should be included in randomized trials examining CAS to better define the risk-benefit profile of this procedure in the elderly.

scholarly journals Dorsal vertical island flap urethroplasty in children with hypospadias: a single center’s experience 75 patients

2019 ◽  
Vol 2 (1) ◽  
pp. e000021
Author(s):  
Gontumukkala Chalapathi ◽  
Kadiri Sitha Ramaiah ◽  
Javvadi Veeraswamy
Keyword(s):  
Good Alternative ◽  
Urethral Diverticulum ◽  
Vertical Tube ◽  
Island Flap ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Cosmetic Appearance ◽  
Good Cosmetic ◽  
The Mean

ObjectiveTo assess the results and complications of dorsal vertical island flap (DVIF) urethroplasty.MethodsA total of 175 children were operated on for hypospadias. Out of these, 41 with proximal hypospadias with severe chordee required two-stage urethroplasty. In 18 babies with glanular hypospadias, a meatal advancement and glanuloplasty procedure was done. In 25 babies with mid-penile and distal penile hypospadias, tubularized incised urethral plate (TIP) urethroplasty was the option. 16 babies with unhealthy urethral plate and chordee were chosen for dorsal vertical tube urethroplasty after excision of the urethral plate. The rest of the 75 babies with proximal, mid-penile or distal penile hypospadias with no or minimal chordee after degloving and poor urethral plate were chosen for DVIF urethroplasty. These 75 babies with DVIF were followed up from 3 months to 5 years to assess complications such as urethrocutaneous fistula, meatal stenosis, glans dehiscence, megalourethra or urethral diverticulum, stricture, and penile torsion/rotation.ResultsA total of 75 patients with proximal, mid-penile, or distal penile hypospadias in whom DVIF was used during the study period were included. The mean age was 3.7 years, ranging from 8 months to 14 years. Fourteen patients developed complications (18.6%). The most common complication was urethrocutaneous fistula, which was seen in seven (9.3%) patients. Glans dehiscence was seen in five patients (6.6%), and one had meatal stenosis with diverticulum formation. Skin necrosis was observed in one patient. In 61 patients, stream was good, with no torsion, and good cosmetic appearance was observed.ConclusionsDVIF is a good alternative to TIP in mid-penile and distal penile hypospadias. Our early experience with DVIF urethroplasty showed an acceptable rate of complications and good cosmetic results.

scholarly journals Prevalence of Asymptomatic Brucellosis in Children 7 to 12 Years Old

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammad Aghaali ◽  
Siamak Mohebi ◽  
Hosein Heydari
Keyword(s):  
Demographic Data ◽  
Clinical Manifestations ◽  
Asymptomatic Infection ◽  
Short Term ◽  
Disease Symptoms ◽  
Blood Samples ◽  
Asymptomatic Children ◽  
The Mean ◽  
One Year

Background. Brucellosis is one of the most common diseases of humans and animals and its clinical manifestations differ from asymptomatic infection to chronic illness associated with recurrence of symptoms. This study aimed to evaluate the prevalence of brucellosis in asymptomatic children 7 to 12 years old in Kahak, Iran.Methods. In this study, 186 children 7 to 12 years old were evaluated. Demographic data and exposure to the brucellosis agent were recorded and blood samples for the Wright, Coombs, and 2ME tests were collected. All the study subjects were followed up for one year about the appearance of symptoms.Results. The mean age was 10 ± 1.72 years and 51% were boys. Family history was positive for brucellosis in 15% of children. A total of 8 children were brucellosis seropositive and, in subsequent follow-up, 6 of them showed the disease symptoms.Conclusion. This study showed that approximately 4.3% of children in endemic areas can have asymptomatic brucellosis and many of these children may be symptomatic in short term.

scholarly journals Effectiveness and Short Term Functional Results of Surgical Treatment with Locking Plate in Proximal Humerus Fractures

2020 ◽  
Author(s):  
Tolgahan Kuru ◽  
Onur YIlmaz
Keyword(s):  
Locking Plate ◽  
Proximal Humerus ◽  
Late Complications ◽  
Proximal Humerus Fractures ◽  
Short Term ◽  
Significant Difference ◽  
Duration Of Hospitalization ◽  
Humerus Fractures ◽  
The Mean

INTRODUCTION: In this study, we aimed to investigate postoperative short term outcomes, union status, early and late complications and the relationship between them in patients treated with plate osteosynthesis due to proximal humerus fractures in our hospital. METHODS: A total of 34 patients aged between 18-92 years were included in the study. Patients’ age, gender, fracture pattern, time from hospitalization to the surgery, time from surgery to discharge and comorbidities were recorded and evaluated. RESULTS: The mean duration of hospitalization was found as 3.4±1.7 days. There was no significant difference between the patients with and without comorbidity in terms of the mean duration of hospitalization. There was no significant difference between the patients with and without complications in terms of the mean time from hospitalization to the surgery. According to Neer classification, postoperative late complications occurred in 40% of Neer Type 4 fractures, 29.4% of Neer Type 3 fractures and 8.3% of Neer Type 2 fractures. DISCUSSION AND CONCLUSION: Internal fixation with locking plate seems a reliable option in the treatment of proximal humerus fractures, especially in osteoporotic bones and Neer Type 2 fractures.

scholarly journals Study on safety of non-descent vaginal hysterectomy for enlarged uterine size for benign uterine pathologies

2019 ◽  
Vol 8 (4) ◽  
pp. 1588
Author(s):  
Neelam Manda ◽  
Oby Nagar ◽  
Lata Rajoria ◽  
C. P. Dadhich
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Demographic Data ◽  
Pelvic Sepsis ◽  
Control Group ◽  
Complication Rates ◽  
Index Group ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
The Mean

Background: Vaginal hysterectomy is less commonly performed for benign pathologies if the uterine size exceeds 12 weeks in the belief that complications could be higher in this group. The aim of this prospective study was to compare surgical outcomes and safety of vaginal hysterectomy in women with non-prolapsed uteri of >12 weeks size to those with uteri of<12 weeks removed vaginally for similar indications.Methods: In this prospective cohort study, 92 patients were included who underwent NDVH for benign uterine conditions between May 2016 to December 2018. The index group comprised 32 women who underwent vaginal hysterectomy for non-prolapse uterus with uterine enlargement (>12 weeks), while the control group consisted of 60 women with uteri <12 weeks. Demographic data, duration of surgery, blood loss, intraoperative and postoperative complications were compared.Results: Women in the two groups had statistically similar mean age, Body Mass Index and parity (44 vs 42.77 years, 20.8 vs 21.56 kg m3 and 3.26 vs 3.83, respectively; p > 0.05). The mean operative time was significantly longer in the index group (62.47min; vs 48.17 min; p <0.0001). Women with enlarged uteri had greater mean estimated blood loss (123.2 ml vs 75.9 ml; p < 0.0001) but the mean length of hospital stay was similar (5.531 days vs 5.177 days; p > 0.05). Intra- and post-operative complications such as blood transfusion and pelvic sepsis, post-operative febrile illness and systemic infections were comparable in both groups.Conclusions: Vaginal hysterectomy in larger non-prolapsed uteri takes longer to perform and is associated with more blood loss compared to uteri <12 weeks but is not associated with a significant increase in complication rates.

Stapled Haemorrhoidopexy in the Treatment of Haemorrhoidal Disease: A Prospective Study

2020 ◽  
Vol 38 (3) ◽  
pp. 126-134
Author(s):  
Md Jahangir Hossan Bhuiyan ◽  
AMM Yahia ◽  
Farhana Begum ◽  
Mainuddin Ahmed ◽  
Nafiz Imtiaz Uddin Ahmed
Keyword(s):  
Hospital Stay ◽  
Stapled Haemorrhoidopexy ◽  
Patient’S Satisfaction ◽  
Haemorrhoidal Disease ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Short And Long Term ◽  
The Mean ◽  
Grade 3 ◽  
A Prospective Study

Background: Haemorrhoids are usually managed by open haemorrhoidectomy which is associated with postoperative pain, prolong hospital stay, longer convalescence and late return to normal activities. Stapled haemorrhoidopexy is a newer alternative for the treatment of haemorrhoid. The present study was designed to evaluate this technique in terms of duration of surgery & hospital stay, complications, convalescence, time return to normal activities, cost effectiveness and patient’s satisfaction. Materials and methods: One hundred and sixty patients of either sex who fulfilled the criteria were included in this study. More than 90% of the patients were in grade 3 & 4. All data were prospectively collected and examined. The patients were evaluated in terms of demographic properties, complaints on admission and postoperative complication. Results: 69.4% were male and 30.6% were female. Mean age was 40.93 years. Grade 3 haemorrhoid was present in 73.75% cases, Grade 4 was 18.12% cases, Grade 1 and Grade 2 were in 8.13% cases. The mean duration of surgery was 30 minutes. The mean duration of hospitalization was 36 hours. Intraoperative bleeding was observed in 9.38% patients. Reactionary haemorrhage was seen in 3.75% patients. Postoperative mild pain in 3.12% patients and residual prolapse in 1.25% cases. Conclusion: Stapled haemorrhoidopexy is safer alternative to open haemorrhoidotectomy with many short and long term benefits. J Bangladesh Coll Phys Surg 2020; 38(3): 126-134

Overlapping single-level lumbar fusion and adverse short-term outcomes

2021 ◽  
pp. 1-12
Author(s):  
Ali S. Farooqi ◽  
Donald K. E. Detchou ◽  
Gregory Glauser ◽  
Krista Strouz ◽  
Scott D. McClintock ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Demographic Data ◽  
Univariate Analysis ◽  
P Value ◽  
Matched Cohort ◽  
Short Term ◽  
Single Level ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Impact

OBJECTIVE There is a paucity of research on the safety of overlapping surgery. The purpose of this study was to evaluate the impact of overlapping surgery on a homogenous population of exactly matched patients undergoing single-level, posterior-only lumbar fusion. METHODS The authors retrospectively analyzed case data of 3799 consecutive adult patients who underwent single-level, posterior-only lumbar fusion during a 6-year period (June 7, 2013, to April 29, 2019) at a multihospital university health system. Outcomes included 30-day emergency department (ED) visit, readmission, reoperation, and morbidity and mortality following surgery. Thereafter, coarsened exact matching was used to match patients with and without overlap on key demographic factors, including American Society of Anesthesiologists (ASA) class, Charlson Comorbidity Index (CCI) score, sex, and body mass index (BMI), among others. Patients were subsequently matched by both demographic data and by the specific surgeon performing the operation. Univariate analysis was carried out on the whole population, the demographically matched cohort, and the surgeon-matched cohort, with significance set at a p value < 0.05. RESULTS There was no significant difference in morbidity or any short-term outcome, including readmission, reoperation, ED evaluation, and mortality. Among the demographically matched cohort and surgeon-matched cohort, there was no significant difference in age, sex, history of prior surgery, ASA class, or CCI score. Overlapping surgery patients in both the demographically matched cohort and the matched cohort limited by surgeon had longer durations of surgery (p < 0.01), but no increased morbidity or mortality was noted. Patients selected for overlap had fewer prior surgeries and lower ASA class and CCI score (p < 0.01). Patients with overlap also had a longer duration of surgery (p < 0.01) but not duration of closure. CONCLUSIONS Exactly matched patients undergoing overlapping single-level lumbar fusion procedures had no increased short-term morbidity or mortality; however, duration of surgery was 20 minutes longer on average for overlapping operations. Further studies should assess long-term patient outcomes and the impact of overlap in this and other surgical procedures.

scholarly journals Stapled hemorrhoidopexy versus open hemorrhoidectomy: a comparative study of short term results

2017 ◽  
Vol 4 (2) ◽  
pp. 472 ◽  
Author(s):  
Idoor D. Sachin ◽  
Om Prakash Muruganathan
Keyword(s):  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Duration Of Surgery ◽  
The Mean ◽  
Grade 3

Background: Hemorrhoids are usually managed by surgical hemorrhoidectomy which is associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer alternative for the treatment of hemorrhoids. In this study, the two methods were compared for short term outcomes.Methods: Hundred patients having grade 3 or 4 hemorrhoids and who fulfilled the criteria were included in the study from June 2012 to May 2014. Fifty patients underwent stapled hemorrhoidopexy and other fifty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3, 6 weeks and 6 months post-operatively. The two groups were compared for duration of surgery, hospital stay, return to work and post-operative complications.Results: The mean (S.D.) age was 40.06 (10.33) in our study. The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. There were no major post-operative complications, recurrence, residual prolapse or incontinence in the follow up period of six months in the stapled group.Conclusions: Stapled hemorrhoidopexy is a safer alternative to open hemorrhoidectomy with many short-term benefits.

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