Background: Ectropion and entropion are eyelid malpositions associated with many unpleasant symptoms. One of many surgical methods that can correct these problems is called the lateral tarsal strip. In this paper, we evaluate the postoperative results and quality of this technique. We also looked at the complications associated with this surgical method.
Methods: The study took place from April 2018 to April 2020 at the Military University Hospital in Prague. The operation was performed by two surgeons. The study included 43 eyes of 33 patients (17 women and 16 men), average age was 79 years. Before the operation, 23 eyes had an ectropion and 20 eyes had an entropion, 35 of 43 were cases of involutional origin. The study does not include patients who underwent other surgical techniques.
Results: There were no intraoperative or postoperative complications in the entropion surgery group. Proper correction was achieved, and bothersome symptoms disappeared in 91,3 % of cases. Correct position of eyelid was not achieved in two cases. For patients with ectropion, surgical correction was successful in 95 % of cases. The ectropion persisted after surgery only for one patient.
Conclusion: The lateral tarsal strip technique is safe, reliable and highly effective surgical technique. Correction of eyelid malposition was achieved in more than 90 % of cases. Vast majority of patients were satisfied and reported relief from preoperative symptoms.
BackgroundSecondary aorto‐enteric fistulae (SAEF) are a rare, complex and life‐threatening complication following aortic repair. Traditional treatment strategy has been with open aortic repair (OAR), with emergence of endovascular repair (EVAR) as a potentially viable initial treatment option. Controversy exists over optimal immediate and long‐term management.MethodsThis was a retrospective, observational, multi‐institutional cohort study. Patients who had been treated for SAEF between 2003 and 2020 were identified using a standardized database. Baseline characteristics, presenting features, microbiological, operative, and post‐operative variables were recorded. The primary outcomes were short and mid‐term mortality. Descriptive statistics, binomial regression, Kaplan–Meier and Cox age‐adjusted survival analyses were performed.ResultsAcross 5 tertiary centres, a total of 47 patients treated for SAEF were included, 7 were female and the median (range) age at presentation was 74 years (48–93). In this cohort, 24 (51%) patients were treated with initially with OAR, 15 (32%) with EVAR‐first and 8 (17%) non‐operatively. The 30‐day and 1‐year mortality for all cases that underwent intervention was 21% and 46% respectively. Age‐adjusted survival analysis revealed no statistically significant difference in mortality in the EVAR‐first group compared to the OAR‐first group, HR 0.99 (95% CI 0.94–1.03, P = 0.61).ConclusionIn this study there was no difference in all‐cause mortality in patients who had OAR or EVAR as first line treatment for SAEF. In the acute setting, alongside broad‐spectrum antimicrobial therapy, EVAR can be considered as an initial treatment for patients with SAEF, as a primary treatment or a bridge to definitive OAR.
Highlights
Orthostatic mediated hypoperfusion transient ischaemic attack is a rare phenomenon.
Aorto-carotid bypass is an uncommon procedure usually performed in the setting of dissections and vasculitis affecting the supra-aortic branch vessels.
Aorto-carotid bypass can be considered in patients with symptomatic atherosclerotic disease of the supra-aortic branch vessels.
Venous cystic adventitial disease is a rare vascular condition that can have significant effects on a patient’s quality of life. The clinical presentation of venous cystic adventitial disease is variable, and there are no established guidelines on investigation or treatment of the disease. We present a series of three patients with venous cystic adventitial disease of the common femoral vein, treated within a single vascular surgery unit. Each of the three patients presented within 18 months of each other, despite the rarity of the disease. These are the only known cases treated within this vascular surgery unit. The investigation, management and treatment of each patient are individualised, with a management focus on quality of life.
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