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https://www.readbyqxmd.com/read/28346263/minimally-invasive-aortic-valve-replacement-via-right-anterior-minithoracotomy-and-central-aortic-cannulation-a-13-year-experience
#1
Daniel M Bethencourt, Jennifer Le, Gabriela Rodriguez, Robert W Kalayjian, Gregory S Thomas
OBJECTIVE: This study reports the evolution of a minimally invasive aortic valve replacement (mini-AVR) technique that uses a right anterior minithoracotomy approach with central cannulation, for a 13-year period. This technique has become our standard approach for isolated primary AVR in nearly all patients. METHODS: This observational study evaluated perioperative clinical outcomes of patients 18 years or older who underwent mini-AVR from November 2003 to June 2015...
March 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28329189/mid-term-results-of-zone-0-thoracic-endovascular-aneurysm-repair-after-ascending-aorta-wrapping-and-supra-aortic-debranching-in-high-risk-patients
#2
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28326427/posterior-stabilized-total-knee-arthroplasty-a-matched-pair-analysis-of-a-classic-and-its-evolutional-design
#3
Pier Francesco Indelli, Gennaro Pipino, Paul Johnson, Angelo Graceffa, Massimiliano Marcucci
BACKGROUND: Total knee arthroplasty (TKA) designs continue to be modified to optimize patient's outcome. This study was designed to compare clinical and radiological results of classic worldwide used TKA posterior-stabilized (PS) design to those of its recent evolution. METHODS: A consecutive group of 100 patients undergoing TKA using a classic cemented fixed-bearing PS TKA system was matched by age, gender, body max index to 100 patients having the newer cemented fixed-bearing PS design, both by the same manufacturer...
December 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28316961/acute-delayed-or-late-infection-of-revision-total-hip-arthroplasty-treated-with-debridement-antibiotic-loaded-cement-beads-and-retention-of-the-prosthesis
#4
Jun-Dong Chang, In-Sung Kim, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28285012/two-stage-treatment-of-ischial-pressure-ulcers-in-spinal-cord-injury-patients-technique-and-outcomes-over-8-years
#5
Sumanas W Jordan, Mauricio De la Garza, Victor L Lewis
BACKGROUND: Despite newly introduced techniques, reconstruction of ischial pressure ulcers remains a difficult problem with high-reported failure rates. METHODS: A retrospective chart review was performed on all spinal cord injury patients who underwent ischial pressure ulcer reconstruction by the senior author (V.L.) between 2004 and 2012. The two-stage procedure consisted of debridement and bone biopsy, followed by bursectomy, partial ischiectomy, fascial release, and gluteus maximus and hamstring advancement flaps...
January 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28275427/resection-and-reconstruction-following-recurrent-malignant-phyllodes-case-report-and-review-of-literature
#6
Aashish Rajesh, Mohammed Farooq
INTRODUCTION: Phyllodes tumors are uncommon biphasic fibroepithelial neoplasms of the breast of varying malignant potential occurring in middle aged women. They exhibit diverse biological behavior. Margin free excision is the mainstay of treatment. CASE PRESENTATION: A 27 year-old lady was referred with a painless ulceroproliferative right breast lesion which had rapidly progressed over six months. Three years back, she had been diagnosed with a borderline phyllodes tumor and underwent a wide local excision followed by a right mastectomy for recurrence...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28273226/parapneumonic-pleural-effusion-reality-and-strategies-in-an-amazon-university-hospital
#7
Claudia Giselle Santos Arêas, Geraldo Roger Normando Júnior, Orlando Sandoval Farias Júnior, Irna Carla DO Rosário Souza Carneiro
OBJECTIVE: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD) . METHODS: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28266294/anterior-transabdominal-laparoscopic-adrenalectomy-without-ligatures-for-a-symptomatic-right-adrenal-myelolipoma-with-intratumoral-hemorrhage
#8
Cătălin Molnar, Laura Lata, Radu Pisica, Cristian Russu, Mircea Gherghinescu, Claudiu Molnar, Angela Borda, Vlad-Olimpiu Butiurca, Bogdan-Andrei Suciu, Constantin Copotoiu
Myelolipomas represent 3-7% fromthe primary tumors of the adrenal gland. Most often they are incidental findings. In most cases are asymptomatic, rarely they present symptoms (pain, abdominal discomfort, hematuria or signs of internal hemorrhage). Histologically benign, this variety of tumor requires only local excision, in symptomatic forms. Their dimensions are generally up to 4-5 cm, so the laparoscopic approach seems the most appropriate. We present the case of a 65 years old patient, electively operated for a right adrenal tumor formation...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28264044/evolution-of-impedance-field-telemetry-after-one-day-of-activation-in-cochlear-implant-recipients
#9
Hao-Chun Hu, Joshua Kuang-Chao Chen, Chia-Mi Tsai, Hsing-Yi Chen, Tao-Hsin Tung, Lieber Po-Hung Li
OBJECTIVES: Changes in impedance between 24 hours and one month after cochlear implantation have never been explored due to the inability to switch on within one day. This study examined the effect of early activation (within 24 hours) on the evolution of electrode impedance with the aim of providing information on the tissue-to-electrode interface when electrical stimulation was commenced one day post implantation. METHODS: We performed a retrospective review at a single institution...
2017: PloS One
https://www.readbyqxmd.com/read/28259505/the-experience-of-treatment-of-coblation-assisted-surgical-approach-to-eagle-s-syndrome
#10
Chenjing Cheng, Cuiping She, Qingfeng Zhang
OBJECTIVE: This article aimed to Summarize our therapeutic experience with Transoral coblation assisted surgical approach used for treatment of Eagle's syndrome. METHODS: sixty-two consecutive patients, from 2010 to 2015, underwent coblation assisted surgical treatment to remove elongated styloid process transorally. Outcomes were assessed in terms of intraoperative and postoperative complications, patients' evolution and efficiency of treatment. RESULTS: The amount of bleeding was 1ml~4ml, average 2...
February 5, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28258911/-interest-of-surgical-companionship-during-the-training-period-of-robot-assisted-radical-prostatectomy
#11
L du Pouget, F X Nouhaud, M Blah, G Defortescu, M Ndangang, P Grise, C Pfister
OBJECTIVE: Study of the learning curve of robot-assisted radical prostatectomy, evaluating intraoperative difficulties and postoperative complications according to Clavien-Dindo classification. PATIENTS AND METHODS: Retrospective study of our first 157 consecutive patients treated with robot-assisted prostatectomy for localized prostate cancer between September 2011 and December 2014. Comparison of learning for each group of 50 procedures and then comparison between patients operated on by a pair of two seniors specially trained for robotic surgery and patients operated on by one mixed pair including a surgeon junior coached by one senior of the first group...
March 1, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28247499/quality-of-life-and-scar-evolution-after-negative-pressure-or-conventional-therapy-for-wound-dehiscence-following-post-bariatric-abdominoplasty
#12
Paolo Limongelli, Giuseppina Casalino, Salvatore Tolone, Luigi Brusciano, Giovanni Docimo, Gianmattia Del Genio, Ludovico Docimo
No studies have examined scars and quality of life after different treatments of wound dehiscence in patients undergoing post-bariatric abdominoplasty. Scars and quality of life of patients with postoperative wound dehiscence managed with negative pressure wound therapy (group A) and conventional wound therapy (group B) were reviewed 6 months after wound healing. Of 38 patients undergoing treatment for wound dehiscence after 203 abdominoplasty, 35 (group A = 14 versus group B = 21) entered the study...
March 1, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28241370/evolution-of-laparoscopic-liver-surgery-as-standard-procedure-for-hcc-in-cirrhosis
#13
Daniel Seehofer, Robert Sucher, Moritz Schmelzle, Robert Öllinger, Andri Lederer, Timm Denecke, Eckart Schott, Johann Pratschke
Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed for HCC in Child-A cirrhosis at our center. Mean MELD score was 9 (6 - 12), and the mean LiMAx was 261 µg/h/kg (101 - 489). All resections were performed by conventional laparoscopy using 4 - 6 trocars...
February 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28239067/recent-evolution-of-endoscopic-endonasal-surgery-for-treatment-of-pituitary-adenomas
#14
Hiroshi Nishioka
For the treatment of pituitary tumors, microscopic transsphenoidal surgery has been considered the "gold standard" since the late 1960s. Over the last two decades, however, a worldwide shift towards endoscopic endonasal surgery is in progress for many reasons. These include a wide panoramic view, improved illumination, an ability to look around anatomical corners using angled tip and, in addition, application to the extended approaches for parasellar tumors. Both endoscopic and microscopic approaches appear equally effective for nonfunctioning adenomas without significant suprasellar or lateral extensions, whereas the endoscopic approach may improve outcomes associated with the extent of resection and postoperative complications for larger tumors...
February 24, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28237371/pain-locations-in-the-postoperative-period-after-cardiac-surgery-chronology-of-pain-and-response-to-treatment
#15
J Roca, R Valero, C Gomar
INTRODUCTION: Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. METHODS: Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables...
February 22, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28223050/tricuspid-regurgitation-associated-with%C3%A2-ischemic-mitral-regurgitation-characterization-evolution-after-mitral-surgery-and-value-of-tricuspid-repair
#16
José L Navia, Haytham Elgharably, Hoda Javadikasgari, Ahmed Ibrahim, Marijan Koprivanac, Ashley M Lowry, Eugene H Blackstone, Allan L Klein, A Marc Gillinov, Eric E Roselli, Lars G Svensson
BACKGROUND: Tricuspid regurgitation (TR) often accompanies ischemic mitral regurgitation and is generally assumed to be a secondary consequence of altered hemodynamics of the left-sided regurgitation. We hypothesized that it may also be a direct consequence of right-sided ischemic disease. Therefore, our objectives were to (1) characterize the nature of this TR and (2) describe its time course after mitral valve surgery for ischemic mitral regurgitation, with or without concomitant tricuspid valve repair...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219088/single-bundle-versus-double-bundle-anterior-cruciate-ligament-reconstruction-a-prospective-randomized-controlled-trial-with-6-year-follow-up
#17
Paolo Adravanti, Francesco Dini, Laura de Girolamo, Massimo Cattani, Michele Attilio Rosa
Single-bundle (SB) anterior cruciate ligament (ACL) reconstruction is increasingly used in a large number of patients and it allows obtaining very good clinical and subjective results; however, functional tests show a persistent rotational instability. Biomechanical studies seem to indicate that double-bundle (DB) ACL reconstruction allows to obtain increased anterior and rotational stability compared with SB. The aim of this prospective randomized controlled study was to compare the clinical outcome and the possible osteoarthritic evolution of patients treated either with a SB (freehand transtibial femoral tunnel) or with a DB technique (outside-in for posterolateral femoral tunnel/inside-out for anteromedial femoral tunnel) at a final follow-up of 6 years...
February 20, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28214967/increased-atrial-%C3%AE-adrenergic-receptors-and-grk-2-gene-expression-can-play-a-fundamental-role-in-heart-failure-after-repair-of-congenital-heart-disease-with-cardiopulmonary-bypass
#18
Marcela Silva Oliveira, Fabio Carmona, Walter V A Vicente, Paulo H Manso, Karina M Mata, Mara Rúbia Celes, Erica C Campos, Simone G Ramos
Surgeries to correct congenital heart diseases are increasing in Brazil and worldwide. However, even with the advances in surgical techniques and perfusion, some cases, especially the more complex ones, can develop heart failure and death. A retrospective study of patients who underwent surgery for correction of congenital heart diseases with cardiopulmonary bypass (CPB) in a university tertiary-care hospital that died, showed infarction in different stages of evolution and scattered microcalcifications in the myocardium, even without coronary obstruction...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28203605/femoral-and-tibial-tunnel-diameter-and-bioabsorbable-screw-findings-after-double-bundle-acl-reconstruction-in-5-year-clinical-and-mri-follow-up
#19
Tommi Kiekara, Antti Paakkala, Piia Suomalainen, Heini Huhtala, Timo Järvelä
BACKGROUND: Tunnel enlargement is frequently seen in short-term follow-up after anterior cruciate ligament reconstruction (ACLR). According to new evidence, tunnel enlargement may be followed by tunnel narrowing, but the long-term evolution of the tunnels is currently unknown. HYPOTHESIS/PURPOSE: The hypothesis was that tunnel enlargement is followed by tunnel narrowing caused by ossification as seen in follow-up using magnetic resonance imaging (MRI). The purpose of this study was to evaluate the ossification pattern of the tunnels, the communication of the 2 femoral and 2 tibial tunnels, and screw absorption findings in MRI...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#20
Emmanuel Moss, Michael E Halkos
Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a "gold standard" valve repair...
January 2017: Annals of Cardiothoracic Surgery
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