scholarly journals Initial experience of complete laparoscopic radical nephroureterectomy combined with transvesical laparoscopic excision of distal ureter in patients with upper urinary tract cancer

2020 ◽  
Author(s):  
Makito Miyake ◽  
Nobutaka Nishimura ◽  
Katsuya Aoki ◽  
Chihiro Ohmori ◽  
Takuto Shimizu ◽  
...  
Keyword(s):  
Rating Scale ◽  
Upper Urinary Tract ◽  
Initial Experience ◽  
Radical Nephroureterectomy ◽  
Specimen Extraction ◽  
Distal Ureter ◽  
Laparoscopic Excision ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

Abstract Background: Selecting the treatment procedure for cancer patients is a challenging task. We report our initial experience of complete laparoscopic radical nephroureterectomy (RNU) for patients with upper urinary tract urothelial cancer (UTUC).Methods: A total of four patients with UTUC underwent complete laparoscopic RNU combined with transvesical laparoscopic excision of the distal ureter using three 5-mm ports. Transvaginal specimen extraction was applied in female patients to reduce incisional pain and improve cosmesis. Peri-operative complications were evaluated using the Clavien–Dindo classification system. Postoperative pain was evaluated during hospitalization using a numeric pain rating scale (scales of 1 to 10). Patients who underwent retroperitoneal laparoscopic surgery combined with open excision of the distal ureter during the same period were included as a control group (conventional RNU, consisting of laparoscopic nephrectomy with open bladder cuff excision) for pain scale evaluation.Results: The novel surgery was successfully completed for all four patients (two males and two females). The mean pneumoperitoneum time for retroperitoneoscopic nephroureterectomy and specimen extraction was 174 min, while the mean pneumovesicum time for the ureteral orifice excision was 88 min. One male patient had bladder leakage at the suture site of the bladder wall, which lasted for two weeks. No patient experienced recurrent disease during the follow-up period (median, 10 months). Mild to moderate pain lasted for 5 or 6 days after RNU. A couple of days after surgery, the numeric pain rating scale of complete laparoscopic RNU and conventional RNU group reached its peak level at 3.0 ± 1.8 and 5.3 ± 2.8, respectively. There was no statistical difference in the degree of postoperative pain (P=0.31).Conclusions: We described our initial experience and outcome of complete laparoscopic RNU for UTUC. Further experience and research are required to determine whether this advanced laparoscopic technique yields better outcomes and has true clinical value.

scholarly journals Initial experience of complete laparoscopic radical nephroureterectomy combined with transvesical laparoscopic excision of distal ureter in patients with upper urinary tract cancer

2020 ◽  
Author(s):  
Makito Miyake ◽  
Nobutaka Nishimura ◽  
Katsuya Aoki ◽  
Chihiro Ohmori ◽  
Takuto Shimizu ◽  
...  
Keyword(s):  
Rating Scale ◽  
Upper Urinary Tract ◽  
Initial Experience ◽  
Radical Nephroureterectomy ◽  
Specimen Extraction ◽  
Distal Ureter ◽  
Laparoscopic Excision ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

Abstract Background: Selecting the best treatment procedure for cancer patients is a challenging task in clinical practice. Here, we report our initial experience of complete laparoscopic radical nephroureterectomy (RNU) for patients with upper urinary tract urothelial cancer (UTUC).Methods: We reviewed patients with UTUC who underwent complete laparoscopic RNU combined with transvesical laparoscopic excision of the distal ureter using three 5-mm ports. Transvaginal specimen extraction was applied in female patients to reduce incisional pain and improve cosmesis. Peri-operative complications were evaluated using the Clavien–Dindo classification system. Postoperative pain was evaluated during hospitalization using a numeric pain rating scale (scales of 1 to 10). Patients who underwent retroperitoneal laparoscopic surgery combined with open excision of the distal ureter during the same period were included as a control group (conventional RNU) for pain scale evaluation.Results: The novel surgery was successfully completed for all four patients (two males and two females). The mean pneumoperitoneum time for retroperitoneoscopic nephroureterectomy and specimen extraction was 174 min, while the mean pneumovesicum time for the ureteral orifice excision was 88 min. One male patient had bladder leakage at the suture site of the bladder wall, which lasted for two weeks. No patient experienced recurrent disease during the follow-up period. Mild to moderate pain lasted for 5 or 6 days after RNU. A couple of days after surgery, the numeric pain rating scale of complete laparoscopic RNU and conventional RNU group reached its peak level at 3.0 ± 1.8 and 5.3 ± 2.8, respectively. There was no statistical difference in the degree of postoperative pain (P=0.31, Mann Whitney U test).Conclusions: Few studies have reported on transvesical three-port bladder cuff excision for UTUC. Further experience and research are required to determine whether this advanced laparoscopic technique yields better outcomes and has true clinical value.

scholarly journals Initial experience of complete laparoscopic radical nephroureterectomy combined with transvesical laparoscopic excision of distal ureter in patients with upper urinary tract cancer

2020 ◽  
Author(s):  
Makito Miyake ◽  
Nobutaka Nishimura ◽  
Katsuya Aoki ◽  
Chihiro Ohmori ◽  
Takuto Shimizu ◽  
...  
Keyword(s):  
Rating Scale ◽  
Upper Urinary Tract ◽  
Initial Experience ◽  
Radical Nephroureterectomy ◽  
Specimen Extraction ◽  
Distal Ureter ◽  
Laparoscopic Excision ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

Abstract Background: Selecting the treatment procedure for cancer patients is a challenging task. We report our initial experience of complete laparoscopic radical nephroureterectomy (RNU) for patients with upper urinary tract urothelial cancer (UTUC).Methods: A total of four patients with UTUC underwent complete laparoscopic RNU combined with transvesical laparoscopic excision of the distal ureter using three 5-mm ports. Transvaginal specimen extraction was applied in female patients to reduce incisional pain and improve cosmesis. Peri-operative complications were evaluated using the Clavien–Dindo classification system. Postoperative pain was evaluated during hospitalization using a numeric pain rating scale (scales of 1 to 10). Patients who underwent retroperitoneal laparoscopic surgery combined with open excision of the distal ureter during the same period were included as a control group (conventional RNU, consisting of laparoscopic nephrectomy with open bladder cuff excision) for pain scale evaluation.Results: The novel surgery was successfully completed for all four patients (two males and two females). The mean pneumoperitoneum time for retroperitoneoscopic nephroureterectomy and specimen extraction was 174 min, while the mean pneumovesicum time for the ureteral orifice excision was 88 min. One male patient had bladder leakage at the suture site of the bladder wall, which lasted for two weeks. No patient experienced recurrent disease during the follow-up period (median, 10 months). Mild to moderate pain lasted for 5 or 6 days after RNU. A couple of days after surgery, the numeric pain rating scale of complete laparoscopic RNU and conventional RNU group reached its peak level at 3.0 ± 1.8 and 5.3 ± 2.8, respectively. There was no statistical difference in the degree of postoperative pain (P=0.31).Conclusions: We described our initial experience and outcome of complete laparoscopic RNU for UTUC. Further experience and research are required to determine whether this advanced laparoscopic technique yields better outcomes and has true clinical value.

scholarly journals Transition from Deep Regional Blocks toward Deep Nerve Hydrodissection in the Upper Body and Torso: Method Description and Results from a Retrospective Chart Review of the Analgesic Effect of 5% Dextrose Water as the Primary Hydrodissection Injectate to Enhance Safety

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Stanley K. H. Lam ◽  
Kenneth Dean Reeves ◽  
An-Lin Cheng
Keyword(s):  
Neuropathic Pain ◽  
Analgesic Effect ◽  
Rating Scale ◽  
Stellate Ganglion ◽  
Upper Body ◽  
Pain Rating ◽  
Perineural Injection ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described. Here we describe ultrasound-guided methods for hydrodissection of deep nerve structures in the upper torso, including the stellate ganglion, brachial plexus, cervical nerve roots, and paravertebral spaces. We retrospectively reviewed the outcomes of 100 hydrodissection treatments in 26 consecutive cases with a neuropathic pain duration of 16±12.2 months and the mean Numeric Pain Rating Scale (NPRS) 0–10 pain level of 8.3±1.3. The mean percentage of analgesia during each treatment session involving D5W injection without anesthetic was 88.1%  ±  9.8%. The pretreatment Numeric Pain Rating Scale score of 8.3±1.3 improved to 1.9±0.9 at 2 months after the last treatment. Patients received 3.8±2.6 treatments over 9.7±7.8 months from the first treatment to the 2-month posttreatment follow-up. Pain improvement exceeded 50% in all cases and 75% in half. Our results confirm the analgesic effect of D5W injection and suggest that hydrodissection using D5W provides cumulative pain reduction.

IMMEDIATE EFFECT OF KINESIOLOGY TAPING IN TREATING UNDISPLACED RIB FRACTURE PAIN

2015 ◽  
Vol 18 (02) ◽  
pp. 1550010 ◽  
Author(s):  
Aarti Sareen ◽  
Piyush Jain ◽  
Venus Pagare
Keyword(s):  
Rating Scale ◽  
Rib Fracture ◽  
Age Group ◽  
Pain Rating ◽  
Deep Breathing ◽  
Orthopedic Surgeon ◽  
Before And After ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

Purpose: To determine the immediate effect of kinesiology taping in treating undisplaced rib fracture pain. Method: The study is a retrospective in which 10 Patients (5 females and 5 males) with 1 or 2 undisplaced middle rib fractured (5th, 6th, 7th) were included. The age group of the patients was 27–57 years. The diagnosis was made by the orthopedic surgeon and referred to Institute of Kinesiology Taping. Numeric pain rating scale readings were obtained and documented before and after the taping session. Results: A significant decrease in pain before and after the kinesiology taping was found both while deep breathing ([Formula: see text]0.001) and during coughing ([Formula: see text]0.001). The Mean[Formula: see text] S.D of NPRS reading in case of pre and post taping for deep breathing was 5.7[Formula: see text]0.95 and 4.4[Formula: see text]0.84, respectively and that for coughing was 7.2[Formula: see text]0.63 and 4.7[Formula: see text]1.16, respectively. Conclusion: Kinesiology taping has immediate effect in treating undisplaced middle rib fracture pain.

Construct Validity of the Chinese Version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH-HKPWH)

2005 ◽  
Vol 30 (1) ◽  
pp. 29-34 ◽  
Author(s):  
E. W. C. LEE ◽  
M. M. H. CHUNG ◽  
A. P. S. LI ◽  
S. K. LO
Keyword(s):  
Construct Validity ◽  
Rating Scale ◽  
Pearson Correlation ◽  
Principal Component ◽  
Principal Component Factor Analysis ◽  
Sf 36 ◽  
Convergent And Divergent Validity ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Pain Rating Scale

The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages.

scholarly journals Early outcomes after intrathecal baclofen therapy in ambulatory patients with multiple sclerosis

2018 ◽  
Vol 129 (4) ◽  
pp. 1056-1062 ◽  
Author(s):  
Bryan S. Lee ◽  
Jaes Jones ◽  
Min Lang ◽  
Rebecca Achey ◽  
Lu Dai ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Rating Scale ◽  
Intrathecal Baclofen ◽  
Modified Ashworth Scale ◽  
Ambulatory Patients ◽  
Scale Scores ◽  
Numeric Pain Rating Scale ◽  
The Mean ◽  
Ashworth Scale ◽  
Pain Rating Scale

OBJECTIVEMultiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination and axonal loss. Walking difficulties are a common and debilitating symptom of MS; they are usually caused by spastic paresis of the lower extremities. Although intrathecal baclofen (ITB) therapy has been reported to be an effective treatment for spasticity in MS, there is limited published evidence regarding its effects on ambulation. The goal of this study was to characterize ITB therapy outcomes in ambulatory patients with MS.METHODSData from 47 ambulatory patients with MS who received ITB therapy were analyzed retrospectively. Outcome measures included Modified Ashworth Scale, Spasm Frequency Scale, Numeric Pain Rating Scale, and the Timed 25-Foot Walk. Repeated-measures ANOVA was used to test for changes in outcome measures between baseline and posttreatment (6 months and 1 year). Significance was set at p < 0.05. Descriptive data are expressed as the mean ± SD, and results of the repeated-measures ANOVA tests and the Wilcoxon rank-sum test are expressed as the mean ± SEM.RESULTSThere was a statistically significant reduction in the following variables: 1) aggregate lower-extremity Modified Ashworth Scale scores (from 14.8 ± 1.0 before ITB therapy to 5.8 ± 0.8 at 6 months posttreatment and 6.4 ± 0.9 at 1 year [p < 0.05]); 2) Numeric Pain Rating Scale scores (4.4 ± 0.5 before ITB, 2.8 ± 0.5 at 6 months, and 2.4 ± 0.4 at 1 year [p < 0.05]); 3) spasm frequency (45.7% of the patients reported a spasm frequency of ≥ 1 event per hour before ITB therapy, whereas 15.6% and 4.3% of the patients reported the same at 6 months and 1 year posttreatment, respectively [p < 0.05]); and 4) the number of oral medications taken for spasticity (p < 0.05). Of the 47 patients, 34 remained ambulatory at 6 months, and 32 at 1 year posttreatment. There was no statistically significant change in performance on the Timed 25-Foot Walk test over time for those patients who remained ambulatory.CONCLUSIONSIn this retrospective study, the authors found that ITB therapy is effective in reducing spasticity and related symptoms in ambulatory patients with MS. Because the use of ITB therapy is increasing in ambulatory patients with MS, randomized, prospective studies are important to help provide a more useful characterization of the effects of ITB therapy on ambulation.

scholarly journals Evaluation of full cup test and numeric pain rating scale in the assessment of orofacial pain

2021 ◽  
Vol 7 (4) ◽  
pp. 292-295
Author(s):  
Roland Prethipa P ◽  
Jimsha V K ◽  
Jonathan Daniel M
Keyword(s):  
Pain Assessment ◽  
Rating Scale ◽  
Orofacial Pain ◽  
Study Data ◽  
Self Report ◽  
P Value ◽  
Pain Rating ◽  
Cross Sectional ◽  
Numeric Pain Rating Scale ◽  
Pain Rating Scale

Pain intensity is a common outcome domain assessed in pain clinical trials. The patient’s self-report is the gold standard and it appears to be embedded in everyday clinical practice. Most often pain assessment is considered to be the cornerstone for ideal treatment.The aim of this study was to assess the dental patients’ level of pain using Full Cup Test (FCT) and Numeric Pain Rating Scale (NPRS), and to compare and validate the Full Cup Test in the assessment of orofacial pain with Numeric Pain Rating Scale.A total of sixty patients presenting with various forms of orofacial pain were included in this cross-sectional study. Data collected include the patient demographic details and the diagnosis of each case was made after proper history taking, clinical examination and radiographic investigation. Pain assessment was done for each patient using both numeric pain rating scale and full cup test.All the data were analysed using inferential statistics Mann Whitney test and the analysis was carried out with SPSS 17.The comparison of mean pain scores using full cup test and numeric pain rating scale shows there was significant differences between acute and chronic pain with P- value of 0.023 and 0.005 respectively. FCT had shown 83 percent sensitivity and 94 percent specificity.Patients who presented with either acute or chronic dental conditions experienced moderate to severe level of pain. FCT is useful for both evaluating and discerning changes in pain and it can be used as a tool in pain assessment.

scholarly journals A De Quervain-féle tendinopathia kezelése konzervatív módszerekkel

2020 ◽  
Vol 161 (11) ◽  
pp. 419-424
Author(s):  
László Földvári-Nagy ◽  
Johanna Takács ◽  
Judit Réka Hetthéssy ◽  
Ágnes Andrea Mayer ◽  
Noémi Szakács ◽  
...  
Keyword(s):  
Rating Scale ◽  
Outcome Measure ◽  
Pain Rating ◽  
De Quervain ◽  
Numeric Pain Rating Scale ◽  
Microsoft Office ◽  
Pain Rating Scale

Absztrakt: Bevezetés: A De Quervain-féle tendinopathia a csukló-kéz régióját érintő betegség. A hüvelykujj mozgatása fájdalmassá válik, a kéz funkciója jelentősen romlik. A betegség a legújabb kutatások szerint inkább degeneratív, semmint gyulladásos eredetű. Első lépésként a kéz sínezése, nemszteroid gyulladáscsökkentő szerek és különböző fizikoterápiás kezelések alkalmazása javasolt. Hatástalanságuk esetén további lehetőség az ínhüvelybe fecskendezett szteroidinjekció és a műtéti úton végzett ínhüvelybemetszés. Célkitűzés: Kutatásunkban megvizsgáltuk, hogy az excentrikus tréninggel kibővített konzervatív kezelés megfelelő alternatíváját nyújthatja-e a jelenleg elfogadott kezelési lehetőségeknek. Módszer: Az excentrikus tréning 8 hétig tartott, melyet indokolt esetben 12 hetesre bővítettünk. A betegek (n = 9) a betanítást követően naponta többször végezték a tréninget, amit a heti találkozók alkalmával kontrolláltunk. Az 1., a 8., valamint a 12. heti találkozó során az inspekciót követően mértük az ízületi mozgástartományt, az izomerőt, a fájdalmas régiók számát, illetve elvégeztük a ’Numeric Pain Rating Scale’, a ’Quick Disabilities of the Arm, Shoulder and Hand’, valamint a ’Patient-Rated Wrist Evaluation’ kérdőívek felvételét. A méréseket páros mintás t-teszttel és ismételt méréses varianciaanalízissel elemeztük. Az elemzéseket IBM SPSS Statistics 25.0 és Microsoft Office Excel Professional Plus 2016 programmal végeztük; p<0,05 esetén tekintettük statisztikailag szignifikánsnak eredményeinket. Eredmények: Szignifikáns javulást mértünk a fájdalom intenzitása (’Numeric Pain Rating Scale’ p = 0,005, n = 9) és a kéz, valamint a csukló funkciója terén (’Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure’ kérdőív 1. rész p<0,001, 2. rész p<0,001, ’Patient-Rated Wrist Evaluation’ kérdőív p<0,001; n = 9). Következtetés: Eredményeink alapján megfelelő betegbeválasztás mellett az excentrikus tréninggel kibővített konzervatív kezelés valós alternatívája lehet a jelenleg alkalmazott kezeléseknek. Orv Hetil. 2020; 161(11): 419–424.

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