Objective: This study aimed to compare the results of oneand two-stage basilic vein transposition (BVT) in haemodialysis patients. Methods: This was a non-randomised, retrospective study between January 2007 and January 2012 on 96 patients who were diagnosed with end-stage renal failure (ESRF) (54 males, 42 females; mean age 43.6 ± 14 years) and underwent one-or two-stage BVT in our clinic. All patients who were not eligible for a native radio-cephalic or brachio-cephalic arterio-venous fistula (AVF) were scheduled for one-or twostage BVT after arterial (brachial, radial and ulnar) and venous (basilic and cephalic) Doppler ultrasonography.Patients were retrospectively divided into two groups: group 1, basilic vein diameter > 3 mm and patients who underwent one-stage BVT; and group 2, basilic vein diameter < 3 mm and patients who underwent two-stage BVT. In group 1, the basilic vein with a single incision was anastomosed to the brachial artery, followed by superficialisation. In group 2, the basilic vein was anastomosed to the brachial artery and they underwent the superficialisation procedure one month postoperatively. Fistula maturation and postoperative complications were assessed. Results: The mean diameter of the basilic vein was statistically significantly higher in group 1 (3.46 ± 0.2 mm) than in group 2 (2.79 ± 0.1 mm) (p < 0.05). In terms of postoperative complications, thrombosis, haemorrhage and haematoma were significantly higher in group 1 (34, 36 and 17%, respectively) than in group 2 (23, 14 and 6%, respectively) (p < 0.05). The rate of fistula maturation was significantly lower in group 1 (66%), compared to group 2 (77%) (p < 0.05). Time to fistula maturation was significantly shorter in group 1 (mean 41 ± 14 days), compared to group 2 (mean 64 ± 28 days) (p < 0.05). Conclusion: Two-stage BVT was superior to one-stage BVT due to its lower rate of postoperative complications and higher fistula maturation, despite its disadvantage of late fistula use. Although the diameter of the basilic vein was larger in patients who underwent one-stage BVT, we observed that one-stage BVT was disadvantageous in terms of postoperative complications and fistula maturation.
We describe a case of gunshot injury presenting with cardiac tamponade in which a dummy bullet advanced through the aorta and caused embolization in the right renal interlobar artery after passing above the sternoclavicular joint and penetrating into the aorta. Emergency surgery with cardiopulmonary bypass was performed to repair the cardiac tamponade and aortic injury. Postoperatively, a direct abdominal x ray revealed a bullet image, confirmed by an ultrasonography examination that demonstrated the presence of a metal object in the right renal pelvis. The bullet was considered to have reached the kidney via an arterial route and to cause embolization in the distal bed. The procedure was successful, and the patient was discharged on postoperative day 8. In gunshot injuries, if all entrance points are not paired with exit points, the possibility of an organ or extremity embolism caused by the presence of a bullet or shrapnel fragments in circulation should be borne in mind, although such occurrences are rare.
Bu çalışmada karotis cisim tümörü eksizyonları ile ilişkili komplikasyonlar ve sonuçları değerlendirildi.Ça lış ma pla nı: Ocak 2013 -Nisan 2016 tarihleri arasında karotis cisim tümörü ön tanısı ile toplam 29 hasta (2 erkek, 27 kadın; ort. yaş 55.2±4.4 yıl; dağılım 17-76 yıl) ameliyat edildi. Shamblin karotis cisim tümörü sınıflamasına göre, 12 hasta tip 1, 13 hasta tip 2 ve dört hasta tip 3 idi. Bul gu lar:Başlıca semptomlar baş dönmesi, boyun bölgesinde ağrı, kulak çınlaması ve baş ağrısı idi. Bu semptomların en sık görüleni baş ağrısı idi. On hastada (%34.4) nörolojik ve cerrahi komplikasyonlar gelişti. Ameliyat edilen hastaların üçünde (%8.7) yutma güçlüğü, ikisinde (%6.8) fasiyal hemiparezi, ikisinde (%6.8) kanama, birinde (%3.4) hematom ile ilişkili solunum sıkıntısı, birinde (%3.4) sol hemiparezi ve birinde (%3.4) geçici bradikardi gelişti. Ekstübasyon sonrası kanama nedeniyle solunum sıkıntısı olan bir hasta tekrar ameliyata alındı. Fasiyal ve sol hemiparezili hastaların parezi durumları geçici idi. Yutma güçlüğü de, takip eden poliklinik kontrollerinde düzeldi. Hiçbir hastada kalıcı komplikasyon görülmedi. So nuç:Cerrahi eksizyonun en uygun tedavi seçeneği olduğu karotis cisim tümörlerinde ameliyat sonrası komplikasyonlar, dikkatli diseksiyonlar ve ekartasyonlar ile en aza indirgenebilir. Özellikle sinir koruyucu cerrahiye dikkat edilmelidir.
A 32-year-old female patient presented with dyspnea and palpitation, and transthoracic echocardiography revealed the presence of pericardial effusion. Pericardiosynthesis was performed for drainage. Because of the rapid accumulation of effusion and the presence of a right atrial mass on follow-up echocardiography, a computed tomography scan was done that revealed a right atrial defect and the presence of advanced pericardial effusion. The patient was prepared for an emergency operation. The mass on the right atrial wall was approached via a midsternal incision with cardiopulmonary bypass. The tumor filled the right atrial cavity, compressed vital structures, extended to the right ventricle, and had local metastases. As the tumor did not appear to be curable with surgery, a palliative approach was adopted. The right atrial free wall and tissues causing cardiac obstruction were totally removed, the tumor itself was partially excised, and local metastases were sampled. The resulting right atrial wall defect was closed with a Dacron patch. The operation ended uneventfully, and the clinical status and vital and hemodynamic findings of the patient returned to normal. The pathological diagnosis based on the samples obtained during the operation was angiosarcoma. The patient had an uneventful postoperative period and was then referred to an oncology center for clinical recovery. No findings of local recurrence or metastases were observed during the postoperative follow-up. The patient completed her combination therapy and currently is free of any clinical problems at her 13th postoperative month. We believe that advancements in radiotherapy and chemotherapy regimes combined with surgery (radical, if possible) for the treatment of cardiac angiosarcomas may provide better survival and quality-of-life results.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.