An experiment on biological objects: composite facial graft cross-transplantation

2020 ◽  
Author(s):  
NA Daykhes ◽  
DN Nazaryan ◽  
KS Gileva ◽  
MA Mokhirev ◽  
IN Lyashev ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Perioperative Complications ◽  
Rejection Reaction ◽  
Biological Objects ◽  
Vital Functions ◽  
Transplantation Technique ◽  
Set Up ◽  
Typical Component ◽  
Tissue Defects ◽  
Therapy Protocol

Facial graft transplantation remains the operation of choice for patients with extensive tissue defects in the maxillofacial region. This study aimed to set up an experiment on biological objects, develop and test a combined facial graft cross-transplantation technique, select the anesthetic aid allowing to reduce the risks of perioperative complications, improve survivability of the subjects by reducing the duration of surgical intervention, develop a postoperative therapy and rehabilitation protocol, assess detection of an acute rejection reaction and develop the immunosuppressive therapy protocol. We conducted three series of facial graft transplantation surgeries on 26 minipigs and tested the typical component combinations and flap designs. At all stages of the experiment, we managed to have the subjects surviving for over 30 days without disrupting their vital functions. The immunosuppression procedure was developed and tested. The chosen technique allows transplanting two grafts within a single surgery on one pair.

scholarly journals Microsurgical Treatment of Epidermoids. Case Report and Literature Review

2019 ◽  
Vol 4 (2) ◽  
pp. 114-121
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
E. G. Belykh ◽  
S. L. Antipina ◽  
D. I. Badaguev
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Aseptic Meningitis ◽  
Epidermoid Cyst ◽  
Surgical Intervention ◽  
Perioperative Complications ◽  
Medical Knowledge ◽  
Clinical Results ◽  
Russian Science ◽  
Russian Science Citation Index

The aim of the research: study the features of surgical treatment of epidermoids.Materials and methods. We present a literature review and the clinical case of surgical treatment of a patient with epidermoid. We have searched medical databases: Medline, Russian Science Citation Index, EMedicine, United Medical Knowledge Base. We considered the features of the clinic, diagnosis, and surgical intervention. The article presents a clinical example of successful surgical treatment of a patient with an epidermoid cyst of the posterior cranial fossa. The result of the literature review was the writing of a clinical lecture; the current state of the issue of etiopathogenesis, diagnosis and management of patients with epidermoids was studied.Results. The authors found that total microsurgical removal is the method of choice, and the operative technique should be aimed at preventing postoperative aseptic meningitis. Although it was not possible to establish the cause of the development of aseptic meningitis, the authors assume that the mechanism of its formation lies in the self-breaking of the capsule of the epidermoid cyst, probability of which was confirmed by a number of studies. Further study of this pathology is a promising direction in neurosurgery.Conclusion. Difficulties in the diagnosis and choice of surgical tactics point at the need for detailed preoperative planning of surgical intervention, performing a precise total removal of a lesion with compliance with preventive measures for aseptic meningitis to improve clinical results and reduce the incidence of perioperative complications.

scholarly journals Is Saddle block superior to spinal anaesthesia for patients undergoing transurethral resection of prostate- a comparative evaluation

2021 ◽  
Vol 12 (10) ◽  
pp. 105-110
Author(s):  
Kirti Kshetrapal ◽  
Priyanka Mishra ◽  
Hemant Kamal ◽  
Priyanka Bansal
Keyword(s):  
Patient Satisfaction ◽  
Spinal Anaesthesia ◽  
Surgical Intervention ◽  
Perioperative Complications ◽  
Randomized Study ◽  
Transurethral Resection Of Prostate ◽  
Haemodynamic Stability ◽  
Bladder Instillation ◽  
Surgical Conditions ◽  
Surgeon Satisfaction

Background: TURP is the most common surgical intervention for patients with benign prostatic hyperplasia. Aims and Objectives: This prospective randomized study was planned to evaluate spinal anaesthesia (SA) versus saddle block with regard to haemodynamic parameters, ephedrine consumption, patient and surgeon satisfaction, perioperative complications in patients undergoing TURP. Materials and Methods: Eighty patients between the ages of 50-80 years with BPH, belonging to ASA grade I- III, prostatic volume between 50 - 80 cc were included in our study. Patients were randomly divided into two groups of 40 patients each. Patients in group SA (n=40) received spinal anaesthesia and the patients in group SBBI (n=40) were given saddle block with bladder instillation of local anaesthetic jelly for undergoing TURP. Results: There was more statistically significant fall in MAP in Group SA as compared to Group SBBI (p<0.05). Complications like hypotension, bradycardia and vasopressor requirement was less but requirement (p=0.021) of supplemental analgesia was more in patients who were administered saddle block. There was significantly lower patient satisfaction in saddle block (p=0.044) but comparable surgical satisfaction in both groups. Conclusion: Both Spinal anaesthesia and saddle block are safe and effective techniques of anaesthesia for patients undergoing TURP. SA has advantages like less requirement of supplemental analgesia, longer duration of post-operative analgesia and more patient satisfaction. However, saddle block is superior to spinal anaesthesia with regard to haemodynamic stability; with less chances of hypotension, bradycardia and less vasopressor requirement. It is similar to SA in terms of providing adequate surgical conditions.

scholarly journals Thoracotomy for emergency repair of iatrogenic tracheal rupture: single center analysis of perioperative management and outcomes

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Manuel F. Struck ◽  
Gunther Hempel ◽  
Uta C. Pietsch ◽  
Johannes Broschewitz ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Airway Management ◽  
Perioperative Management ◽  
Surgical Repair ◽  
Perioperative Complications ◽  
University Hospital ◽  
Management Approach ◽  
High Morbidity ◽  
Tracheal Rupture ◽  
Major Complications ◽  
Vital Functions

Abstract Background Iatrogenic tracheal ruptures are rare but life-threatening airway complications that often require surgical repair. Data on perioperative vital functions and anesthetic regimes are scarce. The goal of this study was to explore comorbidity, perioperative management, complications and outcomes of patients undergoing thoracotomy for surgical repair. Methods We retrospectively evaluated adult patients who required right thoracotomy for emergency surgical repair of iatrogenic posterior tracheal ruptures and were admitted to a university hospital over a 15-year period (2004–2018). The analyses included demographic, diagnostic, management and outcome data on preinjury morbidity and perioperative complications. Results Thirty-five patients who met the inclusion criteria were analyzed. All but two patients (96%) presented with critical underlying diseases and/or emergency tracheal intubations. The median time (interquartile range) from diagnosis to surgery was 0.3 (0.2–1.0) days. The durations of anesthesia, surgery and one-lung ventilation (OLV) were 172 (128–261) min, 100 (68–162) min, and 52 (40–99) min, respectively. The primary airway management approach to OLV was successful in only 12 patients (34%). Major complications during surgery were observed in 10 patients (29%). Four patients (11%) required cardiopulmonary resuscitation, one of whom received extracorporeal membrane oxygenation, and another one of these patients died during surgery. Major complications were associated with significantly higher all-cause 30-day mortality (p = 0.002) and adjusted mortality (p = 0.001) compared to patients with minor or no complications. Conclusions Surgical repair of iatrogenic tracheal ruptures requires advanced perioperative care in a specialized center due to high morbidity and potential complications. Airway management should include early anticipation of alternative OLV approaches to provide acceptable conditions for surgery.

scholarly journals Dysregulation of Tissue Factor, Thrombin-Activatable Fibrinolysis Inhibitor, and Fibrinogen in Patients Undergoing Total Joint Arthroplasty

2017 ◽  
Vol 23 (8) ◽  
pp. 967-972 ◽  
Author(s):  
Christopher Wanderling ◽  
Jeffrey Liles ◽  
Elissa Finkler ◽  
Peter Carlsgaard ◽  
William Hopkinson ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Total Joint Arthroplasty ◽  
Surgical Intervention ◽  
Perioperative Complications ◽  
Joint Arthroplasty ◽  
Enzyme Linked Immunosorbent Assay ◽  
Activity Assay ◽  
Thrombin Activatable Fibrinolysis Inhibitor ◽  
Common Procedure ◽  
Fibrinolysis Inhibitor

Total joint arthroplasty (TJA) of the hip or knee (THA, TKA) has become an increasingly common procedure. While TJA is a successful treatment for individuals experiencing degenerative joint diseases, it is well known that one of the most common perioperative complications of TJA is deep venous thrombosis (DVT). To profile tissue factor (TF), microparticle-tissue factor (MP-TF), thrombin-activatable fibrinolysis inhibitor (TAFI), and fibrinogen levels in patients undergoing TJA to determine potential preexisting Hemostatic dysregulation. De-identified blood samples were obtained from patients undergoing TJA 1 day pre- and 1 day postprocedure. Plasma samples were analyzed using enzyme-linked immunosorbent assay kits for fibrinogen, TAFI, TF, and MP-TF; fibrinogen levels were also assessed using a clot-based activity assay. In comparison with healthy controls, there were significant increases of fibrinogen and MP-TF levels, while there were significant decreases in TF and TAFI levels in the preoperative and postoperative patients. Comparing the pre versus postoperative patients, no significant differences were found; interestingly, however, surgical intervention exacerbated the changes found in the preoperative samples compared to the controls. The results of this study confirm that patients undergoing TJA have preexisting alterations in the fibrinolytic system. Surgical intervention tended to exacerbate these changes. The alterations observed in this study may provide insight as to why TJA is associated with higher rates of DVT and thromboembolism.

scholarly journals Surgical treatment of a newborn in critical condition with intrapericardiac teratoma: a case report

2021 ◽  
Vol 11 (2) ◽  
pp. 169-175
Author(s):  
Yurii I. Kucherov ◽  
Yulia V. Zhirkova ◽  
Marat V. Tarayan ◽  
Maria V. Samorokovskaya ◽  
LIliia V. Shvets
Keyword(s):  
Surgical Treatment ◽  
Critical Condition ◽  
Renal Damage ◽  
Surgical Intervention ◽  
Multiple Organ ◽  
Postnatal Period ◽  
Initial Examination ◽  
Vital Functions ◽  
Multidisciplinary Cooperation ◽  
Direct Results

This article presents a clinical case of the successful surgical treatment of a newborn with intrapericardial teratoma, which was initially diagnosed in the postnatal period, complicated by multiple organ failure, including severe cardio-respiratory disorders and acute renal damage. The systematized results of clinical, electrophysiological, radiation, and morphological diagnostics during the initial examination and at the stages of supervision of the newborn are reported. On the nineteenth day of life, significant multidisciplinary cooperation was implemented to perform a radical surgical intervention to remove the intrapericardial teratoma in a patient in critical condition due to heart compression and intrathoracic tension syndrome, which determined the needed prosthetics for vital functions. Two months after the operation, the efficiency of the intervention and complex therapy was confirmed by the direct results and data of the infants examination. The organizational aspects provided newborns with emergency multidisciplinary specialized medical care.

Effect of Surgical Intervention on Neurologic Recovery in Patients with Central Cord Syndrome

2020 ◽  
Vol 81 (04) ◽  
pp. 318-323
Author(s):  
Li Du ◽  
Shichang Zhao ◽  
Zhongsheng Zhu ◽  
Feng Xue ◽  
Yadong Zhang
Keyword(s):  
Spinal Cord ◽  
Surgical Intervention ◽  
Perioperative Complications ◽  
Spinal Instability ◽  
Indications For Surgery ◽  
Neurologic Recovery ◽  
Central Cord Syndrome ◽  
Time Of Admission ◽  
Better Than

AbstractTo review the experience of managing central cord syndrome (CCS) surgically, we retrospectively reviewed 71 patients from October 2015 to April 2017. Deteriorating neurologic status with evidence of radiologic compression and spinal instability were absolute indications for surgery. The American Spinal and Injury Association (ASIA) motor scores (AMS) were recorded at the time of admission (aAMS), 3 days postoperatively (3dAMS), 1 month postoperatively(1mAMS), and at final follow-up (fAMS). Analysis of variance was performed to compare 3dAMS, 1mAMS, and fAMS. Surgery was successful in all 71 patients without re-injury of the spinal cord, infection, or other perioperative complications. The postoperative AMS at 3 days, 1 month, and at the final follow-up significantly improved over preoperative scores. ASIA sensory scores at fAMS were significantly better than 3dAMS and1mAMS scores. The ASIA motor and sensory scores at 1mAMS showed no significant improvements compared with the 3dAMS. Therefore, for patients diagnosed with CCS, combined with evidence of radiologic compression and spinal instability, surgery was beneficial in terms of gains in neurologic recovery.

The role of imagination in the disease process: pre-Cartesian history (the role of imagination in the disease process)

1976 ◽  
Vol 6 (2) ◽  
pp. 179-184 ◽  
Author(s):  
C. E. McMahon
Keyword(s):  
Therapeutic Efficacy ◽  
Disease Process ◽  
Close Attention ◽  
Vital Functions ◽  
Set Up

SynopsisAncient and Renaissance physicians implicated the soul's imaginative faculty in the genesis and remission of disease. The theory stated that images of objects of desire or aversion aroused emotions, which in turn set up humoral imbalances, disturbing digestion and other vital functions, culminating in various forms of pathology. This concept explained the therapeutic efficacy of ‘placebos’ in forms such as spells, charms and talismans. The theory merits close attention by contemporary physicians and researchers.

scholarly journals Prevalence of Histologically Proven Acute Appendicitis And Incidental Carcinoid Tumour in the Practice of Surgical Pathology at BPKIHS

2016 ◽  
Vol 12 (3) ◽  
pp. 197-203
Author(s):  
P Upadhyaya ◽  
C S Agarwal ◽  
A K Karak ◽  
S Karki ◽  
A Pradhan ◽  
...  
Keyword(s):  
Health Care ◽  
Abdominal Pain ◽  
Retrospective Study ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Carcinoid Tumour ◽  
Common Cause ◽  
Set Up ◽  
Relative Prevalence

Background: Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention. Objective: To determine the relative prevalence of histologically proven acute appendicitis in surgically respected specimens with clinical diagnosis of acute appendicitis and also to find out the rate of occurrence of characinoid tumour as an incidental histologic finding.Methods: It is a retrospective study involving all gross specimens received in the department of pathology over a period of twenty months (1.1.2006 to 31.8.2007). Histologic data on 515 appendicectomy samples (clinically diagnosed as appendicitis) of the total 7295 specimens received over a period of twenty months were retrieved from the archives of department of pathology, with exclusion of appendectomy incidental to another surgical procedure.Results: Appendectomy specimens constituted 7.0% (n=515; M:F 1.1:1) of all surgical pathologic specimens (n=7295) at B.P.K.I.H.S. The breakups of histologic diagnoses are: acute appendicitis with or without periappendicitis and gangrenous change (93.6%, n=482), “receding appendicitis” (5.4%, n=28), and normal histology (1.0%, n= 5). Carcinoid tumours were detected incidentally in three cases (0.58%) out of all appendectomy specimens.Conclusion: Analysis of data revealed a prevalence of 6.99% of histologically proven acute appendicitis in this tertiary health care set up. The rate of occurrence of carcinoid tumour was 0.58%.Health Renaissance 2014;12(3): 197-203

scholarly journals Evaluation of risk and quality management in a Casablanca operating theatre

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Rigobert Lotoko Kapasa ◽  
Sanaa Belabbes ◽  
Abdelaziz Hannoun ◽  
Radouane Belouali ◽  
Btissam Taybi
Keyword(s):  
Operating Room ◽  
Surgical Intervention ◽  
Functional Unit ◽  
Monitoring And Evaluation ◽  
Surgical Instruments ◽  
Surgical Interventions ◽  
Management Concept ◽  
Set Up ◽  
Sterilization Service ◽  
First Contact

Risks at the level of the operating room are permanent and different from one surgical intervention to another. They have diverse sources, hence the importance of risk management concept for a good functioning of the operating room in order to enhance care quality.The recurrent absence of surgical instruments (surgery forceps and other instruments) in their box is still a major problem within the operating room. It often happens during the surgical interventions, whether are major or minor, that the surgical team uses many boxes to fill these lacks.The objective of this study is to help the clinic to establish an ongoing improvement dynamic of processes within the operating room. It is consisted of tracing the steps of management of the patient to be operated, from their first contact with the process staff to their exit from the operating room to the functional unit. With the help of cartography, the connections between the operating room process and the processes of support, the liaison between activities, fluxes and resources are easily understood.The analysis and the prioritization of dominant problems are done according to (SMART) indicators and QQQQCC methodology. The absence of surgical instruments (surgery forceps and other instruments) in their storing boxes was chosen as a dominant problem within this process in complicity with key persons of the operating room and the clinic managers through many meetings.Through the analysis of the causes effects or ishikawa diagram, the weak organizational culture, the competences insufficiency, unsuitable workforce, and the under motivation of staff sterilization service have been recognized as causes of the origin of the problem because it is at the equipment packaging step where the instruments are intertwined.In conclusion, an arsenal of solutions and actions are set up to overcome this problem and as the staff enhancement responsible for sorting and packaging boxes of sterilization (currently only the major is dedicated to these tasks, continuous staff training, a team in charge of monitoring and evaluation of risks and quality within the operating…

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