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Modified Lateral Crural Tensioning: Improving the Tip Without Articulated Alar Rim Grafts
Guilherme Constante Preis Sella,
Bárbara das Neves Linhares,
Mario Bazanelli Junqueira Ferraz
Issue:
Volume 9, Issue 5, October 2021
Pages:
220-225
Received:
13 August 2021
Accepted:
27 August 2021
Published:
4 September 2021
Abstract: Objective: Lateral Crural Tensioning (LCT) is an important technique to refine the tip. However, a frequent problem that can occur is the weakening of the External Nasal Valve (ENV) and the constant use of Articulated Alar Rim Graft (AARG). The aim of this study is to show the results of the same surgeon (MBJZ) within one year of the Modified LCT, and review of the literature. Methods: We analyzes technical details of 149 patients that underwent rhinoplasty in one year (between July 1, 2018 and June 30, 2019) and had at least 1 year of follow-up. Results: Out of 144 patients, 25 (17.36%) were revision surgery. In 114 cases (79.17%) only the septum was used; and Septal Extension Graft (SEG) was performed in 142 of the 144 patients (98.61%). Of these, 130 (91.55%) were latero-lateral and 12 (8.45%) end-to-end. And we found that the modified LCT was used in 136 (94.44%) of the 144 patients; in these, 73 (53.68%) it was necessary to use Floating Alar Rim Graft (FARG) and 5 (3.68%) AARG. Conclusion: we demonstrate a technique that reduce the need for resection of inferior cartilages, the use of grafts and the improvement of nasal function, with strengthening of the ENV without the need to reconstruct the alar border using contour grafts.
Abstract: Objective: Lateral Crural Tensioning (LCT) is an important technique to refine the tip. However, a frequent problem that can occur is the weakening of the External Nasal Valve (ENV) and the constant use of Articulated Alar Rim Graft (AARG). The aim of this study is to show the results of the same surgeon (MBJZ) within one year of the Modified LCT, ...
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Post-cesarean Surgical Complications: A Report of 149 Cases from the Department of General Surgery at Ignace Deen National Hospital of Conakry (Guinea)
Soumaoro Labile Togba,
Fofana Naby,
Kondano Saa Yawo,
Fofana Houssein,
Thea Kokolypé,
Toure Aboubacar,
Diallo Aissatou Taran
Issue:
Volume 9, Issue 5, October 2021
Pages:
226-229
Received:
12 August 2021
Accepted:
3 September 2021
Published:
15 September 2021
Abstract: Introduction: Cesarean section is one of the most commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. The aim of this work was to analyze the post-cesarean surgical complications collected in our department. Methods: This was a retrospective study covering a period of five years (January 2016 to December 2020) on a consecutive series of individual records of patients referred and managed for a post-Cesarean surgical complications in the general surgery department of the Ignace Deen National Hospital of Conakry. Cases of complications occurring within 30 days after cesarean section were included in this study. Results: We collected 149 cases of early surgical complications after cesarean section. The mean age of the patients was 29.25±03 years. The majority of the patients were women from poor social backgrounds (74,50%). Peritonitis (51.01%), intestinal obstruction (19.46%) and surgical site infection (16.78%) were the most noted complications. In the management of these complications, relaparotomy was necessary in 79.19% of cases. The overall mortality rate was 14.09%. Conclusion: The reinforcement of prenatal consultation, the continuous training of health care personnel, and the improvement of the technical facilities of our hospitals are desired to reduce these complications.
Abstract: Introduction: Cesarean section is one of the most commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. The aim of this work was to analyze the post-cesarean surgical complications collected in our department. Methods: This was a retrospective study covering a period of five years (January 20...
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A Date Palm Stone Ileal Perforation Discovered During Treatment of a Strangulated Umbilical Hernia
Fofana Naby,
Kondano Saa Yawo,
Mamy Gnan Francis,
Oulare Ibrahima,
Soumaoro Labile Togba,
Fofana Houssein,
Toure Aboubacar,
Diallo Aissatou Taran
Issue:
Volume 9, Issue 5, October 2021
Pages:
230-232
Received:
13 August 2021
Accepted:
3 September 2021
Published:
15 September 2021
Abstract: Ingestion of foreign bodies is a frequent reason for consultation or admission to the emergency room. It is frequently accidental and involves children whose peak age varies between 9 months and three years. Reported cases of intestinal perforation by stone are rare. Herein we report one case of ileal perforation with a date palm stone discovered during the treatment of an emergency strangulated umbilical hernia in a 2-year-old patient. Clinically, there was a painful, irreducible, non-expansive umbilical swelling with coughing and vomiting. The other hernial orifices were free. Temperature was 36°C, respiratory rate 98 movements per minute, pulse rate 23 beats per minute. Biologically, hemoglobin was 11.4 G/dl, white blood cells were 9 giga/l. The diagnosis of strangulated umbilical hernia was retained. Intraoperatively, we found a small loop incarcerated in the umbilical ring and perforated in two places by a date palm stone. We proceeded with extraction of the stone, resection with both holes, followed by terminal ileo-ileal anastomosis. The postoperative course was simple and no complications were noted after a 2-year follow-up.
Abstract: Ingestion of foreign bodies is a frequent reason for consultation or admission to the emergency room. It is frequently accidental and involves children whose peak age varies between 9 months and three years. Reported cases of intestinal perforation by stone are rare. Herein we report one case of ileal perforation with a date palm stone discovered d...
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The Diagnostic Value of Pathology Examination in Clinically Unsuspected Lipomatous Soft-tissue Tumors
Marije Zwakman,
Judith Eleonora Katharina Regina Hentzen,
Agnes Marije Hoogland,
José van der Starre-Gaal,
Engelbertus Gerardus Johannes Maria Pierik,
Anne Brecht Francken
Issue:
Volume 9, Issue 5, October 2021
Pages:
233-237
Received:
7 September 2021
Accepted:
22 September 2021
Published:
30 September 2021
Abstract: Soft-tissue tumors range from benign to malignant tumors. Although these tumors are frequently unsuspected during surgical excision, additional pathology examination is usually performed in the absence of national guidelines in combination with the fear of missing a malignant tumor. The aim of this study is to investigate if it is safe to refrain from routinely performing pathology examinations of soft-tissue tumors when they are clinically unsuspected to have malignant origins. Data from all routinely performed pathology examinations from patients with one or more clinically unsuspected resected soft-tissue tumors between January 2018 and January 2021 were retrospectively extracted from a merged prospectively maintained institutional database. The primary outcome was the overall rate of premalignant and malignant soft-tissue tumors. Secondary outcomes included specific patient and tumor characteristics in patients with premalignant or malignant soft-tissue tumors and the healthcare costs associated with the performed pathology examinations. In this study, 1,035 resected soft-tissue tumors from 823 patients were analyzed. In total, 1,033 tumors (99.8%) turned out to be benign during the pathology examination, and the remaining two tumors (0.2%) were intermediate soft-tissue tumors without clinical consequences. Both intermediate soft-tissue tumors were larger than 10 cm during clinical examination and were larger than 5 cm during the final pathology examination. The estimated costs spent to perform these pathology examinations were €44,009. Refraining from pathology examination in unsuspected soft-tissue tumors smaller than 5 cm seems to be safe, as no malignant tumor was found in this large cohort of patients. In addition, a cost reduction of €11,000 per year can be achieved by refraining from pathology examinations in this specific group of small non-suspected soft-tissue tumors.
Abstract: Soft-tissue tumors range from benign to malignant tumors. Although these tumors are frequently unsuspected during surgical excision, additional pathology examination is usually performed in the absence of national guidelines in combination with the fear of missing a malignant tumor. The aim of this study is to investigate if it is safe to refrain f...
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Primary Prevention of Heterotopic Ossifications After Total Hip Replacement: Electromyotomy Technique
Jan Debre,
Zdenek Stepan,
Jiri Dupal,
Jan Vanicek,
Jan Potesil
Issue:
Volume 9, Issue 5, October 2021
Pages:
238-245
Received:
1 August 2021
Accepted:
11 August 2021
Published:
19 October 2021
Abstract: We compared the benefit of modification in surgical technique in relation to primary prophylaxis of heterotopic ossifications after total hip replacement with straight stem. This modification contains the so-called electromyotomy technique and was compared versus standard „cold blade“ technique. Two groups were assessed and matched by BMI, sex, age and arthrosis type undergoing hip replacement. Traumatic, dysplastic and rheumatic hips were excluded. A total of 682 patients were evaluated, 262 cemented, 402 uncemented and 18 hybrid types with minimum of 1 year follow-up (average 5.6 years). The standard “sharp blade” technique contained 313 hips, the alternative contained 369 hips. Surgeries were performed according to the same protocols and by one team via anterolateral approach. Patients with risk factors for heterotopical ossifications and administration of secondary prophylaxis modalities were excluded. The development of heterotopic ossification were assessed with blind control of radiologic specialists (Brooker´s grades). Heterotopic ossification (HO) developed in 32.69%, totally in 223 patients. Of those clinically relevant (Brooker III and IV grades) were 8.94%, in 61 patients. In standard group there were 137 HO in 313 hips (43.76%), clinically relevant in 12.78%, 40 patients. In this group there were 123 cemented hips with 53 HO, 174 uncemented with 74 HO and 16 hybrid prostheses with 10 HO. Average age was 68.53 years, 153 males, 160 females. In alternative electromyotomy group there were 369 hips with 86 HO (23.30%), clinically relevant HO cases developed in 5.69%, 21 patients. HO in particular types: 139 cemented hips with 43 HO, uncemented 228 with 42 HO and hybrid 2 with 1 HO. Average age was 70.56y, males 171, females 198. Statistic values of HO occurence between these groups favourising the electromyotomy group were significant, such as comparing the particular Brooker grades distribution and prosthesis type (cemented, uncemented). Significant decrease was observed mainly in uncemented joint replacements and in clinically relevant grades in electromyotomy group. A novel perspective on primary prophylaxis of heterotopic hip ossification after straight femoral stem total hip replacement with engagement of modification in surgical technique so called electromyotomy is presented. Statistical analysis of results in ossification development significantly favorising modified technique in all types of prosthesis fixation, notably in uncemented prosthesis types. The main drop in counts of clinicaly relevant grades of osifications is also statistically relevant. According to these findings this surgical step is routinely implemented in our technique of straight stem implantations nowadays.
Abstract: We compared the benefit of modification in surgical technique in relation to primary prophylaxis of heterotopic ossifications after total hip replacement with straight stem. This modification contains the so-called electromyotomy technique and was compared versus standard „cold blade“ technique. Two groups were assessed and matched by BMI, sex, age...
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Malignant Peritoneal Mesothelioma with Rhabdoid Features Masquerading as Idiopathic Necrotizing Pancreatitis with Mucinous Ascites: A Case Report and Literature Review
Dorcie Gillette,
Jennifer Perone,
Anna Rotkiewicz,
Rawan Dayah,
Jing He,
Douglas Tyler,
John Patrick Walker
Issue:
Volume 9, Issue 5, October 2021
Pages:
246-251
Received:
23 August 2021
Accepted:
22 September 2021
Published:
30 October 2021
Abstract: Background: Malignant peritoneal mesothelioma (PeM) is a rare form of malignant mesothelioma that accounts for 10-15% of all cases of mesothelioma. Of these rare tumors, the rhabdoid subtype is exceptionally infrequent with only three cases reported in the current literature. PeM most commonly presents with non-specific symptoms such as abdominal distention, anorexia and weight loss that are difficult to diagnose until the disease is advanced. In this case report, we present a case of malignant peritoneal rhabdoid mesothelioma and review the literature. Case presentation: The patient is a 76-year-old woman who originally presented with necrotizing pancreatitis one year prior to diagnosis. The patient continued to complain of abdominal pain, nausea, vomiting, and weight loss. She experienced recurrent deep vein thrombosis (DVT), recurrent chylous, and mucinous ascites. Diagnostic work-up including MRI, repeat CT, EUS, and MRCP were inconclusive. Additionally, cytology from multiple paracenteses were negative for malignancy. Diagnostic laparoscopy revealed diffuse carcinomatosis, abdominal wall and peritoneal implants and a large epigastric mass. Biopsies of lesions taken during the procedure were identified as peritoneal mesothelioma. Conclusions: To our knowledge, we have presented the first case of PeM with rhabdoid features present in the peritoneum and in gastric polyps. The large amount of histopathogical variation of these tumors requires surgical biopsy, as cytology alone is non-diagnostic.
Abstract: Background: Malignant peritoneal mesothelioma (PeM) is a rare form of malignant mesothelioma that accounts for 10-15% of all cases of mesothelioma. Of these rare tumors, the rhabdoid subtype is exceptionally infrequent with only three cases reported in the current literature. PeM most commonly presents with non-specific symptoms such as abdominal d...
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