Articles: surgery.
-
Epidural anaesthesia is used extensively for cardiothoracic and vascular surgery in some centres, but not in others, with argument over the safety of the technique in patients who are usually extensively anticoagulated before, during, and after surgery. The principle concern is bleeding in the epidural space, leading to transient or persistent neurological problems. ⋯ These estimates for cardiothoracic epidural anaesthesia should be the worst case. Limitations are inadequate denominators for different types of surgery in anticoagulated cardiothoracic or vascular patients more at risk of bleeding.
-
Z Orthop Ihre Grenzgeb · Jan 2006
[Preoperative planning and computer assisted surgery in ankylosing spondylitis].
The following study describes a technique for preoperative planning and computer-assisted correction osteotomy in the treatment of ankylosing spondylitis. The effect on the overall sagittal profile is evaluated. ⋯ Precise preoperative planning and correction osteotomy exactly according to this planning allow for an excellent correction of the sagittal profile even in severe ankylosing spondylitis. Pelvic tilt and gravity line are normalised, the patient is able to adopt an ergonomic upright position. Navigation facilitates the intraoperative transfer of the preoperative planning.
-
In image-guided therapy, high-quality preoperative images serve for planning and simulation, and intraoperatively as "background", onto which models of surgical instruments or radiation beams are projected. The link between a preoperative image and intraoperative physical space of the patient is established by image-to-patient registration. In this paper, we present a novel 3-D/2-D registration method. ⋯ For the registration of 3DRX and CT images to X-ray images as few as 2-3 X-ray views were sufficient to obtain approximately 0.4 mm TREs, 7-9 mm capture range, and 80%-90% of successful registrations. To obtain similar results for MR to X-ray registrations, an image, reconstructed from at least 11 X-ray images was required. Reconstructions from more than 11 images had no effect on the registration results.
-
Comparative Study Clinical Trial
[Clinical experience with the Siremobil Iso-C(3D) imaging system in pelvic surgery].
In pelvic and acetabular surgery intraoperative control of reduction and implant position is sometimes hard to achieve with conventional C-arm technology. The Siemens C-arm Iso-C(3D) imaging system enables axial cuts and two- or three-dimensional reconstructions to be generated. Following the good experience in surgery of the spine and extremities, its clinical applicability in pelvic surgery was evaluated in 30 patients in a prospective clinical trial. ⋯ One revision was indicated, and one avoided. However, in spite of its advantages in pelvic surgery, handling, sterile covering and data transfer need to be improved. For bilateral pelvic injuries the image size is too small.
-
J Plast Reconstr Aesthet Surg · Jan 2006
Randomised clinical trials in plastic surgery: survey of output and quality of reporting.
Randomised clinical trials (RCTs) are considered the best level of evidence when evaluating interventions. Report quality is often used as a surrogate measure of methodological quality, with poorly reported trials assumed to be poorly conducted. To address this problem the CONsolidated Standards of Reporting Trials (CONSORT) statement was published, encouraging authors to explicitly report certain items of information. ⋯ This study indicates the annual output of plastic surgery RCTs is increasing and a variety of topics are covered. However, reporting of certain key items is inadequate. Awareness of the CONSORT statement and more attention to the quality of reporting may improve matters.