Non-intubated uniportal subxiphoid thoracoscopic extended thymectomy for thymoma associated with myasthenia gravis

Background To describe a technique of non-intubated uniportal subxiphoid thoracoscopic extended thymectomy. Methods Data were collected retrospectively. A single 3-cm transverse incision was made below the xiphoid process. This method for extended thymectomy entails adoption of uniportal subxiphoid VATS combined with using of non-intubated anesthesia for thymoma associated with myasthenia gravis. Results Ten consecutive patients underwent this procedure successfully. Mean operative time was 102.5 min. Conversion to intubated ventilation or thoracotomy was not required. Mean chest tube duration was 3.5 days. Mean postoperative hospital stay was 4.7 days. Histologic examination showed early-stage thymomas. Side effects were rare. Quantitative MG scores decreased during follow-up. Conclusions Patients were uneventfully discharged with fast recovery. This technique may merge the potential benefits of a subxiphoid incision and the non-intubated anesthesia protocol.

Inadvertent laparoelytrotomy in second stage of labour: a case report

Laparoelytrotomy is the accidental delivery via a vaginal incision during caesarean section in second stage of labour. It refers to the inadvertent delivery of the foetus through a transverse incision given over the vagina during a caesarean section (C-section). It is a rather uncommon complication of C-section encountered at advanced dilation which can lead to maternal complications such as traumatic postpartum hemorrhage, injury to bladder, ureters and difficult reconstruction of vagina. Here, we present a case report of inadvertent laparoelytrotomy during C-section.

Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section

Introduction A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. Methods The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.

Obstructed right Duari hernia

The caecum and appendix are uncommon contents of femoral hernia (Duari hernia). Diagnosis is usually intraoperative. We report a rare case of obstructed right femoral hernia in a 65-year-old woman. She was admitted into the accident and emergency department because of sudden irreducibility of a previously reducible right groin swelling of 5 years duration. She had obstructive symptoms with an irreducible right groin mass clinically diagnosed as obstructed right femoral hernia. A combination of infra-inguinal transverse incision and a lower midline laparotomy incision was used. The intraoperative findings included the herniation of the caecum and appendix into the right femoral canal. Patient had an uneventful recovery. Duari hernia is uncommon. A high index of suspicion and an experiencedsurgeon, who can handle uncommon findings should be involved in the management of obstructed femoral hernias.

Applicability of Euphorbia milii var splendens latex in the control of Biomphalaria tenagophila

The present work aimed to evaluate in vitro the molluscicidal activity and latex toxicity of Euphorbia milii var. splendens (Bojer ex Hook) Ursch & Leandri for the control of mollusks of the species Biomphalaria tenagophila. Specimens of E. milii var. splendens cultivated in the rural region of Pindamonhangaba were selected, from which latex was obtained by the transverse incision of the aerial parts. For the molluscicide test, adult mollusks of the species B. tenagophila were separated into groups of 10 and submitted to latex immersion at concentrations of 2.5 ppm, 1.25 ppm, 0.625 ppm, and 0.3125 ppm for 24 hours. In parallel, the toxicity of latex at a concentration of 0.3125 ppm was determined by testing with Artemia salina (mortality assessment) and using the Allium cepa test (determination of growth inhibition, amount, and weight of roots). It was observed an important molluscicidal activity of E. milii var. splendens latex at the various concentrations evaluated. In addition, it was also possible to observe moderate toxicity against A. salina nauplii and in the toxicity test with A. cepa. This demonstrates the potential of using latex from E. milii var. splendens to control populations of B. tenagophila species, not only for the observed molluscicidal activity but also for the moderate mortality of A. salina nauplii, whereas in the A. cepa test no change was observed in the parameters evaluated in relation to the control group, demonstrating safety for use in the environment.

Study on the Method of Enucleation of Anterior Uterine Fibroids by Transverse Incision of Lower Uterine Segment During Cesarean Section

Introduction: A retrospective study was conducted to investigate the effectiveness and feasibility of enucleation fibroids of the anterior wall of the uterus by transverse incision of the uterus at the same time during cesarean section. Methods The medical history, surgical data, preoperative and postoperative blood system changes and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section in the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results There was no significant difference in the number of leiomyoma, pathological type, preoperative and postoperative hemoglobin, incidence of perioperative bleeding, frequency of blood transfusion, incidence of postoperative fever, uterine involution and lochia between the study group and the control group. The proportion of large fibroids in the study group was slightly higher than that in the control group (p < 0.05), and the operation time and average hospitalization time in the study group were slightly longer than that in the control group (p < 0.05).The distribution of type III-V fibroids in the study group was slightly more than that in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion It is safe and effective to enucleate the fibroids of the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. Potential to reduce the risk of pelvic adhesion and intrauterine adhesion in the future, so that some patients avoid the risk of reoperation.