Search results for "Stomy"

Noninvasive respiratory muscle aids during PEG placement in ALS patients with severe ventilatory impairment.

2010

Abstract Although no clear recommendations are given about when percutaneous endoscopic gastrostomy (PEG) should be placed in amyotrophic lateral sclerosis (ALS) patients, some experts underline the risk of respiratory complications when patients had severe ventilatory muscle impairment (SVMI). Aim To evaluate the efficacy of noninvasive ventilation (NIV) and mechanically assisted cough (MAC) to avoid respiratory complications related to PEG placement in ALS patients with SVMI. Material and methods Prospective study including ALS patients who had chosen to have PEG placement timed by swallowing dysfunction with the aid of NIV and MAC if needed. PEG was carried out under volume-cycled NIV th…

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

2019

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associ…

Tracheostomy mechanical ventilation in amyotrophic lateral sclerosis.

2013

Indication and Timing

2016

Tracheostomy is performed in patients requiring prolonged mechanical ventilation aiming at avoiding the potential detrimental effect of a sustained translaryngeal intubation (e.g. laryngeal oedema, mucosal ulcerations). Potential benefits of tracheostomy in critically ill patients are improved comfort and reduced need for sedation, easier clearance of secretions and oral hygiene, and a possible faster weaning from mechanical ventilation. Controversy exists over optimal timing (early, tracheostomy placement compared with later time points) in patients with respiratory failure. Among the published randomised controlled trials, two large studies did not report a significant advantage of an ear…

Tracheostomy mechanical ventilation in patients with amyotrophic lateral sclerosis: Clinical features and survival analysis

2012

article i nfo Background: Tracheostomy mechanical ventilation (TMV) is performed in amyotrophic lateral sclerosis (ALS) patients with a respiratory failure or when the non-invasive ventilation (NIV) is no longer effective. We evaluated the clinical characteristics and survival of a cohort of tracheostomized ALS patients, followed in a single ALS Clinical Center. Methods: Between 2001 and 2010, 87 out of 279 ALS patients were submitted to TMV. Onset was spinal in 62 and bulbar in 25. After tracheostomy, most patients were followed up through telephone interviews to caregivers. A complete survival analysis could be performed in fifty-two TMV patients. Results: 31.3% ALS patients underwent tra…

Cisternostomy: A Timely Intervention in Moderate to Severe Traumatic Brain Injuries: Rationale, Indications, and Prospects.

2019

Traumatic brain injury (TBI) represents a major public health concern worldwide, with no significant change in its epidemiology over the last 30 years. After TBI, the primary injury induces irreversible brain damage, which is untreatable. The subsequent secondary injury plays a critical role in the clinical prognosis because without effective treatment it will provide additional tissue damage. The resulting scenario is the rise in intracranial pressure (ICP) with the development of progressive neurological deficits. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies among which is decompressive hemicraniectom…

Extrathoracic Lengthening (Kimura Technique)

2021

Treatment of congenital long gap esophageal atresia is extremely challenging. Cases are rare, variable, and oftentimes complex. Possible treatment options include delayed primary repair after initial gastrostomy, gastric transposition, intestinal interpositions, traction procedures, myotomy, and gastric tube techniques. Treatment strategies often consist of variations and combinations of different approaches.

Choosing the nephrostomy size after percutaneous nephrolithotomy.

2011

Purpose: To evaluate the effect of nephrostomy tube size on perioperative outcomes of percutaneous nephrolithtotmy (PCNL). Methods: Forty-five well-matched patients with normal renal function were prospectively divided in two nonrandomized groups after uneventful PCNL (to receive either a 22-Fr, group 1 (n = 24 pts), or a 12-Fr nephrostomy tube, group 2 (n = 21 pts)). In all a balloon nephrostomy catheter with detachable funnel (Rüsch Teleflex, Germany) was used. A Visual Analogue Scale (VAS) for measuring the pain was administered 8 and 24 h after the procedure. Postoperative analgesics use (Ketoralac Tromethamine 30 mg), pre- and postoperative Hb, renal function and urinary leaks were reg…

Experience with palliative percutaneous nephrostomy in bladder cancer patients

1985

Minimal percutaneous nephrostomy as a palliative urinary diversion was performed in 50 patients with advanced bladder cancer disease. The average survival time was 6.6 months, with 38% of the patients alive after 6 months. Although 88% of the patients died within one year, 2 (5%) are still alive after more than 2 years. Each case of palliative diversion is an individual one, with many different factors influencing the decision. Prolonging life cannot be an indication for diversion. Percutaneous nephrostomy in combination with other percutaneous techniques provides the urologist with excellent therapeutic tools to avoid surgery in such emergency situations as uremia or local tumor symptoms. …

Risk factors associated with tongue lesions:a propensity score-matched case-control study

2021

Background to analyse the potential risk factors of tongue lesions, comparing the results with a control group. Material and Methods An observational, case-control study was designed. The study included a case group comprising 336 patients with tongue lesions and 336 sex and age-matched controls. We recorded tobacco/alcohol habits, presence of dentures, allergies, medical conditions, and medications. Statistical analysis was performed via logistic regression models to estimate the odds ratio (OR) adjusted for gender, age, tobacco, and alcohol using propensity score-matching analysis (PSM). Results According to the final PSM model, patients with tongue lesions were more likely to suffer from…