Parastomal hernia is not a rare event. Being by definition a complication of ostomy creation, a parastomal hernia also carries the risk of becoming symptomatic and complicated. At present, there are not enough solid data in literature to allow an evidence-based approach to this condition and to its possible complications, especially in the emergency setting. The aim of this paper is to describe through a narrative review of the literature the different surgical approaches concerning parastomal hernias. In order to exemplify the emergency complications we also present two cases in which the watchful waiting approach eventually led to the necessity of urgent surgical treatment, due to bowel incarceration into the parastomal hernia. We chose to tailor the surgical plan on the patient's anatomic and clinical condition, pursuing the laparoscopic approach with two different surgical technique (Sugarbaker and keyhole), each time estimated by the operating surgeon to be the more suitable option for the patient. We acknowledge that laparoscopy can be an optimal choice for the emergency and elective treatment of parastomal hernias, whenever an appropriate know-how is present.
{"title":"Emergency laparoscopic treatment of complicated parastomal hernias.","authors":"Nero Vettoretto, Michela Caprioli, Emanuele Botteri","doi":"10.23736/S0026-4733.20.08462-X","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08462-X","url":null,"abstract":"<p><p>Parastomal hernia is not a rare event. Being by definition a complication of ostomy creation, a parastomal hernia also carries the risk of becoming symptomatic and complicated. At present, there are not enough solid data in literature to allow an evidence-based approach to this condition and to its possible complications, especially in the emergency setting. The aim of this paper is to describe through a narrative review of the literature the different surgical approaches concerning parastomal hernias. In order to exemplify the emergency complications we also present two cases in which the watchful waiting approach eventually led to the necessity of urgent surgical treatment, due to bowel incarceration into the parastomal hernia. We chose to tailor the surgical plan on the patient's anatomic and clinical condition, pursuing the laparoscopic approach with two different surgical technique (Sugarbaker and keyhole), each time estimated by the operating surgeon to be the more suitable option for the patient. We acknowledge that laparoscopy can be an optimal choice for the emergency and elective treatment of parastomal hernias, whenever an appropriate know-how is present.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01Epub Date: 2020-09-25DOI: 10.23736/S0026-4733.20.08362-5
Kausik Ray, Mohammed Albendary, Mirza K Baig, Christie Swaminathan, Parv Sains, Muhammad S Sajid
Introduction: The objective of this study is to compare the effectiveness of Limberg flap (LF) versus Karydakis and Bascom procedure to reduce the recurrence of pilonidal sinus disease.
Evidence acquisition: The data retrieved from the published randomized controlled trials (RCT) comparing the effectiveness of LF versus Karydakis and Bascom procedure was analyzed using the principles of meta-analysis. The summated outcome of the dichotomous data was presented in risk ratio (RR).
Evidence synthesis: Eighteen RCTs on 2073 patients comparing the effectiveness of LF versus Karydakis and or Bascom procedure for the surgical excision of pilonidal sinus disease were analyzed. In the random effects model analysis using the statistical software Review Manager 5.3, the LF was associated with the reduced risk (RR, 0.52; 95% CI: 0.29, 0.93; z=2.19; P=0.03) of disease recurrence after pilonidal sinus excision compared to Karydakis and Bascom procedure. On subgroup analysis the LF was still superior to Karidakys procedure (RR, 0.52; 95% CI: 0.23, 1.17; z=1.57; P=0.12) and Bascom procedure (RR, 0.49; 95% CI: 0.19, 1.29; z=1.44; P=0.15) but statistically it was not significant.
Conclusions: LF seems to have clinical advantage over Karydakis and Bascom procedure in terms of reduced recurrence rate following surgical excision of pilonidal sinus. Although, this advantage was clinically persisted on subgroup analysis but failed to achieve statistical significance.
{"title":"Limberg flap for the management of pilonidal sinus reduces disease recurrence compared to Karydakis and Bascom procedure: a systematic review and meta-analysis of randomized controlled trials.","authors":"Kausik Ray, Mohammed Albendary, Mirza K Baig, Christie Swaminathan, Parv Sains, Muhammad S Sajid","doi":"10.23736/S0026-4733.20.08362-5","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08362-5","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to compare the effectiveness of Limberg flap (LF) versus Karydakis and Bascom procedure to reduce the recurrence of pilonidal sinus disease.</p><p><strong>Evidence acquisition: </strong>The data retrieved from the published randomized controlled trials (RCT) comparing the effectiveness of LF versus Karydakis and Bascom procedure was analyzed using the principles of meta-analysis. The summated outcome of the dichotomous data was presented in risk ratio (RR).</p><p><strong>Evidence synthesis: </strong>Eighteen RCTs on 2073 patients comparing the effectiveness of LF versus Karydakis and or Bascom procedure for the surgical excision of pilonidal sinus disease were analyzed. In the random effects model analysis using the statistical software Review Manager 5.3, the LF was associated with the reduced risk (RR, 0.52; 95% CI: 0.29, 0.93; z=2.19; P=0.03) of disease recurrence after pilonidal sinus excision compared to Karydakis and Bascom procedure. On subgroup analysis the LF was still superior to Karidakys procedure (RR, 0.52; 95% CI: 0.23, 1.17; z=1.57; P=0.12) and Bascom procedure (RR, 0.49; 95% CI: 0.19, 1.29; z=1.44; P=0.15) but statistically it was not significant.</p><p><strong>Conclusions: </strong>LF seems to have clinical advantage over Karydakis and Bascom procedure in terms of reduced recurrence rate following surgical excision of pilonidal sinus. Although, this advantage was clinically persisted on subgroup analysis but failed to achieve statistical significance.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38419608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-25DOI: 10.23736/S0026-4733.20.08384-4
E. Botteri, C. Turolo, M. Caprioli, N. Vettoretto
By the years several locations for specimen extraction site (SES) during laparoscopic surgery for colorectal disease have been proposed and many studies have focused their attention on outcomes and complications, but the 'best' SES has not yet been found. In this paper we describe our experience using the enlargement of umbilical trocar access as SES during laparoscopic colorectal surgery: at the end of the intracorporal phase we remove Hasson's trocar from the umbilicus, therefore the skin and fascial incision is enlarged up to 5-6 cm. In our work we considered 36 patients extracted from our database from 2017 with at least one year follow up. We don't report any skin closure dehiscence or surgical site infection (SSI) and in only one patient (2.7%) occurred incisional hernia (IH). The results of our study are good and an accurate wound closure at the end of the surgery and an optimal perioperative management are important to reach this goal. The enlargement of umbilical access could enable several post-operative advantages such as a fewer painful areas and a reduced number of incisions with a potential risk of SSI and incisional hernia compared to traditional SES options but further studies investigating that are needed. In the future other incisions will not be necessary except the normal trocar site ones.
{"title":"Midline incision as specimen extraction site: always to avoid? Single center experience about the use of enlarged umbilical trocar access.","authors":"E. Botteri, C. Turolo, M. Caprioli, N. Vettoretto","doi":"10.23736/S0026-4733.20.08384-4","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08384-4","url":null,"abstract":"By the years several locations for specimen extraction site (SES) during laparoscopic surgery for colorectal disease have been proposed and many studies have focused their attention on outcomes and complications, but the 'best' SES has not yet been found. In this paper we describe our experience using the enlargement of umbilical trocar access as SES during laparoscopic colorectal surgery: at the end of the intracorporal phase we remove Hasson's trocar from the umbilicus, therefore the skin and fascial incision is enlarged up to 5-6 cm. In our work we considered 36 patients extracted from our database from 2017 with at least one year follow up. We don't report any skin closure dehiscence or surgical site infection (SSI) and in only one patient (2.7%) occurred incisional hernia (IH). The results of our study are good and an accurate wound closure at the end of the surgery and an optimal perioperative management are important to reach this goal. The enlargement of umbilical access could enable several post-operative advantages such as a fewer painful areas and a reduced number of incisions with a potential risk of SSI and incisional hernia compared to traditional SES options but further studies investigating that are needed. In the future other incisions will not be necessary except the normal trocar site ones.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44487582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-25DOI: 10.23736/S0026-4733.20.08317-0
Jiyang Li, Shaoqing Li, Chen Liu, H. Xi, Peifa Liu, Zhi-da Chen, B. Wei, Lin Chen, Z. Qiao
BACKGROUND This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC). METHODS The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (n=42) or without IONM (n=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes. RESULTS IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001). CONCLUSIONS IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.
{"title":"Advantages of intraoperative nerve monitoring in endoscopic thyroidectomy for papillary thyroid carcinoma.","authors":"Jiyang Li, Shaoqing Li, Chen Liu, H. Xi, Peifa Liu, Zhi-da Chen, B. Wei, Lin Chen, Z. Qiao","doi":"10.23736/S0026-4733.20.08317-0","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08317-0","url":null,"abstract":"BACKGROUND\u0000This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC).\u0000\u0000\u0000METHODS\u0000The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (n=42) or without IONM (n=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes.\u0000\u0000\u0000RESULTS\u0000IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001).\u0000\u0000\u0000CONCLUSIONS\u0000IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46678988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-25DOI: 10.23736/S0026-4733.20.08454-0
B. Nardo, M. Lugaresi, M. Doni, I. Vulcano, Domenico Piccione, Daniele Paglione, G. Stabile
BACKGROUND On March 8th, 2020 the Italian Government implemented extraordinary measures to limit COVID-19 viral transmission. The aim of the study was to verify if the use of WhatsApp facilitates communication, improves health information, perception of safe and security, reduce emotional stress during the COVID-19 emergency. METHODS In this study we identified two period, in the pre-COVID 1-month period (February 9th-March 8th, 2020) 34 patients underwent elective surgery for malignancies (21) and benign (13) diseases, respectively. We daily given to families of patients clinical information face-to-face in the ward regarding their postoperative course. In the post-COVID 1-month period (March 9th - April 5th, 2020), 15 patients with malignancies were treated. In this period, patients and their families given a consent form to let the surgical team to communicate clinical data using WhatsApp. At the end of the study period we collected a satisfaction anonymous questionnaire of both patients and families. RESULTS Statistically significant differences were observed in the pre- vs post- COVID period regarding the number of surgical procedures (p = 0.004). In the post-COVID period, the satisfaction questionnaire showed a good reliability (Cronbach's alpha 0.912) and a high percentage of satisfaction of patients and their families for the adopted communication tool, reassurance, privacy protection and reduction of emotional stress. CONCLUSIONS WhatsApp is a safe and fast technology, it offers the opportunity to facilitate clinical communications, reduce stress, improve patient security, obtain clinical and psychological positive implications in patient's care preserving their privacy in the COVID-19 emergency period.
{"title":"WhatsApp video call communication between oncological patients and their families during Covid-19 outbreak.","authors":"B. Nardo, M. Lugaresi, M. Doni, I. Vulcano, Domenico Piccione, Daniele Paglione, G. Stabile","doi":"10.23736/S0026-4733.20.08454-0","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08454-0","url":null,"abstract":"BACKGROUND\u0000On March 8th, 2020 the Italian Government implemented extraordinary measures to limit COVID-19 viral transmission. The aim of the study was to verify if the use of WhatsApp facilitates communication, improves health information, perception of safe and security, reduce emotional stress during the COVID-19 emergency.\u0000\u0000\u0000METHODS\u0000In this study we identified two period, in the pre-COVID 1-month period (February 9th-March 8th, 2020) 34 patients underwent elective surgery for malignancies (21) and benign (13) diseases, respectively. We daily given to families of patients clinical information face-to-face in the ward regarding their postoperative course. In the post-COVID 1-month period (March 9th - April 5th, 2020), 15 patients with malignancies were treated. In this period, patients and their families given a consent form to let the surgical team to communicate clinical data using WhatsApp. At the end of the study period we collected a satisfaction anonymous questionnaire of both patients and families.\u0000\u0000\u0000RESULTS\u0000Statistically significant differences were observed in the pre- vs post- COVID period regarding the number of surgical procedures (p = 0.004). In the post-COVID period, the satisfaction questionnaire showed a good reliability (Cronbach's alpha 0.912) and a high percentage of satisfaction of patients and their families for the adopted communication tool, reassurance, privacy protection and reduction of emotional stress.\u0000\u0000\u0000CONCLUSIONS\u0000WhatsApp is a safe and fast technology, it offers the opportunity to facilitate clinical communications, reduce stress, improve patient security, obtain clinical and psychological positive implications in patient's care preserving their privacy in the COVID-19 emergency period.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46506665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-25DOI: 10.23736/S0026-4733.20.08341-8
X. Serra‐Aracil, Arturo Domínguez, L. Mora-López, Josephine Hidalgo, A. Pallisera-Lloveras, S. Serra-Pla, J. Badia-Closa, A. Garcia-Nalda, S. Navarro-Soto
INTRODUCTION Despite the publication of the Guidelines for Enhanced Recovery After Surgery (ERAS), attitudes to urinary catheter (UC) management vary widely in colorectal surgery. Objective - The aim of the present study is to define current practices in UC management in colorectal surgery. METHODS Cross-sectional observational study carried out in March-April 2019, based on the responses to a survey administered to public hospitals in Catalonia. Respondents were asked about their observance of ERAS programs, the percentage of laparoscopic procedures performed, and the time of UC withdrawal in surgery of the colon and rectum. RESULTS Forty-three of 45 hospitals contacted eventually responded (95.6%). As two hospitals reported that they did not perform colorectal surgery, the study is based on the results from 41 centers. Thirty-five (85.4%) reported following ERAS programs; 30 (73.2%) have Coloproctology units, and 39 (95.1%) perform more than 70% of colorectal surgeries by laparoscopy. In colon surgery, 27 (65.9%) remove the UC at 24 h, and 12 (29.3%) on day 2 or day 3. In rectal surgery, 17 (58.6%) remove the UC on day 2-3. CONCLUSIONS Management of UC in colon and rectal surgery varies widely. There is clearly room for improvement in UC management, but needs to be thoroughly assessed in randomized multicenter studies.
{"title":"Urinary catheter in colorectal surgery. Current practices and improvements in order to allow prompt removal: a cross-sectional study.","authors":"X. Serra‐Aracil, Arturo Domínguez, L. Mora-López, Josephine Hidalgo, A. Pallisera-Lloveras, S. Serra-Pla, J. Badia-Closa, A. Garcia-Nalda, S. Navarro-Soto","doi":"10.23736/S0026-4733.20.08341-8","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08341-8","url":null,"abstract":"INTRODUCTION\u0000Despite the publication of the Guidelines for Enhanced Recovery After Surgery (ERAS), attitudes to urinary catheter (UC) management vary widely in colorectal surgery. Objective - The aim of the present study is to define current practices in UC management in colorectal surgery.\u0000\u0000\u0000METHODS\u0000Cross-sectional observational study carried out in March-April 2019, based on the responses to a survey administered to public hospitals in Catalonia. Respondents were asked about their observance of ERAS programs, the percentage of laparoscopic procedures performed, and the time of UC withdrawal in surgery of the colon and rectum.\u0000\u0000\u0000RESULTS\u0000Forty-three of 45 hospitals contacted eventually responded (95.6%). As two hospitals reported that they did not perform colorectal surgery, the study is based on the results from 41 centers. Thirty-five (85.4%) reported following ERAS programs; 30 (73.2%) have Coloproctology units, and 39 (95.1%) perform more than 70% of colorectal surgeries by laparoscopy. In colon surgery, 27 (65.9%) remove the UC at 24 h, and 12 (29.3%) on day 2 or day 3. In rectal surgery, 17 (58.6%) remove the UC on day 2-3.\u0000\u0000\u0000CONCLUSIONS\u0000Management of UC in colon and rectal surgery varies widely. There is clearly room for improvement in UC management, but needs to be thoroughly assessed in randomized multicenter studies.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46271690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.23736/S0026-4733.20.08354-6
V. Kolte, R. Shenoi, Pranav D Ingole, Jui S Karmarkar, Jignesh Rajguru, Sumedha Deole
BACKGROUND Maxillofacial trauma is complex kind of injury that requires complex treatment, hence it is difficult in selecting the type of intubation technique depending on trauma. With the advent of various technologies and devices ,surgeon and anesthetist should select right method of intubation that will benefit patient. METHODS In a retrospective study, patients of either sex , admitted in Lata Mangeshkar Hospital under Oral and Maxillofacial Surgery unit for treating Maxillofacial trauma operated during year 2018 to year 2019 as elective basis were studied. In total 78 patients [Table 1], majority of patients were in the age group of 21-30 years 37(47.4),followed by age group of young adults 31-40 years-19(24.3)Fracture mandible [Table 2] was found to be the most common injury in 35 patients (44.3%) followed by fracture zygoma in 26(33.3%) patients and panfacial in 8 patients (10.2%) There was frontal bone fracture in 3 patients (3.8%). Fiberoptic intubation under sedation was carried out in 34(43.5%) and submental intubation in 20(25.6%) and nasal intubation with direct visualization of vocal cords in 14(17.9%) and blind nasal intubation was done in 8(10.2%). CONCLUSIONS The results of this study suggest that the old concept of securing the airway in difficult situation by tracheostomy should be revised.
{"title":"Finding a way for airway: a retrospective study.","authors":"V. Kolte, R. Shenoi, Pranav D Ingole, Jui S Karmarkar, Jignesh Rajguru, Sumedha Deole","doi":"10.23736/S0026-4733.20.08354-6","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08354-6","url":null,"abstract":"BACKGROUND\u0000Maxillofacial trauma is complex kind of injury that requires complex treatment, hence it is difficult in selecting the type of intubation technique depending on trauma. With the advent of various technologies and devices ,surgeon and anesthetist should select right method of intubation that will benefit patient.\u0000\u0000\u0000METHODS\u0000In a retrospective study, patients of either sex , admitted in Lata Mangeshkar Hospital under Oral and Maxillofacial Surgery unit for treating Maxillofacial trauma operated during year 2018 to year 2019 as elective basis were studied. In total 78 patients [Table 1], majority of patients were in the age group of 21-30 years 37(47.4),followed by age group of young adults 31-40 years-19(24.3)Fracture mandible [Table 2] was found to be the most common injury in 35 patients (44.3%) followed by fracture zygoma in 26(33.3%) patients and panfacial in 8 patients (10.2%) There was frontal bone fracture in 3 patients (3.8%). Fiberoptic intubation under sedation was carried out in 34(43.5%) and submental intubation in 20(25.6%) and nasal intubation with direct visualization of vocal cords in 14(17.9%) and blind nasal intubation was done in 8(10.2%).\u0000\u0000\u0000CONCLUSIONS\u0000The results of this study suggest that the old concept of securing the airway in difficult situation by tracheostomy should be revised.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43494089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.23736/S0026-4733.20.08414-X
G. Barbato, S. Rollo, A. Borri, F. Staderini, F. Cianchi, F. Coratti
BACKGROUND Pelvic Organ Prolapse etiology is a combination of anatomical, physiological, genetic, lifestyle, and reproductive factors determine pelvic floor dysfunction. POP is very common across all ages women worldwide and has become an increasing socioeconomic problem with public health consequences, with symptoms that could lead to a significant decrease in quality of life. METHODS This study retrospectively analyzes a small case series of our initial experience of laparoscopic vaginal suspension with mesh focusing on the technical aspects of the technique. Although sacrocolpopexy and sacrohysteropexy are the most performed surgical techniques, they are associated with serious complications. Laparoscopic vaginal suspension appears reproducible and safe to learn. RESULTS Between November 2017 and January 2020, fifteen patients underwent laparoscopic vaginal suspension for pelvic organ prolapse repair. Despite the small number, for a minimally invasive skilled surgeon, we notice a significative reduction of the learning curve to become proficient in this procedure. CONCLUSIONS The diagnosis and management of pelvic organ prolapse are further complicated by what is considered "successful" treatment. Laparoscopic vaginal suspension is a feasible surgical procedure for one-stage treatment of pelvic organ prolapse.
{"title":"Laparoscopic vaginal lateral suspension: technical aspects and initial experience.","authors":"G. Barbato, S. Rollo, A. Borri, F. Staderini, F. Cianchi, F. Coratti","doi":"10.23736/S0026-4733.20.08414-X","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08414-X","url":null,"abstract":"BACKGROUND\u0000Pelvic Organ Prolapse etiology is a combination of anatomical, physiological, genetic, lifestyle, and reproductive factors determine pelvic floor dysfunction. POP is very common across all ages women worldwide and has become an increasing socioeconomic problem with public health consequences, with symptoms that could lead to a significant decrease in quality of life.\u0000\u0000\u0000METHODS\u0000This study retrospectively analyzes a small case series of our initial experience of laparoscopic vaginal suspension with mesh focusing on the technical aspects of the technique. Although sacrocolpopexy and sacrohysteropexy are the most performed surgical techniques, they are associated with serious complications. Laparoscopic vaginal suspension appears reproducible and safe to learn.\u0000\u0000\u0000RESULTS\u0000Between November 2017 and January 2020, fifteen patients underwent laparoscopic vaginal suspension for pelvic organ prolapse repair. Despite the small number, for a minimally invasive skilled surgeon, we notice a significative reduction of the learning curve to become proficient in this procedure.\u0000\u0000\u0000CONCLUSIONS\u0000The diagnosis and management of pelvic organ prolapse are further complicated by what is considered \"successful\" treatment. Laparoscopic vaginal suspension is a feasible surgical procedure for one-stage treatment of pelvic organ prolapse.","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48677954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.23736/S0026-4733.20.08446-1
G. Mangiameli, Charles Alzreibi, A. Arame, F. Le Pimpec-Barthes
{"title":"Congenital tracheal diverticulum: from clinical aspects to treatment.","authors":"G. Mangiameli, Charles Alzreibi, A. Arame, F. Le Pimpec-Barthes","doi":"10.23736/S0026-4733.20.08446-1","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08446-1","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48254669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.23736/S0026-4733.20.08422-9
E. Battistella, L. Pomba, S. Merigliano, A. Toniato
{"title":"Oesophageal perforation due to difficult intubation: our experience and review of literature.","authors":"E. Battistella, L. Pomba, S. Merigliano, A. Toniato","doi":"10.23736/S0026-4733.20.08422-9","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08422-9","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45283819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号