Conventional versus Modified Tarso-frontalis Suspension Surgery using Targeted Lid Crease for Simple Congenital Blepharoptosis with Poor Levator Action

Introduction: The routine technique of tarso-frontalis suspension surgery for simple congenital blepharoptosis with poor levator action is cosmetically less rewarding due to either an absence or asymmetry of the postoperative eyelid crease. The objective of this study was to assess the eyelid crease quality after a modified open method of tarso-frontalis suspension surgery compared to the closed method. Materials and methods: This was a retrospective comparative study reviewing the case sheets of all the patients undergoing unilateral tarso-frontalis suspension surgery with silicon rod employing Fox pentagon design from September 2017 to February 2019 at Mechi Eye Hospital, Jhapa, Nepal. A review of 40 case sheets of congenital lid ptosis with poor levator function(<4mm) aged 9 years or more was done. Tarso-frontalis suspension surgery, modified with a mini blepharoplasty incision, direct attachment of silicon rod to tarsus, completion of pentagon design with supra-brow incisions, and skin-orbicularis-tarsus-orbicularis-skin suture (open method) was done in 20 cases whereas other 20 cases underwent surgery with supraciliary stab incisions (closed method). Results: The mean age of the patients was 21.1+5.9 years (range 9-30 years). The ptosis amount ranged from 3–10mm. At the 6th postoperative month, most of the cases had good ptosis correction (90% open group, 85% closed group, p=0.74). However, cosmetic outcomes were better in the open group compared to the closed group: 100% symmetrical eyelid crease compared to 40% (p<0.001) and 90% acceptance rate for eyelid contour compared to 70% (p=0.23). Conclusion: Predictable, targeted, and symmetrical lid crease can be obtained using the modified open method of tarso-frontalis suspension surgery.

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A modified Fox pentagon technique performed using a polytetrafluoroethylene sling in frontalis suspension to treat blepharophimosis syndrome

Science Progress ◽

10.1177/0036850419893880 ◽

2020 ◽

Vol 103 (1) ◽

pp. 003685041989388

Author(s):

Yuan Wang ◽

Qian Wu ◽

Li Li ◽

Wen Liu ◽

Cheng Li ◽

...

Keyword(s):

Retrospective Study ◽

Functional Outcomes ◽

Average Score ◽

Palpebral Fissure ◽

Cosmetic Results ◽

Frontalis Suspension ◽

Good Cosmetic ◽

Cosmetic Outcomes ◽

The Mean

The purpose of this study was to evaluate the functional and cosmetic outcomes of a new modified Fox pentagon technique performed using polytetrafluoroethylene in frontalis suspension surgery for blepharophimosis syndrome. This retrospective study enrolled 40 patients diagnosed with blepharophimosis syndrome from March 2016 to October 2018. All patients underwent frontalis suspension using a new modified Fox pentagon technique. The functional and cosmetic outcomes were evaluated. After the operation, the mean palpebral fissure height increased from 2.68 to 6.93 in right eyes and from 2.73 to 6.98 in left eyes. The mean MRD1 increased from 0.53 to 3.76 in right eyes and from 0.50 to 3.78 in left eyes. While preoperative to postoperative differences were statistically significant ( p < 0.01), there were no significant differences between right and left eyes either before or after the surgery ( p > 0.01). All patients achieved good cosmetic results with an average score of 0.6. We have experimentally created a modified Fox pentagon technique performed using a polytetrafluoroethylene sling in a frontalis suspension to treat BPES; this approach yielded favorable cosmetic and functional outcomes.

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Unilateral Versus Bilateral Frontalis Suspension Sling Surgery for Correction of Severe Unilateral Congenital Ptosis.

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.1.ot2 ◽

2020 ◽

Vol 9 (1) ◽

pp. OT05-OT08

Author(s):

Jyoti Dhaka ◽

Ashok Kumar Grover

Keyword(s):

Comparative Study ◽

Surgical Outcome ◽

Fascia Lata ◽

P Value ◽

Congenital Ptosis ◽

Sling Surgery ◽

Frontalis Suspension ◽

Cosmetic Outcomes ◽

Group 2 ◽

Group 1

Background: To compare the surgical outcome of unilateral silicone sling with bilateral fascia latafrontalis suspension surgery for severe unilateral congenital ptosis.Subjects and Methods:This prospective, interventional and comparative study examined 30 patients of severe unilateral congenital ptosis. 30 patients were divided in to 2 groups, group 1 included 15 patients who underwent unilateral silicone sling frontalis suspension surgery and group 2 included 15 patients who underwent contralateral levator excision with bilateral fascia latafrontalis sling surgery.Results:Mean improvement in MRD1 after surgery in group 1 who underwent unilateral silicone sling surgery was 3.9+1.18 mm and in group 2 who underwent bilateral fascia lata it was 4.9+0.89 mm (p value 0.0001). Excellent results (difference of lid height <1 mm) were seen in 93.3% patients who underwent bilateral fascia latafrontalis sling while in 73.3% patients of unilateral silicone sling. All patients who underwent bilateral fascia lata showed excellent lid crease (symmetric without obliteration) and 80% of the patients who underwent unilateral silicone sling surgery (p value 0.032).Conclusion: Functional and cosmetic outcomes regarding MRD1, symmetry of lid height, lid crease were noted better in group 2 patients who underwent contralateral levator excision with bilateral fascia latafrontalis suspension surgery as compared to group 1 patients who underwent unilateral silicone sling surgery.

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A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184981 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5140

Author(s):

Reena Sharma ◽

B. R. Sharma ◽

Poojan Dogra

Keyword(s):

Comparative Study ◽

Induction Of Labour ◽

Cervical Ripening ◽

Efficacy And Safety ◽

Group A ◽

The Mean ◽

Group 2 ◽

Group B ◽

Retrospective Comparative Study ◽

Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

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Comparative study between open and arthroscopic techniques for scaphoid excision and four-corner arthrodesis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420908820 ◽

2020 ◽

Vol 45 (9) ◽

pp. 952-958

Author(s):

Jae Woo Shim ◽

Joo Whan Kim ◽

Min Jong Park

Keyword(s):

Comparative Study ◽

Range Of Motion ◽

Clinical Outcomes ◽

Bone Union ◽

Open Group ◽

Level Of Evidence ◽

Radiological Indices ◽

Flexion Extension ◽

Postoperative Flexion ◽

The Mean

This study presents our technique of arthroscopic scaphoid excision and four-corner arthrodesis and compares the clinical and radiological outcomes with those achieved with the open method. Twenty-seven patients (14 in arthroscopy group and 13 in open group) were included. Bone union was achieved in 13 of 14 patients in the arthroscopy group and in all 13 patients in the open group. In the open group, severe stiffness (flexion–extension arc was 10°) occurred in one patient after surgery. The mean postoperative flexion–extension arc was 75° and 51° in the arthroscopy group and open group, respectively. The pain, clinical scores, and radiological indices were improved in both arthroscopy and open groups. Arthroscopic and open scaphoid excision and four-corner arthrodesis did not show significant differences in clinical outcomes and bone union rates. The arthroscopic method provided a superior range of motion. Level of evidence: III

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Trans-thoracic versus trans-hiatal resection for oesophageal carcinoma: a retrospective comparative study of a single-centre case series

The Cardiothoracic Surgeon ◽

10.1186/s43057-020-00035-y ◽

2020 ◽

Vol 28 (1) ◽

Author(s):

Aram Baram ◽

Hiwa Sherzad

Keyword(s):

Comparative Study ◽

Case Series ◽

Oesophageal Carcinoma ◽

Single Centre ◽

Term Survival ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

Retrospective Comparative Study

Abstract Background Oesophageal carcinoma (EC) is the eighth most common cancer. Surgery is the cornerstone of management for resectable EC. Trans-thoracic oesophagectomy (TTE) and trans-hiatal oesophagectomy (THE) are the two most widely practised procedures. Most of the related controversies are centred on both early and late post-operative complications and mortality (in terms of overall survival and cancer-free survival). This was a single-centre, retrospective, comparative study analysing the outcomes of two EC resection methods. All 87 patients underwent surgery by the same surgical team over 13 years. Consequently, 87 oesophagectomies with curative intent were performed and divided into the TTE group (group A = 47) and the THE group (group B = 40). Results The mean patient age was 65.60 ± 6.30 years in the TTE group and 63.48 ± 9.34 years in the THE group. No significant difference was found in operative time, blood loss or duration of stay in the intensive care unit. The duration of hospital stay was significantly different between the THE and TTE groups (17.25 ± 5.92 vs. 12.93 ± 3.44, respectively; P ≤ 0.001). In-hospital mortality was higher in the TTE group (9/47, 19.14%) than in the THE group (5/40, 12.5%) (P = 0.400). The mean survival rate from our series showed the superiority of group A (TTE) (65.56 months) over group B (THE) (45.01 months), with P = 0.146. Conclusion No high level of evidence suggests the superiority of one surgical procedure over another. The THE procedure is less time-consuming concerning care and follow-up, and most patients were more satisfied and experienced less pain than with the TTE procedure. Both THE and TTE have comparable post-operative anastomotic complications, and they have no significant long-term survival differences.

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Laparoscopic Cholecystectomy under Epidural Anesthesia: A Retrospective Comparison of 100 Patients

The American Surgeon ◽

10.1177/000313481207800146 ◽

2012 ◽

Vol 78 (1) ◽

pp. 107-110 ◽

Cited By ~ 2

Author(s):

Hong-Wei Zhang ◽

Ya-Jin Chen ◽

Ming-Hui Cao ◽

Feng-Tao Ji

Keyword(s):

Laparoscopic Cholecystectomy ◽

Comparative Study ◽

Epidural Anesthesia ◽

Hospital Cost ◽

Recovery Room ◽

Operation Time ◽

Time Duration ◽

Duration Of Stay ◽

The Mean ◽

Retrospective Comparative Study

There are limited data about laparoscopic cholecystectomy (LC) under epidural anesthesia. This retrospective comparative study aimed to evaluate on the feasibility and advantages of LC under epidural anesthesia. In this retrospective comparative study, 100 patients (46 men and 54 women) with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy using epidural anesthesia (EA) were compared with 100 patients undergoing laparoscopic cholecystectomy using general anesthesia (GA). Both groups were evaluated with regard to intraoperative mean arterial pressure, heart rate, operation time, duration of stay in the recovery room, and hospital cost. Laparoscopic operation was performed for 200 patients. Mean age of patients was 46.4 ± 6.9 years and 45.3 ± 6.8 years in EA and GA, respectively. Forty-six and 50 per cent of subjects were male in EA and GA, respectively. The mean operation time was 24 minutes and 25.58 minutes for EA and GA, respectively ( P = 0.652). The duration of stay in the recovery room was significantly shorter in EA than that in GA (19.56 ± 2.55 minutes vs 56.27 ± 6.85 minutes, respectively; P = 0.0001). In the EA group, 23 patients (23%) had severe shoulder pain during surgery. After receiving pethidine intravenously, all these patients could subsequently undergo surgery smoothly. There were no complications or mortality in either group. Most of the patients regarded EA as a comfortable procedure. The mean hospital cost for the EA group was only three-fourths that of the GA group. LC under EA is feasible and safe in selected patients.

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A Retrospective Comparative Study of Different Methods of Blood Management in Total Knee Replacement

The Journal of Knee Surgery ◽

10.1055/s-0038-1675217 ◽

2018 ◽

Vol 32 (10) ◽

pp. 995-1000

Author(s):

Eleni Pappa ◽

Nikolaos Vergados ◽

Emanouil Spiridakis ◽

George Chountas ◽

Anna Apostolopoulou ◽

...

Keyword(s):

Blood Transfusion ◽

Total Knee Replacement ◽

Tranexamic Acid ◽

Comparative Study ◽

Knee Replacement ◽

Statistical Difference ◽

Blood Management ◽

Total Knee ◽

The Mean ◽

Retrospective Comparative Study

AbstractPerioperative blood management is essential to minimize allogeneic blood transfusion in total knee replacement. The effect of preoperative administration of erythropoietin, intraoperative cell saver, tranexamic acid, and restrictive transfusion strategies on allogeneic transfusion is studied in total knee replacement. A retrospective comparative study of 106 patients who underwent total knee replacement in different time periods was performed. Group A (n 1 = 45) underwent restrictive strategies of transfusion between 2009 and 2010. Group B (n 2 = 24) includes patients where erythropoietin of either 10.000 IU or 20.000 IU was given preoperatively. Patients of Group C (n 3 = 21) underwent autologous washed erythrocytes transfusion through a cell saver. Lastly, in Group D (n 4 = 15) tranexamic acid dose of 1 gr IV was given intraoperatively. The preoperative and discharge hemoglobin together with total units of blood transfusion and creatinine levels was studied. Tranexamic acid noted the least units of blood transfusion (mean = 0.82 units/patient, p < 0.001, CI 95%) in contrast to the two regimens of erythropoietin (1.16 units/patient) OrthoPAT (1.43 units/patient) and restrictive strategies (1.92 units/patient). The mean preoperative hemoglobin was 13.37 g/dL with no statistical difference among the groups of patients. The postoperative mean hemoglobin was 10.59 with no statistical difference among the groups of patients too. Additionally, the mean creatinine level was 0.93 mg/dL; however, no statistical difference among the groups of patients was noted. Finally, tranexamic acid seemed to be the most cost-effective regime. In our study, tranexamic acid proved its superiority concerning the postoperative blood transfusion on patients undergoing total knee replacement, in comparison with the other existing methods of perioperative blood management. This is a Level III, retrospective comparative study.

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