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Biomedical subjects

A Lena

Publications and source records attributed to A Lena.

At least 19 recordsLinked to original sources

Management of benign adnexal masses by vaginal route.

Until recently, surgical treatment of a benign adnexal mass implied a laparotomy. In recent years, the development of laparoscopic surgery, as well as ultrasound-guided aspiration techniques, have significantly modified the treatment options for these patients. These procedures have shown considerable advantages. They have reduced surgical trauma and have shortened the hospital stay. We present the results of our experience on the feasibility of a trans-vaginal surgical approach for the removal of benign adnexal masses. This technique, using traditional and cheap surgical instruments, allows the surgeon to excise benign adnexal masses, by entering the peritoneum through the posterior vaginal fornix and thus avoids the trauma of laparotomy. Fifty-four patients were operated on by this technique at our Department. The mean age was 39 years (range 21-66). In all cases, the operation was completed by the trans-vaginal approach. The median operative time was 30 minutes (range 20-45), and no blood transfusion was needed. The pathological diagnoses were as follows: functional ovarian cyst; 19, endometriotic cyst; 18, dermoid cyst; 11, parovarian cyst; 4 and peduncolated fibroid of the uterine fundus; 2 cases. The diameter of the adnexal masses ranged from 3 to 10 cm (median of 6 cm). In 30 cases, a conservative surgery was done (including 2 myomectomies), whereas in 24 cases, the adnexectomy was needed. Median post-operative stay in hospital was 4 days (range 1-14). This study shows the feasibility of trans-vaginal surgical approach for benign adnexal masses. The advantages and limitations of this technique, as well as of the traditional and laparoscopic surgery are considered and discussed. We believe that the transvaginal approach could be useful and cost-effective for the treatment of selected cases of adnexal masses.

Adnexal Diseases↗

Video-assisted thoracoscopy in the management of recurrent spontaneous pneumothorax.

OBJECTIVE: To present our experience of video-assisted thoracoscopy in the treatment of recurrent spontaneous pneumothorax, and to compare the results with those of a historical control group treated by lateral thoracotomy. DESIGN: Prospective evaluation with historical controls. SETTING: Teaching hospital, Italy. SUBJECTS: 41 Patients with recurrent spontaneous pneumothorax, 20 of whom were treated by video-assisted thoracoscopy and 21 of whom underwent lateral thoracotomy (historical control group). MAIN OUTCOME MEASURES: Duration of chest drainage, length of hospital stay, amount of narcotic analgesia required, postoperative complications, and recurrence during follow up. RESULTS: The mean (range) duration of chest drainage in the group who underwent video-assisted thoracoscopy was 5 days (4-7) compared with 7 days (4-13) in the control group; the corresponding figures for length of hospital stay were 6 days (4-8) compared with 10 days (5-16). 3 Patients (15%) in the thoracoscopy group required parenteral narcotic analgesia compared with 14 (66%) in the control group, and 2 (10%) developed minor complications compared with 5 (24%). The mean length of follow up was 9 months (range 1-18) compared with 26 months (19-34), and no patient in either group developed a recurrence. CONCLUSION: Our early results of treating recurrent spontaneous pneumothorax with video-assisted thoracoscopy have been encouraging, and we have adopted it in preference to lateral thoracotomy.

Adult↗

[Video-assisted thoracoscopy in the treatment of recurrent pneumothorax].

Between April 1992 and May 1994, 45 patients with recurrent spontaneous pneumothorax underwent videoassisted thoracoscopy (group I). The mean chest tube duration, the length of hospital stay, the use of parenteral narcotics, the complications and the follow-up were analyzed and compared to the same data of a group of 21 patients previously treated by open approach between January 1991 and March 1993 (group II). Average age, sex and surgical indications distribution were comparable (group I: 36 males, 9 females, mean age 31.7 years; group II: 17 males, 4 females, mean age 31.5 years). Mean chest tube duration was lower in group I (group I 4.3 days vs group II 7.2 days), as was mean hospital stay (group I 4.6 days vs group II 10.3 days) and the necessity of parenteral narcotics for pain relief (group I 11% vs group II 66% of patients). No episodes of relapsing pneumothorax occurred in either group of patients after a mean follow-up of 12.4 months (range from 1-24 months) for group I and 30 months (range from 24-36 months) for group II. The incidence of minor complications was less in group I (4.4%) than group II (23.8%). Our early results in the treatment of recurrent spontaneous pneumothorax by videoassisted thoracoscopy have been encouraging and the merits of this approach make it preferable to thoracotomy.

Adult↗

Utility of arm circumference as a screening instrument to identify women at nutritional risk.

Anthropometric measurements of 567 healthy nonpregnant women aged 20-40 years were studied to assess the utility of mid-upper-arm-circumference as a screening test to detect malnutrition. The prevalence of malnutrition in the study sample was 38.4%. A cut-off point of 24 cm was found to be most appropriate in the study setting as at that level the sensitivity, specificity and positive predictive values were 71.1%, 69.6% and 59.4%, respectively.

Adult↗