Introduction The collateral pathways between the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) play an important role in colonic surgery. The most well-known are the Drummond marginal artery and Riolan’s arch. The Moskowitz artery, also known as the meandering...
1 October 2021 in Journal of Minimal Access Surgery
Background: The oesophageal hiatus is a long and oblique opening in the diaphragm where the thoracic section of the oesophagus passes into the abdomen. Enlarged hiatal surface and insufficiency are considered to be associated with gastroesophageal reflux disease (GERD) and hiatal hernia (HH). In this study, we aimed to retrospectively evaluate the relationship and the presence of GERD with HH by performing hiatal surface area (HSA) and other hiatal measurements at the thorax and abdominal computed tomography (CT) images in cases without any intra-abdominal or oesophageal surgery history. Patients and Methods: A total of 192 patients of GERD+ and 173 cases with GERD− as a control group were included in the study. In CT examinations of 365 patients included in the study, measurements and comments were made by an experienced radiologist in abdominal radiology. In CT scans, the following were evaluated for each case; HSA, hiatus anterior–posterior (A-P) diameter, hiatus transverse diameter, and HH types. The HSA measurement was made with the freehand region of interest in the picture archiving and communication system. Results: A total of 365 cases were included in this study; there was a significant difference between the median HSA, A-P diameter, and transverse diameter measurements between GERD− and GERD+ groups (P < 0.001). A statistically significant difference was found between the presence of GERD and HH types (P < 0.001). Conclusions: CT imaging helps investigate the presence of HH at GERD+ patients. In addition, pre-operative valuable data can be obtained from the detection of HH types and HSA measurements in cases with HH.
In this study, we aimed to retrospectively evaluate the volumes and cosmetic scores of mixed-type and spongy-type thyroid nodules treated with ethanol and radiofrequency (RF) ablation before and af...
25 June 2021 in International Journal Of Clinical Practice
Background A minimally invasive approach has been adopted to treat benign cystic nodules in recent years, with ethanol ablation (EA) being used as a more common method in routine treatment. For this study, we aimed to investigate the change of nodule volumes and cosmetic scores before and after EA in benign thyroid nodules and the effectiveness of treatment. Therefore, ultrasound data and cosmetic scores of pure cystic, mixed-type and spongy-type benign thyroid nodules undergoing EA in the last two years were reviewed retrospectively. Methods Archive scanning was performed for all cases that were proven benign by fine-needle aspiration biopsy (FNAB) and who underwent EA. In all 46 patients included in the study, thyroid FNAB was performed. Ultrasound images were available to assess the size and volumes at pretreatment and 3 and 6 months after EA. The cosmetic scores obtained before the procedure and at 6 months after EA were compared. Results There was a statistically significant difference when the sizes and volumes of the nodules were compared at pretreatment, 3 and 6 months follow-up (P < .001). The mean pretreatment cosmetic score was 3.09, and at 6 months, it was 1.20, with a statistically significant difference (P < .001). Conclusions Recently, a minimally invasive approach has been adopted in the treatment of benign cystic nodules, with ethanol ablation becoming more common in routine treatment. Therefore, ethanol ablation is very valuable in minimising complications that may arise from surgery.
30 September 2020 in Turkish Journal of Anaesthesiology and Reanimation
The primary aim of the present study was to compare the ‘cross-legged foetal sitting position’ (CFSP) with the ‘sitting foetal position’ (SFP) sonographically. The secondary aim was to compare their comfort. A randomised, consecutive controlled, single-blinded trial was performed in Yeditepe University. A total of 50 healthy volunteers were included in the study. Exclusion criteria were body mass index (BMI) >40 kg m-2, lumbar hernia, scoliosis, history of spine surgery, lower back pain or trauma, especially pelvic or knee problems related to arthropathy and not able to do one/both of the two position techniques. The two positioning techniques were evaluated by ultrasonography (USG) and 5-point Numerical Rating Scale (5-NRS) patient satisfaction of comfort questionnaire. Seven outcomes via USG were evaluated, subcutaneous tissue (ST), skin to spinous process (S–SP), transverse diameters of right and left paraspinal muscles (RPM and LPM), interspinous gap opening (ISGO), mean of bilateral paraspinal muscle (MPM) and CFSP–SFP change (CFSP–SFP). Stretcher comfort, position comfort, lumbar comfort (LC) and abdominal comfort (AC) were evaluated by participants with the 5-NRS. In the CFSP, the mean ST and S–SP were significantly (p<0.0001) shorter, and LPM, RPM and MPM were significantly (p<0.0001) wider. The mean ISGO in the CFSP was significantly (p<0.0001) broader. The CFSP was significantly more comfortable than the SFP according to the LC (p=0.02). Only ISGO was found to be significantly broader in the male participant group (p=0.01) and in the BMI ≥25 group (p=0.02) according to CFSP–SFP. Considering all ultrasonographic anatomical measurements and according to the 5-NRS related to LC, the CFSP appears to be more advantageous than the SFP as a neuraxial positioning technique.