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1.
Unfallchirurg ; 123(2): 89-96, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31970427

RESUMO

The treatment of flexor tendon injuries is still challenging, especially in the region of the narrow annular ligaments and tendon sheaths of the 3­segment fingers and the thumb (zone 2). In the course of time, the primary suture of the flexor tendons has prevailed over traditional recommendations for a secondary tendon replacement after healing of the wound. Improvements regarding suture techniques and materials and, above all the follow-up treatment, have been crucial for better results and remarkable changes in flexor tendon surgery. The suture techniques are determined by the location of the injury but the experience and preferences of the surgeon are also important. Although no technique was found to be optimal, published research and clinical experiences provide important indications for the presumption of successful treatment. To achieve this an early functionally active protocol should be implemented. The tendon suture should enable this by having a high primary strength and therefore at least a 4-strand core suture technique with a ring suture should be given preference. Further important prerequisites for success are the undisturbed gliding of the repaired tendon in its "bed" paying special attention to the annular ligaments and preservation of the blood supply to the tendons.


Assuntos
Traumatismos dos Tendões , Fenômenos Biomecânicos , Dedos , Humanos , Técnicas de Sutura , Suturas , Traumatismos dos Tendões/terapia , Tendões
2.
Zhonghua Yan Ke Za Zhi ; 56(1): 13-16, 2020 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-31937058

RESUMO

Glaucoma surgery is one of the main methods of glaucoma treatment. In recent years, glaucoma surgery has been greatly developed. Minimally invasive surgical procedures for glaucoma have emerged. Patients and surgeons have also increased their expectations of surgery. However, due to the limitation of surgical controllability, the prediction of postoperative efficacy is still not satisfactory. By analyzing the principles and limitations of the existing surgical procedures, the authors put forward the premise of the controllability of glaucoma extrafiltration surgery as that the intraoperative filtration excess can be restricted, so as to effectively avoid the early postoperative complications such as shallow anterior chamber, hypotony and strong inflammation. And within 1 month after surgery, through the filtration of the bubble and the removal of the adjustable suture, the ideal filtration state is gradually achieved. With the controllable maintenance of intraocular pressure at 1 month after surgery, it is possible to effectively predict the intraocular pressure level of 2 years or longer. (Chin J Ophthalmol, 2020, 56: 13-16).


Assuntos
Cirurgia Filtrante/métodos , Glaucoma/cirurgia , Pressão Intraocular , Glaucoma/diagnóstico , Humanos , Implante de Lente Intraocular , Facoemulsificação , Complicações Pós-Operatórias , Suturas , Tonometria Ocular , Resultado do Tratamento
3.
Kyobu Geka ; 73(1): 35-40, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31956248

RESUMO

The natural prognosis of patients with aortic regurgitation (AR) has proved to be poorer than one might expect, thus surgical intervention should be recommended earlier than before. The most of patients with AR are relatively younger and therefore may benefit from aortic valvuloplasty (AVP) to eliminate prosthesis-related late adverse events. However, AVP does not seem popular enough because long-term durability after AVP is still unclear. For this purpose, long-term outcomes after AVP should be improved by standardizing the procedure, especially using aortic root remodeling procedure combined with external suture annuloplasty. The detail of the standardization of these procedures is outlined in this review briefly. We hope more and more aortic valves of the patients with not only aortic root dilatation but also isolated AR will be preserved based on this review in the near future.


Assuntos
Insuficiência da Valva Aórtica , Valva Aórtica , Aorta , Insuficiência da Valva Aórtica/cirurgia , Humanos , Suturas , Resultado do Tratamento
4.
J Surg Oncol ; 121(1): 138-143, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31276208

RESUMO

BACKGROUND: Vascularized lymph node transfer (VLNT) has become one of the effective surgical treatments for extremity lymphedema. This study was to evaluate the re-exploration and total complication rates of VLNT for lower extremity lymphedema between two different flap inset techniques. METHODS: Sixty-nine patients who underwent 74 submental VLNT transfers between 2008 and 2018 were retrospectively studied. Fifty-six flaps were inset using a new delayed primary retention suture (DPRS) technique and other 18 flaps using conventional interrupted sutures as the non-DPRS group. RESULTS: The overall flap success rate was 100%. The DPRS group was released at a mean of 1.7 ± 0.7 times and took a mean of 10.3 ± 3.3 days for wound closure. There were no statistical differences in demographics, mean symptom duration, and mean Cheng's Lymphedema Grading between two groups. Mean frequency of cellulitis of 2.5 ± 1.5 times/year in non-DPRS group was significantly greater than 1.4 ± 1.6 times/year in DPRS group (P = .01). The re-exploration and total complication rates were 5.4% and 7.1% in DPRS group, and 27.8% and 33.3% in non-DPRS group, respectively (P = .02 and .02, respectively). CONCLUSIONS: The DPRS technique is a safe, simple, and reliable method for insetting the submental VLNT, which statistically decreased the re-exploration and total complication rates.


Assuntos
Linfonodos/irrigação sanguínea , Linfonodos/transplante , Linfedema/cirurgia , Retalhos Cirúrgicos/cirurgia , Suturas , Adulto , Idoso , Idoso de 80 Anos ou mais , Extremidades/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Técnicas de Sutura , Resultado do Tratamento
8.
Indian J Ophthalmol ; 68(1): 33-34, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31856461

Assuntos
Âmnio , Pálpebras , Suturas
9.
Am J Orthod Dentofacial Orthop ; 156(6): 745-757, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31784008

RESUMO

INTRODUCTION: Bone-anchored maxillary protraction (BAMP) is an emerging treatment that involves applying a protraction load to the maxillary bone. Although it is believed that such an approach results in better sutural separation, this has not been investigated. This study aimed to assess and compare the deformation of 1 circumaxillary suture (zygomaticomaxillary suture [ZMS]) and 1 facial suture (nasofrontal suture [NFS]) during BAMP and reverse-pull headgear (RPHG) treatment. METHODS: The study was performed ex vivo on 15 pig heads. Miniplates were placed in the maxillary bone and the body of the mandible. A molar tube was bonded to the maxillary first molars. Six single-element strain gauges and 3 differential variable reluctance transducers were installed across the ZMS and NFS bilaterally. Each head underwent BAMP and RPHG unilaterally and bilaterally. RESULTS: In unilateral experiments, both BAMP and RPHG resulted in tension on the ipsilateral ZMS and NFS and compression on the contralateral side, with higher magnitude in the BAMP group. In bilateral experiments, both modalities resulted in tension at the ZMS, with higher magnitude in the BAMP group. Deformation of the NFS was different between the 2 groups: tension in majority of the BAMP and compression in most of the RPHG heads. CONCLUSIONS: Our study shows a higher magnitude of sutural separation in BAMP than in RPHG. The pattern of sutural deformation is consistent with a forward displacement of the midface in BAMP compared with an upward and backward rotation in the RPHG. Rotation of the maxilla was also present in some of the subjects who underwent BAMP.


Assuntos
Má Oclusão de Angle Classe III , Procedimentos de Ancoragem Ortodôntica , Suturas , Animais , Maxila , Técnica de Expansão Palatina , Suínos
10.
Zhongguo Gu Shang ; 32(11): 1034-1037, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31870052

RESUMO

OBJECTIVE: To explore clinical effect of high strength wire under arthroscopy combined with outside anchor nail in treating Meyers McKeever II, III anterior cruciate ligament tibial check point. METHODS: From March 2014 to June 2016, 21 patients with Meyers McKeever II, III avulsion fracture of anterior cruciate ligament tibial check point were treated by high strength wire under arthroscopy combined outside anchor nail. There were 13 males and 8 females aged from 18 to 48 years old with an average of (26.40±5.42) years old. There were 9 cases injured on the left side, and 12 cases on the right side. The courses of disease included sports injuries of 12 cases, falling down injuries of 6 cases, and accident injuries of 3 cases. According to Meyers-McKeever classification, 16 patients were type II and 5 patients were type III. All fractures were fresh, closed and simple injury. The time from injury to operation ranged from 2 to 15 days with an average of (6.20±2.63) d. Lysholm score, IKDC score and the changes of knee mobility were observed and compared before operation and 6 months after operation. RESULTS: Twenty-one patients were followed up for 12 to 24 months with an average of (14.30±3.01) months. Operation time ranged from 40 to 65 min with an average of (45.10±4.82) min, Blood loss ranged from 5 to 15 ml with an average of (10.05±2.75) ml. Lysholm score was improved from 50.29±6.67 before operation to 92.48±2.18 at 6 months after operation. IKDC scores was increased from 47.19±4.57 before operation to 90.71±2.22 at 6 months after operation. Knee joint activity was respectively (83.05±5.33)° and (132.05±7.15)° before operation and 6 months after operation. CONCLUSIONS: High strength wire under arthroscopy combined outside anchor nail in treating Meyers McKeever II, III ACL tibial check point has the advantages of less trauma, firm fixation, and satisfactory clinical effect.


Assuntos
Lesões do Ligamento Cruzado Anterior , Fratura Avulsão , Fraturas da Tíbia , Adolescente , Adulto , Ligamento Cruzado Anterior , Artroscopia , Feminino , Fratura Avulsão/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura , Suturas , Resultado do Tratamento , Adulto Jovem
11.
Zhongguo Gu Shang ; 32(12): 1094-1096, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31870065

RESUMO

OBJECTIVE: To evaluate the surgical technique and clinical effect of arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels. METHODS: From May 2014 to May 2017, 22 patients with posterior root tear of medial meniscus were treated by pullout suture repair via the double tibial tunnels, including 8 males and 14 females, aged 34 to 53 years old, with a mean of averaged(45.7±4.7) years old. The patients were followed up for 12 to 24 months, with a mean of (16.4±5.2) months. RESULTS: The Lysholm score of knee joint before operation was 61.8±4.3, IKDC score before operation was 59.9±2.9, Lysholm score at the latest follow-up was 89.1±3.0, and IKDC score was 89.0±2.5. The difference was statistically significant. CONCLUSIONS: Arthroscopic pullout suture repair via the double tibial tunnelsis an effective treatment for symptomatic posterior root tear of medial meniscus, and it can significantly improve the knee functional outcome.


Assuntos
Meniscos Tibiais , Lesões do Menisco Tibial , Adulto , Artroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura , Suturas , Lesões do Menisco Tibial/cirurgia
12.
Am Surg ; 85(11): 1213-1218, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31775961

RESUMO

The best method for fascial closure during hernia repair remains unknown. This study evaluates the impact of fascial closure techniques on short-term outcomes. All patients undergoing open ventral hernia repair were queried using the Americas Hernia Society Quality Collaborative database. Analysis was stratified by suture type (absorbable and permanent) and technique (figure-of-eight, running, and interrupted). Outcome measures included SSI, surgical site occurrence (SSO), SSO requiring intervention, recurrence rate, and quality of life. Descriptive statistics and logistic regression were used. The study included 6544 patients. Two-thirds of surgeons closed fascia during ventral hernia repair with absorbable suture and one-third with permanent suture. In the absorbable group, 17 per cent used figure-of-eight, 46 per cent running, and 4 per cent interrupted suture. In the permanent group, 13 per cent used figure-of-eight, 8 per cent running, and 11 per cent interrupted suture. There was no significant association between SSO and closure technique (P = 0.2). However, SSO and suture type were significant (P < 0.001) with the odds of SSO for closure with absorbable suture being 62 per cent higher than the odds of permanent. Fascial closure technique and suture type had no significant association (P > 0.5) with SSI, SSO requiring intervention, hernia recurrence rate, or HerQLes or NIH PROMIS 3a scores at 30 days or 6 months. Fascial closure technique and suture material do not have a major impact on outcomes in ventral hernia repair. Despite a significantly higher rate of SSO for absorbable sutures than permanent, this did not increase the rate of interventions.


Assuntos
Fasciotomia/métodos , Hérnia Ventral/cirurgia , Hérnia Incisional/cirurgia , Técnicas de Sutura/estatística & dados numéricos , Técnicas de Fechamento de Ferimentos , Adulto , Idoso , Fáscia , Fasciotomia/estatística & dados numéricos , Feminino , Herniorrafia/métodos , Herniorrafia/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica , Qualidade de Vida , Recidiva , Suturas/estatística & dados numéricos , Técnicas de Fechamento de Ferimentos/estatística & dados numéricos
13.
Medicine (Baltimore) ; 98(44): e17850, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689876

RESUMO

BACKGROUND: Lateral humeral condyle fractures are the second most common elbow fracture in children. Displaced and rotated fractures require stabilization and reduction. Kirschner wires (K-wires) are most commonly used in the fixation of these fractures. Here, we introduce a new fixation method that uses an absorbable screw. We aim to determine if it is feasible to treat lateral humeral condyle fractures with an absorbable screw by comparing functional outcomes following absorbable screw fixation vs. K-wire fixation. METHODS: Between May 2007 and September 2010, 86 patients were treated with absorbable screws (43 patients) or K-wire (43 patients). All patients had been diagnosed with lateral condyle fractures that were classified as either Jacob type II (unstable) or III. One absorbable screw (3.5 mm-diameter) was used for fixation in 1 group, while two 1.6 to 1.8 mm K-wires were used in the other group. Patients were followed 6 months about the elbow function according to Broberg and Morrey standard. On 5-7 years, the patients were followed about the carrying angle (valgus deformities and varus deformities), range of motion (flexion loss and extension loss), prominent lateral condyle, symptomatic implants, and fishtail deformity. RESULTS: Anatomic reduction was achieved in all patients. Each group had one radial nerve injury that were present preoperatively. Nerve function recovered spontaneously within 3 to 4 weeks of surgery in both patients. No patient developed necrosis of the capitulum in both groups. Nine patients in K-wires group and 2 in absorbable screw group developed symptomatic implants (P = .048). On the sixth month, there was no significant difference on elbow function according to Broberg and Morrey standard. On 5 to 7 years (average, 6.7 ±â€Š1.3 years), valgus deformities was 6.8 ±â€Š1.2 vs 5.7 ±â€Š0.8, varus deformities was 7.2 ±â€Š1.5 vs 5.1 ±â€Š1.9, flexion loss was 12.4 ±â€Š2.2 vs 9.5 ±â€Š3.1, extension loss was 11.1 ±â€Š3.1 vs 10.2 ±â€Š2.7, prominent lateral condyle was 27.9% vs 37.2%, fishtail deformity was 7.3% vs 4.9%, no significant difference between these groups. CONCLUSIONS: Open reduction with absorbable screw fixation is feasible and safe for the treatment of lateral condyle fractures of the humerus in children. LEVEL OF EVIDENCE: Therapeutic III.


Assuntos
Implantes Absorvíveis , Parafusos Ósseos , Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Redução Aberta , Suturas , Adolescente , Fios Ortopédicos , Criança , Feminino , Seguimentos , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/instrumentação , Humanos , Fraturas do Úmero/classificação , Fraturas do Úmero/fisiopatologia , Masculino , Complicações Pós-Operatórias , Amplitude de Movimento Articular , Estudos Retrospectivos
14.
J Craniofac Surg ; 30(8): 2390-2392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31633668

RESUMO

INTRODUCTION: Lambdoid craniosynostosis is an extremely rare anomaly in which there is premature fusion of one or both lambdoid sutures. The mainstay of treatment is surgical intervention, for which various procedures have been described, but there is a paucity of data on long-term outcomes. This study examines the long-term outcomes in the surgical management of this challenging condition, showing that accurate diagnosis and careful planning can lead to safe and consistent results. MATERIALS AND METHODS: A retrospective chart review was performed looking at all cases of isolated lambdoid craniosynostosis treated with surgical intervention by the senior author from 1999 to 2016. Data collected included gender, age at diagnosis, age at surgery, length of follow up, method of diagnosis, side of affected suture, pre-operative and post-operative physical exam findings, surgical technique, complications, re-operation rate, and associated torticollis. RESULTS: Twenty-five patients (N = 25) were included in the study. All patients underwent posterior calvarial remodeling with/without barrel stave osteotomies and full thickness calvarial bone grafts. Mean length of follow up after operative intervention was 43.8 months (+/- 23.2 months). All patients were judged to have significantly improved head contour which was near-normal at conversational distance during post-operative follow up by the senior author. Residual plagiocephaly was present in 24% of patients. There were no major complications in this series. Reoperation rate was 8%. Seventy-six percent of patients also presented with torticollis, of which 37% had refractory torticollis that required sternocleidomastoid (SCM) release by the senior author. DISCUSSION: The authors present one of the largest series of operative cases of isolated lambdoid craniosynostosis to date. Our data show that with accurate diagnosis and careful planning, safe and consistent long-term results can be achieved with surgical intervention. A significant number of patients in our series also presented with concomitant torticollis. The authors recommend that all patients being evaluated for posterior plagiocephaly should also be evaluated for torticollis, because without recognition and intervention, patients may continue to have residual facial asymmetry and head shape abnormalities despite optimal surgical correction of the lambdoid synostosis.


Assuntos
Craniossinostoses/cirurgia , Transplante Ósseo , Assimetria Facial/cirurgia , Humanos , Procedimentos Neurocirúrgicos , Osteotomia , Plagiocefalia/cirurgia , Período Pós-Operatório , Reoperação , Estudos Retrospectivos , Crânio/cirurgia , Suturas , Resultado do Tratamento
15.
Am J Vet Res ; 80(11): 1050-1054, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31644337

RESUMO

OBJECTIVE: To determine the optimal intercostal space (ICS) for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats. SAMPLE: 8 cat cadavers. PROCEDURES: Cadavers were placed in lateral recumbency. A 5-cm minithoracotomy incision was made in the middle third of ICS 4 through 7 on the left side and 4 through 8 on the right side, and a wound retractor device was placed. A camera port was made in the middle third of ICS 9. Each lung lobe was sequentially exteriorized at each respective ICS. A thoracoabdominal stapler was placed to simulate a lung lobectomy, and distance from the stapler anvil to the hilus was measured. RESULTS: For the left cranial lung lobe, there was no significant difference in median distance from the stapler anvil to the pulmonary hilus for ICS 4 through 6. Simulated lobectomy of the left caudal lung lobe performed at ICS 5 and 6 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 4 and 7. Simulated lobectomy of the right cranial and right middle lung lobes performed at ICS 4 and 5 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 7. Simulated lobectomy of the accessory and right caudal lung lobes at ICS 5 and 6 resulted in a significantly shorter distance than for lobectomy performed at ICS 8. CONCLUSIONS AND CLINICAL RELEVANCE: An optimal ICS for a minithoracotomy incision was determined for thoracoscopic-assisted lung lobectomy in cats.


Assuntos
Gatos/cirurgia , Pulmão/cirurgia , Toracoscopia/veterinária , Animais , Cadáver , Humanos , Suturas/veterinária , Toracoscopia/métodos , Toracotomia/veterinária
16.
Am Surg ; 85(10): 1159-1161, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657315

RESUMO

There are conflicting views regarding techniques for repair of small umbilical hernias (UHs). Here, we compare the recurrence rate in primary repair with that reported for mesh repair by examining a single surgeon's practice at a large medical center with a comprehensive electronic medical record. A six-year retrospective review of primary UH repairs between January 2012 and December 2017 at Kaiser Permanente Los Angeles Medical Center was undertaken. Patients were identified through a database search of the electronic medical record. The primary endpoint of UH recurrence was examined; median follow-up was 3.4 years. Primary, elective UH repair was performed in 244 patients; 71 per cent of hernias were small (<2 cm). The total number of recurrences was seven (3%). The t test analysis showed significant differences in the average size of hernia defects between those with recurrences (2 cm) and those without (1.4 cm), P < 0.05. Primary repair affords low infection and recurrence rates, comparable to those reported for mesh repair. Our single-surgeon/large-volume study contributes to the evidence that primary UH repair is a safe and durable method, with low risk of recurrence. The use of absorbable monofilament suture, and selection for lower BMI and smaller hernia sizes proved to be effective.


Assuntos
Hérnia Umbilical/cirurgia , Herniorrafia/estatística & dados numéricos , Telas Cirúrgicas/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , California , Feminino , Hérnia Umbilical/patologia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Fumantes/estatística & dados numéricos , Telas Cirúrgicas/efeitos adversos , Suturas , Técnicas de Fechamento de Ferimentos
17.
Khirurgiia (Mosk) ; (10): 75-81, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626243

RESUMO

Postoperative complications in vascular surgery may be partly provoked by suture material. Analysis of the mechanisms of these complications may be useful for their prevention. Mechanisms of suture-induced thrombosis and neointimal hyperplasia, possible strategies for prevention of postoperative complications including those allowing drug deliveries directly to the vascular anastomosis area are discussed in the article. According to the literature data, heparin is the most optimal drug for modifying suture material and prevention of thrombosis and neointimal hyperplasia. Heparin delivery to the vascular anastomosis site will reduce the risk of thrombosis by inhibiting the activity of thrombin. Complex of heparin and antithrombin III increases inhibitory effect of antithrombin against thrombin. In addition, heparin is able to reduce proliferation of vascular smooth muscle cells through inhibition of the synthesis of extracellular matrix proteases involved in migration and proliferation of cells. Thus, heparin delivery to the vascular injury site may be used to prevent thrombosis and myoproliferative response. Moreover, this strategy prevents complications associated with systemic administration of anticoagulants.


Assuntos
Suturas/efeitos adversos , Trombose/prevenção & controle , Doenças Vasculares/prevenção & controle , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Anticoagulantes/administração & dosagem , Heparina/administração & dosagem , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Hiperplasia/prevenção & controle , Neointima/patologia , Trombose/etiologia , Doenças Vasculares/etiologia
18.
JSLS ; 23(3)2019.
Artigo em Inglês | MEDLINE | ID: mdl-31595144

RESUMO

Background and Objective: Laparoendoscopic single-site surgery has been used in treating gynecologic diseases including early-stage cervical and endometrial cancer, but less so in early-stage adnexal cancer. We aimed to demonstrate the use of laparoendoscopic single-site surgery with suture suspension for staging of early-stage ovarian/fallopian-tube cancer and describe the study results. Methods: Seven patients with early-stage adnexal cancer underwent staging surgery via laparoendoscopic single-site surgery at West China Second University Hospital of Sichuan University from November 2017 to September 2018. Results: All cases were successfully staged via this technique. Two patients underwent the high-level para-aortic lymphadenectomy up to the infrarenal vein, and four patients underwent para-aortic lymphadenectomy at the level of the inframesenteric artery; one patient underwent the para-aortic lymph node sampling. The operation time was 305-365 minutes. The estimated intraoperative blood loss was 50-200 mL. No intra-operative complications occurred; one patient developed pneumonia 48 hours postoperation. The number of pelvic and para-aortic nodes was 15-39 and 1-18, respectively. Pain scores 12 and 24 hours postsurgery were 2-3 and 1-2 with the use of butorphanol tartrate, respectively. On 4-14 months followup, the umbilical incision had good cosmesis; no umbilical hernia or vaginal dehiscence and no neoplasm recurrence were noted. Conclusion: Laparoendoscopic single-site surgery may be a feasible and safe technique for staging early-stage ovarian/tubal cancer. This approach has some advantages included providing easier access to the upper abdominal regions when performing high-level infrarenal para-aortic lymphadenectomy; the 2-cm elastic incision favors fast specimen extraction and colpotomy are avoided. However, the long-term oncologic outcomes need to be further investigated.


Assuntos
Neoplasias do Endométrio/diagnóstico , Laparoscopia/métodos , Estadiamento de Neoplasias/métodos , Técnicas de Sutura/instrumentação , Suturas , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Neoplasias do Colo do Útero/cirurgia
19.
Heart Surg Forum ; 22(5): E411-E415, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31596722

RESUMO

BACKGROUND: In this study, we evaluate different annuloplasty modalities to repair functional tricuspid regurgitation. PATIENTS AND METHODS: Between January 2011 and January 2017, 200 patients with moderate or greater functional tricuspid regurgitation received tricuspid valve repair as part of primary surgeries on the left side of their cardiac valves. Of these, 39 patients received rings (Group A), 84 patients received bands (Group B), and 77 patients received suture annuloplasty (Group C). RESULTS: Two patients from Group C were operated on again, during the primary hospital stay due to severe symptomatic tricuspid regurgitation. The degrees of early postoperative tricuspid regurgitation - mean vena contracta and mean jet area - significantly were higher in Group C. During a mean follow-up period of 26 ± 12.6 months, 5 patients within Group C (6.85%) and one patient in Group B (1.3%) were operated on again with tricuspid valve replacement due to severe symptomatic tricuspid incompetence. Also during follow up, mean degrees of tricuspid regurgitation, mean vena contracta, and mean jet areas significantly were higher in Group C. CONCLUSION: Patients who received rings followed by band annuloplasty had better early and late results with lower recurrence rates than those who received suture annuloplasty.


Assuntos
Anuloplastia da Valva Cardíaca/métodos , Complicações Pós-Operatórias/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Valva Tricúspide/cirurgia , Adulto , Anuloplastia da Valva Cardíaca/instrumentação , Feminino , Humanos , Masculino , Reoperação , Suturas , Resultado do Tratamento
20.
Vet Ital ; 55(3): 269-274, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31599552

RESUMO

In this study the caecum and large colon were harvested from 24 slaughtered horses. On each sample, an 8­cm long enterotomy was performed. Enterotomies were closed using either barbed or unbarbed glycomer­631. We compared the time to close, appearance, length of suture material, bursting pressure, and costs associated with each type of material. Our findings demonstrated that time to close was significantly shorter (caecum, P = 0.034; pelvic flexure, P = 0.039) using barbed sutures (caecum 610.4 seconds; pelvic flexure 699.3 seconds) than unbarbed sutures (caecum 661.0 seconds, pelvic flexure 743.1 seconds). The length of suture material used was significantly less (caecum, P < 0.0001; pelvic flexure, P < 0.0001) with barbed (caecum 28.1 cm, pelvic flexure 32.0 cm,) compared with unbarbed sutures (caecum 41.6 cm; pelvic flexure 46.6 cm). There were no significant differences in bursting pressure (caecum, P = 0.294; pelvic flexure, P = 0.430) between barbed (caecum, 172.5 mmHg, pelvic flexure, 188.9 mmHg) and unbarbed sutures (caecum 178.3 mmHg, pelvic flexure 183.3 mmHg). The cost was higher using barbed sutures. However, the use of barbed sutures was faster, left less suture material in the tissue, and sustained comparable bursting pressure to unbarbed sutures. We therefore conclude that barbed sutures are a valid alternative to unbarbed sutures for closing large intestine enterotomy in horses.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/veterinária , Cavalos/cirurgia , Técnicas de Sutura/veterinária , Suturas/veterinária , Animais , Ceco/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Pelve/cirurgia , Técnicas de Sutura/estatística & dados numéricos , Suturas/estatística & dados numéricos
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