scholarly journals Results of laparoscopic extravesical antireflux operation in vesicoureteral reflux in children

2020 ◽  
Vol 17 (4) ◽  
pp. 427-436
Author(s):  
V. I. Dubrov ◽  
A. V. Strotsky
Keyword(s):  
Surgical Treatment ◽  
Vesicoureteral Reflux ◽  
Classical Group ◽  
Perioperative Complications ◽  
Control Group ◽  
Medium Term ◽  
Modified Technique ◽  
Term Outcome ◽  
Antireflux Operation ◽  
The Mean

The objective was to improve the results of surgical treatment of vesicoureteral reflux in children, using laparoscopic access. The prospective study was performed in 111 children (137 ureters) with the primary III–IV grade vesicoureteral reflux. The mean age was 34.7 months. The modified laparoscopic antireflux technique was performed on 73 children (91 ureters). We compared the perioperative complications and the medium-term outcome with a group of 38 children (46 ureters) who underwent classical laparoscopic extravesical reimplantation.3 In the modified group, the mean surgery time was 109.8 ± 31.5 minutes for unilateral cases and 176.5 ± 47.6 minutes for bilateral cases; in the classical group, it was 118.6 ± 34.3 and 209.5 ± 51.2 minutes respectively (p > 0.05). Postoperative vesicoureteral reflux had 2 (2.7 %) patients in the main group and 8 (21.1 %) children in the control group (p  =  0.002). There was no ureteral obstruction in the both groups. The success rate for ureters was 97.8 % with modified technique versus 82.6 % after classical laparoscopic reimplantation (p = 0.003). Laparoscopic extravesical ureteral reimplantation is a safe and effective surgical procedure. The modified technique may improve the surgical treatment results.

scholarly journals MODIFIED SINGLE-SIDED LAPAROSCOPIC EXTRAVESICAL ANTIREFLUX OPERATION

2018 ◽  
Vol 8 (2) ◽  
pp. 24-32 ◽  
Author(s):  
V. I. Dubrov ◽  
S. G. Bondarenko ◽  
I. M. Kagantsov
Keyword(s):  
Surgical Treatment ◽  
Vesicoureteral Reflux ◽  
Standard Technique ◽  
Control Group ◽  
Historical Cohort ◽  
Distal Ureter ◽  
Basic Group ◽  
Antireflux Operation ◽  
Laparoscopic Techniques

Introduction. Laparoscopic techniques have been applied to ensure surgical treatment of the vesicoureteral reflux (VUR) in children during the last decades. We present the experience of using the laparoscopic extravesical antireflux standard and ureter-fixed modified surgery.Materials and methods. A multi-center prospective experimental clinical historical cohort two-group study of patients with III–V stage primary VUR. The basic group consisted of 48 children who had a unilateral laparoscopic extravesical surgery when the ureter was fixed according to the developed technique. 44 children who had a surgery according to the standard technique were included into the control group.Results. Complete VUR removal was noted in 100% of patients from the basic group and 81.2% of patients from the control group (р <0.01). Preservation of the megaureter with complete reflux resolution was seen in 1 child only (2.1%) from the basic group who had V stage VUR (p=0.2).Conclusions. Laparoscopic extravesical antireflux is a safe and effective surgery. Distal ureter fixation reduces the rate of VUR recurrences.

Advances in the Treatment and Outcome of Brainstem Cavernous Malformation Surgery

Neurosurgery ◽  
2011 ◽  
Vol 68 (2) ◽  
pp. 403-415 ◽  
Author(s):  
Adib A. Abla ◽  
Gregory P. Lekovic ◽  
Jay D. Turner ◽  
Jean G. de Oliveira ◽  
Randall Porter ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Patient Outcomes ◽  
Perioperative Complications ◽  
Low Flow ◽  
Tube Placement ◽  
Cerebrospinal Fluid Leakage ◽  
Cavernous Malformations ◽  
Study Population ◽  
The Mean

Abstract BACKGROUND: Brainstem cavernous malformations (BSCMs) are relatively uncommon, low-flow vascular lesions. Because of their relative rarity, relatively little data on their natural history and on the efficacy and durability of their treatment. OBJECTIVE: To evaluate the long-term durability of surgical treatment of BSCMs and to document patient outcomes and clinical complications. METHODS: The charts of all patients undergoing surgical treatment of BSCM between 1985 and 2009 were reviewed retrospectively. The study population consisted of 300 patients who had surgery for BSCM. Forty patients were under 19 years of age at surgery; pediatric BSCMs have been reported separately. Patient demographics, lesion characteristics, surgical approaches, and patient outcomes were examined. RESULTS: The study population consisted of 260 adult patients with a female-to-male ratio of 1.5 and mean age of 41.8 years. Of the 260 patients, 252 presented with a clinical or radiographic history of hemorrhage. The mean follow-up in 240 patients was 51 months. The mean Glasgow Outcome Scale on admission, at discharge, and at last follow-up was 4.4, 4.2, and 4.6. Postoperatively, 137 patients (53%) developed new or worsening neurological symptoms. Permanent new deficits remained in 93 patients 3(36%). There were perioperative complications in 74 patients (28%); tracheostomy, feeding tube placement, and cerebrospinal fluid leakage were most common. Eighteen patients (6.9%) experienced 20 rehemorrhages. Twelve patients required reoperation for residual/recurrent BSCM. The overall annual risk of postoperative rehemorrhage was 2%/patient. CONCLUSION: Although BSCM surgery has significant associated risks, including perioperative complications, new neurological deficits, and death, most patients have favorable outcomes. Overall, surgery markedly improved the risk of rehemorrhage and related symptoms and should be considered in patients with accessible lesions.

scholarly journals Influence of Maternal Preeclampsia on Neurodevelopmental Outcomes of Preterm Infants

2018 ◽  
Vol 24 (2) ◽  
pp. 99
Author(s):  
Halil Degirmencioglu ◽  
Birgul Say ◽  
Zeynep Ustunyurt ◽  
Serife Suna Oguz
Keyword(s):  
Cerebral Palsy ◽  
Preterm Infants ◽  
Gestational Age ◽  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Mean

<p><strong>Objective:</strong> The aim of this study was to determine the neurodevelopmental outcome of preterm infants born to mothers with preeclampsia and to compare them with preterm controls.</p><p><strong>Study design:</strong> This was a retrospective, observational study in a large, tertiary, neonatal intensive care unit. Neurodevelopmental evaluations using Bayley Scales of Infant Development II were performed in 226 two-year-old infants with birth weight ≤1500 g and gestational age ≤32 weeks who were born to mothers with preeclampsia and in 493 infants who were born after normotensive pregnancies, matched for gestational age and gender.</p><p><strong>Results:</strong> The mean gestational ages of the infants in the preeclampsia and control groups were 29.9±2.3 weeks and 28.7±4.1 weeks, respectively (p&lt;0.001). A total of 372 infants with a mean age of 19.2±3.2 months were assessed for long-term outcome. The mean mental developmental index score was significantly higher, and the percentage of infants with cerebral palsy was significantly lower, in the preeclampsia group compared with the control group (p=0.03 and p=0.02, respectively). However, no overall significant differences in neurodevelopmental impairment rates were found between the two groups (p=0.08).</p><p><strong>Conclusion:</strong> Maternal preeclampsia seems to be a protector factor for the development of cerebral palsy in preterm infants.</p>

scholarly journals Outcome of using a modified surgical technique for the repair of complex vesicovaginal fistulas in Nigeria

2017 ◽  
Vol 30 (1) ◽  
Author(s):  
Aniefiok J. Umoiyoho ◽  
Emmanuel C. Inyang-Etoh
Keyword(s):  
Obstetric Fistula ◽  
Conventional Technique ◽  
Control Group ◽  
Study Group ◽  
Success Rates ◽  
Modified Technique ◽  
Repair Technique ◽  
Significant Difference ◽  
The Mean ◽  
Repair Techniques

The relatively low effectiveness of available surgical repair techniques for complex obstetric fistula has justified the need for continued exploration of more effective repair techniques. Subjects who presented at a vesicovaginal fistula referral centre in Nigeria were randomized into the study group (modified technique) and the control group (conventional technique). Success rates between the two groups were compared. The study comprised 29 patients in each arm of the study. The mean age of patients in the study group was 23.9 ± 9.6 years and 24.4 ± 2.1 years among patients in the control group with the vast majority of the patients in the both groups being married, 75.9% and 86.2% respectively. In both groups, the majority were secundipara, 55.2% in the study group and 44.8% in the control group. The majority (41.4% in the study group and 44.8% in the control group) of the patients in both groups had attained primary level of education. The mean duration of the fistulas among patients in the study population was 1.1 ± 0.3 years with over half (50.0% among patients in the study group and 53.5% of patients in the control group) of the patients had their fistula for less than one year. A highly statistically significant difference in success rate between patients in the study group and patients in the control group was obtained (p=0.0004). The modified repair technique presented by this study has proved to produce superior results when compared to the conventional repair technique in the management of complex obstetric fistulas in Nigeria.

scholarly journals Surgical treatment for lumbar spinal stenosis: a single-blinded randomized controlled trial

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Luiz Claudio Lacerda Rodrigues ◽  
Jamil Natour
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Likert Scale ◽  
Control Group ◽  
Walk Test ◽  
Medium Term ◽  
Sf 36 ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Objective To evaluate the effectiveness of surgery for the management of patients with symptomatic lumbar spinal stenosis. Methods Sixty-three patients with lumbar canal stenosis were randomized into two groups: the intervention group (IG) and control group (CG). IG patients underwent surgery and both groups participated in the same physical therapy program twice a week for a period of 12 weeks and were followed up at 1 year. The primary endpoint was visual analogue scale for pain, and the secondary endpoints were function (6-min walk test, Roland Morris and Oswestry questionnaires), quality of life (SF-36 questionnaire) and satisfaction with treatment (Likert scale). Results No significant difference between groups was observed for pain over time (p = 0.145). Significant differences between groups, in favor of the IG, were observed for the Oswestry score (p = 0.006) and vitality domain score of the SF-36 (p = 0.047). Function in the Roland Morris and 6-min walk test and the role of the physical domain of SF-36 also showed significant differences between the groups; however, these differences occurred due to a worsening of the IG in the short term, and the medium-term. The Likert scale demonstrated greater satisfaction with the IG treatment compared to control group. Conclusions Lumbar stenosis surgery did not improve pain in short and medium terms. Function and vitality were better in the group that underwent surgery in the medium term, and patients were more satisfied with the surgical treatment. Trial registration Clinicaltrials.gov (NCT02879461).

scholarly journals Medium Term Outcome of Lancaster Cortical Window Technique For Extraction of Femoral Stem in Revision Hip Arthroplasty

2021 ◽  
Author(s):  
Amit Singh ◽  
Sunirmal Mukherjee ◽  
Kuntal Patel ◽  
Deepak Herlekar ◽  
Srikant Gandavaram ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Medium Term ◽  
Term Outcome ◽  
Window Technique ◽  
Femoral Stems ◽  
The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster Cortical Window technique which can be used for removal of cemented or uncemented femoral stems. Methodology The study was conducted at a specialist centre in the North-West of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using Lancaster Cortical Window technique for removal of femoral implant during a revision hip arthroplasty. Patient’s electronic notes and the radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using Novel Lancaster Window technique. The mean age of the all the patients was 81.5 years and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular component. Rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow up. Conclusion We believe Lancaster cortical window technique can be safely used for removal of cemented stems during revision hip arthroplasty without the need for expensive equipment’s.

scholarly journals Long-term Outcome of Surgical Treatment with Various Reinforcement Material Grafts on Scleromalacia

2021 ◽  
Vol 62 (10) ◽  
pp. 1348-1354
Author(s):  
Sang Wook Jin ◽  
Hyun Chul Jeong ◽  
Hee Jung Cho ◽  
Woo Chan Park
Keyword(s):  
Surgical Treatment ◽  
Amniotic Membrane ◽  
Amniotic Membrane Transplantation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Conjunctival Flap ◽  
Reinforcement Material ◽  
The Mean

Purpose: To investigate the long-term efficacy and stability of the use of various reinforcement material grafts on scleromalacia.Methods: This retrospective study was conducted on scleromalacia patients who underwent surgical treatment with reinforcement material grafts from January 2012 to March 2019. The choice of amniotic membrane, Tenon’s capsule, acellular sclera, or collagen matrix implanted in the area of scleromalacia was made based on disease severity. Amniotic membrane transplantation with a pedicular rotatory inferior conjunctival flap was performed to prevent having a bare sclera. The patient demographics, cause of scleromalacia, best-corrected visual acuity (BCVA), recurrence rate, postoperative complications, and restoration appearance were evaluated.Results: A total of 58 patients (58 eyes) were enrolled in this study. The mean age of patients was 65.7 ± 9.6 years, and 32 patients (55.2%) were women. The mean follow-up period was 28.1 ± 17.3 months. The most common cause of scleromalacia was pterygium operation (53 patients, 91.4%). The reinforcement materials were mainly amniotic membrane (31 patients, 53.4%) and acellular sclera (15 patients, 25.7%). There was no recurrence of scleromalacia or structural instability during the follow-up period. The preoperative and postoperative mean BCVA values were 0.24 ± 0.24 and 0.21 ± 0.23 logMAR, respectively. Wound dehiscence (three patients, 5.2%) and conjunctival cyst (three patients, 5.2%) occurred with the highest frequency.Conclusions: The use of the appropriate reinforcement material graft according to the severity of scleromalacia and amniotic membrane transplantation using a pedicular rotatory inferior conjunctival flap to prevent a bare sclera can be effective for treating scleromalacia, without long-term recurrence.

Tenorrhaphy as an Alternative to Resection in the Treatment of Horizontal Strabismus in Children

2020 ◽  
pp. 26-30
Author(s):  
Y.I. Trilyudina ◽  
◽  
V.N. Kurochkin ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Modified Technique ◽  
Resection Control ◽  
Standard Resection ◽  
Alternative Method ◽  
Additional Correction

Purpose. To evaluate the effectiveness of surgical treatment of horizontal strabismus by modified tenorrhaphy in comparison with standard resection in children. Material and methods. For 3 years (2017–2019), 560 patients with horizontal strabismus at the age from 2 to 14 years were operated. Of these, 288 patients (51.4%) underwent tenorrhaphy using a modified technique (main group) as augmentation surgery, 272 patients (48.6%) underwent classical resection (control group). Results. The average age of patients in the main group was 6 (3.46) years, in the control group – 5.8 (3.34) years. In the main group of patients, orthotropy was achieved in 85.4% of cases, in the control group – in 83.5% of cases, p = 0.523. The residual strabismus angle (up to 5°) was observed in 40 patients (14%) in the main group and in 44 patients (16.5%) in the control group of patients, p = 0.449. In the main group, additional correction of the residual angle was performed on the day after the operation using adjustable suture in 8 patients (2.8%). Reoperation in the long-term period was required for 10 patients (3.7%) in the control group and 3 patients (0.7%) in the main group, p = 0.039. Significant postoperative conjunctival thickening was found in 7.2% of patients in the main group. Conclusion. The effectiveness of tenorrhaphy is not inferior to classical resection and, in combination with recession (tenomyoplasty), gives predictable stable results. The tenorrhaphy method is technically simpler, safer, more physiological, can be easily corrected in the immediate postoperative period, has no risk of «losing» muscle and can be recommended as an alternative method of resection.

scholarly journals Medium term outcome of Lancaster cortical window technique for extraction of femoral stem in revision hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Amit Singh ◽  
Sunirmal Mukherjee ◽  
Kuntal Patel ◽  
Deepak Herlekar ◽  
Srikant Gandavaram ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Medium Term ◽  
Term Outcome ◽  
Window Technique ◽  
Femoral Stems ◽  
The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in the speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster cortical window technique which can be used for the removal of cemented or uncemented femoral stems. Methods The study was conducted at a specialist centre in the north-west of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using the Lancaster cortical window technique for removal of the femoral implant during a revision hip arthroplasty. Patient’s electronic notes and radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using the novel Lancaster window technique. The mean age of all the patients was 81.5 years, and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular components. The rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow-up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow-up. Conclusion We believe Lancaster cortical window technique can be safely used for the removal of cemented stems during revision hip arthroplasty without the need for expensive equipment.

scholarly journals A modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer: a retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Si Yu ◽  
Yong Ji ◽  
Tedong Luo ◽  
Pengjie Xu ◽  
Zuojun Zhen ◽  
...  
Keyword(s):  
Rectal Resection ◽  
Sigmoid Colon Cancer ◽  
Control Group ◽  
Specimen Extraction ◽  
Modified Technique ◽  
Anterior Rectal Resection ◽  
Transanal Specimen Extraction ◽  
Long Term Follow Up ◽  
The Mean

Abstract Background In recent years, natural orifice specimen extraction surgery (NOSES) has become a field of special interest for colorectal surgeons. Some researchers have reported transanal specimen extraction in the laparoscopic anterior rectal resection, including intersphincteric resection (ISR) and rectal eversion-resection. However, these surgical procedures have certain limitations. Based on the proven expertise in laparoscopic surgery, our center has developed a modified technique of transanal specimen extraction. The aim of this study was to investigate the safety and feasibility of a modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection. Methods From January 2011 to January 2014, the patients with upper rectal or lower sigmoid colon cancer who had undergone laparoscopic anterior rectal resection with specimen extraction by a modified transanal technique were enrolled in the observation group, and the patients who had undergone laparoscopic anterior rectal resection with specimen extraction via an abdominal incision by the same surgeons during the same period were enrolled in the control group. Results A total of 36 patients were included in the observation group and 128 patients were included in the control group. There were no significant differences (P > 0.05) between the two groups in terms of the mean operative time [144 ± 10 min vs. 141 ± 11 min], mean intraoperative blood loss [63 ± 6 ml vs. 61 ± 7 ml], and the mean time to anal exhaust [67 ± 7 h vs. 65 ± 8 h]. However, there were significant differences (P < 0.05) between the two groups in terms of the mean postoperative Visual Analogue Scale (VAS) pain scores [3.4 ± 1.1 vs. 4.5 ± 1.2], mean postoperative hospital stay [6.0 ± 1.1 days ± vs. 7.2 ± 1.2 days], and incidence of postoperative complications (4/36 vs. 15/128). Long-term follow-up results showed that there was no significant difference (P > 0.05) between the two groups in terms of the 3- or 5-year overall survival. Conclusions The modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection fulfilled the principle of no-neoplasm touch technique, with advantages, such as minimal trauma, rapid recovery, and fewer complications. Long-term follow-up results also showed satisfactory oncological outcomes.

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