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Scott W Melvin - One of the best experts on this subject based on the ideXlab platform.
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natural orifice translumenal Endoscopic Surgery
Surgical Clinics of North America, 2008Co-Authors: Simon Bergman, Scott W MelvinAbstract:This article provides an overview of the currently available animal data on natural orifice translumenal Endoscopic Surgery (NOTES) on the topics of translumenal access and closure, iatrogenic intraperitoneal complications, especially infection and overinsufflation, spatial orientation, and the development of enabling technologies. Human trials to date are also reviewed and discussed.
Chun Chung Chen - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic Surgery for Intraventricular Hemorrhage (IVH) Caused by Thalamic Hemorrhage: Comparisons of Endoscopic Surgery and External Ventricular Drainage (EVD) Surgery
World Neurosurgery, 2011Co-Authors: Chun Chung Chen, Chun Lin Liu, Ying Nan Tung, Han Chung Lee, Hao Che Chuang, Shinn Zong Lin, Der Yang ChoAbstract:Background Intraventricular hemorrhage (IVH) caused by thalamic hemorrhage has high mortality and morbidity. The aim of this study was to investigate the efficacy and the results of Endoscopic Surgery for the evacuation of IVH caused by thalamic hemorrhage compared with that of external ventricular drainage (EVD) Surgery. Methods From January 2006 to December 2008, 48 patients with IVH caused by thalamic hemorrhage were enrolled and treated in our department. Patients with IVH caused by thalamic hemorrhage who also resulted in acute hydrocephalus were indicated for Surgery; the patients who were included were randomly divided into an EVD group and an Endoscopic Surgery group. The clinical evaluation data included the Glasgow Coma Scale, length of intensive care unit (ICU) stay, age, intracerebral hemorrhage volume, and severity of IVH. Outcome was measured using the 30-day and 90-day mortality rate, ventriculoperitoneal (VP) shunt dependent rate, and Glasgow Outcome Scale after three months. Results The clinical features of the 24 patients in each group showed no significant differences in age or Glasgow Coma Scale assessment on admission. There was also no significant difference in intracerebral hemorrhage volume or Graeb score between the Endoscopic group and the EVD group. The length of ICU stay was 11 ± 5 days in the Endoscopic Surgery group and 18 ± 7 days in the EVD group. The Endoscopic Surgery group had a shorter ICU stay ( P = 0.04) compared with the EVD group. The 30-day and 90-day mortality rates were 12.5% and 20.8% in the Endoscopic Surgery group and 12.5% and 16.6% in the EVD group, respectively. The mean Glasgow Outcome Scale score was 3.08 ± 1.38 in the Endoscopic Surgery group and 3.33 ± 1.40 in the EVD group. Outcome significantly correlated with initial consciousness level; the severity of IVH did not influence the outcome in all of the cases. There was no significant difference in mortality rate or outcome between the Endoscopic group and the EVD group. The VP shunt rates were 47.62% in the Endoscopic Surgery group and 90.48% in the EVD group. Endoscopic Surgery group had a significant lower VP shunt rate ( P = 0.002; odds rate=9.8) compared with the EVD group. Conclusions Endoscopic Surgery was found to have significantly lower shunt-dependent hydrocephalus, and the ICU stay was shorter compared with EVD Surgery. This can decrease the need for permanent VP shunts in patients with IVH caused by thalamic hemorrhage.
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Endoscopic Surgery for spontaneous basal ganglia hemorrhage comparing Endoscopic Surgery stereotactic aspiration and craniotomy in noncomatose patients
Surgical Neurology, 2006Co-Authors: Chun Chung Chen, Cheng-siu ChangAbstract:Abstract Background This prospective study aimed to evaluate the safety, neurological outcomes, and cost-effectiveness of 3 surgical procedures for spontaneous basal ganglia hemorrhage. Methods Ninety noncomatose patients with basal ganglia hemorrhages were randomized into 3 groups. Group A (n = 30) underwent Endoscopic Surgery, group B (n = 30) underwent stereotactic aspiration, and group C (n = 30) underwent craniotomy. Waiting time of Surgery, length of operation time, and blood loss were compared between all groups. On the second operative day, we evaluated the amount of residual hematoma and the hematoma evacuation rate by computed tomography scan. Surgical mortality and complications were recorded 3 months after the procedure. Neurological outcomes were evaluated by functional independence measure (FIM) score, Barthel index score, and muscle power (MP) of affected limbs 6 months after Surgery. We also evaluated the cost-effectiveness of each procedure. Results There was significant delay in waiting timing of the stereotactic aspiration (172.56 ± 93.18 minutes; P Conclusions Both Endoscopic Surgery and stereotactic aspiration are minimally invasive and are effective procedures with low complication and mortality rates; however, the waiting timing of stereotactic aspiration is usually longer. Endoscopic Surgery may be an appropriate substitute for stereotactic aspiration. It produces good neurological outcomes and aids in rapid hematoma evacuation. Craniotomy may be used for emergency decompression of enlarged hematoma if Endoscopic Surgery or stereotactic aspiration is not available.
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Endoscopic Surgery for spontaneous basal ganglia hemorrhage: comparing Endoscopic Surgery, stereotactic aspiration, and craniotomy in noncomatose patients
Surgical Neurology, 2006Co-Authors: Der Yang Cho, Chun Chung Chen, Cheng-siu Chang, Wen-yuan Lee, Melain TsoAbstract:Abstract Background This prospective study aimed to evaluate the safety, neurological outcomes, and cost-effectiveness of 3 surgical procedures for spontaneous basal ganglia hemorrhage. Methods Ninety noncomatose patients with basal ganglia hemorrhages were randomized into 3 groups. Group A (n = 30) underwent Endoscopic Surgery, group B (n = 30) underwent stereotactic aspiration, and group C (n = 30) underwent craniotomy. Waiting time of Surgery, length of operation time, and blood loss were compared between all groups. On the second operative day, we evaluated the amount of residual hematoma and the hematoma evacuation rate by computed tomography scan. Surgical mortality and complications were recorded 3 months after the procedure. Neurological outcomes were evaluated by functional independence measure (FIM) score, Barthel index score, and muscle power (MP) of affected limbs 6 months after Surgery. We also evaluated the cost-effectiveness of each procedure. Results There was significant delay in waiting timing of the stereotactic aspiration (172.56 ± 93.18 minutes; P P P P P = .21). The complication rate was 3.3% in group A, 10% in group B, and 16.6% in group C ( P = .62). The most major complications were rebleeding and infection. The FIM score was higher in the Endoscopic Surgery (79.90 ± 36.64) than in the craniotomy (33.84 ± 18.99; P = .001). The Barthel index score was also significantly better in the Endoscopic Surgery (50.45 ± 28.59) than in the craniotomy (16.39 ± 20.93; P = .006). There was more improvement in MP of affected limbs in Endoscopic Surgery than in craniotomy ( P = .004). Endoscopic Surgery was more cost-effective than craniotomy using FIM and Barthel index ( P P Conclusions Both Endoscopic Surgery and stereotactic aspiration are minimally invasive and are effective procedures with low complication and mortality rates; however, the waiting timing of stereotactic aspiration is usually longer. Endoscopic Surgery may be an appropriate substitute for stereotactic aspiration. It produces good neurological outcomes and aids in rapid hematoma evacuation. Craniotomy may be used for emergency decompression of enlarged hematoma if Endoscopic Surgery or stereotactic aspiration is not available.
Cheng-siu Chang - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic Surgery for spontaneous basal ganglia hemorrhage comparing Endoscopic Surgery stereotactic aspiration and craniotomy in noncomatose patients
Surgical Neurology, 2006Co-Authors: Chun Chung Chen, Cheng-siu ChangAbstract:Abstract Background This prospective study aimed to evaluate the safety, neurological outcomes, and cost-effectiveness of 3 surgical procedures for spontaneous basal ganglia hemorrhage. Methods Ninety noncomatose patients with basal ganglia hemorrhages were randomized into 3 groups. Group A (n = 30) underwent Endoscopic Surgery, group B (n = 30) underwent stereotactic aspiration, and group C (n = 30) underwent craniotomy. Waiting time of Surgery, length of operation time, and blood loss were compared between all groups. On the second operative day, we evaluated the amount of residual hematoma and the hematoma evacuation rate by computed tomography scan. Surgical mortality and complications were recorded 3 months after the procedure. Neurological outcomes were evaluated by functional independence measure (FIM) score, Barthel index score, and muscle power (MP) of affected limbs 6 months after Surgery. We also evaluated the cost-effectiveness of each procedure. Results There was significant delay in waiting timing of the stereotactic aspiration (172.56 ± 93.18 minutes; P Conclusions Both Endoscopic Surgery and stereotactic aspiration are minimally invasive and are effective procedures with low complication and mortality rates; however, the waiting timing of stereotactic aspiration is usually longer. Endoscopic Surgery may be an appropriate substitute for stereotactic aspiration. It produces good neurological outcomes and aids in rapid hematoma evacuation. Craniotomy may be used for emergency decompression of enlarged hematoma if Endoscopic Surgery or stereotactic aspiration is not available.
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Endoscopic Surgery for spontaneous basal ganglia hemorrhage: comparing Endoscopic Surgery, stereotactic aspiration, and craniotomy in noncomatose patients
Surgical Neurology, 2006Co-Authors: Der Yang Cho, Chun Chung Chen, Cheng-siu Chang, Wen-yuan Lee, Melain TsoAbstract:Abstract Background This prospective study aimed to evaluate the safety, neurological outcomes, and cost-effectiveness of 3 surgical procedures for spontaneous basal ganglia hemorrhage. Methods Ninety noncomatose patients with basal ganglia hemorrhages were randomized into 3 groups. Group A (n = 30) underwent Endoscopic Surgery, group B (n = 30) underwent stereotactic aspiration, and group C (n = 30) underwent craniotomy. Waiting time of Surgery, length of operation time, and blood loss were compared between all groups. On the second operative day, we evaluated the amount of residual hematoma and the hematoma evacuation rate by computed tomography scan. Surgical mortality and complications were recorded 3 months after the procedure. Neurological outcomes were evaluated by functional independence measure (FIM) score, Barthel index score, and muscle power (MP) of affected limbs 6 months after Surgery. We also evaluated the cost-effectiveness of each procedure. Results There was significant delay in waiting timing of the stereotactic aspiration (172.56 ± 93.18 minutes; P P P P P = .21). The complication rate was 3.3% in group A, 10% in group B, and 16.6% in group C ( P = .62). The most major complications were rebleeding and infection. The FIM score was higher in the Endoscopic Surgery (79.90 ± 36.64) than in the craniotomy (33.84 ± 18.99; P = .001). The Barthel index score was also significantly better in the Endoscopic Surgery (50.45 ± 28.59) than in the craniotomy (16.39 ± 20.93; P = .006). There was more improvement in MP of affected limbs in Endoscopic Surgery than in craniotomy ( P = .004). Endoscopic Surgery was more cost-effective than craniotomy using FIM and Barthel index ( P P Conclusions Both Endoscopic Surgery and stereotactic aspiration are minimally invasive and are effective procedures with low complication and mortality rates; however, the waiting timing of stereotactic aspiration is usually longer. Endoscopic Surgery may be an appropriate substitute for stereotactic aspiration. It produces good neurological outcomes and aids in rapid hematoma evacuation. Craniotomy may be used for emergency decompression of enlarged hematoma if Endoscopic Surgery or stereotactic aspiration is not available.
Simon Bergman - One of the best experts on this subject based on the ideXlab platform.
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natural orifice translumenal Endoscopic Surgery
Surgical Clinics of North America, 2008Co-Authors: Simon Bergman, Scott W MelvinAbstract:This article provides an overview of the currently available animal data on natural orifice translumenal Endoscopic Surgery (NOTES) on the topics of translumenal access and closure, iatrogenic intraperitoneal complications, especially infection and overinsufflation, spatial orientation, and the development of enabling technologies. Human trials to date are also reviewed and discussed.
M. Silvestrini - One of the best experts on this subject based on the ideXlab platform.
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The role of ultrasonic instruments in pharyngolaryngeal Endoscopic Surgery
European Archives of Oto-Rhino-Laryngology, 2015Co-Authors: Roberto Saetti, M. SilvestriniAbstract:The purpose of this study was to assess the applicability and efficacy of ultrasonic instruments in laryngeal and pharyngeal Endoscopic Surgery. This article describes three cases of supraglottic laryngopharyngeal carcinoma transorally treated with the Harmonic forceps, which are indicative of our preliminary experience in this field. Based on our preliminary experience, we believe that the use of the ACE Harmonic forceps opens up very encouraging prospects in transoral Endoscopic Surgery of pharyngolaryngeal tumors and can potentially become a key instrument in this area. Given their different characteristics, we believe that ultrasonic instruments should be used not so much as an alternative to, but rather in addition to those traditionally used in pharyngolaryngeal Endoscopic Surgery and laser in particular. Finally, we hope that a more widespread use of these instruments in this surgical field may encourage manufacturers to solve the current technical limitations of miniaturization, thus designing and developing more precise and accurate instruments for this type of Surgery.
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The role of ultrasonic instruments in pharyngolaryngeal Endoscopic Surgery
European Archives of Oto-rhino-laryngology, 2015Co-Authors: Roberto Saetti, M. SilvestriniAbstract:The purpose of this study was to assess the applicability and efficacy of ultrasonic instruments in laryngeal and pharyngeal Endoscopic Surgery. This article describes three cases of supraglottic laryngopharyngeal carcinoma transorally treated with the Harmonic forceps, which are indicative of our preliminary experience in this field. Based on our preliminary experience, we believe that the use of the ACE Harmonic forceps opens up very encouraging prospects in transoral Endoscopic Surgery of pharyngolaryngeal tumors and can potentially become a key instrument in this area. Given their different characteristics, we believe that ultrasonic instruments should be used not so much as an alternative to, but rather in addition to those traditionally used in pharyngolaryngeal Endoscopic Surgery and laser in particular. Finally, we hope that a more widespread use of these instruments in this surgical field may encourage manufacturers to solve the current technical limitations of miniaturization, thus designing and developing more precise and accurate instruments for this type of Surgery.
