Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis

Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.

EndoTech® minimally invasive trigger thumb release

We describe a novel minimally invasive technique for the treatment of trigger thumb. 37 patients with a total of 41 thumbs were included in the study. A visual analogue pain scale was used before surgery and also at 2 week and 6 month follow up visits. The pain was significantly improved from a pre op of 7.92 (+/- 1.6) to .65 (+/- .8) at the 2 week follow up and finally .29 (+/- 1.8) at the 6 month follow up. All of the patients had relief of triggering and only 1 patient required any therapy. This endoscopic technique for trigger thumb allows the surgeon to perform a trigger release with a minimal incision and provides excellent relief without any complications.

Experience of using scleroobliteration in venous angiodysplasia (results of 12-month follow-up)

AIM: To evaluate the results of using the minimally-invasive technique of scleroobliteration in patients with venous malformations. MATERIALS AND METHODS: From 2006 to 2020, 41 interventions were performed for venous-cavernous angiomatosis of various localization through scleroobliteration. Nineteen patients (46.3%) underwent complex treatment, which included a combination of this minimally-invasive technique with other surgical interventions (resection of angiomatous tissues, laser coagulation, and radiofrequency obliteration). RESULTS: Clinical improvement was achieved in 38 (92.7%) patients. According to the data of ultrasound control, 25 patients (61%) experienced no blood flow in the obliteration zone, and there was regression of the initial symptoms within 1 year of observation following intervention. The results of treatment were better due to the local spread of the angiomatous process. With diffuse forms, it was not possible to achieve a positive effect in 3 patients (11.1%). CONCLUSION: Scleroobliteration can provide a positive result in the treatment of patients with venous-cavernous angiodysplasia, both as an independent method and in combination with other minimally-invasive techniques.

A new minimally invasive technique for correction of pectus carinatum

Background The Abramson technique for the correction of pectus carinatum (PC) is commonly performed worldwide. However, the postoperative complications of this technique related to bar fixation, including wire breakage and bar displacement, are relatively high. In this study, a new minimally invasive technique for correction of PC is described, in which the pectus bar is secured by bilateral selected ribs, and for which no special fixation to the rib is needed. Methods The procedure was performed by placing the pectus bar subcutaneously over the sternum with both ends of the bar passing through the intercostal space of the selected rib at the anterior axillary line. The protruding sternum was depressed by the bar positioned in this 2 intra- and 2 extra-thorax manners. Between October 2011 and September 2019, 42 patients with PC underwent this procedure. Results Satisfactory cosmetic results were obtained in all the patients. The mean operation time was 87.14 min, and the mean postoperative stay was 4.05 days. Wound infection occurred in 3 patients, 2 were cured by antibiotics, and 1 received bar removal 4 months after the initial operation due to the exposure of the implant resulting from uncontrolled infection. Mild pneumothorax was found in 3 patients and cured by conservative treatment. One patient suffered from hydropneumothorax, which was treated with chest drainage. The bars were removed at a mean duration of 24.4 months since primary repair in 20 patients without recurrence. Conclusions This new technique for minimally invasive correction of PC deformity is a safe and feasible procedure yielding good results and minimal complications.

Migration of urolift clip into the bladder causing haematuria 3-years after insertion: a rare delayed complication of prostatic urolift

Prostatic UroLift placement as a minimally invasive technique for the treatment of bladder outlet obstruction due to benign enlargement of prostate has been well accepted in literature and is practised with minimal post-operative complications. We present an unusual cause of haematuria due to migration of one of the prostatic UroLift clips into the bladder after 3 years from its insertion and its subsequent endourological management. To our knowledge, delayed migration of UroLift clip causing haematuria has not been reported in literature in the past. Urologists should be aware of this possible situation while dealing with patients with UroLift implanted.