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Post renal transplant Castleman's disease resolved after graft nephrectomy: a case report

Al Otaibi T, Al Sagheir A, Ludwin D, Meyer R

Transplant Proc, 2007 May;39(4):1276-7.
PMID: 17524952

Angiofollicular lymphoid hyperplasia (Castleman's disease) is a lymphoproliferative process thought to be mediated by overexpression of II interleukin-6. Castleman's disease has two variants: Castleman's disease has two variants: Hyaline vascular type and plasma cell variant (multicentric Castleman's disease). The hyaline vascular type tends to be localized, and the plasma cell variant shows more systematic signs and carriers a worse clinical prognosis. Castleman's disease is associated with B-cell lymphoma, Kaposi sarcoma, Human herpes virus 8 (HHV-8), and Epstein-Barr virus. Castleman's disease have been described thrice post kidney transplant. In this report, we document the course of a renal recipient who developed the plasma cell variant of Castleman's disease at 16 months after failure of his allograft and return to dialysis. He displayed clinical resolution of this complication after graft nephrectomy. To our knowledge, this is the first case where the disease manifestations disappeared after graft removal. Our patient experienced chronic renal allograft rejection which may have driven all the systematic manifestations of multicentric castleman's disease and possibly reactivated a latent HHV-8 infection. In this case immunohistochemical testing for HHV-8 was not available to prove a role for this agent.

Matched MeSH terms: Reoperation
Fulltext Sliding compression screw fixation for delayed union/non-union of femoral neck fracture: is it a viable option

Faisham WI, Sulaiman AR, Zulmni W

Med J Malaysia, 2006 Feb;61 Suppl A:36-9.
PMID: 17042227

Femoral neck fracture non-unions often present with significant difficult treatment decision as regards to surgical options and the risk of complication. We present three cases of femoral neck non-union treated with double screw stabilization technique using sliding compression hip screw and anti-rotational screw. The rationale for opting to these simple implants in our setting is discussed.

Matched MeSH terms: Reoperation
Fulltext Revision surgery for developmental dysplasia of the hip

Chidambaram S, Abd Halim AR, Yeap JK, Ibrahim S

Med J Malaysia, 2005 Jul;60 Suppl C:91-8.
PMID: 16381291

Revision surgery following failed open reduction for developmental dysplasia of the hip (DDH) is technically demanding. We reviewed 12 patients in our institution that required a revision surgery between January 1994 and December 2003. The aims of this study are to identify the causes of redislocation after the primary open reduction and to determine the clinical and radiological outcome after the revision surgery. The mean age at presentation for DDH was 31 months (range 1-84) and the mean age at primary open reduction surgery was 38 months (range 15-84) and the mean age at revision surgery was 69 months (range 21-180). The mean follow-up period after revision surgery was 20 months (range 3-84). All the revision surgery was performed via an anterior Smith Peterson approach. The most common cause for redislocation was inadequate exposure and failure to release the obstructing soft tissues around the hip. The bony factors for redislocation included failure to perform a femoral shortening and excessive derotation of an anteverted femoral head combined with a Salter osteotomy. Three cases with posterior acetabular wall deficiency needed immobilization of the hip in extension as the hip tended to dislocate in flexion. Six patients had limb length discrepancy ranging from 1 cm to 4 cm and 50% developed avascular necrosis. Only 2 patients were asymptomatic and the majority had a limp and limitation of motion. All were pain free except one. In view of the technically demanding surgery and poor results after revision, the surgeon should recognize the pathology and ensure that the primary procedure achieves a stable and concentric reduction.

Matched MeSH terms: Reoperation
Fulltext Successful revascularisation of near total amputation of the upper limb after ten hours of warm ischaemia

Merican AM, Kwan MK, Cheok CY, Wong ELW, Sara TA

Med J Malaysia, 2005 Jun;60(2):218-21.
PMID: 16114164

Near total amputation of the upper limb if unsalvageable would cause severe disability. However, delayed revascularisation can be life threatening. We report two cases of revascularisation of the upper limb following near total amputation that was successful and functional after a warm ischaemic time of ten hours. The first was a traction avulsion injury of the arm leaving major nerves contused but in continuity. The second was a sharp injury through the mid-forearm attached by only a bridge of skin. Attempting revascularisation of a proximal injury beyond 6 hours, in selected cases is worthwhile.

Matched MeSH terms: Reoperation
Fulltext Analgesic efficacy of transversus abdominis plane block in neonates and early infants for colostomy and reversal of colostomy

Chen CK, Teo SC, Phui VE, Saman MA

Agri, 2015;27(4):210-4.
PMID: 26860495 DOI: 10.5505/agri.2015.66487

The application of ultrasound-guided transversus abdominis plane (TAP) block in paediatric population is gaining popularity among anaesthetists. We present a case series of ultrasound-guided TAP block in ten neonate and infants undergoing colostomy and reversal of stoma. Classical TAP as described by Hebbard was carried out and a maximum dosage of 1ml/kg of 0.25% levobupivacaine was injected. Pain score was assessed using Neonatal Infant Pain Scale for 24 hours. In all patients, the block was successful with minimal hemodynamic changes intraoperatively and no additional systemic analgesia was needed intraoperative and immediate postoperatively. Ultrasound-guided TAP block has an important role in providing safe and effective analgesia for colostomy creation and reversal of stoma surgeries in paediatric population.

Matched MeSH terms: Reoperation
Clinical outcomes of mesh exposure/extrusion: presentation, timing and management

Lo TS, Tan YL, Cortes EF, Wu PY, Pue LB, Al-Kharabsheh A

Aust N Z J Obstet Gynaecol, 2015 Jun;55(3):284-90.
PMID: 26044791 DOI: 10.1111/ajo.12340

The Food and Drug Administration has recently highlighted an increase in reported complications associated with the use of transvaginal mesh.

Matched MeSH terms: Reoperation
Fulltext Candida albicans infection of a prosthetic knee replacement: a case report

Badrul B, Ruslan G

Med J Malaysia, 2000 Sep;55 Suppl C:93-6.
PMID: 11200051

We report a 64 year old man who developed Candida albicans infection following total knee arthroplasty. A two-stage exchange arthroplasty was performed after an initial swab culture grew Acinobacter sp. A scanty growth of yeast was also found from the tissue culture. Intravenous cefuroxime was instituted for six weeks followed by reimplantation four months after the removal. Three weeks after that revision, the prosthesis became infected and a culture of knee aspirate established the diagnosis of Candida albicans infection. Treatment consisted of thorough debridement of the involved joint and oral fluconazole for a year. Infection was never totally resolved and a secondary infection with methicillin resistant staphylococcus aureus then developed. Excision arthroplasty was done at two and a half years after the initial infection. At five years follow-up the infection was quiescent and he had a range of movement of 30 degrees to 70 degrees. Knee brace was used to control the valgus-varus stability.

Matched MeSH terms: Reoperation
Lateral closing wedge supracondylar osteotomy of humerus for post-traumatic cubitus varus in children

Devnani AS

Injury, 1998 6 13;28(9-10):643-7.
PMID: 9624344

Cubitus varus deformity following mal-union of a supracondylar fracture of the humerus in children causes no functional disability, but surgical correction is often requested to improve the appearance of the arm. Maintaining the correction after supracondylar osteotomy is a difficult aspect of the operative treatment and remains controversial. Nine children aged between 6 and 12 years (average 8 years and 11 months) underwent lateral closing wedge supracondylar osteotomy of the humerus, for deformity ranging between 10 and 20 degrees (average 13 degrees). The correction required ranged between 16 and 30 degrees (average 21 degrees). The osteotomy was internally fixed with a two hole marrow plate. At follow-up, which ranged between 3 months and 6 years (average 34 months), six patients were graded as good, two as satisfactory and one as a poor result. One patient had transient radial nerve palsy which recovered completely in 2 months. The patient who was graded poor had undercorrection of the deformity at the original operation. There was no incidence of loss of correction due to implant failure. Complete section of the bone to allow medial displacement of the distal fragment is recommended, thereby avoiding lateral bony prominence at the elbow.

Matched MeSH terms: Reoperation
Fulminant amoebic colitis causing a colonic mucosal tube

Kyaw K

Aust N Z J Surg, 1994 Jan;64(1):67-9.
PMID: 8267547
Matched MeSH terms: Reoperation
Fulltext Continent pouch ileostomy

Tay SK, Meah FA, Isa MR, Phang KS

Med J Malaysia, 1994 Sep;49(3):310-4.
PMID: 7845289

Continent pouch ileostomy is fashioned for patients who need a proctocolectomy. It is usually indicated for cases of ulcerative colitis and familial adenomatous polyposis where the anal sphincter can no longer maintain normal function or has to be removed. A case of familial adenomatous polyposis with features of Gardner's syndrome is reported. The patient presented with carcinoma of the rectum. Abdominoperineal resection followed by completion pancolectomy was performed. A continent pouch ileostomy was fashioned for him. He resumed work as a labourer within six months. The pouch was troublefree, needed to emptied four to six times a day and was fully continent of fluid, flatus and faeces until his demise three years later from liver secondaries. Continent pouch ileostomy is a better alternative than permanent end ileostomy. All care should be taken to rule out the existence of Crohn's disease. It is proposed that continent pouch ileostomy should be offered to patients needing permanent ileostomy if the expertise is available.

Matched MeSH terms: Reoperation
Closed mitral valvotomy in pregnancy--a Malaysian experience

Goon MS, Raman S, Sinnathuray TA

Aust N Z J Obstet Gynaecol, 1987 Aug;27(3):173-7.
PMID: 3435354

Our experience from 1968 to 1985 in 12 women requiring closed mitral valvotomy during pregnancy is reviewed. All patients had severe mitral stenosis and were in functional class 3 (2 patients) or class 4 (10 patients). Mitral valvotomy was performed between the 18th and the 30th week of pregnancy using a transventricular dilator. Improvement in functional class was noted in all patients postoperatively. One patient had postvalvotomy mitral regurgitation and heart failure, which responded to diuretics; the subsequent course was uneventful. Eleven patients had normal deliveries; whilst one patient had a Caesarean section for an obstetric indication. All babies were normal and there was no maternal death. This series confirms that closed mitral valvotomy can be performed with an acceptable degree of safety during pregnancy, when indicated.

Matched MeSH terms: Reoperation
Ciliary-block glaucoma treated by posterior capsulotomy

Lockie P

Aust N Z J Ophthalmol, 1987 Aug;15(3):207-9.
PMID: 3675913

Ciliary-block glaucoma occurred in one eye of a 65-year-old-male, following a combined trabeculectomy and extracapsular lens extraction for long-standing angle-closure glaucoma. After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule.

Matched MeSH terms: Reoperation
Fulltext Major lower limb amputations

Abdul Kadir AH, Myint Han

Med J Malaysia, 1988 Sep;43(3):218-23.
PMID: 3241579
Matched MeSH terms: Reoperation
Recurrent leiomyomatosis peritonealis disseminata

Ng PH, Mahdy Z, Nik NI

J Obstet Gynaecol, 2004 Feb;24(2):188-9.
PMID: 14766471
Matched MeSH terms: Reoperation
Small stem Exeter total hip replacement: clinical and radiological follow-up over a minimum of 2.5 years

Sivananthan S, Arif M, Choon DS

J Orthop Surg (Hong Kong), 2003 Dec;11(2):148-53.
PMID: 14676339

To evaluate the clinical and radiological outcome in patients undergoing small stem Exeter total hip replacement.

Matched MeSH terms: Reoperation
Fulltext Patient-reported Outcome Measures of Revision Total Hip Arthroplasty for Prosthetic Joint Infection is not Inferior to Aseptic Revision Total Hip Arthroplasty

Lim J, Pang HN, Tay K, Chia SL, Yeo SJ, Lo NN

Malays Orthop J, 2020 Nov;14(3):73-81.
PMID: 33403065 DOI: 10.5704/MOJ.2011.012

Introduction: This study aims to investigate whether patients undergoing two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) and one-stage revision THA for aseptic reasons have similar clinical outcomes and patient satisfaction during their post-operative follow-up. We hypothesise that the two-stage revision THA for PJI is associated with poorer outcomes as compared to aseptic revision THA.
Materials and Methods: We reviewed prospectively collected data in our tertiary hospital arthroplasty registry and identified patients who underwent revision THA between 2001 and 2014, with a minimum of two years follow-up. The study group (two-stage revision THA for PJI) consists of 23 patients and the control group (one-stage revision THA for aseptic reasons) consists of 231 patients. Patient demographics, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Hip Score (OHS), Short Form-36 (SF-36) scores and patient reported satisfaction were evaluated. Student's t-test was used to compare continuous variables between the two groups. Statistical significance was defined as p <0.05.
Results: The pre-operative demographics and clinical scores were relatively similar between the two groups of patients. At two years, patients who underwent revision THA for PJI reported a better WOMAC Pain Score and OHS as compared to aseptic revision THA. A similar proportion of patients were satisfied with their results of surgery in both groups (p=0.093).
Conclusions: Although patients who underwent revision THA for PJI had poorer pre-operative functional scores (WOMAC function and SF-36 PF), at two years follow-up, these two groups of patients have comparable post-operative outcomes. Interestingly, patients who had revision THA for PJI reported a better clinical outcome in terms of OHS and WOMAC Pain score as compared to the aseptic group. We conclude that the revision THA for PJI is not inferior to aseptic revision THA in terms of patient satisfaction and clinical outcomes.

Matched MeSH terms: Reoperation
Fulltext Diabetic Foot Management: How Could a Procedural Pathway Improve the Surgical Outcome?

Belgaid V, Courtin C, Desmarchelier R, Fessy M, Besse JL

Malays Orthop J, 2020 Nov;14(3):82-89.
PMID: 33403066 DOI: 10.5704/MOJ.2011.013

Introduction: Diabetic foot ulcer is the main aetiology for non-traumatic amputation, which is a major public health care concern. A multidisciplinary approach in the management of this pathology has been shown to improve the surgical outcome. However, there are little data available on the tools we can use to pursue this multidisciplinary approach. The main goal of this cross-sectional study was to find out whether the implementation of a specific management pathway could improve the treatment outcome in the treatment of diabetic foot.
Materials and Methods: From 2012 to 2014, we consecutively recruited patients with diabetic foot referred to Orthopaedic surgery department of our university for surgical opinion. A specific diabetic foot pathway was introduced in 2013. One group of patients who were treated with previous method were evaluated retrospectively. Another group of patients who were treated after implementation of the pathway were evaluated prospectively. We compared treatment outcome between the two groups.
Results: We included 51 patients. Amputation rate was similar both the groups: 74% in the retrospective group not using the new pathway versus 73% in a prospective group that used the new pathway. Revision surgery was 39% in the retrospective group and 14% in the prospective group (p=0.05).
Conclusion: We recommend the use of this simple and cost-effective pathway to guide the interdisciplinary management of diabetic foot. A prospective study with more subjects would provide a better overview of this management pathway.

Matched MeSH terms: Reoperation
Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers

Al-Namnam NMN, Hariri F, Rahman ZAA

Br J Oral Maxillofac Surg, 2018 06;56(5):353-366.
PMID: 29661509 DOI: 10.1016/j.bjoms.2018.03.002

Our aim was to summarise current published evidence about the prognosis of various techniques of craniofacial distraction osteogenesis, particularly its indications, protocols, and complications. Published papers were acquired from online sources using the keywords "distraction osteogenesis", "Le Fort III", "monobloc", and "syndromic craniosynostosis" in combination with other keywords, such as "craniofacial deformity" and "midface". The search was confined to publications in English, and we followed the guidelines of the PRISMA statement. We found that deformity of the skull resulted mainly from Crouzon syndrome. Recently craniofacial distraction has been achieved by monobloc distraction osteogenesis using an external distraction device during childhood, while Le Fort III distraction osteogenesis was used in maturity. Craniofacial distraction was indicated primarily to correct increased intracranial pressure, exorbitism, and obstructive sleep apnoea in childhood, while midface hypoplasia was the main indication in maturity. Overall the most commonly reported complications were minor inflammatory reactions around the pins, and anticlockwise rotation when using external distraction systems. The mean amount of bony advancement was 12.3mm for an external device, 18.6mm for an internal device and 18.7mm when both external and internal devices were used. Treatment by craniofacial distraction must be validated by long-term studies as there adequate data are lacking, particularly about structural relapse and the assessment of function.

Matched MeSH terms: Reoperation
Case report: the unexpected culprit for multiple shunt revisions

Fitzrol D, Idris B

Childs Nerv Syst, 2019 06;35(6):1063-1065.
PMID: 30806764 DOI: 10.1007/s00381-019-04089-0

Silicone allergy in patients with ventricular shunts is uncommon hence easily missed. However, there are clinical features that could assist in identifying and diagnosing this condition. We discuss a case where a patient with a ventriculoperitoneal (VP) shunt presented to us with features suggestive of silicone allergy.

Matched MeSH terms: Reoperation
Fulltext Malaysian Females With Congenital Adrenal Hyperplasia: Surgical Outcomes and Attitudes

Zainuddin AA, Grover SR, Soon CH, Nur Azurah AG, Mahdy ZA, Wu LL, et al.

Front Pediatr, 2019;7:144.
PMID: 31058121 DOI: 10.3389/fped.2019.00144

Background: Girls born with congenital adrenal hyperplasia have virilized external genitalia. There is considerable debate regarding both the outcomes of feminizing genitoplasty and timing of the surgery in this population. Objective: To investigate outcomes of females 46,XX individuals with CAH in Malaysia, the surgical outcomes of feminizing genitoplasty (FG) and their attitudes toward surgery. Study Design: This is a cross-sectional study involving the two main tertiary centers in Malaysia. All 46,XX patients with CAH and raised female, who had undergone FG were identified and invited to participate. Data on socio-demographic, medical profiles, and attitudes toward surgery were collected. A standardized evaluation of the external genitalia was undertaken including the anatomic and cosmetic evaluation by independent gynecologists. Results: Of 61 individuals identified, 59 participated-consisting of children (n = 12), adolescents (n = 29) and adults (n = 18). All but one had classical CAH (98.3%) and had undergone FG (n = 55, 93.2%) with surgery mostly undertaken by pediatric surgeons trained in DSD work (n = 44, 74.6%). Complications overall were low (20.3%), with repeat surgery rate of 9.1%. External genital examination was performed in 38 participants. Overall 36.8% had absent clitoral glands and 39.5% had a persistent urogenital sinus and in 10.5%, no vaginal orifices were seen. Poor cosmetic outcomes were present in 42.1% with 55.3% recommended for further assessment under general anesthetic. Almost half participants did not venture an opinion on FG, those who did varied from having a positive attitude toward it (18 participants) to 3 opining that it should not be done, or avoided or delayed. From the participants, 35.5% preferred FG to be done early in life compared to 44.0% of the parents. Conclusions: The reoperation rates of the feminizing genitoplasty surgeries were low however due to the anatomic and cosmetic outcomes, reassessment of the external genitalia of these CAH patients may be required once they consider becoming sexually active as they may require further treatment. Many factors such as cultural sensitivities and access to medical treatment and late diagnoses have an impact on attitudes toward FG.

Matched MeSH terms: Reoperation

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