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Postoperative evolution

Deepanshu Jain, Ejaz Mahmood, Shashideep Singhal
Benign intestine strictures secondary to postoperative narrowing or inflammatory bowel disease can be managed surgically or conservatively. Some patients may not be suitable surgical candidates and some patients may choose not to have repeat surgery. Biodegradable (BD) stents offer a prolonged dilatory effect before gradual degradation and obviates the need of a second procedure for stent removal. BD stents have high technical success rates (mean, 94.4%; median, 100%; range, 86% to 100%) but widely variable clinical success rates (range, 45% to 100%)...
October 4, 2016: Journal of Clinical Gastroenterology
Jia-Ming Chang, Kam-Hong Kam, Yi-Ting Yen, Wei-Li Huang, Wei Chen, Yau-Lin Tseng, Ming-Ho Wu, Wu-Wei Lai, Diego Gonzalez-Rivas
Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups...
October 2016: Medicine (Baltimore)
Paulo Domingos Ribeiro-Junior, Ricardo Alexandre Galdioli Senko, Gabriel Cury Batista Mendes, Fernando Gianzanti Peres
Facial nerve has great functional and aesthetic importance to the face, and damage to its structure can lead to major complications. This article reports a clinical case of neuroanastomosis of the facial nerve after facial trauma, describing surgical procedure and postoperative follow-up. A trauma patient with extensive injury cut in right mandibular body causing neurotmesis of the VIIth cranial nerve and mandibular angle fracture right side was treated. During surgical exploration, the nerve segments were identified and a neuroanastomosis was performed using nylon 10-0, after reduction and internal fixation of the mandibular fracture...
September 29, 2016: Journal of Craniofacial Surgery
Christopher J Long, Douglas A Canning
Hypospadias surgery is a humbling art form. The evolution of surgical techniques has made distal hypospadias outcomes favorable, but recent publications suggest that our complication rates for proximal hypospadias are much higher than previously reported. To explain these shortcomings, we examine the literature and focus on the lack of standardized documentation, the subsequent inability to objectify the severity of the phenotype, and the underestimation of complications due to lack of long-term follow up. The variability in surgical technique and the fact that the literature abounds with small case series from single institutions also limits our ability to compare outcomes...
2016: F1000Research
F Vandenbos, D Pop, C Perrotin, N Venissac, J Mouroux
INTRODUCTION: Lung resection for cancer is the cause of significant postoperative pain. The aim of this study was to determine whether pulmonary rehabilitation could induce a resurgence of pain. METHODS: In 2014 and 2015, pulmonary rehabilitation was offered to all patients referred to our institution after lung resection for cancer. Patients were assessed at entry and departure for nociceptive pain, neuropathic pain (DN4), for quality of life using questionnaire EORTC QlQ-C30 and for anxiety and depression (HAD questionnaire)...
October 12, 2016: Revue des Maladies Respiratoires
Didier Roulin, Alend Saadi, Luca Di Mare, Nicolas Demartines, Nermin Halkic
OBJECTIVE: The aim of this study was to compare clinical outcomes of early versus delayed laparoscopic cholecystectomy (LC) in acute cholecystitis with more than 72 hours of symptoms. BACKGROUND: LC is the treatment of acute cholecystitis, with consensus recommendation that patients should be operated within 72 hours of evolution. Data however remain weak with no prospective study focusing on patients beyond 72 hours of symptoms. METHODS: Patients with acute cholecystitis and more than 72 hours of symptoms were randomly assigned to early LC (ELC) or delayed LC (DLC)...
November 2016: Annals of Surgery
Han Pil Lee, Won Chul Cho, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
BACKGROUND: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. METHODS: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Fien Hoefkens, Charlotte Dehandschutter, Johan Somville, Paul Meijnders, Dirk Van Gestel
Soft tissue sarcomas are uncommon tumours of mesenchymal origin, most commonly arising in the extremities. Treatment includes surgical resection in combination with radiotherapy. Resection margins are of paramount importance in surgical treatment of soft tissue sarcomas but unambiguous guidelines for ideal margins of resection are still missing as is an uniform guideline on the use of radiotherapy.The present paper reviews the literature on soft tissue sarcomas of the extremities regarding the required resection margins, the impact of new radiotherapy techniques and the timing of radiotherapy, more particularly if it should be administered before or after surgical resection...
October 12, 2016: Radiation Oncology
Liqi Li, Lishu Liao, Yuxiang Zhong, Yuangui Li, Li Xiang, Wanshan Li
PURPOSE: To evaluate postoperative variation trends of unilateral cleft lip by stages, and to analyze influential factors of nasolabial symmetry. MATERIALS AND METHODS: A total of 145 patients with unilateral cleft lip were treated by the modified Mohler or Tennison-Randall technique, and received routine anti-scarring treatment postoperatively. Photogrammetry was applied to respectively measure 5 indices by stages preoperatively, the first week (1 w), the third month (3 m), the sixth month (6 m), and the first year (1 y) postoperatively...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Aurelie Petit-Monéger, Florence Saillour-Glénisson, Karine Nouette-Gaulain, Vianney Jouhet, Louis-Rachid Salmi
OBJECTIVES: Although graphical formats used to feedback clinical practice data may have an important impact, the most effective formats remain unknown. Using prevention of postoperative nausea and vomiting by anesthesiologists as an application, the objective of this study was to assess which graphical formats for feedback of clinical practice data are the most incentive to change practice. METHODS: We conducted a multicenter cross-sectional study among anesthesiologists randomized in two groups between March and June 2014...
October 7, 2016: Methods of Information in Medicine
Georgios C Sotiropoulos, Nikolaos Machairas, Paraskevas Stamopoulos, Ioannis D Kostakis, Dimitrios Dimitroulis, Dimitrios Mantas, Gregory Kouraklis
BACKGROUND: Liver resection represents the treatment of choice for a small proportion of patients with hepatocellular carcinoma (HCC), amenable to surgery. The remarkable evolution in surgical techniques during the last decades introduced laparoscopic hepatectomy in the operative management of HCC, even in the presence of liver cirrhosis. No comparative study on laparoscopic or open liver resection for HCC has been conducted in Greece yet. METHODS: Patients undergoing liver resection for HCC by one senior hepatobiliary surgeon in our Institution during the period 11/2011-02/2016 were prospectively sampled and retrospectively analyzed for the purposes of this study...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Elodie Perdreau, Pierre-Emmanuel Séguéla, Zakaria Jalal, Adrien Perdreau, Jean-Baptiste Mouton, Marie Nelson-Veniard, Elodie Guillet, Xavier Iriart, Alexandre Ouattara, François Roubertie, Philippe Mauriat, Jean-Benoit Thambo
BACKGROUND: Left ventricular (LV) dysfunction may complicate paediatric cardiac surgery with cardiopulmonary bypass, notably after long aortic cross-clamping (ACC). Assessment of occult myocardial injury by conventional echocardiographic variables may be difficult in the postoperative period. AIMS: To evaluate the feasibility of two-dimensional (2D) strain in the postoperative period, and to assess the effect of ACC duration on this variable. METHODS: Thirty-three paediatric patients (age<18years) with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass were included in this prospective single-centre study...
September 28, 2016: Archives of Cardiovascular Diseases
Bertrand Semay, Alexandre Rambaud, Rémi Philippot, Pascal Edouard
OBJECTIVE: This study aimed to analyze the evolution of the tibiofemoral anterior laxity during the return to sport after anterior cruciate ligament reconstruction. PATIENTS AND METHODS: Twenty patients (11 women, 9 men) with mean age of 22.4±5.1 years, operated for ACL reconstruction by a hamstring technique, competitors in a pivot-contact sport, were enrolled between September 2014 and March 2016. They were evaluated at 6 (n=20), 9 (n=13) and 12 (n=13) months postoperatively by laximetry to 250N using laximètre GnRB(®) (GenouROB, Laval, France)...
September 2016: Annals of Physical and Rehabilitation Medicine
Tabata Cristina do Carmo Almeida, Luiz Vinicius de Alcantara Sousa, Diego Monteiro de Melo Lucena, Francisco Winter Dos Santos Figueiredo, Vitor Engrácia Valenti, Laércio da Silva Paiva, Luiz Carlos de Abreu, Fernando Adami
BACKGROUND: The aim of the study was to evaluate the evolution of patients subject to physical treatment based on guidelines of functional rehabilitation after surgery anterior cruciate ligament reconstruction. METHODS: This is a prospective study of 177 patients with anterior cruciate ligament injury, who underwent surgery and physical therapy guideline conducted in an orthopedic clinic in São Paulo, southeastern Brazil. The clinical evolution of patients was made according to Lysholm and IKDC questionnaire on the 1st day after surgery with 30, 90 and 180 days of treatment...
2016: BMC Research Notes
S R Yarboro, P H Richter, D M Kahler
Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. This revision, if necessary, better achieves the surgical goals and alleviates the stressful situation of obtaining postoperative 3D imaging, where the benefit of revision must be balanced against the cost and risk of returning to the operating room...
October 2016: Der Unfallchirurg
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
September 14, 2016: Revista Brasileira de Anestesiologia
N Sahli, M Khmou, J Khalil, S Elmajjaoui, B El Khannoussi, T Kebdani, H Elkacemi, N Benjaafar
BACKGROUND: Leiomyosarcoma of the rectum is a rare entity that comprises less than 0.1 % of all rectal malignancies. Given the uncommon nature of this tumor and the controversy about its treatment we report one case and review the literature in an attempt to report a particular evolution and to discuss the most appropriate treatment. CASE PRESENTATION: This case report describes the presentation of leiomyosarcoma of the rectum. A 30-year-old man from the north of Morocco presented with rectorrhagia and constipation...
2016: Journal of Medical Case Reports
A Vázquez-Aguilar, A Torres-Gómez, P T Atlitec-Castillo, J E De León-Martínez
Spondylolisthesis is the sliding of a vertebral body with respect to the adjacent one. According to the degree of slippage it is classified into 4 Meyerding grades. Patients with spondylolisthesis who underwent surgery with lumbar instrumentation were included. They were divided into two groups based on their body mass index: obese and non-obese. The functional capacity Oswestry score was calculated preoperatively and at one year, and it was correlated with the BMI. A total of 46 patients, 26 females and 20 males, were included, from 2010 to 2013, all of them with a diagnosis of degenerative spondylolisthesis with lumbar stenosis...
January 2016: Acta Ortopédica Mexicana
K P Wolffenbuttel, V S Menon, G M Grimsby, M J Ten Kate-Booij, L A Baker
INTRODUCTION: The surgical management of girls with masculinized genitalia is gradually changing towards a more conservative approach. Reports on loss of clitoral sensitivity and related impairment of sexual function in women after feminizing genital surgery in childhood have been pivotal in this evolution. An exposed clitoral glans is occasionally seen at follow-up, and while patients may complain of aesthetics, no clitoral discomfort secondary to glans exposure has been reported. A technique has been developed to reconstruct the clitoral hood and the present study reports the preliminary results...
August 21, 2016: Journal of Pediatric Urology
Ricardo Alexandre Stock, Elcio Luiz Bonamigo, Emeline Cadore, Rafael Allan Oechsler
BACKGROUND: Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma. CASE PRESENTATION: A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract...
2016: International Medical Case Reports Journal
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