ABSTRACT
PURPOSE: The first report of miVATT was published in 1998 by Miccoli, leading to a revolution in the field of thyroid surgery. This prospective study aims to evaluate the technique with regard to our department's experience over a four-year period. MATERIAL-METHODS: Between September 2009 and October 2013, 48 adult patients (37 females, 11 males) with a mean age of 41.3 (± 11.6) years underwent scheduled miVATT for benign thyroid lesions. Selection criteria included thyroid volume <15 ml and nodules not exceeding 3.5 cm of diameter. Thyroiditis, previous neck surgery and previous irradiation, mediastinal goiter and involvement in another clinical study constituted the exclusion criteria. The procedure we performed was miVATT as described by Miccoli with the only additions being the use of the Harmonic Scalpel and the fixation of the endoscope on a holding device. Also, no drains were applied. RESULTS: No conversions to open surgery were needed. Operation time for total thyroidectomy was 71.23 min (± 23.81) with a mean hospitalization of 1.14 days (± 0.4). Five patients (10.4%) exhibited transient hypocalcemia, whereas there were no recurrent laryngeal nerve palsies. Post-operative pain was mild and the final aesthetic result was considered excellent by the patients. CONCLUSION: miVATT is a safe and feasible alternative to the conventional thyroidectomy when performed in carefully selected patients by experienced surgeons.
ABSTRACT
BACKGROUND: Gastrointestinal stromal tumors (GISTs) represent 85% of all mesenchymal neoplasms that affect the gastrointestinal track. Aim of this study is to report a case series of 18 GISTs treated surgically in a single centre and to discuss the diagnostic and therapeutic issues regarding these tumors. CASE SERIES: A retrospective search of the unit's medical records from 2002 to 2014 was carried out, to collect all cases diagnosed and treated for GISTs. Demographics and clinical features was obtained for all relevant cases. RESULTS: Eighteen cases (18) of GIST were identified. Eleven tumors were located in the stomach, 3 tumors in the duodenum and 4 tumors in the jejunum. The mean age at diagnosis was 62.5 (range 42-81) years, while the male to female ratio was 1.57/1 (11 males/7 females). Patients presented with a variety of symptoms and all underwent surgery. The 5-year-survival rate of these patients was 50%. CONCLUSION: Due to non-specific presentation of GISTs, initial diagnosis of these tumors may be delayed. High clinical suspicion and knowledge of their characteristics are essentials in order to achieve an early diagnosis and lead patients to surgery as soon as possible. Hippokratia 2015, 19 (1): 73-75.
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AIM: The aim of this series is to study the need of drainage use after total thyreoidectomy. MATERIAL AND METHODS: Retrospective study of a series of patients who underwent total thyroidectomy from 2005 up to 2013. The presence or not of hematomas, seromas and hemorrhage were recorded. RESULTS: Out of the 66 patients included in this series, only one case of post-operative hematoma was recorded. Neither a hemorrhage nor a seroma were identified despite the volume, the underlying pathology and the co-morbidity of the patients involved. CONCLUSION: In our experience a thyroidectomy with adequate hemostasis does not require the use of drains.
ABSTRACT
Introduction. Laparoscopic gastric banding is a first line bariatric procedure that is performed worldwide and can achieve substantial weight loss. Despite its many advantages, as the least invasive bariatric procedure, it has several complications like gastric prolapse, stoma obstruction and migration of the gatstric band. Rarely are these complications life threatening, but re-operation is usually the only treatment. Case presentation. We report a rare case of intrajejunal migration of an adjustable gastric band that was placed laparoscopically four years ago. Conclusion. Gastric band migration is a rather common complication of laparoscopic gastric banding, but intrajejunal migration is very rare and requires high clinical suspicion, close follow-up and thorough pre-operative investigation so as to avoid intraoperative surprises and retrieve the displaced gastric band safely.
ABSTRACT
The effects of soil incorporation of metham-sodium and finely chopped plant residues of broccoli, cabbage, cauliflower, and grass against Meloidogyne incognito and M. javanica over increasing periods of time and a range of dose rates, with or without plastic covering were studied in growth chamber experiments. The scope of this study was to determine the direct effects of fresh organic amendments and the indirect effects of their volatiles on Meloidogyne spp. and tomato plant growth. Amendments were applied at the rate of 5 or 10 kg/m2. The most effective treatment in maintaining low numbers of nematodes was pre-treatment with volatiles of metham-sodium, which resulted in zero invasion of tomato roots. Application of fresh-chopped broccoli, grass and, in some instances, cauliflower also caused a significant reduction in the population of root-knot nematodes. Nematode reduction caused by broccoli was slightly better than by grass. On the other hand, cabbage incorporation did not suppress Meloidogyne spp. to the same extent, though a 19% reduction was observed, even at the lowest dose rate. Suppression of root-knot nematodes was greater in pots amended and covered with plastic tarp as compared to amended non-covered pots. Increased doses for all treatments were further effective in reducing the populations of root-knot nematodes. The direct effect of soil amendments was greater after 2 weeks, while the indirect effects of volatiles were lessened after 2 and 3 weeks.
