ObjectiveThe goal of this retrospective study was to evaluate the outcomes of bilateral video-assisted thoracoscopic sympathectomy for primary hyperhydrosis.MethodsBetween January 2007 and December 2011, a total of 335 patients (192 male, 143 female, mean age 28.3 years) who underwent bilateral thoracoscopic sympathectomy for primary hyperhydrosis were reviewed retrospectively.ResultsHyperhydrosis occurred in the palmar and axillary region in 175 (52.23%) patients, in only the palmar region in 52 (15.52%), in the craniofacial region in 44 (13.13%), in only the axillary region in 42 (12.53%), and in the palmar and pedal regions in 22 (6.56%) patients. Bilateral thoracoscopic sympathectomy was performed in all patients. The mean follow-up period was 24 (6–48) months. The initial cure rate was 95% and the initial satisfaction rate was 93%. There was no mortality in this study. The complication rate was 15.82% in 53 patients.ConclusionVideo-assisted thoracoscopic sympathectomy for the treatment of primary hyperhydrosis was effective, with low rates of morbidity and mortality. Despite the appearance of postoperative complications, such as compensatory sweating, patient satisfaction with the procedure was high and their quality of life improved.
BackgroundWe present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities.MethodsWe present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions.ResultsAll of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire.ConclusionsPectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.
GirişÖzefagus krikoid kıkırdak alt kenarından başlayıp, servikal ve torakal vertebralar önünden seyrederek midenin kardiya orifisinde sona eren, erişkinlerde 23-25 cm uzunluğundaki musküler bir tüptür (1). Özefagial yabancı cisimlerine çocukluk yaş gurubunda sık rastlanıl-maktadır. Gastrointestinal sistem yabancı cisimlerin %28-68'i özefagus-ta bulunur. Özefagus, anatomik darlıkları nedeniyle yabancı cisimlerin sıklıkla takıldığı yerdir. Özefagoskopi, özefagus hastalıklarının tanı ve tedavisi amacıyla yapılan bir işlemdir. Tedavi amaçlı özefagoskopi ise özellikle yabancı cisim varlığında, özefagus divertiküllerinde, akalazyada ve özefagus stenozlarında yapılmaktadır (2).Yabancı cisimler çocukluk çağında tanı ve tedavisi geciktiğinde ciddi ve hayatı tehdit eden komplikasyonlara yol açabilmektedir. Çocukluk çağında sıklıkla metalik para ve oyuncak parçaları yutulurken, ilerleyen yaşlarda et, kemik ve diş protezleri gibi maddeler görülmektedir (3, 4).Çalışmamızda özefagus yabancı cismi nedeniyle genel anestezi altında rijit özefagoskopi uyguladığımız olguları ve sonuçları irdeledik. Gereç ve YöntemKasım 2004 ve Aralık 2009 tarihleri arasında kliniğimize özefagus yabancı cismi tanısıyla yatarak tedavi gören 190 olgunun hastane kayıtları incelendi. Bu olguların dosyaları yaş, cinsiyet, semptom, yabancı cismin tipi, yabancı cismin lokalizasyonu, yapılan tedavi ve komplikasyonlar açısından değerlendirildi. Olgulara anemnez sonrası direkt antero-posterior ve iki yönlü servikal grafi çekildi. Olguların hepsine genel anestezi altında girişim yapıldı.Özefagus birinci darlığa yerleşmiş olan yabancı cisimler için hasta genel anestezi altında sedatize edildikten sonra laringoskopla direk görüş altında Mcgill klemp veya uygun forsepsler kullanılarak yabancı cisim çıkartıldı. Distale yerleşmiş vakalar özfagoskopi yapılarak AbstractObjective: The aim of this study was to review the hospitalized patients with esophageal foreign bodies. Material and Methods: In this study we retrospectively investigated 190 patient who were hospitalized and treated between November 2004 and December 2009. The patients charts were evaluated with regard to age, sex, localization of foreign body, type of foreign body, treatment symptoms and complications. Results: Of the patients, 100 (52.63%) were male and 90 (47.36%) were female. The mean age of the patients was 15,2 years. Location of the foreign body was at the fi rst narrow section in 87%. A metal coin was the most common foreign body detected in 85 (44.73%) patients. The second most common foreign body was a piece of meat and these were removed with a McGill clamp via direct vision. There were no complications during or after the operation. Conclusion: Early diagnosis and treatment of esophageal foreign bodies is important due to the severe complications. Removing the foreign body with esophagoscopy is the most eff ective and secure treatment method. (JAEM 2010; 9: 161-2 (JAEM 2010; 9: 161-2)
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