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[PMID]:28322112
[Au] Autor:Brietzke SE; Ishman SL; Cohen S; Cyr DD; Shin JJ; Kezirian EJ
[Ad] Endereço:1 Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
[Ti] Título:National Database Analysis of Single-Level versus Multilevel Sleep Surgery.
[So] Source:Otolaryngol Head Neck Surg;156(5):955-961, 2017 May.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database. Study Design Retrospective cohort study. Setting National insurance claims database. Subjects and Methods An adult cohort undergoing single-level UPPP versus UPPP with nasal and/or tongue/hypopharyngeal surgery was identified in the Truven Health Analytics MarketScan Research Databases for the years 2010 through 2012. Demographic and outcomes data were assessed at short-term (≤14 days), intermediate (15-60 days), and long-term (61-183 days) intervals via a multivariate regression model adjusted for age, sex, geographic region, insurance type, and the Charlson-Deyo comorbidity score. The primary long-term complication considered was positive airway pressure (PAP) equipment supply, implying possible treatment failure. Results The cohort included 14,633 patients: 7559 (51.6%), UPPP alone; 5219 (35.7%), UPPP + nasal surgery; 1164 (7.95%), UPPP + tongue/hypopharyngeal surgery; and 691 (4.7%), UPPP + nasal + tongue/hypopharyngeal surgery. Demographic data were similar among the groups. UPPP alone had lower rates of postoperative bleeding than UPPP + tongue/hypopharyngeal surgery (4.31% vs 6.19%, P = .004). Multivariate modeling indicated that the addition of either nasal surgery (odds ratio = 1.21, 95% CI = 1.10-1.34, P < .001) or tongue/hypopharyngeal surgery (odds ratio = 1.15, 95% CI = 1.00-1.32, P = .048) to UPPP was associated with increased odds of postoperative continuous positive airway pressure. Conclusions UPPP alone is currently the predominant form of sleep surgery in the United States. Multilevel surgery had greater odds of postoperative bleeding and positive airway pressure equipment supply than UPPP alone. Dedicated studies formally evaluating single- versus multilevel sleep surgery and the impact of possible surgeon/patient selection bias should be a priority.
[Mh] Termos MeSH primário: Palato Mole/cirurgia
Qualidade de Vida
Apneia Obstrutiva do Sono/diagnóstico
Apneia Obstrutiva do Sono/cirurgia
Úvula/cirurgia
[Mh] Termos MeSH secundário: Adulto
Bases de Dados Factuais
Feminino
Seguimentos
Glossectomia/métodos
Seres Humanos
Hipofaringe/cirurgia
Masculino
Meia-Idade
Análise Multivariada
Procedimentos Cirúrgicos Nasais/métodos
Razão de Chances
Faringostomia/métodos
Polissonografia/métodos
Análise de Regressão
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Apneia Obstrutiva do Sono/psicologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817696503


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[PMID]:25831179
[Au] Autor:Koonce CJ; Richards WO; Rodning CB
[Ad] Endereço:Department of Surgery, College of Medicine and Medical Center, University of South Alabama, Mobile, Alabama.
[Ti] Título:Pharyngostomy.
[So] Source:Am Surg;81(4):349-53, 2015 Apr.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A retrospective analysis of a prospective observational study of a cohort of patients who required prolonged foregut/midgut decompression/intraluminal stenting and/or enteral nutritional support was conducted. Those patients were intolerant of protracted nasogastric intubation. They also manifested hostile peritoneal cavities and therefore were not candidates for a laparoendoscopic gastrostomy or jejunostomy. Accordingly, they underwent insertion of a pharyngogastric or pharyngojejunal tube. With patients properly positioned and anesthetized and with attention to the anatomy of the superior carotid cervical triangle, those pharyngostomies and cannulations were performed safely and efficiently. The tubes remained indefinitely or were changed/removed ad libitum. Morbidity was nil and no mortality attributable to the procedure was observed. Pharyngostomy should be part of the armamentarium of all general surgeons.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/métodos
Obstrução Intestinal/cirurgia
Apoio Nutricional/métodos
Faringostomia/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1506
[Cu] Atualização por classe:150402
[Lr] Data última revisão:
150402
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150402
[St] Status:MEDLINE


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[PMID]:25519140
[Au] Autor:Stew B; Dafydd C; Berry S; Howard D
[Ti] Título:A novel surgical method of managing a high output pharyngostome.
[So] Source:Ann R Coll Surg Engl;96(8):e1-2, 2014 Nov.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Pharyngocutaneous fistulas following large oncological surgical resection of the upper aerodigestive tract are common and typically heal over a number of weeks. A pharyngostome is a surgically created non-healing opening into the pharynx, which is far less common and often difficult to manage.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/cirurgia
Neoplasias de Cabeça e Pescoço/cirurgia
Neoplasias Faríngeas/cirurgia
Faringostomia/efeitos adversos
Faringe/cirurgia
Complicações Pós-Operatórias/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Faringostomia/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1502
[Cu] Atualização por classe:141218
[Lr] Data última revisão:
141218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141219
[St] Status:MEDLINE
[do] DOI:10.1308/003588414X13946184902361


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[PMID]:25350164
[Au] Autor:Stew B; Dafydd C; Berry S; Howard D
[Ad] Endereço:Royal Glamorgan Hospital, Llantrisant, UK.
[Ti] Título:A novel surgical method of managing a high output pharyngostome.
[So] Source:Ann R Coll Surg Engl;96(8):e1-2, 2014 Nov.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Pharyngocutaneous fistulas following large oncological surgical resection of the upper aerodigestive tract are common and typically heal over a number of weeks. A pharyngostome is a surgically created non-healing opening into the pharynx, which is far less common and often difficult to manage.
[Mh] Termos MeSH primário: Neoplasias Hipofaríngeas/cirurgia
Faringostomia/instrumentação
Faringostomia/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Qualidade de Vida
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1501
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141029
[St] Status:MEDLINE
[do] DOI:10.1308/003588414X13946184902361


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[PMID]:23522223
[Au] Autor:Zo JI
[Ti] Título:Reply: To PMID 22440367.
[So] Source:Ann Thorac Surg;95(4):1507-8, 2013 Apr.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Neoplasias Esofágicas/cirurgia
Esofagectomia/métodos
Esôfago/irrigação sanguínea
Neoplasias Hipofaríngeas/cirurgia
Jejunostomia/métodos
Jejuno/irrigação sanguínea
Jejuno/transplante
Neoplasias Faríngeas/cirurgia
Faringostomia/métodos
Seio Piriforme/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:COMMENT; LETTER
[Em] Mês de entrada:1305
[Cu] Atualização por classe:131031
[Lr] Data última revisão:
131031
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:130326
[St] Status:MEDLINE


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[PMID]:23522222
[Au] Autor:Sonbare DJ
[Ti] Título:Is free jejunal transfer possible without microvascular anastomosis?
[So] Source:Ann Thorac Surg;95(4):1507, 2013 Apr.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Neoplasias Esofágicas/cirurgia
Esofagectomia/métodos
Esôfago/irrigação sanguínea
Neoplasias Hipofaríngeas/cirurgia
Jejunostomia/métodos
Jejuno/irrigação sanguínea
Jejuno/transplante
Neoplasias Faríngeas/cirurgia
Faringostomia/métodos
Seio Piriforme/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:COMMENT; LETTER
[Em] Mês de entrada:1305
[Cu] Atualização por classe:130325
[Lr] Data última revisão:
130325
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:130326
[St] Status:MEDLINE


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[PMID]:22632487
[Au] Autor:Hagen JA
[Ad] Endereço:Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St #514, Los Angeles, CA 90033, USA. hagen@usc.edu
[Ti] Título:Invited commentary.
[So] Source:Ann Thorac Surg;93(6):1854, 2012 Jun.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Neoplasias Esofágicas/cirurgia
Esofagectomia/métodos
Esôfago/irrigação sanguínea
Neoplasias Hipofaríngeas/cirurgia
Jejunostomia/métodos
Jejuno/irrigação sanguínea
Jejuno/transplante
Neoplasias Faríngeas/cirurgia
Faringostomia/métodos
Seio Piriforme/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:COMMENT; JOURNAL ARTICLE
[Em] Mês de entrada:1207
[Cu] Atualização por classe:120528
[Lr] Data última revisão:
120528
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:120529
[St] Status:MEDLINE
[do] DOI:10.1016/j.athoracsur.2012.03.046


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[PMID]:22614253
[Au] Autor:Abdelfatah MM; Garg A; Sarr MG
[Ad] Endereço:Department of Surgery, Mayo Clinic, Rochester, MN, USA.
[Ti] Título:Tube pharyngostomy--a useful alternative for long-term enteric decompression or enteral feeding.
[So] Source:J Gastrointest Surg;16(12):2318-20, 2012 Dec.
[Is] ISSN:1873-4626
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The tube pharyngostomy has been all but forgotten in recent years, and rightfully so when a PEG or PEJ is possible. Nevertheless, the tube pharyngostomy should remain in the armamentarium of the GI surgeon for selected patients in whom longer term enteral access is not available by PEG or PEJ for various technical reasons, for those who absolutely refuse a nasoenteric tube, or as terminal palliation in patients with nonoperable but obstructing intra-abdominal neoplasms. Not only is it easy to place (albeit requiring a brief general anesthetic), but these tubes are much more comfortable than the "misery" to the patient of a nasoenteric tube by avoiding the annoying nasal and nasopharyngeal irritation,sinusitis, trouble with speech and coughing, and general discomfort of a longer term, indwelling nasoenteric tube. Moreover, the tube can be hidden under a turtleneck-types weater, thereby avoiding the social discomfort of a tube exiting the nares. The overall lack of experience and ignorance, not only with these tubes but also with their concept, has precluded many surgeons from recognizing their usefulness,albeit in highly selected patients. With these advantages and caveats in mind, the tube pharyngostomy can prove a valuable adjunct in selected patients.
[Mh] Termos MeSH primário: Faringostomia/instrumentação
Faringostomia/métodos
[Mh] Termos MeSH secundário: Descompressão Cirúrgica
Nutrição Enteral
Seres Humanos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1305
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120523
[St] Status:MEDLINE
[do] DOI:10.1007/s11605-012-1899-1


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[PMID]:22440367
[Au] Autor:Lee HS; Park SY; Jang HJ; Kim MS; Lee JM; Zo JI
[Ad] Endereço:Department of Thoracic Surgery, Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
[Ti] Título:Free jejunal graft for esophageal reconstruction using end-to-side vascular anastomosis and extended pharyngo-jejunostomy.
[So] Source:Ann Thorac Surg;93(6):1850-4, 2012 Jun.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pharyngo-esophageal reconstruction using free jejunal grafts (FJGs) has been widely used, but the procedure is technically demanding and requires the involvement of multiple departments. We performed simplified reconstruction with FJGs using end-to-side vascular anastomosis and extended pharyngo-jejunostomy. METHODS: The jejunal artery and vein were anastomosed to the neck vessels in an end-to-side fashion without microvascular anastomosis. Pharyngo-jejunostomy with extended end-to-end anastomosis was performed to reduce size mismatch. We retrospectively analyzed the medical records of 32 patients diagnosed with pharyngeal, esophageal, or pyriform sinus cancer who received a FJG. RESULTS: The mean age was 61.5±9.4 years, and there were 25 male patients. Jejunal vessels were commonly anastomosed to the right common carotid artery and the right internal jugular vein (22, 68.8%). The mean ischemic times of the FJG and carotid artery clamping time were 46.5±8.1 and 15.8±4.4 minutes, respectively. During the procedure, 3 patients suffered from inadequate reperfusion of the FJG requiring removal of the initial graft and replacement with another FJG. There were no neurologic complications, postoperative deaths, or adverse events directly related to FJG except for leakage of the pharyngo-jejunostomy site in 1 patient, which was primarily repaired. During the follow-up period, 5 patients (15.6%) suffered from dysphagia, but only 3 patients had evidence of anastomotic strictures at the jejuno-esophagostomy site. Thirteen patients (40.6%) received postoperative adjuvant radiotherapy. CONCLUSIONS: Our technique of FJG with end-to-side vascular anastomosis and extended pharyngo-jejunostomy is simple and safe.
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Neoplasias Esofágicas/cirurgia
Esofagectomia/métodos
Esôfago/irrigação sanguínea
Neoplasias Hipofaríngeas/cirurgia
Jejunostomia/métodos
Jejuno/irrigação sanguínea
Jejuno/transplante
Neoplasias Faríngeas/cirurgia
Faringostomia/métodos
Seio Piriforme/cirurgia
[Mh] Termos MeSH secundário: Idoso
Artéria Carótida Primitiva/cirurgia
Feminino
Seres Humanos
Veias Jugulares/cirurgia
Masculino
Meia-Idade
Complicações Pós-Operatórias/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1207
[Cu] Atualização por classe:130501
[Lr] Data última revisão:
130501
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:120324
[St] Status:MEDLINE
[do] DOI:10.1016/j.athoracsur.2012.01.068


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[PMID]:21429094
[Au] Autor:van der Houwen EB; van Kalkeren TA; Post WJ; Hilgers FJ; van der Laan BF; Verkerke GJ
[Ad] Endereço:Departments of Biomedical Engineering, University Medical Center Groningen, University of Groningen, The Netherlands. e.b.van.der.houwen@med.umcg.nl
[Ti] Título:Does the patch fit the stoma? A study on peristoma geometry and patch use in laryngectomized patients.
[So] Source:Clin Otolaryngol;36(3):235-41, 2011 Jun.
[Is] ISSN:1749-4486
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the geometry of (peri)stomas of laryngectomized patients in relation to patch use. This data will enable improvement of tracheostoma interfaces, specifically addressing patients currently unable to use stoma patches. The low use of Heat-and-Moisture-Exchange (HME) filters and (hands-free) speech valves, although very important to the quality of life of laryngectomized patients, is mainly attributed to poor fit of the adhesive patches to the stoma site. Current patch shapes are not based upon an objective (peri)stoma geometry because this geometry is unknown. DESIGN: Observational anthropometric study of the (peri)stoma of laryngectomized patients. SETTING: Ten hospitals or institutes in eight countries. PARTICIPANTS: About 191 laryngectomized patients, at least 1 year post operative. MAIN OUTCOME MEASURES: (Peri)stomas were photographed and measured. Patients completed a questionnaire on patch-use. Concavity of commercially available patches was measured. RESULTS: In countries with a financial reimbursement system 58% of the patients use patches, compares to only 9% in other countries. Patches stay in situ for an average of 33.3 h. Patch and non-patch users differ on five out of ten measured geometrical parameters. Most striking differences are that patch users have much shallower peristomas (13 versus 18 mm), and stomas far more parallel to the anterior neck plane. The deepest commercially available patch is only 7 mm deep. CONCLUSIONS: This study provides detailed (peri)stoma geometry data of a divers population, and for the first time in relation to patch-use. It reveals a serious mismatch between patients and patches. With these data new patches can be developed that could dramatically improve rehabilitation after laryngectomy.
[Mh] Termos MeSH primário: Laringectomia
Laringe Artificial
Satisfação do Paciente
Faringostomia/instrumentação
Ajuste de Prótese/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Neoplasias Laríngeas/cirurgia
Masculino
Meia-Idade
Desenho de Prótese
Fala
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1112
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:110325
[St] Status:MEDLINE
[do] DOI:10.1111/j.1749-4486.2011.02307.x



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