scholarly journals Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

2021 ◽  
Author(s):  
Xiaojie Tang ◽  
Jianyi Li ◽  
Chunxiao Wang ◽  
Fang Liu ◽  
Jianwei Guo ◽  
...  
Keyword(s):  
Calcium Sulfate ◽  
Operative Time ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Infection Site ◽  
Spinal Stabilization ◽  
Positive Rate ◽  
The Mean

Abstract Background. Various surgical techniques for treating spondylodiscitis have been proposed, but the optimal surgical treatment remains controversial. In this study, we propose a new procedure that is implanting antibiotic-loaded calcium sulfate (CS) beads into the disc after infection site debrided by Quadrant channel combined with percutaneous fixation through a single-stage posterior approach for the treatment of spondylodiscitis. Thus, the purpose of this study is to assess the safety and efficacy of this procedure. Methods. This study collected 32 patients’ clinical data of whom had spine spondylodiscitis treated in our department from July of 2015 to August of 2020. The Demographic data included age, gender, involved segment and complications were collected. The intra-operative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay, laboratory examination were recorded. Results. The mean age of the 32 patients was 61.1 ± 9.7 years old. The mean operative time was 135.0 ± 30.6 minutes, and the mean blood loss was 243.4 ± 92.1 ml. The positive rate of culture was 72%. The mean Visual analogue scale (VAS) and Oswestry Disability Index (ODI) score significantly improved from 7.5 to 1.6 and from 65–10%. Cobb angle was significantly improved and could be maintained at final follow-up. Solid bone fusion was achieved in all patients. There were no recurrences of infection in our study. Conclusions. The procedure we proposed is effective in the treatment of spondylodiscitis, the infection site can be debrided and controlled exactly, and spinal stabilization can also be achieved.

Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction in patients younger than 6 months

2021 ◽  
pp. 039156032199360
Author(s):  
Saeed Alhindi ◽  
Mohamed Mubarak ◽  
Husain Alaradi
Keyword(s):  
Operative Time ◽  
Demographic Data ◽  
Renal Ultrasound ◽  
Ultrasound Scan ◽  
Operative Duration ◽  
Operative Complications ◽  
Efficient Alternative ◽  
The Mean ◽  
Operative Ultrasound

Objective: The transverse dorsal lumbotomy approach provides excellent exposure to the PUJ and causes minimal tissue damage. In this study, we assess the efficacy of dorsal lumbotomy in PUJ obstruction in children younger than 6 months. Methods: All children less than 6 months who were managed with the dorsal lumbotomy approach between 2009 and 2017 were reviewed prospectively. Data included: demographic data, pre/post-operative renal ultrasound scan with SFU grading and RDS, operative time, post-operative complications, and follow up results. Results: A total of 42 children with a mean age of 4.4 ± 1 months were included. On pre-operative RDS, all patients had an obstructive pattern and a SRF of 30.3 ± 9.3. The mean operative duration was 49 min and analgesia was minimal. Post-operative ultrasound at 6 months showed an improvement in hydronephrosis ( p < 0.05) and a mean SRF of 39.3 ± 6.1 ( p < 0.001). Conclusion: Transverse dorsal lumbotomy approach is a safe and efficient alternative in patients less than 6 month.

scholarly journals Anorectal Malignant Melanoma: Retrospective Analysis of Six Patients and Review of the Literature

2018 ◽  
Vol 119 (2-3) ◽  
pp. 97-106 ◽  
Author(s):  
Ibrahim Atak
Keyword(s):  
Malignant Melanoma ◽  
Retrospective Analysis ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Review Of The Literature ◽  
Oncological Treatment ◽  
Malignant Melanomas ◽  
Anorectal Malignant Melanoma ◽  
The Mean

Malignant melanomas are rare aggressive tumours originating from the pigment-producing melanocytes. In our study, a review of the literature and a retrospective analysis of patients undergoing surgery at our clinic due to anorectal malignant melanoma were performed. The information of 6 patients undergoing surgery in our clinic due to anorectal malignant melanoma between January 2010 and January 2018 was retrieved retrospectively. The patients were assessed regarding demographic data, physical examination and imaging findings, the surgical method performed, postoperative complication, histopathological findings, oncological treatment and follow-up results. Four of the patients were female and 2 were male and the mean age was 61.6 (46–83) years. Two patients (33%) had liver metastases at the time of initial presentation. Abdominoperineal resection (APR) was performed in all patients 3 with laparoscopic method. The mean length of hospital stay was recorded to be 6.5 ± 1 days (5–12 days). Adjuvant chemotherapy and radiotherapy were administered in all patients. Also, interferon treatment was administered in one patient additionally. During the follow-up, 4 patients died due to extensive metastatic disease determined approximately in the 13th month. Two patients with regular follow-up are well and free of disease and their mean postoperative lifetime has been determined to be 12.5 months (6–26 months). Anorectal malignant melanomas (ARMM) are rare but aggressive tumours. The treatment should be focused on minimizing morbidity and maximizing the quality of life and function while removing the gross tumour.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Flow diverter stents in the treatment of recanalized intracranial aneurysms

2021 ◽  
pp. 159101992199050
Author(s):  
Erol Akgul ◽  
Hasan Bilen Onan ◽  
Irem Islek ◽  
Mehmet Tonge ◽  
Yavuz Durmus ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Demographic Data ◽  
Previous Treatment ◽  
Flow Diverter ◽  
Serious Adverse Events ◽  
Clinical Complications ◽  
Tertiary Hospitals ◽  
The Mean ◽  
Technical Complication

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

scholarly journals A comparison of screw versus drill and curettage epiphysiodesis to correct leg-length discrepancy

2018 ◽  
Vol 12 (5) ◽  
pp. 509-514 ◽  
Author(s):  
M. Troy ◽  
B. Shore ◽  
P. Miller ◽  
S. Mahan ◽  
D. Hedequist ◽  
...  
Keyword(s):  
Operative Time ◽  
Surgical Techniques ◽  
Leg Length Discrepancy ◽  
Complication Rates ◽  
Leg Length ◽  
Treatment Groups ◽  
Length Discrepancy ◽  
Baseline Activity ◽  
Significant Difference

Purpose To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted. Characteristics including age at surgery, gender, epiphysiodesis location, side, operative time, LOS and hardware removal were compared across treatment groups. LLD, expected growth remaining (EGR) and bone age were determined preoperatively and at most-recent visit. The correction ratio (change in EGR) was calculated along with a 95% confidence interval (CI) to assess if correction in leg length was achieved. Results A total of 115 patients underwent epiphysiodesis in the femur (53%), tibia (24%) or a combination (24%). The cohort was 47% male, with a mean age of 12.6 years (7.7 to 17.7) at surgery. Median follow-up was 3.7 years (2.0 to 12.7). In all, 23 patients underwent PETS and 92 patients had PDED. Both treatment groups achieved expected LLD correction. There was no significant difference in median operative time, complication rates or LOS. PETS patients returned to activity at a mean 1.4 months (interquartile range (IQR) 0.7 to 2.1) while PDED patients returned at a mean 2.4 months (IQR 1.7 to 3) (p < 0.001). Conclusion Effectiveness in achieving expected correction, LOS and operative time are similar between screw and drill/curettage epiphysiodesis. Patients undergoing PETS demonstrated a faster return to baseline activity than patients with PDED. Level of Evidence: III

scholarly journals Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.

2020 ◽  
Author(s):  
Roberta Denise Alkmin Lopes Lima ◽  
Rogerio Serafim Parra ◽  
Marley Ribeiro Feitosa ◽  
Omar Féres ◽  
José Joaquim Ribeiro Rocha
Keyword(s):  
Operative Time ◽  
Average Distance ◽  
Economic Feasibility ◽  
Surgeon Experience ◽  
Average Operative Time ◽  
The Mean ◽  
Average Size ◽  
High Level ◽  
Complex Methods

Abstract Purpose Many transanal endoscopic surgeries require a high level of technical expertise and surgeon experience. Considering the economic feasibility of material acquisition and the technical feasibility of training and experience with complex methods, a simpler technique with available resources is relevant for the excision of rectal adenomas. This study presents the surgical and postoperative results achieved with a novel proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques. Methods We retrospectively investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer. Results This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months. Conclusions The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.

scholarly journals Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Operative Time ◽  
Surgical Techniques ◽  
Satisfaction Rate ◽  
Areola Complex ◽  
Different Types ◽  
Aesthetic Results ◽  
The Mean ◽  
Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

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