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Operative Approach (operative + approach)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Thoracoscopic enucleation of esophageal leiomyoma: a retrospective study on 40 cases

DISEASES OF THE ESOPHAGUS, Issue 3 2009
G. Jiang
SUMMARY Esophageal leiomyoma is the most common benign esophageal tumor. Thoracoscopic enucleation is currently a preferred approach to most of these lesions. We present our experiences of enucleation of these tumors using thoracoscopic approach. A retrospective review of 40 patients who underwent enucleation of esophageal leiomyoma from 1997 to 2007 in our institute was conducted. Presenting symptoms, operative approach, tumor size, tumor shape, outcomes, and indication for this approach were analyzed. Forty patients were identified. Postoperative histopathology confirmed the leiomyoma in all patients. The thoracoscopic enucleation was completed in 34 cases, and the operation was converted to open procedure in six cases. Reasons for conversion included too small tumors to be visualized in two cases, thoracic cavity adhesion in one case, and the too large tumors in three cases. The median operating time was 70 min (50 to 210 min). Mean tumor size was 3.7 cm (0.5,10 cm). There were no major postoperative complications. Symptoms especially dysphasia were relieved postoperatively. Short- and long-term follow-up was satisfactory with none of the patients having tumor recurrences or other problems. Thoracoscopic enucleation of esophageal leiomyoma is technically safe and effective. It is currently the best choice for management of esophageal leiomyoma 1 to 5 cm in diameter. It can also be tried on a tumor larger than 5 cm, although the possibility of conversion to thoracotomy increases along with tumor growing and surrounding the esophagus. [source]

On the evaluation of seismic response of structures by nonlinear static methods

EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 13 2009
Melina Bosco
Abstract In the most recent seismic codes, the assessment of the seismic response of structures may be carried out by comparing the displacement capacity, provided by nonlinear static analysis, with the displacement demand. In many cases the code approach is based on the N2 method proposed by Fajfar, which evaluates the displacement demand by defining, as an intermediate step, a single degree-of-freedom (SDOF) system equivalent to the examined structure. Other codes suggest simpler approaches, which do not require equivalent SDOF systems, but they give slightly different estimation of the seismic displacement demand. The paper points out the differences between the methods and suggests an operative approach that provides the same accuracy as the N2 method without requiring the evaluation of an equivalent SDOF system. A wide parametric investigation allows an accurate comparison of the different methods and demonstrates the effectiveness of the proposed operative approach. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Complications of Bryan cervical disc replacement

ORTHOPAEDIC SURGERY, Issue 2 2010
Jun-ming Cao MD
The primary goals of cervical disc replacement are to avoid fusion in the affected segment, maintain the mobility and function of the involved cervical segments, allow patients to quickly return to routine activities and reduce or eliminate adjacent-segment disease. A large number of patients have already undergone, and more and more patients will in the future undergo, cervical disc replacement. The cervical device which best preserves movement, and has therefore been the device of choice, has been the Bryan cervical disc. Although a safe surgical technique has been demonstrated and favorable results of using the Bryan disc reported, some complications have also accompanied this arthroplasty. Complications of Bryan cervical disc replacement include those related to the operative approach and decompression process, loosening and failure of the device, postoperative kyphosis, heterotopic ossification, and loss of movement due to spontaneous fusion. In order to avoid these complications, strict patient selection criteria and a meticulous knowledge of anatomy are necessary. [source]

Surgical exposures for distal humerus fractures: A review

CLINICAL ANATOMY, Issue 8 2008
J. Whitcomb Pollock
Abstract The majority of distal humerus fractures have complex fracture patterns, with displaced articular segments, requiring operative intervention. The goals of surgery are anatomic reduction and rigid internal fixation via an operative approach that balances maximum required exposure with minimum soft tissue or bony disruption that may necessitate postoperative protection. The selection of a surgical approach depends on multiple factors, including, facture pattern, extent of articular involvement, associated soft tissue injury, rehabilitation protocols, and surgeon preference. This review focuses on the various surgical approaches to the distal humerus. Clin. Anat. 21:757,768, 2008. © 2008 Wiley-Liss, Inc. [source]

Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay

COLORECTAL DISEASE, Issue 9 2008
E. Boyle
Abstract Objective, Laparoscopic surgery for inflammatory bowel disease (IBD) is technically demanding but can offer improved short-term outcomes. The introduction of minimally invasive surgery (MIS) as the default operative approach for IBD, however, may have inherent learning curve-associated disadvantages. We hypothesise that the establishment of MIS as the standard operative approach does not increase patient morbidity as assessed in the initial period of its introduction into a specialised unit, and that it confers earlier postoperative gastrointestinal recovery and reduced hospitalisation compared with conventional open resection. Method, A case,control study was undertaken on laparoscopic resection (LR) vs open colon resection (OR) for IBD. The LR group was collated prospectively and compared with a pathologically matched historical control set. Outcomes measured included: postoperative length of stay, time to normal bowel function and postoperative morbidity. Statistical analysis was performed using spss. Results, Twenty-eight patients were investigated (14 LR, 14 OR). The two groups were matched for type of operation, type of disease and age. There were no conversions in the LR group. Morbidity and readmissions did not differ significantly between the groups. Those undergoing laparoscopic resection had a quicker return to diet (median 2 vs 4 days; P = 0.000002), time to first bowel motion (2 vs 4 days; P = 0.019) and shorter postoperative length of stay (5.5 vs 12.5; P = 0.0067). Conclusion, These findings support the routine use of MIS for the elective surgical management of IBD in our department. Patients undergoing laparoscopic colectomies for IBD can expect faster return of gastrointestinal function and shorter hospitalisation. [source]