scholarly journals Endonasal Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma- The Technical Difficulties & Advantages

2014 ◽  
Vol 4 (2) ◽  
pp. 74-78
Author(s):  
Sudhangshu Shekhar Biswas ◽  
Zaheer Al Amin ◽  
Zaheer Al Amin ◽  
Rajashish Chakrabortty ◽  
Rajashish Chakrabortty ◽  
...  
Keyword(s):  
Blood Loss ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Endoscopic Management ◽  
Operative Blood Loss ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Excision ◽  
First Choice ◽  
Hospital Stays ◽  
The Mean

Objective: Endoscopic excision of juvenile nasopharyngeal angiofibroma (JNA) was carried out with the objective of minimizing blood loss and attempting to complete excision of tumor under direct vision with the help of Hopkins telescope.Study design: A retrospective 12 year study of 6 cases of JNA treated by endoscopic excision is presented.Result: According to Radkowski’s classification, two patients were stage Ia, two were stage Ib and two patients were stage IIb. The mean duration of the surgery was 2 hours. The mean intra-operative blood loss was 575 ml. The mean follow –up after the primary operation was 23.3 months. All the patients but one were free of disease. One patient had a recurrence in the pterygopalatine fossa requiring a successful revision procedure 3 years after the primary surgery.Conclusion: Endoscopic resection of JNA is a difficult but effective operation in experienced hands. The endoscopic management had less intra operative blood loss, lower occurrence of complications, shorter length of hospital stays and lower rate of recurrence. So it should be considered as a first choice option.Birdem Med J 2014; 4(2): 74-78

Coblation-assisted endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma

2011 ◽  
Vol 125 (9) ◽  
pp. 940-944 ◽  
Author(s):  
L Ye ◽  
X Zhou ◽  
J Li ◽  
J Jin
Keyword(s):  
Blood Loss ◽  
Endoscopic Resection ◽  
Class I ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Tumour Resection ◽  
Operative Blood Loss ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Techniques ◽  
Significant Difference ◽  
Complete Tumour

AbstractObjective:Juvenile nasopharyngeal angiofibroma may be successfully resected using endoscopic techniques. However, the use of coblation technology for such resection has not been described. This study aimed to document cases of Fisch class I juvenile nasopharyngeal angiofibroma with limited nasopharyngeal and nasal cavity extension, which were completely resected using an endoscopic coblation technique.Methods:We retrospectively studied 23 patients with juvenile nasopharyngeal angiofibroma who underwent resection with either traditional endoscopic instruments (n = 12) or coblation (n = 11). Intra-operative blood loss and overall operative time were recorded.Results:The mean tumour resection time for coblation and traditional endoscopic instruments was 87 and 136 minutes, respectively (t = 9.962, p < 0.001). Mean intra-operative blood loss was 121 and 420 ml, respectively (t = 28.944, p < 0.001), a significant difference. Both techniques achieved complete tumour resection with minimal damage to adjacent tissues, and no recurrence in any patient.Conclusion:Coblation successfully achieves transnasal endoscopic resection of juvenile nasopharyngeal angiofibroma (Fisch class I), with good surgical margins and minimal blood loss.

scholarly journals Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098278
Author(s):  
Xing Du ◽  
Yunsheng Ou ◽  
Guanyin Jiang ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Bone Graft ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Operative Time ◽  
Bone Grafts ◽  
Surgical Indications ◽  
Operative Blood Loss ◽  
The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

scholarly journals Peripartum hysterectomy for cesarean section with morbidly adherent placenta: case series of 25 patients

2018 ◽  
Vol 7 (10) ◽  
pp. 3980
Author(s):  
Abdulrahman M. Rageh ◽  
Mohamed Khalaf ◽  
Ahmed M. Abbas ◽  
Hossam T. Salem
Keyword(s):  
Blood Loss ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Case Series ◽  
Bladder Injury ◽  
Operative Blood Loss ◽  
Ureteric Injury ◽  
Total Blood ◽  
Peripartum Hysterectomy ◽  
The Mean

Background: The current paper reports the outcome of case series of patients presented with placenta accreta confirmed histopathologicaly after management by peripartum hysterectomy.Methods: The study was set in Women’s Health Hospital, Assiut University, Egypt. This was a case series of 25 women presented with placenta accreta between May 2017 and April 2018. We included all pregnant women with placenta previa as diagnosed by ultrasound with suspicion of abnormal placentation by Doppler, confirmed intra-operatively undergoing either emergent or elective CS. All cases were performed by an expert team of obstetricians and anesthetists. Cesarean delivery was done under general anesthesia through pfannensteil incision. The primary outcome was the estimated intra-operative blood loss through assessment of amount of blood in the suction by ml, difference between the weight of surgical drapes and towels before and after operation.Results: Pre-operative Hb was 10.64±1.01 gm/dL and there was significant decline in the postoperative Hb reaching 8.36±1.21 gm/dL (p<0.001). The mean drop in Hb was 2.28±1.43gm/dL. Estimated intra-operative blood loss was 974.4±398.05 ml in the towels and 847.6±362.56 ml in the suction apparatus. The total blood loss was 1822±653.73 ml. The mean number of units of whole blood transfused was 2160.0±825.6 ml and fresh frozen plasma was 1010.0±349.7 ml. Regarding intra-operative complications, bladder injury was the most common one in 14 cases (56%), followed by ureteric injury in two cases (8%). Postoperative ICU admission was in 6 cases (24%) and the mean duration of hospital stay 12.44 ± 4.07 days. No cases of maternal mortality.Conclusions: In conclusion, peripartum hysterectomy is considered life-saving surgery in patients with placenta accreta.

In defence of transpalatal, transpalatal-circumaxillary (transpterygopalatine) and transpalatal-circumaxillary-sublabial approaches to lateral extensions of juvenile nasopharyngeal angiofibroma

2016 ◽  
Vol 130 (5) ◽  
pp. 462-473 ◽  
Author(s):  
A Mishra ◽  
S C Mishra ◽  
V Verma ◽  
H P Singh ◽  
S Kumar ◽  
...  
Keyword(s):  
Residual Disease ◽  
Tumour Size ◽  
Infratemporal Fossa ◽  
Pterygopalatine Fossa ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Atrophic Rhinitis ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Transpalatal Approach ◽  
Sublabial Approach

AbstractBackground:Juvenile nasopharyngeal angiofibroma often presents with lateral extensions. In countries with limited resources, selection of a cost-effective and least morbid surgical approach for complete excision is challenging.Methods:Sixty-three patients with juvenile nasopharyngeal angiofibroma, with lateral extensions, underwent transpalatal, transpalatal-circumaxillary (transpterygopalatine) or transpalatal-circumaxillary-sublabial approaches for resection. Clinico-radiological characteristics, tumour volume and intra-operative bleeding were recorded.Results:The transpalatal approach was suitable for extensions involving medial part of pterygopalatine fossa; transpalatal-circumaxillary for extensions involving complete pterygopalatine fossa, with or without partial infratemporal fossa; and transpalatal-circumaxillary-sublabial for extensions involving complete infratemporal fossa, even cheek or temporal fossa up to zygomatic arch. Haemorrhage was greatest with the transpalatal-circumaxillary-sublabial approach, followed by transpalatal approach and transpalatal-circumaxillary approach (1212, 950 and 777 ml respectively). Tumour size (volume) was greatest with the transpalatal-circumaxillary approach, followed by transpalatal-circumaxillary-sublabial approach and transpalatal approach (40, 34 and 29 mm3). There was recurrence in three cases and residual disease in two cases. Long-term morbidity included small palatal perforation (n = 1), trismus (n = 1) and atrophic rhinitis (n = 2).Conclusion:These modified techniques, performed with endoscopic assistance under hypotensive anaesthesia, without embolisation, offer a superior option over other open procedures with regard to morbidity and recurrences.

scholarly journals Comparative Study of Rectal Misoprostol to Oxytocin Infusion in Preventing Postpartum Haemorrhage After Caesarean Section

2014 ◽  
Vol 8 (2) ◽  
pp. 34-37 ◽  
Author(s):  
AI Adanikin ◽  
E Orji ◽  
PO Adanikin ◽  
O Olaniyan
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Comparative Study ◽  
Postpartum Haemorrhage ◽  
Post Partum ◽  
Operative Blood Loss ◽  
Oxytocin Infusion ◽  
The Mean ◽  
Post Partum Haemorrhage ◽  
To Receive

Aims: This comparative study aimed to compare the efficacy of rectal misoprostol to oxytocin infusion in preventing primary postpartum haemorrhage after caesarean section. Methods: Fifty pregnant women with identifiable risk factors for post-partum haemorrhage who delivered baby by caesarean section were randomized to receive 600 μg rectal misoprostol and a placebo infusion intravenously or placebo rectally and a 20 iu oxytocin infusion. Post-operative blood loss four hours after surgery was estimated by application of pads of known weight. Results: The mean immediate four hours post-operative blood loss was not significantly different between the rectal misoprostol and oxytocin infusion group (100.08 ± 24.85 ml versus 108.20 ± 29.93 ml; p =0.144) and the change between the pre-operative and post-operative hematocrit was similar. Conclusions: Post-caesarean section rectal misoprostol has comparative efficacy to oxytocin infusion in preventing post-partum haemorrhage. It is recommended for use as alternative uterotonic in settings where there is low refrigeration capacity.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 34-37 DOI: http://dx.doi.org/10.3126/njog.v8i2.9767

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