scholarly journals 3D-printed Prostheses Assisted by Osteotomy Guide Plates for Reconstruction Following Periacetabular Tumor Resection via Two Approaches

Author(s):  
Yong-jie Zhao ◽  
Jing-yu Zhang ◽  
Xiao-qiang Deng ◽  
Xin-chong Du ◽  
Hao Zhang ◽  
...  

Abstract Background: Prosthetic reconstruction after periacetabular tumor resection likely yield good function. However, complications with this technique are common. Therefore, alternative prosthetic design and surgical technique warrant study. Methods: Six patients were retrospectively reviewed with malignant periacetabular tumors who received reconstruction using 3D-printed prostheses assisted by osteotomy guide plates via two approaches between July 2017 and June 2020. The surgical data, including operative duration and intraoperative blood loss were recorded. Preoperative and postoperative pain at rest was examined using the visual analog scale (VAS). The postoperative functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system, and the postoperative complications were analyzed.Results: The mean follow-up was 19 months (range, 3-36 months). The mean intraoperative blood loss was 1416 ml (range, 600-2000 ml), and the mean operative duration was 333 min (range, 300-370 min). Satisfactory surgical margins were achieved in all patients. Six patients complained of severe pain preoperatively (VAS score, mean, 6; range, 4-8) and described significant alleviation of pain at 4 weeks postoperatively (VAS score, mean, 2; range, 0-5). At the 12 weeks after surgery, the mean MSTS score was 15.6 (range, 5-27). Local recurrence occurred in one patient at 3 months after surgery.Conclusions: The 3D-printed prosthesis represents a potential alternative for reconstruction after malignant periacetabular tumor resection. The design of the two approaches and the use of osteotomy guide plates can yield good functional results, as well as low rate of complications.Trial registration: This study has been granted an exemption from requiring ethics approval by the ethics committee of Tianjin Hospital.

2020 ◽  
Author(s):  
YQ Zhang ◽  
Li Min ◽  
Minxun Lu ◽  
J Wang ◽  
Yitian Wang ◽  
...  

Abstract Background This study is to present and evaluate the short-term clinical outcomes and associated complications of 3D-printed customized prostheses for pubic defect reconstruction. Methods 5 patients receiving type III hemipelvectomy and three-dimensional-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analyzed in this study. The operation time and blood loss during operation were recorded. The local and functional recovery was assessed by the physical examination and Musculoskeletal Tumor Society (MSTS) score. The prosthetic position and Osseointegration were evaluated by imaging examination. Oncology result and complications were recorded. Functional comparisons with MSTS score of patients grouped by resection extent were done. Results Of 5 cases, the prosthese consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 17.6 months (range, 10–26 months). All 5 patients were alive with no evidence of disease. No deep infection and local recurrence occurred. The mean blood loss and mean intraoperative time was 1680 ml (range, 300 to 3700 ml) and 294 min (range, 180 to 430 min). The mean functional MSTS score at the final follow-up was 29.8 (range, 29–31). 1 male patient complained erectile dysfunction. Fretting wear around prosthetic stem was found in 3 patients while bone wear on the normal side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusion 3D-printed customized prostheses could be a feasible option to reconstruct the pubic bone defects after type III hemipelvectomy. The good outcomes are inseparable from precision prostheses design and strict surgical procedures.


Author(s):  
Hai Thanh Phan

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy


2018 ◽  
Vol 23 (2) ◽  
pp. 403-407 ◽  
Author(s):  
Takeshi Morii ◽  
Tomonori Kishino ◽  
Naoko Shimamori ◽  
Mitsue Motohashi ◽  
Hiroaki Ohnishi ◽  
...  

Author(s):  
Kirti M. Hurakadli ◽  
L. L. Pujari ◽  
Prashant G.

Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid   return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.


2020 ◽  
pp. 219256822092929 ◽  
Author(s):  
Motohiro Okada ◽  
Munehito Yoshida ◽  
Akihito Minamide ◽  
Kazunori Nomura ◽  
Kazuhiro Maio ◽  
...  

Study Design: Case series. Objectives: To report the clinical outcomes of the decompression procedure using the microendoscopic discectomy system for the treatment of a separation of lumbar posterior ring apophysis in young active athletes. Methods: We retrospectively reviewed 17 cases that underwent the microendoscopic surgery to treat a symptomatic separated lumbar ring apophysis between 2001 and 2014 at our institute or our associated hospital. The cases consisted of 15 males and 2 females, with their ages ranging from 12 to 19 years. The surgeries were performed at total of 18 lumbar levels, including 15 L4/5 and 3 L5/S1 levels. All patients were young athletes. We evaluated the following: (1) the Japanese Orthopaedic Association (JOA) score for low back pain, (2) recovery rates using Hirabayashi’s method, (3) operating time, (4) intraoperative blood loss, (5) perioperative complications, (6) the status of comeback to sports, and (7) the period taken to return to sports. Results: The JOA score was improved after the surgery in all cases. Recovery rate was 92.0% ± 8.1%. The mean operating time per level was 89.2 ± 33.3 minutes. The mean intraoperative blood loss per level was 95.3 ± 93.1 mL. A pinhole size dural tear occurred in one case as a perioperative complication. All cases returned to sports. The mean period taken to return to sports was 10.9 ± 3.5 weeks. Conclusion: Microendoscopic decompression surgery is useful for treating a separation of lumbar posterior ring apophysis.


2005 ◽  
Vol 2 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Shoji Yabuki ◽  
Shin-ichi Kikuchi

Object. The authors report the results of endoscopic partial laminectomy performed in 10 patients with degenerative cervical compressive myelopathy. Methods. Endoscopic partial laminectomy was performed safely in 10 patients with cervical myelopathy. All of the patients experienced symptomatic improvement with slight postoperative wound pain. The mean operative duration was 164 ± 35 minutes and the mean intraoperative blood loss was 45.5 ± 27 ml. Conclusions. Endoscopic partial laminectomy may be used as a minimally invasive alternative for the treatment of cervical compressive myelopathy.


2022 ◽  
Vol 19 (1) ◽  
pp. 77-80
Author(s):  
Anshu Sharma ◽  
Shama Bhandari ◽  
Dhundi Raj Paudel

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.


2021 ◽  
Vol 2 (2) ◽  
pp. 4-8
Author(s):  
Sagar Tontanahal ◽  
Gahukamble Abhay Deodas ◽  
Deeptiman James ◽  
Anand Kurian ◽  
Thomas Palocaren

Background: The management of malignant bone tumors in children has come a long way in the past few decades. The transition from amputation to limb salvage has been made possible due to the rapid development in the diagnosis and the oncological management of these malignant tumors. However, there exist significant reservations regarding endoprosthetic reconstruction in children. Material and methods: A mini-review was conducted of articles detailing the use of prosthetic reconstruction following tumor resection in children. The data regarding complications and functional outcomes following surgery were collected and presented. Results: The studies reviewed reported a 5-year survival rate between 60 – 70 %. Uniform across the studies was the need for multiple surgeries when endoprosthesis was used for limb reconstruction, ranging between 2.8 – 3.5 surgeries. The most common complication noted across the studies was related to soft tissue problems such as joint instability followed by structural failure of the prosthesis. Infections were noted with a frequency of 10 – 15 %. Studies showed successful management of limb length discrepancy with expandible prosthesis. Musculoskeletal Tumor Society (MSTS) score used to evaluate the functional outcome showed satisfactory outcomes. Conclusion: Limb salvage surgery, with recent advances in technique and prosthesis design, is an attractive option in children with extremity malignant bone tumors. In recent time, endoprosthetic reconstruction of extremities have yielded good functional results and are well accepted by the child and the parents. The purpose of this mini-review is to shed some light on the use of endoprosthetic reconstruction in children following tumor resection with its potential benefits and drawbacks.


2021 ◽  
Author(s):  
Yuwei Li ◽  
Shixin Zhao ◽  
Haijiao Wang ◽  
Peng Zhou ◽  
Wei Cui ◽  
...  

Abstract Objective To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for treating patients with cervical spondylotic myelopathy (CSM) coincident retrovertebral body osteophytes adjacent to the endplate or a free nucleus pulposus migrated to the vertebral body, posteriorly; known as complex cervical spondylotic myelopathy (cCSM) here.Methods Forty-seven patients with cCSM underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by traditional tools such as air drill, bone curet and gun-shaped bone forceps (group B). Average operative duration, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores and improvement rate were measured.Results Average operative duration and intraoperative blood loss were significantly lower in the piezosurgery group than those in the traditional group (P < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the piezosurgery and traditional groups (P < 0.05), respectively. Whereas JOA scores and improvement rate were insignificantly different at each data collection period (P > 0.05); preoperative, postoperative 3 days and postoperative 1 year follow-up were included.Conclusion For treating cCSM, both the piezosurgery and traditional tools led to significant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of operative duration, blood loss, and complication rate. Hence, the piezosurgery was a safe and effective adjunct for ACDF treating cCSM.


2021 ◽  
Author(s):  
Pei-Chi Wu ◽  
Bor-Ching Sheu ◽  
Kuan-Ju Huang ◽  
Su-Cheng Huang ◽  
Wen-Chun Chang

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.


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