scholarly journals A CLINICALANALYSIS OF THE OUTCOME OF CHIVATE'S PROCEDURE AND MILLIGAN-MORGAN PROCEDURE FOR HAEMORRHOIDS

2020 ◽  
pp. 1-4
Author(s):  
G. Santhi Vardhani ◽  
Asmat Jahan ◽  
Md Shadab Jaseem
Keyword(s):  
Urinary Retention ◽  
Demographic Data ◽  
Open Hemorrhoidectomy ◽  
Post Operative Period ◽  
Operative Complications ◽  
Mucous Discharge ◽  
Long Term Follow Up ◽  
Suture Rectopexy

Aim: To study the outcome of the Chivate’s transanal suture rectopexy with milligan morgan procedure in patients of haemorrhoids from clinical perspective. Methods: From April 2018 to September 2019,30 patients of haemorrhoids(grade III/ IV) were randomly assigned to undergo either the transanal suture rectopexy (n= 15) or Milligan Morgan procedure (n=15). Outcome assessment was performed at 12 hours,24 hours,3days,weekly once for 1 month,monthly once for 5months. Variables included Post-operative complications, resolution of symptoms. Results: Both the groups were comparable in terms of demographic data. Of the 15 patients who underwent Chivate’s procedure, none of the patients complained of Pain. 1pt had minimal bleeding intra-operatively. 3 pts had urinary retention and another 2 pts had transient anal incontinence to flatus. Mild mucous discharge per rectum noted in 1 patient. All the patients were discharged in 24hrs. Of the 15 patients who underwent Milligan-Morgan procedure, 10 patients complained of severe pain in the post-operative periods. Bleeding was seen intra operatively in 3 pts and urinary retention seen in 1 pt. Mild mucus discharge per rectum was seen in the early post-operative period in 1 pt. Most of the patients stayed under admission for 3-4days. There was difficulty in passing stools postop in 3patients, thus, requiring increased use of laxatives in these patients. None of the patients had residual pile masses or recurrence in this study after long term follow up. Conclusion: Transanal suture rectopexy certainly offers lower incidence of post-op morbidities and better patient compliance than milligan morgan open hemorrhoidectomy.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

Tethered Cord and Anorectal Malformations: A Case Series

2017 ◽  
Vol 28 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Lorena Canazza ◽  
Milena Meroni ◽  
Giorgio Selvaggio ◽  
Cecilia Parazzini ◽  
Laura Valentini ◽  
...  
Keyword(s):  
Demographic Data ◽  
Case Series ◽  
Tethered Cord ◽  
Anorectal Malformations ◽  
International Classification Of Functioning ◽  
Clean Intermittent Catheterization ◽  
Critical Elements ◽  
Long Term Follow Up

Introduction The clinical manifestation of a stretched low-lying cone (LLC) is represented by the tethered cord syndrome (TCS) with cutaneous, urologic, neurologic, and orthopaedic dysfunctions. TC is frequently found in patients with anorectal malformations (ARMs). The aim of our article is to report a series of patients affected by LLC and ARMs and evaluate their management and long-term follow-up results. Materials and Methods We performed a retrospective analysis over a period of 15 years including patients with ARM and TC and excluding those with severe polymalformations. We collected information related to the types of malformations and demographic data. We analyzed their management (perinatal protocol, radiological investigations, surgery, and multidisciplinary follow-up). QOL was assessed through the International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY). Results Thirty-three patients among 210 ARM cases had TC (16%). Eleven of them underwent neurosurgery. One patient had retethering; out of 11 patients, 4 remained stable and 6 improved after surgery (UDS normalization and resolution of symptoms). At a mean follow-up of 10 years, four patients were on clean intermittent catheterization and five on the Peristeen transanal irrigation. The majority of patients were defined as 3 (from 1-bad to 5-excellent) for their physical and mental state. Conclusion The use of MRI is considered to complete the ARM screening in detecting TC. The multidisciplinary approach is crucial and helps in defining the management of patients. In fact, it is not clear how the features of ARM and TC affect each other. The selection of cases for surgery should take into account the critical elements.

Long Term Follow Up of Men with Alfuzosin who Voided Successfully Following Acute Urinary Retention*

2005 ◽  
Vol 37 (3) ◽  
pp. 507-510 ◽  
Author(s):  
V. Palit ◽  
T. Shah ◽  
C. S. Biyani ◽  
Y. Elmasry ◽  
R. Sarkar ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Long Term Follow Up

scholarly journals Surgical cardiac sympathetic denervation in patients with VT storm: long term follow-up data

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Barwad ◽  
Y.Y Lokhandwala ◽  
B Kumar ◽  
A Vyas ◽  
V Shah ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Demographic Data ◽  
Sympathetic Denervation ◽  
Outcome Analysis ◽  
Surgical Removal ◽  
Clinical Parameters ◽  
Long Term Follow Up ◽  
Cardiac Sympathetic Denervation

Abstract Background Surgical Cardiac Sympathetic Denervation (CSD) is a procedure which involves surgical removal of terminal cervical and thoracic sympathetic ganglion for reducing sympathetic discharge to the heart. CSD is usually performed as a last desperate measure in treatment of ventricular tachycardia (VT). We report here the clinical profile and long-term follow-up of all our patients who underwent CSD (unilateral or bilateral) predominantly upfront prior to considering catheter ablation of VT for VT storm. Material and methods We retrospectively collected data of all patients who underwent CSD for VT storm between year 2010 till 2019. Success of CSD was defined as successful discharge of patient from the hospital after the procedure more than 75% decrease in the frequency of VT after two weeks of surgical procedure. Results A total of 65 patients underwent CSD in the above-mentioned period and the average duration of follow-up was 28 months. The clinical parameters, demographic data and outcome analysis is provided in details in table 1. Only 14 (21.5%) patients underwent attempt of catheter ablation of VT prior to considering CSD. CSD was successful in 53 (81.5%) of patients. There was a significant decline in the incidence of number of ICD or external shocks before and after CSD (25.2±39.4 vs 1.09±2.9) respectively. There was no significant effect of CSD on ejection fraction. None of the available clinical parameters predicted the success of CSD. Discussion and conclusion The current retrospective analysis reemphasize the role of surgical CSD in treatment of patients with VT storm. As in predominant patient's CSD was performed even before the attempting catheter-based ablation, it brings in a new dimension in the treatment of VT. Efficacy of CSD (81.5%) in experienced hand is equivalent or even better than catheter-based ablation in patients with VT storm. Funding Acknowledgement Type of funding source: None

Expectant long-term follow-up of patients with chronic urinary retention

2018 ◽  
Vol 38 (1) ◽  
pp. 305-309 ◽  
Author(s):  
Alejandro Abello ◽  
William C. DeWolf ◽  
Anurag K. Das
Keyword(s):  
Urinary Retention ◽  
Long Term Follow Up ◽  
Chronic Urinary Retention

scholarly journals Is the sublay self-gripping mesh effective for incisional ventral hernia repair? Our experience and a systematic review of the literature

2020 ◽  
Vol 72 (4) ◽  
pp. 1195-1200
Author(s):  
Elena Schembari ◽  
Maria Sofia ◽  
Rosario Lombardo ◽  
Valentina Randazzo ◽  
Ornella Coco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Demographic Data ◽  
Review Of The Literature ◽  
Long Term Follow Up ◽  
The Mean ◽  
Retromuscular Repair ◽  
Sublay Mesh

AbstractSublay mesh repair seems to be the most effective method for treating incisional hernias (IHs). The aim of this study was to report our experience with retromuscular repair and self-gripping mesh for the treatment of midline IHs. In addition, we provided a systematic review of the literature regarding the use of this novel combination. All patients undergoing elective IH repair from June 2016 to November 2018 were included. The self-gripping mesh was placed in the sublay position. Demographic data, defect sizes, postoperative complications and follow-up durations were collected. A systematic review of the available literature was conducted in January 2020 using main databases. A total of 37 patients (20/17M/F) were included in this study, and the mean age and body mass index (BMI) were 58 years and 27 kg/m2, respectively. Minor complications occurred in six patients. Long-term follow-up demonstrated recurrence in three patients. Regarding the review, five publications were considered relevant. The highest complication rate was 28.6%, and the recurrence rate varied from 0 to 5.1%. This is the first review of the literature regarding sublay IH repair using a self-gripping mesh. The low rates of postoperative complications and recurrence in our experience and those reported by most of the reviewed articles demonstrate that this is a safe and effective method for repairing IHs.

scholarly journals Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation

OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110366
Author(s):  
Mallory Raymond ◽  
Arian Ghanouni ◽  
Kaitlyn Brooks ◽  
Sarah M. Clark ◽  
Douglas E. Mattox
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Objectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow-up length were recorded. Patient factors were analyzed for association with being lost to follow-up. Results In total, 122 patients were included with a median length of follow-up of 5 months (range, 0-146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow-up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow-up. Of 26 interviewed patients initially lost to follow-up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions. Conclusions The length of follow-up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow-up. Further efforts should be made to identify at-risk patients and provide adequate education to improve long-term surveillance.

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