scholarly journals Myomectomy by vaginal route

2006 ◽  
Vol 53 (1) ◽  
pp. 83-86
Author(s):  
M. Zamurovic ◽  
D. Stanojevic ◽  
P. Srbinovic ◽  
M. Cerovic ◽  
M. Stanojevic
Keyword(s):  
Cost Benefit ◽  
Posterior Wall ◽  
Postoperative Recovery ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Vaginal Route ◽  
Postoperative Course ◽  
Abdominal Myomectomy ◽  
Health Authorities ◽  
Type Of Surgery

Myomectomy by vaginal route is the least invasive of all methods for myoma removal. Compared to classical, abdominal myomectomy, it has numerous advantages, especially in cases of fundal and posterior wall myomas, but still it is relatively rarely performed. This study provides an analysis of operative and postoperative course of patients subjected to myomectomy by vaginal route in the period from 01/01/2003 to 01/11/2005 as well as the corresponding control group of patients which had undergone classical, abdominal myomectomy. The study points out to significance and advantages of application of surgical technique for removal of myoma through the posterior wall of the vagina as opposed to classical, abdominal myomectomy. Transvaginal myomectomy eliminates trauma of laparotomy, intraoperative blood loss is reduced, postoperative complications are down to minimum, postoperative recovery is shorter, and so is the number of days spent in hospital. Thus, by performing this type of surgery, a positive cost-benefit effect is obtained not only for the patient but for health authorities as well.

scholarly journals Myomectomy by vaginal route

2004 ◽  
Vol 132 (1-2) ◽  
pp. 18-21 ◽  
Author(s):  
Zagorka Milovanovic ◽  
Dusan Stanojevic
Keyword(s):  
Operating Time ◽  
Surgical Techniques ◽  
Posterior Wall ◽  
Postoperative Recovery ◽  
Surgical Instruments ◽  
Prospective Clinical Study ◽  
Vaginal Route ◽  
Operative Blood Loss ◽  
Operative Trauma ◽  
Vaginal Myomectomy

In recent years, the development of new surgical techniques in uterus myoma treatment have reduced operative trauma significantly. Our objective was to present operative technique-vaginal myomectomy, making a prospective clinical study where we have evaluated the operative and postoperative period after intentive diagnosis. The result of our study shows the feasibility of myomectomy by entering the peritoneum through the posterior vaginal fornix, using traditional and cheap surgical instruments and thus avoiding the trauma of laparatomy, minimal operative blood loss, reduced operating time and postoperative recovery. In our opinion, vaginal myomectomy could be useful for the treatment of selected cases with fundal or posterior wall uterine myomas.

scholarly journals A non-bioartificial liver support system combined with transplantation in HBV-related acute-on-chronic liver failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peng Li ◽  
Xi Liang ◽  
Shan Xu ◽  
Ye Xiong ◽  
Jianrong Huang
Keyword(s):  
Survival Rate ◽  
Blood Loss ◽  
Liver Failure ◽  
Control Group ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Liver Support System

AbstractWe aim to determine the impact of an artificial liver support system (ALSS) treatment before liver transplantation (LT), and identify the prognostic factors and evaluate the predictive values of the current commonly used ACLF prognostic models for short-term prognosis after LT. Data from 166 patients who underwent LT with acute-on-chronic liver failure (ACLF) were retrospectively collected from January 2011 to December 2018 from the First Affiliated Hospital of Zhejiang University School of Medicine. Patients were divided into two groups depending on whether they received ALSS treatment pre-LT. In the observation group, liver function tests and prognostic scores were significantly lower after ALSS treatment, and the waiting time for a donor liver was significantly longer than that of the control group. Both intraoperative blood loss and period of postoperative ICU care were significantly lower; however, there were no significant differences between groups in terms of total postoperative hospital stays. Postoperative 4-week and 12-week survival rates in the observation group were significantly higher than those of the control group. Similar trends were also observed at 48 and 96 weeks, however, without significant difference. Multivariate Cox regression analysis of the risk factors related to prognosis showed that preoperative ALSS treatment, neutrophil–lymphocyte ratio, and intraoperative blood loss were independent predicting factors for 4-week survival rate after transplantation. ALSS treatment combined with LT in patients with HBV-related ACLF improved short-term survival. ALSS treatment pre-LT is an independent protective factor affecting the 4-week survival rate after LT.

scholarly journals Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hong Lv ◽  
Ning Yang
Keyword(s):  
Tract Infection ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Control Group ◽  
Observation Group ◽  
Activity Time ◽  
Joint Function ◽  
Vein Thrombosis ◽  
Accelerated Rehabilitation

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

ERAS Improves Postoperative Recovery in Children

2021 ◽  
Author(s):  
Tingmei Wu ◽  
Haiwen Li ◽  
Huixia Zhou ◽  
Xuemei Hao ◽  
Xiaojun Wang ◽  
...  
Keyword(s):  
Inflammatory Cytokine ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Final Analysis ◽  
Postoperative Recovery ◽  
Controlled Study ◽  
Control Group ◽  
Robot Assisted ◽  
Cytokine Levels ◽  
Eras Protocol

Abstract Objective: Enhanced recovery after surgery (ERAS) protocols are established in adults but not fully evaluated in children. This study investigated whether an ERAS protocol improved recovery and influenced postoperative inflammatory cytokine levels in children undergoing surgery for hydronephrosis. Methods: This randomized controlled study included patients who underwent robot-assisted laparoscopic surgery for hydronephrosis at Bayi Children's Hospital (Beijing, China) between October 2018 and September 2019. Patients were randomized to an ERAS group (perioperative ERAS protocol) or control group (standard perioperative management). Outcomes related to postoperative recovery and inflammatory cytokine levels were evaluated. Results: The final analysis included 18 patients in each group. Five patients (27.78%) in each group experienced postoperative complications (abdominal pain, nausea and vomiting, subcutaneous emphysema or fever). The ERAS group had a shorter time to first postoperative flatus than the control group (25 vs. 49 hours; P =0.009), although the time for abdominal drainage flow to reach ≤20 mL/day, time to urinary catheter removal and length of hospital stay did not differ significantly between groups. Preoperative plasma cytokine levels were comparable between groups. Compared with the control group, the ERAS group had a higher IL-6 level on postoperative day 2 ( P <0.05) and a lower concentration of IL-1β on postoperative days 1 and 2 ( P <0.05). Postoperative levels of CRP, TNFα and IL-10 did not differ significantly between groups. Conclusions: ERAS may accelerate postoperative recovery and modulate the postoperative inflammatory response in pediatric patients undergoing robot-assisted laparoscopic pyeloplasty for hydronephrosis.

scholarly journals Myocardial involvement in diabetes mellitus: echocardiography data

1996 ◽  
Vol 42 (2) ◽  
pp. 15-17
Author(s):  
Ye. I. Sokolov ◽  
A. P. Zayev ◽  
R. P. Olkha ◽  
T. P. Morozova ◽  
S. A. Zhizhina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Resistance ◽  
Posterior Wall ◽  
Minute Volume ◽  
Left Ventricular ◽  
Specific Power ◽  
Control Group ◽  
End Diastolic Volume ◽  
Myocardial Fibers ◽  
Hyperdynamic Syndrome

Echocardiographic parameters of the central and intracardiac hemodynamics were analyzed in 67 patients with compensated diabetes mellitus of types I and II of 2 to 6 years standing. The control group consisted of 30 subjects. The increase of the minute volume, stroke volume, specific power of the left ventricle, and reduction of total peripheral resistance were revealed in both groups of patients. These shifts are characteristic of a hyperkinetic type of central hemodynamics. The hyperdynamic syndrome was due to left-ventricular hypertrophy in patients with noninsulin-dependent diabetes and due to increased heart rate and the rate of circulatory shortening of myocardial fibers in patients with the insulin-dependent condition. Impaired diastolic function presenting as an increase of the end diastolic volume and a reduced rate of relaxation of the left-ventricular posterior wall myocardium were observed in all the patients, no matter what the type of the condition. The above shifts are predictors of a reduction of myocardial contractility, responsible for the grave and atypical course of coronary disease in diabetics.

scholarly journals Effects of Long-term Nonylphenol Exposure on Myocardial Fibrosis and Cardiac Function in Rats

2021 ◽  
Author(s):  
Chao Liu ◽  
Chengyu Ni ◽  
Weichu Liu ◽  
Xiaolian Yang ◽  
Renyi Zhang ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Myocardial Fibrosis ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Environmental Estrogens ◽  
Control Group ◽  
Cardiac Structure ◽  
Collagen Iii

Abstract Background: Myocardial fibrosis is a critical pathological basis for the poor prognosis of cardiovascular diseases. Studies have found that myocardial fibrosis is closely associated with exposure to environmental estrogens such as nonylphenol (NP), as a representative of environmental estrogens. The aim of this study was to examine the effects of NP chronic exposure on myocardial fibrosis as well as cardiac structure and function. Forty Sprague Dawley rats were randomly divided into four groups (n = 10): control group (C), low NP dose (0.4 mg/kg, L), medium NP dose (4 mg/kg, M), and high NP dose (40 mg/kg, H) groups. The NP dose groups were gavaged with NP for 180 days. Results: The NP level in the heart of the NP groups was significantly higher than those in the control group (F = 43.658, P < 0.001). Serum aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase isozyme (CK-MB), lactate dehydrogenase (LDH) and α-hydroxybutyrate dehydrogenase (α-HBDH) significantly increased in the NP groups compared with the control group (). Histopathological examination of the heart biopsy illustrates that in the medium and high NP groups, the fibrous connective tissue had a disordered and loose gridding shape, muscle fibers had fractured, and muscle fibers were loose with a widened gap. Extensive inflammatory cell infiltration and fibroblast proliferation in the myocardial interstitium were also found. With increasing NP dose, the degree of muscle fiber loosing and disorder became more significant in the NP treatment groups, and the collagen volume fraction (CVF) was higher than that in the control group (P < 0.01). Compared with the control group, the expression of collagen I and collagen III increased significantly in the medium and high NP groups (P < 0.05). The values of the systolic thickness of the left ventricular anterior wall (LVAWs), the diastolic thickness of the left ventricular posterior wall (LVPWd), the systolic thickness of the left ventricular posterior wall (LVPWs), and the left ventricular anterior wall (LVAWd) in the NP groups are were slightly lower than those in of the control group. The values of left ventricular end systolic dimensions (LVIDs) in the NP groups increased compared with the control group. Conclusions: Long-term NP exposure could lead to fibrosis in the rat myocardium, which is characterized by increased expressions of myocardial collagen I and collagen III, as well as elevated cardiac enzymes. In addition, the cardiac structure was affected and changes were observed in the thinner ventricular wall and as an enlarged ventricular cavity.

scholarly journals Effect of Threonine and the Bioactive Component of Saccharomyces Cerevisiae on the Productive Performance of the Broiler Cobb 500

2021 ◽  
Author(s):  
J. Encalada Álvarez ◽  
P. Toalombo Vargas ◽  
C. Vimos Abarca ◽  
J. Trujillo Villacís ◽  
L. Silva Deley
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Broiler Chickens ◽  
Cost Benefit ◽  
Experimental Unit ◽  
Control Group ◽  
Productive Performance ◽  
Growth Promoters ◽  
Bioactive Component ◽  
Palabras Clave ◽  
Level Of Significance

This study was conducted in Chimborazo province, Riobamba Canton to evaluate the effect of threonine and the bioactive component of Saccharomyces cerevisiae on the productive performance of the broiler Cobb 500. A total of 270 one-day-old broiler chicken of both sexes were included, which corresponded to an experimental unit size of 15 birds. Two growth promoters were used for the treatments -- T1: Threonine (aminoacid) 200 g/Tn; and T2: bioactive oligosaccharides, obtained from the cell wall of selected strains of S. Cerevisiae (probiotic) 750 g/Tn. These were compared to a control group. The data were analyzed through Analysis of Variance (ADEVA). The separation of means was performed using the Tukey statistic at a level of significance of p < 0.05 and p < 0.01. The data were processed using the Infostat software version 2010. The results showed that the best productive yields were with treatment 2; the values for this treatment were: weight at 28 days: 1369.42 g; weight gain at 28 days: 48.90 g; food conversion at 28 days: 1.39 points; carcass weight: 2527.05 g; and yield to the carcass: 83.85%. Through the economic analysis, it was determined that the highest cost-benefit index was 1.30 USD with the application of T2. So according to the results, a better use of the nutrients that are present in the feed is achieved when bioactive components of S. cerevisiae are supplied in the diet of broiler chickens. Keywords: Threonine, Saccharomyces cerevisiae, productive performance, broiler, Cobb 500. RESUMEN Se realizó un experimento en la provincia de Chimborazo, Cantón Riobamba, para evaluar los efectos de treonina y componentes bioactivos de Saccharomyces cerevisiae sobre el comportamiento productivo en aves Cobb 500. Se utilizaron 270 pollitos mixtos Cobb 500 de un día de edad de ambos sexos, con un tamaño de unidad experimental de 15 aves. Para los tratamientos se manejaron dos promotores de crecimiento, T1: Treonina (aminoácido) 200 g/Tn y T2: Oligosacáridos bioactivos, obtenidos a partir de la pared celular de cepas seleccionadas de S. Cerevisiae750 g/Tn; frente a un testigo (T0). Los datos obtenidos fueron sometidos a Análisis de Varianza (ADEVA); la separación de medias se realizó mediante el estadístico Tukey a un nivel de significancia (p < 0,05) y (p < 0,01); los datos se procesaron mediante el software Infostat versión 2010. Los resultados muestran los mejores rendimientos productivos con el Tratamiento 2, para los parámetros: peso a los 28 días 1369,42 g; ganancia de peso a los 28 días 48,90 g; y conversión alimenticia a los 28 días con 1,39 puntos; así como peso a la canal 2527,05 g; y rendimiento a la canal 83,85%. Mediante el análisis económico se determinó que el mayor índice beneficio costo fue de 1,30 USD con la aplicación del T2. Lo que brinda un indicativo que mediante el suministro de componentes bioactivos de S. cerevisiae en la dieta de pollos broiler, se logra un mejor aprovechamiento de los nutrientes que se encuentran presentes en el alimento, lo que se refleja en los parámetros productivos. Palabras clave: treonina, Saccharomyces cerevisiae, comportamiento productivo, broilers, Cobb 500.

scholarly journals Safety of laparoscopic pancreaticoduodenectomy in patients with liver cirrhosis using propensity score matching

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246364
Author(s):  
Ke Cheng ◽  
Wei Liu ◽  
Jiaying You ◽  
Shashi Shah ◽  
Yunqiang Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Cirrhosis ◽  
Blood Loss ◽  
Postoperative Morbidity ◽  
Control Group ◽  
Complication Rates ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Intraoperative Blood Loss ◽  
Cirrhotic Patients

Currently, safety of laparoscopic pancreaticoduodenectomy (LPD) in patients with liver cirrhosis is unknown. The aim of this study was to explore postoperative morbidity and mortality and long-term outcomes of cirrhotic patients after LPD. The study was a one-center retrospective study comprising 353 patients who underwent LPD between October 2010 and December 2019. A total of 28 patients had liver cirrhosis and were paired with 56 non-cirrhotic counterparts through propensity score matching (PSM). Baseline data, intra-operative data, postoperative data, and survival data were collected. Postoperative morbidity was considered as primary outcome whereas postoperative mortality, surgical parameters (operative durations, intraoperative blood loss), and long-term overall survival were secondary outcomes. Cirrhotic patients showed postoperative complication rates of 82% compared with rates of patients in the control group (48%) (P = 0.003). Further, Clavien-Dindo ≥III complication rates of 14% and 11% (P = 0.634), Clavien-Dindo I-II complication rates of 68% and 38% (P = 0.009), hospital mortality of 4% and 2% (P = 0.613) were observed for cirrhotic patients and non-cirrhotic patients, respectively. In addition, an overall survival rate of 32 months and 34.5 months (P = 0.991), intraoperative blood loss of 300 (200–400) ml and 150 (100–250) ml (P<0.0001), drain amount of 2572.5 (1023.8–5275) ml and 1617.5 (907.5–2700) ml (P = 0.048) were observed in the cirrhotic group and control group, respectively. In conclusion, LPD is associated with increased risk of postoperative morbidity in patients with liver cirrhosis. However, the incidence of Clavien-Dindo ≥III complications and post-operative mortality showed no significant increase. In addition, liver cirrhosis showed no correlation with poor overall survival in patients who underwent LPD. These findings imply that liver cirrhosis patients can routinely be considered for LPD at high volume centers with rigorous selection and management.

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