Surgical correction of pectus excavatum in an adult with the use of thoracoscopic intercostal nerve cryoablation

2021 ◽  
pp. 61-69
Author(s):  
Aleksey N. Lednev ◽  
Aleksey Aleksandrovich Pechetov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Surgical Approach ◽  
Pectus Excavatum ◽  
Intercostal Nerve ◽  
Regional Analgesia ◽  
Alternative Approach ◽  
Prevention And Treatment ◽  
Optimal Technology ◽  
Modern Technologies

Despite the improvement of the surgical approach for the correction of pectus pectus deformity, the reduction of the invasiveness of the intervention and the use of modern technologies, the optimal technology for the prevention and treatment of postoperative pain has not yet been determined. We have presented an alternative approach to regional analgesia for surgical treatment of pectus excavatum.

scholarly journals Harmonic scalpel® hemorrhoidectomy: A painless procedure?

2007 ◽  
Vol 60 (9-10) ◽  
pp. 421-426 ◽  
Author(s):  
Dejan Ivanov ◽  
Sinisa Babovic ◽  
Dora Selesi ◽  
Mirjana Ivanov ◽  
Radovan Cvijanovic
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Surgical Approach ◽  
Surgical Procedure ◽  
Thermal Damage ◽  
Harmonic Scalpel ◽  
Hemorrhoidal Disease ◽  
Disease Stage ◽  
Analog Scale

Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel? hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoid disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel? hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease. .

scholarly journals Intercostal nerve cryoablation versus thoracic epidural for postoperative analgesia following pectus excavatum repair: a systematic review and meta-analysis

2020 ◽  
Vol 31 (4) ◽  
pp. 486-498
Author(s):  
Jean H T Daemen ◽  
Erik R de Loos ◽  
Yvonne L J Vissers ◽  
Maikel J A M Bakens ◽  
Jos G Maessen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Hospital Stay ◽  
Pectus Excavatum ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Intercostal Nerve ◽  
Nuss Procedure ◽  
Thoracic Epidural

Abstract OBJECTIVES Minimally invasive pectus excavatum repair via the Nuss procedure is associated with significant postoperative pain that is considered as the dominant factor affecting the duration of hospitalization. Postoperative pain after the Nuss procedures is commonly controlled by thoracic epidural analgesia. Recently, intercostal nerve cryoablation has been proposed as an alternative method with long-acting pain control and shortened hospitalization. The subsequent objective was to systematically review the outcomes of intercostal nerve cryoablation in comparison to thoracic epidural after the Nuss procedure. METHODS Six scientific databases were searched. Data concerning the length of hospital stay, operative time and postoperative opioid usage were extracted. If possible, data were submitted to meta-analysis using the mean of differences, random-effects model with inverse variance method and I2 test for heterogeneity. RESULTS Four observational and 1 randomized study were included, enrolling a total of 196 patients. Meta-analyses demonstrated a significantly shortened length of hospital stay [mean difference −2.91 days; 95% confidence interval (CI) −3.68 to −2.15; P < 0.001] and increased operative time (mean difference 40.91 min; 95% CI 14.42–67.40; P < 0.001) for cryoablation. Both analyses demonstrated significant heterogeneity (both I2 = 91%; P < 0.001). Qualitative analysis demonstrated the amount of postoperative opioid usage to be significantly lower for cryoablation in 3 out of 4 reporting studies. CONCLUSIONS Intercostal nerve cryoablation during the Nuss procedure may be an attractive alternative to thoracic epidural analgesia, resulting in shortened hospitalization. However, given the low quality and heterogeneity of studies, more randomized controlled trials are needed.

Clinical experience of quartz reinforcing mesh usage in production of full removable laminar upper dentures

2019 ◽  
pp. 4-9
Author(s):  
V.G. Galonsky ◽  
B.F. Cherkashin ◽  
A.A. Kharlamova ◽  
S.V. Kungurov ◽  
A.V. Gradoboev ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Clinical Observation ◽  
Acrylic Plastic ◽  
Orthopaedic Treatment ◽  
Alternative Approach ◽  
Removable Denture ◽  
Edentulous Patients ◽  
Metal Meshes ◽  
Modern Technologies

The study is devoted to one of relevant topics in orthopaedic dentistry: orthopaedic treatment for fully edentulous patients with application of removable laminar dentures the basis of which is produced from acrylic plastic. The main problem of this approach has been formulated: the possibility of frequent crashing of the basis by the patient within earlier and later periods after the beginning of prosthesis exploitation. Options in prevention of this problem have been considered — reinforcing of the denture basis using standard and individually produced metal meshes — as well as their disadvantages. A study based on longitudinal clinical observation within terms of up to five years of exploitation effectiveness in quartz reinforcing mesh application to removable denture bases as an alternative approach to modern technologies has been carried out. Application features and advantages of this technology have been presented.

scholarly journals An alternative approach for complicated prosthetic aortic valve endocarditis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Dimos Karangelis ◽  
Argyris Krommydas ◽  
Fotios A. Mitropoulos
Keyword(s):  
Surgical Treatment ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Pericardial Patch ◽  
Safe Alternative ◽  
Case Presentation ◽  
Prosthetic Aortic Valve ◽  
Alternative Approach ◽  
Sutureless Valve ◽  
Valve Implantation

Abstract Background Surgical treatment of prosthetic valve endocarditis (PVE) with destruction of the aortic root and aortomitral continuity is demanding even in experienced hands. Case presentation Herein, we describe a case of a 71-year-old female patient who presented with PVE that was further complicated by a fistulous abscess cavity. The patient underwent removal of the dehisced prosthetic valve, radical annular debridement, reconstruction of the aortomitral curtain with a pericardial patch as a patch exclusion technique and implantation of a sutureless valve. Conclusion Patch exclusion technique, followed by sutureless valve implantation, might represent a feasible and safe alternative for the surgical treatment of complicated PVE.

scholarly journals Complex corrective procedure in surgical treatment of asymmetrical pectus excavatum

2017 ◽  
Vol 2 ◽  
pp. 110-114
Author(s):  
Krystian Pawlak ◽  
Łuksasz Gąsiorowski ◽  
Wojciech Dyszkiewicz
Keyword(s):  
Surgical Treatment ◽  
Pectus Excavatum

scholarly journals Our Parenchyma-Sparing Surgical Treatment Results in Carcinoid Tumors and Changes in the Surgical Approach

2021 ◽  
Author(s):  
Figen Türk ◽  
Gökhan Yuncu ◽  
Tolga Semerkant ◽  
Yasin Ekinci ◽  
Gökhan Öztürk
Keyword(s):  
Surgical Treatment ◽  
Carcinoid Tumor ◽  
Surgical Approach ◽  
Carcinoid Tumors ◽  
Diagnostic Methods ◽  
Normal Lung ◽  
Sleeve Resection ◽  
Surgical Methods ◽  
Prolonged Air Leak ◽  
Parenchyma Sparing

INTRODUCTION: Hilar/mediastinal lymph node sampling with lobectomy are the most common surgical methods used for the surgical treatment of carcinoid tumors. Bronchoplastic approaches together with lobectomy enable sparing of normal lung tissue and provide an alternative surgical approach to avoid pneumonectomy by enabling sleeve resection for centrally located tumors. The aim of this study was to present our parenchyma-sparing open surgical treatment experiences with the carcinoid tumor cases operated in our clinic in light of the new developments in the literature METHODS: The 11 tumor cases that had been diagnosed with carcinoid tumor and undergone surgical resection at our clinic between 2006 and 2012 were retrospectively revealed for tumor epidemiology, diagnostic methods, tumor localization, surgical treatment method, type and stage and postoperative complications. RESULTS: There were 7 males and 4 females with a mean age of 54.81±13.75 years (31-72 years). Cough was the most common presentation symptom with 8 cases (72.7%). A bronchoscopic biopsy was used for the definite diagnosis in 8 cases (72.7%). There were 11 (84.6%) typical and 2 (15.4%) atypical carcinoid tumors in the 11 cases. The most common surgical methods were lobectomy in 7 cases (53.8%) (3 sleeve, 1 bronchoplastic) and wedge resection in 4 cases. We found bilateral synchronous and 3 years later metachronous carcinoid tumor in a single case. The postoperative pathology diagnosis was T2N0M0 in 6 cases (54.5%) and T1N0M0 in 3 cases (27.2%). There was 1 atelectasis and 1 prolonged air leak in the postoperative stage. DISCUSSION AND CONCLUSION: Although we still use thoracotomy and lobectomy for the surgical treatment of carcinoid tumors in our clinic, we currently prefer minimal invasive surgery with the VATS and robotic surgery techniques that are gradually becoming more popular.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

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