Success Rate Of Repair Research Articles

Isolated Minimally Invasive Mitral Valve Surgery in Octogenarians: Perioperative Outcome

Introduction: Despite the feasibility, safety, and excellent outcomes of mitral valve surgery through a right mini-thoracotomy, there is data paucity about its use in octogenarians. In this study, we assess the outcomes of mitral valve surgery via right mini-thoracotomy in octogenarians. Methods: We performed a retrospective analysis of the in-hospital perioperative data of 38 octogenarian patients with severe mitral regurgitation undergoing isolated mitral valve surgery via right mini-thoracotomy from 2013 to 2021 in our institution. Results: The median patient age was 82 (81–83) years, and the median EuroSCORE II was 3.1% (2.3–4.9). A total of 19 (50%) patients underwent mitral valve repair. The median cardiopulmonary bypass duration was 78 (54–100) min and the median aortic cross-clamping duration was 57 (40–70) min. Two (5.3%) patients were converted to sternotomy, 1 (2.6%) underwent renal replacement therapy, 5 (13.2%) underwent reexploration for bleeding or tamponade, and 12 (31.6%) underwent permanent pacemaker implantation. The surgical repair success rate was 89.5%, with 2 (10.5%) patients requiring reoperation due to repair failure. No other patients required reoperation on the mitral valve. The median intensive care unit stay was 1 (1–2) day, and the median postoperative stay was 9.5 (8–14) days. There was no perioperative stroke or death. Conclusion: Despite a relatively increased risk of pacemaker implantation and reexploration for bleeding, our data support the feasibility of mitral valve surgery via a right mini-thoracotomy in octogenarians, with short ischemic times, low overall in-hospital morbidity, and no mortality. Preferring replacement in mitral diseases with a high risk for repair failure could minimize reoperations in this high-risk subgroup.

Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature.

Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative anisometropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra- and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.

Urethroplasty Outcomes for Pars Fixa Urethral Strictures Following Gender-affirming Phalloplasty and Metoidioplasty: A Retrospective Study

To evaluate outcomes of three urethroplasty techniques for pars fixa (PF) urethral strictures and provide a treatment algorithm based on stricture characteristics. The PF is an essential anatomic region of the neourethra created in gender-affirming phalloplasty and metoidioplasty. Urethral strictures in this region present a reparative challenge given its unique anatomy and vascularization. A total of 41 urethroplasties performed on 41 patients between March 2018 and June 2021 were reviewed at two surgical centers. A Heineke-Mikulicz (HM) repair was done for strictures under 20 mm when the proximal and distal urethral segments were mobile and supported a tension-free closure. Substitution urethroplasty with ventral onlay buccal mucosal graft was utilized for strictures under 40 mm not suitable for HM repair. Complex or long (≥40 mm) strictures were treated by two-stage Johansen urethroplasty. Success of each surgical approach was defined by a minimum of 12-month follow-up without the need for a repeat intervention. Mean follow-up was 30.2 months (range: 12.4-52.0 months). Mean stricture length was 16.9 mm (range: 2-55 mm). Most strictures (46%) were located at the distal PF. HM urethroplasty had a success rate of 44% (n = 16). Substitution urethroplasty had a success rate of 92% (n = 13). Two-stage Johansen urethroplasty had a success rate of 75% (n = 12). The success rates of PF urethral stricture repair ranged from 44% to 92% depending on the surgical approach, and the best reparative procedure depends on stricture length, severity, and local tissue mobility.

Factors Affecting the Surgical Outcome in Nasal Septal Perforation Repair.

Nasal septal perforation (NSP) repair is challenging surgery considered in patients with symptomatic NSP intractable to conservative treatments. This study aimed to assess the success rate and identify factors affecting the surgical outcome of NSP by analyzing consecutive series of NSP repairs by a single surgeon. We enrolled 84 patients diagnosed with NSP and who underwent surgical repair of NSP by a single surgeon (Y.J.J.) between November 2007 and July 2022. Medical records were retrospectively reviewed regarding variables involving preoperative symptoms, rhinologic history, etiology, surgical techniques, and the outcome of surgery. In addition, features of NSP were objectively evaluated using computed tomography scans. The overall success rate of NSP repair was 64.3% (54 of 84). Nasal obstruction (79.8%), crusting (34.5%), and epistaxis (27.4%) were frequent preoperative symptoms. Iatrogenic injury from previous nasal surgery (70.2%) was the most common cause. The average size of NSP on preoperative CT was 9.53 ± 6.68 mm. Patients with incomplete NSP closure had significantly larger perforations (12.21 ± 7.92 mm) than those with successful closure (8.04 ± 5.41 mm) preoperatively (P = .005). Patients with smoking history (OR = 2.971, 95% CI 1.170-7.548, P = .020) and NSP repair with combined rhinoplasty (OR = 3.811, 95% CI 1.401-10.370, P = .007) were more likely to experience incomplete closure. Patients whose perforations were reinforced with interposition graft were more likely to result in successful repair (OR = 6.752, 95% CI 2.496-18.262, P < .001). The bilaterality of mucosal flap coverage, surgical approach, types of mucosal flap and interposition graft, perforation shape, mucosal thickness around perforation, and distance from the nasal floor were not significantly related to the surgical outcome. Significant factors affecting the outcome of NSP repair were patient's smoking status, combined rhinoplasty, application of interposition graft, and perforation size.

Save the Meniscus: The Meniscal Mantra Remains Durable: Commentary on an article by Rick W. Wright, MD, et al.: "Ten-Year Outcomes of Second-Generation, All-Inside Meniscal Repair in the Setting of ACL Reconstruction".

Commentary Save the meniscus. Save the meniscus. Save the meniscus. This is a subconscious orthopaedic mantra that we have all heard and repeated numerous times. Ever since Fairbank’s landmark study in 1948, “Knee Joint Changes After Meniscectomy,” and numerous later studies, we have learned to respect the importance of preserving the meniscus and, in turn, preventing degenerative changes1. In 2023, we may continue to debate over the best repair technique and the best repair augmentation and/or biologics, but we can all agree that we should do what we can to preserve and repair the meniscus. This has been demonstrated to be even more certain in the setting of a concomitant anterior cruciate ligament reconstruction (ACLR). Literature has demonstrated that meniscal tears heal better in the environment of an ACLR and, therefore, we should attempt to repair and preserve the meniscus as much as possible in this setting2,3. Historically, inside-out meniscal repair techniques were considered the gold standard, but as all-inside techniques have become more reliable, user-friendly, and able to mimic the traditional technique, they are more popularly used4. There are few 10-year outcome studies, and not many that examine all-inside meniscal suture devices; therefore, I commend Wright et al. on their current study. The authors performed a Level-IV retrospective review of 81 patients with a meniscal repair and concomitant primary ACLR using the second-generation, all-inside FAST-FIX Meniscal Repair System (Smith & Nephew). Some of these patients were included in their previous study evaluating outcomes of all-inside, second-generation repair at a 5-year follow-up4. In this current study, 69 of the 81 patients had a 10-year follow-up and 9 (13%) of the 69 patients had a failed meniscal repair, which was defined as a repeat surgical intervention involving resection or revision repair. The authors demonstrated that 84% to 88% of patients had a successful repair and all patients, regardless of failure, had favorable patient-reported outcome measures, which included the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) score, and the Marx Activity Rating Scale score, at 10 years. There were 59 medial repairs and 22 lateral repairs, and, of all the repaired tears, there were 13 bucket-handle tears, and the remaining tears were vertical longitudinal tears in the red-red or red-white vascular region. The study did not include radial tears, root tears, or ramp lesions. The mean number of sutures used for repair was only 2. Concerns with regard to the study include the lack of a comparison group, the use of older devices, and the shorter postoperative rehabilitation protocol. There are now third-generation, all-inside repair devices available, and the postoperative rehabilitation after a meniscal repair and ACLR is now ≥8 months. Perhaps this longer rehabilitation time can influence meniscal repair success or failure rates. The authors have demonstrated that the success rate of meniscal repair is 84% to 88% using an all-inside, second-generation technique with a concomitant ACLR. Although this is considered successful, what else can we do to optimize our success rates even more? Should we use better techniques and devices, or orthobiologics? How will this change as we repair different types of tears, including root and ramp tears? Also, how will longer rehabilitation affect meniscal healing and retear rates? If our mantra, save the meniscus, remains true, then I look forward to future data demonstrating what else we can do to improve success rates with all tears (bucket-handle, longitudinal, root, and ramp) with newer techniques and biologics.

Congenital ptosis repair in children: comparison of frontalis muscle suspension surgery and levator muscle surgery.

Comparing the surgical and refractive outcomes of congenital ptosis repair by different surgical techniques. This longitudinal cohort study reviewed medical records of 101 patients who underwent congenital ptosis repair, from 2006 to 2022 in a single center. Analysis was performed for demographic background, co-morbidities, pre-operative and post-operative ocular examinations and refraction, complications, reoperations, and success rates. Following exclusion criteria, we remained with 80 patients (103 eyes) who underwent either frontalis muscle suspension surgery (FMS) (55 eyes) or levator muscle surgery (LM) (48 eyes). Patients in the FMS group were younger (mean age of 3.1 vs. 6.0years, p < 0.001) and had worse pre-operative ocular assessments including prevalence of visual axis involvement, chin-up head position, ptosis severity, and levator muscle function (LF) (p < 0.001). Both groups had a 25% rate of reoperation, however while in the LM group reoperation was required solely due to undercorrection, in the FMS group various indications prompted reoperation. Success rate was higher in the FMS group (87.3% vs. 60.4%, p = 0.002). While pre-operative astigmatism was higher in the LM group (p = 0.019), no significant differences were observed post-operatively. Spherical and spherical equivalent changes over time were significant only in the FMS group (p = 0.010 and p = 0.004, respectively). Within our cohort, a higher success rate of congenital ptosis repair was observed among patients who underwent FMS compared to LM, despite similar reoperation rates. In cases of severe ptosis and moderate LF, LM demonstrated a lower-than-anticipated success rate. Astigmatic changes following ptosis repair were not consistent in either group.

Do users have the ability to self-repair non-complex electrical appliances? Design and development of a self-guided workshop with repair documentation in different formats

In the context of the circular economy, repair is one of the main strategies to extend the lifespan of products. However, when it comes to non-complex and inexpensive small household electric and electronic equipment (EEE), consumers tend to not repair or self-repair these items but purchase new ones instead. The aim of this study is to analyse the self-repair experience of consumers in a three-stage self-guided workshop designed and carried out using an electric water kettle as a case study. Sixty people with different profiles participated in the self-guided workshop. An initial interview was conducted to ascertain previous repair experience, and there was also a final interview in which future willingness to repair was studied, as well as the motivations and barriers. The main stage of the self-guided workshop consisted of repairing a kettle in which two faults had been induced. Disassembly and repair guidelines were provided in three different formats (a video, step-by-step instructions and a guide). Regarding their preferences for the resource used to carry out the repair, 61.4 % preferred the video, 24.6 % the step-by-step instructions and 14.0 % the guide. The participants who successfully repaired the kettle amounted to 63.2 %, and 24.6 % of the total number of participants did not use the repair instructions. An analysis of the variable “repair success” against participants' socioeconomic characteristics showed that having previous experience of self-repair or not was the only statistically significant variable; therefore, self-reported repair experience does influence the disassembly process. Thus, the repair success rate is 40.4 % for those with previous self-repair experience against a rate of 22.8 % for those without experience. In conclusion, consumers will attempt self-repair if the information to do so is provided and it is more affordable to repair the product than to purchase a new one.

Cerebrospinal fluid rhinorrhea: a novel approach

Background: This study aimed to describe the use of nasal endoscopic technique in the management of cerebrospinal fluid (CSF) rhinorrhea repair. Over the last decade, endoscopic surgery has established itself as the most widely used technique for the repair of CSF leak. Methods: 20 patients diagnosed with CSF rhinorrhea undergoing endoscopic CSF rhinorrhea repair were included in this study. To confirm the diagnosis beta-2 transferrin test was done. Accurate localization of site of lesion using CT cisternography was done. Results: Spontaneous onset of CSF rhinnorhea was noted in 75% of patients. The most common cause of CSF rhinorrhea in our study was spontaneous and the second most common cause was post traumatic. Almost 45% of patients presented with headache as primary complaint, 30% with only CSF leak, 20% with nasal obstruction and rest 5% with hyposmia. Conclusions: Multilayered closure of the dural defect was done. It can be concluded that middle aged people presented as CSF rhinorrhea with female predominance and there was high success rate of endoscopic CSF rhinorrhea repair with low morbidity.

Automatic Repair of Java Programs with Mixed Granularity and Variable Mapping

During the process of software repair, since the granularity of repair is too coarse and the way of fixing ingredient is too simple, the repair efficiency needs to be further improved. To resolve the problems, we propose a Mixed Granularity and Variable Mapping based automatic software Repair (MGVMRepair). We adopt random search algorithm as the framework of program evolution, and utilize the mapping relationship between variables as an auxiliary specification. Firstly, fault localization is used to locate the suspicious statements and to form a list of modification points. Secondly, the ingredient of program repair at statement level is obtained, and the mapping relationship of variables is established. Then, the test case prioritization is improved from the perspective of the modification point. Finally, a program passes all test cases or the program iteration terminates. The experimental results show that MGVMRepair has a higher repair success rate than GenProg, CapGen, SimFix, jKali, jMutRepair and SketchFix on Defects4J.

Using mesh in capsule anatomical reconstruction to enhance the stability of high-dislocation-risk hip arthroplasty: a randomized controlled trial

BackgroundDislocation is a common complication after total hip arthroplasty (THA). This study aimed to compare the outcomes of mesh reconstruction versus conventional capsular repair in maintaining capsular integrity and preventing dislocation after THA.MethodsThis was a prospective, randomized controlled study of consecutive patients. A total of 124 high-dislocation-risk THAs were identified and randomized into two groups, one using mesh reconstruction and the other using the conventional capsular repair method. Perioperative data and radiological data were collected. Patients were followed up regularly. The main indices were the capsular integrity assessed by magnetic resonance imaging (MRI) and hip dislocation rate. The secondary indices included the Harris hip score (HHS), complications, and satisfaction.ResultsA total of 106 patients completed the follow-up and the average follow-up times were 19 ± 3.1 and 18 ± 3.3 months. The operation time of the mesh group was longer than that of the conventional group (P < 0.001). There were minor differences in acetabular anteversion and abduction angle, and the other data showed no differences. MRI results indicated that the success rate of capsular repair was higher in the mesh group (50 hips, 98%) than in the conventional group (37 hips, 67%) (P < 0.001), and the others failed the repair. Three dislocations occurred in the conventional group, while none occurred in the mesh group. The preoperative HHS (30 points) and postoperative HHS (82 points) of the mesh group were similar to those (35 points, 83 points) of the conventional group (P = 0.164, P = 0.328). Satisfaction had no difference (P = 0.532).ConclusionsCompared to conventional repair, mesh reconstruction can effectively maintain capsular integrity and decrease dislocation risk after THA without increasing complications.Level of evidence: Therapeutic study, Level IA.

Predictors and outcomes of surgical repair of obstetric fistula at Mekelle Hamlin Fistula Center, Northern Ethiopia.

Obstetric fistula is a medical condition that involves an opening between vagina and bladder or vagina and rectum. From 2010 to 2013, on average, around 2000 women each year had surgery for obstetric fistula in Ethiopia. The success and failure rate of obstetric fistula repair varies from center to center and is determined by many factors. Thus, this study aimed to assess the predictors and outcomes of surgical repair of obstetric fistula at Mekelle Hamlin Fistula Center (MHFC). A retrospective reviewed medical records of 328 patients with obstetric fistula were carried out at MHFC. Multivariable logistics regression analysis was conducted, a significant association was declared when the p-value was less than 0.05, and the strength of the association was determined by computing the odds ratio at 95% CI. The analysis was done using SPSS version 24. Obstetrics fistula patients who had formal education were 13% more likely to be successfully repaired than obstetrics fistula patients who had no formal education. Additionally, obstetrics fistula patients who had a live birth were 32.325 (exp (β) = 32.325) times more likely to have had a successful repair than those who had a stillbirth. Fistula closure was achieved in 89.3% of cases. The success rate for VVF (vesico-vaginal fistula) and RVF (recto-vaginal fistula) surgical repair was 86.9% and 100% respectively, which is higher than the WHO target. Body mass index between 18.5-24.9kg/m2, formal education, antibiotic use, live birth, large fistula size, and home and cesarean delivery were predictors of successful closure of obstetric fistula.

Hurricane Tree Damage and Repair

ABSTRACT During a moderate to severe hurricane more than 5% of trees snap or uproot, depending on the strength and duration of the storm, causing considerable damage to nearby property, housing, and power lines. This study aims to specify the mechanics of trunk damage and possible repair mechanisms. Field data are assembled from trees after hurricane damage to the trunk. Allometric scaling parameters based on trunk diameter (D ^ exp) are determined for the damaged trees’ height, weight, Safety Factor S.F. and critical wind velocity Vcrit. 55% snap via stress fracture of the trunk, 45% by uprooting of the entire tree. Hurricane boundary layer profiles, shear layer forces, Safety Factor (SF), and critical wind velocity Vcrit are determined. Power law exponents (D ^ exp) predict tree height (0.84), weight (2.68), Safety Factor S.F. (0.74), and critical wind velocity Vcrit (0.33) in terms of trunk diameter, with correlation coefficients r = 0.94 to 0.99. Critical velocity Vcrit (wind velocity above which the tree will fail) is found to scale as the Safety Factor S.F.^ (1/2). In conclusion, strategic use of clamps, bolts, tree sap and cables allows restoration of uprooted or snapped trunks for some hurricane damaged trees. Success rate for repair is 67%, average longevity after repair 5.6 years for medium-sized commercially valuable trees.

Epidemiologic and Therapeutic Aspect of Urogenital Fistula Following Obstetric and Gynecologic Surgeries Repaired at the Nkwen Baptist Hospital

Introduction: Urogenital fistula is an abnormal communication between the urinary and the genital systems. It may occur following vaginal deliveries or following pelvic surgeries. Data concerning urogenital fistula post-surgery is limited and we have noticed in recent years in Sub-Saharan Africa, an increase in the burden of iatrogenic urogenital fistula. Objective: The aim of this study was to assess the epidemiology, clinical profiles and therapeutic aspects of urogenital fistula following obstetric and gynaecologic surgeries repaired at the Nkwen Baptist Hospital Bamenda. Materials/Methods: This was a longitudinal descriptive study with a retrospective and prospective phase carried out at the Nkwen Baptist Hospital for 5 months. However the complete duration of the study was about 17 months. Data was collected using a pretested questionnaire containing socio-demographic information, clinical features, and therapeutic methods used. We used the statistical software SPSS (Social Package for Statistical Sciences) V 26.0 for data analysis. Results: The number of participants in the study was 40. The mean age was 43.5 years (+/- 13.3) ranging from 16 - 74 years. The prevalence of urogenital fistula post obstetric and gynecologic surgeries at the Nkwen Baptist hospital was 64.6%. The most common symptom was urine leakage and the most common surgery that exposed the patient to the urogenital fistula was total abdominal hysterectomy (60%) followed by caesarean section (35%). The different indications for these surgeries were mostly symptomatic leiomyoma (70.8 %) and prolonged labor (64.2%) respectively. The different types of fistula encountered were Vesicovaginal fistula (55%), Ureterovaginal fistula 40% and Vesicoutetrine fistula 5%. The different treatment modalities used were trans abdominal (77.5%) and transvaginal repair (22.5%). The overall repair success rate after one month was 85%. Conclusion: There is high burden of urogenital fistula post surgeries in our setting. Having more specialists trained in obstetric and gynaecologic procedures may help in the prevention of such an event.

Partial thickness subfoveal hole in a patient treated with tamoxifen: a case report and review of the literature

BackgroundWe describe a patient presenting with a partial thickness subfoveal hole in the right eye after tamoxifen treatment for breast cancer.Case presentationA 76-year-old Caucasian female presented with a 1-day history of acute central scotoma and blurry vision in the right eye. The patient had been receiving oral tamoxifen for 5 years as adjuvant treatment for stage I lobular breast cancer. Her past ocular history was significant for complete, uneventful, and bilateral posterior vitreous detachment. Clinical examination and optical coherence tomography revealed a new, partial thickness subfoveal hole sparing the inner retinal layers. Observation was recommended. At the last follow-up examination, 1 year after the initial presentation, the subfoveal hole remained stable and visual acuity remained stable.ConclusionTamoxifen has been associated with a plethora of ophthalmic adverse events, including macular holes, some of which are partial thickness subfoveal holes. Holes with this almost unique morphology are uncommon, and eye care professionals should be aware of this association given the frequency of tamoxifen use, as well as the low success rate of surgical repair with pars plana vitrectomy.

A Novel Cycle Slips Detection and Repair Method with AR Model of BDS-3 Dual-Frequency Signal in Severe Multipath Environments

High-level applications of geo-processing services generally lack accurate temporal and spatial information. BDS-3 provides high precision temporal and spatial reference for geoprocessing services, but their signal is prone to cycle slips in a severe multipath environment. Aiming at the problem of the reliable detection and repair of cycle slips in BDS-3 (B1c + B2a) dual-frequency positioning in a severe multipath environment, an AR (autoregressive) model-assisted MW + GF BDS dual-frequency combined detection method (AMG method) is proposed in this research. A sliding-window autoregressive prediction strategy is introduced to correct the pseudorange observations interfered by a multipath, then an AR + MW + GF cycle slips detection model is constructed, and a cycle slips statistical completeness test index is established to verify the effectiveness of the algorithm. Six groups of cycle slips are artificially added into the different constellations and dual-frequency point phase observations of BDS-3 (B1c and B2a) in a multipath environment to demonstrate the cycle slips’ detection performance. The experimental results show that the traditional MW + GF method fails, but the proposed AMG method still maintains accurate cycle slip detection and repair capabilities. The detection success rate and repair success rate obtained by using the new method are significantly improved by 63.4%, and the cycle slips’ false detection rate and missed detection rate are reduced by 64.5% and 42.0%, respectively, even in harsh environments.

Comparison of early and late postoperative outcomes between chordal reconstruction and quadrangular resection in patients with posterior mitral valve prolapse: a single-center retrospective study

BackgroundTo compare the early and late postoperative outcomes of chordal reconstruction (CR) and quadrangular resection (QR) in patients with posterior mitral valve prolapse (PMPL).MethodsBetween January 2008 and December 2018, 305 patients with PMPL who underwent mitral valve plasty (MVP) were included in this retrospective analysis. The CR and QR procedures were performed in 169 patients (CR group) and 136 patients (QR group), respectively. Early and late postoperative outcomes were compared between the groups.ResultsFollow-up was complete in 96.4% (294/305) of patients, with a mean follow-up of 81.2 ± 30.4 months. No 30-day mortality was observed in any of the patients. The success rate of the mitral valve repair was similar in both groups (99.4% vs. 98.5%, P = 0.850). The incidence of early postoperative hemolysis was lower in the CR group than in the QR group (0.00% vs. 3.0%, P = 0.024). Postoperative left ventricular end-diastolic diameter (LVEDD) decreased more significantly in the CR group than in the QR group at 3 months (8.15 [1.30,12.65] vs. 3.25 [− 0.05, 8.75] mm, P < 0.001). During follow-up, the overall survival rates were 95.1% and 94.6% in the CR and QR groups, respectively. The incidence of reoperation for moderate or severe mitral regurgitation (MR) was similar in both groups (4.3% vs.5.4%, P = 0.653), but the time interval between the initial operation and reoperation was shorter in the QR group than in the CR group (84.3 ± 36.1 vs. 120.9 ± 27.6 months, P = 0.026). The LVEDD enlargement was more significant in the QR group than in the CR group (4.5 [3.6, 4.5] vs. 2.4 [1.3, 2.8] mm, P < 0.001).ConclusionCR and QR are effective techniques for patients with PMPL. Both techniques resulted in a low incidence of recurrent MR. However, CR can reduce early postoperative hemolysis and LVEDD more significantly. During the long-term follow-up, reoperations due to recurrent MR were performed at a longer interval after the initial operation. LVEDD expansion was better avoided in the CR group.

Automatic Repair of Java Programs Weighted Fusion Similarity via Genetic Programming

Recently, automated program repair techniques have been proven to be useful in the process of software development. However, how to reduce the large search space and the random of ingredient selection is still a challenging problem. In this paper, we propose a repair approach for buggy program based on weighted fusion similarity and genetic programming. Firstly, the list of modification points is generated by selecting modification points from the suspicious statements. Secondly, the buggy repair ingredient is selected according to the value of the weighted fusion similarity, and the repair ingredient is applied to the corresponding modification points according to the selected operator. Finally, we use the test case execution information to prioritize the test cases to improve individual verification efficiency. We have implemented our approach as a tool called WSGRepair. We evaluate WSGRepair in Defects4J and compare with other program repair techniques. Experimental results show that our approach improve the success rate of buggy program repair by 28.6%, 64%, 29%, 64% and 112% compared with the GenProg, CapGen, SimFix, jKali and jMutRepair.

Surgical Management of Rectovaginal Fistula: Review Article

Background: Rectovaginal Fistula (RVF) development is a side effect of an underlying illness, wound, or surgical procedure. Although there are several surgical approaches for RVF, including advanced flaps, muscle interposition, plugs, and fistula excision, doing so is challenging and painful. The success rate of surgical repair, on the other hand, ranges from 0 to 80%. Objectives:The study aims to summarize current evidences on prevalence, risk factors and management approaches of rectovaginal fistula. Methods:For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in the review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: The first line of defence against perianal sepsis is drainage and possibly seton placement, which may be the only treatment required. Medical treatments are recommended for both local and distant active Crohn's disease (CD). Repairs frequently fail, necessitating reoperative intervention with acceptable outcomes. It is critical to maintain realistic treatment goals and expectations.

Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study

Background&#x0D; The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia.&#x0D; Methods &#x0D; A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019. Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model.&#x0D; Results&#x0D; In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model.&#x0D; Conclusion &#x0D; Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.

Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study

Background: The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia.&#x0D; Methods: A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019. Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model.&#x0D; Results: In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29 years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model.&#x0D; Conclusion: Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2 weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.