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@#AIM: To compare the efficacy and characteristic of human fibrin sealant in the surgery of pterygium. <p>METHODS: A prospective randomized controlled study was conducted. A total of 148 eyes of 148 patients with pterygium were involved in the study from June 2016 to September 2017. All patients were divided into two groups receiving 10-0 vicryl sutures or human fibrin sealant respectively. Patients were seen on postoperative 1, 3d, 1wk, 1, 3, and 6mo after surgery. The duration of surgery, level of patient discomfort, pterygium recurrence, and complications were retrospectively analyzed between two groups. <p>RESULTS: The duration of surgery in observer group was 15.23±2.26min and 28.22±2.70min in control group, the difference was statistically significant(<i>t</i>=-31.75, <i>P</i><0.01). One week later, the level of patient discomfort at 1, 3 and 7d after surgery were 0.62±0.69, 0.34±0.50, 0.16±0.37 in observation group, and the level of patient discomfort were 1.15±0.92, 0.54±0.60, 0.18±0.38 in control group, and the difference were statistically significant in observer group and control group(<i>P</i><0.01); comparison between any two means in either group was significantly different(<i>P</i><0.01). There were significant difference between the two groups on postoperative 1, 3d after surgery(<i>t</i>=-3.94, -2.22; <i>P</i><0.05), and there was not significant difference between the two groups on postoperative 7d after surgery(<i>t</i>=-0.22, <i>P</i>>0.05). Two eyes(2.7%)were recurrent on postoperative 6mo after surgery in observation group and 4 of 74 eyes(5.4%)in control group, demonstrated no significant differences(<i>χ</i><sup>2</sup>=24.2, <i>P</i>>0.05). Five of 74 eyes(6.8%)were with complications in observation group and 6 of 74 eyes(8.1%)in control group, demonstrated no significant differences(<i>χ</i><sup>2</sup>=16.32, <i>P</i>>0.05). <p>CONCLUSION: The duration of surgery, patient discomfort level were reduced markedly, as less flap dislocation and postoperative reaction with human fibrin sealant compared with 10-0 vicryl sutures. A good result can be obtained by using the human fibrin sealant in the surgery of pterygium.
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<p><b>INTRODUCTION</b>This study aimed to determine the decision-to-delivery intervals (DDIs), total duration of surgery and factors influencing these for Caesarean sections (CSs).</p><p><b>METHODS</b>A retrospective study was conducted of all CSs performed from August 2013 to June 2014 at a single tertiary general hospital. Data collected included maternal demographics, indications for CS, category of urgency, DDI, total duration of surgery, grade of first surgeon and number of previous CSs.</p><p><b>RESULTS</b>In total, 488 CSs (Category 1: n = 28; Category 2: n = 137; Category 3: n = 184; Category 4: n = 139) were studied. Overall mean duration of surgery was 41.7 minutes. Mean DDI was 23.9 minutes and 64.5 minutes for Category 1 and Category 2 CSs, respectively. For Category 1 CSs, deliveries during office hours had a significantly shorter DDI than deliveries out of office hours (p < 0.05). For Category 2 CSs, deliveries during office hours had a significantly longer DDI (p < 0.05). Total duration of surgery for senior surgeons was significantly shorter than for trainee surgeons (p < 0.05). Women with no previous CSs had a significantly shorter duration of surgery than those who had one or more (p < 0.05).</p><p><b>CONCLUSION</b>The majority of the deliveries were within the recommended DDI corresponding to the degree of urgency of CS. The influence of time of day on DDI might be due to challenges of time taken to transfer patients to operating theatres. Total duration of surgery was influenced by surgical experience, history of previous CS and individual surgical styles and preferences.</p>
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STUDY DESIGN: Prospective study. PURPOSE: To compare clinical and radiological outcomes of open vs. minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). OVERVIEW OF LITERATURE: MI-TLIF promises smaller incisions and less soft tissue dissection resulting in lower morbidity and faster recovery; however, it is technically challenging. METHODS: Twenty-five patients with MI-TLIF were compared with 25 matched open TLIF controls. A minimum 2 year follow-up and a statistical analysis of perioperative and long-term outcomes were performed. Potential complications were recorded. RESULTS: The mean ages for the open and MI-TLIF cases were 44.4 years (range, 19-69 years) and 43.6 years (range, 20-69 years), respectively. The male:female ratio was 13:12 for both groups. Average follow-up was 26.9 months for the MI-TLIF group and 29.3 months for the open group. Operative duration was significantly longer in the MI-TLIF group than that in the open group (p<0.05). No differences in estimated blood loss, duration to ambulation, or length of stay were found. Significant improvements in the Oswestry disability index and EQ-5D functional scores were observed at 6-, 12-, and 24-months in both groups, but no significant difference was detected between the groups. Fusion rates were comparable. Cage sizes were significantly smaller in the MI-TLIF group at the L5/S1 level (p<0.05). One patient had residual spinal stenosis at the MI-TLIF level, and one patient who underwent two-level MI-TLIF developed a deep vein thrombosis resulting in a pulmonary embolism. CONCLUSIONS: MI-TLIF and open TLIF had comparable long-term benefits. Due to technical constraints, patients should be advised on the longer operative time and potential undersizing of cages at the L5S1 level.
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Humans , Follow-Up Studies , Length of Stay , Operative Time , Prospective Studies , Pulmonary Embolism , Spinal Stenosis , Venous Thrombosis , WalkingABSTRACT
Procedures involving complex surgical techniques in rats, such as placement of abdominal aortic graft require extended duration of surgical anesthesia, which often can be achieved by repeated administrations of xylazine-ketamine combination. However such repeated anesthetic administration, in addition to being technically challenging, may be associated with potential adverse events due to cumulative effects of anesthesia. We report here the feasibility of using urethane at low dose (~1/10 the recommended anesthetic dose) in combination with a xylazine-ketamine mix to achieve an extended duration of surgical anesthesia in rats. The anesthesia induction phase was quick and smooth with an optimal phase of surgical anesthesia achieved for up to 90 minutes, which was significantly higher compared to that achieved with use of only xylazine-ketamine combination. The rectal temperature, heart rate and respiratory rate were within the physiological range with an uneventful recovery phase. Post surgery the rats were followed up to 3 months without any evidence of tumor or any other adverse effects related to the use of the urethane anesthetic combination. We conclude that low dose urethane can be effectively used in combination with xylazine and ketamine to achieve extended duration of surgical anesthesia up to 90 minutes in rats.