scholarly journals Modified three-step procedure to treat buried penis in children without previous surgery: experience in 150 cases

2021 ◽  
Vol 3 (4) ◽  
pp. 25-30
Author(s):  
Hanzhong HE ◽  
Pengfei GAO ◽  
Sunjie SUN ◽  
Gaoyan DENG
Keyword(s):  
Surgical Procedure ◽  
Operative Time ◽  
Previous Surgery ◽  
Cosmetic Results ◽  
Step Procedure ◽  
Good Cosmetic ◽  
History Of ◽  
The Mean ◽  
Buried Penis

[Background] The buried penis has an abnormally smaller and shorter appearance. We performed a modified three-step procedure to correct the buried penis with satisfactory cosmetic results. [Methods] From May 2014 to December 2020, 150 boys, ranging in age from 2 to 7 years old (median age: 3.3 years), underwent this three-step procedure. The chief complaint was a smaller and shorter appearance of the penis. The surgical procedure consisted of three steps: complete degloving through a diamond-shaped penoscrotal incision, circumcision to remove the majority of the inner plate, and anchoring of the penopubic skin to the base of albuginea penis at the 4 and 8 o’clock positions with unabsorbable sutures. [Results] The mean operative time was 50 minutes (range from 40 to 60 minutes). The mean follow-up time was 2.8 years (range from 10 months to 6 years). There were no complications or recurrences. Good cosmetic results were achieved in all boys. [Conclusions] Our modified three-step procedure had good cosmetic results without complications. We recommend this effective surgical procedure for boys with buried penis who have no history of previous surgery.

How We Do Buried Penis Reconstruction in Children: A Novel Technique

2018 ◽  
Vol 24 (8) ◽  
pp. 6164-6167
Author(s):  
Widi Atmoko ◽  
Gerhard Renaldi Situmorang ◽  
Irfan Wahyudi ◽  
Arry Rodjani
Keyword(s):  
Complete Separation ◽  
Voiding Function ◽  
Novel Technique ◽  
Good Cosmetic ◽  
Asking Questions ◽  
The Mean ◽  
Time Of Operation ◽  
Satisfaction Rates ◽  
Buried Penis

Buried penis is a pathology for which several reconstructive techniques are described. We described a novel technique involving complete separation of dartos fascia from the skin and penis and excision of dartos fascia until penile fixation to pubic region after complete degloving of penis to eradicate the abnormal attachments of the dartos muscle to the corporal bodies and evaluated the efficacy and safety of our technique. From June 2009 and February 2015, 28 patients underwent surgical repair of buried penis with our novel technique. We administered a questionnaire asking questions about penile size, morphology, and voiding status to evaluate parental satisfaction. The mean age of patients at the time of operation was 9.50±2.09 years, and the mean duration of follow-up was 23.27±16.75 months. The mean satisfaction grades for penile size, morphology, and voiding function were improve (p < 0.05) (Fig. 2). The mean preoperative satisfaction grade concerning penile size was 0.82±0.76, and it improved postoperatively to 2.67±0.52 at the last follow-up (p < 0.001). The mean preoperative satisfaction grade for penile morphology was 0.86 ± 0.55, which improved to 2.12±0.40 at the last follow-up visit (p < 0.001). The mean preoperative satisfaction grade for voiding function was 1.10±0.72, which improved to 2.94±0.86 at the last follow-up visit (p < 0.001). There were no complications such as postoperative infection and tissue necrosis. Edema developed in 2 patients, but resolved spontaneously after 1 month. Our method of buried penis correction was found to be technically feasible and safe. It results in a good cosmetic appearance and excellent postoperative satisfaction rates in terms of size, morphology, and voiding function. Further research is needed to understand its pathophysiology.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

scholarly journals Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Avinash Chennamsetty ◽  
Jason Hafron ◽  
Luke Edwards ◽  
Scott Pew ◽  
Behdod Poushanchi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Incisional Hernia ◽  
Operative Time ◽  
Patient Counseling ◽  
Incisional Hernias ◽  
Prostate Weight ◽  
History Of ◽  
Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

Frequency, Predictors, and Outcome of Seizures in Patients With Myelomeningocele: Single-Center Retrospective Cohort Study

2021 ◽  
pp. 088307382110531
Author(s):  
Cemal Karakas ◽  
Emin Fidan ◽  
Kapil Arya ◽  
Troy Webber ◽  
Joan B. Cracco
Keyword(s):  
Good Prognosis ◽  
Cortical Atrophy ◽  
Seizure Freedom ◽  
Single Center ◽  
Seizure Onset ◽  
Shunt Procedure ◽  
History Of ◽  
The Mean

To determine the frequency, predictors, and outcomes of seizures in patients with myelomeningocele, we retrospectively analyzed the data from patients with myelomeningocele followed longitudinally at a single center from 1975 to 2013. We identified a total of 122 patients (61% female). The mean follow-up duration was 11.1 years (minimum-maximum = 0-34.5 years, SD = 8.8, median = 9.1 years). A total of 108 (88.5%) patients had hydrocephalus, and 98 (90.7%) of those patients required a ventriculoperitoneal shunt procedure. Twenty-four (19.7%) patients manifested with seizures, 23 of whom had hydrocephalus. The average age of seizure onset was 4.8 years (median 2 years of age). Falx dysgenesis ( P = .004), lumbar myelomeningocele ( P = .007), and cortical atrophy ( P = .028) were significantly associated with epileptic seizure development. The average seizure-free period at the last follow-up in patients with a history of myelomeningocele and seizures was 8.1 years. We conclude that myelomeningocele patients with seizures have an overall good prognosis with considerable long-term seizure freedom.

Palliative Treatment of Hepatocellular Carcinoma with Transcatheter Arterial Embolization

1993 ◽  
Vol 34 (1) ◽  
pp. 26-29 ◽  
Author(s):  
S. Savastano ◽  
G. P. Feltrin ◽  
D. Neri ◽  
P. da Pian ◽  
M. Chiesura-Corona ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Embolization ◽  
Palliative Treatment ◽  
Arterial Embolization ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection ◽  
History Of ◽  
The Mean ◽  
Hcc Recurrence

Thirty-three consecutive patients with previously untreated hepatocellular carcinoma (HCC) and 6 patients with recurrent HCC were treated with transcatheter arterial embolization (TAE). The patients were not eligible for surgical resection or percutaneous ethanol injection. TAE was performed with Lipiodol Ultra-Fluid, epidoxorubicin and Gelfoam, with a mean of 1.7 treatments per patient. CT was performed 15 days after TAE. The mean cumulative survival was 14.2 months in patients with previously untreated HCC. The survival of patients stages Okuda I and II did not differ significantly (p > 0.05); tumor size did not affect survival (p > 0.05). Two patients with recurrent HCC died 7.0 and 9.3 months after the diagnosis of tumor recurrence; the remaining 4 patients are still alive with a maximum follow-up of 22.5 months from the diagnosis of HCC recurrence. Ten complications occurred in 8 patients, and were controlled by medical therapy. Eleven patients died during the study; no death was related to TAE. The series was not randomized, but comparison with the natural history of HCC suggests that TAE is effective as palliative treatment of advanced or recurrent HCC.

scholarly journals Complications in Mandibular Midline Distraction

2017 ◽  
Vol 10 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Jan Pieter de Gijt ◽  
Atilla Gül ◽  
Eppo B. Wolvius ◽  
Karel G.H. van der Wal ◽  
Maarten J. Koudstaal
Keyword(s):  
Retrospective Cohort ◽  
Mental Nerve ◽  
Safe Method ◽  
Congenital Deformities ◽  
Area Of Interest ◽  
Sensory Disturbances ◽  
History Of ◽  
The Mean ◽  
New Surgical Technique

Mandibular midline distraction (MMD) is a relatively new surgical technique for correction of transverse discrepancies of the mandible. This study assesses the amount and burden of complications in MMD. A retrospective cohort study was performed on patients who underwent MMD between 2002 and 2014. Patients with congenital deformities or a history of radiation therapy in the area of interest were excluded. Patient records were obtained and individually assessed for any complications. Complications were graded using the Clavien-Dindo classification system (CDS). Seventy-three patients were included of which 33 were males and 40 were females. The mean follow-up was 2.1 years. Twenty-nine patients had minor complications, grades I and II. Two patients had a grade IIIa and three patients had a grade IIIb complication. Common complications were pressure ulcers, dehiscence, and (transient) sensory disturbances of the mental nerve. This study shows that although MMD is a relatively safe method, complications can occur. Mostly the complications are mild, transient, and manageable without the need for any reoperation.

scholarly journals Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.

2020 ◽  
Author(s):  
Roberta Denise Alkmin Lopes Lima ◽  
Rogerio Serafim Parra ◽  
Marley Ribeiro Feitosa ◽  
Omar Féres ◽  
José Joaquim Ribeiro Rocha
Keyword(s):  
Operative Time ◽  
Average Distance ◽  
Economic Feasibility ◽  
Surgeon Experience ◽  
Average Operative Time ◽  
The Mean ◽  
Average Size ◽  
High Level ◽  
Complex Methods

Abstract Purpose Many transanal endoscopic surgeries require a high level of technical expertise and surgeon experience. Considering the economic feasibility of material acquisition and the technical feasibility of training and experience with complex methods, a simpler technique with available resources is relevant for the excision of rectal adenomas. This study presents the surgical and postoperative results achieved with a novel proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques. Methods We retrospectively investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer. Results This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months. Conclusions The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.

scholarly journals Vesico-Vaginal Fistula Repair Through Abdominal Approach

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 129-132
Author(s):  
Hafiz Al Asad ◽  
Asif Yazdani ◽  
Zulfia Zinat Chowdhury ◽  
Muhammad Faruk Hussain ◽  
AKM Shahadat Hossaion ◽  
...  
Keyword(s):  
Wound Infection ◽  
Operative Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Vaginal Fistula ◽  
Abdominal Approach ◽  
History Of ◽  
Vesico Vaginal Fistula

Background: Vesico-Vaginal Fistula (VVF) is a major cause for concern in many developing countries with significant morbidity. Among the different techniques abdominal approach of VVF repair is important one. Objective: To find out the outcome of VVF repair by abdominal approach. Materials and Methods: It is a prospective study. Twenty-three patients with VVF were operated with abdominal approach from the period of January 2016 to January 2019. Age of patients, co-morbidities, cause, size and location of VVF were evaluated. Then abdominal approach of VVF repair was done. Operative time and need of blood transfusion were encountered. Post operative (POD) urine leakage, wound infection or other complications were enlisted. Patients were discharged with keeping urethral catheter for 14 days. Follow up was done after 1 and 3 month and in each follow up history and physical examination was done. All collected data were evaluated. Results: Mean age of the patient was 40 years. Among the 23 patients 12 (52%) patients had history of total abdominal hysterectomy, 9 had history of caesarian section and 2 cases had history of pelvic surgery. VVF repair was done at least 12 weeks after its occurrence. Operative time ranged from 90 minutes to 150 minutes. In the immediate POD no obvious complications were noted except one patient developed wound infection on 7th POD. Follow-up done as per schedule and no recurrence of VVF noted. Conclusion: VVF repair through abdominal approach is a feasible, safe and effective technique if performed meticulously. KYAMC Journal Vol. 11, No.-3, October 2020, Page 129-132

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