Category: General

Turk J Med Sci. 2024 May 23;54(5):893-899. doi: 10.55730/1300-0144.5865. eCollection 2024.

ABSTRACT

BACKGROUND/AIM: Peyronie’s disease (PD) is known as a wound-healing disorder for which surgery remains the gold-standard treatment, but studies comparing graft materials are limited in the literature. The aim of this study was to evaluate the mid- and long-term results of patients who underwent surgery for PD with grafting procedures performed by a single experienced surgeon according to graft materials.

MATERIALS AND METHODS: Patients who underwent corporoplasty between 2014 and 2020 with grafting procedures performed by a single experienced surgeon were retrospectively reviewed. A total of 115 patients were divided into 4 groups according to the grafting material used: autologous saphenous venous grafts, Group 1 (n = 36); porcine pericardial extracellular matrix grafts (EMGs; XenoGuard, MBP Medical Biomaterial Products GmbH, Neustadt-Glewe, Germany), Group 2 (n = 40); porcine intestinal submucosal EMGs (BioDesign, Cook Medical, Bloomington, IN, USA), Group 3 (n = 36); and bovine pericardial EMGs (Tutopatch, Tutogen Medical, Inc., Alachua, FL, USA), Group 4 (n = 43).

RESULTS: The mean operation time for Group 1 was longer than that of the other groups (p < 0.001). When comparing the groups in pairs, it was observed that the duration of postoperative loss of sensation (LOS) was significantly shorter in Group 3 (12.3 ± 5.3 days) and Group 4 (15.1 ± 3.1 days) (p < 0.05). There was a statistically significant difference between Groups 1 and 4 in penile length loss when the groups were compared in pairs (p = 0.017). There was a statistically significant difference between patients with penile curvatures of 0° to 59° and patients with curvatures of ≥60° in terms of duration of postoperative LOS (14.4 ± 5 vs. 16.4 ± 5.8 days, respectively; p = 0.028) and penile length loss (2.6 ± 5 vs. 5.7 ± 6.8 mm, respectively; p = 0.002).

CONCLUSION: The findings suggest that EMGs should be preferred to autologous venous grafts due to reduced postoperative erectile dysfunction, shorter operation time, and shorter recovery time for LOS.

PMID:39473729 | PMC:PMC11518321 | DOI:10.55730/1300-0144.5865

J Cardiothorac Surg. 2024 Dec 30;19(1):690. doi: 10.1186/s13019-024-03248-y.

ABSTRACT

OBJECTIVE: Berry syndrome is a group of rare congenital cardiac malformations including aortopulmonary window (APW), aortic origin of the right pulmonary artery (AORPA), interruption of the aortic arch (IAA), patent ductus arteriosus (PDA) (supplying the descending aorta) and intact ventricular septum. This paper will analyze the clinical data of 7 patients with Berry syndrome who underwent surgical treatment in our institution and discuss the one-stage surgical correction of Berry syndrome in combination with the literature.

METHODS: From January 2013 to July 2024, a total of 7 children with Berry syndrome were admitted to the Cardiac Surgery Department of Beijing Children’s Hospital. The median age was 3 months (range, 1-36 months). All patients’ IAA morphology were type A. The APW morphology was type IIA in 2, type IIB in 4, and type III in 1 patient. Three different surgical correction techniques were used to repair the APW and AORPA, including intra-aortic patch in 2, RPA angioplasty with aortic cuff in 2, RPA detachment and reimplant in 3 patients.

RESULTS: Among the 7 patients, one died in the early postoperative period, (1/7, 14.3%). The remaining 6 surviving patients, mechanical ventilation was lasted for 51 to 166 h postoperatively, with an average of (113.3 ± 50.8) hours; the CCU stay was 6 to 23 days, with an average of (11.8 ± 6.5) days. Two cases (2/7, 28.6%) of patients adopted the strategy of delayed sternal closure. The 6 surviving children were followed up for a period ranging from 3 to 132 months, with a median follow-up duration of 36 months. During the follow-up, 2 patients underwent a second operations (2/6, 33.3%). The remaining 4 patients showed no obvious RPA stenosis, descending aorta (DAO) stenosis, aortic valve stenosis or aortic valve regurgitation (AR) during the follow-up period. In the latest follow-up, the average velocity of the RPA of the 4 patients was 1.68 ± 0.36 m/s, and the average pressure gradient was 11.9 ± 4.8 mmHg; the average velocity of the DAO was 2.1 ± 1.7 m/s, and the average pressure gradient was 17.9 ± 2.6 mmHg. All the AR were less than mild.

CONCLUSION: Most children can achieve one-stage surgical correction. For children with APW type IIA, the intra-aortic patch method can be attempted, but its therapeutic effect still requires medium to long-term follow-up. The surgical approach of RPA detachment and reimplant can be applied to all types of patients with Berry syndrome, and the medium to long-term follow-up result is favorable. For the treatment of IAA, it is recommended that end-to-side anastomosis be performed between the DAO and the aortic arch, and the anterior wall be augmented by using bovine pericardial tissue patches. For the residual obstruction at the postoperative anastomosis site, balloon dilation angioplasty can be considered. Compression of the left main bronchus can be supported by intratracheal stents.

PERSPECTIVE STATEMENT: In the English literature accessed thus far, there are less than 50 cases associated with the surgical treatment of Berry syndrome. In this work, we analyzed the clinical data of 7 patients from January 2013 to July 2024 with Berry syndrome who underwent surgical treatment in our institution and showed one-stage surgical correction can achieved acceptable outcomes.

PMID:39736764 | PMC:PMC11684305 | DOI:10.1186/s13019-024-03248-y