Yazar "Thomas, David T." seçeneğine göre listele

Listeleniyor 1 - 3 / 3
  • Küçük Resim Yok
    Yayın
    An alternative and novel usage for ultrasound-guided erector spinae plane block: Extracorporeal shock wave lithotripsy in a paediatric patient
    (WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2020) Ekinci, Mursel; Ciftci, Bahadir; Guven, Selcuk; Thomas, David T.
    An alternative and novel usage for ultrasound-guided erector spinae plane block: Extracorporeal shock wave lithotripsy in a paediatric patient
  • Küçük Resim Yok
    Yayın
    Percutaneous Internal Ring Suturing for the Minimally Invasive Repair of Congenital Inguinal Hernia in Neonates: A Retrospective Cohort Study
    (Springernature, 2023) Thomas, David T.; Tulgar, Serkan
    IntroductionInguinal hernia (IH) repair is among the most frequently performed surgical operations in children. While open herniorrhaphy has been the gold standard surgical method of choice, the popularity of laparoscopic repair has sharply risen over the past two decades. Although a wide range of literature on the use of laparoscopy for IH repair in children exists, data regarding neonates, an especially delicate group of children, is limited to only a few studies. This study aims to evaluate the surgical, anaesthetic, and follow-up data of term neonates undergoing percutaneous internal ring suturing (PIRS) for IH repair in order to determine if it is a viable option for this specific patient population.Materials and methodsThis single-centre retrospective cohort included all children who underwent PIRS for IH repair during an 86 -month period between October 2015 and December 2022. Patients' gender, gestational age at birth, age and weight at surgery, side of IH at diagnosis, per-operative findings (presence of contralateral patent processus vaginalis (CPPV)), surgical time, time under anaesthesia, follow-up time, and follow-up findings were collected from an electronic database and analysed. The primary outcome measures were surgical time, rate of recurrence, and presence of CPPV and the secondary outcome measures were anaesthesia time and the rate of complications.ResultsDuring the study period, 34 neonates (23 male and 11 female) underwent laparoscopic repair for IH using the PIRS technique. Average age and weight at surgery were 25.2 +/- 3.2 (20-30) days and 3530.4 +/- 293.6 (3012 -3952) gm, respectively. IH was detected on the right side in 19 (55.9%), on the left side in 12 (35.3%), and bilaterally in three (8.8%) patients at their presenting physical examination. Nine patients (26.5%) were found to have CPPV perioperatively, which were all repaired simultaneously. The average surgical time was 20.3 +/- 4.5 minutes for unilateral and 25.8 +/- 4.0 minutes for bilateral IH repair (p<0.01). On the contrary, the average time under anaesthesia was 33.2 +/- 4.5 minutes for unilateral and 33.5 +/- 4.9 minutes for bilateral IH repair, but the difference was not statistically significant (p>0.05). No early postoperative complications were observed. The average follow-up time was 27.6 +/- 14.4 (range: 3-49) months. Recurrence was seen in one patient (2.9%) and umbilical incision granuloma was observed in two (5.9%) patients.ConclusionSurgical times, anaesthesia times, complication rates, recurrence rates, and rate of CPPV in neonates undergoing PIRS are similar to those in older children and comparable to those of open herniorrhaphy and other laparoscopic techniques. Despite the suspicion that the rate of CPPV would be higher in neonates, we found that it is similar to that in older children. We conclude that PIRS is a viable option for the minimally invasive repair of IH in neonates.
  • Küçük Resim Yok
    Yayın
    Ultrasound-guided Erector Spinae Plane Block: Indications, Complications, and Effects on Acute and Chronic Pain Based on a Single-center Experience
    (CUREUS INC, 2019) Tulgar, Serkan; Selvi, Onur; Senturk, Ozgur; Serifsoy, Talat E.; Thomas, David T.
    Introduction: Erector spinae plane block (ESPB) is a novel regional anesthesia technique used in postoperative pain and chronic neuropathic pain of the thoracoabdominal region. There are no previously published large case series. This retrospective review aimed to report the indications, levels of block, success of block and complications, and also to evaluate the effect of ESPB on postoperative/chronic pain. Methods: We retrospectively evaluated the charts and medical records of 182 patients who had ESPB in the last one year. All records were collected in the postoperative recovery room, ward, and pain unit. Results: ESPB performed at several different levels and for several different indications led to effective postoperative analgesia when part of a multimodal analgesia plan. Few complications were noted. Conclusion: ESPB is an interfascial plane block with many indications. The possibility of complications must be considered.