Results Of Surgical Treatment Research Articles

Long-term outcome of surgical treatment for idiopathic spinal arachnoid web: A case series

ObjectiveSpinal arachnoid web (SAW) is a rare condition of the spine with limited long-term follow-up data in the literature. The longest reported follow-up period was an average 3.2 years. The objective of this study is to report our long-term results of patients who underwent surgical treatment for symptomatic idiopathic SAW. MethodsWe conducted a retrospective review of cases of idiopathic SAW that were operated between 2005–2020. We collected preoperative and last follow-up (LFU) data on motor force, sensory loss, pain, upper motor neuron (UMN) sign, gait disorder, sphincter dysfunction, syringomyelia, hyperintensity on T2-MRI, appearance of newer symptoms and number of reoperations. ResultsOur study included 9 patients with a mean follow-up period of 3.6years (range 2–9.1years). The surgical intervention involved a standard centered laminectomy, durotomy and arachnoid lysis. At presentation, motor weakness was present in 77.8% of patients, sensory loss in 66.7%, pain in 88.9%, sphincter dysfunction in 33.3%, UMN sign in 22%, gait disorder 55.6%, syringomyelia in 55.6% and MRI T2 hyperintensity in 55.6% of patients. At LFU, there was an improvement in all symptoms and signs to varying degrees. No new neurological symptoms appeared postoperatively, and there was no recurrence during the follow-up period. ConclusionOur results demonstrate that the reported immediate and short-term favorable outcomes following arachnoid lysis for symptomatic SAW persist over a long-term period and the risk of readhesion-correlated neurological deterioration following conventional surgical intervention is low.

Aspects related to left ventricular hypoplasia, possibilities and outcomes of surgical treatments: an integrative literature review

Objective: To analyze the current scientific collection related to left ventricular hypoplasia, analyzing the possibilities and outcomes of surgical treatments. Methodology: Integrative literature review that searched for articles in the Virtual Health Library (VHL), using the descriptors: "left ventricular hypoplasia" AND "treatment" from 2020-2022. Results and discussion: The sample corpus totaled 23 articles, with 02 thematic axes: (I) Studies found and their surgical techniques and (II) Comparison of studies regarding patient survival. Final Considerations: There was a better understanding of the importance of surgical palliation for the viability of patient survival. More scientific evidence is suggested that raises greater knowledge about mortality between stages, as well as mortality from other procedures involved in palliative reconstruction, providing additional evidence for the long-term survival rate.

Outcomes of Surgical Treatment of Malar Mounds and Festoons.

Malar mounds (congenital) and festoons (acquired) are persistent puffiness in the prezygomatic space between the orbicularis retaining ligament (ORL) and zygomatico-cutaneous ligament (ZCL). Non-surgical treatments often yield unsatisfactory results. This paper aims to demonstrate a surgical approach for the treatment of malar bags by outlining the author's surgical technique of treating malar mounds and festoons and reviewing outcomes in 89 cases. Correction of malar mounds and festoons was achieved with subciliary skin-muscle flap, release of the ORL and ZCL, midface lift, canthopexy, and muscle suspension. We performed a retrospective study of 89 patients, all of whom had surgical correction of malar mounds or festoons in the past 10 years and a follow-up period of at least 6 months. This study was conducted over the course of the past year and involved reviewing patient charts in the office. Specifically, patient data spanning 2012 to 2022 were analyzed. The predictor variable in this study is the specific class of malar bags the patient has, as determined by the underlying pathophysiology. Outcome variables include the presence or absence of prolonged lid or malar edema, necessary re-excision of excess orbicularis oculi of the subciliary area, lid malposition, permanent visual changes, the need for additional non-operative treatment, and recurrence requiring reoperation. The majority of patients presented with acquired festoons (81/89) with prior attempts of correction (49/89). The mean follow-up is 11.2 months. Persistent malar edema (> 6 weeks) was documented in 14 patients and mainly resolved with Medrol Dosepak (methylprednisolone) and hydrochlorothiazide. A two-proportion Z-test was conducted, comparing the proportion of patients with poor protoplasm who experienced postoperative malar edema to the proportion of those with excellent protoplasm who experienced postoperative malar edema. A p-value of 3.414e-7 was obtained, indicating a statistically significant difference of proportions between the two groups. Five patients received additional injections of deoxycholic acid and two needed fillers for smoother contour of the lower eyelids. Two patients with severe malar mounds required multiple reoperations including direct excision in one patient. One incidence of transient lid retraction was reported in a patient with previous facelift and facial nerve injury. Malar mounds and festoons present a unique challenge to plastic surgeons. They are persistent in nature and require close-interval, long-term follow-up as additional injections and reoperations are warranted. Our approach to malar mound and festoon correction is safe and effective and provides long-lasting results. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Surgical treatment of penile foreign body granuloma: Penile shaft reconstruction with single- versus two-stage scrotal flap techniques.

To report outcomes of surgical treatment in patients with penile foreign body granuloma and compare surgical outcomes between single- and two-stage scrotal flap reconstructions. Medical records of patients with penile foreign body granuloma who underwent surgical treatment were reviewed. Patients with single- and two-stage scrotal flap reconstructionswere compared. Forty-two patients underwent surgical treatment from January 1, 2018 to October 31, 2022. Twenty-three patients underwent single-stage reconstruction with bilateral scrotal flap while 12 patients underwent two-stage repair with 19 operations. Five patients underwent circumcision; one had excision with primary closure. Another patient underwent reconstruction by penile skin preservation technique. There was no statistically significant differences between single- and two-stage groups in wound infection (8.69% vs. 0%, RR 2.71, 95%CI; 0.14-52.29), wound dehiscence (21.74% vs. 8.33%, RR 2.61, 95%CI 0.34-19.87), reoperation rate (26.08% vs. 8.33%, RR 3.13, 95%CI; 0.42-23.10). Postoperative fever was significantly higher in single-stage group (56.52 vs. 8.33%, RR 6.78, 95%CI; 1.01-43.83). Total length of hospital stay was shorter in single-stage group (7.43 ± 3.19 days vs. 10.86 ± 1.57 days, MD -3.42, 95%CI; -5.28 to -1.57). Incidence of patients without Clavien-Dindo surgical complications was significantly lower in single-stage group (43.48% vs. 83.33%, RR 0.53, 95%CI; 0.31-0.89). Both single- and two-stage techniquesmay be considered for penile foreign body granuloma reconstruction. Although the hospital stay was longer in two-stage group, the complication rates were lower.

Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data.

The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data (clinicaltrials.gov: NCT03125798) compared patients who underwent thoracoscopic lobectomy with the LigaSure device (study group, n = 96) and monopolar device (control group, n = 94). The primary endpoint was the lobe-specific mediastinal lymphadenectomy. Lobe-specific mediastinal lymphadenectomy criteria were met in 60.4% and 38.3% of patients in the study and control groups, respectively (p = 0.002). In addition, in the study group, the median number of mediastinal lymph node stations removed was higher (4 vs. 3, p = 0.017), and complete resection was more often achieved (91.7% vs. 80.9%, p = 0.030). Logistic regression analysis indicated that lymphadenectomy quality was positively associated with the use of the LigaSure device (OR, 2.729; 95% CI, 1.446 to 5.152; p = 0.002) and female sex (OR, 2.012; 95% CI, 1.058 to 3.829; p = 0.033), but negatively associated with a higher Charlson Comorbidity Index (OR, 0.781; 95% CI, 0.620 to 0.986; p = 0.037), left lower lobectomy (OR, 0.263; 95% CI, 0.096 to 0.726; p = 0.010) and middle lobectomy (OR, 0.136; 95% CI, 0.031 to 0.606, p = 0.009). This study found that using the LigaSure device can improve the quality of lymphadenectomy in lung cancer patients and also identified other factors that affect the quality of lymphadenectomy. These findings contribute to improving lung cancer surgical treatment outcomes and provide valuable insights for clinical practice.

Meta-analysis of Randomized Clinical Trials on Long-term Outcomes of Surgical Treatment of Perforated Diverticulitis.

To assess long-term outcomes of patients with perforated diverticulitis treated with resection or laparoscopic lavage (LL). Surgical treatment of perforated diverticulitis has changed in the last few decades. LL and increasing evidence that primary anastomosis (PRA) is feasible in certain patients have broadened surgical options. However, debate about the optimal surgical strategy lingers. PubMed, Scopus, and Web of Science were searched for randomized clinical trials (RCT) on surgical treatment of perforated diverticulitis from inception to October 2022. Long-term reports of RCT comparing surgical interventions for the treatment of perforated diverticulitis were selected. The main outcome measures were long-term ostomy, long-term complications, recurrence, and reintervention rates. After screening 2431 studies, 5 long-term follow-up studies of RCT comprising 499 patients were included. Three studies, excluding patients with fecal peritonitis, compared LL and colonic resection, and 2 compared PRA and Hartmann procedures. LL had lower odds of long-term ostomy [odds ratio (OR) = 0.133, 95% CI: 0.278-0.579; P < 0.001] and reoperation (OR = 0.585, 95% CI: 0.365-0.937; P = 0.02) compared with colonic resection but higher odds of diverticular disease recurrence (OR = 5.8, 95% CI: 2.33-14.42; P < 0.001). Colonic resection with PRA had lower odds of long-term ostomy (OR = 0.02, 95% CI: 0.003-0.195; P < 0.001), long-term complications (OR = 0.195, 95% CI: 0.113-0.335; P < 0.001), reoperation (OR = 0.2, 95% CI: 0.108-0.384; P < 0.001), and incisional hernia (OR = 0.184, 95% CI: 0.102-0.333; P < 0.001). There was no significant difference in odds of mortality among the procedures. Long-term follow-up of patients who underwent emergency surgery for perforated diverticulitis showed that LL had lower odds of long-term ostomy and reoperation, but more risk for disease recurrence when compared with resection in purulent peritonitis. Colonic resection with PRA had better long-term outcomes than the Hartmann procedure for fecal peritonitis.

Meningitis after spinal injury surgery

Postoperative meningitis is quite rare in the practice of a spine surgeon and, as a rule, is associated with unintentional damage to the dura mater or necessary durotomy. According to a number of researchers, emergency interventions, severe spinal cord injury, prolonged preoperative stay in intensive care, diabetes mellitus, obesity, smoking, and age over 65 are risk factors for the development of postoperative meningitis in spinal injury surgery. The development of postoperative meningitis lengthens the time of hospitalization, requires prolonged antibacterial therapy, and significantly deteriorates the outcome of surgical treatment, which determines the relevance and significance of studying this issue. The article presents our own experience of 12 cases of patients with meningitis after spinal injury surgery, which accounted for 0.6 % of all interventions.

Surgical treatment outcomes of solitary fibrous tumors in the head and neck: A retrospective study

The aim of this study was to better characterize head and neck solitary fibrous tumors (SFTs) and to evaluate surgical treatment.This retrospective study included patients who presented with head and neck SFTs. Clinical, radiological, and histological information and data regarding the treatments performed were collected. The risk of locoregional and distant metastases was calculated, and for orbital SFTs a specific classification was used.Overall, 34 patients were included. The majority of the SFTs were found in the oral cavity (n = 10), followed by the neck region (n = 8). The mean time to recurrence was 67.4 months. All patients underwent primary surgical resection. Recurrence was observed in five patients with a low risk of locoregional recurrence and distant metastasis.The treatment of choice is complete resection. Recurrence seems to be highly correlated with positive surgical margins. The safety margin should be increased when removing the lesion, and long-term follow-up should be performed.

Surgical Treatment for Popliteal Artery Entrapment Syndrome in Japan: a Retrospective, Multicentre Study Using a National Clinical Registry

Surgical treatment is an established method for popliteal artery entrapment syndrome (PAES), which, however, mainly derives from single centre experiences where PAES cases are centralised and treated periodically. This study evaluated clinical outcomes of surgical treatment for PAES in a clinical setting where PAES cases were not centralised. Multicentre, retrospective cohort study using a national clinical registry. From a Japanese nationwide clinical registry, data for patients who underwent surgical treatment for PAES between 2013 and 2018, including 58 limbs from 41 institutes, were retrieved and evaluated. Patency was analysed using Kaplan-Meier curves. The mean patient age was 36 ± 19 years, 78% were male, and the incidence of PAES was 0.24 limbs/centre/year, reflecting a clinical setting where PAES cases are not centralised. The most frequent arterial symptom was intermittent claudication (90%). Computed tomography was performed in 57 limbs (98%) for the diagnosis, however active manoeuvres such as dorsiflexion and plantarflexion during the examination was performed in only 13 limbs (22%), and occlusion of the popliteal artery was present in 38 limbs (66%) at diagnosis. Regarding surgical treatment, myotomy alone was performed in only seven limbs (12%), and other limbs were revascularised. Mean follow up was 26 ± 20 months, and surgical treatment was effective as it relieved symptoms in > 96% of limbs, with five year primary and secondary patency of the surgical treatment for PAES of 72% and 93%, respectively. Results of surgical treatment were acceptable even in a clinical setting where PAES cases were not centralised. However, a low incidence of active manoeuvres performed during the examination and a high incidence of occlusion at diagnosis suggests there may be delayed or underdiagnosis of PAES in Japan, and increased awareness for PAES is warranted.

Medium-Term Outcomes of Conservative and Surgical Treatments for Stress Urinary Incontinence: A Medicare Claims Analysis: Developed by the AUGS Payment Reform Committee.

This study aimed to evaluate the 3- to 5-year retreatment outcomes for conservatively and surgically treated urinary incontinence (UI) in a population of women 66 years and older. This retrospective cohort study used 5% Medicare data to evaluate UI retreatment outcomes of women undergoing physical therapy (PT), pessary treatment, or sling surgery. The data set used inpatient, outpatient, and carrier claims from 2008 to 2016 in women 66 years and older with fee-for-service coverage. Treatment failure was defined as receiving another UI treatment (pessary, PT, sling, Burch urethropexy, or urethral bulking) or repeat sling. A secondary analysis was performed where additional treatment courses of PT or pessary were also considered a treatment failure. Survival analysis was used to evaluate the time from treatment initiation to retreatment. Between 2008 and 2013, 13,417 women were included with an index UI treatment, and follow-up continued through 2016. In this cohort, 41.4% received pessary treatment, 31.8% received PT, and 26.8% underwent sling surgery. In the primary analysis, pessaries had the lowest treatment failure rate compared with PT (P<0.001) and sling surgery (P<0.001; survival probability, 0.94 [pessary], 0.90 [PT], 0.88 [sling]). In the analysis where retreatment with PT or a pessary was considered a failure, sling surgery had the lowest retreatment rate (survival probability, 0.58 [pessary], 0.81 [PT], 0.88 [sling]; P<0.001 for all comparisons). In this administrative database analysis, there was a small but statistically significant difference in treatment failure among women undergoing sling surgery, PT, or pessary treatment, but pessary use was commonly associated with the need for repeat pessary fittings.

The relation of changes in intraoperative EEg and ECog with age, anamnesis duration and outcome of surgical treatment in children with symptomatic epilepsy

Aim. To reveal relation of change in intraoperative electroencephalography (EEG), electrocorticography (EсoG) with age of patients, the anamnesis duration, localization and type of pathology, the result of treatment. Materials and methods. 64 patients with symptomatic epilepsy operated at N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of Russia from 2010 to 2016. 28 males, 36 females, age from 3 months to 18 years, on average 7,2 years. The pathology localization: temporal – 21 cases, occipital and parietal – 18, frontal – 25. Pathomorphology: 12 patients with focal cortical dysplasia (FCD) I, 20 patients with FCD II, 5 patients with FCD III, 4 patients with tuberous sclerosis, 20 patients with low grade tumors, and 3 cases else. The duration of diseaseis from 61 to 5081 days. Catamnesis (follow-up) ranged from 364 to 1877 days. There was four criteria for including patients in research: intraoperative EEG, presence of initial and control registration of EсoG, follow-up above 364 days. There are three hallmarks selected as significant concerning the efficiency of neurophysiological monitoring: 1) the positive changes in scalp EEG: decrease of interhemispheric asymmetry due to reduction of slow activity on the side of pathology; significant reduction of the unilateral epileptiform activity on the side of pathology and bilateral if exist; 2) the positive changes in EсoG: significant reduction of the regular epileptiform activity; 3) the absence or existence of residual epileptiform activity in adjacent to resected pathology sites. The statistical processing carried out with application of a Stat10 package. Results. The more expressed positive dynamics of EEG were revealed in patients of smaller age already during operation. A correlation was found between the age of patients and the positive dynamics of intraoperative EEG. An inverse correlation was found between the duration of the disease and the positive dynamics of the scalp EEG during surgery (p = 0.1560). The EEG changes during surgery were shown more often with reduction of the seizure anamnesis. There was found out that residual epileptiform activity on ECoG occurred more often at patients with longer anamnesis of a disease and at patients with frontal localization of pathology. The residual epileptiform activity on ECoG was registered more often at patients with preservation of seizures (outcomes 2, 3, 4, 5 ILAE). Conclusions. During resective interventions for symptomatic epilepsy in children the probability of positive changes was the more, the younger the patient was. Intraoperative ECoG is one of the useful tools in epilepsy surgery, but it does not definitely determine success. There was no statistically significant relationship between the presence of residual epileptiform signs on the ECoG in the cortex adjacent to the removal area and the outcome of surgical treatment for seizures. Patients in follow-up had three times fewer seizures in the absence of residual epileptiform activity on the ECoG of adjacent to the resected areas of the cortex. The dependence is statistically insignificant. Removal of FCD type III and tumors is accompanied by a more complete elimination of epileptiform activity than FCD I, the level of statistical significance of p = 0.0305.

Effect of transfused donor and autoerythrocytes on the oncological outcomes of surgical treatment in patients with renal cell carcinoma with tumor-related venous thrombosis: observational study

Background. The only effective treatment for renal cell carcinoma with tumor inferior vena cava (IVC) thrombosis is surgery. Nephrectomy with thrombectomy (NETE) is usually associated with clinically significant blood loss. The role of blood-sparing methods using autoerythrocyte reinfusion device (ARD) or replacement of blood loss with donor erythrocytes (DE) on the outcomes of NETE has not been well studied.&#x0D; Aim. To study the rate of hemostasis disorders with intraoperative ARD use, as well as the effect of ARD and DE transfusions on specific (SS), relapse-free (RFS), and progression-free (PFS) survival of patients with renal cell carcinoma (RCC) after NETE.&#x0D; Materials and methods. The observational study included medical data of 507 patients with RCC and tumor IVC thrombosis operated after NETE. The median volume of blood loss was 4000 [20006500] mL. In 312 (61.5%) patients, ARD without a leukocyte filter was used to compensate for blood loss (median volume of reinfused autoerythrocytes AE was 1140 [700; 1900] mL). Transfusion of DE was required in 387 (76.3%) cases; the median number of DE transfused doses was 3 [1; 5]; 475 (93.7%) patients were discharged from the hospital. The median follow-up of all surviving patients was 24 (1189) months.&#x0D; Results. Indications for blood transfusions (DE and AE) were directly correlated to the pN (r=0.101; p=0.024) and pT (r=0.091; p=0.040) categories, respectively. The use of AE had no significant effect on the rate of hemostasis disorders and coagulopathic complications compared to other methods of blood loss replacement: 6.8% (21/311) vs 4.7% (9/193), p=0.227; 5.1% (16/311) vs 4.1% (8/193), p=0.394, respectively. ARD had no effect on SS, RFS (after radical surgery), and PFS (after cytoreductive surgery) after NETE. There was a reduction of SS in patients who received DE transfusions compared with those who did not (hazard ratio 0.4; 95% confidence interval 0.10.9; p=0.048). The effects of DE transfusions on RFS and PFS were not identified.&#x0D; Conclusion. Intraoperative ARD use is an effective and safe method of correcting anemia, which does not increase the risk of coagulopathic complications or decrease survival rates. The non-use of the leukocyte filter during AE preparation does not worsen the medium-term oncological results of RCC surgical treatment with tumor IVC thrombosis. The effect of DE transfusion on the survival of RCC patients after NETE requires further research.

Clinical and radiological outcomes of surgically treated osteochondral lesions of the talus in children and adolescents.

Osteochondral lesions of the talus are uncommon in children and adolescents. Surgical procedures differ from those used for adults to avoid iatrogenic physeal injuries. This study aimed to evaluate the clinical and radiological outcomes of surgical treatment in pediatric patients with osteochondral lesions, specifically investigating the patient age and the status of distal tibial physis as factors associated with surgical success. We retrospectively reviewed 28 patients who had symptomatic osteochondral lesions of the talus that were treated surgically between 2003 and 2016. If the lesion was stable and articular cartilage was intact, retrograde drilling was performed under fluoroscopic guidance. Lesions with detached overlying cartilages were treated by debridement of the cartilage combined with microfracture and drilling. Radiographic outcomes, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and skeletal maturity were evaluated. Radiological improvement was observed in 24 (24/28, 86%) patients and complete and incomplete healing in 8 and 16 patients, respectively. Changes in pain grades, American Orthopaedic Foot & Ankle Society scores, and radiological healing after surgery were significant (pain grade, p < 0.001; American Orthopaedic Foot & Ankle Society, p = 0.018; radiological healing, p < 0.001). In addition, patients in the younger age group (≤13 years) showed greater improvements in pain grades than older patients (p = 0.02). Improvement in pain grade after surgery was better in the skeletally immature group than in the skeletally mature group (p = 0.048). Clinical and radiological improvements were observed after surgical treatment. The younger age group and open physis group showed more pain improvement. Therapeutic level IV.

Juvenile Osteochondral Lesions of the Talus: Current Concepts Review and an Update on the Literature.

Osteochondral lesions of the talus (OLTs) are lesions that occur before the physis closes and are frequently associated with acute ankle trauma. These lesions are often difficult to diagnose due to swelling and inflammation that are present after the initial injury. A growing body of literature has assessed the effects of OLTs in the adult population. However, the literature examining these lesions in the juvenile population is sparse. The purpose of this review is to provide a thorough understanding of OLTs, with a specific focus on the juvenile population. We evaluate the recent literature regarding the outcomes of various surgical treatment; modalities in the pediatric patient. While the outcomes after surgical treatment of pediatric OLTs are generally favorable, the paucity of investigation in this demographic is alarming. Further research is needed to better inform practitioners and families regarding these outcomes, as treatment plans are highly dependent on the individual patient in question.

Features of the endothelial status in patients with gastric cancer and its impact on surgical treatment outcomes

BACKGROUND: The incidence of gastric cancer is still high and holds the leading place in the structure of oncological pathology in the world. Prognostic aspects in the treatment of generalized forms of gastric cancer are currently under revision.&#x0D; AIM: To study functional status of vascular endothelium in patients with gastric cancer in perioperative period and evaluate its influence on the outcomes of surgical treatment.&#x0D; MATERIALS AND METHODS: A prospective, randomized study was conducted from 2009 to 2019. Two populations were studied: healthy individuals (control group, n=40); patients diagnosed with gastric cancer (general group, n=122). Patients with gastric cancer underwent gastrectomy with lymphodissection.&#x0D; The functional state of the vascular endothelium was studied: the volume of circulating endotheliocytes (CCE); the level of von Willebrand factor (VF) and the degree of endothelium-dependent vasodilation (EDV). To study their prognostic significance we calculated a conventional cut-off point.&#x0D; RESULTS: The general group patients were divided into 2 subgroups: the main group the laparoscopic access (n=54) and the comparison group the laparotomy access (n=68).&#x0D; Endothelial dysfunction (EDF) correction with Glutargin 1.0 g per day in combination with Enalapril 2.5 mg per day was additionally used in the main subgroup.&#x0D; In the main group, the values of CCE and VF were lower (8.33.0 and 84.621.3, respectively) and the values of EDV were higher (13.73.9) in contrast to the comparison group (p 0.0001).&#x0D; Use of the EDF correction method in the main group resulted in a 4.4-fold and 5.1-fold decrease in CCE and VF concentrations, respectively, and a 4.3-fold normalization of EDV (p 0.0001). Increase of CCE concentration more than 7.0 per 103 platelets; PV more than 120 g/ml, as well as decrease of EDV below 14% in the study stages increased the risk of postoperative complications by 2.9; 1.7 and 1.8 times, respectively (p 0.0001).&#x0D; The incidence of surgical complications was 19.7% and non-surgical complications 31.1%. Hospital mortality was 3.3% and out-of-hospital mortality with up to three years follow-up was 13.1%.&#x0D; The number of purulent-septic complications in the main group was 2.9 times lower, and the rate of thrombotic complications was 4 times lower than in the comparison group (p 0.05).&#x0D; CONCLUSION: Combined use of laparoscopic technique by EDF medication correction reduces manifestations of stress reaction and decreases the potential risk of complications development in the postoperative period. Elevation of CCE, as well as EDV decrease beyond the relevant excision points in patients with gastric cancer in the perioperative period are prognostic predictors of the risk of purulent-septic and thrombotic complications development.

The Anterior Cruciate Ligament Injury Severity Scale (ACLISS): A descriptive tool to assess structural tissue damage profiles in primary ACL-reconstructed patients

The diagnosis of periprosthetic joint infection (PJI) can be made when 1 major criterion or 3 of 5 minor criteria are present. However, the outcomes of patients with a major vs minor criteria for diagnosis have not been studied. The objective of this study was to evaluate if a difference in outcome of surgical intervention existed between patients with PJI who were diagnosed with a major criterion or a combination of minor criteria.A retrospective chart review identified 277 primary total hip or knee arthroplasty patients who had developed PJI based on the International Consensus Meeting definition. Patients were further stratified into “major” vs “minor” groups. Patient demographics, PJI workup, surgical treatment, microbiological growth, and clinical outcomes were recorded. Treatment success was defined by using the Delphi criteria. Standard statistical analysis was performed.Overall, 34 patients met minor-only criteria (12.2%), whereas 243 met major criteria. Of the minor-only patients, 16 (47%) were culture negative. When controlling for confounding variables, there was no statistically significant difference with regard to treatment success (minor 94.1% vs major 82.3%, P = .085) between groups at final follow-up (mean 110 months, range 2.3-567 months). Only higher Charlson comorbidity index (P = .001) and an initial 2-stage surgical procedure (P = .003) were associated with decreased treatment success.PJI patients were similar between both criteria groups, and there was no difference in treatment success as defined by the Delphi criteria between minor-only PJI and major criteria PJI patients.

Outcomes of surgical treatment with patterns of bacterial culture and antimicrobial susceptibility testing in cases of cervical abscessation in dogs: 82 cases (2018–2021)

Objective: The objective of this study was to summarize the presentation, diagnosis, and outcome for dogs surgically treated for chronic cervical abscessation following suspected or reported cervical or oropharyngeal trauma, as well as to report on culture results and antimicrobial susceptibility patterns.Results: Eighty-two dogs were identified by retrospective review. Successful surgical outcome was achieved in 92.7% of dogs. Abscess recurrence was confirmed or suspected in 6/82 (7.3%) cases, and surgical intervention for abscess recurrence was performed in 4/82 (4.9%) cases. Foreign material was identified at surgery in 5/82 (6%) cases. Incisional healing complications were noted in 9/82 (10.9%) cases and required additional surgery in 5/82 (6%) cases. Twenty-three (28%) dogs had negative culture results. The results of antimicrobial sensitivity testing led to a change in antimicrobial treatment in only 9% of cases.Surgically treated cervical abscessation carries a good prognosis with a low incidence of recurrence in this cohort (in contrast to previous reports), despite low frequency of foreign body removal or identification of the underlying cause of the abscess. Excision of chronic inflammatory tissue may not be necessary for a successful outcome, contrary to previous recommendations. Multi-pathogen infections and anaerobic infections are commonly encountered.

Assessment of quality of life in patients with surgically treated maxillofacial fractures

Background: The complex nature of maxillofacial injuries can affect the surgical treatment outcomes and general well-being of the patient. To evaluate the efficiency of the surgical treatment, assessment of the quality of life (QOL) of the patients is of vital importance. Due to the absence of an exclusive QOL assessment tool for maxillofacial fractures, we introduce the ‘Twenty-point quality of life assessment in facial trauma patients in Indian population'. The aim of this study was to assess and evaluate the QOL following surgical management of maxillofacial trauma patients based on the severity of the injury. Methods: The study consisted of 182 subjects divided into two groups of 91 each (Group A: severe facial injury and Group B: mild to moderate facial injury). The Facial Injury Severity Scale (FISS) was used to determine the severity of facial fractures and injuries. The twenty–point quality of life assessment tool includes Zone 1 (Psychosocial impact) and Zone 2 (Functional and aesthetic impact), with ten domains each to assess QOL. Results: In Zone 1, the mean scores for Group A and Group B were 38.6 and 39.26, respectively. In Zone 2, Group B (44.56) had higher mean scores compared to Group A (32.92) (p&lt; 0.001). Group B (83.8) had higher mean scores compared to Group A (71.58) when the total of both Zone 1 and Zone 2 were taken into consideration (p&lt;0,001). In Group A, 9 out of 91 patients had a total score of 81- 100 compared to 68 in the same range in Group B. Conclusions: Proper surgical management with adequate care to the hard and soft tissues can improve the QOL by reducing postoperative psychosocial and functional complications. Aesthetic outcomes play an important role in determining the QOL. Mild/ Moderate injuries show better QOL compared to severe maxillofacial injuries.

Characteristics and Outcomes of Surgical Treatment for Bronchial Anomalies.

Bronchial anomalies are rare but challenging conditions to treat in children, encompassing a variety of structural abnormalities that could compromise airway patency. This includes complete rings, absent cartilage, traumatic avulsions, bronchoesophageal fistulas, and cartilaginous sleeves. The objective of this study is to describe the characteristics and outcomes of a series of pediatric cases of bronchial anomalies that were treated by slide tracheobronchoplasty. This is a single-institution retrospective case series of pediatric patients with bronchial anomalies who underwent surgical treatment between February 2004 and April 2020. Data extracted from electronic medical records included patient demographics, comorbidities, and surgical outcomes. There were a total of 29 patients included in the study, of which 14 had complete bronchial rings, 8 had absent bronchial rings, 4 had traumatic bronchial avulsions, 2 had bronchoesophageal fistulas, and one had a cartilaginous sleeve. Median follow-up time was 13 months (with a range of 0.5-213 months). The overall mortality rate was 17.2% (5 patients), all of whom had complete bronchial rings. Patients with complete bronchial rings also had a higher rate of not only cardiac (85.7%) and pulmonary comorbidities (85.7%) but also secondary airway lesions (78.6%). This is the largest series to date describing surgical treatment for bronchial anomalies. Complete bronchial rings were the most common anomaly treated, followed by absent rings and trauma. Surgical treatment can be successful but mortality rates are higher in patients with complete bronchial rings, possibly due to higher rates of pulmonary and cardiac comorbidities. 4 Laryngoscope, 133:3334-3340, 2023.

Significance of coping strategies on the outcome of surgical treatment of patients with prosoplegia

Aim: to evaluate the impact of coping strategies on the outcomes of surgical treatment of patients with prosoplegia. Material and methods: the analysis of the results of surgical treatment of 50 patients with prosoplegia that developed after removal of tumors of the posterior part of the skull, the lateral part of the skull base, and the parotid-masticatory region involved in reconstructive interventions on the facial nerve was performed. At the preoperative stage a clinical examination of patients was performed according to the House-Brackmann scale, Sunnybrook Facial Grading System (SFGS) scale, and a neurophysiological study was performed. A survey was carried out with the use of the Heim’s questionnaire, WCQ (version by Lazarus), CSI as an indicator of coping strategies before surgery and the Aaron Antonovsky’s Sense of Coherence Scale (SOC). Outcomes were evaluated according to the Johnny Chuieng–Yi Lu subjective scale “Satisfaction with surgical treatment”. Results: all patients from 6 to 10 months after surgery showed signs of muscle recovery, which in the majority (88%, n=44) was accompanied by an improvement in their condition. In 12% of cases (n=6) there were no positive dynamics, which caused unsatisfactory results of treatment. Such painful conditions are often interrupted or recommendations for self-rehabilitation are not followed. The above-described predominance of maladaptive coping strategies in patients with unsatisfactory initial operations is reliable. Adaptive treatment strategies were better developed in patients with favorable treatment outcomes. A high direct correlation was established between the outcomes of treatment, assessed by the Johnny Chuieng–Yi Lu scales, SGFS and SOC coherence scale, Conclusion: Systemic complex rehabilitation and self-rehabilitation have a significant impact on treatment outcomes. Prosoplegia leads to a violation of facial and emotional expression, causing social maladjustment and depressive disorders, minimizing the effects of reinnervation in combination with negative coping strategies. As a result, full-fledged surgical treatment of the facial muscles is currently a very difficult and sometimes insurmountable task.