Results Of Different Techniques Research Articles

Short-Term Outcomes Analysis Comparing Open, Lap-Assisted, Totally Laparoscopic, and Robotic Total Gastrectomy for Gastric Cancer: A Network Meta-Analysis.

Total gastrectomy (TG) is the cornerstone treatment for gastric cancer (GC). While open TG (OTG) with D2 lymphadenectomy remains the gold standard, alternative techniques such as lap-assisted TG (LATG), totally laparoscopic TG (TLTG), and robotic TG (RTG) have been reported with promising outcomes. The present analysis aimed to compare the short-term outcomes of different techniques for TG comprehensively in the setting of GC. A systematic review and network meta-analysis were performed. The primary outcomes were overall complications (OC), severe postoperative complications (SPCs), and anastomotic leak (AL). Pooled effect-size measures included risk ratio (RR), weighted mean difference (WMD), and 95% credible intervals (CrIs). Sixty-eight studies (44,689 patients) were included. Overall, 52.4% underwent OTG, 6.5% LATG, 39.2% TLTG, and 1.9% RTG. Both TLTG (RR 0.82; 95% CrI 0.73-0.92) and RTG (RR 0.75; 95% CrI 0.59-0.95) showed a reduced rate of postoperative OC compared to OTG. SPCs and AL RR were comparable across all techniques. Despite the longer operative time, LATG, TLTG, and RTG showed reduced intraoperative blood loss, time to first flatus, ambulation, liquid diet resumption, and hospital stay compared to OTG. Minimally invasive approaches seem to be associated with improved OC and functional outcomes compared to OTG.

Five-year outcomes of different techniques for minimally invasive mitral valve repair in Barlow's disease.

Barlow's disease is a specific sub-form of mitral valve (MV) disease, characterized by diffuse excessive tissue and multi segment prolapse. The anterolateral mini-thoracotomy represents the standard access for MV regurgitation in many centres. It still remains unclear which surgical technique provides the best results. Therefore, the aim of this study was to compare operative safety and mid-term outcomes after (i) isolated annuloplasty, (ii) use of additional artificial chordae or (iii) leaflet resection in patients suffering from Barlow's disease undergoing minimally invasive MV repair. A consecutive series of patients suffering from Barlow's disease undergoing minimally invasive MV surgery between 2001 and 2020 were analysed (n = 246). Patients were grouped and analysed according to the used surgical technique. The primary outcome was a modified Mitral Valve Academic Research Consortium combined end-point of mortality, reoperation due to repair failure or reoccurrence of severe mitral regurgitation within 5 years. The secondary outcome included operative success and safety up to 30 days. No significant difference was found between the 3 surgical techniques with regard to operative safety (P = 0.774). The primary outcome did not differ between groups (P = 0.244). Operative success was achieved in 93.5% and was lowest in the isolated annuloplasty group (77.1%). Conversion to MV replacement was increased in patients undergoing isolated annuloplasty (P < 0.001). Isolated annuloplasty, use of additional artificial chordae and leaflet resection represent feasible techniques in Barlow patients undergoing minimally invasive MV surgery with comparable 5-year results. In view of the increased conversion rate in the annuloplasty group, the pathology should not be oversimplified.

(022) Penile Implant Reservoir Placement: The Current Utilized Various Techniques and the Associated Outcome: Systematic Review and Meta-Analysis

Abstract Introduction Many innovations in the field of inflatable penile prosthesis (IPP) has been emerged. Since the introduction of the IPP, reservoir positioning in the space of Retzius (SOR) was considered the classical approach that had been utilized for many years. However, in certain group of patients, reservoir insertion in such space might be difficult or even risky. As a result, many alternatives for the reservoir placement outside the SOR has emerged with the intent of safe and reliable reservoir placement. Objective To conduct a systematic review for the studies evaluating the outcomes of different techniques used for IPP reservoir placement to look for possible superiority of any approach over others. Methods A systemic review was performed utilizing (PRISMA) statement. The PubMed and Google scholar were used to look for articles published up to January 2023. Original articles reporting different techniques for IPP reservoir placement and evaluating the associated outcomes were included. Data regarding study design, sample size, approach of reservoir placement, surgical technique, device type and reported outcomes (infection rate, bladder/bowel/vascular injury, reservoir herniation, mechanical failure, auto-inflation, reservoir palpability and patients’ satisfaction) were collected. Pooled proportion was calculated and included in the meta-analysis. The Newcastle-Ottawa scale was used for assessing the quality of the studies. Results A total of 23 articles meeting the inclusion criteria, all were retrospective reviews. 11 compared more than one technique for reservoir placement whereas 12 described a single technique. In total, techniques for 6 main different reservoir locations has been reported, including SOR (7 studies), submuscular/subrectus (6 studies), Lateral retroperitoneal (1 study), subcutaneous (1 study), sub external oblique (1 study) and intraperitoneal (1 study). Another 7 modifications have been described for the SOR technique (traditional SOR, accessing SOR using blunt scissor in post-prostatectomy patients, accessing SOR using blunt scissor in virgin cases, dilating SOR using catheter balloon, accessing SOR under direct vision, accessing SOR through external oblique fascia incision, and the addition of The Tubing Hitch&amp;Lasso, Intussusception Anchor technique (THALIA)). Another 6 modifications for the submuscular/subrectus approach have been described (posterior to transversalis fascia (PTF), anterior to transversalis fascia (ATF), high submuscular, subrectus using counter incision, subrectus with the addition of THALIA, low submuscular with trans-fascial-fixation (TFF)). None of the studies have proven the superiority of one technique over others, with most of the techniques has comparable intra-operative and post-operative outcomes (table 1). The addition of anchoring step (THALIA or TFF) resulted in neglected risk of reservoir herniation, however, related studies has small sample size with no comparison groups. Meta-analysis for the studies of SOR (n=7) and submuscular/subrectus (n=6) groups showed a statistically significant difference only in the herniation rates (figure 1). 10 studies were of strong quality (8 stars) while the remaining 13 studies were of poor quality. Conclusions Modest evidence suggests a comparable favorable outcome of various approaches used for IPP reservoir placement. The lack of enough prospective trials, short term follow up, and diversity in the techniques prescribed prevent the ability to build strong evidence. For the purpose of supporting the superiority of any technique, further prospective studies on a larger number of patients with long-term follow up are needed to reach a solid verdict. Disclosure No.

(394) Penile Implant Reservoir Placement: The Current Utilized Various Techniques and the Associated Outcomes: Systematic Review and Meta-analysis

Abstract Introduction Many innovations in the field of inflatable penile prosthesis (IPP) has been emerged. Since the introduction of the IPP, reservoir positioning in the space of Retzius (SOR) was considered the classical approach that had been utilized for many years. However, in certain group of patients, reservoir insertion in such space might be difficult or even risky. As a result, many alternatives for the reservoir placement outside the SOR has emerged with the intent of safe and reliable reservoir placement. Objective To conduct a systematic review for the studies evaluating the outcomes of different techniques used for IPP reservoir placement to look for possible superiority of any approach over others. Methods A systemic review was performed utilizing (PRISMA) statement. The PubMed and Google scholar were used to look for articles published up to January 2023. Original articles reporting different techniques for IPP reservoir placement and evaluating the associated outcomes were included. Data regarding study design, sample size, approach of reservoir placement, surgical technique, device type and reported outcomes (infection rate, bladder/bowel/vascular injury, reservoir herniation, mechanical failure, auto-inflation, reservoir palpability and patients’ satisfaction) were collected. Pooled proportion was calculated and included in the meta-analysis. The Newcastle-Ottawa scale was used for assessing the quality of the studies. Results A total of 23 articles meeting the inclusion criteria, all were retrospective reviews. 11 compared more than one technique for reservoir placement whereas 12 described a single technique. In total, techniques for 6 main different reservoir locations has been reported, including SOR (7 studies), submuscular/subrectus (6 studies), Lateral retroperitoneal (1 study), subcutaneous (1 study), sub external oblique (1 study) and intraperitoneal (1 study). Another 7 modifications have been described for the SOR technique (traditional SOR, accessing SOR using blunt scissor in post-prostatectomy patients, accessing SOR using blunt scissor in virgin cases, dilating SOR using catheter balloon, accessing SOR under direct vision, accessing SOR through external oblique fascia incision, and the addition of The Tubing Hitch&amp;Lasso, Intussusception Anchor technique (THALIA)). Another 6 modifications for the submuscular/subrectus approach have been described (posterior to transversalis fascia (PTF), anterior to transversalis fascia (ATF), high submuscular, subrectus using counter incision, subrectus with the addition of THALIA, low submuscular with trans-fascial-fixation (TFF)). None of the studies have proven the superiority of one technique over others, with most of the techniques has comparable intra-operative and post-operative outcomes (table 1). The addition of anchoring step (THALIA or TFF) resulted in neglected risk of reservoir herniation, however, related studies has small sample size with no comparison groups. Meta-analysis for the studies of SOR(n=7) and submuscular/subrectus(n=6) groups showed a statistically significant difference only in the herniation rates (figure 1). 10 studies were of strong quality (8 stars) while the remaining 13 studies were of poor quality. Conclusions Modest evidence suggests a comparable favorable outcome of various approaches used for IPP reservoir placement. The lack of enough prospective trials, short term follow up, and diversity in the techniques prescribed prevent the ability to build strong evidence. For the purpose of supporting the superiority of any technique, further prospective studies on a larger number of patients with long-term follow up are needed to reach a solid verdict. Disclosure No.

Abstract 15183: Diabetes is Associated With Worse Postoperative Mortality and Morbidity in Bariatric Surgery, Regardless of the Procedure

Introduction: Bariatric surgery is an efficient treatment for obesity. Objectives: We aimed to assess the impact of diabetes on postoperative outcomes of bariatric surgery. Further, we compared the outcomes of different techniques in patients with diabetes. Methods: We used data from the National Inpatient Sample (2015-2019) to identify patients who underwent either sleeve gastrectomy, Roux-en-Y, or gastric banding. Outcomes included postoperative mortality (primary outcome), major bleeding, atrial fibrillation, and acute renal failure. Results: Patients with diabetes had an overall increased risk of perioperative complications when compared to non-diabetic ones for all three types of bariatric surgery. Among patients who underwent sleeve gastrectomy, diabetes was associated with a higher adjusted risk of mortality [aOR 2.07 (1.36-3.16)], atrial fibrillation [aOR 1.07 (1.02-1.11)], and acute renal failure [aOR 1.51 (1.39-1.64)] but a similar risk of major bleeding. Among patients who underwent Roux-en-Y, diabetes did not increase the risk of mortality and bleeding. Still, it was associated with a higher risk of atrial fibrillation [aOR 2.24 (1.25-4.02)] and acute renal failure [aOR 1.36 (1.21-1.62)]. Among patients who underwent gastric banding, diabetes was only associated with a higher risk of major bleeding [aOR 2.94 (1.42-5.88)]. When comparing the 3 techniques in diabetes patients, Roux-en-Y was significantly associated with a higher mortality rate (1.05%, 0.06%, 0%), atrial fibrillation (7.04%, 3.35%,3.48%), and acute renal failure (6.32%, 1.29%, 3.48%) (Roux-en-Y, sleeve, gastric banding; respectively). Major bleedings were more common in Roux-en-Y (1.05%) than in Sleeve (0.5%) (p&lt;0.001). Conclusions: Diabetes is associated with worse postoperative outcomes regardless of the type of bariatric surgery performed. Among diabetes patients, Roux-En-Y was associated with higher mortality and morbidity.

Different Modalities in Management of Recurrent Patellar Dislocation

Background Patellar instability is a complex pathoanatomical phenomenon that requires an intricate understanding in order to properly treat patients. Often, the etiology of this entity is multifactorial, and can be the result of a combination of coronal limb malalignment, patella alta, malrotation secondary to internal femoral or external tibial torsion, a dysplastic trochlea, or disrupted and weakened medial soft tissue, including the medial patellofemoral ligament (MPFL) and the vastus medialis obliquus. Objective To review the currently available different modalities for management of recurrent patellar dislocation. This Review will analyze results concerned with Patellar instability to reach the most efficient modality that gives the best results. Material and Methods This systematic review study based on inclusion and exclusion criteria conducted to evaluate the outcome of different techniques of medial patellofemoral ligament reconstruction analyzing their efficacy and possible complications. This systematic review demonstrates that MPFL surgery for recurrent patellar dislocation isolated or in combination with other procedures results in a significant improvement in Kujala scores, a low redislocation rate, and an acceptable complication rate. Despite this, there is no consensus on indications for MPFL reconstruction, graft type, surgical technique, and rehabilitation program. The inclusion criteria for future studies were highly important, and consensus agreement within an expert panel should be sought prior to undertaking such a study. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Results Several fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction. However, the optimal management of patients with recurrent patellar dislocation remains controversial. This short-term study showed that after MPFL reconstruction (suture anchors or transosseous sutures), patellar stability could be restored. And no significant differences in outcome scores were observed between patients in the transosseous suture and suture anchor groups. Conclusion Evaluate the outcome of different techniques of medial patellofemoral ligament reconstruction analyzing their efficacy and possible complications.

Primary Repair of Anterior Cruciate Ligament Tear

Background Initially, authors reported deterioration in the outcomes of ACL open primary repair. Consequently, authors considered ACL reconstruction surgery as the gold standard approach in treating ACL injuries. Recently, with the introduction of modern-day technology such as MRIs and arthroscopic repair, emerging reports gained interest in reevaluating the outcomes of primary repair. Aim of the Work We aim to evaluate to evaluate the results of different techniques regarding ACL repair, and determine the ideal candidates for this procedure Patients and Methods We conducted an electronic search via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar from their inception till August 2020. We included randomized, nonrandomized trials, prospective or retrospective cohort and case control studies that were published in English with full text available. We restricted our search to patients diagnosed with acute ACL tear whom underwent open or arthroscopic ACL repair. Outcomes of interest were Functional outcomes (Lysholm, Bivot and Lachman scores), complications and failure rates. Results From a total 2089 screened citations, 24 studies met our inclusion criteria. Eleven studies evaluated primary ACL suture repair of the (1 study used a biologic scaffold in the ACL repair, 4 used microfracturing techniques, and 5 used some form of mechanical augmentation). The remaining 11 studies used dynamic intraligamentary stabilization (DIS). There was male predominance across the studies, with patients aged between 6 to 43.3 years and patients were follow-up to 16 years. There was a wide range of ACL repair survivorship between 60 % and 100% with reoperation rate ranged between 0 % and 51.5%. Re-rupture of the ACL, revision ACLR procedures, and implant removal were as high as 18.2%, 20%, and 100%, respectively. However, results were improved when ACL repair was combined with biological enhancers e.g. microfracturing and scaffolding. In the four comparative studies (primary repair vs. ACLR), there was no significant difference between both approaches regarding; IKDC, Lysholm, Tegner and Lachman, scores.but ACLR was slightly superior in certain outcomes e, g, failure rates and proper positioning. Conclusion We found that still ACL reconstruction is superior to ACL primary repair however, with strict selection criteria mainly; proximal ACL rupture and excellent tissue quality, primary ACL repair could be reconsidered as an effective treatment especially when combined with microfracturing and scaffolding.

Functional nasal surgery in the office-based setting.

Nasal obstruction is a very common problem often addressed by functional nasal surgery. Increasingly, these procedures are being performed in the office setting secondary to decreased down time, cost, and obviation of general anesthesia. Our goal with this review is to discuss how to appropriately select patients for office-based procedures, what procedures may be considered, and current outcomes with in-office functional nasal surgery. PubMed, Scopus, Google Scholar. Research databases were searched for articles discussing techniques for performing functional nasal surgery in an office setting, and outcomes of various in-office functional nasal procedures. Studies found and included in this review discuss many aspects of office-based functional nasal surgery, including practical points on patient selection and office set-up, what procedures can safely be performed, and outcomes of different techniques to address specific problems. Broadly, procedures amenable to performance in the office address the internal and external nasal valves, the nasal septum, and the inferior turbinates. A wide range of techniques to aaddress the nasal valves, septum, and inferior turbinates can be performed in a safe and effective manner without the need for an operative suite.

500 Wound Coverage for Massive Burn Injuries ≥50% TBSA – A Systematic Review and Meta-Analysis

Abstract Introduction Early wound coverage remains one of the most essential variables influencing survival of extensively burned patients, especially with a total burned surface area (TBSA) of more than 50%. In patients with limited donor sites, techniques such as e.g. the Meek micrograft procedure or cultured epidermal allografts have proven to be viable methods. In this systematic review (SR) and meta-analysis (MA) we studied the outcomes of different techniques for wound coverage in patients with massive burn injuries ≥50% TBSA within the last 17 years. Methods According to PRISMA guideline the medical databases PubMed, Cochrane, Embase, Web of Science Medical records were screened in 5 languages from 01/2005 until 01/2022 by three reviewers, independently. Inclusion criteria were prospective or retrospective studies on patients with massive burns of ≥50% TBSA. Results After a two-stage review process, 33 studies were identified for the SR and MA. Regions of publication were Asia (n=15), North America (n=8), Europe (n=7), Australia (n=3). In total, 1678 patients with a mean age of 31.4 ± 14.2 years were included. The male to female ratio was 2.25 : 1. Mean TBSA was 66,5 ± 12.2%. Methods of wound coverage consisted of Meek micrografts, cultured epithelial autografts and/or allografts. The mean length of stay was 76.5 ± 32.4 days. Initial graft-take was 78,0 ± 15.8%. Grafting techniques did neither substantially differ in the length of stay nor the healing rate. Conclusions In patients with massive burn injuries of ≥50% TBSA the length of stay and the healing rates were comparable between Meek micrograft procedure, cultured epithelial allografts and combined techniques. Applicability of Research to Practice Wound coverage by Meek micrograft procedure with expansion of up to 1:10 and a potential combination with cultured epithelial allografts should be considered early in patients with massive burn injury.

Residual stress measurements on a deep rolled aluminum specimen through X-Ray Diffraction and Hole-Drilling, validated on a calibration bench

Residual stress measurements are notably affected by a high sensitivity to errors in input data. Measurements should then be presented together with an estimation of their accuracy. A common strategy is to carry out more measurements and/or to compare the results of different techniques. However, error contributions due to biases could be dangerously left unseen. In a previous work, the authors presented a calibration bench which can impose a known bending stress distribution on a specimen while simultaneously performing X-Ray Diffraction (XRD) or Hole-Drilling Method (HDM) residual stress measurements. Since the external load can freely be applied and removed, the superposition principle can be exploited to simultaneously identify either the reference bending stress distribution or the actual residual stress distribution, with the same experimental setup. A deep rolling treatment was measured and analyzed on the calibration bench with both XRD and HDM. First, residual stresses on the surface were evaluated with XRD measurements, then electrochemical material removal was performed to investigate stresses at higher depths. After that, HDM measurements were carried out and compared with the results of XRD. Both methods were also used to identify the known bending stresses, providing an additional validation of the residual stress results.

Outcomes of middle turbinate-septal adhesion technique and trans-septal middle turbinate suture technique to prevent middle turbinate lateralization: a comparative study

Background Middle turbinate lateralization (MTL) is the most common undesirable sequela after functional endoscopic sinus surgery (FESS), which can result in recurrent sinusitis. Objectives To examine the efficacy and outcomes of different techniques to prevent failure of the primary surgery. Patients and methods Eighty patients who presented with chronic rhinosinusitis listed for FESS were enrolled in this study. Patients were divided randomly into two groups, with 40 patients each. In group A, middle turbinate (MT) was stabilized by adhesion technique, and in group B, MT was stabilized via suture technique. A comparison of the effectiveness and the outcomes of both techniques was done by assessing the MT position and synechiae formation, which is considered a primary outcome. Secondary and tertiary outcomes were assessed through Lund–Kennedy Score and Lund–Mackay, and Sino-nasal Outcome Test-8 and Sniffin Sticks identification test scores, respectively. Results Although a higher incidence of MTL and synechiae was detected in the adhesion group after 1, 3, and 6 months of follow-up, there was no significant difference between both groups, with P values of 0.74, 0.11, and 0.089, respectively. We found at the end of the sixth month postoperatively, a noticeable improvement in Lund–Kennedy Score, Lund and Mackay Score, Sino-nasal Outcome Test-8, and Sniffin Sticks identification test scores in both groups, with P values of 0.0004/0.0002, 0.001, 0.000, and 0.0002/0.0001, respectively, which are highly statistically significant differences, but there was no significant difference among both groups, with a P value of 0.24. Conclusion The primary goal must be considered to be prevention of MTL, and the medialization techniques should not be carried out routinely in FESS.

Outcomes After Abductor Reattachment to Proximal Femur Endoprosthesis After Tumor Resection

Resection of the proximal femur raises several challenges including restoration of the abductor mechanism. Few evaluated the outcomes of different techniques of abductor fixation to the proximal femur endoprosthesis. A retrospective review of patients who underwent proximal femoral arthroplasty with a minimum follow-up of 12 months was conducted. Patients were divided into two groups: (1) those with preserved greater trochanter (GT) reattached to the implant and (2) those with direct abductor muscle reattachment. Both groups were compared for surgical and functional outcomes. Group 1 patients were subdivided into those who received GT reinsertion using grip and cables and those reattached using sutures. Fifty-three patients were included with a mean follow-up of 49 months. There were 22 patients with reinserted GT and 31 patients with soft-tissue repair. The endoprosthesis revision rate was comparable between groups (P = 0.27); however, the incidence of dislocations was higher in group 2 (0/22 versus 6/31; P = 0.035). Trendelenburg gait (77% versus 74%), use of walking aids (68% versus 81%), and abductor muscle strength were comparable between both groups (P > 0.05). In group 1, 15 patients had GT reinsertion with grip and cables. Of those, five patients (33%) had cable rupture within 13 months of follow-up. GT displacement reached 12 mm at 12 months of follow-up in patients with grip and cables compared with 26 mm in patients with GT suture reinsertion (P < 0.05). Although GT preservation did not improve functional outcomes, it was associated with a lower dislocation rate despite frequent cable failure. Less displacement was observed when GT reattachment used grip and cables.

Comparative microleakage outcomes of different techniques used for creating the occlusal anatomy in occlusal direct restorations using the dental operating microscope.

Microleakage in direct dental restorations is a primary causal factor in the restoration's failure. The aim of this study was to evaluate whether the technique for occlusal layering of the composite resin (the use of brush adaptation, the use of magnification, cusp build-up, stamp technique) has any effect on microleakage of direct restorations in occlusal cavities. One hundred extracted human molars were restored using five restoration techniques (Packable Bulk technique, Occlusal Stamp technique, Successive Cusp Build-up technique, Successive Cusp Build-up technique + Brush adaptation, Successive Cusp Build-up technique + brush adaptation + Dental Operative Microscope magnification). The teeth were subjected to thermal aging for 800 cycles at 5°C and 55°C, infiltrated with basic fuchsin dye for 24 h, and then sectioned buccolingually in the middle of the crown. Infiltration was measured in four areas of the tooth section by five different observers and then given a score from 1 to 3, proportional to infiltration depth. The lowest mean scores for infiltration (meaning less infiltration observed) were present in Group A (1.41 ± 0.878) and Group C (1.46 ± 0.679), while Group D showed the highest infiltration scores (1.75 ± 0.853). When comparing the groups for differences, no statistically significant difference in infiltration was found between any technique p < .586. The techniques examined for placing the occlusal layer of composite in direct restorations do not differ significantly in terms of marginal infiltration, although a slight improvement was found when using the bulk technique and the successive cusp build-up.

Comparative Assessment of the Results of Different Techniques of Carotid Bifurcation Reconstruction

INTRODUCTION: Nowadays, to restore the patency of the carotid artery bifurcation in atherosclerotic stenoses, three main methods of reconstruction are used, namely, classic carotid endarterectomy (cCEAE), prosthetic repair of the internal carotid artery, and eversion carotid endarterectomy (eCEAE). The study conducted a comparative analysis of the immediate and long-term results of using these methods in the case of stenosis of the carotid artery bifurcation. CONCLUSION: As regards the immediate results, the analysis of literature does not permit allow making an unambiguous conclusion about the evident advantages of a particular method of intervention. Thus, several authors obtained better results with the use of eCEAE, whereas others did not find any significant differences between eCEAE and cCEAE, if it was not a question about using a straight seam, and this can be referred to both meta-analyses and original studies. Regarding the long-term results, practically all literary sources indicate more optimal results with the use of the eversion technique. The results of the analysis imply the preference for eCEAE if the character of the lesion of the carotid bifurcation and anatomical interrelations in the surgical wound allow it.

Geoscience Poster G14: Natural hydrogen exploration in Australia – state of knowledge and presentation of a case study

Poster G14 Hydrogen will play a major role in Australia’s transition to a net zero emissions energy future. The hydrogen industry and technology are scaling up with hydrogen produced via two pathways, thermochemical and electrochemical, that involve the use of fossil fuel feedstock or the use of an electrical current to split water into hydrogen and oxygen. Exploration for and production of natural hydrogen is one of the most promising ways to get large quantities of green hydrogen cheaper than the ‘blue’ hydrogen produced from methane. Some predictions from this growing industry even estimate that the production of natural hydrogen can quickly become economically viable. We propose to review the state of knowledge of natural hydrogen exploration and production in the world and focus on the exploration of the Australian natural seeps in the frame of the incredible exploration rush we are currently experiencing. Surface emanations often referred to as ‘fairy circles’ are often associated with high hydrogen soil-gas measurement and have been described in numerous countries. In the frame of our research, we recently showed that similar hyrdrogen-emitting structures are present in Australia. New regional scale soil-gas measurements reveal persistent hydrogen concentration along the Darling Fault, in the Perth Basin and on the Yilgarn Craton. Those geological settings promote processes such as deep serpentinisation of ultramafic rocks as potential hydrogen sources that are of massive potential economic value. We review the results of different techniques to explore and quantify the presence of natural hydrogen leakage. To access the poster click the link on the right. To read the full paper click here

Visual Outcomes of Pupilloplasty in Ocular Trauma and Iatrogenic Damage.

Purpose: To report the visual outcomes of different techniques for iris pupilloplasty in eyes after traumatic and iatrogenic damage. Methods: 70 consecutive eyes with posttraumatic (80%) and postoperative (20%) iris damage were included. According to the preoperative diagnosis, the eyes were divided into three groups: mydriasis (50%), partial iris defects (24%), and iridodialysis (26%). Multiple techniques were performed: the Siepser slip-knot technique, the “lasso” technique, and suturing to the sclera. These techniques were combined in some cases. Results: The best improvement of visual acuity was found for the Siepser slip-knot technique with a median of 0.7 (SD ± 0.83) before surgery and 0.52 logMAR (SD ± 0.65) after surgery with regard to the surgical technique, and for mydriasis with a median of 0.7 (SD ± 0.75) before surgery and 0.52 logMAR (SD ± 0.49) after surgery with regard to preoperative diagnosis. Pupilloplasty was combined with additional surgery (corneal suturing, secondary intraocular lens implantation, anterior or pars plana vitrectomy) in 80% of cases. Apart from corneal suturing, all additional procedures ensured improvement in visual acuity. Conclusions: The slip-knot technique was the only suturing technique that resulted in a significant improvement in visual acuity. Other surgical procedures are usually needed in the majority of cases that undergo pupilloplasty, and they also give visual gain.

BREAST CANCER PREDICTION WITH HYBRID ML MODELS

In recent times various types of cancer propagation in humans are alarmingly increasing and especially women are prone to and threatened by breast cancer with high morbidity and mortality. The absence of robust prognosis models results in difficulty for physicians to prepare a treatment plan that may extend patient survival chances and time. Hence, the need of the time is to develop the technique which offers minimum error with increased accuracy. Different legacy algorithms like SVM, Regression, are compared with the proposed hybrid prediction model outcome. All experiments are executed within a parallel environment and conducted in anaconda python platform with relevant libraries. This is helpful in domains like. prediction of cancer before diagnosis, prediction of diagnosis and outcome during treatment. The proposed work combining detailed pre-prepressing stages over a deep neural network model with tuned hyper parameters, validated to yield needed accuracy. This can be used to derive and compare the outcome of different techniques and suitable one having max accuracy and stability, can be used depending upon requirement. Different data sets are tried and analysed for prediction with different parameters and results are compared. Keywords — Breast Cancer detection, machine learning, feature selection, classification, hybrid deep learning, image classification, KNN , Random Forest, ROC.

Natural hydrogen exploration in Australia – state of knowledge and presentation of a case study

Hydrogen will play a major role in Australia’s transition to a net zero emissions energy future. The hydrogen industry and technology are scaling up with hydrogen produced via two pathways, thermochemical and electrochemical, that involve the use of fossil fuel feedstock or the use of an electrical current to split water into hydrogen and oxygen. Exploration for and production of natural hydrogen is one of the most promising ways to get large quantities of green hydrogen cheaper than the ‘blue’ hydrogen produced from methane. Some predictions from this growing industry even estimate that the production of natural hydrogen can quickly become economically viable. We propose to review the state of knowledge of natural hydrogen exploration and production in the world and focus on the exploration of the Australian natural seeps in the frame of the incredible exploration rush we are currently experiencing. Surface emanations often referred to as ‘fairy circles’ are often associated with high hydrogen soil-gas measurement and have been described in numerous countries. In the frame of our research, we recently showed that similar hyrdrogen-emitting structures are present in Australia. New regional scale soil-gas measurements reveal persistent hydrogen concentration along the Darling Fault, in the Perth Basin and on the Yilgarn Craton. Those geological settings promote processes such as deep serpentinisation of ultramafic rocks as potential hydrogen sources that are of massive potential economic value. We review the results of different techniques to explore and quantify the presence of natural hydrogen leakage.

MP29-01 COMPARISON OF POSTOPERATIVE OUTCOMES OF TRANSURETHRAL RESECTION OF THE PROSTATE, LASER VAPORIZATION OR LASER ENUCLEATION FOR BENIGN PROSTATIC HYPERPLASIA TREATMENT USING THE AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM (ACS-NSQIP) DATASET

You have accessJournal of UrologyCME1 May 2022MP29-01 COMPARISON OF POSTOPERATIVE OUTCOMES OF TRANSURETHRAL RESECTION OF THE PROSTATE, LASER VAPORIZATION OR LASER ENUCLEATION FOR BENIGN PROSTATIC HYPERPLASIA TREATMENT USING THE AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM (ACS-NSQIP) DATASET Christian Ayoub, Rachelle Haber, Reem Amine, Diana Mikati, and Albert El Hajj Christian AyoubChristian Ayoub More articles by this author , Rachelle HaberRachelle Haber More articles by this author , Reem AmineReem Amine More articles by this author , Diana MikatiDiana Mikati More articles by this author , and Albert El HajjAlbert El Hajj More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002572.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Novel laser techniques for treating benign prostatic hyperplasia (BPH) are challenging gold standard techniques such as transurethral resection of the prostate (TURP). Comparing the outcomes of different techniques might serve in determining safety and efficacy compared to the current gold standard. The aim of this study is to compare the postoperative outcomes of three types of endourologic surgeries (TURP, laser vaporization (PVP) and laser enucleation (LEP)) for BPH treatment using the ACS-NSQIP database. METHODS: The ACS-NSQIP database was queried for men >50 years of age who underwent TURP, PVP and LEP for treatment of BPH from 2005 till 2017. Demographics, clinical, operative characteristics, and 30-day outcomes were compared. Univariate and multivariate regression models were performed for return to the operating room, morbidity, and length of hospital stay. RESULTS: 56,436 patients underwent endourologic surgeries for BPH, 64.0% had TURP, 31.1% PVP, and 4.9% LEP. Patients undergoing TURP were more likely to be smokers (11.2%, p-value<0.001), have diabetes (21.8%, p-value<0.001), with history of COPD (6.8%, p-value<0.001), disseminated cancer (1.5%, p-value<0.001), weight loss (0.6%, p-value 0.039), congestive heart failure (1%, p-value 0.02), and presenting as emergency cases (2.3%, p-value<0.001). Lower rates were seen in laser vaporization followed by laser enucleation with morcellation. After adjusting for covariates, PVP and LEP showed less return to the operating room with a 48.1% and 21.7% decrease in the odds as compared to TURP, respectively. PVP showed a significant 13.2% increase in the odds of experiencing morbidity as opposed to a decrease of 37.5% in LEP as compared to TURP. PVP and LEP showed a decrease in hospital stay by 0.988 and 0.305 days as compared to TURP, respectively. CONCLUSIONS: This study shows superiority of laser techniques in 30-day postoperative outcomes as compared to TURP. Further research is needed to account for longer duration of follow-up and patient-specific urologic outcomes, such as prostate size, urinary incontinence, erectile dysfunction, and retrograde ejaculation. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e469 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Ayoub More articles by this author Rachelle Haber More articles by this author Reem Amine More articles by this author Diana Mikati More articles by this author Albert El Hajj More articles by this author Expand All Advertisement PDF DownloadLoading ...

Pediatric Nephrectomy: Comparison of Perioperative Outcomes of Three Different Minimally Invasive and Open Approaches.

Background: Minimally invasive surgery (MIS) is now the gold standard for nephrectomy in pediatric patients. Retroperitoneoscopic (using either one or two instruments) and transperitoneal (TP) approaches are described. We compared the perioperative outcomes of different techniques [single-instrument retroperitoneoscopic (SIRP), two-instrument retroperitoneoscopic (TIRP), TP, and open approach]. Patients and Methods: Retrospective review of patients who underwent nephrectomy surgery in the period from January 2009 to January 2020 at a single center was carried out. We excluded patients who underwent other procedures under the same anesthetic, underwent heminephrectomy, and those with incomplete records. The primary outcome measures were operative time, intraoperative complications, postoperative complications, and length of hospital stay. One-way analysis of variance (ANOVA) test was used to analyze continuous variables. Chi square test was used to compare categorical variables. Results: A total of 213 nephrectomies were analyzed; SIRP (n = 35), TIRP (n = 50), TP (n = 74), and open (n = 54). Median age (months) was 71 for SIRP, 113 for TIRP, 67 for TP, and 21 for open. No statistical difference was identified for mean operative time (P = .067) or mean hospital stay (P = .69). Intraoperative complications were significantly more in the open group (P = .03). Postoperative complications were rare and only noted in the open group. There was no conversion to open surgery in the SIRP and TIRP groups. Conversion rate was 5.4% (4/74) in the TP group. Conclusion: MIS nephrectomy is safe, and no difference among techniques (SIRP, TIRP and TP) has been demonstrated. They are comparable to open surgery in terms of operative time and hospital stay, but are associated with significantly less complications.