scholarly journals Decision-Making for ALL Reconstruction and Surgical Techniques

Author(s):  
Tahsin Gurpinar
ESC CardioMed ◽  
2018 ◽  
pp. 1733-1736
Author(s):  
Jean-François Obadia ◽  
Benoit Cosset ◽  
Matteo Pozzi

The clinical picture of infective endocarditis is extremely variable and recently updated European guidelines must face this practical issue. The decision-making algorithm might be driven by the patient’s characteristics with a collaborative approach—the ‘endocarditis team’—in order to find the best antibiotic and surgical treatments.


2020 ◽  
Vol 36 (04) ◽  
pp. 395-403 ◽  
Author(s):  
Fred G. Fedok

AbstractOver the history of facial rejuvenation surgery there has been a progressive assimilation of knowledge about the anatomy of neck structures that are central to the manifestations of the aging neck. These advances in knowledge have been accompanied by the innovation and introduction of several surgical techniques to restore the neck to a more youthful appearance. The rejuvenation of the aging neck frequently incorporates a consideration and execution of accepted methods to restore the platysma muscles to a more aesthetic form. Lasting and dependable surgical techniques remain somewhat elusive and late failures in the neck continue to be a frustration for both patients and surgeons.In this manuscript, the author reviews some of the more enduring and innovative methods to manage the platysma in facelifting and cites the rationale and limitations of the various techniques. The concept of the restoration of an effective platysma “sling” in the upper neck to eliminate platysma bands and recreate a defined jawline is highlighted. A framework of patient evaluation and decision making is presented, and a suggested individualized application of accepted surgical maneuvers is suggested.


Author(s):  
Georgios Psychogios ◽  
Christopher Bohr ◽  
Jannis Constantinidis ◽  
Martin Canis ◽  
Vincent Vander Poorten ◽  
...  

2020 ◽  
Vol 41 (4) ◽  
pp. 882-886
Author(s):  
Asitha D L Jayawardena ◽  
Sarah Bouhabel ◽  
Robert L Sheridan ◽  
Christopher J Hartnick

Abstract The management of laryngotracheal stenosis (LTS) in the pediatric burn patient is complex and requires a multidisciplinary approach. The mainstay of treatment for LTS is laryngotracheal reconstruction (LTR), however, limited reports of burn-specific LTR techniques exist. Here, we provide insight into the initial airway evaluation, surgical decision making, anesthetic challenges, and incision modifications based on our experience in treating patients with this pathology. The initial airway evaluation can be complicated by microstomia, trismus, and neck contractures—the authors recommend treatment of these complications prior to initial airway evaluation to optimize safety. The surgical decision making regarding pursuing single-stage LTR, double-stage LTR, and 1.5-stage LTR can be challenging—the authors recommend 1.5-stage LTR when possible due to the extra safety of rescue tracheostomy and the decreased risk of granuloma, which is especially important in pro-inflammatory burn physiology. Anesthetic challenges include obtaining intravenous access, securing the airway, and intravenous induction—the authors recommend peripherally inserted central catheter when appropriate, utilizing information from the initial airway evaluation to secure the airway, and avoidance of succinylcholine upon induction. Neck and chest incisions are often within the TBSA covered by the burn injury—the authors recommend modifying typical incisions to cover unaffected skin whenever possible in order to limit infection and prevent wound healing complications. Pediatric LTR in the burn patient is challenging, but can be safe when the surgeon is thoughtful in their decision making.


2020 ◽  
pp. 084653712094143
Author(s):  
Jaryd R. Christie ◽  
Pencilla Lang ◽  
Lauren M. Zelko ◽  
David A. Palma ◽  
Mohamed Abdelrazek ◽  
...  

Lung cancer remains the most common cause of cancer death worldwide. Recent advances in lung cancer screening, radiotherapy, surgical techniques, and systemic therapy have led to increasing complexity in diagnosis, treatment decision-making, and assessment of recurrence. Artificial intelligence (AI)–based prediction models are being developed to address these issues and may have a future role in screening, diagnosis, treatment selection, and decision-making around salvage therapy. Imaging plays an essential role in all components of lung cancer management and has the potential to play a key role in AI applications. Artificial intelligence has demonstrated value in prognostic biomarker discovery in lung cancer diagnosis, treatment, and response assessment, putting it at the forefront of the next phase of personalized medicine. However, although exploratory studies demonstrate potential utility, there is a need for rigorous validation and standardization before AI can be utilized in clinical decision-making. In this review, we will provide a summary of the current literature implementing AI for outcome prediction in lung cancer. We will describe the anticipated impact of AI on the management of patients with lung cancer and discuss the challenges of clinical implementation of these techniques.


Author(s):  
T. Vu-Han ◽  
S. Hardt ◽  
R. Ascherl ◽  
C. Gwinner ◽  
C. Perka

Abstract Introduction Total hip arthroplasty (THA) surgeries are expected to exponentially increase in the upcoming years, likely because of the overall broader indication of THAs. With these developments, an increasing number of younger (< 50 years) and active patients will receive surgical interventions, and expectations for an active lifestyle will accordingly increase. In addition, surgeons now have a growing array of techniques and implant materials to choose from. Despite these developments, evidence to provide the best standard-of-care to patients with high expectations for return to sports (RTS) is scarce and urgently needed. What recommendations do arthroplasty surgeons currently make to patients with high return to sports expectations, what factors may influence their recommendations and what surgical techniques and implant specifications are considered favorable in the treatment of patients with a more active lifestyle? This study was conducted to analyze the current recommendations, patient assessment, and patient counseling after THA to identify trends and relevant factors for surgical decision-making in patients with high-RTS expectations. Material and methods We designed a questionnaire comprising five general items and 19 specific items that included 46 sub-items for hip arthroplasty and conducted a survey among 300 German surgeons specialized in arthroplasty at the German Arthroplasty Society (AE) to assess expert opinions, recommendations, surgical decision-making, and patient counseling for patients with high expectations for RTS after THA. Results The majority of surgeons (81.9%) were in favor of RTS after THA. Risks associated with sports after THA were considered minimal (1%), with periprosthetic fractures ranking highest, followed by hip dislocation and polyethylene wear. Some surgical decision-making was influenced by high-RTS expectations in regard to implant fixation, stem type, femoral head diameter, and bearing-surface tribology. We observed an increasingly liberal counseling of patients for high-impact sports. Conclusion With the improvement of implants and surgical techniques, surgeons are more willing to encourage patients to adopt a more active lifestyle. However, the true long-term limitations need further investigation in future studies. Level of evidence 5 Expert opinions.


Author(s):  
Eva Llopis ◽  
Alexeys Perez ◽  
Luis Cerezal

AbstractShoulder pain accounts for 16% of the musculoskeletal complaints and represents an important cause of absenteeism of work. Abnormalities of the rotator cuff, including tears, are frequently seen on imaging studies. Unfortunately, asymptomatic tears are frequent, up to 60% in patients older than 60 years old; therefore clinical correlation is essential.New anatomical concepts and new surgical techniques have evolved within the entire spectrum of lesions. It is essential to be aware of the information that is important for the decision-making as this information should stand out in our reports.In this course we will therefore review the different rotator cuff tears and its differential diagnosis.


2021 ◽  
pp. 1473-1480
Author(s):  
Christopher Abela ◽  
Mark Soldin

The abdominoplasty or ‘tummy tuck’ is one of the most commonly requested aesthetic procedures and refers to a variety of surgical techniques. A detailed understanding of the surgical anatomy, deformity, the components that need redress, and the clinical decision-making algorithms are essential. Meticulous attention to perioperative optimization mitigates risk and complications. The evolution of the surgical techniques is ongoing particularly following the increased demand from massive weight-loss patients.


2020 ◽  
Vol 277 (12) ◽  
pp. 3539-3540
Author(s):  
Georgios Psychogios ◽  
Christopher Bohr ◽  
Jannis Constantinidis ◽  
Martin Canis ◽  
Vincent Vander Poorten ◽  
...  

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