We aimed to compare results between patients with early- stage prostate cancer who underwent robot-assisted and open radical prostatectomy. We examined preoperative and postoperative data, early and late complications, and analysed oncological and functional outcomes (continence and erectile function) during follow-up.
We studied the data of 123 patients with localized prostate cancer, operated with nerve-sparing retropubic radical prostatectomy, divided into two groups. Group 1 included 70 patients who underwent robot-assisted radical prostatectomy (RARP). Group 2 included 53 patients, on whom open retropubic radical prostatectomy (RRP) was performed. We compared preoperative data, complications rate, oncological, and functional outcome (continence and erectile function) during the follow-up period.
Operative time was significantly lower in the RRP group. Blood loss and earlier removal of the urinary catheter were significantly lower in the RARP group. The percentage of significant postoperative complications (Clavien-Dindo III-IV) was 0% in the first group and 3% in the second group. During follow-up, the improvement in the functional outcome - continence and erectile function was significantly better in the robot-assisted surgery patients.
There were statistically significant better functional outcomes in patients operated on using the robot-assisted technique. The operating time was shorter in the classic radical prostatectomy. The application of robot-assisted radical prostatectomy may help achieve earlier recovery, as compared to open radical prostatectomy.
Background: Injection of alloplastic material underneath the penile skin for penile augmentation causes many complications such as inflammation, infection, ulceration, and pain during sexual activity. One of the treatments for complications after these penile augmentation procedures is surgical excision of the foreign body granuloma followed by penile skin coverage with bilateral scrotal flaps. There are no prior prospective studies published about anatomical and functional outcomes.
Objective: To study the anatomical and functional outcome of one-stage bilateral scrotal flap reconstruction in patients after surgical removal of paraffinoma from penile shafts.
Methods: Patients who suffered from complications of penile foreign body granuloma were treated by surgical excision and reconstruction with bilateral scrotal flaps. The penile lengths and circumferences when flaccid and erect were recorded preoperatively and postoperatively. The patients were interviewed using questionnaires and satisfaction scored to determine their sexual experiences were recorded before and after surgery.
Results: Thirteen patients were enrolled in this study. The mean follow-up time was 23.5 (11.5-40.5) weeks. The mean erectile length and the maximal circumference were 11.8 (9-15) cm, 14.5 (11.5-17) cm preoperatively, and 11.7 (10-14) cm, 11.8 (10-13) cm postoperatively. Satisfaction scores of sexual activity is 6.84 (0-9) preoperatively, and 8.38 (5-10) postoperatively.
Conclusion: One-stage bilateral scrotal flap coverage is a good option for penile skin reconstruction. This technique can achieve satisfactory results both anatomically and functionally.
differences in acute ischemic stroke: etiology, stroke patterns and response to thrombolysis. Stroke. 2009; 40: 2428-2432. 22. Putaala J, Metso AJ, Metso TM, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke. 2009; 40: 1195-1203. 23. Fukuda M, Kanda T, Kamide N, et al. Gender differences in long-term functionaloutcome after first-ever ischemic stroke.Intern Med. 2009; 48: 967-973. 24. Smith DB, Murphy P, Santos P, et al. Gender differences in the Colorado Stroke Registry. Stroke. 2009; 40
Time trends in ability level and functional outcome of stroke and multiple sclerosis patients undergoing comprehensive rehabilitation in Slovenia
Background: The University Rehabilitation Institute in Ljubljana provides comprehensive rehabilitation for the whole territory of Slovenia. The aim of the study was to verify a clinical observation that the demandingness of rehabilitation has been increasing because of a decrease in patients' functional abilitites on admission, with rehabilitation outcomes having remained unchanged or even improved.
Methods: Functional Independence Measure (FIM) scores of 651 cerebrovascular insult (CVI) and 151 multiple sclerosis (MS) patients gathered between September 2004 and September 2006 (all eligible cases) were compared with those for patients with the same diagnosis (N=144 and 74, respectively) collected during the period from September 1999 to September 2000 (a random sample), considering only first-admission cases. The average FIM (motor, cognitive and total) scores and FIM gain after rehabilitation during the two periods were determined for each diagnostic group adjusted for patient age. Rehabilitation efficiency and effectiveness levels were compared in the same way. Effect Size and Standardised Response Mean were also analysed.
Results: There were no differences in gender structure of the groups between the periods studied. During the recent period, the average age was higher by around two years in both groups. The length of stay was marginally shortened for CVI patients and remained unchanged for MS patients. There were no differences between the two periods concerning the time elapsed since stroke. In both groups, admission motor and cognitive FIM scores were on average approximately five points lower in the recent period, while the average rehabilitation gain from admission to discharge increased over time (in total by 1 in CVI patients and by 3 in MS patients). Regarding motor and total FIM scores, the standardised gain, rehabilitation efficiency and rehabilitation effectiveness increased as well.
Conclusions: The Institute is admitting more severely affected patients than it did five to ten years ago, and parallelly the patient age has increased. Despite that and notwithstanding the tendency towards shorter rehabilitation, expected age-adjusted functional independence gain, rehabilitation efficiency, rehabilitation effectiveness, and the standardised functional independence gain have increased.
Background: Reasonable function can be restored after total femur replacement after massive resection of bone and soft tissue sarcomas of the thigh. The type of femoral prosthesis and surgical approach are tailored to the clinical characteristics of individual patients and to tumor anatomy. Though the complication rate is high, total femur replacement offers the patient limb salvage and a chance at functional ambulation.
Objective: We described the function and complications of total femur replacement performed at the institution as well as relevant literature reviews.
Methods: Seven patients underwent total femur replacement for the treatment of malignant bone and soft tissue tumors of the lower extremities between 1992 and 2010 at our institute. Ages ranged from 12 to 68 (mean=34) years. The tumor was pathologically diagnosed as osteosarcoma in two patients, Ewing’s sarcoma in two, chondrosarcoma (grade 3) in one, soft tissue malignant fibrous histiocytoma in one, and bone metastasis from renal cancer in one. Follow-up periods ranged from 1 to 17 years (mean = six years three months). All patients underwent wide resection, using the Howmedica Modular and Reconstruction System in five cases and the Kyocera Limb Salvage System in two cases. Function, complications and outcomes were evaluated in these patients, and the usefulness of the operative procedures is discussed herein.
Results: The mean functional score was 60%. X-ray examination revealed migration in only one case. Complications were infection (n=2), bipolar head dislocation (n=1) and patellar fracture (n=2). The outcomes were DOD (died of disease) in three cases, NED (no evidence of disease) in two, AWD (alive with disease) in one, and CDF (continuous disease free) in one.
Conclusion: The results suggest that total femur replacement is useful as a means of reconstructing affected limbs in patients with malignant bone and soft tissue tumors, but that latissimus dorsi muscle transplantation, as well as other procedures, must also be considered in cases requiring extensive soft tissue resection to prevent infection. Furthermore, early one-stage revision is advisable in cases showing signs of infection.
Conclusion. There are numerous surgical options for repairing nose defects. Oncological radicality
and satisfactory aesthetic and functionaloutcome are the main objectives in choosing the method.
The aims of reconstructive surgery are functionality of the nose, aesthetic appearance with finer
scars, preserving the aesthetic subunits of the nose, but also the relationship with the neighboring
Keywords: nasal pyramid, non-melanocytic skin cancers, reconstruction after oncologic
. The main complications after using reconstruction with bone graft are represented
by mechanical failure, due to the lack of strong fixation, or biological failure of graft integration.
Infection is another complication, patients being usually immunosuppressed. The aim of this study
was to investigate a retrospective single center experience of surgically treated malignant bone
tumors of long bones, respectively oncological, surgical, and functionaloutcome differences after
Materials and methods. Between 2007 and 2017, we conducted a
rehabilitation goals adjust according to the patient’s problems. The rehabilitations needs to start early enough in order to reach the established goals, prevent the complications and achieve better functionaloutcome. 7 Symptoms of brain tumours The symptoms of brain tumours are dependent on the size and location of the tumour. They are caused by mass effect of the tumour and by the surrounding vasogenic brain oedema. First symptom is usually headache, which is usually worse in the morning and can be accompanied by nausea and vomiting. 8 Sometimes an epileptic seizure is the