Search results for "Surgical procedure"
showing 10 items of 1127 documents
The Fontan-Operation: From Intra- to Extracardiac Procedure
2003
Purpose For treatment of univentricular heart, the Fontan operation has been established as the definitive palliation. The current controversy is mainly based on the high incidence of arrhythmias after an intra-atrial lateral tunnel Fontan operation. Methods From January 1995 until April 2002. 46 children underwent a Fontan-type operation with or without a small fenestration. In 33 patients (group I) an Intracardiac tunnel and in 13 patients (group II) an extracardiac conduit procedure was performed. Principal findings There was no perioperative mortality. All patients showed postoperative a significant increase of arterial oxygen saturation, from 76 to 86% after surgery with fenestration, …
Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature
2015
Patient: Male, 30 Final Diagnosis: Acute epidural hematoma Symptoms: — Medication: — Clinical Procedure: Observation Specialty: Neurosurgery Objective: Unusual clinical course Background: Trauma is the leading cause of death in people younger than 45 years and head injury is the main cause of trauma mortality. Although epidural hematomas are relatively uncommon (less than 1% of all patients with head injuries and fewer than 10% of those who are comatose), they should always be considered in evaluation of a serious head injury. Patients with epidural hematomas who meet surgical criteria and receive prompt surgical intervention can have an excellent prognosis, presumably owing to limited unde…
Functional evaluation of patients with anterior cruciate ligament injury. A transversal analytical study.
2018
Abstract Objective To evaluate, by means of biomechanical analysis, functional alterations of gait and balance of patients with anterior cruciate ligament (ACL) injury. Material and methods Transversal analytical study on 64 people, 27 health subjects and 37 patients with ACL injury. Biomechanical analysis of gait in all individuals was performed by means of four tests: (1) kinematic test, to characterize gait pattern; (2) kinetic test, to characterize forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of the gait; (3) pivot-shift test, to analyze the rotational stability of the knee on the sagittal axis; and (4) equilibrium test. Results Alteration…
The value of MRI in the evaluation of the ACL deficient knee and in the post-operative evaluation after ACL reconstruction
1993
To evaluate the usefulness of magnetic resonance imaging (MRI) in the exploration of the anterior cruciate ligament (ACL) deficient-knee, a total of twenty-five patients with chronic instability of the knee joint and who underwent both MRI and arthroscopy were studied prospectively. Twenty-three of these patients underwent an intra-articular reconstruction of the ACL with bone-patellar tendon-bone autografts. For the ACL lesions MRI had a sensitivity of 95.8%, a specificity of 100% and a diagnostic accuracy of 97.7%. Associated bowing of the PCL was seen in 20 cases of the study group. For the associated meniscal lesions MRI had a sensitivity of 77.7%, a specificity of 94.7% and a diagnosti…
Laparoscopic-assisted Retropubic Midurethral Sling Placement: A Technique to Avoid Major Complications
2015
Abstract Study Objective To describe a technique for the safe placement of retropubic midurethral slings in patients undergoing concomitant laparoscopic surgery in order to avoid major complications associated with this procedure such as bladder perforation and retropubic hematomas. Design Step-by-step video demonstration of the technique. Setting A university tertiary care hospital. Patients Patients with an indication for retropubic midurethral sling placement because of recurrent stress urinary incontinence, intrinsic sphincter deficiency, or severe pelvic organ prolapse in whom a concomitant laparoscopic surgery has to be performed for other medical conditions. Intervention Laparoscopic…
Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator? Description of four cases
2011
Objective To report the development of parasitic myomas after the use of a morcellator. Design Retrospective study. Setting Tertiary care referral center for the treatment of benign gynecologic pathologies. Patient(s) Women undergoing surgery for uterine fibroids. Intervention(s) Chart review. Main Outcome Measure(s) Presence of parasitic leiomyomas. Result(s) We identified four cases of parasitic myomas over the 3-year study period. Two out of the four were symptomatic. The prevalence of this complication, considering all women with whom the electric morcellator was used (n = 423) was 0.9% (95% CI, 0.3–2.2%). Considering exclusively the women who underwent myomectomy (n = 321), it was 1.2%…
Laparoscopic surgery for isolated inguinal node relapse of high grade serous ovarian cancer using a bipolar combination instrument
2020
Abstract Objective To demonstrate step-by-step minimally invasive surgical technique for dissection of isolated inguinal node relapse of high grade serous ovarian cancer. Methods A 54-year-old woman, BRCA1 +, underwent to open abdominal total hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and aortic lymphadenectomy with zero residual disease, for high grade serous ovarian carcinoma FIGO stage IIB. After surgery, patient underwent platinum-based chemotherapy for six cycles and follow-up examinations every 3 months for the first year and biannual for the second one. Abdominal TC-PET scan after 18 months revealed a right distal iliac external/inguinal nodal relapse (S…
Is ‘anxiety sensitivity’ predictive of postoperative nausea and vomiting?
2019
BACKGROUND Postoperative nausea and vomiting (PONV) is an extremely distressing side effect for patients. Despite PONV prophylaxis guided by well established scoring systems, the incidence of PONV is still high. OBJECTIVE The aim of the current study was to investigate the predictive value of anxiety sensitivity as an additional independent risk factor for PONV in patients with an increased risk of PONV. DESIGN A noninterventional, observational study. SETTING A tertiary care university hospital. PATIENTS Patients with an increased risk of PONV (i.e. female, nonsmoking) undergoing elective surgery (general, gynaecological, urological, musculoskeletal or neurosurgical) under general anaesthe…
How to select early-stage cervical cancer patients still suitable for laparoscopic radical hysterectomy: a propensity-matched study
2020
Background: Recently, it was reported that minimally invasive surgery (MIS) has a negative impact on early-stage cervical cancer (ECC) patient survival. At the same time, advantages of MIS regarding quality of life and low rate of intra- and postoperative complications are well known. Therefore, it is essential to select patients who may benefit from MIS without worsening their oncologic outcomes. The aim of this study is to investigate which pathological factors could guide surgeons’ choice about the best approach in ECC. Patients and Methods: Patients with 2009 FIGO stage from IA1 with lymphovascular space invasion (LVSI) to IB1/IIA1 treated by open or laparoscopic surgery were judged eli…
Risk Factors in Patients With Rapid Recurrent Hepatitis C Virus–Related Cirrhosis Within 1 Year After Liver Transplantation
2009
Abstract Background Recurrent cirrhosis (RC) due to pretransplant underlying disease leads to organ failure and subsequent death after orthotopic liver transplantation (OLT). RC occurs in up to 30% of patients with recurrent hepatitis C (HCV) within 5 years after OLT. We sought to identify early risk factors for rapid RC within the first year after OLT in HCV-positive patients. Methods Among 404 liver transplanted patients at the University of Mainz between 1998 and 2008, 90 were HCV-RNA positive. To identify predictive factors for rapid RC, we compared HCV-positive patients with advanced fibrosis stages within 1 year after OLT ( n = 13) with these without RC at 5 years after OLT ( n = 23).…