Surgical treatment of children with a combination of congenital lung malformations and tuberculosis

Congenital malformations of the bronchopulmonary system in combination with tuberculosis are extremely rare in practice, but they usually require surgical treatment. This combination often causes diagnostic difficulties.Characteristics of children and research methods. We have analyzed the experience of surgical treatment of a combination of various congenital lung defects and tuberculosis in 20 children. 9 (45%) children had lung sequestration, 4 (20%) children had lung hypoplasia, 5 (25%) children had congenital bronchiectasis, 1 (5%) child had arteriovenous malformation, and 1 (5%) child had a congenital lung cyst. There were 3 segmental resections, 15 lobeand bilobectomies, and 3 pneumonectomies. All surgeries were performed using minimally invasive approaches (VATS).Results. 11 (55%) patients had diagnostic difficulties of concomitant pathology. Only in 5 (25%) cases they found mycobacteria in sputum before surgery. Postoperative study of material from tuberculous lesions helped to establish multidrug resistance of mycobacterium tuberculosis and to change the chemotherapy regimen in 3 (15%) patients. There were no postoperative complications or deaths. All surgeries were effective. Long-term results were studied in 16 (80%) of 20 patients over a period from 1 to 10 years. No cases of reactivation of tuberculosis or disability.Conclusion. Resection surgery for combination of tuberculosis and congenital lung defects allowed to clarify the diagnosis and to achieve a direct effect in all patients by clarifying the drug resistance of mycobacterium tuberculosis and to optimize postoperative chemotherapy.

Secondary hypospadias repair using Buccal mucosa graft: case series of 50 patients

Background: The aim of the study was to assess the various complications noticed following primary hypospadias repair and to evaluate the impact of preoperative, perioperative and postoperative study of primary hypospadias repair on patients’ quality of life, independence, and complication rates. Objective of this study was to assess the success of buccal mucosa graft in secondary hypospadias repair and study the incidence and severity of complications both to the donor and recipient sites.Methods: A total of 50 patients with previous failed hypospadias repair were included in the study who were admitted in plastic surgery unit from August 2013 to December 2016. The age of patients studied ranged from 8 to 16 years, in which about 60% cases that were presented with previous hypospadias repair were in age group 11-14 years. Patients in this study had undergone multiple previous surgeries for hypospadias repair. Ten patients had 1-2 surgeries and 40 patients had undergone 3 or more procedures for hypospadias repair.Results: In study of 50 patients only 12 had complications following buccal mucosa graft urethroplasty.Conclusions: Overall it showed that buccal mucosal graft urethroplasty had better results in hypospadias cripples.

The modified polymethyl methacrylate-silicone keratoprosthesis in rabbit model

Purpose: To evaluate the safety and effectiveness of a modified polymethyl methacrylate-silicone keratoprosthesis and its operation method in alkali-burned rabbit model. Methods and materials: The polymethyl methacrylate-silicone keratoprostheses were implanted into seven alkali-burned rabbit corneas by a special operation method using autologous graft as the keratoprosthesis (Kpro) carrier. The long-term postoperative outcomes were evaluated. Results: During a postoperative study period of 16 months, except for one Kpro extruded at 3 months, all Kpros were in good position and were kept transparent without Kpro extrusion, keratolysis, infection, endophthalmitis, or retinal detachment. The postoperative complications included elevated intraocular pressure in two cases and temporary retroprosthetic membrane formation in two cases. Conclusion: The modified polymethyl methacrylate-silicone Kpro and its operation method is a relatively safe and effective choice for alkali-burned rabbit eyes. Elevated intraocular pressure is the main complication needing to be resolved.