scholarly journals Laparoscopic Retrieval of Abdominal Cysts in Sheep and Goat

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nida Handoo ◽  
Mujeeb Fazili ◽  
Mohmmad Abrar Gayas ◽  
Riyaz Ahmad Shah ◽  
Hakim Athar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Accuracy ◽  
Abdominal Wall ◽  
Recurrence Rate ◽  
Regional Anesthesia ◽  
Small Ruminants ◽  
Safe Procedure ◽  
Sheep And Goats ◽  
Laparoscopic Vision

Abstract The study was planned to evaluate the use of laparoscopy for the diagnosis and retrieval of abdominal cysts in sheep and goats. The abdominal cysts were located in 10 of 135 adult, healthy small ruminants by using ultrasonography (USG). Percutaneous Puncture-Aspiration-Injection-Reaspiration (PAIR) technique was used for six animals. Thirty animals, including four diagnosed with abdominal cysts by USG, were subsequently subjected to laparoscopy under diazepam sedation (0.1 mg/kg, IV) and lumbosacral epidural regional anesthesia using 2% lignocaine hydrochloride (1.0 ml/5 kg). The animals were restrained in dorsal recumbency and two-port paramedian laparoscopy was performed. Abdominal cysts were located in seven animals (one cyst/animal). The cysts were grasped carefully, lifted close to the abdominal wall, and evacuated percutaneously under laparoscopic vision. The collapsed cysts were then retrieved. In two animals enlarged ports were sutured, treated with an antibiotic and an analgesic, resulting in uneventful healing. Five cysts were nonparasitic, two were parasitic, one extracted from a sheep, and one from a goat. In conclusion, laparoscopy has higher diagnostic accuracy in detecting unattached abdominal cysts in sheep and goats compared to USG. It is also a reliable, minimally invasive, and safe procedure for cyst retrieval. However, a larger-scale study is necessary for ascertaining long-term complications and the recurrence rate.

Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration

2021 ◽  
pp. 155335062110012
Author(s):  
Mihaela Ignat ◽  
Madeleine Pérouse ◽  
François Lefebvre ◽  
Deborah Kadoche ◽  
Alessio Imperiale ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ct Scan ◽  
Recurrence Rate ◽  
Imaging Study ◽  
Neck Exploration ◽  
Preoperative Imaging ◽  
Invasive Approach ◽  
Sestamibi Scan ◽  
Line Imaging

Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning of parathyroidectomy—particularly for selection of a minimally invasive approach. The objective of this cohort study was to evaluate the diagnostic precision of 3D virtual neck exploration (3D-VNE), to evaluate its impact on choice of surgical approach, and to document the correlation with long-term outcomes. Methods. 235 consecutive patients with PHPT were studied (January 2014 to December 2018), with 6-month follow-up. 220 patients had a preoperative computed tomography (CT), 172 of these had a 3D-VNE based on the CT, and 226 patients had a Tc-99m sestamibi scan. Results. Sensitivity of exact, per gland, adenoma localization was 57.09% (95% CI: 50.85–63.10%) for nonspecialized radiologist interpretation of CT scan, 58.17% (95% CI: 51.99–64.10%) for Tc-99m sestamibi scan, and 90.21% (95% CI: 85.21–93.64%) for 3D-VNE, and thereby favoring 3D-VNE compared to CT scan alone (OR 34.5, 95% CI: 9.19–290.56%, P < 2.2 × 10−16) and to Tc-99m sestamibi scan (OR 16.25, 95% CI: 6.05–61.42%, P = 3.1 × 10−15). Specificity was 87.38% for CT scan, 86.36% for 3D-VNE, and 90% for Tc-99m sestamibi scan ( P > .05). The cure rate was 100%. The long-term recurrence rate (RR) was 2.978%. The RR was 1.324% in the video-assisted parathyroidectomy group of 151 patients and 5.952% in the group of 84 patients with cervicotomy ( P = .0459). Conclusion. CT-based 3D-VNE proved to be the most accurate localizing study in PHPT and aided in selecting patients for targeted minimally invasive parathyroidectomy, which was associated with the lower recurrence rate. 3D-VNE could be proposed as a first-line imaging study in patients with PHPT.

P1028Impact of atrial fibrillation ablation procedural volume on complication and recurrence rate across European centers. An ESC EORP registry: atrial fibrillation long-term

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Pagourelias ◽  
V Vassilikos ◽  
C Blomstrom-Lundqvist ◽  
J Kautzner ◽  
A P Maggioni ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Recurrence Rate ◽  
Complication Rate ◽  
Cardiovascular Complications ◽  
Safe Procedure ◽  
Success Rates ◽  
Af Ablation ◽  
Procedural Volume ◽  
One Year

Abstract Background Catheter ablation has emerged as an effective therapy in patients with symptomatic and drug refractory atrial fibrillation (AF). Despite high success rates of the method, there is still heterogeneity of outcomes and complication rate across Europe. The impact of the annual procedural volume per center on success and complication rate of AF ablation, based on real-life data, has not been addressed till now. Purpose The aim of the study was to investigate if center AF ablation volume might be associated with one-year success or complication rate after the procedure. Methods Data for this analysis were extracted from the European AF Ablation Long-Term Study, a prospective registry designed to describe the clinical epidemiology of patients undergoing AF ablation. Based on 25th and 75th percentiles of AF ablation numbers performed, the participating centers were classified into high volume (HV) (≥250 procedures/year), medium volume (MV) (<250 and ≥58/year) and low volume (LV) (<58/year). One-year success was defined as patient survival free from any atrial arrhythmia, from the end of the 3-month blanking period to 12 months following the ablation procedure. Results A total of 91 centers in 26 European countries enrolled 3368 patients. There was a significantly higher reporting of cardiovascular complications in LV centers (5.2%), especially pericarditis (0.6%) and cardiac perforation (1.4%), while the HV and MV centers reported cardiovascular complications in 3.0 and 4.3% of cases, respectively (p=0.039). Additionally, stroke incidence after ablation was significantly higher in LV centers (0.5% of cases vs 0% in HV and MV centers, p=0.008). Kaplan-Meier survival analysis based on adjusted data of all complications demonstrated, however, that there was not a significant difference in complication rate according to volume's center (p=0.402, Figure A). One-year success after AF ablation ranged from 77.8% in HV vs 70.5% in LV vs 77.3% in MV centers (p<0.001). Nonetheless, adjusted recurrence rate was not significantly different among centers (p=0.363, Figure B), a result driven by differences both in ablation technical characteristics and risk/severity of cases ablated in different volume centers. Conclusions Despite the notion that “the higher, the better”, our results suggest that AF ablation is a safe procedure with high success rates in all European centers, independent of the AF ablation procedural volume. Differences in patients and procedural characteristics may justify the equality of complication and recurrence rate among centers, since expertise level counterbalances the risk of each case.

Effects of overmilking and liner type and characteristics on teat tissue in small ruminants

2014 ◽  
Vol 81 (2) ◽  
pp. 215-222 ◽  
Author(s):  
Manuel Alejandro ◽  
Amparo Roca ◽  
Gema Romero ◽  
José-Ramón Díaz
Keyword(s):  
Wall Thickness ◽  
Strong Influence ◽  
Small Ruminants ◽  
Latin Square ◽  
Experimental Period ◽  
Significance Level ◽  
Sheep And Goats ◽  
Wall Area ◽  
Teat Canal

The aim of this work was to study the effect on teat wall thickness and canal length in sheep and goats of overmilking for 2 min (OM+2) and of milking with used (AL; +3000 milkings) and twisted (TL; 45°) liners in sheep and goats, as well as the effect of milking goats with liners designed for sheep (SL, shorter length and diameter than liners for goats). To this end, we performed four experiments in goats and three in sheep, in a Latin square design with two experimental periods. During the experimental period 4 controls were carried out, performing ultrasound scans before and immediately after milking to determine the teat wall thickness (TWT), teat wall area (TWA), teat end area (TEWA) and teat canal length (TCL). OM+2 caused a significant increase in TWT, TWA, TEWA and TCL in goats and in TWA, TEWA and TCL in sheep. Liner features had a strong influence on the variables studied; aged liners caused significant changes in TWT and TCL in goats and in TWT in sheep; twisted liners produced a significant effect on the increase of TWT and TCL in goats, without reaching significance level in sheep; and milking goats with sheep liners led to a significant increase in TWT, TWA, TEWA and TCL. In practice, it is therefore important to avoid overmilking and the use of worn-out liners. It is also necessary to use liners designed for the morphological features of each species, taking special care to carry out periodic liner positioning revisions to ensure the benefits of pulsation on the teat end. Finally, it would be necessary to carry out long-term experiments to study whether the increase in thickness observed in some experiments is sufficient to affect milking efficiency and mammary gland health status.

scholarly journals P-OGC61 Long-term outcomes following minimally invasive oesophago-gastric resection for oesophageal and gastro-oesophageal junctional cancer: a single center experience

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Amira Orabi ◽  
Gauri Chillarge ◽  
Davide Di Mauro ◽  
Darmarajah Veeramootoo ◽  
keith Mitchell ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Recurrence Rate ◽  
Disease Free Survival ◽  
Hospital Death ◽  
Published Data ◽  
Historical Cohort ◽  
Invasive Approach ◽  
Free Survival ◽  
Disease Free

Abstract Background Oesophago-gastric surgical resection for cancer has been associated with high morbidity and poor long-term prognosis. Medical advances have led to improvements and the con-current development of videoscopic technology enabled a paradigm shift in many areas of surgical practice. Between 2004 - 2010, a three-stage total (thoracoscopic/laparoscopic) minimally invasive oesophagectomy (MIO) with curative intent, was offered to all patients diagnosed and treated for esophageal and oesophago-gastric junctional (GOJ) cancers as an alternative to open surgery at our specialist Centre. Previously we have reported on safety, feasibility, short term outcomes, quality of life and complication profiles; this study now reports on eventualities at least a decade after surgery. Methods All patients who underwent MIO (laparoscopic/thoracoscopic) three-stage procedure from April 2004 to January 2010 for oesophageal and GOJ malignancy were identified. A retrospective analysis of patients’ records in conjunction with an updated clinical follow-up was carried out.  Patients’ demographics, oncologic stage (in accordance to the American Joint Committee on Cancer 6th and 7th Edition), overall survival, 5-year and 10-year survival, recurrence rate and disease-free survival (DFS) were retrospectively analyzed. Statistical analysis was conducted using Prism version 9.1.0 (GraphPad Holdings LLC, California). Results A total of 120 patients (majority of which were males – 84.2%) were included in the study. Mean age was 66.7 ± 0.74. 43 patients. In-hospital death occurred in 4 (3.3%) patients. Over the time period, 25 (20.8%) patients were alive. Of those deceased Sixty-six (69.5%) succumbed to cancer, and 29 (30.5%) died from other causes. 43 patients (35.8%) were alive at 5 years and 33 (27.5%) at 10 years. Excluding those with Stage 0 disease, the 5-year and 10-year survival rates were 32.4% and 24.1%, respectively. The recurrence rate was 63 (52.5%) patients and the overall median DFS was 24 months (IQR, 186); Stage 3 patients had the shortest DFS (p &lt; 0.0001). Conclusions Survival and disease-free survival in this historical cohort of patients who underwent a total MIO for cancer is comparable to published data from similar open series of that era as well as modern reported outcomes from specialist centers. Benefits of a minimally invasive approach can therefore be realized without compromise to oncological and overall prognosis.

Abdominal wall paresis as a complication of minimally invasive lateral transpsoas interbody fusion

2011 ◽  
Vol 31 (4) ◽  
pp. E18 ◽  
Author(s):  
Elias Dakwar ◽  
Tien V. Le ◽  
Ali A. Baaj ◽  
Anh X. Le ◽  
William D. Smith ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Abdominal Wall ◽  
Nerve Injury ◽  
Interbody Fusion ◽  
Operative Procedure ◽  
Case Series ◽  
Transpsoas Approach ◽  
First Case

Object The minimally invasive lateral transpsoas approach for interbody fusion has been increasingly employed to treat various spinal pathological entities. Gaining access to the retroperitoneal space and traversing the abdominal wall poses a risk of injury to the major nervous structures. Nerve injury of the abdominal wall can potentially lead to paresis of the abdominal musculature and bulging of the abdominal wall. Abdominal wall nerve injury resulting from the minimally invasive lateral retroperitoneal transpsoas approach has not been previously reported. The authors describe a case series of patients presenting with paresis and bulging of the abdominal wall after undergoing a minimally invasive lateral retroperitoneal approach. Methods The authors retrospectively reviewed all patients who underwent a minimally invasive lateral transpsoas approach for interbody fusion and in whom development of abdominal paresis developed; the patients were treated at 4 institutions between 2006 and 2010. All data were recorded including demographics, diagnosis, operative procedure, positioning, hospital course, follow-up, and complications. The onset, as well as resolution of the abdominal paresis, was reviewed. Results The authors identified 10 consecutive patients in whom abdominal paresis developed after minimally invasive lateral transpsoas spine surgery out of a total of 568 patients. Twenty-nine interbody levels were fused (range 1–4 levels/patient). There were 4 men and 6 women whose mean age was 54.1 years (range 37–66 years). All patients presented with abdominal paresis 2–6 weeks postoperatively. In 8 of the 10 patients, abdominal wall paresis had resolved by the 6-month follow-up visit. Two patients only had 1 and 4 months of follow-up. No long-term sequelae were identified. Conclusions Abdominal wall paresis is a rare but known potential complication of abdominal surgery. The authors report the first case series associated with the minimally invasive lateral transpsoas approach.

Abdominal Wall Fat Necrosis after Extraperitoneal Bladder Perforation

2019 ◽  
Vol 3 ◽  
pp. 11
Author(s):  
Jerel Chacko ◽  
Jason Kondrat
Keyword(s):  
Case Report ◽  
Urinary Tract ◽  
Abdominal Wall ◽  
Therapeutic Intervention ◽  
Surgical Intervention ◽  
Bladder Perforation ◽  
Safe Procedure ◽  
Fat Necrosis

Suprapubic catheters (SPCs) are a therapeutic intervention used to manage long-term urinary tract dysfunction; it is commonly used in patients who may be poor candidates for surgical intervention. Generally considered a relatively safe procedure, this case report describes a rare but serious complication of insertion of an SPC.

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