scholarly journals Advances in surgical treatment of lymphedema

2021 ◽  
Vol 48 (6) ◽  
pp. 670-677
Author(s):  
Maureen Beederman ◽  
David W. Chang
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Imaging Modalities ◽  
Debulking Surgery ◽  
Compression Garments ◽  
The Past ◽  
Nonsurgical Management ◽  
Microsurgical Techniques ◽  
Decongestive Therapy

An estimated 250 million people worldwide suffer from lymphedema. In the past, the firstline option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

Energy Sources for the Surgical Treatment of Atrial Fibrillation

2019 ◽  
Vol 14 (6) ◽  
pp. 503-508
Author(s):  
Robert M. MacGregor ◽  
Spencer J. Melby ◽  
Richard B. Schuessler ◽  
Ralph J. Damiano
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Tissue Injury ◽  
Surgical Techniques ◽  
Maze Procedure ◽  
Energy Sources ◽  
Surgical Approaches ◽  
Surgical Ablation ◽  
The Past ◽  
Minimally Invasive Surgical

The surgical treatment of atrial fibrillation has evolved over the past 2 decades due to the advent of ablation technology, and the introduction of less invasive surgical approaches. Current devices produce ablation lines that aim to replace the incisions of traditional surgical ablation strategies, such as the Cox-Maze procedure. This has helped to simplify and shorten surgical ablation procedures and has allowed for the development of minimally invasive surgical techniques. This review discusses surgical ablation energy sources and devices, providing background on device characteristics, mechanism of tissue injury, and success in creating transmural lesions.

scholarly journals On the issue of critical arterial stenosis

2021 ◽  
Vol 28 (2) ◽  
pp. 9-16
Author(s):  
A. A. Suprunovich ◽  
A. Ya. Bedrov ◽  
A. A. Vrabiy ◽  
A. A. Moiseev ◽  
A. V. Baykova ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Surgical Treatment ◽  
Gold Standard ◽  
Surgical Intervention ◽  
Arterial Stenosis ◽  
Functional Tests ◽  
The Past ◽  
Atherosclerotic Lesions ◽  
Weak Side ◽  
The Brain

Cardiovascular disease (CVD) is the leading cause of death worldwide. The main contribution to the structure of mortality from CVD is made by atherosclerosis. Indications for surgical treatment of patients with diseases caused by atherosclerotic lesions of the arteries are set taking into account the degree of their stenosis. Angiography has been considered the gold standard for screening patients with CVD for many years. Numerous studies carried out over the past several decades have revealed the weak side of this method in assessing the significance of borderline stenosis. Therefore, to analyze such changes, functional tests were introduced to clarify the indications for surgical intervention. Currently, criteria for the significance of stenosis of the iliac, renal and coronary arteries have been determined. The significance of stenosis of the arteries supplying the brain and intestines is still a matter of debate and requires further study.

scholarly journals The bariatric patient: basic aspects preparation for surgical treatment of obesity and conducting after it. Lecture for practitioners

2021 ◽  
Vol 23 (4) ◽  
pp. 339-346
Author(s):  
Ekaterina V. Ershova ◽  
◽  
Kseniya A. Komshilova ◽  
Natalya V. Mazurina ◽  
Ekaterina A. Troshina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Surgical Treatment ◽  
Surgical Techniques ◽  
Bariatric Patient ◽  
Negative Effects ◽  
The Past ◽  
Carbohydrate And Lipid Metabolism ◽  
Treatment Of Obesity ◽  
Surgical Treatment Of Obesity

Over the past years and decades, in the world in general and particularly in Russia, bariatric surgery is becoming more widespread for the treatment of severe forms of obesity. There is an increase in the number of operations performed along with the effectiveness and minimising risks of the operations held due to the improvement of surgical techniques. In this lecture, there are clearly stated indications and contraindications for the surgical treatment of obesity. Here are presented various types of bariatric surgeries and their pathophysiological mechanisms which affect on body weight, carbohydrate and lipid metabolism. There is also presented their effectiveness in comorbid obesity pathology, primarily among patients with type 2 diabetes. Here was held an analysis of possible negative effects after surgical treatment for obesity, including secondary hyperparathyroidism, post-bariatric hypoglycemia, etc., as well as predictors of postoperative prognosis in relation on metabolic control among patients with obesity and type 2 diabetes.

scholarly journals Treatment of adult thoracolumbar spinal deformity: past, present, and future

2019 ◽  
Vol 30 (5) ◽  
pp. 551-567 ◽  
Author(s):  
Justin S. Smith ◽  
Christopher I. Shaffrey ◽  
Christopher P. Ames ◽  
Lawrence G. Lenke
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Spinal Deformity ◽  
State Of The Art ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Limited Ability ◽  
The Past ◽  
Current State ◽  
The Future

Care of the patient with adult spinal deformity (ASD) has evolved from being primarily supportive to now having the ability to directly treat and correct the spinal pathology. The focus of this narrative literature review is to briefly summarize the history of ASD treatment, discuss the current state of the art of ASD care with focus on surgical treatment and current challenges, and conclude with a discussion of potential developments related to ASD surgery.In the past, care for ASD was primarily based on supportive measures, including braces and assistive devices, with few options for surgical treatments that were often deemed high risk and reserved for rare situations. Advances in anesthetic and critical care, surgical techniques, and instrumentation now enable almost routine surgery for many patients with ASD. Despite the advances, there are many remaining challenges currently impacting the care of ASD patients, including increasing numbers of elderly patients with greater comorbidities, high complication and reoperation rates, and high procedure cost without clearly demonstrated cost-effectiveness based on standard criteria. In addition, there remains considerable variability across multiple aspects of ASD surgery. For example, there is currently very limited ability to provide preoperative individualized counseling regarding optimal treatment approaches (e.g., operative vs nonoperative), complication risks with surgery, durability of surgery, and likelihood of achieving individualized patient goals and satisfaction. Despite the challenges associated with the current state-of-the-art ASD treatment, surgery continues to be a primary option, as multiple reports have demonstrated the potential for surgery to significantly improve pain and disability. The future of ASD care will likely include techniques and technologies to markedly reduce complication rates, including greater use of navigation and robotics, and a shift toward individualized medicine that enables improved counseling, preoperative planning, procedure safety, and patient satisfaction.Advances in the care of ASD patients have been remarkable over the past few decades. The current state of the art enables almost routine surgical treatment for many types of ASD that have the potential to significantly improve pain and disability. However, significant challenges remain, including high complication rates, lack of demonstrated cost-effectiveness, and limited ability to meaningfully counsel patients preoperatively on an individual basis. The future of ASD surgery will require continued improvement of predictability, safety, and sustainability.

scholarly journals Indikaciona podrucja neoperativnog i operativnog lecenja intraartikularnih preloma kalkaneusa

2006 ◽  
Vol 53 (4) ◽  
pp. 125-131
Author(s):  
I.J. Butkovic
Keyword(s):  
Surgical Treatment ◽  
Preoperative Evaluation ◽  
Fracture Pattern ◽  
Medical Illness ◽  
The Past ◽  
Nonsurgical Management ◽  
Chronic Medical Illness ◽  
Orthopedic Surgeons ◽  
Anatomic Reduction ◽  
Simple Fracture

Historically, intra-articular calcaneal fractures have been managed, as a rule, nonsurgically, although surgical treatment has more advocates in the past 20 years. Even today many high specialized orthopedic surgeons have a lot of controversies relating the indications fields of nonsurgical and operative treatment of these fractures. For getting correct decision adequate preoperative evaluation of fracture type, overall patients health and his functional needs is necessary. Generally, elderly patients with sedentary habits, without or with minimal fracture displacement, might be treated successfully with nonsurgical management. Good result after surgical treatment might be predicted in patients younger than 40 years, with a simple fracture pattern and high probability of achieving anatomic reduction. Highly precise and good surgical technique is necessary for getting a good final result with a long learning curve of the surgeon. Smoking, diabetes, chronic medical illness, peripheral vascular disease as well workers compensation claim (!) markedly increase the risk of surgical complications.

scholarly journals Operative Outcomes for Cervical Myelopathy and Radiculopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
J. G. Galbraith ◽  
J. S. Butler ◽  
A. M. Dolan ◽  
J. M. O'Byrne
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Intractable Pain ◽  
Spinal Stability ◽  
Nerve Roots ◽  
Operative Outcomes ◽  
Anterior Posterior

Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

scholarly journals Degenerative scoliosis of the ventricle: diagnosis, classification and surgical approach in older patients

2021 ◽  
Author(s):  
Anton Yarikov
Keyword(s):  
Surgical Treatment ◽  
Physical Therapy ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Surgical Techniques ◽  
Neurological Status ◽  
Point Of View ◽  
Degenerative Scoliosis ◽  
Instrumental Methods

Adult scoliosis is a deformity of the spine with an angle of more than 10 (according to Cobb) in people with a fully formed bone system. Due to the aging of the population, the improvement of surgical techniques, the appearance of new implants and the improvement of anesthetic aids, the problem of degenerative scoliosis is increasingly being considered from the point of view of the possibilities of surgery. There are many theories that contribute to the formation of degenerative scoliosis. Conservative therapy of degenerative scoliosis includes non-steroidal anti-inflammatory drugs, corset therapy, epidural and paravertebral injections with glucocorticosteroids, physical therapy, and physical therapy. With complete ineffectiveness of conservative therapy and with a significant decrease in the quality of life of the patient, the question of performing surgical intervention is individually decided. Currently, the question of the role and scope of surgical intervention in individuals with this pathology remains debatable. The choice of surgical intervention depends on a thorough assessment of clinical symptoms, neurological status, data of instrumental methods of examination and mandatory consideration of the parameters of the global vertebral-pelvic balance. Therefore, in this article, special attention is paid to the algorithms of surgical treatment based on the choice of the type of decompression and the length of the fusion. The paper describes the generally accepted criteria for selecting the level of spondylosynthesis. Special attention is paid to the risk factors for surgical treatment. As well as the complications associated with surgical treatment are described.

scholarly journals Treatment of congenital spinal deformities in children: yesterday, today, tomorrow

2020 ◽  
Vol 17 (1) ◽  
pp. 15-24
Author(s):  
S. O. Ryabykh ◽  
E. V. Ulrikh ◽  
A. Yu. Mushkin ◽  
A. V. Gubin
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Functional Status ◽  
Treatment Planning ◽  
Anesthetic Management ◽  
Surgical Techniques ◽  
Spinal Deformities ◽  
The Past ◽  
Control Introduction

The paper presents an unsystematized review of technologies, techniques and options for surgical treatment of congenital spinal deformities in children over the past 40 years. The main trends in the surgery of spinal deformities are highlighted: evolution of methods of visual diagnostic, treatment planning, and surgeon action control, introduction of adapted functional status scales and questionnaires for quality of life, hybridization of surgical techniques, evolution of spinal implants and instruments, and progress of anesthetic management. At the same time, new clinical and scientific problems are also discussed in the paper: questions of unifying terminology, planning the volume of treatment, the difficulty of comparing treatment methods and technologies, education, and integration.

SURGICAL TREATMENT OF PULMONARY CYSTS IN INFANCY

PEDIATRICS ◽  
1954 ◽  
Vol 14 (6) ◽  
pp. 651-658
Author(s):  
HENRY SWAN ◽  
G. E. ARAGON
Keyword(s):  
Surgical Treatment ◽  
General Hospital ◽  
Respiratory Function ◽  
Surgical Intervention ◽  
Surgical Removal ◽  
Lung Cysts ◽  
The Past ◽  
Pulmonary Cysts ◽  
Pulmonary Parenchyma

Although some lung cysts in infancy may be harmless and the pathology reversible, many of these lesions seriously jeopardize life by causing compression atelectasis with pneumonia, by enlarging to sizes incompatible with adequate respiratory function, or by becoming grossly infected. In such instances, surgical removal becomes urgent. The three cases of this disease seen at Colorado General Hospital in the past six years illustrated these complications, and all required surgical intervention. Lung cysts in infancy, if they are symptomatic, should be surgically removed, preserving as much pulmonary parenchyma as possible.

Thrombolysis in Arterial Occlusion

1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe
Keyword(s):  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
Arterial Occlusion ◽  
Second Step ◽  
Severe Bleeding ◽  
Initial Management

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.

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