Holding it together � patients� perspectives on postoperative recovery when using an e-assessed follow-up

2018 ◽  
Author(s):  
Karuna Dahlberg ◽  
Maria Jaensson ◽  
Ulrica Nilsson ◽  
Mats Eriksson ◽  
Sigrid Odencrants
Keyword(s):  
Postoperative Recovery

scholarly journals Role of Invasive Urodynamic Studies in Establishing Cauda Equina Syndrome and Postoperative Recovery

2020 ◽  
pp. 219256822097964
Author(s):  
Abhinandan Reddy Mallepally ◽  
Bibhudendu Mohapatra ◽  
Kalidutta Das
Keyword(s):  
Clinical Symptoms ◽  
False Positive Rate ◽  
Cauda Equina ◽  
Postoperative Recovery ◽  
Normal Bladder ◽  
Acontractile Detrusor ◽  
Positive Rate ◽  
Acute Radiculopathy ◽  
Operative Recovery

Study design: Retrospective with prospective follow-up. Objective: Confirming the diagnosis of CES based purely on symptoms and signs is unreliable and usually associated with high false positive rate. A missed diagnosis can permanently disable the patient. Present study aims to determine the relationship between clinical symptoms/ signs (bladder dysfunction) with UDS, subsequently aid in surgical decision making and assessing post-operative recovery. Methods: A prospective follow-up of patients with disc herniation and bladder symptoms from January 2018 to July 2020 was done. All patients underwent UDS and grouped into acontractile, hypocontractile and normal bladder. Data regarding PAS, VAC, GTP, timing to surgery and onset of radiculopathy and recovery with correlation to UDS was done preoperatively and post operatively. Results: 107 patients were studied (M-63/F-44). Patients with PAS present still had acontractile (61%) or hypocontractile (39%) detrusor and with VAC present, 57% had acontractile and 43% hypocontractile detrusors. 10 patients with both PAS and VAC present had acontractile detrusor. 82% patients with acute radiculopathy (<2 days) improved when operated <24 hrs while only 47% showed improvement with chronic radiculopathy. The detrusor function recovered in 66.1% when operated <12 hours, 40% in <12-24 hours of presentation. Conclusion: Adjuvant information from UDS in combination with clinicoradiological findings help in accurate diagnosis even in patients with no objective motor and sensory deficits. Quantitative findings on UDS are consistent with postoperative recovery of patient’s urination power, representing improvement and can be used as a prognostic factor.

scholarly journals Clitorial inclusion cyst in an adult: a rare presentation

2019 ◽  
Vol 8 (8) ◽  
pp. 3374
Author(s):  
Tanweerul Huda ◽  
Tarun Sutrave ◽  
Bharati Pandya
Keyword(s):  
Postoperative Recovery ◽  
Cystic Mass ◽  
The Body ◽  
Inclusion Cyst ◽  
Rare Presentation ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Rare Site ◽  
Local Examination

Dermoid cysts are benign lesions that grow slowly and can occur anywhere in the body. Clitoris is an extremely rare site for dermoids cysts. We present a case of inclusion cyst of clitoris in a middle aged woman, who had it for 10 years before presenting for relief from her symptoms. Local examination revealed a 3 cm X 4 cm size cystic mass at the clitoris giving it an appearance of clitoromegaly. She underwent an excision of the cyst at our hospital with the histopathology report suggesting the lesion to be a dermoid cyst. Postoperative recovery was uneventful with no evidence of recurrence on follow up.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

scholarly journals Gastric schwannoma: a case report and literature review

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095782
Author(s):  
Changsheng Pu ◽  
Keming Zhang
Keyword(s):  
Wedge Resection ◽  
Postoperative Recovery ◽  
Postoperative Treatment ◽  
Laparoscopic Wedge Resection ◽  
Case Presentation ◽  
Gastric Tumors ◽  
Gastric Schwannoma ◽  
History Of ◽  
Upper Abdominal

Background Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination. Conclusion Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.

scholarly journals Rapunzel syndrome resulting in gastric perforation

2016 ◽  
Vol 98 (1) ◽  
pp. e6-e7 ◽  
Author(s):  
JS Parakh ◽  
A McAvoy ◽  
DJ Corless
Keyword(s):  
Gastric Perforation ◽  
Postoperative Recovery ◽  
Patch Repair ◽  
Free Fluid ◽  
Proximal Jejunum ◽  
Rapunzel Syndrome ◽  
Omental Patch ◽  
History Of ◽  
Entire Stomach

We report the case of an 18-year-old female patient with no past medical history who presented to the emergency department with acute abdominal pain and vomiting on the background of a long history of ingesting hair (trichophagia). Computed tomography revealed pneumoperitoneum and free fluid in keeping with visceral perforation. In addition, a large hair bolus was seen extending in contiguity from the stomach to the jejunum. A laparotomy was performed, revealing an anterior gastric perforation secondary to a 120cm long trichobezoar, which had formed a cast of the entire stomach, duodenum and proximal jejunum. The bezoar was removed and an omental patch repair to the anterior ulcer was performed. The patient made an excellent postoperative recovery and was discharged home with psychiatric follow-up review.

scholarly journals Video Assisted Thoracoscopic Surgical Enucleation of a Giant Esophageal Leiomyoma Presenting with Persistent Cough

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Parvez Mujawar ◽  
Tushar Pawar ◽  
Rahulkumar Narayan Chavan
Keyword(s):  
Benign Neoplasm ◽  
Postoperative Recovery ◽  
Open Thoracotomy ◽  
Esophageal Leiomyoma ◽  
Main Symptom ◽  
Video Assisted ◽  
Persistent Cough ◽  
Esophageal Tumors ◽  
Giant Esophageal Leiomyoma

Esophageal leiomyoma is a relatively rare tumor of esophagus but it is the most common benign neoplasm of the esophagus. Small esophageal leiomyoma can be observed but larger ones and those producing symptoms should be excised. As observed for other esophageal tumors, dysphagia is its main symptom. Traditionally, open thoracotomy and enucleation are its main treatment but in the last few years video assisted thoracoscopic surgical (VATS) enucleation is gaining recognition with proven advantages of minimally invasive surgery. Herein we present our experience with patient presenting with cough rather than dysphagia as a main symptom, who was diagnosed to be having giant esophageal leiomyoma. VATS guided enucleation was accomplished successfully. Size of lesion was16×4×3 cm. Postoperative recovery was uneventful and patient is not having any signs of recurrence, after three years during follow-up period.

Low sense of coherence during postoperative recovery is associated with a poorer lumbar spinal stenosis – surgical outcome: A 5-year follow-up study

2016 ◽  
Vol 22 (3) ◽  
pp. 347-355 ◽  
Author(s):  
Maarit Pakarinen ◽  
Sanna Sinikallio ◽  
Heli Koivumaa-Honkanen ◽  
Timo Aalto ◽  
Olavi Airaksinen ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Sense Of Coherence ◽  
Functional Ability ◽  
Postoperative Outcome ◽  
Postoperative Recovery ◽  
Pain Ratings ◽  
Lumbar Spinal

This study investigated the association between the 3-month postoperative sense of coherence and the 5-year postoperative outcome of decompressive surgery for lumbar spinal stenosis. The participants with a lower sense of coherence at the 3-month follow-up had a poorer functional ability and lower satisfaction with surgery, higher pain ratings, lower life satisfaction and more depressive symptoms 5 years postoperatively. A low 3-month sense of coherence associated with greater pain and a poorer functional ability 5 years postoperatively. Evaluating sense of coherence and depressive symptoms in patients who have had lumbar spinal stenosis surgery may help in identifying those in need of enhanced support for postoperative recovery.

Feasibility of Adjuvant Chemotherapy After Pelvic Exenteration for Gynecologic Malignancies

2013 ◽  
Vol 23 (5) ◽  
pp. 923-928 ◽  
Author(s):  
Vaagn Andikyan ◽  
Fady Khoury-Collado ◽  
Samith Sandadi ◽  
William P. Tew ◽  
Roisin E. O’Cearbhaill ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Confidence Interval ◽  
Pelvic Exenteration ◽  
Gynecologic Cancer ◽  
Survival Rates ◽  
Postoperative Recovery ◽  
Gynecologic Malignancies ◽  
Select Group ◽  
Lymphovascular Space Invasion

ObjectiveIt is well documented that recurrence after pelvic exenteration remains high (up to 50%), and patients may require a prolonged period of recuperation following this aggressive surgery. We conducted a retrospective review to evaluate the feasibility of administering adjuvant chemotherapy after pelvic exenteration for gynecologic malignancies.MethodsWe reviewed the medical records of patients with any gynecologic cancer who underwent exenterative surgery between January 2005 and February 2011 at our institution. Patients were referred for postexenteration adjuvant chemotherapy based on surgeon’s discretion and/or presence of high-risk features: positive margins, positive lymph nodes, and/or lymphovascular space invasion. Suitability for chemotherapy was assessed by a gynecologic medical oncologist. Regimens consisted of 4 to 6 cycles of platinum-based doublet chemotherapy. Chemotherapy-related toxicities were assessed using the Common Terminology Criteria for Adverse Events version 4.ResultsWe identified 42 patients who underwent pelvic exenteration during the study period. Eleven (26%) were referred for adjuvant chemotherapy. Three (27%) of the 11 patients did not receive chemotherapy because of delayed postoperative recovery or physician choice. Seven (88%) of the remaining 8 patients completed all scheduled chemotherapy. Grade 2 toxicities or greater were documented in 6 patients (75%), the most common being neutropenia, neuropathy, and fatigue. Median follow-up time was 25 months (range, 6–56 months). The 3-year progression-free and overall survival rates of the 8 patients who received chemotherapy were 58% (95% confidence interval, 18%–84%) and 54% (95% confidence interval, 13%– 83%), respectively.ConclusionsThe administration of adjuvant chemotherapy is feasible for a select group of patients after pelvic exenteration for gynecologic malignancies. Our results need to be interpreted with caution because of the small and heterogeneous cohort of patients included.

scholarly journals The treatment of distal radius fractures accompanying dorsally displaced free fragments beyond the watershed line with turning radius and distal volaris radius system plate fixation via the distal palmar approach

2020 ◽  
Author(s):  
Zhaofeng Jia ◽  
Shijin Wang ◽  
Wei Jiang ◽  
Chuangli Li ◽  
Jiandong Lin ◽  
...  
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Postoperative Recovery ◽  
Distal Radius Fractures ◽  
Therapeutic Effects ◽  
Dash Score ◽  
Radius Fractures ◽  
X Ray ◽  
Palmar Approach

Abstract Background: Although distal radius fractures (DRFs) are clinically common, DRFs accompanied by dorsally displaced free fragments beyond the watershed line are much less so. At present, it is very difficult to fix and stabilize the displaced free fragments far away from the watershed line with a plate. Our aim was to investigate the clinical effect of DRFs with distally displaced dorsal free mass treated with distal volaris radius (DVR) combined with turning of the radius via the distal palmar approach. Methods: From 2015 to 2019, 25 patients with distal radius fractures associated with dorsally displaced free fragments beyond the watershed line were selected and treated with distal volaris radius (DVR) combined with turning of the radius via the distal palmar approach. This study involved 14 males and 11 females, with an average age of 34.5 years (ranging from 21 to 50 years). The mean follow-up period was 16.5 months (ranging from 12 to 22 months). The dorsal displacement of the free fragments was analyzed by X-ray and three-dimensional computed tomography, allowing characterization of postoperative recovery effects by radial height, volar tilt and radial inclination. For the follow-up, we evaluated effects of the surgery by analyzing range of motion (ROM); Modified Mayo Wrist Score (MMWS); and Disabilities of Arm, Shoulder and Hand (DASH) score. Postoperative wound recovery and complications were also monitored to evaluate the clinical therapeutic effects of the surgical procedures. Results: X-ray showed that all patients showed reduced fractures, well-healed wounds and recovered function with no obvious complications. Based on the follow-up, patients had a mean radial height of 10.5mm (ranging from 8.1 to 12.6 mm), mean MMWS of 78.8° (ranging from 61 to 90°), mean DASH score of 16.25 (ranging from 11 to 21), mean ROM for volar flexion of 76.5° (ranging from 62 to 81°), mean ROM for dorsiflexion of 77.1° (ranging from 59 to 83) and mean VAS score of 1.4 (ranging from 1 to 3). Conclusion: Treatment of distal radius fractures with accompanying dorsally displaced free fragments beyond the watershed line with turning of the radius and the DVR plate system via the distal palmar approach is effective and has no obvious complications.

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