scholarly journals Partial Vaginectomy, Complete Vaginectomy, Partial Vestibule-Vaginectomy, Vulvo-Vestibule-Vaginectomy and Vulvo-Vestibulectomy: Different Surgical Procedure in Order to Better Approach Vaginal Diseases

Animals ◽  
2022 ◽  
Vol 12 (2) ◽  
pp. 196
Author(s):  
Daniele Zambelli ◽  
Simona Valentini ◽  
Giulia Ballotta ◽  
Marco Cunto
Keyword(s):  
Clinical Experience ◽  
Surgical Procedure ◽  
Congenital Abnormalities ◽  
Perioperative Complications ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Correct Identification ◽  
Malignant Tumours ◽  
Anatomical Nomenclature ◽  
Vaginal Disease

Total or partial vulvo-vaginectomy or vaginectomy are not routinely performed due to the complexity of the techniques and because they are considered radical treatments. Little information can be found in the literature, as the same technique is often named in a different way by different authors, confusing the reader. Therefore, the aim of this essay is to describe five different surgical techniques: partial vaginectomy, complete vaginectomy, partial vestibule-vaginectomy, vulvo-vestibule-vaginectomy and vulvo-vestibulectomy. All techniques are described on the basis of the correct identification of the anatomical nomenclature related to structures involved in surgery, in order to give a more precise and unambiguous description and execution of surgical techniques. Moreover, possible intraoperative and perioperative complications and the authors’ clinical experience in 33 dogs are described. All techniques are well tolerated and could be curative in case of benign or malignant tumours that have not yet metastasized and palliative in other cases. Moreover, they are also useful for therapeutic purposes for chronic vaginitis, severe vaginal cysts or congenital abnormalities. It is our opinion that having five different available techniques to approach vaginal disease is useful to perform the best surgery according to the clinical findings, patient’s characteristics, technique invasiveness and whether it is palliative or not.

scholarly journals Forequarter amputation for malignant tumours of the upper extremity: Case report, techniques and indications

2007 ◽  
Vol 15 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Vanessa Dimas ◽  
Jennifer Kargel ◽  
John Bauer ◽  
Peter Chang
Keyword(s):  
Case Report ◽  
Upper Extremity ◽  
Surgical Procedure ◽  
Surgical Techniques ◽  
Malignant Tumours ◽  
Traumatic Injuries ◽  
Classic Case ◽  
Forequarter Amputation ◽  
Interscapulothoracic Amputation ◽  
Surgical Option

Forequarter (interscapulothoracic) amputation is a major ablative surgical procedure that was originally described to manage traumatic injuries of the upper extremity. Currently, it is most commonly used in the treatment of malignant tumours of the arm. With the advent of limb-sparing techniques, primary forequarter amputation is performed less frequently, but remains a powerful surgical option in managing malignant tumours of the upper extremity; therefore, surgeons should be familiar with this procedure. A classic case report of forequarter amputation, with emphasis on indications and surgical techniques, is presented.

A Lethal Syndrome of Microcephaly with Multiple Congenital Anomalies in Three Siblings

PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 610-612
Author(s):  
Richard L. Neu ◽  
Tadashi Kajii ◽  
Lytt I. Gardner ◽  
Stephen F. Nagyfy ◽  
Saddie King
Keyword(s):  
Corpus Callosum ◽  
Congenital Anomalies ◽  
Congenital Abnormalities ◽  
Clinical Findings ◽  
Cytogenetic Abnormality ◽  
Multiple Congenital Anomalies ◽  
Multiple Congenital Abnormalities

The clinical findings are described in three siblings with a syndrome of microcephaly and multiple congenital abnormalities. All three infants had congenital anomalies of the limbs, described as flexion deformities. Infant 2 showed atrophic gyri and absence of the corpus callosum, with atrophy of cerebrum, cerebellum, and pons. Infant 2 exhibited unusual canine facies. Chromosomal studies were normal on infant 3 (leucocyte and skin cultures). Leucocyte cultures from the mother and father revealed no cytogenetic abnormality.

scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

scholarly journals Prevalence of cholelithiasis in patients with chagasic megaesophagus

2011 ◽  
Vol 44 (3) ◽  
pp. 324-326 ◽  
Author(s):  
Eduardo Crema ◽  
Ellen Caroline Rosa Resende Silva ◽  
Priscila Melo Franciscon ◽  
Virmondes Rodrigues Júnior ◽  
Aiodair Martins Júnior ◽  
...  
Keyword(s):  
General Population ◽  
Chagas Disease ◽  
Biliary Tract ◽  
Surgical Procedure ◽  
Clinical Findings ◽  
Parasympathetic Nerve ◽  
Subtotal Esophagectomy ◽  
Significant Difference ◽  
The Mean ◽  
Chagasic Megaesophagus

INTRODUCTION: The prevalence of cholelithiasis in the general population ranges from 9 to 18%. This prevalence is known to be higher in the presence of parasympathetic nerve damage of the biliary tract either due to surgery (vagotomy) or neuronal destruction (Chagas disease). The objective of this study was to evaluate the association of cholelithiasis and chagasic or idiopathic megaesophagus. METHODS: The ultrasound scans of 152 patients with megaesophagus submitted to cardiomyotomy and subtotal esophagectomy surgery were evaluated. The presence of cholelithiasis was compared between chagasic and idiopathic esophagopathy and ultrasound and clinical findings were correlated with age, sex and race. RESULTS: A total of 152 cases of megaesophagus, including 137 with chagasic megaesophagus and 15 with idiopathic megaesophagus, were analyzed. The mean age was 56.7 years (45-67) in the 137 patients with chagasic megaesophagus and 35.6 years (27-44) in the 15 cases of idiopathic megaesophagus, with a significant difference between the two groups (p < 0.0001). The group with chagasic megaesophagus consisted of 59 (43%) women and 78 (56.9%) men, while the group with idiopathic megaesophagus consisted of 8 (53.3%) women and 7 (46.6%) men, showing no significant difference between the groups. Of the 137 patients with confirmed chagasic megaesophagus, 39 (28.4%) presented cholelithiasis versus one case (6.6%) in the 15 patients with idiopathic megaesophagus. CONCLUSIONS: The prevalence of cholelithiasis is high in patients with chagasic megaesophagus and preoperative ultrasound should be performed routinely in these patients in order to treat both conditions during the same surgical procedure.

scholarly journals Complications and Pitfalls in Maxillofacial Trauma

2014 ◽  
Vol 48 (2) ◽  
pp. 91-97
Author(s):  
Vidya Rattan ◽  
Sachin Rai ◽  
Shikha Yadav
Keyword(s):  
Treatment Failure ◽  
Surgical Procedure ◽  
Treatment Plan ◽  
Surgical Techniques ◽  
Maxillofacial Trauma ◽  
Trauma Surgeon ◽  
Form And Function ◽  
Fixation Devices ◽  
And Function ◽  
Made In

ABSTRACT Complications and pitfalls are unavoidable sequel of any surgical procedure. Although advances have been made in surgical techniques and fixation devices, these are far from ideal. The aim of trauma surgeon is to restore the patient to pre-injury form and function, but it may not be possible in each and every case. Treatment failure and poor outcome in a case of severe maxillofacial trauma is not uncommon. This is mainly dependent upon the extent of injury, delay in management, improper diagnosis, wrong treatment plan, poor execution of a treatment plan, wrong choice of fixation devices, inexperience of the surgeon and inability to seek help from other specialists, etc. The objective of this article is to discuss and analyze common complications and pitfalls along with the various methods and modalities to prevent and manage it. How to cite this article Rattan V, Rai S, Yadav S. Complications and Pitfalls in Maxillofacial Trauma. J Postgrad Med Edu Res 2014;48(2):91-97.

scholarly journals Simple versus complicated appendicitis

2021 ◽  
Author(s):  
Mahendra Pal Singh
Keyword(s):  
Acute Appendicitis ◽  
Clinical Experience ◽  
Surgical Techniques ◽  
Perforated Appendicitis ◽  
Complicated Appendicitis ◽  
Natural Course ◽  
Intraluminal Pressure ◽  
Research Papers

Aim of this study is to understand appendicitis in its various presentations. We encounter patients in different stages of the disease. One end of the spectrum is presenting with simple acute appendicitis while other extreme is represented by serious cases of perforated appendicitis. In between cases with various stages of complications could be seen. Simple appendicitis progresses towards complicated one in its natural course. Rise in intraluminal pressure leads to gangrenous perforation. Expertise of the treating surgeon lies in timely detection and intervention. Desired and favorable results are possible to achieve with judicious use of gastrointestinal surgical techniques by the expert. Present study reviews the literature, different research papers and studies available. My own clinical experience in the understanding of appendicitis and its management has enabled me to shape up the article.

Is Early Benign Prostatic Hyperplasia (BPH) Treatment Worthwhile?

2017 ◽  
Vol 84 (3) ◽  
pp. 142-147 ◽  
Author(s):  
Fabrizio Presicce ◽  
Cosimo De Nunzio ◽  
Andrea Tubaro
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Ad Hoc ◽  
Perioperative Complications ◽  
Evidence Synthesis ◽  
Surgical Techniques ◽  
Prostatic Hyperplasia ◽  
Treatment Result ◽  
Urinary Tract Symptoms ◽  
Patients At Risk ◽  
Risk Of Disease

Background The medical armamentaria for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) have been extensively implemented over the past decade. Nevertheless, the timeliest moment for a possible treatment has not been fully established. Evidence Acquisition A systematic literature search in January 1996 until June 2016 was performed to answer the following question: in men with LUTS due to BPH, does early treatment result in better outcome? An ad hoc Population/patient Intervention/indicator Comparator/control Outcome (PICO) was developed. The Medline, PubMed and Scopus databases were searched. Each article title and abstract were reviewed for relevance and appropriateness with regard to the topic of this review. Evidence Synthesis Overtime, the introduction of novel medications and the implementation of surgical techniques have significantly improved the treatment outcomes and markedly reduced the rate of BPH surgery. Early treatments in patients at risk of disease progression may result in better clinical outcomes than a delayed approach. However, the evidence to support early intervention remains weak and criteria to identify the patient phenotype that could best benefit from immediate treatment remain ill-defined. On the contrary, the patients who ultimately undergo surgery following prolonged pharmacological treatment present with larger prostates, older age and comorbidities. At the same time, the technological progress has partly compensated this critical scenario, and commonly, a nonpejorative trend has been recorded in perioperative complications. Conclusions The ideal moment to begin a treatment in LUTS/BPH patients is still uncertain, and surprisingly, rare good quality studies are available on this topic.

The Role of Clinical “Experience” in Diagnostic Performance

1998 ◽  
Vol 18 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Angelo Fasoli ◽  
Silvia Lucchelli ◽  
Renato Fasoli
Keyword(s):  
Pulmonary Embolism ◽  
Multiple Regression ◽  
Clinical Experience ◽  
Diagnostic Performance ◽  
Roc Curves ◽  
Clinical Findings ◽  
X Ray ◽  
Biochemical Studies ◽  
Recorded Data

Twenty-one physicians examined records of 43 patients who had attended the hospital because of chest pain. Of these patients, 20 had had coronary heart disease (CHD), 15 had had nonspecific pain, and eight had had pulmonary embolism. The physicians indicated the probability of CHD in each case on the basis of 18 clinical findings, not including ECG, x-ray, or biochemical studies. The trial was repeated five years later, using the same records, by 16 of the same physicians. Diagnostic accuracy was evaluated by ROC curves, and the weight ascribed to each cue was inferred by multiple regression with estimated probability of CHD as the dependent variable. No significant change of areas under the ROC curves with increasing length of clinical experience was observed. Multiple regression was significant in 30 of 37 analyses. The distributions of most physicians' estimates of probabilities had similar shapes five years apart. It is concluded that “experience” does not have a clear role in diagnostic performance based on recorded data and that personal calibration and preferences in estimating probabilities often persist for years.

Introduction and epidemiology

ESC CardioMed ◽  
2018 ◽  
pp. 2637-2639
Author(s):  
Hans Erik Bøtker
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Procedure ◽  
Congenital Heart ◽  
Perioperative Complications ◽  
Left Ventricular ◽  
Medical Attention ◽  
Cardiac Complications ◽  
Postoperative Risk ◽  
Number Of Patients

Perioperative complications during non-cardiac surgery depend on the condition of the patient prior to surgery, the prevalence of co-morbidities, and the magnitude, duration, and timing of the surgical procedure. Cardiac complications most frequently arise in patients with documented or asymptomatic ischaemic heart disease, left ventricular dysfunction, valvular heart disease, and arrhythmias, including the presence of a pacemaker or implantable cardioverter defibrillator, when they undergo surgical procedures that are associated with prolonged haemodynamic and cardiac stress. The increasing ageing of the population has a major impact on perioperative patient management. The number of elderly patients with co-morbidities undergoing surgery increases and new surgical and anaesthesia techniques allow surgeons to operate on patients who were previously declined. In addition, the life expectancy of children with congenital heart disease has improved. Hence, this population increasingly seeks medical attention for other illnesses, adding a rising number of patients who will undergo non-cardiac surgeries. Reduction of peri- and postoperative risk in relation to non-cardiac surgery requires a practical, stepwise evaluation of the patient that integrates clinical risk factors and test results with the estimated stress of the planned surgical procedure.

Incorporating New Technology Into a Surgical Technique: The Learning Curve of a Single Surgeon's Stereo-Electroencephalography Experience

Neurosurgery ◽  
2019 ◽  
Vol 86 (3) ◽  
pp. E281-E289 ◽  
Author(s):  
Robert A McGovern ◽  
Robert S Butler ◽  
James Bena ◽  
Jorge Gonzalez-Martinez
Keyword(s):  
Surgical Technique ◽  
Learning Curve ◽  
Clinical Experience ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
New Technology ◽  
Surgical Techniques ◽  
Vascular Imaging ◽  
New Paradigm ◽  
Cusum Analysis

Abstract BACKGROUND Technological improvements frequently outpace the publication of randomized, controlled trials in surgical patients. This makes the application of new surgical techniques difficult as surgeons solely use clinical experience to guide changes in their practice. OBJECTIVE To quantitatively examine the learning curve of incorporating new technology into a surgical technique and discuss the clinical significance of incorporating this new technology into daily practice. To identify areas of improvement for operative efficiency and safety. METHODS A retrospective observational study examining quantitative measures of operative efficiency and safety from 2009 to 2017 in 454 consecutive patients undergoing stereo-electroencephalography depth electrode implantations. RESULTS The transition to a new robotic technique significantly improved operative times (196 min [95% CI 173-219] vs 115 min [95% CI 111-118], P &lt; .0001). Cumulative sum (CUSUM) analysis demonstrated that mastery of the robotic technique took much longer than the frame-based technique (operative time peak at case 75 vs case 25, plateau of 150 vs 10 cases). Although hemorrhage rates using different vascular imaging techniques did not appear to differ using traditional statistical analysis (magnetic resonance imaging, MRI 22.3%, computed tomography angiography, CTA 17.9%, angiogram 18.1%, likelihood ratio χ2 = 4.84, P = .30), CUSUM analysis suggested MRI as the vascular imaging modality leading to higher hemorrhage and symptomatic hemorrhage rates at our center. CONCLUSION This experience demonstrates an improvement in operative efficiency through a series of changes made using clinical experience and intuition while transitioning to a completely new paradigm. CUSUM analysis identified potential areas for improvement in both operative efficiency and safety if used in a prospective manner.

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