The Experts below are selected from a list of 164862 Experts worldwide ranked by ideXlab platform
Lieschen H Quiroz - One of the best experts on this subject based on the ideXlab platform.
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is de novo stress incontinence after sacrocolpopexy related to anatomical changes and Surgical Approach
International Urogynecology Journal, 2014Co-Authors: Edgar L Leclaire, Dena White, Marium S Mukati, Dianna Juarez, Lieschen H QuirozAbstract:Introduction and hypothesis The objective was to investigate the relationship between new onset postoperative stress urinary incontinence (SUI) after sacrocolpopexy (SCP) and anatomical change/Surgical Approach.
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is de novo stress incontinence after sacrocolpopexy related to anatomical changes and Surgical Approach
International Urogynecology Journal, 2014Co-Authors: Edgar L Leclaire, Dena White, Marium S Mukati, Dianna Juarez, Lieschen H QuirozAbstract:The objective was to investigate the relationship between new onset postoperative stress urinary incontinence (SUI) after sacrocolpopexy (SCP) and anatomical change/Surgical Approach. We analyzed a retrospective cohort of patients with negative preoperative testing for SUI who underwent SCP from 2005 to 2012. Our primary outcome was new onset postoperative SUI. Logistic regression was used to examine the relationship among anatomical change, defined as ΔAa, ΔBa, ΔC, and ΔTVL, and Surgical Approach, categorized as abdominal (ASCP) for open cases and minimally invasive (MISCP) for laparoscopic and robot-assisted cases, and postoperative SUI. Of 795 cases, 33 ASCP (43%) and 44 MISCP (57%) met the inclusion criteria for analysis. New onset SUI was demonstrated by 15 patients (45%) of the ASCP group and 7 patients (15%) of the MISCP group (p = 0.005). New onset SUI was significantly associated with route of SCP and ΔAa (p = 0.006 and p = 0.033 respectively). Controlling for ΔAa, the odds of new onset SUI were 4.4 times higher in the ASCP group compared with the MISCP group (OR 4.37, 95% CI 1.42, 13.48). Controlling for route of SCP, the odds of new onset SUI were 2.2 times higher with moderate ΔAa compared with low ΔAa (OR 2.16 95% CI 1.07, 4.38). The odds of new onset SUI was 4.7 times higher in those with high ΔAa than in those with low ΔAa (OR 4.67 95% CI 1.14, 19.22). ΔBa, ΔC, and ΔTVL were not associated with new onset SUI. Greater reduction in point Aa and abdominal Surgical route are risk factors for new onset postoperative SUI after SCP.
Joseph Woo - One of the best experts on this subject based on the ideXlab platform.
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impact of Surgical Approach in double lung transplantation median sternotomy decreases operative and cardiopulmonary bypass time compared to clamshell thoracotomy
Journal of Heart and Lung Transplantation, 2019Co-Authors: Yasuhiro Shudo, Daniel Rinewalt, Bharathi Lingala, Flora Y Kim, Jack H Boyd, Anson M Lee, William Hiesinger, Maria E Currie, John W Macarthur, Joseph WooAbstract:Purpose Double lung transplantation (DLT) remains the gold standard for end-stage lung disease. While DLT was historically performed via clamshell thoracotomy, recently the median sternotomy has emerged as a viable alternative. As the ideal Surgical Approach remains unclear, the aim of our study was to compare the short and long-term outcomes of these two Surgical Approaches in DLT. Methods We retrospectively reviewed 192 consecutive adult patients who underwent primary DLT at our institution between 2012 and 2017 (Sternotomy, n=147; Clamshell, n=45). The impact of each Surgical Approach on post-transplant morbidity and overall survival probability analysis was performed. Results There were no significant differences in recipients’ baseline and donors’ characteristics and bilateral allograft ischemic time (Table). Freedom from primary graft dysfunction, acute rejection episode, post-operative prolonged ventilator support, tracheostomy, postoperative stroke, and airway dehiscence was comparable between these two groups (p=NS for all). However, the durations of cardiopulmonary bypass (p=0.01) and operative time (p Conclusion The median sternotomy Approach in DLT decreases operative time and more importantly leads to a shorter duration of cardiopulmonary bypass. The type of Surgical Approach did not show any statistically significant impact on adult DLT recipients’ morbidity and survival probability.
Wolfgang Koenen - One of the best experts on this subject based on the ideXlab platform.
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functional and aesthetic reconstruction of full thickness defects of the lower lip after tumor resection analysis of 59 cases and discussion of a Surgical Approach
Dermatologic Surgery, 2010Co-Authors: Jorg Faulhaber, Cyrill Geraud, Sergij Goerdt, Wolfgang KoenenAbstract:BACKGROUND Carcinoma of the lower lip is a common cancer of the head and neck region. The accepted standard of care is Surgical resection and reconstruction. The delicate location poses a challenge to surgeons because they have to aim for conflicting goals: complete oncological resection and functional and aesthetic restoration. For over a century, this challenge led to the development of more than 100 different reconstructive procedures. OBJECTIVE To develop a standardized Surgical Approach to simplify selection of an adequate reconstructive procedure. MATERIALS AND METHODS We performed a review of the literature and a retrospective analysis of 59 patients treated according to a standardized Surgical Approach over the past 5 years. RESULTS By taking into account the anatomic location, the width of the defect, and the amount of tissue loss, three flowcharts have been developed to guide the physician to a selection of suitable reconstructive procedures for each case. CONCLUSION This Surgical Approach facilitated the successful reconstruction of all encountered defects, and over a mean period of 31 months, no recurrences or major complications were seen.
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functional and aesthetic reconstruction of full thickness defects of the lower lip after tumor resection analysis of 59 cases and discussion of a Surgical Approach
Dermatologic Surgery, 2010Co-Authors: Jorg Faulhaber, Cyrill Geraud, Sergij Goerdt, Wolfgang KoenenAbstract:BACKGROUND Carcinoma of the lower lip is a common cancer of the head and neck region. The accepted standard of care is Surgical resection and reconstruction. The delicate location poses a challenge to surgeons because they have to aim for conflicting goals: complete oncological resection and functional and aesthetic restoration. For over a century, this challenge led to the development of more than 100 different reconstructive procedures. OBJECTIVE To develop a standardized Surgical Approach to simplify selection of an adequate reconstructive procedure. MATERIALS AND METHODS We performed a review of the literature and a retrospective analysis of 59 patients treated according to a standardized Surgical Approach over the past 5 years. RESULTS By taking into account the anatomic location, the width of the defect, and the amount of tissue loss, three flowcharts have been developed to guide the physician to a selection of suitable reconstructive procedures for each case. CONCLUSION This Surgical Approach facilitated the successful reconstruction of all encountered defects, and over a mean period of 31 months, no recurrences or major complications were seen. The authors have indicated no significant interest with commercial supporters.
Yasuhiro Shudo - One of the best experts on this subject based on the ideXlab platform.
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impact of Surgical Approach in double lung transplantation median sternotomy vs clamshell thoracotomy
Transplantation proceedings, 2020Co-Authors: Yasuhiro Shudo, Daniel Rinewalt, Bharathi Lingala, Flora Y Kim, Jack H Boyd, Anson M Lee, William Hiesinger, Maria E Currie, John W Macarthur, Joseph Y WooAbstract:Abstract Background Double lung transplantation (DLT) remains the gold standard for end-stage lung disease. Although DLT was historically performed via clamshell thoracotomy, recently the median sternotomy has emerged as a viable alternative. As the ideal Surgical Approach remains unclear, the aim of our study was to compare the short- and long-term outcomes of these 2 Surgical Approaches in DLT. Methods We retrospectively reviewed 192 consecutive adult patients who underwent primary DLT at our institution between 2012 and 2017 (sternotomy, n = 147; clamshell, n = 45). The impact of each Surgical Approach on post-transplant morbidity was investigated, and the overall survival probability analyses were performed. Results There were no significant differences in recipients’ baseline and donors’ characteristics and bilateral allograft ischemic time. Freedom from primary graft dysfunction, acute rejection episodes, postoperative prolonged ventilator support, tracheostomy, postoperative stroke, and airway dehiscence were comparable between these 2 groups. The duration of cardiopulmonary bypass and operative time were significantly longer in the clamshell thoracotomy group. Postoperative extracorporeal membrane oxygenation usage tended to be more frequent in the clamshell thoracotomy group than the median sternotomy group, despite no statistical significance. Length of hospital and intensive care unit stay were not influenced by the type of incision. There was no significant difference in overall survival between these 2 procedure groups (P = .61, log-rank test). Conclusions The median sternotomy Approach in DLT decreases operative time and more importantly leads to a shorter duration of cardiopulmonary bypass. The type of Surgical Approach did not show any statistically significant impact on adult DLT recipients’ morbidity and survival.
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impact of Surgical Approach in double lung transplantation median sternotomy decreases operative and cardiopulmonary bypass time compared to clamshell thoracotomy
Journal of Heart and Lung Transplantation, 2019Co-Authors: Yasuhiro Shudo, Daniel Rinewalt, Bharathi Lingala, Flora Y Kim, Jack H Boyd, Anson M Lee, William Hiesinger, Maria E Currie, John W Macarthur, Joseph WooAbstract:Purpose Double lung transplantation (DLT) remains the gold standard for end-stage lung disease. While DLT was historically performed via clamshell thoracotomy, recently the median sternotomy has emerged as a viable alternative. As the ideal Surgical Approach remains unclear, the aim of our study was to compare the short and long-term outcomes of these two Surgical Approaches in DLT. Methods We retrospectively reviewed 192 consecutive adult patients who underwent primary DLT at our institution between 2012 and 2017 (Sternotomy, n=147; Clamshell, n=45). The impact of each Surgical Approach on post-transplant morbidity and overall survival probability analysis was performed. Results There were no significant differences in recipients’ baseline and donors’ characteristics and bilateral allograft ischemic time (Table). Freedom from primary graft dysfunction, acute rejection episode, post-operative prolonged ventilator support, tracheostomy, postoperative stroke, and airway dehiscence was comparable between these two groups (p=NS for all). However, the durations of cardiopulmonary bypass (p=0.01) and operative time (p Conclusion The median sternotomy Approach in DLT decreases operative time and more importantly leads to a shorter duration of cardiopulmonary bypass. The type of Surgical Approach did not show any statistically significant impact on adult DLT recipients’ morbidity and survival probability.
Robert B Bourne - One of the best experts on this subject based on the ideXlab platform.
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isolated liner exchange in revision total hip arthroplasty clinical results using the direct lateral Surgical Approach
Journal of Arthroplasty, 2004Co-Authors: Jeremy J Obrien, Robert B Bourne, Stephen R J Burnett, Richard W Mccalden, Steven J Macdonald, Cecil H RorabeckAbstract:Abstract Twenty-four hips (23 patients) underwent isolated polyethylene liner exchange (modular and nonmodular liners) via the direct lateral Surgical Approach for a preoperative diagnosis of polyethylene wear and acetabular osteolysis. Accessible osteolytic lesions were bone grafted with cancellous allograft. Patients were followed up clinically and radiographically, with a mean follow-up time of 36 months (range, 12–100 months). A computer-assisted method measured lesional area from the radiographs of the 18 hips that presented with osteolysis. Seventeen of 18 lesions either regressed or resolved since the procedure. Two patients required repeat revisions, and no dislocations were noted. Clinically, both Harris Hip and Western Ontario and McMaster Universities Osteoarthritis Index scores improved postoperatively. In selected patients, isolated liner exchange with or without bone grafting is effective for treating polyethylene wear and associated osteolysis. Dislocation rates with revision may be reduced using a Surgical Approach that preserves an adequate capsular layer for closure in liner exchange surgery.
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Surgical Approach abductor function and total hip arthroplasty dislocation
Clinical Orthopaedics and Related Research, 2002Co-Authors: John L Masonis, Robert B BourneAbstract:Dislocation is a leading early complication of total hip arthroplasty. The effect of Surgical Approach on instability and abductor function is a controversial topic. A comprehensive literature review was done to evaluate the correlation of Surgical Approach and primary total hip arthroplasty dislocation. Two hundred sixty clinical studies were identified between 1970 and 2001. Four prospective studies were identified but individually they contained insufficient power or control groups to reach statistical significance regarding Surgical Approach and dislocation. Fourteen studies involving 13,203 primary total hip arthroplasties met the inclusion criteria based on variables previously shown to affect stability. These studies were evaluated with respect to Surgical Approach and dislocation. The combined dislocation rate for these studies was 1.27% for the transtrochanteric Approach, 3.23% for the posterior Approach (3.95% without posterior repair and 2.03% with posterior repair), 2.18% for the anterolateral Approach, and 0.55% for the direct lateral Approach. Eight studies involving 2455 primary total hip arthroplasties evaluated postoperative limp. The incidence of postoperative limp was 4% to 20% for patients who had the lateral Approach and 0% to 16% for patients who had the posterior Approach. The quality of the literature regarding Surgical Approach, dislocation rates, and abductor function is limited. Larger controlled prospective studies are needed to investigate the potential benefits of the posterior Approach in lieu of a dislocation rate six times higher than the direct lateral Approach for primary total hip arthroplasty.
