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- Lopera, Carlos, et al.
(författare)
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Literature Review of the Frequency of Reoperations after One Stage Transanal Endorectal Pull-Through Procedure for Hirschsprung’s Disease in Children
- 2012
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Ingår i: Surgical Science. - : Scientific Research Publishing, Inc.. - 2157-9415 .- 2157-9407. ; 3, s. 290-294
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Forskningsöversikt (refereegranskat)abstract
- Background: Transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung’s disease (HD) has gained worldwide acceptance. However surgical success is often reported separately, while the necessity for true reoperation is difficult to establish. Aim: To evaluate the incidence of reoperations following TERPT procedure. The findings will be important in counseling and planning childcare for HD patients as well as providing a benchmark for single centers clinical results. Methods: A literature review of reported TERPT operations on children with HD between 1998 through 2011 was performed. Only planned TERPT operation reports were included. Information was collected with particular emphasis on reoperations and their reasons. Results: Out of 26 published articles 23 were in-cluded, reporting on 836 children, female/male ratio: 1/3.3, undergoing the TERPT procedure as the only operative in-tervention with described postoperative courses. The children comprised neonates, <4 weeks (38%), babies <1 year (35%), toddlers, 1 - 3 years (15%) and children >3 years of age (12%). The average follow up was 18.5 (6 - 38) months. The resected bowel length mean was 20.5 cm. Forty-one reoperations were reported (4.9%), including 24 laparotomies, 8 laparoscopies, 6 colostomies and ileostomies in 3 children. Only 2 re-do TERPT were reported (0.2%). Seven patients were considered TERPT failures (0.8%) with 5 requiring diverting colostomies and additional transabdominal pull- through operations. Two myectomies were performed (0.2%). One child with aganglionosis underwent a Duhamel pull through. Two (0.2%) had serious damage to the urinary tract also one child with a vas deferens lesion was reoperated. Two bowel obstructions required adhesiolysis. Eight anastomotic dehiscences (0.9%) required surgery after reparation. One prolapse of the pulled through colon was reported. Six patients (0.7%) suffered anastomotic leaks. Anastomotic strictures rate was 2.8%, all repaired with anal dilatation. Conclusion: The review supports the low incidence of re-ported reoperations for the TERPT procedure.
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| 2. |
- Pettersson, Monica, 1963, et al.
(författare)
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Health Related Quality of Life after Treatment of Abdominal Aortic Aneurysm with Open and Endovascular Techniques—A Two-Year Follow Up
- 2012
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Ingår i: Surgical Sciences. - : Scientific Research Publishing, Inc.. - 2157-9407 .- 2157-9415. ; 3:9, s. 436-444
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with Abdominal Aortic Aneurysm can be treated with two different surgical methods: Open repair (OR) or Endovascular Aortic Repair (EVAR). These two different treatments can probably result in different sense of Health related Quality of life, both in a short term and a long term perspective. The purpose of this prospective study was to examine patients’ Health related Quality of life after surgical treatment of Abdominal Aortic Aneurysm over two years using different instruments for the observations. Methods: Patients were invited consecutively to answer questionnaires before operation, and 1, 12 and 24 months after surgery. The study was conducted by using the Health related Quality of life questionnaires Short Form (SF-36) and Nottingham Health Profile (NHP). 76 patient (40 in the OR and 36 in the EVAR group) participated in the study. The mean age in the OR group were 68 years, range 52 - 80 and in the EVAR group 75 years, range 65 - 85. The results from these two groups of patients were compared to a matched reference group. Results: Patients treated with EVAR rated their Health related Quality of life significantly lower in the domain of Mental Health and Mental Component Score in relation to a matched reference population before surgery. This difference was not present two years after intervention. After one month Health related qualities of life were worse for the OR group. After two years significant improvements in relation to baseline were observed only among patients in the OR group. No such long-term benefits were seen in the EVAR group. Conclusions: As the component mental health seemed to be impaired for these study group before surgery in relation to the matched reference group, nursing and doctors care actions may be of importance during the pre-operative phase. In the short perspective Health related Quality of life is worse for OR patients than the EVAR group but in the long term perspective improvements beyond preoperative status can only be seen with OR patients.
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