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surgical technique. management

S Castañeda, I Molina, P Jaimes, J Beltrán, J Valero, F Fierro
INTRODUCTION: The aim of the present study was to evaluate clinical presentation and management of sigmoid volvulus in children. Sigmoid volvulus is one of the three leading causes of acute obstruction of the colon and is between 50 and 90% of all large bowel volvulus. In the pediatric population only 3 to 5% of bowel obstructions are caused by volvulus and there are less than 100 cases reported in the literature. The presence of a redundant sigmoid with a narrow mesentery (dolicosigmoide) is a prerequisite for the volvulus formation...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Shafi Mussa, Nigel E Drury, John Stickley, Natasha E Khan, Timothy J Jones, David J Barron, William J Brawn
OBJECTIVES: Despite the challenges of surgical management of congenital heart disease, excellent outcomes are being achieved. Newly appointed congenital heart surgeons may have limited first operator experience for many complex conditions but are expected to achieve similar outcomes. A strategy of routine mentorship from more experienced surgeons may be the key to enabling new surgeons to become proficient while maintaining excellent outcomes for patients. METHODS: The arterial switch operation (ASO) is a technically demanding but relatively commonly performed, reproducible, and easily visualized neonatal procedure, making it valuable for mentoring newly appointed congenital heart surgeons...
October 23, 2016: European Journal of Cardio-thoracic Surgery
P Metais, P Clavert, J Barth, P Boileau, R Broszka, G Nourissat, J Leuzinger, G Walch, L Lafosse
BACKGROUND: The Latarjet-Patte procedure consisting in transfer and screw fixation of the coracoid process to the anterior glenoid is a treatment of reference for anterior shoulder instability. Over time, surgical innovations translated into a number of improvements and, in late 2003, an arthroscopically assisted variant of the procedure was described. OBJECTIVE: To evaluate and compare clinical outcomes of the modified Latarjet-Patte procedure performed by open surgery, arthroscopy with screw fixation, or arthroscopy with endobutton fixation...
October 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
O T A Lyons, M Baguneid, T D Barwick, R E Bell, N Foster, S Homer-Vanniasinkam, S Hopkins, A Hussain, K Katsanos, B Modarai, J A T Sandoe, S Thomas, N M Price
OBJECTIVE/BACKGROUND: The management of aortic graft infection (AGI) is highly complex and in the absence of a universally accepted case definition and evidence-based guidelines, clinical approaches and outcomes vary widely. The objective was to define precise criteria for diagnosing AGI. METHODS: A process of expert review and consensus, involving formal collaboration between vascular surgeons, infection specialists, and radiologists from several English National Health Service hospital Trusts with large vascular services (Management of Aortic Graft Infection Collaboration [MAGIC]), produced the definition...
October 19, 2016: European Journal of Vascular and Endovascular Surgery
Luigi Olper, Elena Bignami, Ambra L Di Prima, Santina Albini, Simona Nascimbene, Luca Cabrini, Giovanni Landoni, Ottavio Alfieri
BACKGROUND: Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors' aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. DESIGN: Randomized, open-label trial...
August 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Paweł J. Zawadzki, Bohdan Starościak, Konrad Perkowski, Wanda Baltaza, Marcin Padzik, Krzysztof Pionkowski, Lidia Chomicz
In this research, a comparative analysis of results of investigations involving different human populations, in terms of a relation between the oral cavity health and the species composition of mouth microbiota is reported. The purpose of this analysis was to identify and assess microorganisms that could cause health complications in patients with neoplasm requiring dental problem-related surgical management. The patients with the oral cancer surgically treated and those without neoplasm were assessed for their oral health: status of teeth, gingiva, periodontium, and occurrence of inflammatory processes...
October 1, 2016: Annals of Parasitology
Michael Buchfelder, Sven-Martin Schlaffer
PURPOSE: Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. METHODS: Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. RESULTS: The rapid reduction of tumour volume is an asset of surgery...
October 21, 2016: Pituitary
Giuseppe Brescia, Giorgia Saia, Federico Apolloni, Gino Marioni
INTRODUCTION: Over the last 30years, dental implants have become widespread all over the world. Though the implantation procedure is standardized and safe, the displacement of implants into the maxillary sinus can occur. The aim of the study has been to describe a novel combined nasal endoscopic approach through the middle and lower meatus for managing dental implants displaced into the maxillary sinus. METHODS/RESULTS: A 40-year-old man was examined for a titanium osteo-integrated implant displaced within the alveolar recess of the left maxillary sinus...
September 28, 2016: American Journal of Otolaryngology
Denis Querleu, Jacques Meurette, Emile Daraï, Philippe Morice, François Planchamp
Surgery has evolved as a mainstay of the management of ovarian cancer since evidence of the major benefit of complete surgery, i.e. achieving complete resection of the disease without visible macroscopic residue in a comprehensively explored abdominal cavity, has been made available. This objective may be difficult to complete in case of advanced ovarian cancer, as it requires the use of advanced techniques of peritoneal and visceral surgery, in the setting of adapted perioperative care, generally in institutions where the caseload is sufficient to ensure an appropriate surgical experience, and where specifically trained surgeons are available...
October 18, 2016: Bulletin du Cancer
Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Robert J Gillespie, Derrick M Knapik, Ozan Akkus
Rotator cuff injuries are common in both young and elderly patients. Despite improvements in instrumentation and surgical techniques, the failure rates following tendon reconstruction remain unacceptably high. To improve outcomes, graft patches have been developed to provide mechanical strength and to furnish a scaffold for biologic growth across the delicate tendon-bone junction. Although no patch effectively re-creates the structured, highly organized system of prenatal tendon development, augmenting rotator cuff repair may help restore native tendon-to-bone attachment while reproducing the mechanical and biologic properties of native tendon...
October 20, 2016: Journal of the American Academy of Orthopaedic Surgeons
Marina Pieri, Anna Mara Scandroglio, Marcus Müller, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Evgenij Potapov, Marian Kukucka
BACKGROUND AND AIM OF THE STUDY: Driveline infections in patients with implantable left ventricular assist devices (VAD) carry increasing risk for pump infection, thromboembolic events, decreased quality of life, and increased hospitalization. We report our experience with a surgical technique for refractory driveline infections without mediastinitis consisting of translocation and wrapping of the driveline with greater omentum tissue. METHODS: We retrospectively reviewed data of VAD patients who underwent surgical treatment by translocation and wrapping with omentum for severe chronic driveline infection...
October 20, 2016: Journal of Cardiac Surgery
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
October 20, 2016: Updates in Surgery
Paul Castellanos, Manjunath Mk, Ihab Atallah
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years...
October 20, 2016: European Archives of Oto-rhino-laryngology
Conor F Hynes, Michael D Greenberg, Shawn Sarin, Gregory D Trachiotis
Stanford Type A aortic dissection is a rapidly progressing disease process that is often fatal without emergent surgical repair. A small proportion of Type A dissections go undiagnosed in the acute phase and are found upon delayed presentation of symptoms or incidentally. These chronic lesions may have a distinct natural history that may have a better prognosis and could potentially be managed differently then those presenting acutely. The method of repair depends on location and extent of the false lumen, as well as involvement of critical structures and branch arteries...
February 2016: Aorta (Stamford, Conn.)
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
October 7, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Kumar C Pradeep, Shahid M A Mohammed, Mandavia Anisha
A natural appearing ear with appropriate projection from the head remains a great challenge in the reconstruction of the ear. Surgical and prosthetic means have been addressed in the management of patients with microtia, with each carrying its own merits and demerits. Lack of adequate projection of the ear and adhesion of tissues are some common complications of reconstructive surgery that can adversely affect the treatment outcome. This article describes a technique for the fabrication of a postsurgical stent to prevent adhesion of the surgically reconstructed ear to the underlying tissues...
October 17, 2016: Journal of Prosthetic Dentistry
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
S Chawla, J Bowman, M Gandhi, B Panizza
BACKGROUND: The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage...
October 20, 2016: Journal of Laryngology and Otology
Soo Yeon Hahn, Jung Hee Shin, Hyun Kyung Lim, So Lyung Jung, Young Lyun Oh, In Ho Choi, Chan Kwon Jung
BACKGROUND: A recent concept was proposed that the non-invasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) reclassified as "non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is benign. Our aim was to identify the differences between NIFTP and non-NIFTP preoperatively. METHODS: This retrospective study included a total of 208 patients with 208 FVPTCs that were surgically confirmed at 3 university hospitals from 2008 through 2014...
October 19, 2016: Clinical Endocrinology
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