scholarly journals The outcome of limited urethral mobilization urethroplasty for anterior hypospadias.

2020 ◽  
Vol 27 (01) ◽  
pp. 210-216
Author(s):  
Shafiq-ur- Rehman ◽  
Yasir Makki ◽  
Fareena Ishtiaq ◽  
Waleeja Shami Khan ◽  
Nauman Aziz ◽  
...  
Keyword(s):  
Wound Infection ◽  
Functional Outcome ◽  
Study Design ◽  
Complication Rate ◽  
Surgical Techniques ◽  
Significant Risk ◽  
Paediatric Surgery ◽  
Urethrocutaneous Fistula ◽  
Cosmetic Appearance ◽  
Minimum Age

Objectives: Hypospadias, one of the most common genital anomalies, is characterized by an abnormal meatal opening on the ventral aspect of penis. Anterior hypospadias are the most common. Most of the surgical techniques involves the construction of neourethra with significant risk of urethrocutaneous fistula. Limited urethral mobilization technique involves the advancement of native urethra. Study Design: The objective of this study was to evaluate the outcome of Limited Urethral Mobilization Urethroplasty for Anterior Hypospadias. Setting: The study was conducted in the Department of Paediatric Surgery, DHQ teaching Hospital Sahiwal. Period: From January 2016 to December 2018. Material & Methods: A total number of 187 patients were included in this study. Limited urethral mobilization technique was used in all patients. Minimum age was 2.5 Years and maximum age was 12 years. Cosmetic appearance, functional outcome and complication rate were assessed. Results: Wound infection developed in 3.20 %( n=6) patients. Complete glanular disruption was seen in 2.13 %( n=4) patients. Partial disruption of glans with meatal retraction was observed in 1.60 %( n=3) patients. Post-operative haematoma was seen in 1.60 %( n=3) patients. Meatal stenosis in 1.06 %( n=2) patients.   Post-operative bleeding and diverticula was observed in 0.5 %( n=1) patients each. Vertical oriented, slit like meatus at the tip of glans was achieved in 95.72 %( n=179) patients. Conclusion: Limited urethral mobilization urethroplasty is a technique with proven benefits and effectiveness in the terms of cosmesis and functional outcome with a minimal number of complications because of the usage of native elastic urethra.

scholarly journals LIMITED URETHERAL MOBILIZATION PROCEDURE (LUMP) FOR DISTAL PENILE HYPOSPADIAS REPAIR, A SINGLE CENTRE RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 9 (5) ◽  
pp. 1335-1343
Author(s):  
Muhammad Riaz-ul-Haq ◽  
◽  
Arslan Raza Wasati ◽  
Mazhar Rafi ◽  
Sohail Jamil ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Postoperative Management ◽  
Fistula Formation ◽  
Paediatric Surgery ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Cosmetic Appearance

Background: Distal penile hypospadias is one of the commonest varieties of hypospadias. Different techniques have been mentioned in literature. The success rate is usually assessed by rate of fistula formation and over all cosmetic appearance and functional outcome. Limited Uretheral Mobilization Procedure (LUMP) for distal penile hypospadias is considered a good technique with almost zero fistula rate in some series. As no new urethral tube is constructed there is no risk of fistula. Objective: To evaluate the results of the Limited Urethral Mobilization Procedure (LUMP) for distal hypospadias repair. Methods.It is retrospective analysis of 32 patients aged up to 12 years who were treated with Limited urethral mobilization procedure for distal penile hypospadias in the Department of Paediatric Surgery Jinnah Hospital Lahore from December 2018 to November 2019. All patients were operated under general anesthesia. The urethra proximal to the meatus was mobilized adequately in such a way that it should reach the tip of glans easily without any ventral bending of penis.Then the urethra was placed in the glandular wings and reconstruction of glans was carried out. Dartos flap was also placed to cover the urethra as a safety measure to avoid urethrocutaneous fistula formation. Follow up was done for a period of 3 months with respect to fistula formation, meatal stenosis, retraction , chordee and over all cosmetic appearance. Results: Age range of children was 9 months to 12 years. Operation time ranged from 60-80 minutes. Seven of 32 cases were previously operated for distal penile hypospadias but after disruption of repair meatus was lying at coronal or subcoronal level. They also underwent LUMP. Five cases had minor chordee, it was corrected at the time of uretheral mobilization by simple excision of fiberous tisse in 4 patients while modified Nesbit dorsal placation was done in one. Cosmetically normal looking circumcised penis with slit like meatus was achieved in all.Two cases got superficial wound infection, two had meatal stenosis, one meatal retraction, one ventral chordee and one urethrocutaneous fistula. Conclusion: LUMP for distal penile hypospadias is a simple and effective procedure with minimum complications.There is no chance for development of urethrocutaneous fistula, a major postoperative complication of other surgical techniques for uretheroplasty. Postoperative management is simple and hospital stay is short.

scholarly journals Assessment of post-surgical functional outcome in children with anorectal malformation

2018 ◽  
Vol 5 (4) ◽  
pp. 1286 ◽  
Author(s):  
Jiwan Lal Patel ◽  
M. Amin Memon ◽  
Shipra Sharma ◽  
Jeewan Verma
Keyword(s):  
Functional Outcome ◽  
Anorectal Malformation ◽  
Bowel Movement ◽  
Surgical Techniques ◽  
Anorectal Malformations ◽  
Paediatric Surgery ◽  
Vaginal Fistula ◽  
Number Of Patients ◽  
Vestibular Fistula ◽  
Pouch Colon

Background: Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge for paediatric surgeons. Advances in modern surgical techniques and neonatal care have greatly improved survival among ARM patients over the last decades, and early mortality is now unusual in the absence of fatal associated cardiac or chromosomal defects. The aim of this study is to measure the functional outcome of ARM by most recent krickenburg classification.Methods: The present longitudinal study was conducted in Department of paediatric surgery, Dr. BRAM hospital, Raipur, Chhattisgarh during study period February 2016 to September 2017. Those patients who had completed their all stages of surgery for anorectal malformation at-least 6 months back and arriving at outpatient department of paediatric surgery were included.Results: Maximum number of patients were in age group of 3 to 5 years (77.8%) and minimum were 9 to 11 years (3.7%). A 50.6% male and 49.4% female child were included in the study. Maximum number of patients had vestibular fistula (38.27% followed by perineal fistula (24.69%), rectobulbar (18.51%) then rectovaginal (7.4%) and rectoprostatic (7.4%). Minimum patients had pouch colon (2.4%) and cloaca (1.09%). Voluntary bowel movement was present in 50% of rectoprostatic and 66.6% of rectovaginal fistula. Eighty percentage rectobulbar and 83.87% vestibular fistula had voluntary bowel movement. Cloaca and Pouch colon had no voluntary bowel movement. In recto-vaginal fistula 66.6% had soiling, of which 50% had grade 1 and 16.6% had grade 2 soiling. In recto-bulbar fistula 40% cases had soiling, out of which 20% had grade1 and 20% had grade 2. In recto-vaginal fistula cases 33 % had constipation, of which 16.5% had grade 1 and 16.6 % had grade 2. In recto-prostatic fistula 16% had constipation which was grade1.Conclusions: In this study, author showed that functional outcomes comparable to matched peers are achieved in the majority of low ARMs after minimally invasive, individualized perineal procedures and regular surgical follow-up. In high type of ARM soiling is the prominent feature while in intermediate ARM constipation is more common.

Subtotal Pedal Amputations

2001 ◽  
Vol 91 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Christopher Funk ◽  
Gregg Young
Keyword(s):  
Functional Outcome ◽  
Diabetic Foot ◽  
Surgical Techniques ◽  
Surgical Correction ◽  
Proper Treatment ◽  
Review Of The Literature ◽  
Human Foot

Proper treatment for the compromised diabetic foot often requires surgical correction and subtotal pedal amputation. This article discusses various levels of amputation of the human foot, including digital, ray, transmetatarsal, midfoot, and Syme amputations. Surgical techniques and biomechanical considerations are presented in order to assist the surgeon in planning for the most functional outcome of the patient. A review of the literature and the experiences of the authors are presented. (J Am Podiatr Med Assoc 91(1): 6-12, 2001)

Otoplasty for Prominent Ears: A Versatile Combined Technique to Master the Shape of the Ear

2007 ◽  
Vol 137 (2) ◽  
pp. 224-227 ◽  
Author(s):  
Marzia Salgarello ◽  
Carlo Gasperoni ◽  
Antonella Montagnese ◽  
Eugenio Farallo
Keyword(s):  
Retrospective Study ◽  
Study Design ◽  
Complication Rate ◽  
Prominent Ears ◽  
Major Complications ◽  
Aesthetic Results ◽  
Skin Excision ◽  
The Aesthetic ◽  
Combined Technique

OBJECTIVE: We present our experience with an otoplasty technique that combines “closed” anterior scoring using the Stenström otoabrader with mattress sutures to the posterior cartilage. STUDY DESIGN AND SETTING: In a retrospective study, we report our experience with 135 patients operated on in the last 12 years. Some surgical principles make our procedure different from previous combination techniques: the posterior access incision is linear without skin excision; anterior scoring is performed along the entire antihelix and scapha, with care to score toward the concha at the tail of the antihelix to bring the ear lobe nearer to the mastoid; Mustarde's mattress sutures are used to stabilize the result. RESULTS: There were no major complications and few minor complications. The aesthetic results were graded as very good or good in 95% of the cases; the rest were graded as satisfactory. CONCLUSIONS: Our technique is versatile, gives pleasant, natural-looking results, and has a low complication rate. It is a simple, reliable, reproducible, and easily mastered method.

FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES AND THEIR MANAGEMENT

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Raman Shrivastava ◽  
Namita Shrivastava
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Railway Track ◽  
Distal Femoral Fractures ◽  
Minimally Invasive Surgical ◽  
Fall From Height ◽  
Classification Management ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Center, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1-C1, 4-C2 and 3-C3 fractures. Results were found to be excellent in 17, good in 1, moderate in 3 and poor in 4 patients. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced. Keywords: Distal fractures, Muller Classification, Management, Femoral fractures

scholarly journals Functional outcome and complication rate after percutaneous suture of fresh Achilles tendon ruptures with the Dresden instrument

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Sebastian Manegold ◽  
Serafim Tsitsilonis ◽  
Jakob Schumann ◽  
Tobias Gehlen ◽  
Alison N. Agres ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Functional Outcome ◽  
Complication Rate ◽  
Tendon Ruptures

scholarly journals Obesity Does Not Increase Mortality after Emergency Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Paula Ferrada ◽  
Rahul J. Anand ◽  
Ajai Malhotra ◽  
Michel Aboutanos
Keyword(s):  
Wound Infection ◽  
Emergency Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Patient Characteristics ◽  
Obese Patients ◽  
Exact Test ◽  
Icu Admission ◽  
Nonobese Patients ◽  
The Impact

Objective.The aim of this study is to evaluate the impact of obesity on patient outcomes after emergency surgery.Methods.A list of all patients undergoing emergent general surgical procedures during the 12 months ending in July 2012 was obtained from the operating room log. A chart review was performed to obtain the following data: patient characteristics (age, gender, BMI, and preexisting comorbidities), indication for surgery, and outcomes (pulmonary embolus (PE), deep venous thrombosis (DVT), respiratory failure, ICU admission, wound infection, pneumonia, and mortality). Obesity was defined as a BMI over 25. Comparisons of outcomes between obese and nonobese patients were evaluated using Fischer’s exact test. Predictors of mortality were evaluated using logistic regression.Results.341 patients were identified during the study period. 202 (59%) were obese. Both groups were similar in age (48 for obese versus 47 for nonobese,P=0.42). Obese patients had an increased incidence of diabetes, (27% versus 7%,P<0.05), hypertension (52% versus 34%,P<0.05), and sleep apnea (0% versus 5%,P<0.05). There was a statistically significant increased incidence of postoperative wound infection (obese 9.9% versus nonobese 4.3%,P<0.05) and ICU admission (obese 58% versus nonobese 42%,P=0.01) among the obese patients. Obesity alone was not shown to be a significant risk factor for mortality.Conclusions.A higher BMI is not an independent predictor of mortality after emergency surgery. Obese patients are at a higher risk of developing wound infections and requiring ICU admission after emergent general surgical procedure.

Results of the Surgical Treatment in Children with Hirschprung Disease: A 12-Year Experience

2021 ◽  
Author(s):  
Ceren Cesur ◽  
Ayşenur Celayir
Keyword(s):  
Surgical Treatment ◽  
Complication Rate ◽  
Operative Procedure ◽  
Surgical Techniques ◽  
Hirschsprung Disease ◽  
Rectal Biopsy ◽  
X Rays ◽  
Surgical Methods ◽  
Pull Through ◽  
Subacute Intestinal Obstruction

Objective: In the treatment of Hirschsprung’s disease, many surgical techniques have been developed and modified including laparotomy, resection of the affected colon segment, and pull-through of the functional bowel segment to the anus. Conventional surgical methods have many early and late postoperative complications, albeit at a reduced rate today. In this study, it was aimed to compare the treatment results of children with Hirschsprung Disease who were operated with single or two-stage techniques in our department. Method: Hospital records of the patients operated for Hirschsprung disease were retrospectively evaluated. Demografic characteristics, findings of physical and rectal examinations, X-rays findings, rectal biopsy results, surgical treatment methods and outcomes were analyzed. Results: Fifty-two children including 41-male (78.8%) and 11-female (21.2%) patients with age ranging from 1-day to 5-year and mean age of 6.8-day in neonates and 6.3-month in others were enrolled in the study. All patients presented with acute or subacute intestinal obstruction. Levels were observed on supine abdominal radiographs in all; transition zone and retention of opaque material were observed on opaque enema or retention radiographs.In patients whose rectal biopsies revealed aganglionic megacolon two staged procedures were performed including initial colostomy followed by definitive procedure of Duhamel with stapler in 30, and Soave in 12, and Swenson in 1 patient. Nine patients were operated with one-stage endorectal pull-through technique. The complication rate in 43 patients with Hirschsprung disease managed by two staged operative procedure was (78.8%), and it was 11.1% in 9 cases that underwent transanal endorectal pullthrough procedure. It was learned that effective anal dilatation was not performed in 22-patients who had postoperative enterocolitis attacks. Conclusion: In addition to the low complication rate, the morbidity rates in the transanal endorectal pull-through method, which achieved successful results with only one procedure, were very low compared to multiple-stage operations.

scholarly journals Anterior knee pain and functional outcome following different surgical techniques for tibial nailing: a systematic review

2020 ◽  
Author(s):  
Mandala S. Leliveld ◽  
Michael H. J. Verhofstad ◽  
Eduard Van Bodegraven ◽  
Jules Van Haaren ◽  
Esther M. M. Van Lieshout
Keyword(s):  
Systematic Review ◽  
Functional Outcome ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Surgical Techniques ◽  
Anterior Knee

Factors Predictive of Venous Thromboembolism in Bariatric Surgery

2011 ◽  
Vol 77 (10) ◽  
pp. 1403-1406 ◽  
Author(s):  
Hossein Masoomi ◽  
Brian Buchberg ◽  
Kevin M. Reavis ◽  
Steven D. Mills ◽  
Michael Stamos ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Venous Thromboembolism ◽  
Surgical Techniques ◽  
Significant Risk ◽  
Patient Characteristics ◽  
Morbidly Obese ◽  
Open Gastric Bypass ◽  
Open Operation ◽  
Surgical Options

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in bariatric surgery. The aim of this study was to evaluate the effect of patient characteristics, payer type, comorbidities, and surgical techniques on development of VTE in bariatric surgery. Using the National Inpatient Sample (NIS) database from 2006 to 2008, clinical data of 304,515 morbidly obese patients who underwent bariatric surgery were examined. Multiple regression analysis was performed to identify factors predictive of VTE. The overall rate of in-hospital VTE was 0.17 per cent, with the highest rate of VTE observed in open gastric bypass (0.45%). The VTE rate was significantly lower in laparoscopic compared with open gastric bypass (0.13% vs 0.45%, respectively, P < 0.01) and in nongastric bypass compared with gastric bypass procedures (0.06% vs 0.21%, respectively, P < 0.01). Alcohol abuse [odds ratio (OR): 8.7], open operation (OR: 2.5), gastric bypass procedures (OR: 2.4), renal failure (OR: 2.3), congestive heart failure (OR: 2.0), male gender (OR: 1.5), and chronic lung disease (OR: 1.4) were associated with a higher rate of VTE. This study identified several significant risk factors for development of VTE in bariatric surgery. To minimize the risk of VTE, surgeons may consider these factors in selection of appropriate prophylaxis and bariatric surgical options.

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