-
JACC. Cardiovascular Interventions Dec 2019
Topics: Dilatation; Echocardiography, Transesophageal; Humans; Mitral Valve; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 31857017
DOI: 10.1016/j.jcin.2019.10.016 -
The Journal of International Medical... May 2020This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous...
OBJECTIVE
This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous nephrolithotomy (PCNL) and antegrade balloon dilation.
METHODS
We retrospectively reviewed 31 patients who underwent PCNL and antegrade balloon dilation for treatment of renal calculi and recurrent UPJO. The inclusion criterion was the presence of UPJO after failed pyeloplasty with ipsilateral renal calculi. Success was defined as achievement of both symptomatic and radiographic resolution of any stones and obstruction.
RESULTS
All operations were successful without grade III or higher postoperative complications. A stone-free status was observed in all patients and the overall success rate of the procedure was 87.1% (27/31). The success rate of the procedure was significantly higher in patients with mild or moderate preoperative hydronephrosis (96%) than in those with high-grade preoperative hydronephrosis (50%). Moreover, the success rate of the procedure was lower in patients with poor preoperative renal function (0%) than in those with good or moderate renal function (93.1%).
CONCLUSION
Combined PCNL and antegrade balloon dilation management represents a safe and effective approach for patients with renal calculi and recurrent UPJO after failed pyeloplasty.
Topics: Adolescent; Adult; Combined Modality Therapy; Dilatation; Female; Humans; Hydronephrosis; Kidney Calculi; Kidney Pelvis; Male; Middle Aged; Nephrolithotomy, Percutaneous; Postoperative Complications; Recurrence; Retrospective Studies; Severity of Illness Index; Treatment Outcome; Ureteral Obstruction; Young Adult
PubMed: 32356681
DOI: 10.1177/0300060520911252 -
Jornal Brasileiro de Pneumologia :... Apr 2021
Topics: Bronchial Diseases; Dilatation; Humans; Lung Diseases; Thoracic Surgical Procedures
PubMed: 33950093
DOI: 10.36416/1806-3756/e20210012 -
CMAJ : Canadian Medical Association... Sep 2022
Topics: Humans; Dilatation
PubMed: 36265066
DOI: 10.1503/cmaj.146831-l -
Jornal Brasileiro de Pneumologia :... Aug 2023
Topics: Humans; Dilatation; Bronchiectasis
PubMed: 37610963
DOI: 10.36416/1806-3756/e20230235 -
Medicine Aug 2022Benign anastomotic stricture is a frequent complication after rectal surgery. This study investigated the feasibility of endoscopic dilation combined with bleomycin...
Benign anastomotic stricture is a frequent complication after rectal surgery. This study investigated the feasibility of endoscopic dilation combined with bleomycin injection for benign anastomotic stricture after rectal surgery. 31 patients who diagnosed with benign anastomotic stricture after rectal surgery were included in this study. 15 patients received simple endoscopic dilation (dilation group) and 16 patients received endoscopic dilation combined with bleomycin injection (bleomycin group). The clinical effect and adverse events were compared in the 2 groups. The strictures were managed successfully and the obstruction symptoms were relieved immediately. There were 2 minor complications in dilation group and 3 minor complications in bleomycin group. The difference was not significant between the 2 groups (P > .05). During the follow-up, the mean reintervention interval was 4.97 ± 1.00 months in dilation group and 7.60 ± 1.36 months in bleomycin group. The median treatment times was 4 (range 3-5) in dilation group and 2 (range 2-3) in bleomycin group. The differences in the 2 groups were significant (P < .05). Compared with endoscopic dilation, endoscopic dilation combined with bleomycin injection may reduce the treatment times and prolong the reintervention interval, which is a safe and effective endoscopic management for benign anastomotic stricture after rectal surgery.
Topics: Anastomosis, Surgical; Bleomycin; Colonoscopy; Constriction, Pathologic; Dilatation; Humans; Retrospective Studies; Treatment Outcome
PubMed: 35984174
DOI: 10.1097/MD.0000000000030036 -
BMC Urology Jul 2020To evaluate the feasibility and safety of balloon dilation (BD) in totally ultrasound-guided percutaneous nephrolithotomy (PCNL).
BACKGROUND
To evaluate the feasibility and safety of balloon dilation (BD) in totally ultrasound-guided percutaneous nephrolithotomy (PCNL).
METHODS
The data of 95 patients underwent BD were collected in this retrospective study between August 2016 and December 2018. During the same period, telescopic metal dilation was used in 1161 patients. Ninety five patients were selected as the control group and matched at a 1:1 ratio to index balloon dilation (BD) cases in regards to Guy's stone score, age, sex, BMI, degree of hydronephrosis and stone area. Peri-operative data were compared between the two groups.
RESULTS
Total operative time was significantly shorter in the BD group (62.2 ± 22.4 min vs. 70.2 ± 25.8 min, p = 0.024). Tract establishment time was significantly shorter in the BD group (3.4 ± 1.8 min vs. 4.3 ± 2.3 min, p < 0.001). The success rate of tract dilation by first attempt was higher in the TMD group compared with that of BD group; however the difference was not statistically significant. There was no significant difference between groups with regards to complication and stone-free rates. The cost of PCNL in the BD group was significantly higher than that of the TMD group (US $4831.4 ± 1114.8 vs. US $4328.4 ± 975.7, p = 0.012). Subsequent analysis revealed that mild or no hydronephrosis were risk factor for failure of balloon dilation under ultrasound.
CONCLUSIONS
BD has acceptable complication and stone free rates compared with those in TMD; however, BD under ultrasound is not suggested for stone cases without hydronephrosis.
Topics: Dilatation; Feasibility Studies; Humans; Kidney Calculi; Nephrolithotomy, Percutaneous; Retrospective Studies; Surgery, Computer-Assisted; Ultrasonography, Interventional
PubMed: 32611424
DOI: 10.1186/s12894-020-00654-x -
Oral Oncology Apr 2019Neopharyngeal stenosis is a recognized sequela of total laryngectomy (TL). We aim to investigate the incidence of stenosis requiring dilation, risk factors for stenosis...
BACKGROUND
Neopharyngeal stenosis is a recognized sequela of total laryngectomy (TL). We aim to investigate the incidence of stenosis requiring dilation, risk factors for stenosis and complications of dilation.
METHODS
Retrospective cohort study of patients undergoing TL in two dedicated head and neck centers in the Netherlands.
RESULTS
A total of 477 patients, (81% men, median age of 64 at TL) were included. Indication for TL was previously untreated primary tumor in 41%, salvage following (chemo)radiotherapy (CRT) in 44%, dysfunctional larynx in 9% and a second primary tumor in 6%. The cumulative incidence of dilatation at 5 years was 22.8%, and in total 968 dilatations were performed. Median number of dilations per patient was 3 (range 1-113). Female gender, a hypopharynx tumor, and (C)RT before or after the TL were significantly associated with stenosis requiring dilation. We observed 8 major complications (0.8%) predominantly during the first dilation procedures. Use of general anesthesia is a risk factor for complications. The most frequent major complication was severe esophageal perforation (n = 6 in 5 patients).
CONCLUSION
The cumulative incidence of pharyngeal stenosis needing dilation was 22.8% at 5 years. Roughly half of these patients could be treated with a limited number of dilations, the rest however needed ongoing dilations. Major complications are rare (0.8%) but can be life threatening. General anesthetics is a risk factor for complications, and complications occurred predominantly during the first few dilations procedures. This should alert the physician to be extra careful in new patients.
Topics: Adult; Aged; Aged, 80 and over; Dilatation; Female; Humans; Incidence; Laryngectomy; Male; Middle Aged; Retrospective Studies; Risk Factors; Young Adult
PubMed: 30926055
DOI: 10.1016/j.oraloncology.2019.02.025 -
Acta Bio-medica : Atenei Parmensis Jan 2019The nasal valve deserves relevant in patients presenting with nasal obstruction. In particular, the nasal valve plays an important role in nasal airflow control, it is... (Comparative Study)
Comparative Study Review
The nasal valve deserves relevant in patients presenting with nasal obstruction. In particular, the nasal valve plays an important role in nasal airflow control, it is relevant for the otolaryngologist to not only consider but also fully evaluate the nasal valve when seeing a patient with nasal obstruction. These data reported in this Supplement confirms the clinical relevance of the nasal valve in different groups of patients and normal subjects. In fact, an integrity of nasal valve is fundamental to ensure a physiological nasal breathing that in turn guarantees a correct pulmonary function. The possibility to use the non-surgical and well-accepted option constituted by the nasal internal dilator represent an interesting opportunity for both the physician and the patient.
Topics: Cross-Sectional Studies; Dilatation; Female; Humans; Male; Nasal Cavity; Nasal Obstruction; Nasal Septum; Quality of Life; Reference Values; Respiration
PubMed: 30715036
DOI: 10.23750/abm.v90i2-S.8105 -
Surgical Endoscopy Jul 2018Patients with therapy-resistant benign esophageal strictures (TRBES) suffer from chronic dysphagia and generally require repeated endoscopic dilations. For selected...
BACKGROUND
Patients with therapy-resistant benign esophageal strictures (TRBES) suffer from chronic dysphagia and generally require repeated endoscopic dilations. For selected patients, esophageal self-dilation may improve patient's autonomy and reduce the number of endoscopic dilations. We evaluated the clinical course and outcomes of patients who started esophageal self-dilation at our institution.
METHODS
This study was a retrospective case series of patients with TRBES who started esophageal self-dilation between 2012 and 2016 at the Academic Medical Center Amsterdam. To learn self-dilation using Savary-Gilliard bougie dilators, patients visited the outpatient clinic on a weekly basis where they were trained by a dedicated nurse. Endoscopic dilation was continued until patients were able to perform self-bougienage adequately. The primary outcome was the number of endoscopic dilation procedures before and after initiation of self-dilation. Secondary outcomes were technical success, final bougie size, dysphagia scores, and adverse events.
RESULTS
Seventeen patients started with esophageal self-dilation mainly because of therapy-resistant post-surgical (41%) and caustic (35%) strictures. The technical success rate of learning self-bougienage was 94% (16/17). The median number of endoscopic dilation procedures dropped from 17 [interquartile range (IQR) 11-27] procedures during a median period of 9 (IQR 6-36) months to 1.5 (IQR 0-3) procedures after the start of self-dilation (p < 0.001). The median follow-up after initiation of self-dilation was 17.6 (IQR 11.5-33.3) months. The final bougie size achieved with self-bougienage had a median diameter of 14 (IQR 13-15) mm. All patients could tolerate solid foods (Ogilvie dysphagia score ≤ 1), making the clinical success rate 94% (16/17). One patient (6%) developed a single episode of hematemesis related to self-bougienage.
CONCLUSIONS
In this small case series, esophageal self-dilation was found to be successful 94% of patients when conducted under strict guidance. All patients performing self-bougienage achieved a stable situation where they could tolerate solid foods without the need for endoscopic dilation.
Topics: Adult; Aged; Dilatation; Endoscopy; Esophageal Stenosis; Female; Humans; Male; Middle Aged; Patient Education as Topic; Retrospective Studies; Self Care
PubMed: 29349540
DOI: 10.1007/s00464-018-6037-z