Acute Effects of Ultrasonic Shears and Monopolar Electrosurgery on Sciatic Nerve Electrophysiology

Chen, Chaoyang; Cavanaugh, John M.; Kallakuri, Srinivasu; Tanimoto, Katsumasa; Broughton, Duan; Clymer, Jeffrey W.; Widenhouse, Tamara V.; Amaral, Joseph F.

doi:10.9734/bjmmr/2016/25233

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…In open surgery, the authors use more "cold weapons" such as scissors and clamps, while in VATS pulmonary resections we rely mostly on energy devices such as hook cautery and harmonic scalpel (22). As lateral energy damage could be 7 mm from the currently available energy devices, care should be taken to stay away enough distance (at least 1 cm) from the phrenic nerve to avoid potential thermal injury (23,24).…”

Section: Discussionmentioning

confidence: 99%

Significant diaphragm elevation suggestive of phrenic nerve injury after thoracoscopic lobectomy for lung cancer: an underestimated problem

Ventura

Zhao

Chen

et al. 2020

Transl Lung Cancer Res

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Background: Phrenic nerve injury (PNI) during lung cancer surgery, without apparent nerve section or damage, is still not well-studied. The aim of our study is to find an easy and objective way to evaluate a significant diaphragm elevation (SDE) suggestive of inadvertent PNI and its incidence and impact on lung cancer patients undergone video-assisted thoracoscopic surgery (VATS) lobectomy.Methods: Extent of diaphragm elevation was first examined on chest X-ray in a cohort of patients with invasive thymoma in whom phrenic nerve was intentionally transected. The result was then used as the criterion to diagnose a SDE suggestive of PNI in another cohort of VATS lobectomy patients. Fluoroscopy test was used to validate the results. Spirometry test was repeated to evaluate pulmonary function loss after surgery.Results: Diaphragm elevation was 24.24%±6.2% in 22 invasive thymoma-patients, with 30% elevation adopted as the criterion to diagnose SDE suggestive of PNI. In 753 VATS lobectomy patients, 56 (7.4%) were diagnosed of SDE. On Fluoroscopy test, diaphragm movement was significantly less in patients with diaphragm elevation >30% than those without (5.0 vs. 11.0 mm, P=0.003), together with a significantly smaller diaphragm movement ratio on the operation (OP) side than on the contralateral side (17% vs. 42%, P=0.018). Although no difference in postoperative complications was found, reduction in FEV1, FVC, and DLCO was significantly greater in patients with a SDE than those without (P=0.009).Conclusions: Patients with more than 30% diaphragm elevation after VATS lobectomy is highly likely to have PNI and should undergo fluoroscopic validation. Inadvertent PNI during VATS lobectomy is an underestimated phenomenon and is associated with significantly greater loss of pulmonary function.

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Section: Discussionmentioning

confidence: 99%

Significant diaphragm elevation suggestive of phrenic nerve injury after thoracoscopic lobectomy for lung cancer: an underestimated problem

Ventura

Zhao

Chen

et al. 2020

Transl Lung Cancer Res

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“…It was thought that technique of harmonic scalpel is beneficial as compare to conventional procedure .By using harmonic scalpel two major changes occur, first of all the time duration is reduced and second the risk of hypocalcaemia and recurrent laryngeal nerve paresis is reduced. From the beginning of this century a large number of persons did research on advantageous use of harmonic scalpel [13]. Some important studies are given below in this regard.…”

Section: Discussionmentioning

confidence: 99%

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

2019

JMPB

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Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy.Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant.Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ 2 =0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion:The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Introduction:The description about the thyroid gland is very prehistoric' for the first time it was name as "shield shape gland" by the Romans [1] . In the literature during 12 th or 13 th century not only the thyroid masses were mentioned but in 1170 Robert Frugard explained the complication of goiter. Thyroid surgery was begun in 12 th century by using hot iron, Setons and caustics powers (most results were fatal).At that time, the major advancement was, antisepsis, artery forceps and anesthesia to be practice [2] .The pioneers of thyroid surgery, Theodor Koches and Theodor Billroth, formulated many acceptable techniques of thyroid surgery between the year 1873 and 1883 [3] . In conventional method knot tying and ligation were important process. The very important thing of this operation is that the thyroid gland is one of the highly vascularized among all the organs having rich blood vessels and plexuses present in the parenchyma. This needs to be controlle...

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The association between health literacy and self-medication behaviors among women referred to comprehensive health care centers in Sirjan, Iran, in 2017

Mousaeipour

Jaberi

Bonabi

2018

JOHE

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Article Info Background: Self-medication is a challenging issue in health care systems and it seems that health literacy is a determining factor in safe self-medication behaviors. Limited studies are available in this field. Therefore, the aim of this study was to determine the relationship between health literacy and self-medicating behaviors among women referred to comprehensive health care centers Materials and Methods: In this descriptive study, 540 women, who were referred to comprehensive health care centers in 2017, were selected randomly and their health literacy and self-medicating behaviors were assessed through self-reporting method. The data collection tools were the standard Health Literacy for Iranian Adults (HELIA), and the self-medication behaviors questionnaires. Data were analyzed using chi-square, Mann-Whitney U, and Kruskal-Wallis H tests. Results: The results showed that the majority of women (94.6%) had inadequate health literacy. More than 89% of them approved self-medication and more than 98% of them performed self-medication. Older women and those who had a higher education level had lower mean health literacy scores (P = 0.021 and P = 0.001, respectively). There was no significant relationship between self-medication and demographic characteristics. Furthermore, there was no significant relationship between health literacy and confirmation and performance of self-medication. Conclusions: The women had low health literacy levels and high incorrect selfmedication behaviors. Self-medication behaviors are performed independent of health literacy. It seems a reform in women's health programs and the empowerment of women in the target population is necessary in order to promote health literacy skills and appropriate self-medication behaviors.

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Acute Effects of Ultrasonic Shears and Monopolar Electrosurgery on Sciatic Nerve Electrophysiology

Cited by 3 publications

References 13 publications

Significant diaphragm elevation suggestive of phrenic nerve injury after thoracoscopic lobectomy for lung cancer: an underestimated problem

Significant diaphragm elevation suggestive of phrenic nerve injury after thoracoscopic lobectomy for lung cancer: an underestimated problem

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

The association between health literacy and self-medication behaviors among women referred to comprehensive health care centers in Sirjan, Iran, in 2017

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