Comparison of cosmetic ef­fects after short longitudinal and transverse skin incision for carotid endarterectomy

2019 ◽  
Vol 82/115 (2) ◽  
pp. 194-202
Author(s):  
Tomáš Hrbáč ◽  
David Školoudík ◽  
David Otáhal ◽  
Táňa Fadrná ◽  
Roman Herzig
Neurosurgery ◽  
2014 ◽  
Vol 75 (2) ◽  
pp. 110-116 ◽  
Author(s):  
George A. C. Mendes ◽  
Joseph M. Zabramski ◽  
Ali M. Elhadi ◽  
M. Yashar S. Kalani ◽  
Mark C. Preul ◽  
...  

Abstract BACKGROUND: Cranial nerve injury (CNI) is the most common neurological complication associated with carotid endarterectomy (CEA). Some authors postulate that the transverse skin incision leads to increased risk of CNI. OBJECTIVE: We compared the incidence of CNI associated with the transverse and longitudinal skin incisions in a high-volume cerebrovascular center. METHODS: We reviewed the charts of 226 consecutive patients who underwent CEAs between January 2007 and August 2009. Pre- and postoperative standardized neurological evaluations were performed by faculty neurologists and neurosurgeons. RESULTS: One hundred sixty nine of 226 (75%) CEAs were performed with the use of a transverse incision. The longitudinal incision was generally reserved for patients with a high-riding carotid bifurcation. Mean patient age was 69 years (range, 45–91 years); 62% were men; 59% of patients were symptomatic and had high-grade stenosis (70%-99%). CNI occurred in 8 cases (3.5%): 5 (3%) in transverse and 3 (5.3%) with longitudinal incisions (P = .42). There were 2 marginal mandibular nerve injuries, 1 (0.6%) transverse and 1 longitudinal; 5 recurrent laryngeal nerve injuries, 4 transverse and 1 longitudinal; and 1 case of hypoglossal nerve injury associated with longitudinal incision. One hematoma was associated with CNI. All injuries were transient. Fourteen wound hematomas required surgical evacuation. CONCLUSION: The transverse skin incision for CEAs is not associated with an increased risk of CNI (P =.42). In this study, the incidence of CNI associated with the transverse incision was 3% (n = 5) vs 5% (n = 3) for longitudinal incisions. All CNIs were temporary.


2017 ◽  
Vol 381 ◽  
pp. 517
Author(s):  
T. Hrbac ◽  
D. Skoloudik ◽  
D. Otahal ◽  
T. Fadrna ◽  
Z. Vecera

2021 ◽  
pp. 65-70
Author(s):  
Bibekananda Das ◽  
Abhijit Pahari ◽  
Kajal Kumar Patra

Background: The most common major abdominal operation done on women is Caesarean section. Over the past century delivery by Caesarean section has been increased in both developed and developing countries. Various abdominal incisions have been used for Cesarean delivery. Today most of the caesarean section are performed with either a vertical infra umbilical midline incision [VIUI] or pfannenstiel incision. Both the skin incisions possess some benets and drawbacks. Methods: This study was a prospective cohort study conducted in the department of Gynaecology & Obstetrics, Burdwan Medical College & Hospital, Burdwan, West Bengal a tertiary teaching institute, from July, 2017 to November, 2018. 142 mothers were included in the study after informed consent from the patient about being a part of this study. Among them, 37 were with midline vertical skin incision, 51 were with transverse skin incision, and 54 were primigravida. Categorical variables are expressed as Number of patients and percentage of patients and compared across the groups using Pearson's Chi Square test for Independence of Attributes/ Fisher's Exact Test as appropriate. Results: 57.41% of primigravida are in 18 to 20 years age group, 42.59 % in 21-25 years, no women was over 25 years. women with previous vertical incision 27.03% have no adhesion, 59.46 % have mild adhesion, and 13.51% have severe adhesion. In women with previous transverse incision 21.57% have no adhesion, 47.06% have mild adhesion and 31.37%have severe adhesion. 34.7% adhesion are between uterus and bladder, 26.5% adhesion are between uterus and omentum, 20.4% adhesion are between uterus and abdominal wall, 12.2% adhesion between omentum and abdominal wall, 6.2% adhesion are in others organ Conclusions: There was signicant delay in delivery of neonates in post caesarean mothers with previous transverse skin incision than vertical incision. Previous transverse skin incision is associated with more severe adhesion than vertical skin incision


2014 ◽  
Vol 33 (2) ◽  
pp. 104
Author(s):  
El-SayedA Abd El-Mabood ◽  
HazemE Ali ◽  
MokhtarA Bahbah ◽  
Hamed Rashad ◽  
NasserA Zaher ◽  
...  

2005 ◽  
Vol 42 (6) ◽  
pp. 1089-1093 ◽  
Author(s):  
Enrico Ascher ◽  
Anil Hingorani ◽  
Natalie Marks ◽  
Richard W. Schutzer ◽  
Manikyam Mutyala ◽  
...  

2020 ◽  
Vol 11 ◽  
pp. 147
Author(s):  
Masaru Honda ◽  
Hajime Maeda

Background: The twisted carotid artery is a variant, in which the internal carotid artery (ICA) courses medially to the external carotid artery. Due to the sparse descriptions in the literature, we, here, report our experience with cases of carotid endarterectomy (CEA) for twisted carotid artery and its clinical features. Methods: Fifty-seven consecutive CEA-treated patients were evaluated, and the twist angle was measured on the source images of axial slices of computed tomography angiography (CTA). Results: Eight male patients (14.2%) demonstrated a twisted right ICA (mean age, 77.0 ± 2.6 years; and mean stenosis, 66.9% ± 19.9%). The mean twist angle was 30.1° ± 17.9°, while the normal ICA is angled at −23.0° ± 12.3°. No statistical differences in the distribution of coexisting diseases were found between the normal and twisted ICA cases. CEA was successfully performed with the correction of the carotid position in all cases; however, significant position correction was not observed in the postoperative evaluation. Right-side dominancy (P = 0.045) and prolonged clamping time (P = 0.053) were observed in the twisted cases. Conclusion: Twisted ICA was preferentially found in the right ICA and men. CEA of the twisted ICA was safely performed with appropriate head rotation and wider longitudinal skin incision than usual without a significant increase in the operative time. CTA is useful for preoperative evaluation. This specific variation should be considered by the neurosurgeon involved in the evaluation and treatment of carotid stenoses.


Author(s):  
Gianmarco de Donato ◽  
Edoardo Pasqui ◽  
Claudia Panzano ◽  
Massimiliano Walter Guerrieri ◽  
Domenico Benevento ◽  
...  

1999 ◽  
Vol 6 (5) ◽  
pp. E3
Author(s):  
Hae-Dong Jho

Object To minimize the invasiveness and maximize the adequacy of the decompressive proceedure in thoracic discectomy, a 70° endoscope was adopted to perform transpedicular thoracic discectomy. Methods A posterior transpedicular approach was performed via a 2-cm transverse skin incision, using the operating microscope or a 0°-lens endoscope. Using a 70°-lens endoscope, discectomy was performed after obtaining direct visualization of the ventral aspect of the spinal cord dura mater. This surgical technique has been used in 25 patients. There were 12 men and 13 women whose age ranged from 29 to 70 years (median 46 years). Thirteen patients experienced myelopathy, with or without radiculopathy, 10 presented with radiculopathy, and two patients suffered from segmental pain. The follow-up period ranged from 4 to 60 months (median 27 months). In 12 of the 13 patients with myelopathy, excellent improvement was shown postoperatively. In the remaining patient, symptoms recurred when she was injured in a motor vehicle accident 3 months postsurgery. In nine of 10 patients with radiculopathy pain resolved completely. In the one patient with right-sided hypochondral pain and in the two patients with segmental pain no relief was obtained despite excellent discectomy results that were demonstrated on postoperative magnetic resonance images. The average length of hospital stay was overnight. Conclusions The use of a 70°-lens endoscope via a transpedicular route has made thoracic discectomy comparable with cervical or lumbar discectomy in its surgical invasiveness, in the patient's recovery time, and in complexity of surgical procedure.


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