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Childhood Intestine Rotation Anomalies in Aba, Nigeria
Samuel Chidi Ekpemo,
Lisa Eweputanna,
Emeka Nkwo
Issue:
Volume 7, Issue 1, June 2019
Pages:
1-4
Received:
23 November 2018
Accepted:
21 January 2019
Published:
7 February 2019
Abstract: Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.
Abstract: Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotat...
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Clinical Application Analysis of Tunneled-PICC
Yu-Xia Yin,
Lu-Ning Wang,
Ming-Kun Cao,
Hai-Jun Zhang
Issue:
Volume 7, Issue 1, June 2019
Pages:
5-8
Received:
16 December 2018
Accepted:
3 January 2019
Published:
7 February 2019
Abstract: Peripherally inserted central catheters (PICCs) play a critical role in the infusion of parenteral nutrition, chemotherapy and intravenous fluids for the increased safety and efficacy for long-term use. However, during the insertion and management of PICCs, there are still some PICC-related complications need to be reduced as much as possible for both operators and researchers. In this case, the tunneled-PICC provides a new “a nedesl subcutaneous route” technology for PICC application. This article reviews the principle and characteristics of tunneled-PICC. Tunneled PICCs, seems to be a safe option and easy to perform as an alternative to standard placement for its advantages of the better exit location, reduced incidences of thrombosis and infection, reduced the shift rate as well as extended retention time. However, more research on the standard tunneling technique and large-scale clinical applications need to be proposed.
Abstract: Peripherally inserted central catheters (PICCs) play a critical role in the infusion of parenteral nutrition, chemotherapy and intravenous fluids for the increased safety and efficacy for long-term use. However, during the insertion and management of PICCs, there are still some PICC-related complications need to be reduced as much as possible for b...
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Surgical Treatment of Dysembryoplastic Neuroepithelial Tumor
Guo Rongzeng,
Yang Zhongxu,
Cui Lihua,
You Zehong,
Du Ligong,
Wang Yan,
Tang Zhensheng
Issue:
Volume 7, Issue 1, June 2019
Pages:
9-14
Received:
16 December 2018
Accepted:
3 January 2019
Published:
15 February 2019
Abstract: Objective Investigating the surgical treatment for dysembryoplastic neuroepithelial tumor. Methods A total of 12 cases (7 males, 5 females, aged 4~36 years) of dysembryoplastic neuroepithelial tumors from 2010 to 2014 in Shanghai Blue Cross Brain Hospital were analyzed retrospectively, including 9 cases of temporal lobe tumor, 2 cases of frontal lobe tumor, and 1 case of parietal lobe tumor. The tumors and epileptogenic foci outside the lesions were resected under the guidance of electrocorticogram in all patients. Results The pathological examination showed that all the tumors were dysembryoplastic neuroepithelial tumors. All the patients had been followed up for 2 to 4 years. Epilepsy occurred in 2 patients and the others were seizure free after the surgery. No tumor recurrence occurred during the follow-up. Conclusion Dysembryoplastic neuroepithelial tumor is a benign tumor often causes intractable epilepsy, which can be controlled by the extended excision of the tumors and epileptogenic cortex under the guidance of electrocorticogram.
Abstract: Objective Investigating the surgical treatment for dysembryoplastic neuroepithelial tumor. Methods A total of 12 cases (7 males, 5 females, aged 4~36 years) of dysembryoplastic neuroepithelial tumors from 2010 to 2014 in Shanghai Blue Cross Brain Hospital were analyzed retrospectively, including 9 cases of temporal lobe tumor, 2 cases of frontal lo...
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Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center
Salah Ahmed Binziad,
Abdulla Saleh Alyamani,
Khalid Ahmed Baeesa,
Waleed Khaled Kaleem,
Adnan Abdullah Bakarman,
Moutez Alyazedi
Issue:
Volume 7, Issue 1, June 2019
Pages:
15-20
Received:
23 December 2018
Accepted:
23 January 2019
Published:
15 February 2019
Abstract: Background: Loco-regional surgery remains the mainstay therapy of extremity soft tissue sarcoma (ESTS) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience, radiotherapy, adjuvant and neoadjuvant chemotherapy increased the survival. Aim of study: to evaluate the effect of the type of surgical intervention on the survival and quality of life of ESTS Patients. Methods: This is a prospective study to evaluate the impact of loco-regional surgical control on the survival among ESTS patients attended the National Cancer Center, Hadhramout -Yemen, between April 2010 and October 2018. Extremity soft tissue sarcoma patients were operated either by wide-local excision with safety margin or amputation or disarticulation. The study population consisted of 52 patients in which males and females represented (53.85%) and (46.15%) respectively. The three variable methods were compared using Chi-square test. Survival rate was analyzed by Kaplan-Meier test. Results: Fifty two patients, 12 patients in Group I (23, 1%), 10 patients in Group II (19.2%) and 30 patient’s in Group III (57.7%). The mean survival in patients underwent disarticulation was (77.5) months, while patients who had an amputation, the survival was (45.5) months, and in wide local resection patients was (59.9) months. The mean overall survival was (65.9) months, P value > (0.026) which was significant. Among the 3 different types of management, high overall survival rate was found in patients underwent disarticulation, while overall survival rate was also high in patient underwent wide local excision or compartmental resection in spite of functional limb preservation and good quality of life. The mean overall survival rate was low in patients who had limb amputation with loss of limb function. Conclusion: The wide local excision or compartmental resection mandates margin-negative, accepted post-operative local wound complication, associated with prolonged disease-free-survival and overall survival than other methods. Must be deal with improve patient overall survival, decrease local recurrence and obtained best Oncological outcome by preserve function with good quality of life for ESTS patients who underwent wide or compartmental resection or radical limb sparing surgery.
Abstract: Background: Loco-regional surgery remains the mainstay therapy of extremity soft tissue sarcoma (ESTS) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience, radiotherapy, adjuvant and neoadjuvant chemotherapy increased the survival. Aim of study: to evaluate the effect of the type of surgical inter...
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Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy
Takehiro Sejima,
Toshihiko Masago,
Tetsuya Yumioka,
Shuichi Morizane,
Masashi Honda,
Atsushi Takenaka
Issue:
Volume 7, Issue 1, June 2019
Pages:
21-28
Received:
8 February 2019
Accepted:
14 March 2019
Published:
8 April 2019
Abstract: Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scans were examined pre- and 6 months postoperatively. Renal global functional deterioration after PN was assessed by postoperative percent of eGFR decline. Pre- and postoperative renal parenchymal volume (RPV) was measured by the Synapse Vincent volumetric analyzer which creates a reconstructed image from a CT scan. Additional factors that were analyzed included patient demographics, comorbidities, surgical factors and tumor pathology. All factors demonstrating statistical tendencies (P < 0.1) in univariate analyses were subjected to multivariate logistic regression analysis. Two groups were categorized according to the degree of eGFR decline. Groups A and B were categorized as less than 15% and greater than 15% declines, respectively. Results: The case distributions of hypertension (HTN) and male gender were significantly shifted in group B. Significant compensatory renal hypertrophy of the contralateral side occurred postoperatively. The percent increment of RPV in the contralateral side in group B was significantly lower than that in group A. In multivariate analysis, HTN was the sole independent associated factor in group B. Conclusions: Host factors, rather than surgical factors, may be associated with postoperative renal global functional deterioration in PN. Surgeons should consider medical problems in addition to surgical skills especially in HTN patients.
Abstract: Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) ...
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