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Surgical Technique Used (surgical + technique_used)
Selected AbstractsLong-term quality of life of postoperative rectal cancer patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2002CHISATO HAMASHIMA AbstractBackground: The long-term quality of life (QOL) of postoperative rectal cancer patients has not been previously investigated in Japan and may vary depending on the surgical technique used (i.e. with or without a stoma). Methods: The Kanagawa Cancer Registry was used to select 348 rectal cancer patients who underwent surgery at the St Marianna University Hospital between 1978 and 1997. Of these, 164 surviving patients were sent a postal survey consisting of the Japanese EuroQol instrument with an additional questionnaire on present symptoms and lifestyle. Results and conclusions: One hundred and ten responses were received, including 38 from stoma patients. The presence of a stoma did not affect the QOL of the male patients, while it did affect that of the female patients. The QOL of the long-term survival group was associated with several items concerning lifestyle, symptoms and usual activity, and the association did not depend on the presence of a stoma. The long-term QOL could be recognized according to the characteristics of rectal cancer patients, independent of the presence of a stoma. © 2002 Blackwell Publishing Asia Pty Ltd [source] Complications of Surgery for Nasal Polyposis and Chronic Rhinosinusitis: The Results of a National Audit in England and WalesTHE LARYNGOSCOPE, Issue 8 2006Claire Hopkins Abstract Objective: The objective of this study was to determine the rate of complications of surgery for nasal polyposis and chronic rhinosinusitis as well as their risk factors. Study Design, Setting, Participants, and Outcome Measures: The authors conducted a prospective study of 3,128 patients who underwent sinonasal surgery during 2000 and 2001 in 87 National Health Service hospitals in England and Wales. Patients completed a preoperative questionnaire that included the Sino-Nasal Outcome Test, a measure of sinonasal symptoms severity and health-related quality of life. Surgeons provided information about polyp extent, opacity of the sinuses on computed tomography (Lund-Mackay score), comorbidity (American Society of Anesthesiologists score), and the occurrence of perioperative complications. Results: Major complications (orbital or intracranial complications, bleeding requiring ligation or orbital decompression, or return to the operating room) occurred in 11 patients (0.4%). Minor complications (all other untoward events) occurred in 207 patients (6.6%). Most frequently reported minor complications were excessive perioperative hemorrhage bleeding (5.0%) as well as postoperative hemorrhage requiring treatment (0.8%). Multivariate analysis indicated that the complication rate was linked to the extent of disease measured in terms of symptom severity and health-related quality of life, the extent of polyposis, level of opacity of the sinuses on computed tomography, and the presence of comorbidity, but not surgical characteristics (extent of surgery, use of endoscope or microdebrider, grade of surgeon, and adjunctive turbinate surgery). Conclusions: The risk of complications depended on patient characteristics rather than on the surgical technique used. Measures of the extent of disease and comorbidity may help in identifying patients at high risk of complications. [source] 15-YEAR AUDIT OF POST-TONSILLECTOMY HAEMORRHAGE AT DUNEDIN HOSPITALANZ JOURNAL OF SURGERY, Issue 7 2007Emily A. Macassey Post-tonsillectomy haemorrhage is a significant complication because of its frequency and consequences. Increases in post-tonsillectomy haemorrhage prevalence have been reported. There is a controversy about whether increasing the use of diathermy techniques or anti-platelet aggregation effects of analgesia could have caused this increase. We carried out an audit of post-tonsillectomy haemorrhage and examined the rates of readmission for bleeding during the period 1990,2004. We also recorded the surgical technique used and the use of perioperative non-steroidal anti-inflammatory drugs and corticosteroids. During this period there has been a significant increase in post-tonsillectomy haemorrhage with an average annual increase of 15.3% (P < 0.0001, 95% confidence interval 8.5,22.5%). The increase is coincidental with the change-over to predominant diathermy technique and a routine use of postoperative non-steroidal anti-inflammatory drugs and steroids. [source] Protecting the retinal pigment epithelium during macular hole surgeryCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2005Jeffrey L Olson MD Abstract Herein a new surgical technique used during pars plana vitrectomy with internal limiting membrane peeling for macular hole surgery is reported. Perfluorocarbon liquid is used to tamponade the macular hole in order to prevent indocyanine green contact with the retinal pigment epithelium. [source] Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2010Afsheen Tabassum Abstract Objective: The aim of this biomechanical study was to assess the interrelated effect of both surface roughness and surgical technique on the primary stability of dental implants. Material and methods: For the experiment, 160 screw-designed implants (Biocomp®), with either a machined or an etched surface topography, were inserted into polyurethane foam blocks (Sawbones®). As an equivalent of trabecular bone, a density of 0.48 g/cm3 was chosen. To mimic the cortical layer, on top of these blocks short-fibre-filled epoxy sheets were attached with a thickness varying from 0 to 2.5 mm. The implant sites were prepared using either a press-fit or an undersized technique. To measure the primary stability of the implant, both the insertion and the removal torques were scored. Results: Independent of the surgical technique used, both implant types showed an increased insertion and removal torque values with increasing cortical thickness, although >2 mm cortical layer no further increase in insertion torque was observed. In the models with only trabecular bone (without cortical layer) and with a 1 mm cortical layer, both implant types showed a statistically higher insertion and removal torque values for undersized compared with the press-fit technique. In addition, etched implants showed a statistically higher insertion and removal torque mean values compared with machined implants. In the models with 2 and 2.5 mm cortical layers, with respect to the insertion torque values, no effect of either implantation technique or implant surface topography could be observed. Conclusion: The placement of etched implants in synthetic bone models using an undersized preparation technique resulted in enhanced primary implant stability. A correlation was found between the primary stability and the cortical thickness. However, at or above a cortical thickness of 2 mm, the effect of both an undersized surgical approach, as also the presence of a roughened (etched) implant surface, had no extra effect. Besides the mechanical aspects, the biological effect of undersized drilling, i.e. the bone response on the extra insertion torque forces should also be elucidated. Therefore, additional in vivo studies are needed. To cite this article: Tabassum A, Meijer GJ, Wolke JGC, Jansen JA. Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory study. Clin. Oral Impl. Res. 21, 2010; 213,220. doi: 10.1111/j.1600-0501.2009.01823.x [source] Eversion thromboendovenectomy in organized portal vein thrombosis during liver transplantationCLINICAL TRANSPLANTATION, Issue 1 2004Ricardo Robles Abstract: Portal thrombosis is no longer considered a contraindication for transplantation because of the technical experience acquired in the field of liver transplantation and the development of various surgical techniques. All the same, the results obtained in portal thrombosis patients are at times suboptimal, and the surgical technique used (thromboendovenectomy or veno-venous bypass) is also controversial. Between May 1988 and December 2001, 455 liver transplants were performed, of which 32 (7%) presented portal vein thrombosis. Of these, eight belonged to the first 227 transplants (group I), and 24 to the other 228 (group II). Of the 32 cases with portal thrombosis, 20 (62%) were type Ib, seven (22%) type II/III and five (16%) type IV. Twenty-two were males (69%), with a mean age of 50 yr (range: 30,70 yr); the thrombosis in all cases developed over a cirrhotic liver: 15 cases of an ethanolic origin, 11 because of hepatitis C virus, two cases of autoimmune aetiology, one case of primary biliary cirrhosis, one case because of hepatitis B virus and two cases of a cryptogenic origin. Five cases had a history of surgical treatment for portal hypertension. The surgical method in all cases consisted of an eversion thromboendovenectomy (ETEV) under direct visual guidance, with occlusion of the portal flow using a Fogarty balloon. Once re-canalization was achieved, we performed local heparinization and end-to-end portal anastomosis. In no case was systemic post-operative heparinization performed. In the 32 cases in which thrombectomy was attempted it was achieved in 31 of them (96%), failing only in a case of type IV thrombosis, which was resolved by portal arterialization. Of the 31 successful cases, only one with type IV thrombosis re-thrombosed. The 5-yr survival rate of the patients in the series was 69%, with 10 patients dying, of whom only two from causes related to the thrombosis and the thrombosis treatment, both with type IV thrombosis. The ideal treatment for portal thrombosis during liver transplantation is controversial and depends on its extension and the experience of the surgeon. In our experience, ETEV resolves most thromboses (types I, II and III), but management of type IV, which occasionally can be treated with this technique, may require more complex procedures such as bypass, portal arterialization or cavoportal haemitransposition. [source] | ||||||||||