scholarly journals Conservative management of major anastomotic leaks occurring after primary repair in esophageal atresia with fistula: Role of extrapleural approach

2020 ◽  
Vol 25 (3) ◽  
pp. 155
Author(s):  
Sanjay Kulshrestha ◽  
Meeta Kulshrestha ◽  
Vinay Tewari ◽  
Nikhil Chaturvedi ◽  
Atul Goyal ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Conservative Management ◽  
Primary Repair ◽  
Anastomotic Leaks ◽  
Extrapleural Approach

Esophageal Atresia and Associated Duodenal Atresia: A Cohort Study and Review of the Literature

2020 ◽  
Author(s):  
Maria Enrica Miscia ◽  
Giuseppe Lauriti ◽  
Dacia Di Renzo ◽  
Angela Riccio ◽  
Gabriele Lisi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Esophageal Atresia ◽  
Primary Repair ◽  
English Literature ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Primary Treatment ◽  
Duodenal Atresia ◽  
Staged Approach ◽  
Missed Diagnosis

Abstract Introduction Esophageal atresia (EA) is associated with duodenal atresia (DA) in 3 to 6% of cases. The management of this association is controversial and literature is scarce on the topic. Materials and Methods We aimed to (1) review the patients with EA + DA treated at our institution and (2) systematically review the English literature, including case series of three or more patients. Results Cohort study: Five of seventy-four patients with EA had an associated DA (6.8%). Four of five cases (80%) underwent primary repair of both atresia, one of them with gastrostomy placement (25%). One of five cases (20%) had a delayed diagnosis of DA. No mortality has occurred. Systematic Review: Six of six-hundred forty-five abstract screened were included (78 patients). Twenty-four of sixty-eight (35.3%) underwent primary correction of EA + DA, and 36/68 (52.9%) underwent staged correction. Nine of thirty-six (25%) had a missed diagnosis of DA. Thirty-six of sixty-eight underwent gastrostomy placement. Complications were observed in 14/36 patients (38.9 ± 8.2%). Overall mortality reported was 41.0 ± 30.1% (32/78 patients), in particular its incidence was 41.7 ± 27.0% after a primary treatment and 37.0 ± 44.1% following a staged approach. Conclusion The management of associated EA and DA remains controversial. It seems that the staged or primary correction does not affect the mortality. Surgeons should not overlook DA when correcting an EA.

scholarly journals ROLE OF PHYSICAL THERAPY IN THE TREATMENT OF POSTERIOR ANKLE IMPINGEMENT IN PEDIATRIC ATHLETES - A PROSPECTIVE STUDY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Adam Saloom ◽  
Nick Purcell ◽  
Matthew Ruhe ◽  
Jorge Gomez ◽  
Jonathan Santana ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Prospective Study ◽  
Conservative Management ◽  
Pediatric Patients ◽  
Weight Bearing ◽  
Return To Sport ◽  
Time To Surgery ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Background: Posterior ankle impingement (PAI) is a known cause of posterior ankle pain in athletes performing repetitive plantarflexion motion. Even though empirically recommended in adult PAI, there is minimal literature related to the role of conservative physical therapy (PT) in pediatric patients. Purpose: To identify patient characteristics and determine if there is a difference in pediatric patients with PAI who were successful with conservative PT and those who were unsuccessful, requiring surgical intervention. Methods: Prospective study at a tertiary children’s hospital included patients <18 years diagnosed with PAI and underwent PT. Patients who received PT at an external facility were excluded. Collected data included demographics, initial presentation at PT evaluation, treatment throughout PT, patient presentation at PT discharge, time to return to sport (RTS) from initial PT evaluation (if successful), time to surgery from initial PT evaluation (if unsuccessful). Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were collected. Group comparisons were conducted using independent t-tests or chi-square analyses (alpha level set at .05). Results: 31 (12 males, 19 females) patients diagnosed with PAI were enrolled with a mean age 12.61 years (range: 8-17). Gymnastics, football, and basketball were the most commonly implicated sports (42% patients). All patients underwent initial conservative PT for an average of 16.24 weeks (9.23 visits ±7.73). 20/31(64.5%) patients failed conservative management and underwent arthroscopic debridement. PAI pathology was predominantly bony in 61.3% and soft tissue 38.7%. Between the successful PT group and unsuccessful PT group, there was no difference in the proportion of athletes/non-athletes (p=.643). Average RTS time for successful group was 11.47 weeks and average time to surgery for unsuccessful group was 17.82 weeks. There were no significant differences in sex (p=.332), age (p=.674), number of PT visits (p=.945), initial weight-bearing status (p=.367), use of manual therapy (p=.074) including manipulation (p=.172) and mobilization (p=.507), sport (p=.272), initial evaluation ankle ROM (p>.05). Initial AOFAS scores for pain, function, alignment, or total were not significantly different (p=.551, .998, .555, .964 respectively). Conclusion: The first prospective study in pediatric patients with PAI demonstrates that even though success of PT is not dependent on age, sex, sport or PAI pathology, a notable proportion of patients who undergo PT do not need surgery. Conservative management including PT should be the initial line of management for PAI. PT treatment and surgery (if unsuccessful with PT) allowed patients to return to prior level of activity/sports. Tables/Figures: [Table: see text]

The Role of Conservative Management in Incidental Os Odontoideum

2016 ◽  
Vol 88 ◽  
pp. 695.e15-695.e17 ◽  
Author(s):  
David White ◽  
Rafid Al-Mahfoudh
Keyword(s):  
Conservative Management ◽  
Os Odontoideum

Clinically Relevant Tracheomalacia after Repair of Esophageal Atresia: the Role of Minimal Intra-Operative Dissection and Timing for Aortopexy

2006 ◽  
Vol 54 (03) ◽  
pp. 178-181 ◽  
Author(s):  
A. Dodge-Khatami ◽  
D. Deanovic ◽  
P. Sacher ◽  
M. Weiss ◽  
A. Gerber
Keyword(s):  
Esophageal Atresia

A flexible approach to achieve a true primary repair for all infants with esophageal atresia

2005 ◽  
Vol 14 (1) ◽  
pp. 8-15 ◽  
Author(s):  
John E. Foker ◽  
Tara C. Kendall ◽  
Kirsti Catton ◽  
Khalid M. Khan
Keyword(s):  
Esophageal Atresia ◽  
Primary Repair ◽  
Flexible Approach

The role of intra-operative radiotherapy (IORT) in the conservative management of early-stage breast cancer

2005 ◽  
pp. 422-431
Author(s):  
Roberto Orecchia ◽  
Alberto Luini ◽  
Giovanna Gatti ◽  
Mattia Intra ◽  
Mario Ciocca ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Conservative Management ◽  
Early Stage ◽  
Early Stage Breast Cancer

scholarly journals Role of Ayurveda in the conservative management of avascular necrosis of the femoral head: A case study

2016 ◽  
Vol 35 (3) ◽  
pp. 173
Author(s):  
Ashutosh Chaturvedi ◽  
MAshvini Kumar ◽  
BA Lohith ◽  
BS Praveen ◽  
C Swathi
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Conservative Management
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