Surgical Techniques Development最新文献_第3页

Anesthetic Management for a Pregnant Patient with Bilateral Vocal Cord Granuloma Using High-Flow Nasal Cannula Oxygenation with Oxygen Reserve Index Monitoring: A Case Report 高流量鼻插管加氧及氧储备指数监测对妊娠双侧声带肉芽肿的麻醉处理1例

Surgical Techniques Development Pub Date : 2023-09-07 DOI: 10.3390/std12030015

Hyo Sung Kim, S. Oh, Jae Eun Lee, Hyun Ah Lee, Jae Gu Cho

{"title":"Anesthetic Management for a Pregnant Patient with Bilateral Vocal Cord Granuloma Using High-Flow Nasal Cannula Oxygenation with Oxygen Reserve Index Monitoring: A Case Report","authors":"Hyo Sung Kim, S. Oh, Jae Eun Lee, Hyun Ah Lee, Jae Gu Cho","doi":"10.3390/std12030015","DOIUrl":"https://doi.org/10.3390/std12030015","url":null,"abstract":"Anesthetic management for pregnant patients suffering from airway pathology poses unique challenges. The presence of a bilateral vocal cord granuloma adds further complexity to anesthetic management as it can potentially cause a compromised airway and respiratory distress. This case presents a pregnant patient with a bilateral vocal cord granuloma who underwent anesthesia using high-flow nasal cannula (HFNC) oxygenation and oxygen reserve index (ORi) monitoring. A 33-year-old pregnant woman, who underwent intubation six months ago, experienced hoarseness and was ultimately diagnosed with a bilateral granuloma. Due to the significant airway obstruction, neither intubation nor ventilation was feasible, thereby requiring a surgical intervention. Before the surgical removal, the patient’s oxygenation was ensured using HFNC oxygenation. After confirming the sufficient oxygenation of the patient with an ORi of 0.38, the operation commenced, and as it lasted approximately 3 min, the patient was able to tolerate the brief period without additional oxygen supply. Post-surgical excision, mask bagging, and HFNC oxygenation was resumed, driving the ORi to 0.39; then, the operation was resumed. Throughout the procedure, the SpO2 remained above 98. The combination of HFNC and ORi ensured adequate oxygenation and allowed for the early detection of hypoxemia during the procedure. This approach may be a good option for managing granulomas.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42797708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Evaluation of the Caudal End Deviation of the Nasal Septum Using the Quantitative Analysis of Computed Tomography 应用计算机断层定量分析鼻中隔尾端偏曲的评价

Surgical Techniques Development Pub Date : 2023-08-24 DOI: 10.3390/std12030014

Tomohisa Hirai, T. Ueda, T. Ishino, S. Takeno

{"title":"An Evaluation of the Caudal End Deviation of the Nasal Septum Using the Quantitative Analysis of Computed Tomography","authors":"Tomohisa Hirai, T. Ueda, T. Ishino, S. Takeno","doi":"10.3390/std12030014","DOIUrl":"https://doi.org/10.3390/std12030014","url":null,"abstract":"Objectives: This study was designed to determine objective surgical indications of correcting caudal end deviation of the nasal septum. Methods: We employed quantitative computed tomographic (CT) analysis and assessed the validity by comparing this with anterior rhinoscopic findings (AR findings). The study population consisted of 300 patients. The archived CT data were transferred to a workstation, and 3D CT volume-rendered images were generated using computer graphics tools. In the plane of the nostril entrance, we calculated ratios of the cross-sectional area of the convex side (narrower side) and the concave side (wider side), which is abbreviated as the N/W ratio. We also examined the presence of laterality between the right and the left cross-sectional area of the nasal valve based on the AR findings. Surgical procedures for whether to expose the caudal end were planned based on the AR findings and the N/W ratio. Results: A significant correlation was found between the AR findings and the N/W ratio. After surgery, the average N/W ratio improved from 0.53 ± 0.15 to 0.81 ± 0.15, and the average values of VAS scaling for nasal obstruction improved from 8.1 ± 0.2 to 1.0 ± 0.1. Conclusions: The quantitative CT analysis proposed in the study is a useful modality to objectively determine the surgical indications of managing the caudal end of the nasal septum.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48330590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Factors for Union Time in Adult Diaphyseal Forearm Fractures 成人桡骨前臂骨折愈合时间的预测因素

Surgical Techniques Development Pub Date : 2023-08-09 DOI: 10.3390/std12030013

S. Factor, Ron Gurel, G. Eisenberg, D. Tordjman, Y. Rosenblatt, T. Pritsch, F. Atlan

{"title":"Predictive Factors for Union Time in Adult Diaphyseal Forearm Fractures","authors":"S. Factor, Ron Gurel, G. Eisenberg, D. Tordjman, Y. Rosenblatt, T. Pritsch, F. Atlan","doi":"10.3390/std12030013","DOIUrl":"https://doi.org/10.3390/std12030013","url":null,"abstract":"Purpose: Although open reduction and internal fixation (ORIF) by plating are the treatment of choice for diaphyseal fractures of the forearm, delayed union and non-union remain as existing complications. This study aimed to analyze predictive factors for the union time in diaphyseal fractures of the forearm. Methods: A retrospective study was conducted on all adult patients with diaphyseal forearm fractures who underwent surgical treatment with plate fixation between 2007 and 2016 at a tertiary care referral center. The patients were divided into two groups based on their union times: ≤3 months or >3 months. They were then compared for demographics, fracture pattern and characteristics, associated injuries, type of fixation, and quality of postoperative reduction. Results: Eighty-six diaphyseal forearm bone fractures (radius, ulna, or both) were observed in 55 adults. Out of these fractures, 55 (65.1%) achieved union within ≤3 months, 26 (30.3%) took more than 3 months to achieve union, and 4 (4.6%) resulted in nonunion. The use of a locking plate in open reduction and internal fixation of diaphyseal forearm fractures significantly increased the likelihood of union within ≤3 months (p = 0.043). The parameter of gap width at the fracture site, as observed on postoperative X-rays, showed a qualitative and quantitative correlation with union time (p = 0.028). Conclusion: The use of a locking plate, combined with reducing the gap width at the fracture site after reduction during open reduction and internal fixation (ORIF) of diaphyseal forearm fractures, is significantly correlated with an increased likelihood of achieving bone union within 3 months.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42848225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Ileojejunal Bypass: The Forgotten Procedure 回空肠旁路手术:被遗忘的手术

Surgical Techniques Development Pub Date : 2023-07-26 DOI: 10.3390/std12030012

Caroline Mercedes Sobotta, E. Tanay, Shadi Sued, Christopher Kieninger, J. Köninger, T. Meile

引用次数: 0

Achalasia Post-Bariatric Surgery, Placement Roux-En-Y Gastric Bypass: Case Report 贲门失弛缓症减肥术后Roux-En-Y胃旁路移植术1例报告

Surgical Techniques Development Pub Date : 2023-07-25 DOI: 10.3390/std12030011

Juan Pablo Landeros-Ruiz, L. M. Zúñiga-Ramos, Daniela Cárdenas-Guerrero, Q. Torres-Salazar

{"title":"Achalasia Post-Bariatric Surgery, Placement Roux-En-Y Gastric Bypass: Case Report","authors":"Juan Pablo Landeros-Ruiz, L. M. Zúñiga-Ramos, Daniela Cárdenas-Guerrero, Q. Torres-Salazar","doi":"10.3390/std12030011","DOIUrl":"https://doi.org/10.3390/std12030011","url":null,"abstract":"Introduction: Achalasia is a pathology with an incidence of 1 in 100,000 inhabitants per year. There are very limited data on achalasia in the obese population, especially in those undergoing bariatric surgery. The approach of choice for cases of achalasia is the procedure partial fundoplication to correct the reflux; however, lacking a fundus due to a previous gastrectomy, an alternative that offers optimal results should be chosen. Here, we present the surgical approach in a case of esophageal achalasia and a history of vertical sleeve gastrectomy, where we performed a simultaneous Heller’s cardiomyotomy and laparoscopic Roux-en-Y gastric bypass, as well as the results obtained. Case Presentation: A 44-year-old woman with no chronic degenerative diseases, who had a vertical sleeve gastrectomy carried out 5 years ago. Her first symptoms manifested 17 months before, and they were dysphagia to liquids and then to solids, in addition to weight loss of 10 kg in 4 months. Her body mass index before the vertical sleeve gastrectomy was 32 kg/m2; her body mass index at the time of admission was 20 kg/m2; she also presented regurgitation and generalized weakness. After analyzing the surgical options, it was decided to perform a Heller cardiomyotomy and a Roux-en-Y gastric bypass. Discussion and Conclusions: The procedure turned out to be safe and successful in treating achalasia symptomatology, in addition to completely resolving the reflux symptoms.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43542239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric Supracondylar Fracture of the Humerus with Sideward Displacement 儿童肱骨髁上骨折伴侧移位

Surgical Techniques Development Pub Date : 2023-06-30 DOI: 10.3390/std12030010

M. Zaidman, M. Eidelman, K. Abu-Dalu, P. Kotlarsky

{"title":"Pediatric Supracondylar Fracture of the Humerus with Sideward Displacement","authors":"M. Zaidman, M. Eidelman, K. Abu-Dalu, P. Kotlarsky","doi":"10.3390/std12030010","DOIUrl":"https://doi.org/10.3390/std12030010","url":null,"abstract":"Background: Supracondylar humeral fracture is probably the most common elbow fracture in children requiring surgical intervention. We observed a subtype of pediatric supracondylar humeral fracture with a sideward translation, without substantial displacement in the sagittal plane on initial radiographs. The purpose of this study was to calculate the incidence of this fracture subtype and suggest a modification to the standard operative technique, to achieve the desired fracture alignment and fixation. Methods: We reviewed the clinical records and radiographs of all pediatric patients with supracondylar humeral fractures surgically treated in our institution between the years 2006 and 2014. The fracture types, fixation configuration and any complications were recorded. Results: Overall, 263 consecutive patients were included. The incidence of supracondylar fracture of the humerus with solely sideward displacement was 6%. The fracture was characterized clinically and radiographically. We proposed a modification to the standard operative technique for this fracture subtype for successful closed reduction and percutaneous pinning. Conclusions: Special attention to this fracture subtype, including appropriate operating room setup and the application of a suitable reduction and pinning technique, has the potential to achieve successful results and avoid the need for open reduction.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45018697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally Invasive Peritoneal Dialysis Catheter Insertion with Intraoperative Ultrasound-Doppler Measurement of Rectus Muscle Width and Inferior Epigastric Artery Localization 微创腹膜透析置管术中超声多普勒测量腹直肌宽度及腹壁下动脉定位

Surgical Techniques Development Pub Date : 2023-06-09 DOI: 10.3390/std12020009

J. Janež, J. Grosek

{"title":"Minimally Invasive Peritoneal Dialysis Catheter Insertion with Intraoperative Ultrasound-Doppler Measurement of Rectus Muscle Width and Inferior Epigastric Artery Localization","authors":"J. Janež, J. Grosek","doi":"10.3390/std12020009","DOIUrl":"https://doi.org/10.3390/std12020009","url":null,"abstract":"Laparoscopic peritoneal dialysis catheter insertion is an established method for peritoneal dialysis catheter placement. One critical aspect of this procedure is rectus sheath tunneling. Proper peritoneal dialysis catheter incorporation within the abdominal wall is important for reducing pericatheter leaks and for proper peritoneal dialysis functioning. Particularly, accurate positioning of the internal cuff within the rectus muscle sheath is crucial to prevent potential dialysate fluid leakage. In the present report, we describe the utilization of intraoperative ultrasound as a valuable tool for determining the ideal location of the internal cuff and assessing the course of the inferior epigastric artery during rectus sheath tunneling. This technique aims to optimize the position of the internal cuff and minimize complications such as vessel injury and pericatheter leaks. Furthermore, we demonstrate that post-catheter insertion, ultrasound imaging offers valuable insights into evaluating the appropriate placement of the internal cuff, external subcutaneous cuff, and potential bleeding within the abdominal wall.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43130274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Old but Gold: The Surgeon’s Affair to Manage Inguinal Hernia 老而精:外科医生处理腹股沟疝的方法

Surgical Techniques Development Pub Date : 2023-05-25 DOI: 10.3390/std12020008

M. Giuffrida, G. Nita, F. Biolchini

{"title":"Old but Gold: The Surgeon’s Affair to Manage Inguinal Hernia","authors":"M. Giuffrida, G. Nita, F. Biolchini","doi":"10.3390/std12020008","DOIUrl":"https://doi.org/10.3390/std12020008","url":null,"abstract":"Purpose: Inguinal hernia repair is a common surgical procedure. It was widely reported worldwide during the COVID-19 pandemic. To manage the lack of anesthesiologists, we have introduced a new protocol to manage inguinal hernia repair. Methods: This protocol is the result of a strong collaboration between surgeons and anesthesiologists. It was based on EHS recommendations and the well-described percutaneous ilioinguinal–iliohypogastric and genitofemoral nerves block. Results: More than 400 patients have been treated at our institution. The application of the protocol has led to a sensible reduction in initially planned spinal anesthesia. The complications traditionally related to spinal anesthesia have not been reported in 80% of the patients. Only three patients required the infusion of atropine or flumazenil without the need to involve anesthesiologist. Conclusion: The application of our protocol seems promising. Preliminary results have shown the safety and efficacy of percutaneous ilioinguinal–iliohypogastric and genitofemoral nerves block. The combination of this kind of anesthesia with wound protector and adequate postoperative pain control can lead to a reproducible system avoiding the not strictly necessary presence of an anesthesiologist. The changes that have occurred in the healthcare system in recent years should be new opportunities for the improvement of resources and results.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47118905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior Cervical Unilateral Biportal Endoscopic One-Block Resection Technique for Cervical Ossified Ligamentum Flavum 后颈单侧双门静脉内窥镜单块切除技术治疗颈黄韧带骨化

Surgical Techniques Development Pub Date : 2023-05-09 DOI: 10.3390/std12020007

Rajeesh George, P. Wu

引用次数: 0

Analysis of Facial Nerve Functionality and Survival Rates of Patients with Parotid Salivary Gland Carcinoma Submitted to Surgery, Facial Nerve Reconstruction, and Adjuvant Radiotherapy 腮腺唾液腺癌手术、面神经重建及辅助放疗患者面神经功能及生存率分析

Surgical Techniques Development Pub Date : 2023-04-18 DOI: 10.3390/std12020006

W. Bernaola-Paredes, Franco Novelli, Estefani Albuja-Rivadeneira, A. Flosi, Anna Victoria Garbelini Ribeiro, H. Nogueira, H. F. Köhler, C. Pinto, K. A. Vallejo-Rosero, A. Pellizzon

{"title":"Analysis of Facial Nerve Functionality and Survival Rates of Patients with Parotid Salivary Gland Carcinoma Submitted to Surgery, Facial Nerve Reconstruction, and Adjuvant Radiotherapy","authors":"W. Bernaola-Paredes, Franco Novelli, Estefani Albuja-Rivadeneira, A. Flosi, Anna Victoria Garbelini Ribeiro, H. Nogueira, H. F. Köhler, C. Pinto, K. A. Vallejo-Rosero, A. Pellizzon","doi":"10.3390/std12020006","DOIUrl":"https://doi.org/10.3390/std12020006","url":null,"abstract":"Background and Objectives: Parotid cancer (PC), when treated surgically, may have associated damage to the functionality of the facial nerve. The role of radiotherapy in the recovery of facial motricity remains controversial. This study aimed to evaluate the impact of radiotherapy (RT) on facial nerve functionality in patients who underwent parotidectomy and facial nerve microsurgical reconstruction. Materials and Methods: Four groups of patients were composed: (a) those who underwent parotidectomy without facial nerve reconstruction and RT; (b) those with nerve reconstruction and without RT; (c) those without nerve reconstruction and RT; and (d) those with nerve reconstruction and RT. Results: 49 patients were male, and 43 were female. A total of 89 underwent parotidectomy, 45 partials, and 44 total. Thus, in nine patients, the sural nerve was used for microsurgical reconstruction. Moreover, 48 patients had a normal facial pattern, 15 with paresthesia, and 29 with permanent paralyses after the House–Brackmann (HB) scale evaluation. Conclusions: The evaluation of nerve functionality after parotidectomy by the House–Brackmann scale is a feasible way to evaluate facial motricity that has already decreased in these patients. Finally, longitudinal studies must be performed to clarify the role of each therapy in the multimodal approach and their clinical impact in facial nerve function.","PeriodicalId":40379,"journal":{"name":"Surgical Techniques Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69819321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0