scholarly journals Various surgical techniques influence on the local immunity state in the postoperative period in children's tonsils hypertrophy

2020 ◽  
pp. 12-19
Author(s):  
Alexander Bredun ◽  
Oleg Melnikov ◽  
Anatoly Kosakovsky ◽  
Julia Shuklina ◽  
Мarina Timchenko
Keyword(s):  
Surgical Technique ◽  
Immune Complexes ◽  
Surgical Techniques ◽  
General Purpose ◽  
Surgical Instruments ◽  
Local Immunity ◽  
Palatine Tonsils ◽  
Surgical Methods ◽  
Comparison Groups ◽  
Immunity Function

Topicality: There are many conflicting opinions in the literature regarding the best surgical technique for the treatment of OSAS related to palatine hypertrophy – partial (tonsillotomy) or complete (tonsillectomy) removal of lymphoid tissue of the tonsils. Also, there are many opinions about the use of a variety of traditional and modern surgical instruments to reduce the volume of the tonsils, including using a laser, a radiofrequency knife, an ultrasonic knife, a shaver (microdebrider) and a coblator. Aim of the study: The aim of the study was to compare the surgical methods effectiveness of tonsils hypertrophy treatment which the based on the restoration of the mucous membrane's local immunity function. Materials and methods: Children who undergoing surgical treatment for palatine tonsils hypertrophy 2-3 degrees according to the Brodsky classification and the presence of OSAS took part in the study. The patients were randomized and divided into four comparison groups using different surgical techniques. The first group, which used the surgical technique of classical tonsillotomy (TT) included 28 patients, the second group, which used the surgical technique of intracapsular shavertonsillotomy(STT) included 18 patients, the third group, which used surgical technique of intracapsular coblationtonsillotomy (CTT), and groups which using surgical technique of tonsilloplasty included 12 patients (TP). Determined the state of local immunity before surgery and 1 month after surgery by concentration levels of sIgA, α-IFN, IL-1β, TGF-1β and general-purpose immune complexes. Results: Recovery of the concentration of the major marker of local immunity sIgA occurs significantly (P<0.05) faster when using the surgical technique of CTT and STT. Recovery of the concentration of the major marker of antiviral immunity α-IFN occurs significantly (P <0.05) faster when using the surgical technique of CTT, STT and TP. Recovery of the concentration of the anti-inflammatory cytokine IL-1β occurs significantly (P<0.05) faster with the use of the surgical technique of STT and TP. Indicators of the regeneration factor TGF-1β are significantly the highest when using the surgical techniques of STT, TT and TP. The concentration of immune complexes in the oropharyngeal secretions of patients with tonsil hypertrophy at 1 month after surgery significantly decreased with the use of surgical techniques TT and TP. Significant (P <0.05) increase in IgG level was de- termined in all comparison groups except the group where tonsilloplasty was used. Conclusions: The safety surgical technique of palatine tonsils volume reduction – TP and STT promotes significantly (P<0,05) faster restoration of concentration of the main mucous membrane's local immunity markers.

Effectiveness of Bypass and Sleeve Bariatric Surgical Methods in Weight Reduction

2021 ◽  
Vol 7 (4) ◽  
pp. 1-5
Author(s):  
Cristianne Confessor Castilho Lopes ◽  
Keyword(s):  
Surgical Technique ◽  
Surgical Techniques ◽  
Psychosocial Problems ◽  
Morbid Condition ◽  
Endocrine Disease ◽  
Surgical Methods ◽  
Effective Option ◽  
Grade Ii ◽  
Grade Iii

Obesity is a chronic disease described by the large amount of body fat that leads to an increase in Body Mass Index (BMI). It is subdivided into three levels, being grade I with a BMI between 30 and 34.9 kg/m2, grade II between 35 and 39.9 kg/m2 and grade III or morbid obesity with a BMI above 40 kg/m2. Aiming at reversing the morbid condition caused by the disease, the bariatric surgical technique presents itself as the most effective option to contain grade III obesity, as well as the associated co morbidities. The objective of surgical techniques is to improve the quality of life of the obese, reducing both physical and psychosocial problems. As endocrine disease is related to several co morbidities, such as high blood pressure, sleep apnea and even some types of cancer, it is necessary to carry out an investigation into the surgical technique to be applied as well as its effectiveness during and after the surgical procedure.

scholarly journals Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction: an experimental study using radiostereometry

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Torben Bæk Hansen ◽  
Bo Munk ◽  
Maiken Stilling
Keyword(s):  
Experimental Study ◽  
Surgical Techniques ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Clinical Recommendation ◽  
Surgical Methods ◽  
Custom Made ◽  
Stabilizing Effect

Abstract Purpose Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children

2021 ◽  
pp. 019459982110151
Author(s):  
Rahul G. Baijal ◽  
Karla E. Wyatt ◽  
Teniola Shittu ◽  
Eugenia Y. Chen ◽  
Eric Z. Wei ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Chart Review ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Airway Disease ◽  
Respiratory Complications ◽  
Patient Factors ◽  
Children's Hospital ◽  
Reactive Airway Disease ◽  
Children’S Hospital

Objectives The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques. Study Design The study was a retrospective cohort study. Setting Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. Methods Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications. Results A total of 2437 patients underwent a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection. Conclusion Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.

scholarly journals Surgical techniques: past, present and future

2012 ◽  
Vol 2 (1) ◽  
pp. 9 ◽  
Author(s):  
Karim Qayumi
Keyword(s):  
Middle Ages ◽  
Technological Progress ◽  
Surgical Techniques ◽  
Neolithic Period ◽  
Minimally Invasive Surgical ◽  
Surgical Methods ◽  
Modern Hospital ◽  
The 19Th Century ◽  
Further Development ◽  
Shed Light

The aim of this paper is to provide an analytical survey of the information available on the development of past and present surgical techniques, and to make projections for the future. For the purposes of this paper, the <em>Past</em> starts in the Neolithic period and ends in the 1800s. In this context, I have divided the <em>Past</em> into <em>Prehistoric</em>, <em>Ancient</em> and <em>Middle Ages</em>, and this period ends in the second half of the 19th century when the major obstacles to the further development of surgery, such as overcoming pain and infection, were removed. We will discuss the development of surgical techniques, and the obstacles and opportunities prevalent in these periods. In the context of this paper, the <em>Present</em> begins in 1867, when Louis Pasteur discovered microorganisms, and ends in the present day. There have been many important changes in the development of surgical techniques during this period, such as the transfer of surgery from the unsterile operating room to the modern hospital operating theater, the development of advanced and specialized surgical practices, such as transplants and laparoscopy, and minimally invasive surgical methods, robotic and Natural Orifice Transluminal Endoscopic Surgery. It is very difficult to foresee how surgical techniques will develop in the <em>Future</em> because of the unpredictable nature of technological progress. Therefore, in this paper, the forecast for the <em>Future</em> is limited to the next 50- 100 years and is a realistic calculation based on already existing technologies. In this context, the <em>Future</em> is divided into the development of surgical techniques that will develop in the <em>near</em> and <em>distant</em> future. It is anticipated that this overview will shed light on the historical perspective of surgical techniques and stimulate interest in their further development.

scholarly journals Hospitalization time after open appendectomy by three different surgical techniques

2014 ◽  
Vol 27 (3) ◽  
pp. 188-190 ◽  
Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Site Infection ◽  
Hospitalization Time ◽  
Contingency Coefficient ◽  
Appendicular Stump

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.

scholarly journals Different Surgical Techniques in Tubo-ovarian Abscess Management

2017 ◽  
pp. 1
Author(s):  
Hale GÖKSEVER ÇELİK ◽  
Engin Çelik ◽  
Semra Yüksel ◽  
Ercan Baştu ◽  
Hasan Cemal Ark
Keyword(s):  
Surgical Techniques ◽  
Operation Technique ◽  
Blood Cell Count ◽  
Abscess Drainage ◽  
Mean Values ◽  
Surgical Methods ◽  
Training And Research ◽  
Poor Outcomes ◽  
One Year ◽  
Ovarian Abscess

<p><strong>Objectıve:</strong> Tubo-ovarian abscess is mostly a consequence of pelvic inflammatory disease. We aimed to compare success of the different surgical methods in tubo-ovarian abscess treatment.<br /><strong>Study Design:</strong> 53 patients with Tubo-ovarian abscess that were hospitalized and operated in the Department of Obstetrics and Gynecology at Kanuni Sultan Suleyman Training and Research Hospital during one year were included. Patients who had underwent salpingectomy/salpingo-oophorectomy and only abscess drainage were compared.<br /><strong>Results:</strong> Salpingectomy/salpingo-oophorectomy had been done in 74.5% of cases and only drainage had been applied in 25.5% of cases. Difference in mean values between 2 groups were not observed except white blood cell count. <br /><strong>Conclusıon:</strong> Treatment of Tubo-ovarian abscess must be a combination of parenteral antibiotics and early surgical procedure to prevent poor outcomes. There is not any difference between different surgical techniques. But additionally more studies are needed to better understand which operation technique is more effective and less complicated.</p>

scholarly journals Blister like aneurysm: a review about its surgical management / Aneurismas blister-like: uma revisão sobre seu manejo cirúrgico

2019 ◽  
Vol 64 (2) ◽  
pp. 131
Author(s):  
Rodrigo Salmeron de Toledo Aguiar ◽  
Guilherme Brasileiro de Aguiar ◽  
Rafael Gomes dos Santos ◽  
André Freitas Nunes ◽  
Renan Maximilian Lovato ◽  
...  
Keyword(s):  
Surgical Management ◽  
Intracranial Aneurysms ◽  
Surgical Techniques ◽  
Vascular Lesion ◽  
High Morbidity ◽  
Good Efficiency ◽  
Treatment Techniques ◽  
Pubmed Database ◽  
Surgical Methods ◽  
Ruptured Intracranial Aneurysms

ABSTRACT Introduction: Blister aneurysms are of uncertain pathogenesis and are a vascular lesion located in the brain. Overall, they represent 0.3% - 1.0% of all intracranial aneurysms and 0.9% - 6.5% of ruptured intracranial aneurysms. They are associated with high morbidity and mortality. Even with the first description being from 1969, there is still debate in the literature about which type of treatment is the best: surgical or endovascular. In this review, we focus on the surgical management. Method: The authors performed a review of available surgical techniques used for blood blister-like aneurysms treatment. Pubmed database was used as search source introducing blister-like aneurysm and blister aneurysms as keywords. The most relevant articles and those that focused on surgical treatment techniques were selected. Discussion: The most used surgical methods are clipping, trapping, wrapping and bypass. As main features of each technique, we can highlight clipping with good efficiency, when there is good neck exposure; trapping being employed in ruptured aneurysm; wrapping for avulsion and bypass that promotes vascularization to the distal territory of the aneurysm. Conclusion: The endovascular method has shown to be promising and efficient. However, different surgical techniques are still being employed based on their efficiency when facing certain surgical scenarios.Keywords: Neurosurgery, Subarachnoid hemorrhage, Intracranial aneurysm, Endovascular proceduresRESUMOIntrodução: Aneurismas cerebrais blister-like são lesões vasculares de patogenia incerta. De modo geral, representam 0.3%-1.0% de todos aneurismas intracranianos e 0.9% - 6.5% dos aneurismas intracranianos que rompem. Estão associados a alta morbimortalidade. Mesmo com a primeira descrição sendo de 1969, ainda há debate na literatura sobre qual tipo de tratamento é o melhor: cirúrgico ou endovascular. Nessa revisão, focamos no tratamento cirúrgico. Métodos: Os autores realizaram uma revisão das técnicas cirúrgicas utilizadas para tratamento de aneurismas blister-like. A plataforma Pubmed foi utilizada para a pesquisa das palavras chaves “blister-like aneurysm” e “blister aneurysm”. Os artigos de maior relevância e aqueles que enfatizam as técnicas cirúrgicas foram selecionados. Discussão: Os métodos cirúrgicos empregados são clipagem, trapping, wrapping e bypass. Quanto às características de cada método, podemos salientar a eficácia da clipagem, quanto melhor for a exposição do aneurisma; o uso do trapping em situações de rompimento do aneurisma; wrapping para casos em que houve avulsão do aneurisma e by-pass que promove a vascularização distal ao aneurisma. Conclusão: O método endovascular tem se mostrado promissor e efetivo. No entanto, as diferentes técnicas cirúrgicas ainda são empregadas e defendidas devido a sua eficiência frente certos cenários cirúrgicos.Descritores: Neurocirurgia, Hemorragia subaracnóidea, Aneurisma intracraniano, Procedimentos endovasculares

scholarly journals EVALUATION OF A TRAINING COURSE ON OPEN VASCULAR SURGICAL TECHNIQUES IN AORTOILIAC PATHOLOGY - 5 YEARS OF EXPERIENCE

2015 ◽  
Vol 88 (2) ◽  
pp. 196-202
Author(s):  
Bogdan Stancu ◽  
Florin Beteg ◽  
Aurel Mironiuc ◽  
Aurel Muste ◽  
Claudia Gherman
Keyword(s):  
Surgical Technique ◽  
Vascular Surgery ◽  
Prospective Study ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Technical Quality ◽  
Statistical Association ◽  
Abdominal Aortic

Introduction. The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008-2012), and to verify the viability and the feasibility of the vascular anastomoses.Material and method. Vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. Endpoints of the study were the surgical skills and the technical quality, evaluated on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants.Result. A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a semnificative statistical association between the quality of suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05).Conclusions. Our course contributed to the improvement of technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment as in human patients.

scholarly journals Therapeutic difficulties in vesicorectal fistula treatment using several techniques in one center

2021 ◽  
Author(s):  
Maciej Przudzik ◽  
Maria Derkaczew ◽  
Robert Hofman ◽  
Marek Roslan
Keyword(s):  
Radical Cystectomy ◽  
Gold Standard ◽  
Ileal Conduit ◽  
Surgical Techniques ◽  
Anterior Rectal Resection ◽  
Surgical Methods ◽  
The Mean ◽  
Fistula Treatment ◽  
No Gold Standard ◽  
Radiotherapy Treatment

Introduction: Vesicorectal fistula (VRF) is a rare but devastating condition that may develop after surgery or radiotherapy. Many surgical methods to treat VRF have been described, but there is still no gold standard of VRF treatment. Aim: The aim of the study is to present our experience in the treatment of VRFs and analyze different surgical techniques applied in our center retrospectively. Material and methods: From June 2016 to June 2020, 7 patients (5 males and 2 females) aged 59–73 years (average 67.3 years) were treated for VRF in our center. The primary causes of VRFs were complications after laparoscopic radical prostatectomy (LRP), sigmoidectomy, laparotomy with removal of the tumour of the vaginal stump and anterior rectal resection and colostomy, Hartmann’s operation due to rectosigmoid carcinoma, radiotherapy, treatment of cervical cancer and transurethral resection of bladder tumor (TURBT). The patients were treated with one of the following methods: transvesical laparoscopic single-site surgery (T-LESS), transanal minimally invasive surgery (TAMIS), transurethral fulguration and radical cystectomy with the Bricker’s ileal conduit. Results and discussion: Five patients underwent T-LESS, 2 TAMIS, 1 transurethral fulguration and 1 radical cystectomy with the Bricker’s ileal conduit. The mean postoperative hospital stay was 4 days (range 2–8 days). The mean operative time was 139 minutes (range 100–285 minutes). Only 1 patient had a recurrence of a fistula. Conclusions: Surgical management of VRFs is obligatory to prevent possible complications. Currently, there is no gold standard for treatment of VRFs. Therefore, this condition requires further investigation.

scholarly journals Other Scar Types: Optimal Functional and Aesthetic Outcome of Scarring in Cleft Patients

2020 ◽  
pp. 51-57
Author(s):  
Wouter B. van der Sluis ◽  
Nirvana S. S. Kornmann ◽  
Robin A. Tan ◽  
Johan P. W. Don Griot
Keyword(s):  
Surgical Technique ◽  
Psychosocial Functioning ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Surgical Techniques ◽  
Anatomical Structures ◽  
Patient Dissatisfaction ◽  
Optimal Function ◽  
Scar Management

AbstractCleft lip and palate are facial and oral malformation due to failures in the embryologic craniofacial development during early pregnancy. A unilateral cleft lip and palate is the most common type, whereby the upper lip, the orbicularis muscle, the alveolar bone, the floor of the nose, and the hard and soft palate are interrupted, creating an open communication between nasopharynx and oropharynx. Patients with a cleft lip and palate are treated in specialized cleft centers by a multidisciplinary team. Having cleft lip and/or palate has a noteworthy impact on quality of life and psychosocial functioning. Postoperative scarring is a common cause of patient dissatisfaction. The goal of cleft lip surgery is to close the lip, provide optimal function in terms of speech, mastication, dental protection, breathing and feeding, and provide an aesthetically pleasing facial scar. Precise surgical technique and adequate aligning of anatomical structures is important for the postoperative aesthetic result and scar formation. Different surgical techniques are available for this purpose. Optimal scar management can be divided in surgical (precise surgical technique, planning, and adequate aligning of anatomical structures) and nonsurgical methods (botulinum toxin, silicone application, carbon dioxide fractional laser).

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