Advances in the surgical outcomes of 300 cases of pure laparoscopic living donor right hemihepatectomy divided into three periods of 100 cases: a single-centre case series

Background Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. Methods all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. Results Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. Conclusion At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.

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Highly selective diversion with proactive leakage management after low anterior resection for rectal cancer

British Journal of Surgery ◽

10.1093/bjs/znab018 ◽

2021 ◽

Author(s):

K Talboom ◽

I Vogel ◽

R D Blok ◽

S X Roodbeen ◽

C Y Ponsioen ◽

...

Keyword(s):

Low Anterior Resection ◽

Case Series ◽

Fecal Diversion ◽

Single Center ◽

Single Centre ◽

Diverting Stoma ◽

Faecal Diversion ◽

One Year ◽

Diversion Rate

Abstract In this single center case series with nine percent primary diversion, 86 of 94 patients alive and with complete follow-up at one year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. Meaning: Highly selective fecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared all disadvantages of a diverting stoma. In this single-centre case series, with a primary diversion rate of 9 per cent, 86 of 94 patients who were alive and had complete follow-up at 1 year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. The results indicate that, with highly selective faecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared the disadvantages of a diverting stoma.

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Transient cutaneous manifestations after administration of Pfizer‐BioNTech COVID‐19 Vaccine: an Italian single centre case series

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.17268 ◽

2021 ◽

Author(s):

M. Corbeddu ◽

A. Diociaiuti ◽

MR. Vinci ◽

A. Santoro ◽

V. Camisa ◽

...

Keyword(s):

Case Series ◽

Single Centre ◽

Cutaneous Manifestations

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Comparison of Efficacy between 120° and 180° Schlemm’s Canal Incision Microhook Ab Interno Trabeculotomy

Journal of Clinical Medicine ◽

10.3390/jcm10143181 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3181

Author(s):

Naoki Okada ◽

Kazuyuki Hirooka ◽

Hiromitsu Onoe ◽

Yumiko Murakami ◽

Hideaki Okumichi ◽

...

Keyword(s):

Surgical Outcomes ◽

Open Angle Glaucoma ◽

Case Series ◽

Glaucoma Surgery ◽

Success Rates ◽

Schlemm’S Canal ◽

Schlemm's Canal ◽

Kaplan Meier ◽

The Mean ◽

Ab Interno

We compared surgical outcomes in patients with either primary open-angle glaucoma or exfoliation glaucoma after undergoing combined phacoemulsification with either a 120° or 180° incision during a Schlemm’s canal microhook ab interno trabeculotomy (μLOT-Phaco). This retrospective comparative case series examined 52 μLOT-Phaco eyes that underwent surgery between September 2017 and December 2020. Surgical qualified success was defined as an intraocular pressure (IOP) of ≤20 mmHg, ≥20% IOP reduction with IOP-lowering medications, and no additional glaucoma surgery. Success rates were evaluated by Kaplan-Meier survival analysis. The number of postoperative IOP-lowering medications and occurrence of complications were also assessed. Mean preoperative IOP in the 120° group was 16.9 ± 7.6 mmHg, which significantly decreased to 10.9 ± 2.7 mmHg (p < 0.01) and 11.1 ± 3.1 mmHg (p = 0.01) at 12 and 24 months, respectively. The mean number of preoperative IOP-lowering medications significantly decreased from 2.8 ± 1.4 to 1.4 ± 1.4 (p < 0.01) at 24 months. Mean preoperative IOP in the 180° group was 17.1 ± 7.0 mmHg, which significantly decreased to 12.1 ± 3.2 mmHg (p = 0.02) and 12.9 ± 1.4 mmHg (p = 0.01) at 12 and 24 months, respectively. The mean number of preoperative IOP-lowering medications significantly decreased from 2.9 ± 1.2 to 1.4 ± 1.5 (p < 0.01) at 24 months. The probability of qualified success at 24 months in the 120° and 180° groups was 50.4% and 54.6%, respectively (p = 0.58). There was no difference observed for hyphema formation or IOP spikes. Surgical outcomes were not significantly different between the 120° and 180° incisions in Schlemm’s canal.

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Holmium laser enucleation of the prostate: A single-centre case series of 1000 patients

Journal of Clinical Urology ◽

10.1177/20514158211033741 ◽

2021 ◽

pp. 205141582110337

Author(s):

Danielle Whiting ◽

Branimir Penev ◽

Katherine Guest ◽

Mark Cynk

Keyword(s):

Case Series ◽

Reoperation Rate ◽

Late Complications ◽

Holmium Laser ◽

Urinary Flow ◽

Single Centre ◽

Level Of Evidence ◽

Laser Enucleation ◽

Holmium Laser Enucleation

Objective: To describe the short and long-term complications of over 1000 cases of Holmium laser enucleation of the prostate (HoLEP) in a single centre. Methods: A prospective database of all HoLEP procedures performed between December 2003 and March 2017 was analysed. Results: A total of 1016 HoLEP procedures were performed. Median patient age was 72 years (range 41–95). There was a significant improvement in urinary flow, post-void residual volume, IPSS and QoL score ( p < 0.0001). Pre-operative acute urinary retention was present in 403 patients (39.7%). Post-operatively five patients (1.2%) continued with a long-term catheter. Early and late complications consisted of failed initial voiding trial (10.6%), stress incontinence (transient 6.5%; persistent 0.3%), frequency/dysuria (5.6%), urinary tract infection (5.3%), urethral stricture (4.8%), submeatal stenosis (1.9%), return to theatre (1.5%), bladder neck stenosis (1.3%), bleeding (1.2%), epididymitis (0.7%), confusion (0.3%), transurethral resection of the prostate conversion (0.2%), ureteric obstruction (0.2%), vomiting (0.2%), anuric renal failure (0.1%), chest infection (0.1%), chest pain (0.1%), myocardial infarction (0.1%), rectoprostatic fistula (0.1%), supraventricular tachycardia (0.1%) and urinary sepsis (0.1%). Five-year reoperation rate was 3.7%. Conclusion: HoLEP is a safe treatment for bladder outflow obstruction secondary to an enlarged prostate. It is associated with few early and late complications and has a low reoperation rate. Level of evidence: 4

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