scholarly journals New Techniques in Hemorrhoidal Disease but the Same Old Problem: Anal Stenosis

2021 ◽  
Author(s):  
Sezai Leventoglu ◽  
Bulent Mentes ◽  
Bengi Balci ◽  
Halil Can Kebiz
Keyword(s):  
Surgical Treatment ◽  
Functional Results ◽  
Surgical Reconstruction ◽  
Anal Stenosis ◽  
Ultrasonic Dissector ◽  
Significant Deterioration ◽  
New Techniques ◽  
Different Shapes ◽  
Non Surgical Treatment

Anal stenosis, which develops as a result of aggressive excisional hemorrhoidectomy, especially with the stoutly use of advanced technologies (LigaSure, Ultrasonic Dissector, Laser, etc.), has become common, causing significant deterioration in the patient's quality of life. Although non-surgical treatment is effective for mild anal stenosis, surgical reconstruction is unavoidable for moderate to severe anal stenosis that causes distressing, severe anal pain, and inability to defecate. The problem in anal stenosis, unlike anal fissure, is that the skin does not stretch as a result of chronic fibrosis due to surgery. Therefore, the application of lateral internal sphincterotomy does not provide satisfactory results in the treatment of anal stenosis. Surgical treatment methods are based on the use of flaps of different shapes and sizes to reconstruct the anal caliber and flexibility. This article aims to review the functional results, postoperative care, and complications of these methods.

scholarly journals QUALITY OF LIFE IN THE ELDERLY PATIENTS AFTER SURGERY FOR GASTRIC CANCER

2017 ◽  
Vol 22 (6) ◽  
pp. 313-315 ◽  
Author(s):  
Sergey N. Nered ◽  
I. S Stilidi ◽  
G. A Rokhoev
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Surgical Treatment ◽  
Elderly Patients ◽  
Gastric Resection ◽  
Functional Results ◽  
The Elderly ◽  
Significant Deterioration ◽  
Eortc Qlq

The problem of the quality of life of elderly gastric cancer patients after surgical treatment, is still insufficiently studied. Functional results of the management of 91 patients, underwent surgical treatment at the age of 75 years and older, are represented. 35 patients underwent gastrectomy, 56 patients - subtotal distal resection. The quality of life was assessed at the second year after surgery according to both the Performance Scales for the Karnofsky & ECOG Scores, as well as the modified form of EORTC QLQ-STO 22. Only 40% of patients were fully recovered after total gastrectomy and 57.1% of cases - after gastric resection. 28.6% and 35.7% of patients respectively were incapable for full activity and required support. Patients with severe disability and cases needed a significant care amounted to 28.6% and 2.8% in the group of patients after gastrectomy and only 3.6% in the group of cases after the gastric resection. Thus, in elderly patients with gastric cancer after surgical treatment, a significant deterioration of the quality of life is observed, and therefore the tactic of minimization of the radical surgical intervention in this age group is reasonable.

Long-Term Functional Results of the Non-Surgical Treatment of Common Bacterial Infections of Joints

1982 ◽  
Vol 11 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Herman Mielants ◽  
Eric Dhondt ◽  
Luc Goethals ◽  
Gust Verbruggen ◽  
Eric Veys
Keyword(s):  
Surgical Treatment ◽  
Bacterial Infections ◽  
Functional Results ◽  
Non Surgical Treatment

scholarly journals Osteopetrosis. Presentación de dos casos [Non-surgical management of osteopetrosis: two case reports an review of the literature]

2019 ◽  
Vol 84 (4) ◽  
pp. 386-392
Author(s):  
Juan Carlos Caruso ◽  
Juan Martín Patiño
Keyword(s):  
Surgical Treatment ◽  
Case Reports ◽  
Bone Dysplasia ◽  
Invasive Treatment ◽  
Non Invasive ◽  
History Of ◽  
Diaphyseal Fractures ◽  
Non Surgical Treatment ◽  
Delayed Consolidation

Las osteopetrosis (enfermedad de Albers-Schönberg) es un síndrome con cuatro tipos clásicos e instituye una displasia ósea secundaria a la falta de resorción de hueso por anormalidad de los osteoclastos, lo cual provoca un tejido óseo duro y quebradizo,propenso a fracturas difíciles de tratar quirúrgicamente. Se han publicado escasos artículos sobre el tema; por este motivo, decidimos presentar a dos pacientes con fracturas diafisarias de húmero con osteopetrosis, ambas tratadas en forma incruenta.Los objetivos son comunicar nuestra experiencia y el método de tratamiento de dicha afección y realizar una revisión bibliográfica acerca del tema. Creemos que el tratamiento de elección para las fracturas diafisarias de húmero en pacientes con osteopetrosises el incruento, ya que su tipo de tejido óseo dificulta la implementación de cualquier osteosíntesis. Además, la colocación de implantes puede provocar algunas complicaciones, como infecciones, retraso de la consolidación y seudoartrosis. La cirugía se reserva para ciertos casos, como en pacientes con riesgo de desarrollar deformidades incapacitantes, aquellos que han sufrido fracturas repetidas, con retraso de la consolidación, seudoartrosis, quienes no responden al tratamiento incruento o con unadeformidad previa.AbstractOsteopetrosis (also known as Albers-Schönberg disease) is a syndrome that includes four classic types and is characterized by bone dysplasia and lack of bone resorption due to abnormal osteoclastic activity and consequent development of brittle and hard bone that is prone to fractures that are difficult to treat surgically. Herein we present two cases of osteopetrosis with diaphyseal fractures of the humerus, both managed with non-surgical treatment. The objectives of our manuscript are to document our experience in the management of these cases and review the literature. The non-invasive treatment provides the best outcome for dyaphyseal fractures on the humerus in patients with osteopetrosis, given that the quality of the bone in these patients impairs the implementation of osteosynthesis. In addition, the placement of implants can lead to complications such as infections, delayed consolidation and pseudoarthrosis, among others. Surgical treatment should reserved for certain patients such as those with delayed consolidation, pseudoarthrosis, a history of repeated fractures, pre-existing deformity and those who are at risk for the development of disabling deformities or do not respond to non-surgical treatment.

scholarly journals Our results in the treatment of tarsal dislocations

2020 ◽  
Vol 148 (9-10) ◽  
pp. 554-559
Author(s):  
Maksim Kovacevic ◽  
Marijana Kovacevic ◽  
Sanja Maric ◽  
Nenad Lalovic ◽  
Milivoje Dostic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Result ◽  
Functional Results ◽  
High Energy ◽  
University Hospital ◽  
Adequate Treatment ◽  
Tarsometatarsal Dislocation ◽  
Excellent Functional Result ◽  
The University ◽  
Non Surgical Treatment

Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they are caused by high-energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment, and outcome. Methods. Tarsal dislocation cases treated in the University Hospital in Foca were analyzed during the period 2009?2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analogue scale. Results. All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In 10 patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion. Out of the 13 reviewed patients with tarsal dislocations, functional results were rated as excellent in 10 dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but a favorable functional outcome can be expected with an adequate treatment of these injuries.

scholarly journals Non-surgical interventions for excessive anterior pelvic tilt in symptomatic and non-symptomatic adults: a systematic review

2020 ◽  
Vol 5 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Anders Falk Brekke ◽  
Søren Overgaard ◽  
Asbjørn Hróbjartsson ◽  
Anders Holsgaard-Larsen
Keyword(s):  
Surgical Treatment ◽  
Pelvic Tilt ◽  
Clinical Symptoms ◽  
Risk Of Bias ◽  
Low Back ◽  
Surgical Interventions ◽  
Anterior Pelvic Tilt ◽  
Grade Approach ◽  
Non Surgical Treatment

Excessive anterior pelvic tilt is suspected of causing femoroacetabular impingement, low back pain, and sacroiliac joint pain. Non-surgical treatment may decrease symptoms and is seen as an alternative to invasive and complicated surgery. However, the effect of non-surgical modalities in adults is unclear. The aim of this review was to investigate patient- and observer-reported outcomes of non-surgical intervention in reducing clinical symptoms and/or potential anterior pelvic tilt in symptomatic and non-symptomatic adults with excessive anterior pelvic tilt, and to evaluate the certainty of evidence. MEDLINE, EMBASE, Web of Science and Cochrane (CENTRAL) databases were searched up to March 2019 for eligible studies. Two reviewers assessed risk of bias independently, using the Cochrane Risk of Bias tool for randomized trials and the ROBINS-I tool for non-randomized studies. Data were synthesized qualitatively. The GRADE approach was used to assess the overall certainty of evidence. Of 2013 citations, two randomized controlled trials (RCTs) (n = 72) and two non-RCTs (n = 23) were included. One RCT reported a small reduction (< 2°) in anterior pelvic tilt in non-symptomatic men. The two non-RCTs reported a statistically significant reduction in anterior pelvic tilt, pain, and disability in symptomatic populations. The present review was based on heterogeneous study populations, interventions, and very low quality of evidence. No overall evidence for the effect of non-surgical treatment in reducing excessive anterior pelvic tilt and potentially related symptoms was found. High-quality studies targeting non-surgical treatment as an evidence-based alternative to surgical interventions for conditions related to excessive anterior pelvic tilt are warranted. Cite this article: EFORT Open Rev 2020;5:37-45. DOI: 10.1302/2058-5241.5.190017

scholarly journals Intersphincteric Resection for Low Rectal Cancer – Case Report

2016 ◽  
Vol 62 (1) ◽  
pp. 142-145
Author(s):  
Cristian Russu ◽  
Călin Molnar ◽  
Sanda Maria Copotoiu ◽  
Claudiu Sărăcuț ◽  
Mircea Gherghinescu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Multimodality Treatment ◽  
Functional Results ◽  
Radical Resection ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Cancer Case ◽  
One Year

Abstract Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

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