scholarly journals Study of clinical parameters and comparison of conservative management, percutaneous drainage and surgical management in pseudocyst of pancreas

2019 ◽  
Vol 3 (4) ◽  
pp. 264-268
Author(s):  
Dr. Abhishek Vats ◽  
Dr. Karan Vats
Keyword(s):  
Surgical Management ◽  
Conservative Management ◽  
Percutaneous Drainage ◽  
Clinical Parameters

Management of Acute Anastomotic Leaks

2021 ◽  
Author(s):  
Traci L. Hedrick ◽  
William Kane
Keyword(s):  
Anastomotic Leak ◽  
Surgical Management ◽  
Conservative Management ◽  
Percutaneous Drainage ◽  
Patient Specific ◽  
Anastomotic Leaks ◽  
Degree Of Contamination ◽  
Stoma Creation ◽  
Colorectal Stenting ◽  
Endoscopic Clipping

AbstractManagement of the acute anastomotic leak is complex and patient-specific. Clinically stable patients often benefit from a nonoperative approach utilizing antibiotics with or without percutaneous drainage. Clinically unstable patients or nonresponders to conservative management require operative intervention. Surgical management is dictated by the degree of contamination and inflammation but includes drainage with proximal diversion, anastomotic resection with end-stoma creation, or reanastomosis with proximal diversion. Newer therapies, including colorectal stenting, vacuum-assisted rectal drainage, and endoscopic clipping, have also been described.

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

Radiological Management of Abdominal Abscess

1983 ◽  
Vol 76 (4) ◽  
pp. 256-261 ◽  
Author(s):  
D P Mac Erlean ◽  
R G Gibney
Keyword(s):  
Success Rate ◽  
Surgical Management ◽  
Local Anaesthesia ◽  
Percutaneous Drainage ◽  
Ultrasound Guidance ◽  
Abdominal Abscess

Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure.

scholarly journals Surgical Management of Necrotizing Sialometaplasia of Hard Palate: A Case Report

2020 ◽  
Vol 03 (12) ◽  
Author(s):  
Indu Palanivel ◽  
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Surgical Management ◽  
Conservative Management ◽  
Hard Palate ◽  
Complete Regression ◽  
Self Healing ◽  
Healing Period ◽  
Necrotizing Sialometaplasia

Necrotizing Sialometaplasia is rare and in the oral cavity it accounts <1% of all biopsied lesion. For decades Necrotizing Sialometaplasia were treated by conservative management as it is a self healing lesion. The progressive healing period was reported from 2 weeks to 3 months in the literature. Is necrotizing sialometaplasia a self-limiting disease? Here we report a case of non-healing necrotizing sialometaplasia which was treated by surgical management. Complete regression of the lesion was evident after the surgical management and no recurrence until two years of follow-up.

Successful Conservative Management of a Retroperitoneal Abscess With a Sinus to the Colon: A Case Report

2016 ◽  
Vol 101 (3-4) ◽  
pp. 133-136
Author(s):  
Suk-Bae Moon
Keyword(s):  
Case Report ◽  
Diverticular Disease ◽  
General Condition ◽  
Conservative Management ◽  
Percutaneous Drainage ◽  
Performance Status ◽  
Left Colon ◽  
Retroperitoneal Abscess ◽  
Rare Entity ◽  
Primary Condition

A sinus between the colon and a retroperitoneal abscess is a rare entity that usually occurs as a complication of a primary condition such as Crohn's disease, radiation enteritis, or diverticular disease. Herein, we report a 72-year-old woman with a retroperitoneal abscess and a sinus formation between the abscess and the colon after an iatrogenic injury to her left colon. The retroperitoneal abscess was detected 1 week after the patient had undergone a left nephroureterectomy for recurrent ureteral cancer. The patient's general performance status allowed conservative management with antibiotics and percutaneous drainage. The abscess resolved, and the sinus closed after 3 weeks of treatment. In the absence of surgical pathology in the colon, and if the patient's general condition is good enough to tolerate conservative management, treatment using antibiotics plus percutaneous drainage is effective for cases of retroperitoneal abscess with a sinus between the colon and abscess.

Grommets Don't Work

PEDIATRICS ◽  
1980 ◽  
Vol 65 (6) ◽  
pp. 1198-1199
Author(s):  
A. Mervyn Fox
Keyword(s):  
Surgical Management ◽  
Middle Ear ◽  
Conservative Management ◽  
Controlled Trial ◽  
The Other ◽  
Matched Pairs ◽  
Middle Ear Effusion ◽  
Tube Dysfunction ◽  
Glue Ear ◽  
Ear Effusion

I would like to draw to the attention of readers of the paper by Donaldson ("Surgical Management Eustachian Tube Dysfunction and its Importance in Middle Ear Effusion," Pediatrics 61:6774-6777, 1978) a recent report by Brown et al (Brown MJKM, Richards SH, Ambegaokar AG: "Grommets and Glue Ear—A Five-Year Followup of a Controlled Trial," J R Soc Med 71:353-356, 1978) in which the results of management of seromucinous otitis media were studied in 60 matched pairs of ears by drainage in one ear and conservative management in the other.

Pectoralis Major Rupture: Presentation of Two Cases and Review of 74 Cases

1997 ◽  
Vol 5 (2) ◽  
pp. 118-122
Author(s):  
Hubert YM Chao ◽  
Ralph T Manktelow
Keyword(s):  
Surgical Management ◽  
Conservative Management ◽  
English Language ◽  
Surgical Repair ◽  
Case Reports ◽  
Pectoralis Major ◽  
Review Of The Literature ◽  
The Past ◽  
Sporting Activities ◽  
Language Literature

Pectoralis major rupture is uncommon. Injury usually occurs from sporting activities. The incidence and management of pectoralis major rupture is not well known, despite 74 case reports in the English language literature over the past 34 years. Two cases of chronic pectoralis ruptures and their successful surgical management are described. A review of the literature shows that most injuries occur at the humeral insertion, and most are complete ruptures. Distinguishing between complete and partial ruptures is important. Complete ruptures are best treated surgically in the acute situation. When chronic complete ruptures present, surgical repair yields fair to good results. Acute partial ruptures can be effectively managed conservatively or with surgery. Chronic partial ruptures can be managed surgically with good results, following unsatisfactory conservative management in the acute situation.

Surgical Management of Bronchobiliary Fistula After Thoracoabdominal Trauma

2020 ◽  
pp. 000313482094526
Author(s):  
Julia M. Coughlin ◽  
Steven Bonomo ◽  
Edie Y. Chan ◽  
Jafar Hasan ◽  
Mark A. Grevious ◽  
...  
Keyword(s):  
Surgical Management ◽  
Conservative Management ◽  
Wedge Resection ◽  
Management Strategies ◽  
Lower Lobe ◽  
Disease Process ◽  
High Morbidity ◽  
Posterolateral Thoracotomy ◽  
Biliary Stenting ◽  
Bronchobiliary Fistula

Bronchobiliary fistulas are exceedingly rare pathological connections between the biliary and the bronchial systems, which result from hepatobiliary neoplasms, abscesses, or thoracoabdominal trauma. Prompt recognition, diagnosis, and intervention is essential in order to prevent the high morbidity and mortality associated with this disease process. Multiple management strategies have been described in the literature; however, the optimal course has not been well defined. We present a case of a 31-year-old male who developed a bronchobiliary fistula 1 month after thoracoabdominal trauma. After conservative management with biliary stenting failed, he successfully underwent latissimus sparing right posterolateral thoracotomy, complete fistulectomy, right lower lobe wedge resection, and diaphragmatic reconstruction with subsequent resolution of his symptoms.

scholarly journals Surgical versus non surgical management of Geriatrics ankle fractures. A Systematic Review and Meta-analysis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0014
Author(s):  
Abduljabbar Alhammoud ◽  
Karim Mahmoud Khamis ◽  
Mohamed Maged Mekhaimar
Keyword(s):  
Patient Satisfaction ◽  
Mortality Rate ◽  
Surgical Management ◽  
Conservative Management ◽  
Meta Analysis ◽  
Admission Rate ◽  
Ankle Fractures ◽  
Union Rate ◽  
Non Union ◽  
Surgical Group

Category: Trauma Introduction/Purpose: Ankle fractures are common orthopedics injuries especially in elderly. Bone quality, activity, and other comorbidities play a role in the management of ankle fracture in older age group. Conservative treatment by casting with or without reduction consider valid option whereas the open reduction and internal fixation still the stander of care for all age groups. This review aims to provide evidence-based difference between surgical and non-surgical management of geriatrics ankle fracture in regards to healing, complication and functional outcome. Methods: Relevant comparative studies in English literature were identified up to October 2017 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic-based search on MEDLINE (PubMed), EMBASE, Google Scholar and Cochrane databases, and hand searching of abstracts in orthopedics, trauma and foot and ankle journals. The research team systematically reviewed published studies according to the following criteria:(1) subjects whom sustained ankle fractures with age above 50 years;(2) the intervention was done through surgical management (open reduction and internal fixation) or conservative management (closed reduction and casting or casting alone) (3) the study reported at least one desirable outcome(non-union/mal-union rate, hospital stay, period on cast, mortality, re-admission rate, functional outcome, complication rate)(4) followed up at least one year after surgical /conservative management. The data analysis was done by Comprehensive meta-analysis software using a random-effect model and SPSS 22. Statistical heterogeneity across the studies was tested using I2. Results: The non-union rate in surgical group was significantly less than conservative group, (OR: 0.127, 95% CI: [0.055, 0.292], [P <0.001])and the mal-union was similarly less in surgical group (OR: 0.128, 95% CI: [0.063, 0.262], [P <0.001]). No difference in the hospital stays detected between two groups and similarly in re-admission rate. No difference in the period in cast reported between two groups. The return to pre-injury level was better in surgery group comparing to surgical one, whereas no difference in patient satisfaction was reported between two group. The mortality rate was less in the surgical group. The total number of skin complication was more in the conservative group.No difference in the incidence of DVT between two groups whereas the PE was in the surgical group. Conclusion: Geriatrics ankle fractures are challenging injury. The surgical management of such injuries showed superior results comparing to conservative management in terms of non-union /mal-union rate and return to pre-injury level with less mortality rate, whereas no difference in complications rate, hospital stay and patient satisfaction.

scholarly journals An Infected Mediastinal Cyst

2000 ◽  
Vol 7 (2) ◽  
pp. 191-192
Author(s):  
Lindsay M Lawson ◽  
Andrew C Mason
Keyword(s):  
Clinical Outcome ◽  
Surgical Management ◽  
Percutaneous Drainage ◽  
Mediastinal Mass ◽  
Mediastinal Cyst ◽  
Drainage Catheter ◽  
Excellent Clinical Outcome

The authors describe a 43-year-old patient who had a mediastinal mass that became infected after a transbronchial needle aspirate biopsy. A paraspinal, extrapleural window with a saline-lidocaine mixture was created that allowed the placement of a percutaneous drainage catheter into the infected lesion. This procedure resulted in an excellent clinical outcome, and obviated the need for a thoracotomy and more invasive surgical management.

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