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Surgery procedures

Martin Dübbers, Elena Nikolaou, Hans Fuchs, Janina Fischer, Hakan Alakus, Jessica Leers, Christiane Bruns, Grigore Cernaianu
BACKGROUND: Transumbilical laparoscopic-assisted appendectomy (TULAA) is fast and cost-effective since no endoloops, staplers or wound protection devices are used. We analyzed the effects of TULAA as first approach for perforated (PA) and non-perforated (NPA) appendicitis in children. PATIENTS: We performed a retrospective analysis of 181 children for whom TULAA was the first approach for appendicitis between October 2010 and March 2016. METHODS: Morbidity, additional laparoscopic instrument insertion (AI), conversions to open extraumbilical appendectomy (OC), and complications were evaluated...
March 15, 2018: Klinische Pädiatrie
Claire M Lawlor, Charles A Riley, John M Carter, Kimsey H Rodriguez
Importance: The 1996 Tonsillectomy and Adenoidectomy Inpatient Guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Pediatric Otolaryngology Committee recommended that children younger than 3 years be admitted following tonsillectomy. Recommendations for hospital observation were not included as a key action statement in the 2011 AAO-HNS Clinical Practice Guidelines for Tonsillectomy in Children. Objective: To examine the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Mireguli Tuersunjiang, Xing Long, Yuchuan Fu, Jin Ke, He Huijun, Jian Li
Bifid nose, an indicator of Tessier No.0, is a rare congenital malformation. Because of its rarity, few cases were reported and the optimal surgical procedure and the best time for surgery have not been widely acknowledged. In this brief report, a 9-year-old girl with mild bifid nose and unilateral mini-microform cleft lip, and its surgical management, is presented. We focused our attention on modifying the shape of the nose through open rhinoplasty without excising the surplus skin on the nasal dorsum and achieved good results...
March 14, 2018: Journal of Craniofacial Surgery
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Justyna Bartoszko, Duminda N Wijeysundera, Keyvan Karkouti, Jeannie Callum, Vivek Rao, Mark Crowther, Hilary P Grocott, Ruxandra Pinto, Damon C Scales, Blaine Achen, Sukhpal Brar, Doug Morrison, David Wong, Jean S Bussières, Tonya de Waal, Christopher Harle, Étienne de Médicis, Charles McAdams, Summer Syed, Diem Tran, Terry Waters
BACKGROUND: Research into major bleeding during cardiac surgery is challenging due to variability in how it is scored. Two consensus-based clinical scores for major bleeding: the Universal definition of perioperative bleeding and the European Coronary Artery Bypass Graft (E-CABG) bleeding severity grade, were compared in this substudy of the Transfusion Avoidance in Cardiac Surgery (TACS) trial. METHODS: As part of TACS, 7,402 patients underwent cardiac surgery at 12 hospitals from 2014 to 2015...
March 15, 2018: Anesthesiology
Kurt P Spindler, Laura J Huston, Kevin M Chagin, Michael W Kattan, Emily K Reinke, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Charles L Cox, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert A Magnussen, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Angela D Pedroza, Armando F Vidal, Michelle L Wolcott, Brian R Wolf, Rick W Wright
BACKGROUND: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years...
March 2018: American Journal of Sports Medicine
Christopher L Camp, Stan Conte, John D'Angelo, Stephen A Fealy, Christopher S Ahmad
BACKGROUND: In recent years, there has been a dramatic rise in the annual number of ulnar collateral ligament (UCL) reconstructions performed in amateur baseball pitchers. Accordingly, increasing numbers of players are entering professional baseball having already undergone the procedure; however, the effect of prior UCL reconstruction on future success remains unknown. PURPOSE: (1) To provide an epidemiologic report on baseball players who undergo UCL reconstruction before being selected in the Major League Baseball (MLB) Draft, (2) to define the outcomes in terms of statistical performance, and (3) to compare these results with those of matched controls (ie, non-UCL reconstruction)...
March 1, 2018: American Journal of Sports Medicine
B A Kadashev, A N Konovalov, L I Astaf'eva, P L Kalinin, M A Kutin, I S Klochkova, D V Fomichev, O I Sharipov, D N Andreev
The pituitary stalk (PS) is a relatively thin bundle connecting the hypophyseal stalk to the pituitary gland; it consists of both axons of the hypothalamic nuclei (terminating in the neurohypophysis) and the system of portal vessels. Compression of the PS by a space-occupying lesion or its transection (forced or intended) during surgery may lead to the development of endocrine disorders: hypopituitarism, diabetes insipidus, and hyperprolactinemia. The modern literature lacks studies evaluating the severity of endocrine disorders depending on the PS condition before and after surgery...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
I A Filatova
By improving the existing surgical technologies for dacryocystitis, one enhances the effectiveness of patient rehabilitation. AIM: To evaluate the effectiveness of radio-wave surgery in the treatment of dacryocystitis and lacrimal sac abscesses. MATERIAL AND METHODS: The clinical group consisted of 207 patients ranging in age from 7 to 89 years (the mean age of 41±7.3 years). For 39% of patients this was a repeated treatment, while 9.3% had undergone 4-5 surgical interventions...
2018: Vestnik Oftalmologii
Judit Karacsonyi, Ehrin J Armstrong, Huu Tam D Truong, Ryan Tsuda, Damianos G Kokkinidis, Jose Roberto Martinez-Parachini, Aya J Alame, Barbara A Danek, Aris Karatasakis, Michele Roesle, Houman Khalili, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis, Bavana V Rangan
BACKGROUND: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described. METHODS: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n = 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016. RESULTS: Mean age was 68...
March 15, 2018: Journal of Invasive Cardiology
Cristina Remondi, Francesco Sesti, Giuseppe Sorrenti, Giovannella Venezia, Roberto Sorge, Adalgisa Pietropolli, Beatrice Silvi, Emilio Piccione
OBJECTIVE: The aim of this study was to compare 22 Fr unipolar resectoscope with the traditional 26 Fr unipolar resectoscope in endometrial polypectomy performed under paracervical block anesthesia. METHODS: The trial took place in Gynecologic Unit, Department of Surgery, Tor Vergata University Hospital, Rome. Inclusion criteria were: diagnosis of endometrial polyps <3 cm at office hysteroscopy; agreement of patients to perform surgery under paracervical block anesthesia but not in office setting...
March 15, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
S-M Lee, K Gordon, R McMillan, F Crystal, P Acher
Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay...
March 15, 2018: Annals of the Royal College of Surgeons of England
S P Paul
Objective There remains confusion between Langer's lines and wrinkle lines with respect to the optimal orientation of elliptical excisions on the trunk. This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. These lines were mapped. Skin tension measurements were taken during the procedure and analysed...
March 15, 2018: Annals of the Royal College of Surgeons of England
Msj Wilson, P Maniam, A Ibrahim, N Makaram, S R Knight, P Patil
Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015...
March 15, 2018: Annals of the Royal College of Surgeons of England
F Mushtaq, C O'Driscoll, Fct Smith, D Wilkins, N Kapur, R Lawton
Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework...
March 15, 2018: Annals of the Royal College of Surgeons of England
Juliane Kupsch, Thomas Jackisch, Klaus E Matzel, Joerg Zimmer, Andreas Schreiber, Anja Sims, Helmut Witzigmann, Sigmar Stelzner
PURPOSE: Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score. METHODS: We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire...
March 15, 2018: International Journal of Colorectal Disease
Vladimir Nakov, Toma Spiriev, Evgeni Stavrev
BACKGROUND: Vertebrobasilar junction aneurysms occur rarely, but have a higher rupture rate than supratentoral aneurysms, and higher morbidity and mortality. Their location ventral to the neuroaxis makes them a challenging surgical lesion. METHODS: In this paper, we share our experience with the surgical technique for the management of these complex aneurysms. CONCLUSION: An in-depth understanding of the anatomy of these aneurysms, careful preoperative planning, and a meticulous surgical technique, including knowledge of every detail of the procedure-positioning, an advanced skull base technique, and careful aneurysm dissection and clipping-is essential for a successful outcome of the surgery...
March 14, 2018: Acta Neurochirurgica
Nazmi Narin, Ozge Pamukcu, Aydin Tuncay, Ali Baykan, Suleyman Sunkak, Onur Tasci, Kazim Uzum, Levent Saltık
Untreated ventricular septal defect (VSD) is an important cause of congestive heart failure in early infancy. Growth is impaired in this population, and surgical closure is challenging because of congestion in the lungs, making infants prone to respiratory infection, and because of their poor nutritional status. The aim of this study is to share our experience with percutaneous VSD closure in patients under 1 year of age. Patients with hemodynamically significant left-to-right shunt, less than 1 year of age, and with VSD diameter ≤ 6 mm were retrospectively included in the study between December 2014 and January 2017...
March 15, 2018: Pediatric Cardiology
Wes M Allen, Kelsey M Kennedy, Qi Fang, Lixin Chin, Andrea Curatolo, Lucinda Watts, Renate Zilkens, Synn Lynn Chin, Benjamin F Dessauvagie, Bruce Latham, Christobel M Saunders, Brendan F Kennedy
Currently, 20-30% of patients undergoing breast-conserving surgery require a second surgery due to insufficient surgical margins in the initial procedure. We have developed a wide-field quantitative micro-elastography system for the assessment of tumor margins. In this technique, we map tissue elasticity over a field-of-view of ~46 × 46 mm. We performed wide-field quantitative micro-elastography on thirteen specimens of freshly excised tissue acquired from patients undergoing a mastectomy. We present wide-field optical coherence tomography (OCT) images, qualitative (strain) micro-elastograms and quantitative (elasticity) micro-elastograms, acquired in 10 minutes...
March 1, 2018: Biomedical Optics Express
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