scholarly journals Operative Management of Neonatal Lymphatic Malformations: Lesson Learned From 57 Consecutive Cases

2021 ◽  
Vol 9 ◽  
Author(s):  
Marianna Scuglia ◽  
Andrea Conforti ◽  
Laura Valfrè ◽  
Giorgia Totonelli ◽  
Chiara Iacusso ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Residual Disease ◽  
Statistical Significance ◽  
Operative Management ◽  
Fisher Exact Test ◽  
Lymphatic Malformations ◽  
Exact Test ◽  
Life Threatening ◽  
Group A ◽  
Group B

Aim of the study: Lymphatic malformations (LMs) are rare entities, sometimes difficult to treat, that may be life-threatening when intricately connected to airway structures. Invasive treatments are occasionally required, with sclerotherapy considered the treatment of choice and surgery as a second-line approach. The aim of the present study was to evaluate our multidisciplinary team experience in treating newborns affected by LMs requiring operative management, while defining early outcomes.Methods: Retrospective review of all consecutive patients admitted for LMs requiring operative management between January 2000 and January 2019. Patients were mainly characterized based on anatomical district of the LM (and further stratified based on the development of respiratory distress), need for tracheostomy, number of sclerotherapies, indication for surgery, and residual disease beyond the 1st year. Morbidity and mortality were also evaluated. Fisher exact test and Mann–Whitney test were used as appropriate. Statistical significance was set at p < 0.05.Results: Fifty-seven patients were included in the study, 36 with cervicofacial and/or mediastinal LMs and 21 with LMs of other anatomical districts. Due to the risk of developing respiratory distress at birth, patients with cervicofacial and/or mediastinal LMs were divided into two groups (8/36 group A vs. 28/36 group B). Group A patients are at higher risk for tracheostomy (7/8 group A vs. 1/28 group B, p = 0.0001) and more often require surgical reduction of the residual lymphatic abnormality (5/8 group A vs. 4/28 group B, p = 0.013). They also require sclerotherapies more often, but the difference is not statistically significant (8/8 group A vs. 19/28 group B, p = 0.15). Patients with cervicofacial/mediastinal LMs frequently suffer from persistent residual disease beyond the 1st year of life, significantly more often in group A (7/8 group A vs. 12/28 group B, p = 0.043).Conclusion: LMs are rare conditions with potential life-threatening behavior. Their intrinsic clinical complexity requires a multidisciplinary approach to the affected patients. Planning a long-term follow-up is essential because of the late-term problems those patients may experience.

Prevention of postoperative posterior tethering of spinal cord after resection of ependymoma

2003 ◽  
Vol 99 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Takeo Goto ◽  
Kenji Ohata ◽  
Toshihiro Takami ◽  
Misao Nishikawa ◽  
Akimasa Nishio ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neurological Deterioration ◽  
Fisher Exact Test ◽  
Content Type ◽  
Exact Test ◽  
Spinal Ependymoma ◽  
Group A ◽  
Delayed Neurological Deterioration ◽  
Group B ◽  
Fine Print

Object. The authors evaluated an alternative method to avoid postoperative posterior tethering of the spinal cord following resection of spinal ependymomas. Methods. Twenty-five patients with spinal ependymoma underwent surgery between 1978 and 2002. There were 16 male and nine female patients whose ages at the time of surgery ranged from 14 to 64 years (mean 41.8 years). The follow-up period ranged from 6 to 279 months (mean 112.4 months). In the initial 17 patients (Group A), the procedure to prevent arachnoidal adhesion consisted of the layer-to-layer closure of three meninges and laminoplasty. In the subsequently treated eight patients (Group B), the authors performed an alternative technique that included pial suturing, dural closure with Gore-Tex membrane—assisted patch grafting, and expansive laminoplasty. In Group A, postoperative adhesion was radiologically detected in eight cases (47%), and delayed neurological deterioration secondary to posterior tethering of the cord was found in five cases. In Group B, there was no evidence of adhesive posterior tethering or delayed neurological deterioration. A significant intergroup statistical difference was demonstrated for radiologically documented posterior tethering (p < 0.05, Fisher exact test). Moreover, patients with radiologically demonstrated posterior tethering suffered a significant delayed neurological functional deterioration (p < 0.01, Fisher exact test). Conclusions. This new technique for closure of the surgical wound is effective in preventing of postoperative posterior spinal cord tethering after excision of spinal ependymoma.

scholarly journals Single penile incision for combined hypospadias and inguinal surgery: A comparative study

2017 ◽  
Vol 11 (5) ◽  
pp. 192
Author(s):  
Michael E. Chua ◽  
Naif Alqarni ◽  
Jessica M. Ming ◽  
Fahad Alyami ◽  
Joana Dos Santos ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Operative Time ◽  
Conventional Approach ◽  
Fisher Exact Test ◽  
Hypospadias Repair ◽  
Exact Test ◽  
Group A ◽  
Baseline Characteristics ◽  
Group B ◽  
Inguinal Surgery

Introduction: We sought to compare the surgical outcomes of hypospadias repair with correction of inguinal pathology using a single penile incision vs. conventional approach using two incisions.Methods: This is a retrospective study that reviewed all patients who underwent concurrent surgical repair for both hypospadias and inguinal pathologies between January 2003 and November 2015. Patients were classified into Group A, conventional (inguinal or scrotal and penile incision) approach; or Group B, single penile incision approach. Baseline characteristics, including age, degree of hypospadias, type and laterality of inguinal pathology, operative time, and surgical outcomes, were collected. Between groups, variable comparisons were analyzed using Mann-Whitney U-Test and Fisher-exact test. Statistical significant set at <0.05.Results: Seventy-six patients (Group A: 40; Group B: 36) were eligible for study. Baseline characteristics of both groups were comparable, with no significant statistical difference. Overall meanoperative time for Group A was 139.3 ± 56.2 minutes, while Group B was 107.8 ± 46.7 minutes (Z=2.6; U=470.5; p=0.009). Two patients in Group A and two patients in Group B had testicularascension, all of which also had hypospadias-related complications (p=1.0). Hypospadias-related complications in Group A included seven urethrocutaneous fistulae and two repair dehiscence. Eighturethrocutaneous fistulae, one urethral stricture, and two repair dehiscence occurred in Group B (p=0.448). Surgical outcome appearance in both groups were comparable, with no statisticallysignificant difference (p=0.466).Conclusions: Single penile incision for both hypospadias repair and correction of inguinal pathology is a feasible technique and comparable to the conventional approach, with similar surgical outcomes and shorter overall operative time.

Three-Year Experience with Totally Endoscopic Robotic Thymectomy

2006 ◽  
Vol 1 (3) ◽  
pp. 111-114 ◽  
Author(s):  
Charles Y. Ro ◽  
Joseph J. DeRose ◽  
Cliff P. Connery ◽  
Sandhya K. Balaram ◽  
Robert C. Ashton
Keyword(s):  
Myasthenia Gravis ◽  
Operation Time ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Entire Cohort ◽  
Bilateral Approach ◽  
Group A ◽  
Robotic Thymectomy ◽  
Group B ◽  
Robotic Resection

Background Robotic technology has facilitated the evaluation and treatment of anterior mediastinal pathology. We describe a 3-year experience using the da Vinci Robotic Surgical System to perform thymectomies for a range of diseases. Methods From March 2002 to November 2004, 9 patients (3 myasthenia gravis, 3 mediastinal mass, 2 myasthenia gravis plus thymoma, 1 hyperparathyroidism) underwent totally endoscopic robotic thymectomy. Medical records and operative databases were reviewed. The cohort was divided into an early experience (group A) and a later experience (group B). Data were analyzed with the Fisher exact test and Mann-Whitney test. Results Complete robotic resection of the thymus was accomplished in all 9 patients. The mean age for the entire cohort was 40 ± 12 years (range 28–66 years) and 78% of the patients were women. No significant differences in age, gender, or operative conversions were detected between the groups. Patients in group A were more likely to have a bilateral approach. Group B demonstrated statistically significant reductions in operating room and operation time and a trend toward decreased chest tube days and length of stay. No morbidity or mortality associated with the procedure was noted in either group. Conclusions Robotic thymectomy is a safe and effective procedure. Its steep learning curve promises to allow more surgeons to adopt minimally invasive approaches to the mediastinum safely and efficiently.

scholarly journals Effectiveness of Buteyko Breathing Technique versus Nadi Shuddhi Pranayama to Improve Pulmonary Function in Subjects with Bronchial Asthma

2021 ◽  
Vol 6 (4) ◽  
pp. 124-135
Author(s):  
G Swathi ◽  
T Sunil Kumar ◽  
N Raghunadh
Keyword(s):  
Pulmonary Function ◽  
Bronchial Asthma ◽  
Statistical Significance ◽  
T Test ◽  
Age Group ◽  
Consent Document ◽  
Post Test ◽  
Life Threatening ◽  
Group A ◽  
Group B

Background: Asthma is a chronic life-threatening disease as the airways in the lungs often swollen or inflamed, which makes the airways very sensitive. So, the exposure to the environment in day-to-day life triggers asthma. Asthma can affect at any age group. This study mainly focuses on comparing the effects of Buteyko breathing technique and Pranayama on improving Pulmonary Function in subjects with Bronchial Asthma. Method: Total of 79subjects selected, out of those 66 subjects were included after obtaining the consent document. Subjects are divided into two groups by lottery method, in which 6 subjects dropped. So, the study was completed with 60 subjects. Both groups performed intervention for 1 hour a day 5 days week for 4 weeks. The outcomes of the study were FEV1, FVC & FEV1/FVC ratio. Results: Paired t test was used to assess statically significance between pre and post test scores with in the groups, independent t test was used to access statistical significance of post-test mean score between the groups, statistical analysis of the data revealed that Buteyko Breathing technique group has more difference when compare to Pranayama group. Conclusion: The results had shown that both Group-A (Buteyko Breathing Group) and Group-B (Pranayama Group) has improved significantly on pre and post-test values within the groups but when compared between the groups statistical significance is noted in Group-A. So, this study concludes that Group-A showed significant improvement on Pulmonary Function in subjects with Bronchial Asthma. Keywords: Buteyko Breathing technique, Nadishuddhi Pranayama, FEV1/FVC, Bronchial Asthma.

scholarly journals Influence of Irrigation with NaOCl and Chlorhexidine on Microleakage

2015 ◽  
Vol 19 (1) ◽  
pp. 38-42
Author(s):  
Zoumpoulia Mylona ◽  
Christos Gogos ◽  
Nikolaos Economides
Keyword(s):  
Fisher Exact Test ◽  
Human Teeth ◽  
Fluid Filtration ◽  
Filtration Method ◽  
Exact Test ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Endodontic Sealers

SUMMARYBackground: Irrigation during endodontic therapy is required in order to remove debris, tissue remnants, microbes and smear layer. Sodium hypochlorite (NaOCl) and Chlorhexidine (CHX) are the most commonly used irrigants. Although they are reported to have good antimicrobial effects, both have limitations. Hence, a combination of NaOCl and CHX has been proposed to compensate for these limitations. However, this association forms a dense, orange-brown precipitate that stains walls of the pulp chamber. The aim of this study was to clarify in vitro if this precipitate affects the microleakage of endodontic sealers.Material and Methods: Extracted human teeth were used for this study. The teeth were cut at the height of the cervix and instrumented with NiTi rotary instruments. They were then divided into 2 experimental groups. In the first group (Group A) irrigations were performed with 2ml NaOCl 1%, 1ml EDTA 17% and 1ml CHX 0.2% and in the second (Group B) with 2ml NaOCl and 2ml CHX. Following this, they were obturated with gutta-percha and roth sealer. The microleakage was determined using a fluid filtration method. The measurements were repeated a month later. All analyses were performed using Fisher exact test.Results: Microleakage of Group A was lower than microleakage of Group B but the difference was not statistically significant.Conclusion: The precipitate that is formed by NaOCl and CHX did not affect microleakage of endodontic sealers.

Emerging Concepts in Airway Infantile Hemangioma Assessment and Management

2009 ◽  
Vol 141 (2) ◽  
pp. 207-212 ◽  
Author(s):  
Jonathan A. Perkins ◽  
William Duke ◽  
Eunice Chen ◽  
Scott Manning
Keyword(s):  
Infantile Hemangioma ◽  
Primary Treatment ◽  
Fisher Exact Test ◽  
Pediatric Hospital ◽  
Exact Test ◽  
New Methods ◽  
Group A ◽  
Group B ◽  
New Treatments ◽  
Intralesional Steroids

OBJECTIVE: The purpose of this study was to evaluate changes in airway infantile hemangioma treatment. STUDY DESIGN: Retrospective. SUBJECTS: Airway hemangioma patients, tertiary pediatric hospital. METHODS: Data collected included age at diagnosis, evaluation methods, hospitalizations, airway size, and interventions. Patients were divided into group A (1981–1993) and group B (1994–2005) and were analyzed using descriptive statistics, the Fisher exact test, and the Student t test. RESULTS: Thirty-two subjects were identified. Nasopharyngoscopy was used more in group B (11/16 [69%]) than group A (4/16 [25%], P = 0.032). CT angiography (3/16 [19%]) and laryngeal distractors (11/16 [69%]) were only used in group B; these techniques showed airway hemangiomas to be “transglottic,” not just “subglottic.” Intralesional steroids alone (3/16 [19%]) and primary hemangioma excision (2/16 [13%]) were new treatments used in group B. Frequent direct laryngoscopies (>six) correlated with tracheotomy (5/32 [16%], P = 0.015). Presenting age (<2 months) impacted treatment more than airway hemangioma size. CONCLUSIONS: New methods of airway infantile hemangioma assessment changed our concept of airway hemangiomas and their primary treatment.

Treatment of anterior communicating artery aneurysms: complementary aspects of microsurgical and endovascular procedures

2003 ◽  
Vol 99 (1) ◽  
pp. 3-14 ◽  
Author(s):  
François Proust ◽  
Bertrand Debono ◽  
Didier Hannequin ◽  
Emmanuel Gerardin ◽  
Erick Clavier ◽  
...  
Keyword(s):  
Morbidity And Mortality ◽  
Anterior Communicating Artery ◽  
Fisher Exact Test ◽  
Content Type ◽  
Exact Test ◽  
Excellent Outcome ◽  
Group A ◽  
Permanent Morbidity ◽  
Group B ◽  
Fine Print

Object. Endovascular and surgical treatment must be clearly defined in the management of anterior communicating artery (ACoA) aneurysms. In this study the authors report their recent experience in using a combined surgical and endovascular team approach for ACoA aneurysms, and compare these results with those obtained during an earlier period in which surgical treatment was used alone. Morbidity and mortality rates, causes of unfavorable outcomes, and morphological results were also assessed. Methods. The prospective study included 223 patients who were divided into three groups: Group A (83 microsurgically treated patients, 1990–1995); Group B (103 microsurgically treated patients, 1996–2000); and Group C (37 patients treated with Guglielmi Detachable Coil [GDC] embolization, 1996–2000). Depending on the direction in which the aneurysm fundus projected, the authors attempted to apply microsurgical treatment to Type 1 aneurysms (located in front of the axis formed by the pericallosal arteries). They proposed the most adapted procedure for Type 2 aneurysms (located behind the axis of the pericallosal arteries) after discussion with the neurovascular team, depending on the physiological status of the patient, the treatment risk, and the size of the aneurysm neck. In accordance with the classification of Hunt and Hess, the authors designated those patients with unruptured aneurysms (Grade 0) and some patients with ruptured aneurysms (Grades I–III) as having good preoperative grades. Patients with Grade IV or V hemorrhages were designated as having poor preoperative grades. By performing routine angiography and computerized tomography scanning, the causes of unfavorable outcome (Glasgow Outcome Scale [GOS] score < 5) and the morphological results (complete or incomplete occlusion) were analyzed. Overall, the clinical outcome was excellent (GOS Score 5) in 65% of patients, good (GOS Score 4) in 9.4%, fair (GOS Score 3) in 11.6%, poor (GOS Score 2) in 3.6%, and fatal in 10.3% (GOS Score 1). Among 166 patients in good preoperative grades, an excellent outcome was observed in 134 patients (80.7%). The combined permanent morbidity and mortality rate accounted for up to 19.3% of patients. The rates of permanent morbidity and death that were related to the initial subarachnoid hemorrhage were 6.2 and 1.5% for Group A, 6.6 and 1.3% for Group B, and 4 and 4% for Group C, respectively. The rates of permanent morbidity and death that were related to the procedure were 15.4 and 1.5% for Group A, 3.9 and 0% for Group B, and 8 and 8% for Group C, respectively. When microsurgical periods were compared, the rate of permanent morbidity or death related to microsurgical complications decreased significantly (Group A, 11 patients [16.9%] and Group B, three patients [3.9%]); Fisher exact test, p = 0.011) from the period of 1990 to 1995 to the period of 1996 to 2000. The combined rate of morbidity and mortality that was related to the endovascular procedure (16%) explained the nonsignificance of the different rates of procedural complications for the two periods, despite the significant decrease in the number of microsurgical complications. Among 57 patients in poor preoperative grade, an excellent outcome was observed in 11 patients (19.3%); however, permanent morbidity (GOS Scores 2–4) or death (GOS Score 1) occurred in 46 patients (80.7%). With regard to the correlation between vessel occlusion (the primary microsurgical complication) and the morphological characteristics of aneurysms, only the direction in which the fundus projected appeared significant as a risk factor for the microsurgically treated groups (Fisher exact test: Group A, p = 0.03; Group B, p = 0.002). The difference between endovascular and microsurgical procedures in the achievement of complete occlusion was considered significant (χ2 = 6.13, p = 0.01). Conclusions. The direction in which the fundus projects was chosen as the morphological criterion between endovascular and surgical methods. The authors propose that microsurgical clip application should be the preferred option in the treatment of ACoA aneurysms with anteriorly directed fundi and that endovascular packing be selected for those lesions with posteriorly directed fundi, depending on morphological criteria.

scholarly journals Intralesional 3% sodium tetradecyl sulphate versus hot water in oral cavity hemangioma: a comparative study

2021 ◽  
Vol 7 (11) ◽  
pp. 1768
Author(s):  
Sayambika Mishra ◽  
Souvagini Acharya ◽  
Arunima Kar ◽  
Fakir Mohan Mohanta ◽  
Smruti Ranjan Samal
Keyword(s):  
Oral Cavity ◽  
Statistical Significance ◽  
Hot Water ◽  
Surgical Ablation ◽  
Easy Method ◽  
Life Threatening ◽  
Group A ◽  
Sodium Tetradecyl Sulphate ◽  
Group B ◽  
Care Procedure

<p class="abstract"><strong>Background:</strong> Oral cavity lesions fall among the few most common presentations in the outpatient department of ENT. Hemangioma in oral cavity though do not usually account for any life threatening or serious condition but hampers day to day activities like chewing, speaking and occasionally bleeding from oral cavity. Timely diagnosis and treatment solves the above problem. Though there are various modalities of treatment ranging from cryosurgery to surgical ablation, sclerotherapy is an evolving, effective and easy method for reduction of the size of lesion and preventing recurrence. It can be done as a day care procedure. The aim was to compare between the efficacy of 3% sodium tetradecyl sulphate and hot water in oral cavity hemangiomas.</p><p class="abstract"><strong>Methods:</strong> A total of 20 patients presenting to the OPD, department of ENT, VIMSAR, Burla, with diagnosis of hemangioma in oral cavity between January 2018 to January 2019 were selected for the study. They were divided into two groups. Group A was administered 3% sodium tetradecyl sulphate whereas group B was administered hot water, both intralesionally, at multiple sites of lesion. Injection were repeated after an interval of 2 weeks for a period of 3-4 months. The results were routinely analysed clinically and statistically and the statistical significance was set at p&lt;0.05.</p><p class="abstract"><strong>Results:</strong> There was a significant improvement (p&lt;0.05) in most of the parameters measured, in group A patients as compared to group B patients.</p><p class="abstract"><strong>Conclusions:</strong> 3% sodium tetradecyl sulphate is a better sclerosing agent than hot water in cases of oral cavity hemangiomas.</p>

scholarly journals Immunohistochemical Evaluation of Gingival CD4+ lymphocytes in Response to Allograft Bone Powder (Ceno Bone) - Animal Study

2021 ◽  
Vol 3 (1) ◽  
pp. 17-21
Author(s):  
Hadis Moradi ◽  
Ahmad Motaghi ◽  
Atousa Aminzadeh ◽  
Alireza Sadighi ◽  
Mohammad Hossein Shafazand
Keyword(s):  
Connective Tissue ◽  
Fisher Exact Test ◽  
Allergic Reactions ◽  
Chi Square ◽  
Exact Test ◽  
Bone Powder ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Cd4 Lymphocytes

CD4 T lymphocytes play a central role in allergic reactions. Thus the present study aimed to, immunohistochemically, evaluate the presence of these lymphocytes in rabbit gingival tissues after the replacement of Cenobone. This experimental one way blinded study was performed on 20 gingival tissues gathered from disease-free rabbits with or without bone powder, respectively groups A and B. Immunohistochemical envision method was performed for mapping CD4 lymphocytes. The number and intensity of staining were compared between groups in 5 consequent HPF without overlap with the light microscope in connective tissue. Data were analyzed by Fisher exact test, Wilcoxon, and chi-square statistically in SPSS20 software. The number of CD4 T cells was higher in group A compared to group B.(P=0.02) Pattern of distribution in connective tissue did not show a difference between the two groups. (P=0.41). Results of the present study might confirm the role of CD4 T in an allergic reaction to bone powder material and suggest this cell as a useful factor for the prediction of allergic reactions in the first weeks of surgery. Further studies in this field are required.

scholarly journals Comparison of Propofol Vs Thiopentone in Post Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Statistical Significance ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Fisher Exact Test ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  

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