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The Ligation of Intersphincteric Fistula Tract Technique: A Preliminary Experience
Pasquale Cianci,Nicola Tartaglia,Alberto Fersini,Libero Luca Giambavicchio,Vincenzo Neri,Antonio Ambrosi 대한대장항문학회 2019 Annals of Coloproctolgy Vol.35 No.5
Purpose: Surgery is the only treatment for anal fistula. Many surgical techniques have been described. The aim of this study was to communicate the authors’ preliminary experience in the use of a recently proposed, simplified technique. Methods: This was a prospective study of 28 patients admitted from January 13, 2016 through July 20, 2017. Patients were managed with the ligation of intersphincteric fistula tract (LIFT) technique and results were observed and documented, including recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 28 patients were studied. The mean operation time was 31 minutes (range, 23–44 minutes), and there were no intra- and postoperative complications. The overall complete healing rate was 85.7%, and the recurrence rate was 14.2%. Follow-up was conducted at 1, 3, and 6 months. Conclusion: Many surgical techniques have been described for the treatment of anal fistula. The correct choice of surgical technique out of available procedures is the most important factor for proper treatment and reducing the risk of recurrence or incontinence. In the authors’ experience, the LIFT technique is simple and easy to learn, and is a good choice for the treatment of simple anal fistula; however, a tailored surgery remains the gold standard for this condition.
Endoscopic Adenoidectomy in Children With Otitis Media With Effusion and Mild Hearing Loss
Pasquale Capaccio,Sara Torretta,Givlia Anna Marciante,Paola Marchisio,Stella Forti,Lorenzo Pignataro 대한이비인후과학회 2016 Clinical and Experimental Otorhinolaryngology Vol.9 No.1
Objectives. Surgical management of children with chronic otitis media with effusion (OME) includes tympanostomy tube insertion or adenoidectomy, alone or with myringotomy and tube insertion. The aim of this study was to compare the effectiveness of transoral microdebrider endoscopic-assisted adenoidectomy (TOMEA) and traditional adenoidectomy in the management of children with mild hearing loss due to OME and chronic adenoiditis. Methods. This prospective, double-blind and controlled study involved 120 consecutive patients aged 4–12 years, who were randomised 1:1 to undergo TOMEA or traditional adenoidectomy under general anesthesia. All the patients underwent a complete otolaryngological examination, including nasopharyngeal fibre endoscopy (NFE), pneumatic otoscopy, otomicroscopy, tympanometry and supraliminar tonal audiometry, upon enrolment, and three and nine months postoperatively. Results. There were no statistically significant differences in age or gender distribution between the TOMEA group (mean age, 4.9±1.1 years; 53.3% males) and the traditional adenoidectomy group (mean age, 5.3±0.9 years; 56.7% males). Both procedures led to a significant improvement in choanal patency (P<0.01) and all of the otological and audiological parameters (P<0.01) 3 and 9 months postoperatively, although postoperative NFE showed that the mean percentage of residual choanal obstruction was significantly less in the TOMEA group (P=0.02). There was no significant between-group difference in the percentage of children with tympanic membrane changes, but the postoperative prevalence of children with a type B tympanogram was significantly lower in the TOMEA group after 3 (15.0% vs. 31.7%, P=0.05) and 9 months (18.3% vs. 38.3%, P=0.02), as was the percentage of children with mild conductive hearing loss (3.3% vs. 23.3%, P<0.01; and 8.3% vs. 28.3%, P<0.01). Conclusion. Although both TOMEA and traditional adenoidectomy are effective in treating children with mild hearing loss due to adenoidal hypertrophy and OME, the former achieves the greater reduction in residual adenoidal hypertrophy and better audiological outcomes.
Effective Admission Policy for Multimedia Traffic Connections over Satellite DVB-RCS Network
Pasquale Pace,Gianluca Aloi 한국전자통신연구원 2006 ETRI Journal Vol.28 No.5
Thanks to the great possibilities of providing different types of telecommunication traffic to a large geographical area, satellite networks are expected to be an essential component of the next-generation internet. As a result, issues concerning the designing and testing of efficient connection-admission-control (CAC) strategies in order to increase the quality of service (QoS) for multimedia traffic sources, are attractive and at the cutting edge of research. This paper investigates the potential strengths of a generic digital-video-broadcasting return-channel-via-satellite (DVBRCS) system architecture, proposing a new CAC algorithm with the aim of efficiently managing real-time multimedia video sources, both with constant and high variable data rate transmission; moreover, the proposed admission strategy is compared with a well-known iterative CAC mainly designed for the managing of realtime bursty traffic sources in order to demonstrate that the new algorithm is also well suited for those traffic sources. Performance analysis shows that, both algorithms guarantee the agreed QoS to real-time bursty connections that are more sensitive to delay jitter; however, our proposed algorithm can also manage interactive real-time multimedia traffic sources in high load and mixed traffic conditions.