Énucléation

协会
  • 文章类型: Journal Article
    目的:本研究的目的是探讨开放性眼球损伤(OGI)后摘除或摘除手术的预测因素,并探讨眼外伤评分(OTS)在预测结果方面的有效性。
    方法:对380例接受OGI修复的患者资料进行回顾性分析。该研究纳入了31例患者的眼睛,这些患者在OGI修复后接受了摘除或摘除,并随访了至少6个月。人口特征,破裂的存在,穿透性损伤,眼内炎,评估视网膜脱离和传入瞳孔缺损,并计算OTS。OGI的病因,OGI修复和去内脏之间的间隔,眼睑和泪小管撕裂的存在,眼眶骨折,脉络膜组织脱垂,还分析了异物的存在。摘除/摘除后球体的大小,评估了翻修手术的必要性和翻修手术的时间.
    结果:在380名患者中,31例(8.15%)在OGI后进行了摘除或摘除。31例患者中的19例接受了OGI一期修复后的内脏,10例患者在没有OGI修复的情况下接受了内脏摘除;1例患者在OGI修复后接受了摘除,1例患者在没有OGI修复的情况下接受了摘除。OGI修复后有内脏摘除/摘除组的平均OTS为37.95,无修复组的平均OTS为29.55。OGI和内脏内脏的平均间隔为2.4±5.9(0-13)个月。10例(32.2%)OGI的病因是交通事故,9例(29%)为穿透性外伤,使用切割或穿透性器械,8例(25.8%)为钝性外伤,另有4人(12.9%)为枪伤。平均随访时间为38.9±23.59(6~72)个月。OTS按年龄差异无统计学意义,性别,患侧和病因。尽管有额外伤害的患者的OTS低于没有受伤的患者,差异无统计学意义。OTS从1区(角膜和角膜缘)到3区(角膜缘后方5mm)有统计学意义的降低(P=0.015,r=-0.433)。
    结论:对于患者和医生来说,决定和同意在开放性地球损伤后进行摘除/摘除是非常困难的。我们认为,3区损伤的存在和破裂的存在是不良的预后因素,OTS低于49可能是内脏/摘除的危险因素。总之,OTS可能是一个客观参数,提供视觉康复和预后的客观思路,并有助于进一步手术的决策.
    OBJECTIVE: The aim of this study was to investigate the predictive factors for evisceration or enucleation surgery after open globe injury (OGI) and to investigate the effectiveness of the ocular trauma score (OTS) in predicting the outcome.
    METHODS: Data from 380 patients who underwent OGI repair were retrospectively analyzed. The eyes of 31 patients who underwent evisceration or enucleation after OGI repair and who were followed up for at least 6 months were included in the study. Demographic characteristics, presence of rupture, penetrating injury, endophthalmitis, retinal detachment and afferent pupillary defect were evaluated and OTS was calculated. The etiology of OGI, the interval between OGI repair and evisceration, the presence of eyelid and canalicular laceration, orbital fractures, prolapsed choroidal tissue, and the presence of foreign bodies were also analyzed. The size of the sphere after evisceration/enucleation, the need for revision surgery and the time to revision surgery were evaluated.
    RESULTS: Of the 380 patients, 31 (8.15%) underwent evisceration or enucleation after OGI. 19 of 31 patients underwent evisceration after primary repair of OGI, 10 patients underwent evisceration without OGI repair; 1 patient underwent enucleation after OGI repair and 1 patient underwent enucleation without OGI repair. The mean OTS was 37.95 in the group with evisceration/enucleation after OGI repair and 29.55 in the group without repair. The mean interval between OGI and evisceration was 2.4±5.9 (0-13) months. The etiology of 10 (32.2%) OGIs were traffic accidents, 9 (29%) were penetrating trauma with cutting or penetrating instruments, 8 (25.8%) were blunt trauma, and 4 (12.9%) were gunshot wounds. The mean follow-up time was 38.9±23.59 (6-72) months. There was no significant difference in OTS according to age, gender, affected side and etiology. Although OTS was lower in patients with additional injuries than in those without, the difference not statistically significant. There was a statistically significant decrease in OTS from zone 1 (cornea and limbus) to zone 3 (posterior to 5mm from the limbus) (P=0.015, r=-0.433).
    CONCLUSIONS: The decision and consent for evisceration/enucleation after an open globe injury is very difficult for both patients and physicians. We believe that the presence of the injury in zone 3 and the presence of rupture are poor prognostic factors and that an OTS below 49 could be a risk factor for evisceration/enucleation. In conclusion, the OTS could be an objective parameter that provides an objective idea of visual rehabilitation and prognosis and helps in decision making for further surgery.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    目的:本研究的目的是报告在不使用包装材料的情况下进行一系列丙烯酸眼眶植入物放置的结果。
    方法:我们回顾性回顾了在眼科接受无巩膜包裹的丙烯酸眼眶植入物摘除的患者的记录,波兹南医科大学,波兰,2013年至2020年。
    结果:共有192名患者:102名女性和90名男性,平均年龄:60岁(范围:13-90岁)。在大多数情况下,摘除的原因是葡萄膜黑色素瘤(148例患者-77.1%),其次是继发性青光眼22例(11.5%)和疼痛,Phthisicaleyein16(8.3%).中位随访时间为23个月(范围:1-96个月)。在大多数情况下,植入物的稳定性令人满意,并且在研究期间没有发现植入物迁移的病例。我们注意到总共4次(2%)植入物暴露。其他术后主诉包括眼睑错位-21例患者(11%),Tenon’s囊变薄(15例-7.8%)和眼球摘除后眼窝综合征(PEES)-7例(3.6%)。术后并发症的发生率仅与既往眼科手术史相关(P=0.006)。
    结论:在随访期间,该组患者未包裹的丙烯酸眼眶植入物的稳定性和功能结局令人满意。
    OBJECTIVE: The purpose of this study is to report the results in a series of acrylic orbital implant placements without the use of wrapping material.
    METHODS: We retrospectively reviewed the records of the patients who underwent enucleation with acrylic orbital implant insertion without scleral wrapping at the Department of Ophthalmology, Poznań University of Medical Sciences, Poland, between 2013 and 2020.
    RESULTS: There were 192 patients: 102 women and 90 men, mean age: 60 years (range: 13-90 years). In the majority of cases, the reason for enucleation was uveal melanoma (148 patients-77.1%), followed by secondary glaucoma in 22 patients (11.5%) and painful, phthisical eye in 16 (8.3%). The median follow-up was 23 months (range: 1-96 months). The stability of the implants was satisfactory in the majority of cases, and there were no cases of implant migration identified during the study period. We noted a total of 4 (2%) implant exposures. Other postoperative complaints included eyelid malposition-21 patients (11%), Tenon\'s capsule thinning (15 patients-7.8%) and post-enucleation eye socket syndrome (PEES)-7 patients (3.6%). The rate of postoperative complications was associated only with a history of previous ocular surgery (P=0.006).
    CONCLUSIONS: The stability and functional outcomes of unwrapped acrylic orbital implants in this group of patients were satisfactory during the follow-up period.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    BACKGROUND: The study aimed to describe clinical indications for eye enucleation and exenteration, the occurrence of complications and long-term outcome in cattle, and examine owners\' attitude towards enucleation and exenteration and their satisfaction with the surgical outcome. Medical records from the two veterinary teaching hospitals in Switzerland were reviewed to identify cattle that underwent unilateral enucleation or exenteration between January 2013 and December 2020. Data extracted included medical history, ocular examination, clinical diagnosis, surgical procedure including anesthesia, suture material and pattern used, complications, and treatment thereof. Long-term follow-up was evaluated via national animal database inquiries to determine survival time and via owners\' interviews with the use of a standardized questionnaire that included questions regarding the occurrence of complications and reason for culling, production performances and perceived quality of life after surgery, concerns, factors affecting the decision to proceed with surgery, and general satisfaction with the outcome. Descriptive statistics, Fisher\'s exact tests and unpaired t-test were used to summarize the data and assess association between variables. Association was considered significant if p < 0,05. Thirty-eight cases were identified, with a median age of 5 years. More than half of the cases (55,3 %) were diagnosed with non-neoplastic ocular lesions represented by severe trauma with loss of globe content, globe rupture with history of infectious keratoconjunctivitis or hypopyon, or congenital malformations. The remaining cases were diagnosed with neoplastic lesions, including ocular squamous cell carcinoma (OSCC), melanoma, or sarcoma. Complications following surgery were reported in 29 % of cases and included postoperative infection and recurrence of OSCC. There was no significant association between ocular diagnosis and the occurrence of postoperative complications or survival time. Surgery did not seem to influence the animals\' postoperative production performance or the perceived quality of life. Most owners (92 %) were satisfied with the surgical outcome. The occurrence of postoperative complications leading to increased overall costs and culling was the main reason for lower owner satisfaction.
    BACKGROUND: Ziel der Studie war es, die klinischen Indikationen für die Enukleation und Exenteration des Augapfels, das Auftreten von Komplikationen und das Langzeitergebnis beim Rind zu beschreiben. Zusätzlich wurde die Einstellung der Besitzer zur Enukleation und Exenteration sowie ihre Zufriedenheit mit dem chirurgischen Ergebnis untersucht. Die Krankenakten der beiden veterinärmedizinischen Lehrspitäler in der Schweiz wurden überprüft, um Rinder zu identifizieren, die zwischen Januar 2013 und Dezember 2020 einer einseitigen Enukleation oder Exenteration unterzogen wurden. Die extrahierten Daten umfassten Anamnese, Augenuntersuchung, klinische Diagnose, chirurgischer Eingriff einschliesslich Anästhesie, verwendetes Nahtmaterial und – technik, Komplikationen und deren Behandlung. Zur Bestimmung der Langzeitbehandlungsergebnisse wurde die Überlebenszeit der Tiere mittels Abfragen in der nationalen Tierdatenbanken bestimmt und Besitzerinterviews unter Verwendung eines standardisierten Fragebogens durchgeführt. Abgefragt wurde das Auftreten von Komplikationen, Gründe für das Keulen, Produktionsleistung, wahrgenommene Lebensqualität nach dem Eingriff, Bedenken, Entscheidungsfaktoren die Operation durchzuführen, und allgemeine Zufriedenheit mit dem Ergebnis. Die Daten wurden mittels deskriptiver Statistik zusammengefasst und mögliche Unterschiede zwischen den Variablen mittels Exaktem Fisher-Tests und ungepaarten t-Test analysiert. Das Signifikanzniveau wurde bei p < 0,05 festgelegt. Die Studie umfasste 38 Fälle mit einem Durchschnittsalter von 5 Jahren. Mehr als die Hälfte der Fälle (55,3 %) wurden mit nicht-neoplastischen Augenläsionen diagnostiziert, die durch ein schweres Trauma mit Verlust des Bulbusinhaltes, Bulbusruptur mit Vorgeschichte einer infektiösen Keratokonjunktivitis, Hypopyon oder angeborene Fehlbildungen gekennzeichnet waren. Bei den verbleibenden Fällen wurden neoplastische Läsionen diagnostiziert, darunter okulares Plattenepithelkarzinom (OSCC), Melanom oder Sarkom. Postoperative Komplikationen wurden in 29 % der Fälle berichtet und umfassten Infektionen und Rezidive von OSCC. Es gab keine signifikanten Zusammenhänge zwischen der Diagnose und dem Auftreten postoperativer Komplikationen oder der Überlebenszeit. Die Operation schien die postoperative Produktionsleistung der Tiere oder die wahrgenommene Lebensqualität nicht zu beeinflussen. Die meisten Besitzer (92 %) waren mit dem Ergebnis zufrieden. Das Auftreten von postoperativen Komplikationen, die zu erhöhten Gesamtkosten und Keulungen führten, war der Hauptgrund für die geringere Zufriedenheit der Tierhalter.
    BACKGROUND: La présente étude vise à décrire les indications cliniques de l’énucléation et de l’exentération de l’œil, la survenue de complications et le résultat à long terme chez les bovins et à examiner l’attitude des propriétaires vis-à-vis de l’énucléation et de l’exentération et leur satisfaction quant au résultat chirurgical. Les dossiers médicaux des deux hôpitaux universitaires vétérinaires de Suisse ont été examinés pour identifier les bovins qui ont subi une énucléation ou une exentération unilatérale entre janvier 2013 et décembre 2020. Les données extraites comprenaient les antécédents médicaux, l’examen oculaire, le diagnostic clinique, la procédure chirurgicale y compris l’anesthésie, le matériel et le patron de suture utilisés, les complications et leur traitement. Le suivi à long terme a été évalué en utilisant la base de données nationale sur les animaux afin de déterminer la durée de survie, et par d’entretiens avec les propriétaires à l’aide d\'un questionnaire standardisé qui comprenait des questions concernant l’apparition de complications et la raison de la réforme, les performances de production et la qualité de vie perçue après la chirurgie, les réserves, les facteurs affectant la décision de procéder à la chirurgie et la satisfaction générale du résultat. Les données ont été résumées à l’aide de statistiques descriptives et les différences éventuelles entre les variables ont été analysées à l’aide de tests exacts de Fisher et de tests t non appariés. L’association a été considérée comme significative si p < 0,05. Trente-huit cas ont été identifiés, avec un âge médian de 5 ans. Plus de la moitié des cas (55,3 %) ont été diagnostiqués avec des lésions oculaires non néoplasiques causées par un traumatisme grave avec perte du contenu du globe, une rupture du globe avec des antécédents de kératoconjonctivite infectieuse ou d’hypopion ou des malformations congénitales. Les autres cas ont été diagnostiqués comme des lésions néoplasiques, notamment carcinome épidermoïde oculaire, mélanome ou sarcome. Des complications après l’opération ont été signalées dans 29 % des cas, notamment infection postopératoire et récidive du carcinome épidermoïde oculaire. Il n’y avait pas d’association significative entre le diagnostic et l’apparition de complications postopératoires ou la durée de survie. L’intervention chirurgicale n’a pas semblé influencer les performances de production postopératoires des animaux ni la qualité de vie perçue. La plupart des propriétaires (92 %) étaient satisfaits du résultat de la chirurgie. L’apparition de complications postopératoires entraînant une augmentation des coûts globaux et l’abattage des animaux était la principale raison de la baisse de satisfaction des propriétaires.
    BACKGROUND: Lo studio si proponeva di descrivere le indicazioni cliniche per l’enucleazione e l’esenterazione del bulbo oculare, l’insorgenza di complicazioni e l’esito a lungo termine nei bovini, nonché di esaminare l’atteggiamento dei proprietari nei confronti dell’enucleazione e dell’esenterazione e la loro soddisfazione per l’esito dell’intervento. Le cartelle cliniche dei due ospedali veterinari in Svizzera sono state esaminate per identificare i bovini sottoposti a enucleazione o esenterazione unilaterale tra gennaio 2013 e dicembre 2020. I dati estratti comprendevano l’anamnesi, l’esame oculare, la diagnosi clinica, la procedura chirurgica, compresa l’anestesia, il materiale di sutura e la tecnica utilizzata, le complicazioni e il relativo trattamento. Il follow-up a lungo termine è stato valutato tramite indagini sul database nazionale degli animali per determinare il tempo di sopravvivenza e tramite interviste ai proprietari con l’uso di un questionario standardizzato che includeva domande riguardanti l\'insorgenza di complicazioni e il motivo della macellazione, le prestazioni produttive e la qualità di vita percepita dopo l’intervento, le inquietudini, i fattori che hanno influenzato la decisione di procedere con l’intervento e la soddisfazione generale per il risultato. I dati sono stati sintetizzati utilizzando le statistiche descrittive e le eventuali differenze tra le variabili sono state analizzate utilizzando il test esatto di Fisher e il t-test non accoppiato. L’associazione è stata considerata significativa se il valore di p < 0,05. Sono stati identificati 38 casi, con un’età media di 5 anni. In più della metà dei casi (55,3%) sono state diagnosticate lesioni oculari non neoplastiche, rappresentate da gravi traumi con perdita del contenuto del globo, rottura del globo con anamnesi di cheratocongiuntivite infettiva o ipopion, o malformazioni congenite. Nei restanti casi sono state diagnosticate lesioni neoplastiche, tra cui carcinoma oculare spinocellulare (OSCC), melanoma o sarcoma. Le complicazioni successive all’intervento chirurgico sono state riportate nel 29% dei casi e comprendevano infezioni postoperatorie e recidive di OSCC. Non è stata riscontrata alcuna associazione significativa tra la diagnosi oculare e la comparsa di complicazioni postoperatorie o il tempo di sopravvivenza. L’intervento chirurgico non sembrava influenzare le prestazioni produttive degli animali dopo l’intervento o la qualità di vita percepita. La maggior parte dei proprietari (92%) era soddisfatta dell’esito dell’intervento. L’insorgenza di complicazioni post-operatorie che hanno comportato un aumento dei costi complessivi e la macellazione è stata la ragione principale della minore soddisfazione dei proprietari.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    In oncology, and even more so in oncopediatrics, the quality of care is based on the medical and healthcare expertise of the teams, as well as their know-how in supporting patients and their families. A childcare assistant-nurse pair, committed to the patient journey of a child, hospitalised for the enucleation of an eye, and his family, illustrates this quest for excellence.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: English Abstract
    BACKGROUND: We aimed to assess the impact of antiplatelet and anticoagulation therapy for patients undergoing HoLEP.
    METHODS: We performed a study during the learning curve on a consecutive series of patients who underwent HoLEP surgery from 2015 to 2018. The patients were divided into 3 groups: a control group, patients with antiplatelet therapy and patients with anticoagulation therapy.
    RESULTS: A total of 223 patients underwent HoLEP surgery during this period: 124 in the control group, 63 in the antiplatelet group and 36 in the anticoagulant group. In the anticoagulant group, we observe significant differences with the control group for the catheterization time (2.05 days vs 5.17 days; P<0.001), the hospital length of stay (1.5 nights vs 4.49 nights; P<0.001) and complications (8.9% vs 58%; P<0.001). No difference between the control and antiplatelet groups in terms of catheterization time, hospital length of stay and complications (2.05 days vs 2.68 days; 1.5 nights vs 1.6 nights) but variation in terms of complications and bleeding complications (8.9% vs 21%; P<0,001; 8.1% vs 19%; P<0,001) CONCLUSION: Our study shows that HoLEP is therefore associated with a higher risk of bleeding for patients treated with anticoagulation therapy. Complications increase morbidity with longer catheterization time, hospitalization times and higher transfusion\'s rates, revision surgery and readmission.
    METHODS: 3.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    神经鞘瘤是最常见的周围神经良性肿瘤。肿瘤摘除术是传统的手术治疗方法。手术后神经系统并发症的发生率各不相同,并且这些并发症的预测因素尚未明确定义。这项研究的目的是寻找上肢神经鞘瘤手术治疗后神经功能缺损的预测因素。回顾性分析了从21例患者中切除的24例神经鞘瘤。患者平均年龄为45.4岁,平均随访时间为64.4个月。研究的临床参数是年龄,性别,术前症状的性质,症状持续时间,进行的手术类型,肿瘤的位置和大小,涉及神经,QuickDASH和DN4分数。术后神经功能缺损14例(67%),11人感觉缺陷,7人运动无力。手术前不存在11个(6个感觉,5电机)。在术后缺陷亚组,6例神经鞘瘤累及臂丛神经,4尺神经,和4个正中神经。所有因肿瘤摘除不可行而进行束状切除术的患者均属于术后缺陷亚组。十名患者在手术后QuickDASH和/或DN4评分不变或更差。神经鞘瘤的手术治疗可导致术后并发症。尽管我们的发现都没有统计学意义,高龄,大肿瘤大小,从最初的症状到手术超过16个月,在术后神经功能缺损的患者中,臂丛神经的位置似乎更常见。
    Schwannomas are the most frequent benign tumors of the peripheral nerves. Tumor enucleation is the traditional surgical treatment. The incidence of neurological complications after surgery varies and predictive factors for these complications are not clearly defined. The aim of this study was to find predictive factors of postoperative neurological deficit after surgical treatment of schwannomas of the upper limb. Twenty-four schwannomas removed from 21 patients were analyzed retrospectively. The patients\' mean age was 45.4years and the mean follow-up was 64.4months. Clinical parameters studied were age, gender, nature of preoperative symptoms, duration of symptoms, type of surgery performed, tumor location and size, nerve involved, QuickDASH and DN4 scores. Postoperative neurological deficits occurred in 14 patients (67%), with 11 having a sensory deficit and 7 a motor weakness. Eleven did not exist before surgery (6 sensory, 5 motor). In the postoperative deficit subgroup, 6 schwannomas involved the brachial plexus, 4 the ulnar nerve, and 4 the median nerve. All patients who had a fascicular resection because tumor enucleation was not feasible were in the postoperative deficit subgroup. Ten patients had either unchanged or worse QuickDASH and/or DN4 scores after surgery. Surgical treatment of schwannomas can lead to postoperative complications. Although none of our findings were statistically significant, advanced age, large tumor size, more than 16months between the first symptoms and surgery, and brachial plexus location seem to be more frequently observed in those with a postoperative neurological deficit.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Case Reports
    OBJECTIVE: Evisceration can be performed for blind, painful eyes. This surgery can promote the dissemination of tumor cells within the orbit if an ocular tumor has been missed preoperatively.
    METHODS: We reviewed the medical records of patients who were eviscerated for blind, painful eyes between 2009 and 2014 and who were referred after the surgery to the Institut Curie or the Rothschild Foundation in Paris. We included the patients with a histological diagnosis of ocular tumor or orbital recurrence. Cytogenetic analysis was performed whenever possible.
    RESULTS: Four patients turned out to have an ocular tumor after evisceration (two choroidal melanomas, a rhabdoid tumor and an adenocarcinoma of the retinal pigment epithelium); two had a history of prior ocular trauma. The tumors were diagnosed either on histological analysis of the intraocular contents (2 patients) or biopsy of orbital recurrence (2 patients). Prior to evisceration, fundus examination was not performed in 3 patients. One had preoperative imaging but no intraocular tumor was suspected. At the time of this study, 3 patients had had an orbital recurrence and died. We also found 2 patients who had an evisceration despite a past history of choroidal melanoma treated with proton beam therapy.
    CONCLUSIONS: We showed that evisceration of eyes with unsuspected ocular malignancies was associated with a poor prognosis due to orbital recurrence and metastasis. The evisceration specimen should therefore always be sent for histological analysis in order to perform prompt adjuvant orbital radiotherapy if an ocular tumor is found.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    背景:膀胱内腺瘤(MIA)的碎裂是内窥镜摘除术的重要组成部分。这项研究的目的是分析前列腺内镜摘除术期间MIA的学习曲线。
    方法:我们进行了一项前瞻性研究,研究对象是前90例患者,由一名外科医生在没有MIA经验的情况下进行前列腺内镜摘除术。将该人群分为3组,每组30名患者。MIA用粉碎器Pinranha(Wolf)和一次性刀片(Vmax©)进行。ThecriteriaselectedtoassessingtheprogressofMIAovertimewere:durationofMIA(min),在MIA和重量组织中遇到的术中并发症。MIA的功效用重量样品/MIA持续时间(min/g)随时间的比率来评估。
    结果:三组在年龄方面具有可比性,前列腺体积的ASA评分。在第1组和第2组之间发现MIA的持续时间显着减少(12对5.5分钟,P<0.0001),在第3组(3min)达到平台期。在第1组和第2组之间发现MIA的效率显着提高(5.5对11g/min,P<0.0001),在第3组达到平台期(20g/min)。膀胱损伤有限(7.7%),肤浅,在早期学习阶段遇到。
    结论:根据我们的经验,MIA需要估计在30到60个程序之间的学习曲线。
    方法:IV.
    BACKGROUND: Morcellation of intravesical adenoma (MIA) is an important part of the endoscopic enucleation procedure. The aim of this study was to analyse the learning curve of the MIA during endoscopic enucleation of the prostate.
    METHODS: We conducted a prospective study of the first 90 patients treated by endoscopic enucleation of the prostate by a single surgeon without previous experience of MIA. The population was divided into 3 consecutive groups of 30 patients. MIA was performed with the morcellator Pinranha (Wolf) and disposable blades (Vmax©). The criteria selected to assess the progress of MIA over time were: duration of MIA (min), the intraoperative complications encountered during MIA and weight morcelleted tissue. The efficacy of MIA was assessed with the ratio weight specimen/MIA duration (min/g) over time.
    RESULTS: The three groups were comparable in terms of age, ASA score of prostate volume. A significant decrease in the duration of MIA was found between groups 1 and 2 (12 versus 5.5min, P<0.0001), to reach a plateau in the group 3 (3min). A significant increase in the efficiency of MIA was found between group 1 and 2 (5.5 versus 11g/min, P<0.0001), to reach a plateau in the group 3 (20g/min). Bladder injuries were limited (7.7%), superficial and encountered in the early learning phase.
    CONCLUSIONS: In our experience, the MIA required a learning curve estimated between 30 and 60 procedures.
    METHODS: IV.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    目的:钬激光前列腺摘除术(HoLEP)以其学习曲线的难度而闻名。我们的目标是评估HoLEP学习曲线中三步教程的兴趣,在大学中心。
    方法:这是一个回顾性研究,单中心研究了由同一操作员连续完成的82个第一个程序,并在早期经验和40个程序之后进行了监督。对所有患者进行记录:摘除效率(g/min),分块效率(g/min),去核组织的百分比(通过超声评估去核组织/腺样体weigth。g/g),围手术期发病率(Clavien),住院时间,尿引流长度,短期和中期的功能结果(Qmax,后空隙剩余体积[PVR],3个月和6个月的QOL评分和IPSS)。
    结果:第二次进行后,眼球摘除和碎裂效率显着提高(0.87vs0.44g/min;P<0.0001和4.2vs3.37g/min,分别为P=0.038),例如前列腺体积(43.5对68.1mL,P=0.0001)。第二组的去核组织百分比更高,然而,差异不显著(69.5%vs80.4%,P=0.03)。围手术期和术后并发症,住院时间,3个月和6个月时的尿引流长度和功能结果没有显着差异。
    结论:学习曲线不干扰功能结果。为了掌握技术,第二次监督对我们至关重要。这些数据强调了教学反思的必要性,以便为HoLEP建立标准化的形成技术。
    方法:4.
    OBJECTIVE: Holmium laser enucleation of prostate (HoLEP) is renowned for the difficulty of its learning curve. Our aim was to evaluate the interest of a three-step tutorial in the HoLEP learning curve, in a university center.
    METHODS: It is a retrospective, monocentric study of the 82 first procedures done consecutively by the same operator with a proctoring in early experience and after 40 procedures. For all patients were noted: enucleation efficiency (g/min), morcellation efficiency (g/min), percentage of enucleated tissue (enucleated tissue/adenome weigth evaluated by ultrasonography. g/g), perioperative morbidity (Clavien), length of hospital stay, length of urinary drainage, functional outcomes at short and middle term (Qmax, post-void residual volume [PVR], QOL scores and IPSS at 3 and 6months).
    RESULTS: Enucleation and morcellation efficiency were significantly higher after the second proctoring (0.87 vs 0.44g/min; P<0.0001 and 4.2 vs 3.37g/min, P=0.038, respectively) so as the prostatic volume (43.5 vs 68.1mL, P=0.0001). Percentage of enucleated tissue was higher in the second group, however, the difference was not significant (69.5% vs 80.4%, P=0.03). Per- and postoperative complications, hospital length of stay, urinary drainage length and functional results at 3 and 6months were not significantly different.
    CONCLUSIONS: The learning curve did not interfere with functional results. The second proctoring was essential to us in order to grasp the technique. These data underlined the necessity of a pedagogic reflexion in order to built a standardized formation technique to the HoLEP.
    METHODS: 4.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    BACKGROUND: Evisceration consists in removal of the orbital content whilst preserving the sclera. It allows for good esthetic results after fitting of an eye prosthesis.
    METHODS: The \"on the table\" evisceration technique consists in 3 operative steps: (1) removal of the eyeball after optic nerve section (enucleation); (2) removal of the content of the globe on the operating table (evisceration) and (3) implantation in the orbital cavity of a hydroxyapatite orbital implant wrapped into the sclera in order to keep the orbital volume.
    CONCLUSIONS: Evisceration is indicated in blind, painful and unaesthetic eyes that cannot be preserved. The \"on the table\" evisceration technique is an easy procedure allowing for a good volume restauration and for supporting a mobile eye prosthesis thanks to the placement of a hydroxyapatite orbital implant wrapped into the patient\'s own sclera and to muscular re-insertion.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号