فهرست مطالب
Annals of Bariatric Surgery
Volume:3 Issue: 4, Autumn 2014
- تاریخ انتشار: 1393/09/17
- تعداد عناوین: 6
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Page 1IntroductionSolitary fibrous tumor (SFT) is a rare mesenchymal tumor that is usually located in the pleural cavity, but it can arise in any part of the body. SFTs can develop in the extremities, in the head and neck region, meninges, orbits, thoracic wall, mediastinum, pericardium, peritoneum, retroperitoneum, pelvis, adrenal glands, liver and urogenital system..Case PresentationA 29-year-old female, was admitted in the gynaecology and obstetrics unit, for suspected pelvic tumor. CT scan showed a mass with hypervascular behavior and adherent to the uterus. The patient underwent laparoscopic resection of the mass. Abdominal exploration revealed a 5 cm mass, rising from the right iliac retroperitoneum above the pelvic space. The tumor was resected totally laparoscopically. The final histological findings were consistent with benign SFT. There were few mitotic cells (2 × 10 HPF) and a positivity for CD34 BCL2 and actin 1A4 and negative for CD117, desmin and CD99; MIb1 was < 5%..ConclusionsThis is the first case of SFT of the retroperitoneum removed laparoscopically. The laparoscopic approach is useful for the advantages of minimally invasive surgery especially in case of peduncolate tumor as the case reported..Keywords: Solitary Fibrous Tumor, Retroperitoneal Space, Laparoscopy
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Page 2IntroductionSince 1996 with improvement of endoscopic instrumentation several novel minimally invasive techniques have been developed to perform thyroid operations. The advantages of endoscopic procedure includes better magnification of anatomy, improved illumination of the operation field, earlier recovery, better pain control, and better cosmetic results. Yet it’s performed rarely and only by few surgeons around the world, as it has some limitations like the size of the nodule..Case PresentationWe herein present a patient with right-sided thyroid cold nodule and follicular presentation on fine needle aspiration (FNA), which successfully underwent endoscopic thyroidectomy through an axillary incision in Hazrat Rasul Akram hospital and tolerated the procedure well without any complications and was discharged with a very good condition..ConclusionsIf the indications and contraindications of minimally invasive thyroidectomy are taken into account, it seems to be a safe procedure and regarding the benefits of this procedure, it''s recommended that surgeons pay more attention to this newly developed technique..Keywords: Minimally Invasive Surgery, Thyroidectomy, Thyroid Nodule
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Page 3IntroductionCystic lesions of spleen are rare. Most of these cysts are parasitic and are caused by Echinococcal infection. Various treatment options for splenic hydatid cyst have evolved over the years..Case PresentationWe report a case of splenic hydatid cyst in a 55-year-old male, managed laproscopically with enucleation and omentopexy..ConclusionsIn conclusion, we recommend that laparoscopic spleen preserving procedures should be preferred for hydatid spleen when conditions are favorable and enough precautions are taken to prevent spillage. We suggest the use of aspirator for giving the scolicidal agent and favor the albendazole as an adjuvant therapy to prevent its recurrence..Keywords: Echinococcal, Hydatid Spleen, Enucleation, Omentopexy
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Page 4IntroductionAcute abdominal wall rupture with visceral herniation due to blunt traumas and bowel incarceration or perforation are generally rare phenomena. Such hernias tend to occur at anatomically weak spots in the lateral and lower abdominal wall..Case PresentationA 24-year-old man with event of falling down from third floor was brought to Emergency Department of Hazrat Rasul Akram hospital. On Focused Assesment with sonography in trauma FAST examination there was fluid in the hepato-renal space and abdominal wall hematoma, as it seemed in the physical examination. The patient underwent midline laparotomy and 100cm of his small bowel was nonviable..ConclusionsTraumatic Abdominal Wall Hernia TAWH, although uncommon, is associated with significant rate of morbidity and mortality in cases of delayed diagnosis and intervention. Early intervention leads to a significantly better outcome..Keywords: Trauma, Ventral Hernia, Gangrene
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Page 5BackgroundPostoperative pain following laparoscopic cholecystectomy can be due to various reasons. In this study reduction of visceral and shoulder tip pain is studied with intra peritoneal instillation of ropivacaine..ObjectivesThe study was done to see the effect of intraperitoneal instillation of ropivacaine on postoperative abdominal pain and shoulder pain in laparoscopic cholecystectomy..Patients andMethodsSixty patients with symptomatic gall stone diseases undergoing laparoscopic cholecystectomy were randomized into two groups. In study group A (n = 30 patients) 0.5% of 30 mL (150 mg) of ropivacaine, and in control (placebo) group B (n = 30) 30 mL of normal saline was instilled in the gall bladder bed..ResultsAbdominal pain is worse during the first 24 hours after laparoscopic cholecystectomy. After 6 and 12 hours abdominal pain was significantly less in group A compared to group B (P < 0.035). Group A experienced less shoulder tip pain during the first postoperative day, compared to control group..ConclusionsIntraperitoneal instillation of ropivacaine is more effective than placebo instillation at early postoperative hours in reducing postoperative abdominal pain after laparoscopic cholecystectomy..Keywords: Laparoscopy, Cholecystectomy, Pneumoperitoneum, Pain, Ropivacaine
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Page 6BackgroundPrimary hyperhidrosis (PHH) is characterized by sweating more than physiologic need for thermoregulation in certain parts of body without a known cause, for a period of at least six months. Surgical methods such as sympathicotomy are efficient and permanent treatments for PHH..ObjectivesThis study was planned to evaluate and compare complications and patients’ satisfaction of thoracoscopic sympathicotomy in levels of R2-R4 versus R3-R5 for PHH treatment..Patients andMethodFrom March 2010 to January 2013, a prospective single-blinded randomized study was performed on 94 patients with PHH in two groups, which were treated by thoracoscopic R2-R4 (group A) and R3-R5 (group B) sympathicotomies. The patients were evaluated at the first week and at least after six months postoperatively for outcomes, complications and satisfactions. Collected data were analyzed by SPSS version 18 using Student T test and Chi-square test..ResultsIn a total of 94 patients, 73 (77.7%) were men and 21 (22.3%) were women. Their mean age was 26.5 ± 6.5 years. Thoracoscopic R2-R4 sympathicotomy was done in 47 patients (group A) and thoracoscopic R3-R5 sympathicotomy was also done in 47 patients (group B). Early compensatory sweating (CS) were 78.7% and 66.0% in groups A and B (P = 0.167). The rates of late compensatory sweating were 74.4% (group A) and 70.7% (group B) (P = 0.241). Early and late postoperative satisfactions were 98.6% and 98.2% in group A and 97.9% and 97.3% in group B, respectively (P > 0.05). There were no statistical significant differences between two groups in early and late CS and postoperative satisfactions. The Rates of other early and late complications, such as pneumothorax, hemorrhage, hemothorax, and infection, were lower in group B. (P = 0.006 and P = 0.005).ConclusionsThoracoscopic sympathicotomy shows proper results in treatment of PHH. Thoracoscopic R3-R5 sympathicotomy compared with R2-R4 sympathicotomy is a preferable method, because of similar results and fewer complications..Keywords: Hyperhidrosis, Satisfaction, Complications, Sympathicotomy