scholarly journals Microsurgery of chronic post-intubation laryngeal stenosis using a CO2-laser

2020 ◽  
pp. 132-138
Author(s):  
V. V. Vavin ◽  
I. I. Nazhmudinov ◽  
Kh. Sh. Davudov ◽  
T. I. Garashchenko ◽  
B. Kh. Davudova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Result ◽  
Scar Tissue ◽  
Middle Part ◽  
Laryngeal Stenosis ◽  
Operational Capabilities ◽  
Working Age ◽  
Cervical Trachea ◽  
One Year ◽  
Post Intubation

Introduction. Despite significant progress achieved in the surgical treatment of cicatricial laryngeal stenosis and cervical trachea in recent decades, this issue appears relevant, especially among people of young and working age.Aim of the study: To develop tactics for surgical treatment of post-intubation laryngeal stenosis using a CO2-laser.Materials and methods: During the period from 2015 to 2019, surgical treatment was performed for 105 patients with post-intubation cicatricial stenosis of the larynx using microsurgical techniques and a CO2-laser, provided that the cartilage frame of the larynx was preserved, which was determined in a preoperative examination.Results and discussion: In the postoperative period, patients were monitored from 6 months to 3 years. Localization of cicatricial post-intubation laryngeal stenosis in the vestibular region is quite rare. According to the results of the study, achievement of a stable functional result was obtained in 20 (84%) of 24 patients with lesions of the vocal section of the larynx, in one case a cicatricial membrane of this section of the larynx was required to be excised after one year, and laryngoplasty with extra laryngeal access in four cases. Post-intubation stenosis of sub-folded localization is most widespread, and in our observations they amounted to 79%. The use of endolaryngeal access using a CO2-laser made it possible to achieve a good functional result in 66% of cases, reconstruction of the larynx by extra-laryngeal access was required in 33%, and laryngotracheal resection in 1%.Conclusion: It is shown that the use of a CO2-laser in the surgical treatment of chronic post-intubation laryngeal stenosis significantly expands operational capabilities due to the high accuracy and low level of damage to surrounding tissues. This method allows the formation of minimal wound surfaces by submucosal excision of scar tissue and makes it possible to cover the wound with microlosks of the mucous membrane, reducing the time of epithelization in the intervention area, which is an important prevention of repeated stenosis. In the surgical treatment of extended stenosis of the middle part of the larynx, there are prerequisites for repeated wound replacement with scar tissue, which in our observations was avoided by using endoprostheses. The defeat of the sub-follicular part of the larynx is prone to restenosis even in the absence of data for the defeat of the cartilaginous framework of the larynx.

Variants of surgical treatment of chronic post-intubation laryngeal stenosis in children

2021 ◽  
Vol 16 (2) ◽  
pp. 2-13
Author(s):  
V.V. Vavin ◽  
◽  
I.I. Nazhmudinov ◽  
T.I. Garashchenko ◽  
O.V. Karneeva ◽  
...  
Keyword(s):  
Co2 Laser ◽  
Scar Tissue ◽  
Laryngeal Stenosis ◽  
Recurrent Stenosis ◽  
Silicone Stent ◽  
Laryngeal Cartilages ◽  
Surgical Tactics ◽  
Post Intubation ◽  
Autologous Grafts ◽  
Preoperative Examination

Objective. To evaluate the effectiveness of a surgical tactics used for the treatment of children with chronic post-intubation laryngeal stenosis depending on the condition of their laryngeal cartilages. Patients and methods. We treated 47 children with chronic post-intubation laryngeal stenosis. Preoperative examination included endoscopy and computed tomography (CT) of the larynx and trachea. We evaluated the condition of their laryngeal cartilages in order to choose an optimal surgical tactics. Children with intact laryngeal cartilages (n = 20) have undergone endolaryngeal microsurgery using a CO2 laser. This method caused minimal injury due to submucosal excision of scar tissue, which enabled wound coverage with mucous microflaps to prevent recurrent stenosis. Surgery for extensive stenosis in the middle portion of the larynx was associated with a risk of recurrent scarring. In our study, we prevented it by using endografts during 21 days. However, patients with lesions in the subglottic larynx still had a high risk of recurrent stenosis (5 out of 12 patients) even if there was no evidence of damage to the laryngeal cartilages. Results. Twenty-seven patients with laryngeal post-intubation stenosis with lesions to the laryngeal cartilages detected before surgery have undergone extralaryngeal laryngotracheoplasty. Eighteen children have undergone laryngofissure with subsequent stenting between 6 and 18 months with a T-shaped silicone stent. Nine patients have undergone single-stage laryngotracheoplasty with autologous grafts. Conclusion. The methods used in this study have demonstrated high effectiveness, while the use of grafts reduced the number of stages of surgery and its duration. Key words: laryngotracheoplasty in children, laryngeal microsurgery, complications of tracheal intubation in children, chronic laryngeal stenosis, cartilage autologous grafts, CO2 laser

Epicardial cryoablation as surgical treatment for atrial fibrillation: One year follow up in 84 patients

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
R Uhl ◽  
I Marcolino ◽  
E Zimmer ◽  
F Beyersdorf ◽  
E Eschenbruch
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
One Year

Osteosynthesis at pelvic injuries in toy-breed dogs

2020 ◽  
pp. 32-33
Author(s):  
Nikolay I. Antonov ◽  
Keyword(s):  
Surgical Treatment ◽  
Urban Environment ◽  
Pelvic Trauma ◽  
X Rays ◽  
Skeletal Trauma ◽  
Companion Dogs ◽  
Pelvic Injuries ◽  
Behavioral Features ◽  
Osteosynthesis Techniques ◽  
One Year

Pelvic injuries account for 16 to 25% of all skeletal trauma in small pets. Small dogs as companion dogs are now widespread. Unusual exterior and behavioral features have made them popular and at the same time vulnerable in the modern urban environment. The author defined the nature of injuries and adapted technique of transosseous osteosynthesis for the treatment of toy-breed dogs with pelvic trauma. The study of the X-rays in 226 dogs with pelvic injuries demonstrated that toy-breed dogs accounted for 16% of the total. Multiple pelvic trauma was revealed in 95% of them. Surgical treatment was performed in 24 dogs, conservative one - in 13, that amounted to 65% and 35%, respectively. Surgical treatment consisted in open juxtaposing of fragments and focal transosseous and/or internal osteosynthesis with subsequent external fixation using devices of various designs. The external structures were of three types: half-ring support or U-shaped staple, pair of parallel curved plates connected by two threaded rods with each other, and pair of curved plates located bilaterally on both sides of the pelvis and connected by two threaded rods with the help of threaded ends. The terms of fixation for pelvic injuries in toy-breed dogs at the age under one year were 42 days on the average, and in the dogs at the age above one year - 60 days. Surgical treatment in toy-breed dogs with pelvic injuries was performed more often in comparison with conservative one. Pelvic trauma was accompanied by pronounced pain shock. The osteosynthesis techniques used in toy-breed dogs are little traumatic and not limiting functions thereby contributing to recovery of all the structures of pelvis and pelvic limbs.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

The Surgical Treatment of Paralytic Laryngeal Stenosis

BMJ ◽  
1887 ◽  
Vol 1 (1367) ◽  
pp. 593-594
Author(s):  
G. B. Hope
Keyword(s):  
Surgical Treatment ◽  
Laryngeal Stenosis

scholarly journals POSTFUNDOPLICATION DYSPHAGIA CAUSES SIMILAR WATER INGESTION DYNAMICS AS ACHALASIA

2016 ◽  
Vol 53 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Roberto Oliveira DANTAS ◽  
Carla Manfredi SANTOS ◽  
Rachel Aguiar CASSIANI ◽  
Leda Maria Tavares ALVES ◽  
Weslania Viviane NASCIMENTO
Keyword(s):  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Chagas Disease ◽  
Water Volume ◽  
Flow Volume ◽  
Water Ingestion ◽  
Idiopathic Achalasia ◽  
One Year ◽  
Over Time

ABSTRACT Background - After surgical treatment of gastroesophageal reflux disease dysphagia is a symptom in the majority of patients, with decrease in intensity over time. However, some patients may have persistent dysphagia. Objective - The objective of this investigation was to evaluate the dynamics of water ingestion in patients with postfundoplication dysphagia compared with patients with dysphagia caused by achalasia, idiopathic or consequent to Chagas' disease, and controls. Methods - Thirty-three patients with postfundoplication dysphagia, assessed more than one year after surgery, together with 50 patients with Chagas' disease, 27 patients with idiopathic achalasia and 88 controls were all evaluated by the water swallow test. They drunk, in triplicate, 50 mL of water without breaks while being precisely timed and the number of swallows counted. Also measured was: (a) inter-swallows interval - the time to complete the task, divided by the number of swallows during the task; (b) swallowing flow - volume drunk divided by the time taken; (c) volume of each swallow - volume drunk divided by the number of swallows. Results - Patients with postfundoplication dysphagia, Chagas' disease and idiopathic achalasia took longer to ingest all the volume, had an increased number of swallows, an increase in interval between swallows, a decrease in swallowing flow and a decrease in water volume of each swallow compared with the controls. There was no difference between the three groups of patients. There was no correlation between postfundoplication time and the results. Conclusion - It was concluded that patients with postfundoplication dysphagia have similar water ingestion dynamics as patients with achalasia.

scholarly journals Surgical Treatment of Persistent Fetal Vasculature and Visual Rehabilitation: One-Year Followup

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
N. Kozeis ◽  
K. T. Tsaousis ◽  
D. Gidaris
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Hand Movement ◽  
Good Prognosis ◽  
Posterior Chamber ◽  
Visual Rehabilitation ◽  
Postoperative Course ◽  
Persistent Fetal Vasculature ◽  
One Year ◽  
The One

We present the management and postoperative course of a persistent fetal vasculature (PFV) case. A four-year-old girl visited the Eye Department of Hippokration, General Hospital of Thessaloniki due to reduced visual acuity of her left eye. She was diagnosed with PFV and underwent surgery (lensectomy, capsulorhexis of the posterior capsule, insertion of an intraocular lens in the posterior chamber, and posterior vitrectomy) in order to dissect the PFV. Along with the postoperative medical care, she underwent intensive treatment for amblyopia. The postoperative course was uncomplicated, and the visual acuity of her left eye improved from hand movement to 20/25 with proper correction. Patients with unilateral PFV and gradually deteriorating visual acuity could be good candidates for a combined surgical procedure, as the one described above, with a good prognosis.

scholarly journals Cerebellar metastases – may surgery play a role in the presence of multiple lesions?

2017 ◽  
Vol 31 (2) ◽  
pp. 152-160
Author(s):  
M. Dabija ◽  
V. Dorobăţ ◽  
Alina Paiu
Keyword(s):  
Surgical Treatment ◽  
Life Expectancy ◽  
Operative Time ◽  
Oncological Surgery ◽  
Effective Treatment Option ◽  
Oncological Patients ◽  
Intracranial Metastases ◽  
Cerebellar Lesions ◽  
One Year

Abstract Brain metastases are the most common form of malignancy presence in the CNS having a more frequent appearance than primary brain tumors. Although secondary cerebellar tumors represent only 15% of all intracranial metastases, they are quite frequent among primary oncological patients and pose a challenge for all of the medical caretakers starting with the neurosurgeon. Among those, a small percent of patients have multiple cerebellar lesions and the therapeutic challenge turns into a medical controversy, especially when it comes to surgical treatment taking into consideration that the life expectancy is lower than one year. A key asset which we have on our side is the anatomical vicinity these lesions occur, this leading us to take into consideration eliminating as many lesions in one single operative time as possible without changing the position of the head during surgery. Based on a retrospective study which concluded that patients with resection of all lesions tend to have a longer life expectancy, and on modern concepts of risks and benefits of oncological surgery and surgery in general, we followed up on three patients presenting posterior and even multiple posterior fossa metastases, taking into consideration individual comorbidities, tumor aspects and the possibility/opportunity of surgical treatment. It turned out that surgery is a safe and effective treatment option and should not be considered harmful or aggressive especially because all of the patients which were under study had a favorable post-operative prognostic and an improved quality of life. We emphasize furthermore the importance of complete lesion resection in as few interventions as possible followed up by radiotherapy/chemotherapy as a key in prolonging these patients life expectancy taking into consideration that the outcome is directly related to the number of lesions rather to the location or volume of them.

scholarly journals Observation of Synchronous Primary Multiple Carcinoid of the Trachea and Main Bronchus

2021 ◽  
Vol 4 (1) ◽  
pp. 94-100
Author(s):  
V. D. Chkhikvadze ◽  
N. V. Nudnov ◽  
N. V. Chernichenko ◽  
Y. Yu. Murzin ◽  
D. S. Kontorovich ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory System ◽  
Main Bronchus ◽  
Left Main Bronchus ◽  
Malignant Neoplasms ◽  
Left Main ◽  
Timely Manner ◽  
Low Degree ◽  
Cervical Trachea ◽  
Trachea And Bronchi

Carcinoid tumors are rare malignant neoplasms of the respiratory system. They belong to neuroendocrine tumors with a low degree of (G1, G2) malignancy. Even less common is the primary multiplicity of these tumors in the trachea and bronchi, which can complicate the only radical, surgical treatment. We present an observation of a 75-year-old patient who was able to diagnose a carcinoid of the cervical trachea and left main bronchus in a timely manner, determine the exact localization and prevalence of the tumor, and successfully conduct surgical treatment in 2 stages. 

Sign in / Sign up

Export Citation Format

Share Document