scholarly journals Complications of Total Thyroidectomy in 50 Cases in The Department of Endocrine Surgery in BSMMU

2019 ◽  
Vol 17 (1) ◽  
pp. 25-29
Author(s):  
Md Alamgir Hossain Sikder ◽  
AEM Mahfuzur Rahman ◽  
Abul Khair ◽  
Md Jahangir Alam ◽  
Mohammed Rafiqul Lslam
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Endocrine Surgery ◽  
Published Data ◽  
Female Ratio ◽  
Male Female Ratio ◽  
A Prospective Study ◽  
Surgery Department

Objective: To determine the complications of the patients undergoing total thyroidectomy. Method: A prospective study was held at Department of Endocrine Surgery in BSMMU from January 2006 to December 2006 Method: Fifty patients with multinodular goiter and carcinoma thyroid of both sexes were selected from admitted patient of endocrine surgery department. All patients were evaluated preoperatively and total thyroidectomy was done and post operative was followed up. Out of 50 patients 35 patients were female and 15 patients male, male - female ratio 1 :2.3. 40 patients were carcinoma thyroid, 10 patients were multinodular goiter. The overall incidence of postoperative complication in this series was 4. out of 50 patients 1 patient developed haematoma. 1 patient developed wound infection and 1 patient developed transient tetany on 2nd postoperative day which was improved later on. 1 patient developed a thyroid nodule 6th month after total thyroidectomy for carcinoma thyroid. In long term from total thyroidectomy 40 patients were followed up, 10 patients did not attend an subsequent follow up. Out of 40 patients 36 patients were out of complication. Conclusion: The results are comparable with the current published data and demonstrate that total thyroidectomy can performed with minimum complication rate. Journal of Surgical Sciences (2013) Vol. 17 (1) : 25-29

scholarly journals Total or less than total thyroidectomy for multinodular goiter long term follow-up

2021 ◽  
Vol 8 (3) ◽  
pp. 181-186
Author(s):  
Didem Dereli Akdeniz ◽  
Gürkan Avcı
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Long Term Follow Up ◽  
Microsurgical Techniques ◽  
Partial Thyroidectomy ◽  
Group 2 ◽  
Group 1

Objective: Multinodular goiter is a common surgical disease. There is no common consensus regarding the extent of thyroidectomy for multinodular goiter. This  study aims to present personal experience on treating patients with multinodular goiter and to compare complication rates and results of total and partial thyroidectomy for multinodular goiter. Material and Method: Three hundred fifty patients underwent thyroidectomy for multinodular goiter between May 2003 and October 2010. All patients were diagnosed as multinodular goiter and were referred to surgery by one endocrinologist. All operations were also performed by one surgeon using microsurgical techniques. Partial thyroidectomy (bilateral subtotal or unilateral total thyroidectomy and contralateral subtotal thyroidectomy) was performed in 65 patients (Group-1) and extracapsular total thyroidectomy was performed in 285 patients (Group-2). All patients are being followed followed from the day they were diagnosed until now by the same endocrinologist. Fisher exact test was used for statistical analysis. Results: In Group-1, one patient had transient vocal-cord palsy and but none had hypoparathyroidism. On the other hand, in Group-2, two patients had transient vocal-cord palsy, five had hypocalcemia (one was permanent), and one had a hematoma. Mortality and wound infection were absent in both groups. The histopathological studies showed that 40 incidental thyroid carcinomas occurred among Group-2 patients. During long-term follow-up, 13 patients had goiter recurrence (n = 65, 20%) in Group-1, whereas none had goiter recurrence in Group-2. Conclusion: There were no statistically significant differences in the complication rate between subtotal and total thyroidectomy groups (p>0.05). However, the recurrence rate was higher (statistically significant) after subtotal thyroidectomy than after total thyroidectomy (p<0.05). Total thyroidectomy eliminated future recurrence of the disease and is also curative in incidental thyroid carcinomas. In addition, it can be safely performed using microsurgical techniques.

Proximal fusion constructs in minimally invasive scoliosis surgery are successful without interbody or intertransverse fusion

2019 ◽  
Vol 31 (6) ◽  
pp. 851-856
Author(s):  
S. Shelby Burks ◽  
Juan S. Uribe ◽  
John Paul G. Kolcun ◽  
Adisson Fortunel ◽  
Jakub Godzik ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Deformity Correction ◽  
Scoliosis Surgery ◽  
Inclusion Criteria ◽  
Female Ratio ◽  
Adult Deformity ◽  
Male Female Ratio ◽  
Invasive Techniques

OBJECTIVEMinimally invasive techniques are increasingly used in adult deformity surgery as surgeon familiarity improves and long-term data are published. Concerns raised in such cases include pseudarthrosis at levels where interbody grafts are not utilized. Few previous studies have specifically examined the thoracolumbar component of long surgical constructs, which is commonly instrumented without interbody or intertransverse fusion.METHODSA retrospective analysis was performed on all patients who underwent hybrid minimally invasive deformity corrections in two academic spine centers over a 9-year period. Inclusion criteria were at least 2 rostral levels instrumented percutaneously, ranging from T8 to L1 as the upper end of the construct. Fusion assessment was made using CT when possible or radiography. Common radiographic parameters and clinical variables were assessed pre- and postoperatively.RESULTSA total of 36 patients fit the inclusion criteria. Baseline characteristics included a 1:1.8 male/female ratio, average age of 65.7 years, and BMI of 30.2 kg/m2. Follow-up imaging was obtained at a mean of 35.7 months. The average number of levels fused was 7.5, with an average of 3.4 instrumented percutaneously between T8 and L1, representing a total of 120 rostral levels instrumented percutaneously. Fusion assessment was performed using CT in 69 levels and radiography in 51 levels. Among the 120 rostral levels instrumented percutaneously, robust fusion was noted in 25 (20.8%), with 53 (44.2%) exhibiting some evidence of fusion. Pseudarthrosis was noted in 2 rostral segments (1.7%). There were no instances of proximal hardware revision. Eight patients exhibited radiographic proximal junctional kyphosis (PJK; 22.2%), none of whom underwent surgical intervention.CONCLUSIONSIn the present series of adult patients with scoliosis undergoing thoracolumbar deformity correction, rostral segments instrumented percutaneously have a very low rate of pseudarthrosis, with radiographic evidence of bone fusion occurring in more than 60% of patients. The rate of PJK was acceptable and similar to other published series.

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

scholarly journals Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases

2021 ◽  
Vol 09 (02) ◽  
pp. E258-E262
Author(s):  
Christian Suchy ◽  
Moritz Berger ◽  
Ingo Steinbrück ◽  
Tsuneo Oyama ◽  
Naohisa Yahagi ◽  
...  
Keyword(s):  
Case Series ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Published Data ◽  
Low Grade ◽  
Recurrence Rates ◽  
En Bloc ◽  
Long Term Follow Up

Abstract Background and study aims We previously reported a case series of our first 182 colorectal endoscopic submucosal dissections (ESDs). In the initial series, 155 ESDs had been technically feasible, with 137 en bloc resections and 97 en bloc resections with free margins (R0). Here, we present long-term follow-up data, with particular emphasis on cases where either en bloc resection was not achieved or en bloc resection resulted in positive margins (R1). Patients and methods Between September 2012 and October 2015, we performed 182 consecutive ESD procedures in 178 patients (median size 41.0 ± 17.4 mm; localization rectum vs. proximal rectum 63 vs. 119). Data on follow-up were obtained from our endoscopy database and from referring physicians. Results Of the initial cohort, 11 patients underwent surgery; follow-up data were available for 141 of the remaining 171 cases (82,5 %) with a median follow-up of 2.43 years (range 0.15–6.53). Recurrent adenoma was observed in 8 patients (n = 2 after margin positive en bloc ESD; n = 6 after fragmented resection). Recurrence rates were lower after en bloc resection, irrespective of involved margins (1.8 vs. 18,2 %; P < 0.01). All recurrences were low-grade adenomas and could be managed endoscopically. Conclusions The rate of recurrence is low after en bloc ESD, in particular if a one-piece resection can be achieved. Recurrence after fragmented resection is comparable to published data on piecemeal mucosal resection.

Good long-term patency: 10-year follow-up using the mid-thigh adductor loop arteriovenous graft

2018 ◽  
Vol 20 (3) ◽  
pp. 313-320 ◽  
Author(s):  
Samantha J McEwan ◽  
Hannah Maple ◽  
Paul J Gibbs
Keyword(s):  
Venous Access ◽  
Fistula Formation ◽  
Published Data ◽  
Arteriovenous Graft ◽  
Patient Journey ◽  
Graft Thrombosis ◽  
Arteriovenous Grafts ◽  
Good Patency

Introduction: Definitive access in patients requiring renal replacement therapy is an ever-increasing challenge. For those where autogenous venous access is no longer a viable option, arteriovenous grafts can be considered. This article describes long-term follow-up, complications and patency rates of the mid-thigh ‘adductor loop’ arteriovenous graft. Methods: 50 mid-thigh loop arteriovenous grafts have been inserted into 48 patients in our unit over the past 11 years. A prospective database was collected on patients receiving an arteriovenous graft at our unit by the senior author. All remained under the care of our unit ensuring accurate follow-up data collection and database was updated at regular intervals. Results: Death-only censored primary patency at 1, 3 and 5 years was 76%, 44% and 23%, respectively. Patients receiving transplants were not censored as follow-up of the arteriovenous grafts was possible. Secondary patency at 1, 3 and 5 years was 95%, 63% and 45%. These rates are higher than previous studies looking at lower limb arteriovenous grafts. Graft thrombosis occurred in 14 patients (28%). Six patients were treated for an infection (12%) but only four grafts were excised; much lower than documented in previous studies. Conclusion: Autogenous venous access remains the perceived gold standard for patients requiring dialysis for end stage renal failure, despite some published data reporting poor outcomes. We have shown that adductor loop arteriovenous grafts can be a reliable, safe and long-term alternative in those whom fistula formation is not possible and may have a role earlier in the patient journey than previously thought, as a result of good patency and lower complications.

scholarly journals Twist drill aspiration of chronic subdural hematoma at the Ignace Deen hospital of Conakry

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Alpha Boubacar Bah ◽  
Seylan Diawara ◽  
Ibrahima Sory Souare ◽  
Abdoulaye Barry ◽  
Ansoumane Donzo ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Outcome Data ◽  
Twist Drill ◽  
Suitable Alternative ◽  
Female Ratio ◽  
Tertiary Centre ◽  
Male Female Ratio ◽  
Reasonable Approach

Bedside percutaneous twist drill aspiration (TDA) is described as a surgical method of management of Chronic subdural hematoma (CSDH) and appear to be a reasonable approach in low medical resources environment. We report the results of TDA of CSDH in a single tertiary centre in Conakry Republic of Guinea in West Africa, for the period March 2015 to October 2017. The charts and medical record of 38 cases of CSDH treated with TDA were collected retrospectively, with a mean follow-up of 84.2 days. The outcome data assessed were neurologic status evaluated by the follow-up Markwalder grading scale (MGS: 0=normal to 4=coma), recurrence, infection and mortality. The Male-Female ratio was 1.3:1. Mean age at diagnosis was 78.2+/-12 years. Traumatic brain injury (TBI) was identified as causal in 28.2% of cases studied. All patients were operated on under local anesthesia and had a postoperative drain left in place for 3 days. The mean postoperative MGS was 1.06, up from a mean preoperative MGS of 3.7. Two cases of recurrence occurred subsequent to TDA causing death and three other patients died from unknown causes during the follow-up period. No cases of post-operative infection were diagnosed during the follow-up. Our study shows that Bedside TDA appears to be a suitable alternative to burr hole craniotomies in urgent cases of CSDH in the low socio-economic setting, where a surgical theatre is not always available.

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