DOCSLIB.ORG

Report Scientifico 2017

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Report Scientifico 2017 IRCCS – Istituto Giannina Gaslini Report Scientifico 2017 Sommario LA RICERCA AL GASLINI ...................................................................................................................... - 1 - PRESENTAZIONE DEL DIRETTORE SCIENTIFICO .......................................................................................... - 2 - TOP ITALIAN SCIENTISTS (TIS) DELLA VIA ACADEMY .................................................................................. - 4 - PUBBLICAZIONI - ANNO DI RIFERIMENTO 2017 ............................................................................................ - 6 - CONTRIBUTO DELLE VARIE UNITÀ OPERATIVE ALLA PRODUZIONE SCIENTIFICA 2017 ..................................... - 9 - LINEE DI RICERCA E PUBBLICAZIONI 2017 .......................................................................................... - 13 - LINEA DI RICERCA 1: STRATEGIE DIAGNOSTICHE INNOVATIVE ................................................................... - 14 - LINEA DI RICERCA 2: PEDIATRIA CLINICA , MEDICINA PERINATALE E CHIRURGIE PEDIATRICHE ..................... - 27 - LINEA DI RICERCA 3: IMMUNOLOGIA CLINICA E SPERIMENTALE E REUMATOLOGIA ....................................... - 59 - LINEA DI RICERCA 4: ONCO -EMATOLOGIA E TERAPIE CELLULARI ................................................................ - 74 - LINEA DI RICERCA 5: PATOLOGIE MUSCOLARI E NEUROLOGICHE ................................................................ - 86 - SEMINARI 2017 .............................................................................................................................. - 104 - POTENZIALITÀ PROGETTI ANNO 2017 ............................................................................................. - 106 - PRESIDENTE E CONSIGLIO DI AMMINISTRAZIONE ........................................................................... - 111 - DIREZIONE SCIENTIFICA .................................................................................................................. - 112 - CURRICULUM VITAE ET STUDIORUM ...................................................................................................... - 113 - STAFF .................................................................................................................................................. - 115 - U.O.S.I.D. EPIDEMIOLOGIA E BIOSTATISTICA ......................................................................................... - 120 - U.O.S.I.D. CENTRO TRIAL .................................................................................................................... - 125 - TRIALS CLINICI ANNO 2017 ............................................................................................................. - 127 - DIREZIONE GENERALE .................................................................................................................... - 150 - DIREZIONE AMMINISTRATIVA ........................................................................................................ - 153 - DIREZIONE SANITARIA .................................................................................................................... - 154 - UOC E UOSD DELLA AA LABORATORI RICERCA ................................................................................ - 155 - U.O.C. GENETICA MEDICA ................................................................................................................... - 156 - U.O.C. LABORATORIO DI IMMUNOLOGIA CLINICA E SPERIMENTALE ......................................................... - 166 - U.O.C. LABORATORIO DI BIOLOGIA MOLECOLARE .................................................................................. - 170 - U.O.C. LABORATORIO CELLULE STAMINALI POST -NATALI E TERAPIE CELLULARI ..................................... - 174 - U.O.S.D. LABORATORIO DI NEUROGENETICA E NEUROSCIENZE ............................................................. - 180 - U.O.S.D. CENTRO MALATTIE AUTOINFIAMMATORIE E IMMUNODEFICENZE ............................................... - 184 - U.O.S.D. LABORATORIO TERAPIE SPERIMENTALI IN ONCOLOGIA ............................................................ - 185 - U.O.S.D. LABORATORIO DI GENETICA MOLECOLARE E BIOBANCHE ........................................................ - 188 - U.O.S.D. LABORATORIO DI GENETICA GENOMICA DELLE MALATTIE RARE ............................................... - 191 - CORE FACILITIES .................................................................................................................................. - 193 - DIPARTIMENTO INTEGRATO DI SCIENZE PEDIATRICHE ED EMATO-ONCOLOGICHE ........................... - 198 - U.O.C. CLINICA PEDIATRICA E REUMATOLOGIA ..................................................................................... - 199 - U.O.C. CLINICA PEDIATRICA E ENDOCRINOLOGIA .................................................................................. - 206 - U.O.C. GASTROENTEROLOGIA PEDIATRICA ED ENDOSCOPIA DIGESTIVA ................................................. - 211 - U.O.C. PEDIATRIA D ’U RGENZA E PRONTO SOCCORSO ........................................................................... - 214 - U.O.C. EMATOLOGIA ............................................................................................................................ - 218 - U.O.C. ONCOLOGIA ............................................................................................................................. - 222 - U.O.C. MALATTIE INFETTIVE ................................................................................................................. - 226 - U.O.C. NEFROLOGIA E TRAPIANTO RENE .............................................................................................. - 229 - U.O.S.D. PRONTO SOCCORSO E OBI ................................................................................................... - 232 - U.O.S.D. AREA CRITICA MEDICA .......................................................................................................... - 237 - U.O.S.D. CENTRO DI DIALISI ................................................................................................................ - 241 - U.O.S.D. CENTRO NUTRIZIONALE ......................................................................................................... - 245 - U.O.S.D. CENTRO MALATTIE RARE ...................................................................................................... - 246 - U.O.S.D. CENTRO DI TRAPIANTO DI MIDOLLO OSSEO ............................................................................ - 249 - U.O.S.D. CENTRO DI EMOSTASI E TROMBOSI ........................................................................................ - 252 - DIPARTIMENTO INTEGRATO CHIRURGIA E ALTA INTENSITÀ CUTE (AIC) ........................................... - 255 - U.O.C. CARDIOLOGIA ........................................................................................................................... - 256 - U.O.C. DERMATOLOGIA E CENTRO ANGIOMI ......................................................................................... - 260 - U.O.C. CHIRURGIA PEDIATRICA ............................................................................................................ - 262 - U.O.C. RADIOLOGIA ............................................................................................................................. - 267 - U.O.S.D. TEAM DELLE VIE AEREE ........................................................................................................ - 271 - U.O.S.D. CENTRO DI ANESTESIOLOGIA, TERAPIA DEL DOLORE ACUTO E PROCEDURALE ......................... - 273 - U.O.S.D. CENTRO DI TERAPIA INTENSIVA NEONATALE E PEDIATRICA ..................................................... - 276 - DIPARTIMENTO INTEGRATO NEUROSCIENZE MEDICHE E CHIRURGICHE E RIABILITAZIONE-CONTINUITÀ CURE (RCC) .................................................................................................................................... - 279 - U.O.C. NEUROCHIRURGIA .................................................................................................................... - 279 - U.O.C. ORTOPEDIA .............................................................................................................................. - 286 - U.O.C. OTORINOLARINGOIATRIA ........................................................................................................... - 287 - U.O.C. OCULISTICA ............................................................................................................................. - 289 - U.O.C. MEDICINA FISICA E RIABILITAZIONE ........................................................................................... - 291 - U.O.C. NEUROPSICHIATRIA INFANTILE .................................................................................................. - 293 - U.O.C. NEURORADIOLOGIA .................................................................................................................. - 298 - U.O.C. ODONTOSTOMATOLOGIA E ORTODONZIA PEDIATRICA ................................................................. - 305 - U.O.S.D. HOSPICE (PERCORSO INIZIATO COME ASSISTENZA DOMICILIARE )............................................. - 306 - U.O.S.D. MICROCHIRURGIA RICOSTRUTTIVA E CHIRURGIA DELLA MANO .................................................. - 308 - AREA AGGREGAZIONE SERVIZI E LABORATORI DIAGNOSTICI ..........................................................
Load more

Recommended publications
  • The Novel Use of Nuss Bars for Reconstruction of a Massive Flail Chest
    BRIEF TECHNIQUE REPORTS The novel use of Nuss bars for reconstruction of a massive flail chest Paul E. Pacheco, MD,a Alex R. Orem, BA,a Ravindra K. Vegunta, MD, FACS,a,b Richard C. Anderson, MD, FACS,a,b and Richard H. Pearl, MD, FACS,a,b Peoria, Ill We present the case of a patient who sustained a massive flail chest from a snowmobile accident. All ribs of the right side of the chest were fractured. Nonoperative management was unsuccessful. Previously reported methods of rib stabiliza- tion were precluded given the lack of stable chest wall ele- ments to fixate or anchor the flail segments. We present a novel surgical treatment in which Nuss bars can be used for stabilization of the most severe flail chest injuries, when reconstruction of the chest is necessary and fixation of fractured segments is infeasible owing to adjacent chest wall instability. CLINICAL SUMMARY The patient was a 40-year-old male snowmobile driver who was hit by a train. Evaluation revealed severe multiple right-sided rib fractures, right scapular and clavicular frac- tures, and a left femur fracture. A thoracostomy tube was placed and intubation with mechanical ventilation instituted. With stability, he was taken for intramedullary nailing of the femur. Despite conventional efforts, he was unable to be weaned from the ventilator inasmuch as he consistently FIGURE 1. Posterior view of 3-dimensional computed tomographic scan had hypercapnic respiratory failure with weaning trials. Ad- showing reconstruction of massive flail chest used during preoperative ditionally, a worsening pneumonia developed on the side of planning.
    [Show full text]
  • The Minimally Invasive Nuss Technique for Recurrent Or Failed Pectus Excavatum Repair in 50 Patients
    Journal of Pediatric Surgery (2005) 40, 181–187 www.elsevier.com/locate/jpedsurg The minimally invasive Nuss technique for recurrent or failed pectus excavatum repair in 50 patients Daniel P. Croitorua,*, Robert E. Kelly Jrb,c, Michael J. Goretskyb,c, Tina Gustinb, Rebecca Keeverb, Donald Nussb,c aDivision of Pediatric Surgery, Children’s Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, Dartmouth Medical School, Lebanon, NH 03766 bDivision of Pediatric Surgery, Children’s Hospital of the King’s Daughter, Norfolk, VA 23507 cDepartment of Surgery, Eastern Virginia Medical School, Norfolk, VA Index words: Abstract Pectus excavatum; Purpose: The aim of this study was to demonstrate the efficacy of the minimally invasive technique for Minimally invasive; recurrent pectus excavatum. Recurrence; Methods: Fifty patients with recurrent pectus excavatum underwent a secondary repair using the Reoperative surgery minimally invasive technique. Data were reviewed for preoperative symptomatology, surgical data, and postoperative results. Results: Prior repairs included 27 open Ravitch procedures, 23 minimally invasive (Nuss) procedures, and 2 Leonard procedures. The prior Leonard patients were also prior Ravitches and are therefore counted only once in the analyses. The median age was 16.0 years (range, 3-25 years). The median computed tomography index was 5.3 (range, 2.9-20). Presenting symptoms included shortness of breath (80%), chest pain (70%), asthma or asthma symptoms (26%), and frequent upper respiratory tract infections (14%). Both computed tomography scan and physical exam confirmed cardiac compression and cardiac displacement. Cardiology evaluations confirmed cardiac compression (62%), cardiac displacement (72%), mitral valve prolapse (22%), murmurs (24%), and other cardiac abnormalities (30%). Preoperative pulmonary function tests demonstrated values below 80% normal in more than 50% of patients.
    [Show full text]
  • Diminished Pulmonary Function in Pectus Excavatum: from Denying the Problem to Finding the Mechanism
    Featured Article Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism Robert E. Kelly Jr, Robert J. Obermeyer, Donald Nuss Departments of Surgery and Pediatrics, Children’s Hospital of The King’s Daughters, Eastern Virginia Medical School, Norfolk, Virginia, USA Correspondence to: Robert E. Kelly, Jr., MD, Surgeon-in-Chief. Children’s Hospital of The King’s Daughters, 601 Children’s Lane, Ste. 5B, Norfolk, Virginia, USA. Email: [email protected]; [email protected]. Background: Recently, technical improvement in the ability to measure lung function and the severity of chest deformity have enabled progress in understanding the mechanism of limitations of lung function in pectus excavatum. Methods: After establishing that most patients with pectus excavatum do have symptoms of exercise intolerance, easy fatigability, and shortness of breath with exertion, lung function has been evaluated by a variety of methods in different centers. Spirometry, plethysmography, exercise testing, oculo electronic plethysmography, and imaging methods have been used to assess lung function in pectus excavatum and its response to surgery. Results: Not all patients with pectus excavatum have subnormal static pulmonary function testing; some have above-average values. However, in more than 1500 adult and pediatric surgical patients with anatomically severe pectus excavatum at a single center, the bell curve of FVC, FEV1, and FEF 25- 75 is shifted to significantly lower values in pectus excavatum. The curve is shifted to higher values after operation by approximately one standard deviation. Previous work has demonstrated that patients with more anatomically severe pectus excavatum are more likely to have diminished PFT’s.
    [Show full text]
  • Pectus Correction Surgery Information for Patients Introduction This Booklet Is Designed to Provide Information About Your Forthcoming Pectus Correction Surgery
    Oxford University Hospitals NHS Trust Oxford Heart & Lung Centre Pectus Correction surgery Information for patients Introduction This booklet is designed to provide information about your forthcoming pectus correction surgery. We appreciate that coming into hospital for pectus correction surgery may be a major event for you. The Information in this booklet will hopefully allay some of the fears and apprehensions you may have and increase your understanding of what to expect during your stay in the Oxford Heart Centre, at the John Radcliffe Hospital. Our aim is to provide a high quality service to our patients. We would therefore welcome any suggestions you may have. A patient satisfaction survey can be found in the information folder by every bed on the Cardiothoracic Unit, alternatively please speak to a member of the senior nursing team. page 2 Modified Ravitch procedure In the modified Ravitch procedure, the rib cartilages are cut away on each side and the sternum is flattened so that it will lie flat. One or more bars (or struts) may then be inserted under the sternum to ensure it keeps its shape. This is the procedure we use for complex pectus anomalies, predominantly rib deformities and for pectus carinatum. The operation involves making a horizontal cut from one side of the chest to the other. Drains are inserted on each side of the chest to remove any fluid from the surgical site and the wound is closed using dissolvable stitches. If a strut is inserted it is intended to remain in place permanently but may be removed if it causes pain or other problems.
    [Show full text]
  • Pectus Excavatum (Nuss) V2.0
    Pectus Excavatum (Nuss) v2.0 Summary of Version Changes Explanation of Evidence Ratings Inclusion Criteria · Patient age 13 years to adult with Pectus Approval and Citation Excavatum requiring repair Exclusion Criteria · None Intraoperative Management Anesthesia and pain management Safety Precautions Standard anesthesia procedures · · Sternal saw available and open on the field to assure proper · Ketorolac IV at end of case function · Standard PACU orders Intraoperative Pain Management Infection prevention · Cryoablation to 2 nerves above and below bar entry level on · Double glove each side · Ioban drape ® · Bupivacaine 0.5% (2mL per nerve) 2 nerves above and below · Irrigate wounds with Betadine solution bar entry level on each side · Perioperative antibiotics Other · Cefazolin · Dictation must clearly state number of bars and which side · Clindamycin if allergic stabilizer is placed · Vancomycin if MRSA · Write General Surgery Pectus Repair Plan admit orders Thrombosis prevention prior to patient transfer out of the O.R. · Sequential compression device (SCD) if age 16 years or older, prior to induction Postoperative Management Admit to surgical floor from PACU Medications · Chest X-ray in PACU to assess for pneumothorax · Continue perioperative antibiotics x 2 doses Activity Pain · Showering ok on POD1 · POD1 or 2: start oral pain medicines. · POD1 out of bed to chair and ambulate goal is 3-4 times per day in · Oxycodone short acting (no long-acting), as needed halls, minimum of 2 times per day (bathroom does not count) · Acetaminophen/ibuprofen
    [Show full text]
  • Cosmetic and Reconstructive Procedures Corporate Medical Policy
    Cosmetic and Reconstructive Procedures Corporate Medical Policy File Name: Cosmetic and Reconstructive Procedures File Code: UM.SURG.02 Origination: 06/2016 Last Review: 01/2020 Next Review: 01/2021 Effective Date: 04/01/2020 Description/Summary The term, “cosmetic and reconstructive procedures” includes procedures ranging from purely cosmetic to purely reconstructive. Benefit application has the potential to be confusing to members because there is an area of overlap where cosmetic procedures may have a reconstructive component and reconstructive procedures may have a cosmetic component. These procedures are categorized and benefits are authorized based upon the fundamental purpose of the procedure. The American Medical Association and the American Society of Plastic Surgeons have agreed upon the following definitions: • Cosmetic procedures are those that are performed to reshape normal structures of the body in order to improve the patient’s appearance and self- esteem. • Reconstructive procedures are those procedures performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function but may also be done to approximate a normal appearance. In order to be considered medically necessary, the goal of reconstructive surgery must be to correct an abnormality in order to restore physiological function to the extent possible. As such, for reconstructive surgery to be considered medically necessary there must be a reasonable
    [Show full text]
  • Anesthesic and Pain Management Considerations for the Nuss Procedure
    Anesthesic and Pain Management Considerations for the Nuss Procedure Lynne G. Maxwell, MD, FAAP Pectus Excavatum Pectus excavatum (PE) is a relatively common deformity of the chest wall, occurring in approximately 1 in 300 births. Although it is often referred to as a congential abnormality, many children do not have obvious manifestations until age 1 or older. It occurs more often in males in a ratio of 4:1. In some cases there is a genetic component with some evidence of autosomal dominance with male to male transmission. Although the development of PE may be related to upper airway obstruction and/or sleep apnea (OSAS) and disorders of connective tissue such as Marfan syndrome, most patients with PE have no associated medical conditions. Pectus excavatum has been recognized for centuries. Bauhinus described a patient in 1594 with pulmonary insufficiency (dyspnea and paroxysmal cough) associated with a severe pectus excavatum. Multiple case reports were decribed in the 19th century, including one by Ebstein in 1882 describing 4 patients. Treatment consisted of “fresh air, breathing exercises, aerobic activities, and lateral pressure.” Thoracic surgical approaches were developed in the early part of the 20th century, but it wasn’t until mid- century that Ravitch reported the technique which became the standard prior to the advent of the Nuss procedure. The Ravitch operation involved a mobilization of the sternum by resection of the costal cartilages bilaterally and sternal osteotmy. A modification involving the placement of a bar through the distal end of the sternum was reported in 1956 by Wallgren and Sulamaa which prevented the recurrence of the deformity.
    [Show full text]
  • Nuss Procedure for Surgical Stabilization of Flail Chest with Horizontal Sternal Body Fracture and Multiple Bilateral Rib Fractures
    Case Report Nuss procedure for surgical stabilization of flail chest with horizontal sternal body fracture and multiple bilateral rib fractures Sung Kwang Lee, Do Kyun Kang Department of Thoracic and Cardiovascular Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea Correspondence to: Do Kyun Kang, MD. Department of Thoracic and Cardiovascular Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, 875 (Jwadong) Haeundae-ro, Haeundaegu, Busan 612-030, South Korea. Email: [email protected]. Abstract: Flail chest is a life-threatening situation that paradoxical movement of the thoracic cage was caused by multiply fractured ribs in two different planes, or a sternal fracture, or a combination of the two. The methods to achieve stability of the chest wall are controversy between surgical fixation and mechanical ventilation. We report a case of a 33-year-old man who fell from a high place with fail chest due to multiple rib fractures bilaterally and horizontal sternal fracture. The conventional surgical stabilization using metal plates by access to the front of the sternum could not provide stability of the flail segment because the fracture surface was obliquely upward and there were multiple bilateral rib fractures adjacent the sternum. The Nuss procedure was performed for supporting the flail segment from the back. Flail chest was resolved immediately after the surgery. The patient was weaned from the mechanical ventilation on third postoperative day successfully and was ultimately discharged without any complications. Keywords: Nuss procedure; sternum fracture; rib fractures; flail chest Submitted Feb 13, 2016. Accepted for publication Mar 10, 2016. doi: 10.21037/jtd.2016.04.05 View this article at: http://dx.doi.org/10.21037/jtd.2016.04.05 Introduction the sternal body and bilaterally fractured ribs adjacent to the sternum (Figure 1).
    [Show full text]
  • Short Nuss Bar Procedure
    Art of Operative Techniques Short Nuss bar procedure Hans Kristian Pilegaard1,2 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Correspondence to: Hans Kristian Pilegaard. Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Palle Juul- Jensens Boulevard 99, DK-8200 Aarhus N, Denmark. Email: [email protected]. The Nuss procedure is now the preferred operation for surgical correction of pectus excavatum (PE). It is a minimally invasive technique, whereby one to three curved metal bars are inserted behind the sternum in order to push it into a normal position. The bars are left in situ for three years and then removed. This procedure significantly improves quality of life and, in most cases, also improves cardiac performance. Previously, the modified Ravitch procedure was used with resection of cartilage and the use of posterior support. This article details the new modified Nuss procedure, which requires the use of shorter bars than specified by the original technique. This technique facilitates the operation as the bar may be guided manually through the chest wall and no additional stabilizing sutures are necessary. Keywords: Pectus excavatum repair (PE repair); Nuss; short bar; minimally invasive surgery Submitted Mar 14, 2016. Accepted for publication Jul 12, 2016. doi: 10.21037/acs.2016.09.06 View this article at: http://dx.doi.org/10.21037/acs.2016.09.06 Introduction The optimal age for the operation is still under discussion. According to the findings of Nuss, there is an increased Pectus excavatum (PE) is the most common anomaly of risk of recurrence if the operation occurs before puberty.
    [Show full text]
  • Enhanced Recovery After Surgery: Pectus Excavatum
    Enhanced Recovery After Surgery: Pectus Excavatum LEGAL DISCLAIMER: The information provided by Dell Children’s Medical Center of Texas (DCMCT), including but not limited to Clinical Pathways and Guidelines, protocols and outcome data, (collectively the "Information") is presented for the purpose of educating patients and providers on various medical treatment and management. The Information should not be relied upon as complete or accurate; nor should it be relied on to suggest a course of treatment for a particular patient. The Clinical Pathways and Guidelines are intended to assist physicians and other health care providers in clinical decision-making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions. These guidelines should not be considered inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment regarding care of a particular patient must be made by the physician in light of the individual circumstances presented by the patient. DCMCT shall not be liable for direct, indirect, special, incidental or consequential damages related to the user's decision to use this information contained herein. Definition Enhanced Recovery After Surgery (ERAS) Multimodal enhanced recovery after surgery (ERAS) protocols introduce an integrated, multidisciplinary approach that requires participation and commitment from the patient, surgeons, anesthesiologists, pain specialists, nursing staff, physical and occupational therapists, social services, and hospital administration [8,9,10,11]. Initially, ERAS protocols converted many operations performed as inpatient to outpatient "day surgery" procedures. As experience developed with these protocols, principles of enhanced recovery were applied to increasingly complex procedures to reduce hospital length of stay and expedite return to baseline health and functional status [10,11].
    [Show full text]
  • In Pectus Excavatum Patients Following Nuss Procedure
    3042 Original Article Clinical application of enhanced recovery after surgery (ERAS) in pectus excavatum patients following Nuss procedure Pingwen Yu, Gebang Wang, Chenlei Zhang, Hongxi Liu, Yawei Wang, Zhanwu Yu, Hongxu Liu Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110042, China Contributions: (I) Conception and design: P Yu, H Liu; (II) Administrative support: P Yu, Z Yu, H Liu; (III) Provision of study materials or patients: P Yu, G Wang, C Zhang, H Liu; (IV) Collection and assembly of data: P Yu, Y Wang; (V) Data analysis and interpretation: P Yu; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Hongxu Liu, MD, PhD. Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110042, China. Email: [email protected]. Background: Evaluate the effect of enhanced recovery after surgery (ERAS) protocol on postoperative recovery quality of pectus excavatum patients with Nuss procedure. Methods: A retrospective study was performed on patients undergoing Nuss procedure from the Department of Thoracic Surgery of The Cancer Hospital of China Medical University between September 2016 and September 2019. Patients were divided into 2 groups by perioperative management: the traditional procedure group (T group) and the ERAS strategy group (E group). The outcome measures were postoperative drainage time, postoperative hospital time, and postoperative complications measured by the Clavien-Dindo method. Results: Of the 168 patients from this time period, 148 met the inclusion criteria (75 in Group T and 73 in Group E). All operations involved in this study were completed successfully.
    [Show full text]
  • Cosmetic and Reconstructive Surgery
    MEDICAL POLICY Cosmetic and Reconstructive Procedures (All Lines of Business Except Medicare) Effective Date: 9/1/2020 Section: SUR Policy No: 193 Medical Policy Committee Approved Date: 7/90; 5/95; 7/97; 6/98; 9/98; 5/99; 5/00; 5/01; 7/02; 7/03; 2/04; 4/04; 1/06; 1/07; 7/08; 5/10; 5/11; 4/13; 4/14; 8/15; 4/16; 6/17; 7/18; 5/19; 11/19; 8/2020 9/1/2020 Medical Officer Date See Policy CPT/HCPCS CODE section below for any prior authorization requirements SCOPE: Providence Health Plan, Providence Health Assurance, Providence Plan Partners, and Ayin Health Solutions as applicable (referred to individually as “Company” and collectively as “Companies”). APPLIES TO: All lines of business except Medicare BENEFIT APPLICATION Medicaid Members Oregon: Services requested for Oregon Health Plan (OHP) members follow the OHP Prioritized List and Oregon Administrative Rules (OARs) as the primary resource for coverage determinations. Medical policy criteria below may be applied when there are no criteria available in the OARs and the OHP Prioritized List. POLICY CRITERIA Notes: Many member contracts have specific language regarding covered reconstructive services and excluded cosmetic procedures. Contract language takes precedence over medical policy. This policy does not address services and procedures related to the treatment of gender dysphoria, which is addressed in the PHP Gender Affirming Interventions medical policy. This policy does not address breast reconstruction following a mastectomy, which is addressed in the PHP Breast Reconstruction medical policy. Other, more specific, PHP medical policies may apply to indications and/or procedures mentioned in this policy.
    [Show full text]