Results Of Different Techniques Research Articles

Predicting Outcome After Surgery for Carpometacarpal Osteoarthritis

Objective: Research on carpometacarpal (CMC) osteoarthritis (OA) is primarily focused on comparing surgical outcome of different techniques, in case series or comparative studies. Many studies do not demonstrate significant differences in outcome between surgical techniques. However, it has been reported that a relatively large part of treated patients have significant residual pain and functional limitations, or even deterioration of their initial complaints. Overall outcome may also be improved by selecting “the right patients” for surgical treatment. Therefore, the aim of this study is to (1) describe the outcome of widely used techniques for CMC OA in a large, multicenter cohort and (2) identify predictive factors of poor surgical outcome, defined in terms of pain, complications, hand function, and patient satisfaction to predict possible failure after surgical treatment. Materials and Methods: We included 668 patients in a multicenter, prospective study between 2011 and 2015, who were surgically treated for CMC OA with trapeziectomy with ligament reconstruction and tendon interposition (LRTI).Outcome parameters, registered preoperatively, 3 months and 12 months after surgery, included pain (visual analogue scale [VAS]), function (Michigan Hand Questionnaire [MHQ]), complications, and satisfaction with the hand. Postoperative outcomes were compared with baseline levels. Multiple imputation was performed after missing value analysis. Baseline pain, function and strength, sociodemographics, and hand surgical history were analyzed as possible predictors for outcome after surgery, by multivariate regression analysis. Results: For all measurements, outcomes improved significantly after surgery, with effect sizes greater than 0.8 for pain, total MHQ score, and patient satisfaction outcomes. However, we found a residual rest pain of 19 (VAS 0-100) after 1 year. In total, there were 327 complications in 229 patients, of which 43% required no or conservative treatment. Univariate analysis showed that only a few of the baseline variables correlated with postoperative outcome measurements at 12 months. These associated variables were combined with predictors selected from literature and were considered in multivariable analyses. For pain and the number of complications, the multivariable regression models could only explain 2% of the variance in the model. For self-reported satisfaction of the hand, this was only 5%. For the MHQ score, the multivariable regression analysis could explain 17% of the variance in the model, with a history of De Quervain tendinitis, smoking, lower baseline MHQ total score, and increased preoperative pain, independently predicting a worse postoperative MHQ score. Conclusions: After surgical treatment for CMC OA, improvements in pain, strength, and function in our study are highly significant and clinically relevant. Despite the large overall improvement, we found significant percentages of patients with unfavorable outcomes (residual pain and functional deficits) in this large cohort, which is also in line with present literature. Based on this study, we conclude that we cannot predict which patients will have bad surgical results after surgical treatment for thumb CMC OA, despite our relatively large sample of baseline characteristics and large cohort. Our study suggests that we need to look beyond the commonly evaluated predictive factors (age, gender, baseline functional scores, etc) and treatment algorithms to improve outcome of all patients with CMC OA.

Techniques of Proximal Root Reconstruction and Outcomes Following Repair of Acute Type A Aortic Dissection.

The goal of this study was to compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute Type A aortic dissection, including aortic valve (AV) resuspension, aortic valve replacement (AVR), and a root replacement procedure. All patients who underwent acute Type A aortic dissection repair between January 2000 and October 2010 at four academic institutions were compiled from each institution's Society of Thoracic Surgeons Database. This included 189 patients who underwent a concomitant aortic valve (AV) procedure; 111, 21, and 57 patients underwent AV resuspension, AVR, and the Bentall procedure, respectively. The median age of patients undergoing a root replacement procedure was significantly younger than the other two groups. Early clinical outcomes and 10-year actuarial survival rates were compared. Trends in outcomes and surgical techniques throughout the duration of the study were also analyzed. The operative mortality rates were 17%, 29%, and 18%, for AV resuspension, AVR, and root replacement, respectively. Operative mortality (p = 0.459) was comparable between groups. Hemorrhage related re-exploration did not differ significantly between groups (p = 0.182); however, root replacement procedures tended to have decreased rates of bleeding when compared to AVR (p = 0.067). The 10-year actuarial survival rates for the AV resuspension, Bentall, and AVR groups were 72%, 56%, and 36%, respectively (log-rank p = 0.035). The 10-year actuarial survival was significantly lower in those receiving AVR compared to those receiving root replacement procedures or AV resuspension. Operative mortality was comparable between the three groups.

Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC) follows the posterior semicircular canal (PSCC) as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1–24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic). Level Ia evidence (systematic review of RCTs) shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

Diagnostic implications of intrapatient genetic tumor heterogeneity

ABSTRACTThe complex genetic composition of neuroblastoma emphasizes the importance of conscientious and meticulous diagnosis. Clones with amplification or segmental chromosomal aberrations sometimes remain hidden. Several determinations should be performed when sufficient tumor material is available to establish the final diagnosis by combining the results of different techniques on tumor fragments or liquid biopsies.

Self-organized criticality, plasticity and sensorimotor coupling. Explorations with a neurorobotic model in a behavioural preference task.

During the last two decades, analysis of 1/ƒ noise in cognitive science has led to a considerable progress in the way we understand the organization of our mental life. However, there is still a lack of specific models providing explanations of how 1/ƒ noise is generated in coupled brain-body-environment systems, since existing models and experiments typically target either externally observable behaviour or isolated neuronal systems but do not address the interplay between neuronal mechanisms and sensorimotor dynamics. We present a conceptual model of a minimal neurorobotic agent solving a behavioural task that makes it possible to relate mechanistic (neurodynamic) and behavioural levels of description. The model consists of a simulated robot controlled by a network of Kuramoto oscillators with homeostatic plasticity and the ability to develop behavioural preferences mediated by sensorimotor patterns. With only three oscillators, this simple model displays self-organized criticality in the form of robust 1/ƒ noise and a wide multifractal spectrum. We show that the emergence of self-organized criticality and 1/ƒ noise in our model is the result of three simultaneous conditions: a) non-linear interaction dynamics capable of generating stable collective patterns, b) internal plastic mechanisms modulating the sensorimotor flows, and c) strong sensorimotor coupling with the environment that induces transient metastable neurodynamic regimes. We carry out a number of experiments to show that both synaptic plasticity and strong sensorimotor coupling play a necessary role, as constituents of self-organized criticality, in the generation of 1/ƒ noise. The experiments also shown to be useful to test the robustness of 1/ƒ scaling comparing the results of different techniques. We finally discuss the role of conceptual models as mediators between nomothetic and mechanistic models and how they can inform future experimental research where self-organized critically includes sensorimotor coupling among the essential interaction-dominant process giving rise to 1/ƒ noise.

Burning bright or burning out?

Ophthalmology is a rapidly evolving field: Therapeutic models are constantly evolving and so are the drugs used. Striking examples of this would be the treatment of choice for age-related macular degeneration. A decade or so ago the treatment would have been different from what is advised today; refractive surgery too is another subspecialty where one has to be constantly updated with current research and techniques. The need to be constantly updated with one's profession can be an added source of stress to an already stressful life that a doctor leads. While it is only prudent that the patient himself or herself, weighs all options, evaluates the pros and cons of any treatment or surgery, and willfully consents for it, often times, we find ourselves in the unenviable position of being asked to make decisions on the patients’ behalf. Other factors such as unpredictable work hours, mental exhaustion, emotional fatigue, challenging patients, and workplace related issues can all contribute what is now becoming a significant issue – physician burnout. It is a state of mental exhaustion caused by the doctor's professional life, and is characterized by emotional exhaustion, depersonalization, and a reduced sense of accomplishment or success and it is largely an unrecognized entity.[1] Burnout can also affect professionalism, the quality of care offered, and even increase the risk for medical errors in addition to cause issues with personal lives as well.[2] Beyond the clinical aspect of practice, it is time to introspect, assess, and look into the quality of the lives, we ourselves are leading. It is time leaders in ophthalmology who make an attempt to tackle these issues. Staying on the same topic of life beyond the realm of clinical practice, Saurabh et al.[3] in their insightful study have attempted to assess the work-family balance and satisfaction among male and female ophthalmologists in India. This information is vital as work satisfaction directly affects the efficiency of health care delivery system of a country. While on one hand, it is reassuring to read that male and female ophthalmologists alike find the field equally rewarding, it is of concern to find that a significant number of female ophthalmologists reported having been subjected to physically uncomfortable gesture or being in physically uncomfortable position due to their gender at workplace. Only if the morale and job satisfaction levels of the entire work force are high can they be more productive; only if we are able to achieve good work-life balance can we lead fulfilling and gratifying lives and this applies to us, ophthalmologists as well. In this issue, we have a host of interesting articles: Raizada et al.[4] presented and discussed the management of nontractional diabetic macular edema comparing the outcomes of pars plana vitrectomy with three intravitreal injections of bevacizumab in a comparative study. Yadav et al.[5] have presented the outcomes of different techniques of pterygium excision with conjunctival autografting in a pediatric population. This issue also carries an article on a highly debated topic – comparison of cost effectiveness of small incision cataract surgery versus phacoemulsification and the quality-adjusted life years of subjects. This article by Dr. Amitava et al.[6] studies a sample of 52 subjects.

Techniques of laparoscopic cholecystectomy: Nomenclature and selection

There are more than 50 different techniques of laparoscopic cholecystectomy (LC) available in literature mainly due to modifications by surgeons in aim to improve postoperative outcome and cosmesis. These modifications include reduction in port size and/or number than what is used in standard LC. There is no uniform nomenclature to describe these different techniques so that it is not possible to compare the outcomes of different techniques. We brief the advantages and disadvantages of each of these techniques and suggest the situation where particular technique would be useful. We also propose a nomenclature which is easy to remember and apply, so that any future comparison will be possible between the techniques.

Outcome of different techniques of pterygium excision with conjunctival autografting in pediatric population: Our experience in central India.

Aim:To analyze surgical outcome of pterygium excision with conjunctival autografting in pediatric population ≤16 years.Settings and Design:Retrospective case series.Materials and Methods:A case sheet review of 145 patients (167 eyes) aged ≤16 years consecutively presented with pterygium from April 2008 to August 2014 in the single center was done. Twenty-six eyes of 25 children who underwent pterygium excision with conjunctival autograft were analyzed. Different techniques used to secure conjunctival autograft in a position were multiple interrupted 8-0 vicryl sutures, single 8-0 vicryl suture in the center of graft and sutureless glue free. Outcome measures were a failure of surgery and recurrence.Results:Of the total 167 eyes, 26 eyes of 25 children, mean age 13.07 ± 3.08 years (range 7–16 years) were managed surgically with pterygium excision and conjunctival autograft. The rest of the patients were managed conservatively. In 18 eyes, the graft was secured with multiple sutures, in 6 eyes with a single suture, whereas in 2 eyes, sutureless glue-free graft opposition was done. Mean follow-up was 8.03 months. No case of graft retraction, graft dehiscence or graft displacement was found. Recurrence occurred in 6 eyes and managed surgically.Conclusions:Occurrence of pterygium is not uncommon in the pediatric population. A single suture or sutureless glue-free technique may be good alternative for securing conjunctival autograft after pterygium excision in children.

Apport de la RCMI rotationnelle et de la tomothérapie hélicoïdale dans les cancers pelviens : étude dosimétrique prospective sur 51 patients

PurposeTo compare the dosimetric results of different techniques of dynamic intensity modulated radiation therapy (IMRT) in patients treated for a pelvic cancer with nodal irradiation. Patients and methodsData of 51 patients included prospectively in the Artpelvis study were analyzed. Thirty-six patients were treated for a high-risk prostate cancer (13 with helical tomotherapy, and 23 with Rapid’Arc®) and 15 patients were treated for a localized anal cancer (nine with helical tomotherapy and six with Rapid’Arc®). Plan quality was assessed according to several different dosimetric indexes of coverage of planning target volume and sparing of organs at risk. ResultsAlthough some dosimetric differences were statistically significant, helical tomotherapy and Rapid’Arc provided very similar and highly conformal plans. Regarding organs at risk, Rapid’Arc® provided better pelvic bone sparing with a lower non-tumoral integral dose. ConclusionIn pelvis cancer with nodal irradiation, Rapid’Arc and helical tomotherapy provided very similar plans. The clinical evaluation of Artpelvis study will verify this equivalence hypothesis.

The Management of Abdominal Contour Defects Following TRAM Flap Breast Reconstruction

Incisional hernia can develop following breast reconstruction with abdominal tissue regardless of technique, and the management is often challenging. The authors characterize hernias following transverse rectus abdominis musculocutaneous (TRAM) flap procedures and evaluate outcomes of different strategies for repair. All patients who underwent repair of a TRAM-related hernia or bulge between 2003 and 2011 at a single institution were retrospectively reviewed. A minimum of 2 years' follow-up was required for inclusion in this series. Outcomes of different techniques for repair were compared and risk factors for hernia recurrence identified. Forty-three patients underwent repair of a TRAM-related hernia or bulge, most often with mesh (74.4%, n=32). At a mean overall follow-up of 5.2 years, 9 patients (20.9%) developed recurrent hernia or bulge. Compared to primary suture closure, the use of mesh was protective against recurrence (odds ratio, 0.05; 95% confidence interval, 0.00-0.65; P=.02), with the best results observed with fascial closure and underlay mesh reinforcement. Incisional hernia following TRAM flap breast reconstruction can be a challenging problem. Attention to surgical technique and the use of mesh minimize the risk of recurrence.

Biliary Reconstruction and Complications in Adult Living Donor Liver Transplantation: Systematic Review and Meta-analysis

ObjectiveThe purpose of this meta-analysis was to compare outcomes of different techniques used for biliary reconstruction in adult donor liver transplantation. MethodsWe searched the literature via Pubmed, Embase, Ovid, the Cochrane Hepato-Biliary Group Controlled Trials Regsistry, the Cochrane Central Registry of Controlled Trials, the Cochrane Library database, and Web of Science. Then with the data extracted from the literature, the effects that biliary reconstruction techniques in living-donor liver transplantation (LDLT) had on the occurrence of biliary complications were compared. With the use of random-effects and fixed-effect models, the results were obtained and expressed as odds ratio. ResultsWe found 16 eligible studies from various medical centers around the world. Duct-to-duct (DD) reconstruction was performed in the majority of patients (922/1,564). Multiple biliary ducts were encountered in 16.7%–60.4%, and ductoplasty was performed in 7.9%–74% of the patients. Both graft and posterior layer of bile duct anastomosis in DD reconstruction were studied, and no statistically differences in incidence of biliary complications were found between the Roux-en-Y hepaticojejunostomy (RYHJ) and DD groups. Nonsurgical management of biliary complications was the first choice of treatment. ConclusionsOur study found that there is no clear evidence in favor of using DD or RYHJ during adult LDLT.

Is ankle arthrodesis or total ankle replacement the better treatment for end stage arthrosis?

This is the question that has been asked for the last 40 years. A few papers have tried to come up with the answer studying the literature for the results of both treatments [1,2]. They have failed to give the answer. No one will conduct a study comparing hip and knee arhrodesis to total replacements. The reason is obvious in those cases. Arthrodesis of hips and knees carry a major negative functional loss. This may not be so in the ankle provided the subtalar joints are intact, without arthrosis, and well functioning. If a prospective randomized study should be conducted to answer whether ankle arthrodesis or total replacement is the better treatment, the result will depend on the period of follow-up. Replacements may deteriorate, and need revision, and subtalar arthrosis needing treatment may develop after arthrodesis. The results will also depend on who is performing the surgeries. Is the surgeons’ technique equally good performing arthrodesis and total replacement? and which kind of technique for arthrodesis should be included? The results of different techniques – arthroscopic or open with internal or external fixation – may differ as well as the population chosen for these methods. Which kind of total ankle replacement should be used as the standard or does that not matter? That answer will probably have to await the results of a European ankle replacement register based on UDI (Unique Device Identification). It is all a juggling with bananas and coconuts. What about patients’ conditions that should be excluded in the study: diabetes, smoking, subtalar arthrosis, psoriatric arthritis, talus necrosis, ankle angulations of >108, unstable ankles, neurological disorders, mental disorders, age under 40 and above 80 and so on? It will be very difficult to collect similar cohorts for comparison. Furthermore, how many patients will withdraw from the study when they are scheduled for arthrodesis? Even if a true comparison could be established for comparative groups of patients, how should we judge the results? Should ankle mobility be one parameter, and with what weight? If we only want the patients’ evaluation – what is it they want? Certainly freedom of pain, and a good function. While pain is an obvious parameter, patients cannot differentiate between function and mobility [3] – unless they have an arthrodesis on one side and a total replacement on the opposite side. The closest judgement for a comparison was pragmatic and was conducted in USA. Using the same inclusion criteria several clinics performed the same total ankle replacement, while other clinics performed ankle arthrodesis [4]. The short-term results showed the same positive effect on pain reduction, but that function was better after total ankle replacement. It was a prospective study, but not randomized, and this was the weakness. The title question remains unanswered, but maybe the question was wrong. If a prospective randomized study in a well defined population showed a positive long-term result for one of the treatments – should we then give up the other option? In my opinion we must still judge patients individually giving them the choice of treatment after solid information about the pros and cons of ankle arthrodesis and ankle replacement in their particular case. Therefore the real question should be: ‘‘Which cases are best suited for ankle arthrodesis and which are best treated with ankle replacement’’.

From the Editors

From the Editors

Approach to accuracy improvement and uncertainty determination of radius of curvature measurement on standard spheres

In high accuracy radius of curvature (ROC) measurement, significant discrepancy may exist in results on the same optical surface obtained by different techniques. Metrological standard sphere is a potential solution to this problem. Mathematical models are built up to characterize the relationship between the ROC of standard spheres and the roundness error as well as the aperture angle. Equations for calculating the uncertainty of ROC are derived and tested on several ROC measuring methods. The reason for the inconsistency between results of different techniques is analyzed and solutions are proposed. A method is developed which can remarkably reduce the uncertainty of ROC. Experiments are carried out on a set of high quality spheres whose diameters are from 11mm to 93mm and roundness below 0.1μm, measured by instruments with relative accuracy of 10−5–10−6, which are a length measuring machine, a profilometer and a homemade differential confocal system. Relative uncertainties of ROC are calculated and analyzed against several factors. Experimental results show good consistency with theoretical analysis. Approaches to trace the ROC to the metrological length standard area discussed.

Knee arthrodesis - ultima ratio for the treatment of the infected knee.

The irretrievable destruction of the knee due to trauma, tumor or infection is the indication for knee arthrodesis. The main reason for knee arthrodesis in terms of infection ist the infected total knee arthroplasty. Central problem is the definition of the term “irretrievable”. It is based on the subjective opinion of the attending physician and depends on his expert knowledge of this specific entity. The preservation of a functioning extremity is the main goal.This article shows the typical indications and contraindications for knee arthrodesis following septic knee diseases. In addition it gives insight into the biomechanical and technical considerations to be kept in mind. Finally the postoperative care and outcome of different techniques are analysed.

A novel approach to determine the plasma frequency for wire media

Analytical, simulation and experiment based technique has been reported in this paper to determine the plasma frequency of artificial media formed by arrays of parallel conducting wires called wire media. A generalized analytical approach based on quasi-static analysis has been done and compared with previously reported results to determine the plasma frequency of wire media. An eigenmode solver based simulation method has been used for plasma frequency extraction of infinite wire array using a commercial finite element method (FEM) based electromagnetic solver. The limitations of scattering-parameter based technique has been discussed and a new loss-factor method has been proposed. On the basis of simulated data, wire array has been fabricated and experiments has been carried out at X-band (8.2–12.4GHz). Loss-factor method has been validated using the experimental data. Finally, the results of different techniques are compared to establish the efficacy of the loss-factor method supported by experimental results.

Techniques for wound closure at caesarean section: a randomized clinical trial

It is unclear which technique for skin closure should be used at caesarean section (CS) in order to get the best cosmetic result. We conducted a randomized controlled trial to assess the cosmetic result of different techniques for skin closure after CS. A two-center single-blind randomized controlled trial was performed in The Netherlands. Women undergoing their first CS were eligible for the trial. In a factorial design, women were randomly allocated to (1) closure of the fat layer versus non-closure and (2) staples or intracutaneous stitches for skin closure. The cosmetic result was assessed using the Patient and Observer Scar Assessment Scale (POSAS). We included 124 women. In the stitches group 63% [39/62] women judged the scar as satisfactory, versus 63% [38/60] in the staples group (RR 1.01; 95% CI 0.64-1.6). When the subcutaneous fat layer was closed, 52% [33/63] of the women scored the scar as satisfactory, versus 75% [44/59] of the women in whom the fat layer was not separately closed (RR 0.53; 95% CI 0.32-0.89). This effect was independent of the subcutaneous thickness (p-value for interaction 0.64). Of the secondary outcomes, subcutaneous closure of the fat layer was associated with a longer admission time (median 4 days; IQR 3-5 versus 3 days; IQR 3-5, p-value 0.023). The choice of staples or stitches does not affect the cosmetic result after a caesarean section. Closing of the subcutaneous fat layer, however, negatively affects the cosmetic result and is associated with a longer admission time.

Editorial Comment

Hypospadias repair, along with the management of vesicoureteral reflux, are arguably the 2 leading problems that helped to define modern pediatric urology. John Duckett coined the term “hypospadiology” to encourage those who performed hypospadias repair to view the complex topic as one deserving of serious dedicated study. 1 Duckett J.W. Hypospadias. in: Walsh P.C. Retik A.B. Vaughan E.D. Campbell's Urology. 7th ed. WB Saunders, Philadelphia1998 Google Scholar For many urologists, it meant the development of new procedures such as the meatal advancement and glanduloplasty, transverse island flap, or tubularized incised plate (TIP or Snodgrass). However, it should also encompass an understanding of how these methods have been adapted and their limitations. Surgical solutions are not fixed but reflect the level of medical knowledge of their era. Improvements in the understanding of the underlying problem, anatomy, technique, and materials have led to advances in nearly all types of operations. Fashion also is a factor; some operations become quite in vogue for a number of years and then fade away as a new style emerges or if a major advancement in knowledge makes them obsolete. Surgical Outcome of Different Types of Primary Hypospadias Repair During Three Decades in a Single CenterUrologyVol. 79Issue 6PreviewTo evaluate the surgical outcome of different techniques of primary hypospadias repair in a single department. Full-Text PDF ReplyUrologyVol. 79Issue 6PreviewWe would like to thank the reviewer for the valuable comments. We do agree that the surgical techniques in the “hypospadiology” field have undergone a major evolution. Our report reflects this evolution. During the past 3 decades, many techniques were applied in our patients, along with the changes in the hypospadias surgery around the world. However, the surgical outcome is still not optimal. Even in the distal shaft hypospadias repair, the complications ratio can reach 30% and can be greater in the proximal localization of the hypospadias meatus. Full-Text PDF

Surgical Outcome of Different Types of Primary Hypospadias Repair During Three Decades in a Single Center

To evaluate the surgical outcome of different techniques of primary hypospadias repair in a single department. We retrospectively evaluated the medical files of all patients who had undergone primary hypospadias repair at our department during the past 3 decades (1978-2009). A total of 820 patients were divided into 3 groups. The first group of 309 patients (37.7%) had glanular hypospadias, the second group of 398 patients (48.5%) had distal hypospadias, and the third group of 113 patients (13.8%) had proximal hypospadias. Of these 820 patients, 67 (8.2%) required corpoplasty to straighten the penis. In the first group, 67 (21.7%) children underwent meatal advancement or meatoplasty, 211 (68.3%) underwent meatal advancement and glanduloplasty, 8 (2.6%) underwent tubularized incised plate hypospadias repair, and 23 (7.4%) underwent Mathieu flap hypospadias repair. In the second group, 196 (49.2%) underwent Mathieu hypospadias repair, 38 (9.5%) underwent tubularized incised plate repair, 142 (35.7%) underwent meatal advancement and glanduloplasty, and 22 (5.5%) underwent onlay-type hypospadias repair. In the third group, 28 (24.8%) underwent 2-stage hypospadias repair, 85 (75.2%) underwent single-stage surgery (including 68 [60.2%] onlay and 11 [9.7%] tubularized island flap), and 6 (5.3%) underwent tubularized incised plate hypospadias repair. Immediate complications developed in 46 (14.9%) in the first, 123 (30.9%) in the second, and 66 (58.4%) in the third group; 38 (4.6%) required additional surgery during or after adolescence. Our data have shown that despite the numerous techniques used for hypospadias surgery, the incidence of complications is still high in patients who undergo hypospadias repair.

Single center experience with transcatheter aortic valve implantation in over 500 patients: Results of different techniques

Single center experience with transcatheter aortic valve implantation in over 500 patients: Results of different techniques