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Introducción: El quiste pilonidal puede ser abordado según técnicas quirúrgicas abiertas y cerradas, con distintos resultados estéticos. La cicatriz es un factor importante y representa un indicador de satisfacción. Una herramienta para valorar cicatrices es el cuestionario POSAS 2.0, adaptado transculturalmente para Chile. Objetivo: Conocer la valoración subjetiva de los pacientes operados de quiste pilonidal respecto a su cicatriz, según la técnica quirúrgica. Material y Método: Estudio es de carácter retrospectivo, observacional, transversal, analítico y de cohorte. Se aplica la escala de evaluación por el paciente del cuestionario POSAS 2.0, con una calificación desde 1 a 10, con puntaje total entre 7 y 70. Se recolectaron variables clínico-demográficas. Se aplicó estadística analítica, se compararon los resultados obtenidos entre técnicas abiertas y cerradas. Resultados. Se encuestaron 101 pacientes operados de quiste pilonidal entre 2013 y 2019, de los cuales 59 (59,4%) fueron de sexo masculino. La edad promedio fue de 23 años (DS 7,2). Del total, 22 (21,8%) de los pacientes fueron manejados con técnicas cerradas y 79 con técnicas abiertas (78,2%). El promedio del puntaje total de la escala fue 20 (DS 11,4), 22 en técnicas cerradas y 19,6 en técnicas abiertas. No se encontraron diferencias estadísticamente significativas. Conclusión: La cicatriz postoperatoria es valorada positivamente, con un puntaje que denota características similares a la piel normal. No existen diferencias significativas de la percepción de los pacientes respecto a su cicatriz. Esta es la primera comunicación chilena que evalúa la valoración subjetiva de pacientes sobre la cicatriz postoperatoria de quiste pilonidal.
Introduction: The pilonidal cyst can be approached according to open and closed surgical techniques, with different aesthetic results. The scar is an important factor and represents an indicator of satisfaction. A tool to assess scars is the POSAS 2.0 questionnaire, adapted cross-culturally for Chile. Objective: To know the subjective assessment of patients operated on for pilonidal cyst with respect to their scar, according to the surgical technique. Material and Method: This is a retrospective, observational, cross-sectional, analytical, and cohort study. The patient evaluation scale of the POSAS 2.0 questionnaire is applied, with a score from 1 to 10, with a total score between 7 and 70. Clinical-demographic variables were collected. Analytical statistics were applied, the results obtained between open and closed techniques were compared. Results: We surveyed 101 patients operated on for pilonidal cyst between 2013 and 2019, of which 59 (59.4%) were male. The mean age was 23 years (SD 7.2). Of the total, 22 (21.8%) of the patients were managed with closed techniques and 79 with open techniques (78.2%). The mean total score of the scale was 20 (SD 11.4), 22 in closed techniques and 19.6 in open techniques. No statistically significant differences were found. Conclusion: The postoperative scar is positively valued, with a score that denotes similar characteristics to the normal skin. There are no significant differences in patient's perception of their scar. This is the first chilean communication that evaluates the subjective assessment of patients on the postoperative scar of pilonidal cyst.
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Impacted teeth are a frequent phenomenon encountered by every clinician. The artificial eruption of embedded teeth is the process of directing an impacted tooth into normal occlusion. This procedure is currently attracting attention, with the aim of finding the best technique to use according to each case. This article presents key information regarding impacted incisors, canines, and premolars. In addition, we describe the most common techniques to use for artificial eruption, the open and closed techniques. We review the literature concerning these techniques and outline how clinicians can manage every type of impacted tooth.
Subject(s)
Bicuspid , Incisor , Surgery, Oral , Tooth , Tooth, ImpactedABSTRACT
Objective: To analyze the restoration of intervertebral height and lordosis of fusion segment after open-transforaminal lumbar interbody fusion (Open-TLIF) and minimally invasive-TLIF (MIS-TLIF). Methods: Between January 2013 and February 2016, patients who treated with TLIF due to lumbar degenerative diseases and met the selection criteria were selected as the study objects. Among them, 41 patients were treated with open-TLIF (Open-TLIF group), 34 patients were treated with MIS-TLIF (MIS-TLIF group). There was no significant difference between the two groups ( P>0.05) in gender, age, body mass index, disease type, disease duration, pathological segment, and other general data. The intraoperative bleeding volume, hospital stay, visual analogue scale (VAS) score of waist and leg, and Oswestry disability index (ODI) were recorded before and after operation. The anterior disc height (ADH), posterior disc height (ADH), and segmental lordosis (SL) of fusion segment were measured by X-ray film before and at 6 months after operation. The differences of ADH, PDH, and SL between pre- and post-operation were calculated. Results: The intraoperative bleeding volume and hospital stay in Open-TLIF group were significantly higher than those in MIS-TLIF group ( t=14.619, P=0.000; t=10.021, P=0.000). All incisions healed by first intention without early complications. All patients were followed up 6-24 months (mean, 12.6 months) in Open-TLIF group and 6-24 months (mean, 11.5 months) in MIS-TLIF group. The preoperative VAS scores of waist and leg and ODI of the two groups significantly improved ( P0.05). Imaging examination showed the good intervertebral fusion. There was no significant difference in ADH, PDH, and SL between the two groups before operation and at 6 months after operation ( P>0.05). The differences of ADH, PDH, and SL between the two groups were not significant ( P>0.05). The ADH, PDH, and SL after operation significantly increased in the two groups ( P<0.05). Conclusion: Open-TLIF and MIS-TLIF show similar effectiveness and radiological change in the treatment of single lumbar degenerative diseases and the improved intervertebral height and lordosis, but MIS-TLIF can significantly reduce hospital stay and intraoperative blood loss.
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Background: The link between varicocele and infertility was first reported by cessius in 1st century AD but it was not widely acknowledged until TULLOCH and colleagues reported the improvement of sperm parameters in 26 of 30 patients undergoing varicocelectomy. Varicocele is defined as excessive dilatation of pampiniform venous plexus of spermatic cord. varicocele is an important cause infertility which can be corrected by surgery. Several methods have been used for its treatment including open surgical ligation of spermatic veins as well as laparoscopic varicocelectomy. Open varicocelectomy has more risk of recurrence and complications whereas laparoscopic varicocelectomy is simple, has less risk of recurrence and complication in expert hands. Objectives: To compare Laparoscopic varicocelectomy with open varicocelectomy, in terms of postoperative pain, recurrence rate, hospital stay, cost, cosmetic and complication. To prove hospital stay was more in open group than laparoscopic group and also patient of laparoscopic group return to normal activities earlier than open group. To standardize the laparoscopic varicocelectomy procedure for varicocele. Materials and methods: It was a randomized clinical trial done in Department of General Surgery, Vinayaka Mission Medical College, Karaikal. Study was carried out from 1 st March, 2015 to 1st R. Bharathidasan, Reny Jayaprakash, Subith P. Bhaskar, G. Ambujam. Laparoscopic varicocelectomy now the gold standard procedure for varicocele - A comparative study with open technique based on our experience. IAIM, 2017; 4(7): 218-221. Page 219 March, 2016. A total 70 patients was taken in our study of its 36 patient undergone open varicocelectomy and 34 patient undergone laparoscopic varicocelectomy. Results: Recurrence rate 0% in Laparoscopic Varicocelectomy and 5.6% in open varicocelectomy. Wound complication was 0% in Laparoscopic varicocelectomy and 2.5% in open varicocelectomy. Post-operative pain was more in open group as compared to laparoscopic varicocelectomy. Laparoscopic varicocelectomy has less post-operative morbidity and early return to normal activity. Also there was improvement in seminal analysis in both groups. Conclusion: We would like to standardize laparoscopic varicocoelectomy and make it as a gold standard for Varicocele by replacing open technique provided there is good experienced surgical team and good instrumentation. Cost of the procedure is comparatively high.
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Introducción: La traqueotomía se puede realizar por vía percutánea y por vía abierta. Objetivo: Analizar la experiencia clínica con traqueotomías abiertas en el Hospital Clínico Regional de Concepción (HCRC). Material y método: Estudio descriptivo-retrospectivo de fichas clínicas y protocolos quirúrgicos de las traqueotomías abiertas realizadas en el HCRC durante los años 2002 al 2006. Resultados: Se realizaron 342 traqueotomías. La edad promedio fue 48,9 años. El 84,3 por ciento se realizaron en el pabellón quirúrgico y el resto en UCI. El 16,33 por ciento fue realizado por residentes del Servicio de Otorrinolaringología (ORL), el 16,9 por ciento por ORL staff y el 66,66 por ciento por una residente y un staff. Las complicaciones alcanzaron el 18,9 por ciento. Perioperatorias en 3,2 por ciento y posoperatorias en 16 por ciento. No se encontró diferencia en la tasa de complicaciones al analizar según cirujano y lugar de la cirugía. Conclusiones: La tasa de complicaciones concuerda con las presentadas en la literatura. La traqueotomía abierta es una cirugía segura que puede ser realizada por residentes ORL en formación.
Introduction: The tracheotomy can be performed percutaneously and by open approach. Aim: To analyze clinical experience with open tracheotomy at the Hospital Regional de Concepción (HCRC). Material and method: Descriptive - retrospective study of medical records and surgical protocols for open tracheotomy performed in the HCRC during the years 2002 to 2006. Results: We performed 342 tracheotomy. The average age was 48.9 years. The 84.3 percent were performed in the operating room and the rest in the ICU. The 16.3 percent was held by residents of the service of otolaryngology (ORL), 16.9 percent for the ORL staff and 66.6 percent for a resident and a staff. The complications reached 18.9 percent. Perioperative 3.2 percent and postoperative 16 percent. There was no difference in complication rate was analyzed according to surgeon and surgical site. Conclusions: The complication rate is consistent with those reported in the literature. Open the tracheotomy is a safe surgery can be performed by ENT residents in training.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Tracheotomy/statistics & numerical data , Tracheotomy/methods , Postoperative Complications/epidemiology , Chi-Square Distribution , Retrospective StudiesABSTRACT
PURPOSE: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. MATERIALS AND METHODS: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. RESULTS: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. CONCLUSION: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.