Nonpalpable testes: Ultrasound and contralateral testicular hypertrophy predict the surgical access, avoiding unnecessary laparoscopy

2018 ◽  
Vol 14 (2) ◽  
pp. 163.e1-163.e7 ◽  
Author(s):  
Christoph Berger ◽  
Bernhard Haid ◽  
Tanja Becker ◽  
Mark Koen ◽  
Judith Roesch ◽  
...  
Keyword(s):  
Surgical Access ◽  
Testicular Hypertrophy

Holmes tremor: a delayed complication after resection of brainstem cavernomas

2020 ◽  
pp. 1-11
Author(s):  
Marco Cenzato ◽  
Davide Colistra ◽  
Giorgia Iacopino ◽  
Christian Raftopoulos ◽  
Ulrich Sure ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Neurophysiological Monitoring ◽  
Strict Adherence ◽  
Surgical Access ◽  
Holmes Tremor ◽  
Neurophysiological Studies ◽  
Metropolitan Hospital ◽  
Delayed Complication ◽  
Brainstem Cavernoma ◽  
Predicting Factor

OBJECTIVEIn this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).METHODSAfter operating on 2 patients with brainstem cavernoma at the Great Metropolitan Hospital Niguarda in Milan and noticing a similar pathological pattern postoperatively, the authors asked 10 different neurosurgery centers around the world to identify similar cases, and a total of 20 were gathered from among 1274 cases of brainstem cavernomas. They evaluated the tremor, cavernoma location, surgical approach, and SEZ for every case. For the 2 cases at their center, they also performed electromyographic and accelerometric recordings of the tremor and evaluated the postoperative tractographic representation of the neuronal pathways involved in the tremorigenesis. After gathering data on all 1274 brainstem cavernomas, they performed a statistical analysis to determine if the location of the cavernoma is a potential predicting factor for the onset of HT.RESULTSFrom the analysis of all 20 cases with HT, it emerged that this highly debilitating tremor can occur as a delayed complication in patients whose postoperative clinical course has been excellent and in whom surgical access has strictly adhered to the SEZs. Three of the patients were subsequently effectively treated with deep brain stimulation (DBS), which resulted in complete or almost complete tremor regression. From the statistical analysis of all 1274 brainstem cavernomas, it was determined that a cavernoma location in the midbrain was significantly associated with the onset of HT (p < 0.0005).CONCLUSIONSDespite strict adherence to SEZs, the use of intraoperative neurophysiological monitoring, and the immediate success of a resective surgery, HT, a severe neurological disorder, can occur as a delayed complication after resection of brainstem cavernomas. A cavernoma location in the midbrain is a significant predictive factor for the onset of HT. Further anatomical and neurophysiological studies will be necessary to find clues to prevent this complication.

Improvement of surgical access in autogenous infrainguinal reconstruction by the method «in situ»

2018 ◽  
Vol 16 (7(part 2)) ◽  
pp. 81-85
Author(s):  
M. V. Plotnikov ◽  
◽  
A. V. Maksimov ◽  
Keyword(s):  
Surgical Access

SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

2017 ◽  
Vol 63 (1) ◽  
pp. 146-152
Author(s):  
Mikhail Ter-ovanesov ◽  
Aleksandr Levitskiy ◽  
E. Lesnidze ◽  
Aram Gaboyan ◽  
Mariya Kukosh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Esophageal Reconstruction ◽  
Gastroesophageal Cancer ◽  
Colonic Interposition ◽  
Simultaneous Application ◽  
High Involvement ◽  
Surgical Access ◽  
Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

scholarly journals The Impact of the COVID-19 Pandemic on Breast Reconstruction: A Canadian Perspective

2021 ◽  
pp. 229255032110300
Author(s):  
Caroline F. Illmann ◽  
Christopher Doherty ◽  
Margaret Wheelock ◽  
Joshua Vorstenbosch ◽  
Joan E. Lipa ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Care Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Reconstructive Procedures ◽  
Surgical Access ◽  
Canadian Perspective ◽  
Canadian Provinces ◽  
The Impact

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.

scholarly journals Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Chaerim Oh ◽  
Hyun Joo Kim
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
General Anesthesia ◽  
Distal Part ◽  
High Flow ◽  
Tracheal Resection ◽  
Two Stage ◽  
Partial Obstruction ◽  
Surgical Access ◽  
Surgical Field

In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.

Comprehensive Analysis of Long-Term Outcomes after HeartMate 3 LVAD Implantation Depending on Surgical Access

2021 ◽  
Vol 40 (4) ◽  
pp. S180-S181
Author(s):  
R. Antończyk ◽  
A. Biełka ◽  
M. Kalinowski ◽  
J. Waszak ◽  
J. Małyszek-Tumidajewicz ◽  
...  
Keyword(s):  
Comprehensive Analysis ◽  
Long Term Outcomes ◽  
Surgical Access
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