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plastic surgery or reconstructive surgery or cosmetic surgery

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34761. Airway management of patients undergoing oral cancer surgery: a retrospective study. (Abstract)

Airway management of patients undergoing oral cancer surgery: a retrospective study. This retrospective study aims to describe the airway management and benefits of nasotracheal intubation over tracheostomy in 260 patients with oral cancer undergoing surgery.The medical records of 260 patients undergoing surgery for oral cancer were reviewed for airway management during the perioperative period. Eighteen patients had previous surgery for oral cancer and were scheduled for flap reconstruction (...) of the cases was elective tracheostomy under local anaesthesia performed before surgery for the maintenance of the airway for anaesthesia. Elective tracheostomies were done in 17 cases. Three patients remained intubated for 24-48 h because of a high suspicion of airway obstruction following extubation due to a large pectoralis major flap. These three patients received a tracheostomy because of increased oropharyngeal and laryngeal oedema. In three cases emergency tracheostomies were performed due to upper

2005 European Journal of Anaesthesiology

34762. Perception of oral maxillofacial surgery by health-care professionals. (Abstract)

of OMFS. To investigate recognition of the scope of OMFS, 400 questionnaires were sent to dentistry students, medical students, dentists and doctors, in 4 equal groups. The questionnaire covered 26 clinical situations in four different specialties (OMFS, Plastic Surgery, Ear Nose and Throat Surgery, Head and Neck Surgery) and an option with no specialty specified. Each interviewee had to correlate the clinical situation with the respective specialist. For facial trauma, dento-facial deformities (...) , mandibular reconstruction and temporomandibular joint surgery, most respondents would consult the OMF surgeon for treatment (mean, 90%). In cases of oral biopsy and treatment of benign mandibular tumours the mean referral rate to OMFS was low (48%). On the basis of the questionnaire responses, a good level of knowledge of the scope of OMFS was found. In order to ensure the correct referral of all patients, the specialty needs to broaden its horizons.

2007 International Journal of Oral and Maxillofacial Surgery

34763. Change in practice patterns of an academic division of vascular surgery. Full Text available with Trip Pro

Change in practice patterns of an academic division of vascular surgery. Technological advances have required that faculty of academic divisions of vascular surgery acquire new technical skills and significantly alter their past clinical practice patterns.Retrospective medical record review.An academic tertiary referral center and a community teaching hospital.All patients undergoing 10 specific vascular procedures during a 5-year period.We analyzed volumes for 10 specific open and endovascular (...) index procedures performed by 5 vascular surgeons during a 60-month period. Procedures reviewed included open abdominal aortic aneurysm repair, endovascular abdominal aortic aneurysm repair, carotid endarterectomy, carotid artery stent, suprainguinal arterial reconstruction, suprainguinal percutaneous transluminal angioplasty/stent (PTA/S), infrainguinal arterial reconstruction, infrainguinal PTA/S, renal and visceral arterial reconstruction, and renal and visceral PTA/S. In-hospital length of stay

2007 Archives of Surgery

34764. Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery. (Abstract)

Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery. To evaluate the impact of vocal cord dysfunction on feeding in children after cardiovascular surgery.Of the 2255 children who had cardiovascular surgery between January 2000 to January 2006, 38 (1.7%) had postoperative vocal cord dysfunction confirmed at laryngoscopy. The following data were obtained retrospectively: type of surgery, laryngoscopic examination results, swallowing studies, upper (...) gastrointestinal (UGI) studies, and feeding route: oral, nasogastric tube (NG), and gastrostomy.Surgeries included aortic arch reconstruction (n = 20), patent ductus arteriosus ligation (n = 8), arterial switch (n = 3), cervical cannulation for extracorporeal membrane oxygenation (n = 2), and others (n = 5). A swallowing study confirmed dysfunction in 27 of 29 patients. Gastrostomy was placed in 18/38 patients. At discharge, 18 patients were fed by gastrostomy, 13 orally, 3 by NG, and 4 by combination oral/NG

2007 Journal of Pediatrics

34765. Long-term results of surgery for forearm deformities in patients with multiple cartilaginous exostoses. (Abstract)

Long-term results of surgery for forearm deformities in patients with multiple cartilaginous exostoses. Surgical treatment of forearm deformities in patients with multiple cartilaginous exostoses remains controversial. The purpose of the present study was to determine the reasonable indications for operative treatment and to evaluate long-term results of forearm surgery in these patients.We retrospectively reviewed twenty-three patients (thirty-one forearms) after a mean duration of follow-up (...) of nearly thirteen years. The mean age at the time of the initial procedure was eleven years. The patients underwent a variety of surgical procedures, including excision of exostoses; corrective procedures (lengthening of the radius or ulna and/or corrective osteotomy of the radius and/or ulna) and open reduction or excision of a dislocated radial head. Clinical evaluation involved the assessment of pain, activities of daily living, the cosmetic outcome, and the ranges of motion of the wrist, forearm

2007 The Journal of Bone and Joint Surgery. American Volume

34766. Mohs micrographic surgery for penile cancer: management and long-term followup. (Abstract)

who underwent a total of 41 Mohs procedures. Average +/- SD lesion size was 509 +/- 699 mm(2). An average of 2.6 +/- 1.4 stages were done using Mohs micrographic surgery. Five procedures were terminated with positive margins, including 3 due to urethral involvement and 2 due to defect size. Of the tumors 26 were stage Tis, 4 were T1, 7 were T2 and 4 were T3. A total of 13 defects were reconstructed by primary repair or granulation, 4 were reconstructed by skin grafts and 25 were reconstructed (...) Mohs micrographic surgery for penile cancer: management and long-term followup. Mohs micrographic surgery is efficacious for the primary treatment and local recurrence control of nongenital and cutaneous squamous and basal cell cancers. The efficacy of this procedure for squamous cell carcinoma of the penis was reviewed.We retrospectively reviewed the charts of all patients treated with Mohs micrographic surgery for penile cancer at our institution from 1988 to 2006.We identified 33 patients

2007 Journal of Urology

34767. Radical cystectomy and extended pelvic lymphadenectomy: survival of patients with lymph node metastasis above the bifurcation of the common iliac vessels treated with surgery only. (Abstract)

Radical cystectomy and extended pelvic lymphadenectomy: survival of patients with lymph node metastasis above the bifurcation of the common iliac vessels treated with surgery only. We assessed the clinical outcome in patients with invasive bladder cancer and lymph node metastasis above the bifurcation of the common iliac vessels treated with radical cystectomy including extended pelvic lymph node dissection without adjunct therapy.Between 1993 and June 2005 a total of 336 consecutive patients (...) underwent radical cystectomy and extended pelvic lymphadenectomy without preoperative or postoperative chemotherapy by 1 surgeon. A total of 263 patients (78.3%) had orthotopic bladder reconstruction. The pelvic lymph node dissection began at the distal aorta including the common and external iliac lymph nodes, and the periaortic, presacral and obturator fossa nodes. The lymphatic tissue removed above and below the bifurcation of the common iliac vessels was submitted separately for histopathological

2007 Journal of Urology

34768. Reoperative aortic root replacement in patients with previous aortic surgery. (Abstract)

Reoperative aortic root replacement in patients with previous aortic surgery. Reoperative aortic root reconstruction is increasingly performed and remains a clinical challenge. The aim of this study is to evaluate the outcome of patients undergoing reoperative aortic root replacement after previous aortic surgery.From 1995 to 2006, 156 consecutive patients underwent reoperative aortic root replacement after previous aortic valve replacement (group 1, n = 106, 67.8%), proximal aortic (...) reconstruction (group 2, n = 25, 16.1%), and aortic root replacement (group 3, n = 25, 16.1%). Their records were retrospectively reviewed.The mean age was 58.1 +/- 14.4 years, and 73.7% (n = 115) were men. Reoperation was performed 98.4 months after previous operation, with 14.7% (n = 23) having undergone three or more sternotomies. Indications for reoperations were endocarditis in 55 (35.3%), prosthetic valve dysfunction in 28 (17.9%), paravalvular leak in 12 (7.7%), aortic aneurysm or pseudoaneurysm in 29

2007 Annals of Thoracic Surgery

34769. Anterior spinal arthrodesis with structural cortical allografts and instrumentation for spine tumor surgery. (Abstract)

Anterior spinal arthrodesis with structural cortical allografts and instrumentation for spine tumor surgery. The authors report on anterior vertebral reconstruction following tumor resection with use of fresh-frozen, cortical, long-segment allografts prepared from diaphyseal sections of long bones. A retrospective analysis of clinical outcomes is presented.To analyze the results following the use of cortical allografts in the treatment of spine tumors.Metastatic disease and primary spinal bone (...) . Ninety-three percent of all allografts were radiographically incorporated as early as 6 months after surgery in spite of adjuvant chemotherapy and radiation therapy. Fourteen patients (46%) had intraoperative or postoperative complications. Two patients underwent revision surgery for local recurrence. There were no allograft infections, fractures, or collapse.Anterior column reconstruction with structural cortical allografts proved to be a reliable technique in patients with spine tumors

2004 Spine

34770. The role of thoracoscopic spinal surgery in the management of pyogenic vertebral osteomyelitis. (Abstract)

from minimal invasive techniques that avoid the complications of more extensive open approaches. We performed thoracoscopic spinal surgery in patients with pyogenic vertebral osteomyelitis, attempting to reduce the morbidity attributable to standard open thoracotomy surgery.The technique and results of minimally invasive thoracoscopic spinal surgery for pyogenic vertebral osteomyelitis in three patients, including radical debridement and anterior spinal reconstruction, are presented.Radical (...) The role of thoracoscopic spinal surgery in the management of pyogenic vertebral osteomyelitis. Case report, operative technique.Vertebral osteomyelitis is frequently associated with elderly and debilitated patients who have significant medical comorbidities. If surgical debridement is contemplated, an open anterior approach like a thoracotomy can be associated with significant complications in this patient population. Thus, patients with vertebral osteomyelitis who need surgery may benefit

2004 Spine

34771. Swing of the surgical pendulum: a return to surgery for treatment of head and neck cancer in the 21st century? (Abstract)

Swing of the surgical pendulum: a return to surgery for treatment of head and neck cancer in the 21st century? Treatment for head and neck cancer has evolved significantly during the past 100 years. Beginning with Bilroth's total laryngectomy on New Year's Day in 1873, "radical" surgery remained the only accepted treatment for head and neck cancer when optimal local and regional control was the goal. Bigger was still better when it came to managing the primary tumor and the neck. The "commando (...) " procedure and radical neck dissection were the hallmarks of this first generation of treatments of head-and-neck cancer. With the advent of microvascular reconstructive techniques, larger and more comprehensive resections could be performed. Despite these large resections and their "mutilating" sequelae, overall survival did not improve. Even for intermediate-stage disease in head-and-neck cancer, the 5-year survival rate did not improve >50%. Many concluded that more than the scalpel was needed

2007 Biology and Physics

34772. Gasless Laparoscopy-Assisted Subtotal Gastrectomy for Early Gastric Cancer: A Novel Minimally Invasive Surgery. (Abstract)

Gasless Laparoscopy-Assisted Subtotal Gastrectomy for Early Gastric Cancer: A Novel Minimally Invasive Surgery. Due to the highly invasive nature of traditional surgery and the limitation of gas-filling laparoscopic surgery in gastric cancers, we developed a new method of gasless laparoscope-assisted subtotal gastrectomy (GLASG). This study investigated the technique and clinical results of this procedure and compared it with traditional radical subtotal gastrectomy (TRSG) for early gastric (...) and laparoscopic view simultaneously. B-II gastrojejunostomy reconstruction was performed by intracorporeal anastomosis using an endostapler. The TRSG group underwent the standard open method used for gastric cancer. Preoperative characteristics and postoperative recovery between the two groups were compared.The operative time was comparable between the two groups, but the bleeding was significantly less severe in the GLASG group. Postoperative pain was significantly less in the GLASG group, as well as body

2007 Journal of Gastrointestinal Surgery

34773. Pushing back the frontiers of resectability in liver cancer surgery. (Abstract)

Pushing back the frontiers of resectability in liver cancer surgery. Thanks to advances in surgical technique, anaesthesia and peri-operative care, hepatic resection has evolved from a rare procedure with an associated mortality rate of up to 20% to a routine surgery carried out in high volume liver units with an operative risk of less than 5%. This review concentrates on the techniques employed in radical hepatic resection, considering in particular: (1) The feasibility of extended hepatic (...) parenchymal resections; (2) The treatment of lesions compromising the hepatic in-flow; and (3) The treatment of lesions compromising the hepatic out-flow. We discuss how these aims can be achieved by: minimizing the blood loss; minimizing the remnant liver parenchymal injury; performing an adequate oncological resection; and creating adequate venous out-flow reconstruction, using case series and case histories to illustrate these points.

2007 European Journal of Surgical Oncology

34774. Organ preservation surgery for advanced unilateral glottic and subglottic cancer. Full Text available with Trip Pro

Organ preservation surgery for advanced unilateral glottic and subglottic cancer. Functional surgery of unilateral T(2b) to T3 glottic cancer and cricoid chondrosarcoma is possible using the technique of tracheal autotransplantation. The objective of this paper is to report the functional and oncologic outcome of 24 consecutive patients treated with this technique between 2001 and 2007.Seventeen patients, of whom nine were previously irradiated, had unilateral glottic cancer with impaired (...) reconstruction was performed after 2 to 3 months and consisted of removal of the skin paddle from the laryngeal defect and a transplantation of a patch of revascularized cervical trachea to reconstruct the laryngeal defect.Swallowing and speech were restored after the first operation. The glottic and subglottic airway lumen was restored during the second operation. The tracheostomy could be closed in 20 patients. After a median follow-up period of 33 (range, 1-66) months or almost 3 years, 23 patients

2007 Laryngoscope

34775. Chronic ear surgery in patients with syndromes and multiple congenital malformations. (Abstract)

disease.Retrospective chart review.Charts were reviewed to identify patients diagnosed with either a congenital syndrome or multiple major malformations with a known association with the development of chronic ear disease who underwent ear surgery for chronic ear disease (excluding tympanostomy tube placement). Syndromes encountered, surgeries performed, operative outcomes, complications, and the efficacy of ossicular chain reconstruction is reported.Forty-three patients with 14 different syndromes or malformations (...) were identified. These patients underwent 66 surgical procedures on 56 ears. Seventy-nine percent of patients had undergone an ear procedure prior to presentation. Disease eradication was achieved in 64% of ears with a single procedure, and 89% of ears were controlled with two surgeries or less. Thirty-two percent of surgeries involved a canal wall down procedure, a rate similar to that seen for all patients in our practice over the past decade. When used, ossicular chain reconstruction

2007 Laryngoscope

34776. Revisiting the risks involved in using homograft ossicles in otological surgery. Full Text available with Trip Pro

Revisiting the risks involved in using homograft ossicles in otological surgery. Despite the fact that cartilage, cortical bone and corneal homograft tissue is still widely used in South Africa and that there has never been a reported case of human immunodeficiency virus or Creutzfeldt-Jakob disease infection transmission via this route, otolaryngologists are still reluctant to use homograft ossicles. In third world countries, such as South Africa, where ossicular prostheses are not always (...) readily available due to financial constraints, the question arises as to whether we should be reconsidering the use of homograft ossicles. This review examines the risk of developing Creutzfeldt-Jakob disease or acquiring human immunodeficiency virus following the use of homograft ossicles during ossicular reconstruction, and discusses sterilization techniques that have proven effective in eradicating the human immunodeficiency virus and prions. For decades, homograft ossicles have been used

2007 Journal of Laryngology & Otology

34777. Incisional bladder hernia and refractory urinary urgency after pelvic surgery: a case report. (Abstract)

Incisional bladder hernia and refractory urinary urgency after pelvic surgery: a case report. Isolated incisional herniation of the bladder is very rare following pelvic surgery and may present as suprapubic discomfort. We report a case of incisional bladder hernia following pelvic surgery presenting as refractory urinary urgency.A 70-year-old woman, para 2, presented with a long history of suprapubic tenderness and refractory urinary urgency following reconstructive pelvic surgery. Over the 3 (...) urgency.An incisional bladder hernia may present as refractory urinary urgency following reconstructive pelvic surgery. Strong clinical suspicion can allow earlier diagnosis and surgical treatment of this rare condition. Primary herniorrhaphy offers successful repair of the fascial defect and resolution of the urgency symptoms.

2006 Journal of Reproductive Medicine

34778. Incidence of concomitant surgery for pelvic organ prolapse in patients surgically treated for stress urinary incontinence. (Abstract)

concomitant reconstructive pelvic procedures.Women who require surgical correction of stress urinary incontinence have a high incidence of concomitant pelvic support defects that require surgical repair. The incidence of concomitant surgery for pelvic organ prolapse between the 2 sites was not significantly different. (...) Incidence of concomitant surgery for pelvic organ prolapse in patients surgically treated for stress urinary incontinence. To examine the concomitant incidence of surgery for pelvic organ prolapse in patients undergoing a surgical procedure to correct stress urinary incontinence in both an academic and private urogynecology practices.A retrospective chart review was performed on all patients undergoing surgical correction of stress urinary incontinence over a 1-year period at 2 centers.Among

2006 Journal of Reproductive Medicine

34779. Superior oblique tendon damage resulting from eyelid surgery. (Abstract)

developed. The causative eyelid procedures consisted of surgery to correct ptosis in four patients, tumor removal in two patients, and cosmetic blepharoplasty in one patient.The SO tendon may be damaged as a result of eyelid surgery. The anatomy of the SO tendon should be kept in mind while performing surgery in the superomedial aspect of the upper eyelid. (...) Superior oblique tendon damage resulting from eyelid surgery. To describe the occurrence of superior oblique (SO) tendon damage resulting from upper eyelid surgery and to explain its cause and treatment.Retrospective, observational case series.An institution-based retrospective observational case series of seven patients in whom damage to the SO tendon secondary to eyelid surgery developed.In four of the patients, ipsilateral SO palsy developed, and three patients, a Brown syndrome pattern

2007 American Journal of Ophthalmology

34780. Preoperative assessment and management to prevent complications during high-risk vascular surgery. (Abstract)

Preoperative assessment and management to prevent complications during high-risk vascular surgery. Most patients requiring vascular surgical reconstruction are at high risk for major morbidity and mortality, with certain vascular procedures at particularly high risk for complications. Although numerous comorbid conditions are precisely the risk factors that determine outcome, we review particular factors for each surgery that may be optimized to alter outcome and minimize postoperative (...) complications.Literature review.Certain aspects of care are common to all vascular surgery procedures, including thoracoabdominal aortic aneurysm repair, pararenal and ruptured abdominal aortic aneurysm repair, mesenteric and renal revascularization, and carotid endarterectomy. Some factors that are important include careful preoperative assessment and optimization of cardiac, pulmonary, and renal function and volume status. In addition, the use of experienced teams during and after the procedure, as well as clear

2004 Critical Care Medicine

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