scholarly journals Stapling technology with triple-row and enhanced staple configurations evaluated in a series of 124 consecutive laparoscopic vertical gastrectomies

2019 ◽  
Vol 6 (6) ◽  
pp. 1857
Author(s):  
Alessandro Bianchi ◽  
Alberto Pagan-Pomar ◽  
Marina Jimenez-Segovia ◽  
Carla Soldevila-Verdeguer ◽  
Jaume Bonnin-Pascual ◽  
...  
Keyword(s):  
Staple Line ◽  
Suture Line ◽  
Clinical Results ◽  
Anthropometric Parameters ◽  
Surgical Time ◽  
Vertical Gastrectomy ◽  
Gastric Leakage ◽  
Mechanical Suture ◽  
Group 2 ◽  
Group 1

Background: Laparoscopic sleeve gastrectomy (LSG) is a procedure frequently used to treat morbid obesity, due to its simplicity compared to other bariatric techniques. However, LSG can lead to serious complications, such as gastric leakage and bleeding from the staple line. To reduce these complications, seroserosal reinforcement of the mechanical suture line after gastrectomy is generally recommended. In recent decades, studies have focused on the safety of anastomosis with staples, especially compared to manual sewing techniques. Since studies on the improvement of stapling technology are limited, this study arises to compare the clinical results of staple line oversewing versus stapling technology with triple-row and enhanced staple configurations in laparoscopic sleeve gastrectomy.Methods: A retrospective review from a prospectively maintained database of 124 laparoscopic vertical gastrectomies performed at single centre between March 2010 and December 2016. Patients were divided into two groups, with comparable anthropometric parameters and inclusion criteria. Seroserosal reinforcement was used in the first group, and stapling technology with triple-row and enhanced staple configurations in the second. Rates of anastomotic leakage, bleeding, reoperation, and 30-day mortality were compared.Results: In Group 1 the average surgical time was 125 min, whereas in Group 2 it was 87 min. No differences were found between the two groups regarding leakage or bleeding of the staple line.Conclusions: The use of triple-row stapling devices during laparoscopic vertical gastrectomy enables surgical time to be reduced. Further high-quality studies to evaluate the efficacy and effectiveness of stapling technology with triple-row and enhanced staple configurations are needed.

scholarly journals The effect of hormonal disbalance on the aging rate change in the patients with arterial hypertension and comorbid endocrinopathies

2019 ◽  
Vol 23 (2) ◽  
pp. 277-282
Author(s):  
V. D. Nemtsova ◽  
I. A. Ilchenko ◽  
V. V. Zlatkina
Keyword(s):  
Arterial Hypertension ◽  
Premature Aging ◽  
Endocrine Disorders ◽  
Anthropometric Parameters ◽  
Aging Rate ◽  
Age Related ◽  
Number Of Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Due to the growing number of patients with age-related diseases, the aim of the study was to investigate in the changes of aging rate (AR) in patients with comorbid course of arterial hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SH) and to study the features of these changes depending on hormonal imbalance. 118 patients (63 women and 55 men, average age — 53.6±4.3 years) were divided into 3 groups: group 1 (n=37) with isolated H; group 2 (n=42) — with H and T2DM; group 3 (n=39) — with H, T2DM and SH. The investigation program included: measurement of anthropometric parameters (blood pressure, height, body weight (BW), body mass index (BMI)), carbohydrate and thyroid metabolism using standard methods, biological age (BA) by V.P. Voitenko et al. Statistical processing was performed using the Statistica for Windows 8.0 software package. When evaluating AR, physiological aging was found in 8 patients (21.6%) of group 1, in 4 (9.5%) patients of group 2 and 3 (7.7%) of patients in group 3. In the overwhelming majority of the examined patients, premature aging (PA) was noted, however, the acceleration of PA between patients of groups 2 and 3 was not differ significantly (p>0.05). The increase in AR in group 2 patients was accompanied by an increase in BA by 7.2 years, in 3 group patients — by 7.3 years compared with their chronological age. A correlation analysis revealed a positive relationship between BMI and coefficient of aging rate (CAR) (r=0.679; p<0.05); BMI and BA (r=0.562; p<0.05) and CAR and the TSH level (r=0.050; p=0.388) in the 3rd group. Thus, the presence of hypertension and comorbid endocrinopathies — T2DM and SH significantly increases the AR and when assessing the effect of endocrine disorders, the presence of T2DM is more important than SH.

scholarly journals A comparative analysis of outcomes after surgical reconstruction of stenoses in the upper respiratory tract in children

2021 ◽  
Vol 25 (4) ◽  
pp. 235-243
Author(s):  
A. Yu. Razumovsky ◽  
Z. B. Mitupov ◽  
V. E. Rachkov ◽  
N. S. Stepanenko ◽  
A. V. Adler ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Plastic Surgery ◽  
Costal Cartilage ◽  
Treatment Technique ◽  
Upper Respiratory Tract ◽  
Surgical Time ◽  
Significant Difference ◽  
Upper Respiratory ◽  
Group 2 ◽  
Group 1

Introduction. Definition " upper respiratory tract stenosis " (URTS) includes a large number of nosologies. The most common are cicatricial stenoses, in particular, post-intubation ones as well as bilateral paralysis of the larynx. An important issue for nowadays is choosing the curative modality for such patients.Purpose. To compare outcomes after treating children with URTS.Material and methods. The authors have assessed results of treatment of 110 patients who had reconstructive surgery in 2010-2019. Patients were divided into two groups depending on the nosology: stenosis of the upper respiratory tract (n = 71) and bilateral paralysis of the larynx (n-39). In each group, four types of surgeries were performed: costal cartilage plasty, plasty with T-tube (TT), a modified version of plasty with TT, plasty with a stent. The choice of treatment technique was determined mostly by the tendency to make this or that type of surgery in authors' departments, as well as by the nosology, severity of the disease and patient's age. Decannulation terms, surgical time, early and late postoperative complications as well as relapse-free period were assessed.Results. 66% patients were decannulated in Group 1; in Group 2 - 69%. Group 1 a statistically reliable comparison was possible between the following techniques: costal cartilage plasty and laryngeal stent plasty (p > 0.005) as well as plasty with TT implantation and the proposed modified technique (p > 0.005). While using Mann-Whitney test and Log Rank, the authors found out that in Group 1 there were no significant difference in surgical time, relapse-free period and stenosis degree (p > 0.005). However, decannulation terms after plastic surgery of the larynx with costal cartilage implantation are longer than after plastic surgery with stent implantation (p < 0.005). In Group 2, the authors compared three abovementioned curative modalities, excluding laryngeal plasty with TT implantation. Thus, surgical time for costal cartilage plasty is longer, if to compare to other two techniques (p < 0.005). There is also no significant difference in decannulation terms and relapse-free periods between all three techniques (p > 0.005).Conclusion. The results obtained have demonstrated the effectiveness of long-term stenting with TT placement in children, mainly with cicatricial stenoses, and in older children. The trial also revealed that laryngoplasty with costal cartilage in children with bilateral laryngeal paralysis is an effectiveness choice too.

scholarly journals Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877089 ◽  
Author(s):  
Cen Tao Liu ◽  
Heng an Ge ◽  
Rui Hu ◽  
Jing Biao Huang ◽  
Yi Chao Cheng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Pain Score ◽  
Operation Time ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Single Row ◽  
Repair Technique ◽  
Randomized Controlled Studies ◽  
Group 2 ◽  
Group 1

Background: The comparison of clinical outcomes of arthroscopic footprint-preserving knotless single-row repair with the tear completion repair technique for articular-sided partial-thickness rotator cuff tears (PTRCTs) remains unclear. Methods: A total of 68 patients diagnosed with articular-sided PTRCTs who underwent rotator cuff repair between December 2014 and June 2015 were included. Of the 68 patients, 30 received footprint-preserving knotless single-row repair (group 1) and 38 received the tear completion repair technique (group 2). Preoperative and postoperative assessments were compared. Results: Both groups had significantly improved American Shoulder and Elbow Surgeons (ASES) scores (group 1: 48.2 preoperatively to 81.9 postoperatively, p < 0.001; group 2: 47.1 preoperatively to 84.9 postoperatively, p < 0.001) and visual analog scale (VAS) pain score (group 1: 6.0 preoperatively to 0.93 postoperatively, p < 0.001; group 2: 6.1 preoperatively to 1.1 postoperatively, p < 0.001), showing that the two procedures significantly improved postoperative shoulder function. No significant differences were shown in ASES score or VAS pain score between the two groups ( p > 0.05). The mean operation time was significantly shorter in group 1 with an average of 48.1 min than in group 2 with an average of 60.4 min ( p < 0.001). Conclusions: Footprint-preserving knotless single-row repair obtains similar clinical results compared to tear completion repair in the treatment of articular-sided PTRCTs. Footprint-preserving knotless single-row repair may be a convenient choice for the treatment of articular-sided PTRCTs. Randomized controlled studies are needed to investigate whether the footprint-preserving knotless single-row repair yields better long-term outcomes through the protection of the bursal cuff and restoration of the healthy footprint.

scholarly journals The Effect of Patient-Specific Instrumentation Incorporating an Extramedullary Tibial Guide on Operative Efficiency for Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Oh-Ryong Kwon ◽  
Kyoung-Tak Kang ◽  
Juhyun Son ◽  
Dong-Suk Suh ◽  
Dong Beom Heo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Surgical Time ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

This retrospective study was to determine if patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) leads to shortened surgical time through increased operating room efficiency according to different tibial PSI designs. 166 patients underwent primary TKA and were categorized into three groups as follows: PSI without extramedullary (EM) tibial guide (group 1, n=48), PSI with EM tibial guide (group 2, n=68), and conventional instrumentation (CI) group (group 3, n=50). Four factors were compared between groups, namely, operative room time, thickness of bone resection, tibial slope, and rotation of the component. The mean surgical time was significantly shorter in the PSI with EM tibial guide group (group 2, 63.9±13.6 min) compared to the CI group (group 3, 82.8±24.9 min) (P<0.001). However, there was no significant difference in the PSI without EM tibial guide group (group 1, 75.3±18.8 min). This study suggests that PSI incorporating an EM tibial guide may lead to high operative efficiency in TKA compared to CI. This trial is registered with KCT0002384.

scholarly journals Comparison of perioperative parameters in one-handed rotational phacoemulsification versus conventional phacoemulsification and femtosecond laser-assisted cataract surgery

2021 ◽  
Vol 14 (12) ◽  
pp. 1868-1875
Author(s):  
Samuele Gigliola ◽  
◽  
Alfredo Niro ◽  
Carmela Palmisano ◽  
Pasquale Puzo ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
The Other ◽  
Dissipated Energy ◽  
Surgical Time ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AIM: To compare perioperative parameters of one-handed rotational phacoemulsification technique (one-handed phaco-roll) with each of other two techniques, “Divide et Conquer” and femtosecond laser-assisted cataract surgery (FLACS) METHODS: In this retrospective and comparative cohort study, eyes with uncomplicated cataract (nuclear density grade 2 to 3) treated routinely with one-handed phaco-roll (n=23; Group 1) or “Divide et Conquer” (n=23; Group 2) or FLACS (n=23; Group 3) were enrolled. Intraoperative parameters including effective phaco-time (EPt), ultrasound time (USt), aspiration time, surgical time, phacoemulsification (phaco)-power, balanced salt solution (BSS) use, cumulative dissipated energy (CDE) were recorded and compared. Clinical outcomes including best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT) and central macular thickness (CMT), were assessed and compared pre-operatively and at 1mo after surgery. RESULTS: Aspiration and surgical time, and BSS used were lower in Group 1 (P<0.01) than other groups. EPt, phaco-power and CDE were lower in Group 1 (P<0.05) than Group 2 but not significantly different from Group 3. In Group 1, USt was lower (P<0.05) than Group 2 but higher (P<0.05) than Group 3. BCVA improved in all groups without significant difference between Group 1 and the other ones. No significant differences regarding all post-operative morphologic outcomes (ECD, ECL, CCT, CMT) were reported. No clinical complications occurred. CONCLUSION: One-handed phaco-roll seems to be less time-consuming than “Divide et Conquer” and FLACS and less energy-consuming than “Divide et Conquer”. Furthermore, one-handed phaco-roll seems to have an equal safety profile compared to the other two techniques.

Modified versus Standard Mechanical Valved Aortic Conduit

2005 ◽  
Vol 13 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Paul P Urbanski ◽  
Witold Dinstak ◽  
Stefan Frank ◽  
Alexander Siebel ◽  
Robert W Hacker
Keyword(s):  
Postoperative Mortality ◽  
Mechanical Valve ◽  
Composite Graft ◽  
Clinical Results ◽  
Valve Prosthesis ◽  
Early Results ◽  
Hemodynamic Characteristics ◽  
The Difference ◽  
Group 2 ◽  
Group 1

The aim of this study was to compare the hemodynamic characteristics and early clinical results of a commercially available standard aortic conduit with those of a modified valved composite graft, which consists of a mechanical valve prosthesis sewn into a vascular tube and placed in a supraannular position. The modified conduit was placed in 40 patients (group 1) and the standard conduit in another 40 patients (group 2). The early postoperative mortality rates (within 30 days after surgery) were 0% in group 1 and 5% (2 patients) in group 2; the difference was not statistically significant. The mean geometric orifice area of the valve prosthesis was significantly larger in group 1 than in group 2 (3.7 ± 0.7 cm2 versus 2.9 ± 0.5 cm2). Early results showed a hemodynamic advantage of the modified conduit, with significantly lower transvalvular gradients.

scholarly journals Catch-up growth in children with late-diagnosed coeliac disease

2005 ◽  
Vol 94 (3) ◽  
pp. 437-442 ◽  
Author(s):  
A. K. Patwari ◽  
Gaurav Kapur ◽  
L. Satyanarayana ◽  
V. K. Anand ◽  
Amit Jain ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Repeated Measures ◽  
Anthropometric Parameters ◽  
Significant Difference ◽  
Marginal Means ◽  
Catch Up ◽  
Group 2 ◽  
Height For Age ◽  
Group 1

Anthropometric parameters and catch-up growth were prospectively evaluated in fifty late-diagnosed children with coeliac disease aged 2·25–10 years after 1–4 years of adhering to a strict gluten-free diet (GFD). The anthropometric parameters were expressed as Z scores relative to National Centre for Health Statistics standards using Epi Info 2000 (weight-for-height Z score (WHZ) and height-for-age Z score (HAZ)). Catch-up growth was evaluated by repeated measures. ANOVA, overall significance by an F test and pair-wise comparisons for estimated marginal means using the least significant difference. At the time of enrolment, no significant difference was observed in WHZ and HAZ between children diagnosed before (group 1) or after (group 2) 4 years of age. On follow-up, HAZ was significantly higher in group 1 after the first and third years of the GFD (P=0·04 and 0·02, respectively), with a non-significant increase after completing 4 years of the GFD (P=0·22). Feeding the GFD resulted in an overall significant (F=3·99, P=0·011) increase in HAZ up to 4 years of follow-up. However, the catch-up in height was incomplete, with stunting in sixteen (55·4 %) of twenty-nine children after 3 years and in seven (46·6 %) of fifteen children after 4 years on the GFD. Pair-wise comparisons demonstrated a linear catch-up growth during the initial follow-up on GFD. Treatment with the GFD did not result in an overall significant increase in WHZ up to 4 years of follow-up (F=1·01, P=0·42). Our results suggest that, in children with late-diagnosed coeliac disease, treatment with a GFD leads to a normalisation of body mass and a significant but incomplete recovery in HAZ during 4 years of follow-up.

Comparison of bursting pressure on sleeve gastrectomy staple lines between stapling, buttressing, and oversewing

2020 ◽  
pp. 155335062096900
Author(s):  
Salvatore Tolone ◽  
Claudio Gambardella ◽  
Gianmattia del Genio ◽  
Luigi Brusciano ◽  
Roberto Ruggiero ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Staple Line ◽  
Barbed Suture ◽  
Burst Pressure ◽  
Obese Patients ◽  
Staple Line Reinforcement ◽  
Bursting Pressures ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Backgrounds. One of the major complications after laparoscopic sleeve gastrectomy (LSG) is represented by leaks along the staple line. Several reinforcement techniques have been proposed, but scarce data about the real strengthening offered are present. Thus, we aimed to evaluate if different reinforcements produced different bursting pressures after LSG, and then to verify if the clinical application of the stronger reinforcement produced a reduction in leakage rate. Methods. We prospectively enrolled all consecutive obese patients that underwent LSG. We tested 3 different types of staple lines, as follows: group 1, no reinforcement; group 2, bioabsorbable buttress reinforcement; group 3, invaginating overrunning barbed suture. A burst pressure test was applied to the gastric specimen by means of high-resolution manometric catheter. After burst pressure tests, a subsequent consecutive series of patients were treated with the most effective reinforcement, and rate of leaks was recorded. Results. We enrolled in total 110 obese patients; 20 patients for each group of staple line reinforcement and then other 50 consecutive patients underwent LSG with the higher burst pressure staple line reinforcement. Median burst pressures were similar in group 1 and group 2; group 3 showed a statistically significant pressure increase ( P < .0001) than group 1 and group 2, with a 5.2-fold value. Other consecutive 50 obese patients underwent LSG with overrunning reinforcement. In none of them a leak was detected. Conclusions. Reinforcement of the SG staple line, with overrunning suture, seems to drastically increase bursting pressures in an ex vivo model and it is promising when reproduced in vivo.

29 to 24 Year-Clinical Results of Total Hip Arthroplasty Cemented with HA by Interface Bioactive Bone Cement (IBBC)

2011 ◽  
Vol 493-494 ◽  
pp. 366-369
Author(s):  
Hironobu Oonishi ◽  
Hiroyuki Oonishi Jr. ◽  
Shigekazu Mizokawa ◽  
Hirotsugu Ohashi ◽  
Masaru Ueno ◽  
...  
Keyword(s):  
Bone Cement ◽  
Radiolucent Line ◽  
Clinical Results ◽  
Bone Surface ◽  
Appearance Rate ◽  
Group 3 ◽  
Group 2 ◽  
The One ◽  
Very High ◽  
Group 1

To improve the fixation of bone and bone cement in THA we used Interface Bioactive Bone Cement technique (IBBC) since 1982. For prostheses 28 mm-alumina head with polyethylene socket (Kyocera Co.) were used. In IBBC not-resorbable pure crystalline HA granules (0.3– 0.5 mm) were smeared on the bone surface in one to three layers just before packing bone cement. Group 1: IBBC was used in six joints in 1982. Group 2: In 25 patients, conventional bone cement technique (non-IBBC) in the one hip (in 1985 to 1986) and IBBC technique in the other hip (in 1986) were performed in the same patients. Group 3: In 65 patients (71 joints) IBBC were performed. Neither radiolucent line nor osteolysis appeared in all case in group 1. In group 2 in Non-IBBC the appearance rate of radiolucent line and osteolysis were rather high, however in IBBC they were extremely low. In Non-IBBC loosening were seen in 5 joints in the acetabulum and in 2 joints in the femur. However, in IBBC there was no loosening. In group 3 the radiolucent line and the osteolysis appeared extremely low. There was no loosening. In Non-IBBC the appearance rate of radiolucent line and the osteolysis was very high and the rate of loosening was 20%. However, in IBBC, radiolucent line and osteolysis will be prevented eternally.

scholarly journals Еxperimental estimation of the stapler suture peritonization as a method of prevention of complications after sleeve resection of stomach

2018 ◽  
Vol 85 (4) ◽  
pp. 46-48
Author(s):  
І. М. Тоdurov ◽  
О. V. Perekhrestenko ◽  
І. М. Savitska ◽  
S. V. Kosiuchno ◽  
О. О. Каlashnikov ◽  
...  
Keyword(s):  
Structural Changes ◽  
Gastric Resection ◽  
Gastric Wall ◽  
Suture Line ◽  
Postoperative Hemorrhage ◽  
Sleeve Resection ◽  
Experimental Animals ◽  
Resection Line ◽  
Group 2 ◽  
Group 1

Objective. Estimation of expediency for peritonization of the stapler resection line, aiming to prevent the stapler suture hemorrhage and insufficiency. Маterials and methods. The investigation was conducted on laboratory rabbits, to which the sleeve gastric resection was performed: in 9 experimental animals (Group 1) – with peritonization of the stapler suture line, in experimental animals (Group 2) – without peritonization. Structural changes of gastric wall in the stapler suture portion in both groups of experimental animals were investigated. Results. Peritonization of the stapler suture line have caused exaggeration of the gastric walls ischemic changes. Conclusion. Peritonization of the sleeve gastric resection line promotes prophylaxis of postoperative hemorrhage from the stapler suture, but do not prevent its insufficiency.

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