scholarly journals Morphological and functional state of the nasal cavity after surgical interventions in the vertical section of the lacrimal ducts

2020 ◽  
Vol 5 (1) ◽  
pp. 28-31
Author(s):  
Lyubov V. Fileva ◽  
Andrey Y. Ovchinnikov
Keyword(s):  
Nasal Cavity ◽  
Mucociliary Clearance ◽  
Vertical Section ◽  
Questionnaire Data ◽  
Anatomical Structures ◽  
Surgical Interventions ◽  
Chronic Dacryocystitis ◽  
External Dacryocystorhinostomy ◽  
Group 2 ◽  
Group 1

Objectives - to compare the condition of the nasal cavity after a dacryocystorhinostomy of external and endonasal access. Material and methods. Comparative assessment of the results of the study of 96 patients with chronic dacryocystitis was done. The patients were divided into 2 groups: group 1 included persons who underwent the videoendoscopic endonasal dacryocystorhinostomy; group 2 - patients with external dacryocystorhinostomy. For all the participants, there were registered the complaints and anamnesis, the data of video-endoscopy of the nasal cavity, anterior active rhinomanometry, transport and olfactory functions. The information on the state of the nasal cavity after surgery in the vertical section of the lacrimal ducts was also obtained. Results. In both groups we revealed the changes in the mucous membrane, in the anatomical structures of the nasal cavity, in the mobility of the ciliated epithelium, respiratory functions and olfaction. When comparing the results in both groups, the statistically significant differences were found in the questionnaire data - a complaint of lacrimation, and the data on the mucociliary clearance disorders (p

The importance of clinical presentation on long-term outcomes of external dacryocystorhinostomies: Our experience on 245 cases

2021 ◽  
pp. 112067212110597
Author(s):  
Antonio Giordano Resti ◽  
Alessandro Vinciguerra ◽  
Alessandro Bordato ◽  
Andrea Rampi ◽  
Umberto Tanzini ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Clinical Signs ◽  
The Elderly ◽  
Guiding Principle ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
External Dacryocystorhinostomy ◽  
Group 2 ◽  
Group 1

Purpose External dacryocystorhinostomy (EXT-DCR) is a surgical approach commonly used to treat post-canalicular acquired lacrimal obstruction whose success rate has been described, equally with endoscopic DCR, to be superior to other available treatments. Methods At San Raffaele Hospital, Milan (Italy), from January 2008 to December 2020, 245 EXT-DCRs were performed. All patients underwent routine pre-operative work-up including Jones tests and probing and irrigation of the lacrimal pathway; when necessary, a multidisciplinary approach with nasal endoscopy was performed. The surgical approach was followed by positioning of a bicanalicular stent which was left in place for 6 months. Success was defined as resolution of clinical signs/symptoms and free lacrimal flow on functional test. Results Of the cases enrolled, 26.9% were treated for recurrent epiphora (group 1), and 73.1% for epiphora associated with chronic dacryocystitis (group 2). After a median follow-up of 71 months, group 1 had success at T0 (1 month) and T1 (long-term) of 81.8% and 60.6%, respectively, compared to 93.8% and 77.7% in group 2. Statistical analysis showed a significant association with surgery both at T0 ( p = 0.018) and T1 ( p = 0.012) with group 2 showing better outcomes. Additionally, the cosmetic outcome of the external scar was defined as invisible in 91.8% of cases and slightly visible in 8.2%. Conclusions External dacryocystorhinostomy provides long-term reliable results particularly in case of chronic dacryocystitis. Moreover, the optimal esthetic outcome of the external scar should be no longer considered the only guiding principle of treatment modality, particularly in the elderly.

Diagnosis and surgical correction of isthmocele after caesarean section

2021 ◽  
Vol 20 (3) ◽  
pp. 56-62
Author(s):  
N.S. Mikhaelyan ◽  
◽  
D.V. Bryunin ◽  
I.D. Khokhlova ◽  
T.A. Dzhibladze ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Surgical Correction ◽  
Postoperative Rehabilitation ◽  
Double Row ◽  
Anatomical Structures ◽  
Group 3 ◽  
Group 2 ◽  
Uterine Scar ◽  
Group 1

Objective. To compare the efficacy of different methods of surgical correction of isthmocele after caesarean section. Patients and methods. The study included 56 patients aged 29–41 years, who were divided into three groups: group 1 (n = 16) – patients who underwent surgical laparoscopy with suturing the uterine wound with single-row separate muscularmuscular sutures; group 2 (n = 23) – patients after repair of the uterus with a double-row continuous seromuscular and muscular-muscular suture performed by laparoscopy; group 3 (n = 17) consisted of patients who underwent laparotomy and suturing the uterine wound with a double-row continuous suture. Results. We developed a three-stage plastic and reconstructive surgical laparotomic and laparoscopic program in case of the uterine scar incompetence, which improved the quality of life in all patients. Pregnancy occurred 9–14 months after plastic and reconstructive surgery on the uterus and resulted in timely surgical delivery in 4 (25%) patients in group 1, in 7 (30.4%) patients in group 2 and in 3 (17.6%) patients in group 3. Two (12.5%) patients in group 1 and three (13.04%) patients in group 2 were observed during pregnancy with a period of 10–28 weeks. Conclusion. The use of laparoscopy ensured better visualization of anatomical structures (vessels, nerves, ureters, bladder), which led to a decrease in intraoperative blood loss, in the risk of damage to adjacent organs and in the development of adhesions, and to accelerated postoperative rehabilitation of patients. Key words: double-row suture, istmocele, laparoscopy, metroplasty

scholarly journals Outcomes of external dacryocystorhinostomy and endoscopic endonasal dacryocystorhinostomy in the management of nasolacrimal duct obstruction

2015 ◽  
Vol 7 (1) ◽  
pp. 39-46 ◽  
Author(s):  
S Duwal ◽  
R Saiju
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Dence Interval ◽  
External Dacryocystorhinostomy ◽  
Group 2 ◽  
External Dcr ◽  
Group 1

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Although external DCR is regarded as the gold standard, endoscopic DCR is evolving as an equally-effective alternative. Objectives To compare the success rate of treating nasolacrimal duct obstruction by endoscopic endonasal method compared to the conventional DCR surgery.Materials and methods This prospective, comparative, non-randomised study was conducted in 2009 - 2010. Thirty consecutive patients undergoing endoscopic endonasal DCR (Group 1) and 30 consecutive patients undergoing external DCR (Group 2) between July 2009 and September 2010 at the oculoplasty unit of the Tilganga institute of ophthalmology were included in this study. A patent lacrimal passage on syringing and symptomatic improvement at six months after surgery was de¿ned as a successful outcome. The intraoperative and postoperative complications were also compared. Results Our study included 31 eyes of 30 patients in Group 1 and 34 eyes of 30 patients in Group 2. The success rate for endoscopic endonasal dacryocystorhinostomy was 90.3 % (95 % con¿dence interval 80 - 100) and external dacryocystorhinostomy was 94.1 % (95 % con¿dence interval 80 - 100). The difference of surgical success among the two methods was not statistically significant (p = 0.7). The rate of intra-operative and post-operative complications was similar in the two methods (p = 0.5). Conclusion: The short term outcomes and complication rates of endoscopic endonasal dacryocystorhinostomy and external dacryocystorhinostomy were similar.

A beneficial technique for preventing the device protrusion to the aorta during percutaneous patent ductus arteriosus closure: “Balloon-assisted device releasing technique”

2019 ◽  
Vol 29 (11) ◽  
pp. 1380-1386 ◽  
Author(s):  
Serdar Epçaçan ◽  
Mustafa Orhan Bulut ◽  
İlker Kemal Yücel ◽  
Ahmet Çelebi
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Safe Procedure ◽  
Disc Protrusion ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Patent Ductus Arteriosus Closure ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

AbstractBackground:Although percutaneous closure of patent ductus arteriosus is an established safe procedure, protrusion of the device to descending aorta may occur in various degrees during these procedures, especially in small infants. The aim of our study is to evaluate the benefits of balloon-assisted device releasing technique in the era of preventing device protrusion and conditions related to protrusion.Methods:One hundred and fifty-five infants, who underwent patent ductus arteriosus closure with Amplatzer duct occluder I device between January, 2012 and December, 2018, were retrospectively analysed. Balloon-assisted device releasing technique was used in 20 cases (group 1, 12.9%), between January, 2015 and December, 2018. Procedures in which the technique had been used were compared with the remaining ones (group 2, 87.1%, n = 135) with regard to device stabilisation, aortic disc protrusion to the aorta, iatrogenic coarctation, and device embolisation.Results:There was no significant difference by means of gender, age, weight, and the ductal diameter, whereas the average mean pulmonary artery pressure was significantly higher in group 1. Device protrusion and related complications were significantly higher in group 2; thus, additional catheterisations or surgical interventions were required, while no additional intervention was required in group 1.Conclusion:The balloon-assisted device releasing technique provides a good device stabilisation and prevents protrusion of the device and related complications during percutaneous patent ductus arteriosus closure in selected cases.

scholarly journals Diaphragmatic Peritonectomy versus Full Thickness Diaphragmatic Resection and Pleurectomy during Cytoreduction in Patients with Ovarian Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
P. N. J. Pathiraja ◽  
R. Garruto-Campanile ◽  
R. Tozzi
Keyword(s):  
Pleural Effusion ◽  
Residual Disease ◽  
University Hospital ◽  
Tumour Resection ◽  
Effusion Rate ◽  
Full Thickness ◽  
Surgical Morbidity ◽  
Surgical Interventions ◽  
Group 2 ◽  
Group 1

Objectives. Compare the surgical morbidity of diaphragmatic peritonectomy versus full thickness diaphragmatic resection with pleurectomy at radical debulking.Design. Prospective cohort study at the Oxford University Hospital.Methods. All debulking with diaphragmatic peritonectomy and/or full thickness resection with pleurectomy in the period from April 2009 to March 2012 were part of the study. Analysis is focused on the intra- and postoperative morbidity.Results. 42 patients were eligible for the study, 21 underwent diaphragmatic peritonectomy (DP, group 1) and 21 diaphragmatic full thickness resection (DR, group 2). Forty patients out of 42 (93%) had complete tumour resection with no residual disease. Histology confirmed the presence of cancer in diaphragmatic peritoneum of 19 patients out of 21 in group 1 and all 21 patients of group 2. Overall complications rate was 19% in group 1 versus 33% in group 2. Pleural effusion rate was 9.5% versus 14.5% and pneumothorax rate was 14.5% only in group 2. Two patients in each group required postoperative chest drains (9.5%).Conclusions. Diaphragmatic surgery is an effective methods to treat carcinomatosis of the diaphragm. Patients in the pleurectomy group experienced pneumothorax and a higher rate of pleural effusion, but none had long-term morbidity or additional surgical interventions.

scholarly journals Patients >40 years with a glenohumeral dislocation have a lower incidence of Symptomatic Rotator Cuff Tear than previously reported and can be managed safely without routine advanced imaging

2020 ◽  
Author(s):  
Chibuzo Manafa ◽  
Ahmed Barakat ◽  
Felicity Auld ◽  
Joideep Phadnis
Keyword(s):  
Rotator Cuff ◽  
Cost Analysis ◽  
Rotator Cuff Tears ◽  
Advanced Imaging ◽  
Surgical Interventions ◽  
Group 2 ◽  
Over 40 Years ◽  
Glenohumeral Dislocation ◽  
Selective Referral ◽  
Group 1

Abstract Background Incidence of rotator cuff tears (RCT) following primary anterior glenohumeral dislocation in patients over 40 years is thought to be high. Current guidelines recommend specialist clinic review and advanced imaging for all patients. The aim of this study was to report the incidence of symptomatic RCT in a large cohort of patients and to assess the safety and efficacy of a physiotherapy led virtual protocol where patients were selectively investigated and treated based on symptoms. Methods 238 consecutive patients over 40 years of age with a primary anterior glenohumeral dislocation were identified between January 2015 and June 2018 (42 months). All patients were managed initially through a physiotherapy led virtual clinic with selective referral of patients with red flag symptoms to a specialist shoulder clinic. Advanced imaging (MRI or USS) was performed at the discretion of the shoulder specialist following patient assessment. The incidence of symptomatic RCT was assessed and compared between two groups (Group 1: 40-70 years, Group 2: >70 years). All surgical interventions were recorded. Patients were assessed at a mean of 22 months (range 10-54) using the Oxford shoulder score; patient satisfaction and return to pre-injury functional level. Cost analysis was performed to compare management using this protocol versus published guidelines.Results A total of 238 patients were identified with mean age of 65 years (range 40-96). 69% (n=164/238) were symptomatic and were referred to specialist clinic. The other 31% (n=74/238) were asymptomatic and were discharged to physiotherapy. Of those referred to a specialist clinic, only 46% (n=75/164) were sent for advanced imaging following clinical examination. The incidence of symptomatic RCTs was 31% (n=51/164) in this group and only 22% (n=11/51) of those underwent subsequent surgical repair of their rotator cuff. Of those patients discharged to physiotherapy, 62% (n=47/74) responded to the questionnaire with 89% fully satisfied, 85% returned to pre-injury level and mean Oxford score was 42 (33-38, SD 3.2) indicating excellent shoulder function. With all patients pooled excluding those lost to follow-up (n=27), the incidence of symptomatic RCTs was 24% (51/211). The incidence in group 1 was 16% (n=22/137) and was significantly lower than in group 2 which was 39% (n=29/74) (p<0.05). Cost analysis demonstrated 49% cost reduction using this protocol.Conclusion Incidence of symptomatic cuff tears following a primary glenohumeral dislocation in patients over 40 years was lower than previously reported. A protocol based on selective referral and investigation for symptomatic patients was cost effective and safe.

Outcomes of Surgical Treatment of Fractures in Concomitant and Multiple Injuries in Children

2009 ◽  
Vol 16 (2) ◽  
pp. 72-75
Author(s):  
Tokhir Sidikovich Musaev ◽  
N N Tolipov ◽  
F A Masharipov ◽  
T S Musaev ◽  
N N Tolipov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Duration ◽  
Simple Technique ◽  
Bone Fractures ◽  
Locomotor System ◽  
Surgical Interventions ◽  
Fixation Devices ◽  
Duration Of Hospitalization ◽  
Group 2 ◽  
Group 1

Outcomes of surgical treatment of 72 children with concomitant (55) and multiple (17) injuries of locomotor system were analyzed. In 53 patients (group 1) surgical interventions for bone fractures were performed in early terms (within 3 days after trauma), in 19 patients (group 2) the interventions were postponed. In group 1 good and satisfactory result was achieved in 92% of patients (63 segments), in group 2 - in 85.2% of patients (23 segments). Duration of hospitalization made up in two groups 11.5 and 14.5 days, respectively. Application of pirod external fixation devices facilitated the treatment course due to the reduction of treatment duration and traumatization, as well as use of more simple technique of long bones and pelvis osteosynthesis.

Outcomes in different age groups with primary Ewing sarcoma of the spine: a systematic review of the literature

2019 ◽  
Vol 30 (5) ◽  
pp. 664-673 ◽  
Author(s):  
Garrett K. Berger ◽  
Peyton L. Nisson ◽  
Whitney S. James ◽  
Kristen N. Kaiser ◽  
R. John Hurlbert
Keyword(s):  
Ewing Sarcoma ◽  
Age Groups ◽  
Favorable Outcome ◽  
Adjunctive Treatment ◽  
Age Group ◽  
Surgical Interventions ◽  
Increased Risk ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

OBJECTIVEEwing sarcoma (ES) is among the most prevalent of bone sarcomas in young people. Less often, it presents as a primary lesion of the spine (5%–15% of patients with ES).METHODSA systematic literature search was performed, querying several scientific databases per PRISMA guidelines. Inclusion criteria specified all studies of patients with surgically treated ES located in the spine. Patient age was categorized into three groups: 0–13 years (age group 1), 14–20 years (age group 2), and > 21 (age group 3).RESULTSEighteen studies were included, yielding 28 patients with ES of the spine. Sixty-seven percent of patients experienced a favorable outcome, with laminectomies representing the most common (46%) of surgical interventions. One-, 2-, and 5-year survival rates were 82% (n = 23), 75% (n = 21), and 57% (n = 16), respectively. Patients in age group 2 experienced the greatest mortality rate (75%) compared to age group 1 (9%) and age group 3 (22%). The calculated relative risk score indicated patients in age group 2 were 7.5 times more likely to die than other age groups combined (p = 0.02).CONCLUSIONSPrimary ES of the spine is a rare, debilitating disease in which the role of surgery and its impact on one’s quality of life and independence status has not been well described. This study found the majority of patients experienced a favorable outcome with respect to independence status following surgery and adjunctive treatment. An increased risk of recurrence and death was also present among the adolescent age group (14–20 years).

scholarly journals Implementation of a new Single-Pass Whole-Body Computed Tomography Protocol: Is it safe, effective and efficient in patients with severe trauma?

2020 ◽  
Author(s):  
Carlos Ordoñez ◽  
Carlos García ◽  
Michael W. Parra ◽  
Edison Angamarca ◽  
Mónica Guzmán-Rodríguez ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Injury Severity ◽  
Penetrating Trauma ◽  
Severe Trauma ◽  
Whole Body ◽  
Surgical Interventions ◽  
Single Pass ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose: The objective of this study was to evaluate the implementation of a new Single-Pass WBCT Protocol in the management of patients with severe trauma. Methods: This was an observational, prospective study of polytrauma patients who underwent WBCT. Patients were divided into three groups: 1. Blunt trauma hemodynamically stable 2. Blunt trauma hemodynamically unstable and 3. Penetrating trauma. Demographics, WBCT parameters and outcome variables were evaluated. Results: 263 patients were included. Median Injury Severity Score (ISS) was 22 (IQR: 16-22). Time between arrival to the ED and completing the WBCT was under 30 minutes in most patients [Group 1: 28 minutes (IQR: 14-55), Group 2: 29 minutes (IQR: 16-57), and Group 3: 31 minutes (IQR: 13-50); p=0.96]. 172 patients (65.4%) underwent non-operative management. The calculated and the real survival rates did not vary among the groups either [Group 1: TRISS 86.4% vs. RSR 85% (p=0.69); Group 2: TRISS 69% vs. RSR 74% (p=0.25); Group 3: TRISS 93% vs. RSR 87% (p=0.07)]. Conclusion: This new Single-Pass WBCT Protocol was safe, effective and efficient to decide whether the patient with severe trauma requires a surgical intervention independently of the mechanism of injury or the hemodynamic stability of the patient. Its use could also potentially reduce the rate of unnecessary surgical interventions of patients with severe trauma including those with penetrating trauma.

scholarly journals Morphometric analysis of the intercellular substance of hypertrophic scars after anti-scar treatment

2021 ◽  
Vol 11 (1) ◽  
pp. 39-46
Author(s):  
Sergey V. Minaev ◽  
Alina N. Grigorova ◽  
Oksana V. Vladimirova ◽  
Anna A. Ivchenko ◽  
Petr M. Lavreshin ◽  
...  
Keyword(s):  
Histological Examination ◽  
Morphometric Analysis ◽  
Burn Injury ◽  
Scar Tissue ◽  
Collagen Fibers ◽  
Intercellular Substance ◽  
Surgical Interventions ◽  
Before And After ◽  
Group 2 ◽  
Group 1

AIM: This study aimed to assess the formation of scar tissue after burns under the influence of an anti-scar gel. Understanding of the processes involving scars and the morphofunctional features of the tissue at different stages of development allows targeted selection of therapy and prevention of scars. MATERIALS AND METHODS: We conducted a comparative prospective analysis from 2005 to 2020. Of which two groups were identified. In group 1 (n = 47), burns were treated according to the standard scheme without the use of modern wound coverings. In group 2 (n = 41), early primary prevention of pathological scarring was performed, where the Contractubex gel was applied to the area of burn injury from the moment of epithelialization. Histological examination included the analysis of skin biopsies in the area of damage before and after conservative treatment. RESULTS: Histological examination showed quantitative changes in the cellular composition of the scar tissue in all groups. The average quantitative index of the fibroblast activity was significantly reduced in group 2 using Contractubex gel. Thickness of collagen fibers, according to the morphometric analysis, is most reduced in all layers of the dermis in group 2 (p 0.05). In group 1, collagen fibers are represented as nodular clusters; in some areas of the reticular layer of the dermis, fibers have a more fragmented appearance. In group 2, the use of Contractubex leads to a significant decrease in the level of tumor growth factor- in the papillary and reticular layers of the dermis. CONCLUSION: The use of Contractubex gel in the early prevention of pathological scarring significantly reduces the need for subsequent reconstructive surgical interventions

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