PURPOSE: To compare the clinical outcomes between high and low fluid-dynamic parameter settings during phacoemulsification. METHODS: In this retrospective study we analyzed 183 consecutive eyes with senile cataracts that underwent cataract surgery between October 2010 and January 2015. The phacoemulsifications were performed with high and low fluidic parameter settings, which were designated by different fluid heights, aspiration flow rates, and vacuum settings. We measured and compared the intraoperative factors including fluid consumption, cumulative dissipated energy (CDE), ultrasound time, intraoperative complications, and pupil size changes during the phacoemulsification. Central corneal thickness (CCT), endothelial cell density (ECD), uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA) were measured and compared preoperatively and postoperatively. RESULTS: There was no statistically significant difference in the fluid consumption, CDE, or ultrasound time during phacoemulsification between the 2 groups. The frequencies of intraoperative complications were not statistically significant. UCVA, BCVA, and ECD were not statistically significantly different between the 2 groups during the postoperative follow-up. The low parameter group showed the lower increase in CCT on postoperative day 30. CONCLUSIONS: The phacoemulsifications with low fluid-dynamic parameter resulted in less damage to intraocular tissue without any significantly different postoperative findings. The phacoemulsification with low fluid-dynamic parameter setting is more advantageous due to stable and safe aspects.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Intraoperative Complications ; Phacoemulsification* ; Pupil ; Retrospective Studies ; Ultrasonography ; Vacuum ; Visual Acuity

Thoracic duct cysts are uncommon lesions that most commonly occur in the abdominal and thoracic portion of the thoracic duct: the cervical portion is the rarest location. The main causes of thoracic duct cyst are surgical injuries such as neck dissection and blunt trauma. We report here on a rare case of spontaneous cervical thoracic duct cyst that was noted on ultrasonography and CT. The thoracic duct cyst was confirmed by fine needle aspiration and it was treated by sclerotherapy.
Biopsy, Fine-Needle ; Intraoperative Complications ; Mediastinum ; Neck Dissection ; Sclerotherapy ; Thoracic Duct* ; Ultrasonography

The postoperative neurological complications is associated with intraoperative cerebral emboli, which results from extracorporeal circulation and operation. It can effectively reduce the incidence of neurological complications with ultrasonic radiation. In fluids, a particle will change it's motion trail when it is acted by the radiation force generated by the ultrasound. This article mainly discuss how to shielding emboli with ultrasound. The equipment can transmit phased ultrasonic signals, which is designed on a FPGA development board. The board can generate a square wave, which is converted into a sine wave through a power amplifier. In addition, the control software has been developed on Qt development environment. The result indicates it's feasible to shielding emboli with ultrasonic radiation force. This article builds a strong foundation for the future research.
Humans ; Intracranial Embolism ; diagnostic imaging ; prevention & control ; Intraoperative Complications ; prevention & control ; Postoperative Complications ; prevention & control ; Ultrasonics ; instrumentation ; Ultrasonography

Venous air embolism (VAE) is the entrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. The incidence of VAE during cesarean delivery ranges from 10 to 97% depending on surgical position or diagnostic tools, with a potential for life-threatening events. We reviewed extensive literatures regarding VAE in detail and herein described VAE during surgery including cesarean delivery from background and history to treatment and prevention. It is intended that present work will improve the understanding of VAE during surgery.
Anesthesia, Obstetrical/adverse effects ; Cesarean Section/*adverse effects ; Echocardiography, Transesophageal/methods ; Embolism, Air/*diagnosis/prevention & control/*ultrasonography ; Female ; Humans ; Intraoperative Complications/ultrasonography ; Monitoring, Intraoperative/methods ; Obstetrics/methods ; Pregnancy ; Risk Factors ; Ultrasonography, Doppler/methods

PURPOSE: A conventional thyroidectomy requires a wide transverse incision on the anterior neck, which can cause significant scaring. We developed an endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure in order to produce better cosmetic results. We reports the clinical analysis of endoscopic thyroid lobectomy and compare the result with those from a conventional thyroid lobectomy. METHOD: From July 2003 and December 2004, 55 consecutive patients with benign thyroid nodules, who underwent endoscopic thyroid lobectomy, and 51 consecutive patients with benign thyroid nodules, who underwent a conventional thyroid lobectomy, were retrospectively reviewed. The preoperative diagnosis of the thyroid nodules was performed using high-resolution ultrasonography and fine- needle aspiration cytology. The clinical results of endoscopic thyroid lobectomy were analyzed and compared with those from a conventional thyroid lobectomy. RESULTS: There were no significant differences between the two groups in terms of the patients' gender, size of tumor, preoperative diagnosis (follicular tumor/adenomatous nodule), postoperative diagnosis (cancer/benign), level of postoperative discomfort, length of hospital stay. The patients who underwent endoscopic thyroidectomy were significantly younger than those underwent conventional thryoidectomy (37.4+/-10.3 years vs. 48.8+/-13.0 years; P<0.001). The operation time for the endoscopic group was significantly longer than that for the conventional group (171.9+/-35.6 min vs. 92.5+/-26.5 min; P<0.001). The length of closed drainage in the endoscopic group was longer than that in the conventional group (2.8+/-0.8 days vs. 1.4+/-1.3 days; P<0.001). However, these factors did not affect the length of the hospital stay, and the number of intraoperative complications. CONCLUSION: Endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure has cosmetic benefits and is a feasible and safe procedure.
Breast ; Carbon Dioxide ; Diagnosis ; Drainage ; Humans ; Intraoperative Complications ; Length of Stay ; Neck ; Needles ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

OBJECTIVETo determine the diagnostic value for predicting cerebral hyperperfusion syndrome (CHS) by adding a transcranial Doppler (TCD) measurement at the end of the carotid endarterectomy (CEA) at the operating room.

METHODSPatients who underwent CEA between August 2009 and December 2011 of the prospective clinical trial in whom both intra- and post-operative TCD monitoring were performed were included. The middle cerebral artery velocities pre-clamping, post-declamping and post-operatively were measured by TCD. The intra-operative velocity increase ratio (VR1) was compared to the postoperative velocity increase ratio(VR2) in relation to CHS by calculating the sensitivity,specificity, positive predictive value, negative predictive value. The receiver operating characteristic curve (ROC) were also performed. The area under the curve (AUC) of ROC of VR1 and VR2 were compared.All the data were analyzed using SPSS 20.0 software.

RESULTSVR1 > 100% was identified in 6 patients, while VR2 > 100% was identified in 18 patients, respectively. Ten patients were diagnosed with CHS. The AUC of VR2 (0.728) was higher than AUC of VR1 (0.636). The best fit cutoff point of VR2 was 100%. The sensitivity, specificity, positive predictive value, negative predictive value were 70%, 83%, 39%, 95%, respectively, which demonstrates a better predictive power than VR1.

CONCLUSIONBesides the commonly used intra-operative TCD monitoring, additional TCD measurement at the end of the carotid endarterectomy at the operating room is more useful to more accurately predict CHS.

Adult ; Aged ; Aged, 80 and over ; Cerebrovascular Circulation ; Endarterectomy, Carotid ; Female ; Humans ; Intraoperative Complications ; diagnostic imaging ; Male ; Middle Aged ; Middle Cerebral Artery ; ultrastructure ; Monitoring, Intraoperative ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography, Doppler, Transcranial

In this case, a successful mitral valve repair was confirmed by transesophageal echocardiography (TEE) at the end of a cardiopulmonary bypass. The left ventricular vent was placed through the mitral valve to remove the air after the TEE examination, and on its way out, the left ventricular vent damaged the anterior mitral leaflet (AML). Re-examination of the valve with TEE detected the new mitral valve insufficiency. The CPB was reinstituted, and tearing of the lateral third part of the anterior mitral leaflet was found. This case emphasizes the importance of TEE in the operating room as a continuous monitor, not only to evaluate the result of the cardiac surgery, but also to detect any unpredictable events during the surgery.
Mitral Valve Insufficiency/*surgery/*ultrasonography ; Mitral Valve/*injuries/surgery ; Middle Aged ; Intraoperative Complications/surgery ; Humans ; Female ; *Echocardiography, Transesophageal ; Cardiopulmonary Bypass/*adverse effects

OBJECTIVE: Ultrasound can be used in the treatment of large intracerebral hematoma. The authors present our experiences with Ultrasound-guided catheter placement for lysis and drainage of ganglionic hematoma, with emphasis on technical aspects. METHODS: The authors applied real-time ultrasonography for the aspiration of intracerebral hematoma in 6cases. Ultrasound-guided aspiration via a burrhole was performed under local anesthesia. We selected a temporal entry point instead of the frequently used precoronal approach in ganglionic hematoma. A burrhole was made 4 to 6cm posterior from posterior border of frontal process of the zygomatic bone at the level of 4 to 5cm above the external auditory meatus. RESULTS: In all patients, the catheter was placed accurately into the hematoma target. All patients were irrigated with urokinase once to three times a day. The catheter could be removed within two or three days. The mean hematoma volume was reduced from initially 32mL to 5mL in an average of two days. There were no intraoperative complications related to the use of real-time ultrasonography and no postoperative infections were noted. CONCLUSION: Ultrasound allows an easy and precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.
Anesthesia, Local ; Basal Ganglia* ; Catheters ; Cerebral Hemorrhage* ; Drainage ; Fibrinolysis ; Ganglion Cysts ; Hematoma ; Humans ; Intraoperative Complications ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator

PURPOSE: The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM). METHODS: Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences. RESULTS: The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days. CONCLUSION: TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.
Adenoma ; Biopsy ; Chemoradiotherapy, Adjuvant ; Demography ; Humans ; Intraoperative Complications ; Length of Stay ; Lithuania ; Lost to Follow-Up ; Magnetic Resonance Imaging ; National Cancer Institute (U.S.) ; Pathology ; Postoperative Complications ; Postoperative Hemorrhage ; Prognosis ; Rectal Neoplasms* ; Recurrence ; Transanal Endoscopic Microsurgery* ; Ultrasonography ; Urinary Retention ; Wounds and Injuries

OBJECTIVES: Here the author report the mid-term clinical outcomes analysis with efficacy and safety of HoLEP. METHODS: From May 2010 to September 2012, 270 consecutive patients treated with HoLEP were enrolled in this study. All patients was evaluated by digital rectal examination (DRE), transrectal ultrasonography (TRUS), serum PSA preoperatively. International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and postvoid residual urine (PVR) were documented preoperatively and 1, 3, 6, 12, 24 months postoperatively. The perioperative data and complications were analyzed. All procedures of HoLEP was done by a single surgeon. RESULTS: The mean patient age at the surgery was 67.5 years (45-82), and the mean PSA was 3.7 ng/mL (0.4-19.4). Mean operation time was 73.6 minutes (30-150). Mean prostate volume was 64.3 mL (20-150) and mean resected tisssue weight was 9.3 g (2-63). Mean catheter indwelling time was 2.7 day (1-6), and mean hospital stay was 3.2 day (1-7). The blood loss was minimal, so transfusion was not needed. The baseline data were IPSS; 23.0 (7-35), QoL score; 5.4 (4-6), Qmax (mL/s); 12.5 (1.2-16.5), PVR (mL); 59 (20-250). Postoperatively, IPSS and QoL scores and PVR decreased, and Qmax increased significantly. Intraoperative complication was minor capsular perforation (n = 5). Postoperative complications were acute urinary retention (n = 9), transient incontinence (n = 17), urinary tract infection (n=4), urethral stricture (n=4) and bladder neck contracture (n = 12). CONCLUSIONS: HoLEP showed statistical improvement of clinical parameters after 1 month operation and these results sustained for 24 months regardless of prostatic size.
Catheters ; Contracture ; Digital Rectal Examination ; Holmium* ; Humans ; Intraoperative Complications ; Lasers, Solid-State* ; Length of Stay ; Neck ; Postoperative Complications ; Prostate* ; Prostatic Hyperplasia* ; Ultrasonography ; Urethral Stricture ; Urinary Bladder ; Urinary Retention ; Urinary Tract Infections