One patient I took care of about seven years ago complained of the sudden onset of severe right lower abdominal pain and nothing was found on ultrasound so I performed a laparoscopy. Preoperatively there was no sign of metastasis; the pathology indicated complete removal of the tumour, a renal cell carcinoma. A HOLC with a calculus was revealed and retrieved by stone forceps through the urethra. USA.gov. Do surgical clips interfere with radiofrequency thermal ablation? We present a case in which migration of a metal clip into the urinary bladder occurred after retropubic radical prostatectomy. We report here a case in which common bile duct stones were formed around surgical clips, and other clips were found to have penetrated into the common hepatic duct, which we believe were in the process of migration after laparoscopic cholecystectomy. Surg Lap Endosc Percut Tech. (B) Cystoscopic evidence of clip-induced erosion. Mucosal eversion is not necessary in the parachute repair. Titanium clip migration after cholecystectomy: original technique for laparoscopic transcystic extraction when endoscopic retrograde cholangiopancreatography fails. The proper formation of a watertight anastomosis to decrease urinary leakage may help to reduce the occurrence of BNC. laparoscopic radical prostatectomies (RARPs). The risk factors for anastomotic stricture and the treatment outcome in these patients were analyzed. Apart from surgical technique, other variables, including patient age, previous transurethral resection of the prostate, Gleason score, T stage, urine infection rate, urinary leakage, blood loss, drain tube removal, anastomotic suture material, catheter type and catheter removal times were statistically comparable in both groups. Please enable it to take advantage of the complete set of features! The aim of this study was to describe the surgical clip-related complications that can occur after open retropubic prostatectomy (RRP), pure laparoscopic prostatectomy (LRP), and robot-assisted laparoscopic radical prostatectomy (RALP). Laparoscopic cholecystectomy and laparoscopic common bile duct exploration (LC+LCBDE) is currently a widely use technology for patients with gallstone and choledocholithiasis. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government, Intravesical Migration and Spontaneous Expulsion of a Hem-o-lok Polymer Ligating Clip After Laparoscopic Radical Prostatectomy, Bladder neck contracture after radical retropubic prostatectomy: Incidence and risk factors from a large single-surgeon experience, An Unusual Complication of a Hem-o-Lok Clip (R) Following Laparoscopic Radical Prostatectomy, Migration of a metal clip into the urinary bladder, An analysis of the causes of bladder neck contracture after open and robot-assisted laparoscopic radical prostatectomy, Anastomotic Strictures Following Radical Prostatectomy: Risk Factors and Management, It's Like a Pain in the … Perineum: a Surgical Clip Protruding into the Urethra Through the Urethrovesical Anastomosis After Radical Prostatectomy, Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: Experience of over 1100 cases, Prevalence and Risk Factors of Bladder Neck Contracture After Radical Prostatectomy, Erosion of Hem-o-Lok Clips at the Bladder Neck After Robot-Assisted Radical Prostatectomy. This case shows that the metallic surgical clips can penetrate into the intact bile duct wall through serial maceration, and we believe that careful application of clips may be the only way to prevent their migration after laparoscopic cholecystectomy. The patients were divided into the LigaSure (n = 125) and Hem-o-lok (n = 348) groups, based on the device used to ligate the vascular pedicle. Cystography and echography disclosed a possible aetiology that was later confirmed by cystoscopy: a metal clip protruding into the urethra through the urethrovesical anastomosis. As treatment for these stones, transurethral holmium laser lithotripsy was performed. Surgical clip migration into the common bile duct can cause recurrent cholangitis and serve as a nidus for stone formation. They also do not cause any interference with other medical investigation or radiographs that may need to be done in the future. 2005;15(5):279-282. Interested in research on Surgical Instruments? Blood clots 5. Surgical clip migration and subsequent stone formation in the common bile duct is a rare but well-established complication after laparoscopic cholecystectomy. Prolonged urinary leakage results from an anastomotic gap, which heals by second intention, thereby causing scarring and BNC. A flexible cystoscopy revealed a tight bladder neck. Patients with BNCs were compared with those without BNCs to identify the risk factors for BNC occurrence. Up to date, few cases of surgical clip migration have been reported in the literature. In the multivariate analysis, the length of time before drain removal was the only predictor of BNC (odds ratio, 1.12; p=0.001). Pantoja Pachajoa DA, Bruno MA, Doniquian AM, Alvarez FA. We describe the presentation, treatment, and possible methods to avoid this, To investigate the effect of previous bladder outlet surgery (BOS) on the peri-operative variables of patients having laparoscopic radical prostatectomy (LRP), as reported evidence as to whether BOS affects the outcome of RP is contradictory. Background . Potential Complications Associated with Tubal Ligation. We report here a case in which c … A HOLC with a calculus was revealed and retrieved by stone forceps through the urethra. To evaluate the difference in outcome of bladder neck contracture (BNC) and its causes between large groups of patients undergoing open radical prostatectomy (ORP) and robot-assisted laparoscopic prostatectomy (RALP). Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017. 1. Case Discussion. Aneurysm Clipping Surgery, Recovery, and Complications At UPMC, Microsurgical clipping for the treatment of aneurysms has demonstrated excellent durability and results and also has seen many modern advancements for treating brain aneurysms , such as the use of: bundle. Surgical clip application expands the indications for PAPD treatment in the newborn unit or outpatient setting with lesser incidences of complications. A member asked: what if they left parts of your gallbladder in. More than half of the patients did not respond to simple dilation alone. The LigaSure system was associated with fewer positive surgical margins and shorter operation time, indicating that it could be a useful alternative to Hem-o-lok clips for controlling the prostatic pedicle in robot-assisted radical prostatectomy, despite its high costs. Development of bioabsorbable zinc–magnesium alloy wire and validation of its application to urinary tract surgeries, Nonabsorbable polymer clip as a cause of chronic perineal pain after radical prostatectomy: Description of a case treated by transperineal approach, LigaSure versus the standard technique (Hem-o-lok clips) for robot-assisted radical prostatectomy: a propensity score-matched study, Bladder stone following intravesical migration of surgical clip five years after radical prostatectomy, Factores de riesgo de estenosis de cuello vesical asociada a prostatectomía radical por carcinoma prostático – experiencia en un único centro, Incidental detection of asymptomatic migration of Hem-o-lok clip into the bladder after laparoscopic radical prostatectomy, Endoscopic Management of Bladder Neck Contracture Following Radical Prostatectomy, Minimally Invasive Reconstructive Techniques, Migration of clips to the colon after laparoscopic partial nephrectomy, Intravesical migration of a Hem-O-Lok clip after robot-Assisted radical prostatectomy: A case report, Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy, Risk factors for vesicourethral anastomotic stricture after radical prostatectomy 1 1 The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, D.C., Clinical Investigation Program, sponsored this report S99-070 as required by NSHSBETHINST 6000.41A. eCollection 2020 Sep. JSLS. A 54 year-old man underwent RARP with nerve- sparing procedure with HOLCs in the left neurovascular bundle. Cystoscopic view of a bladder stone that formed around a metal clip. Author information: (1)Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Ave., OH 44106, USA. Sometimes there will be complications, too -- things that aren't a normal part of the healing process. The relationship between comorbidities identified preoperatively by patient interview and medical record review (coronary artery disease [CAD], diabetes mellitus [DM], hypertension [HTN], cerebral vascular accident, chronic obstructive pulmonary disease, and smoking history) and the incidence of BNC was determined. 2006 Apr;16(2):122; author reply 122-3. Surg Laparosc Endosc Percutan Tech. The important surgical factors in preventing BNCs are to avoid closing the BN too tightly and attaining good apposition of the BN with the urethral stump with a watertight closure. How many clips are used you ask…. Incision of the stricture with electrocautery resulted in urinary incontinence in all patients. A retrospective review of 467 consecutive patients (mean age 63.2 years) undergoing RP between 1991 and 1999 was performed. Endoscopic management of a major bile duct stricture from surgical clips following laparoscopic hemicolectomy. He presented severe perineal pain that prevented him from sitting normally after removal of the urethral catheter. This takes me back to surgical clips and staples. The median follow-up time for the entire cohort was 19.0 months (range, 1-42 months). Tumour characteristics were similar in the men with BNCs and those with no BNCs, and the rates of organ-confined disease were also similar (65% vs 70%, P = 0.27). Urinary extravasation, operative time and blood loss, radiotherapy, surgeon experience, prior outlet procedures, tobacco usage, age, comorbidities and body mass index (BMI) have all been suggested as risk factors for the development of BNC. J Minim Access Surg. Encontramos mayor riesgo en aquellos pacientes con débito por drenaje Jackson-Pratt (J-P) mayor de 500cc, drenaje J-P retirado después del tercer día, estancia superior a 8 días, hemoglobina postoperatoria baja, PSA preoperatorio bajo, densidad de PSA elevada o que fueron intervenidos por el cirujano 1 o 5. Gallbladder Removal Surgery: Side Effects and Complications A database of 641 patients who underwent RRP (n=439), LRP (n=49), and RALP (n=153) at our institution between January 2006 and April 2009 was reviewed to identify patients with complications related to the use of surgical clips. Questionnaire results were independently analyzed by a third party and correlated to demographic, operative, and tumor factors in an ongoing comprehensive PC database. Surgical clip migration and subsequent stone formation in the common bile duct is a rare but well-established complication after laparoscopic cholecystectomy. Conclusions: Surgical clips are prone to migration and may cause, or significantly con- tribute to, bladder neck contracture or the formation of bladder stones after radical prostatectomy. Several types of complications can be caused by the retention of these metals in the body, such as local infections, inflammation, migration, and artifacts in computed tomography [1][2], ... Several types of complications can be caused by the retention of these metals in the body, such as local infections, inflammation, migration, and artifacts in computed tomography [1][2][3][4][5][6][7][8]. Linear reduction of ring volume in urine was observed based on the concentration of magnesium within the ring. 2000 Dec;14(12):1188. doi: 10.1007/s004640040030. Excessive intraoperative blood loss, extravasation of urine at the anastomotic site and a prior transurethral prostatic operation significantly contributed to the development of stricture. COVID-19 is an emerging, rapidly evolving situation. One of the stones had formed around a metal clip that had presumably migrated into the urinary bladder. Clip migration has been reported previously, but to our knowledge we present the first case of clip migration to the colon after laparoscopic partial nephrectomy. 53 days postoperatively the patient had acute onset of rectal bleeding. A 75-year-old man, who had undergone retropubic radical prostatectomy three years before, presented with painful micturition and gross hematuria. Hem-o-lok clips have been widely used in laparoscopic or robot-assisted surgery. Following a C-section, Filshie Clips are applied to the fallopian tubes just prior to closure of the C-section incision. They are designed to stay inside the body forever without causing any complications. Early recognition and adequate treatment should be a standard of care for the most common postoperative complications: anastomotic leakage, pneumonia, atrial fibrillation, chylothorax, and recurrent laryngeal nerve palsy. The bladder to membranous urethral anastomosis was made using six 2/0 chromic catgut sutures over an 18 F Foley catheter. Clipboard, Search History, and several other advanced features are temporarily unavailable. Hong T, Xu XQ, He XD, Qu Q, Li BL, Zheng CJ. 28 years experience General Practice. Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs.The use of staples over sutures reduces the local inflammatory response, width of the wound, and the time it takes to close. Surgical clips are applied during cholecystectomy on the cystic duct and artery. Surgical clip application expands the indications for PAPD treatment in the newborn unit or outpatient setting with lesser incidences of complications. Rarely one or more clips can get displaced.  |  This chapter reviews some of the more common instruments used in laparoscopic reconstructive surgery and techniques for obtaining hemostasis in the laparoscopic setting. Hernias 3. Overall, BNCs occurred in 21 of 488 patients (4.3%): 17 patients (4.7%) who underwent ORP, 4 patients (4%) who underwent LRP, and no patients who underwent RARP. Ugeskr Laeger. Complications peculiar to Pneumo peritoneum. In this article, we describe the case of a 67-year-old gentleman who had undergone a laparoscopic radical prostatectomy and returned 8 months later for follow-up investigations due to intractable urinary symptoms. The patient experienced a clinically significant reduction of pain that remained stable at three months’ follow-up. Nearly all rings were covered with a thin layer of calculus. Epub 2000 Oct 5. doi: 10.1093/jscr/rjaa289. Bleeding after pancreatic surgery is rare but characterized by high mortality. Excessive bleeding 2. Extracted bladder tissues were subjected to histological analysis.ResultsThe strength of the zinc wire was enhanced by more than fourfold upon the addition of magnesium, without loss of ductility. NLM ... Of the 13 reported cases, 9 (62 %) showed BNC; and 4 (31 %), stone formation. A cystolithotripsy for a bladder stone was performed until the surface of it was broken. Pneumo thorax, extensive emphysema can complicate prolonged surgical procedures or by accidental increase in the intra abdominal pressure during surgery. Surgical clips are applied during cholecystectomy on the cystic duct and artery. Rats were euthanized at the end of the observation period, and the rings were removed for volume evaluation. Factors were evaluated for their ability to predict BNC using both univariate and multivariate analysis. We could not remove it with forceps in the outpatient clinic, so we performed the procedure again under general anesthesia and successfully removed the Hem-o-lok clip. We analysed 200 consecutive RPs performed by one surgeon for prostate cancer, 100 by ORP and 100 by RALP, between March 2003 and September 2007. © 2008-2021 ResearchGate GmbH. Complete inversion and necrosis of the involuted duct then leaves the surgical clips free within the lumen of the common bile duct with subsequent complication such as obstructive jaundice, cholangitis, biliary colic or pancreatitis . The goals of the VIP technique are to cure cancer, preserve urinary continence, preserve potency, and decrease morbidity, along with the benefits of a minimally invasive surgery and excellent cosmesis. All rights reserved. A cholecystectomy (koh-luh-sis-TEK-tuh-me) is a surgical procedure to remove your gallbladder — a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. To examine a large, single-surgeon series of patients with prostate cancer who underwent retropubic radical prostatectomy (RRP) for men with postoperative bladder neck contractures (BNCs). Surgical clips are commonly used for urologic surgeries and provide a reliable means of closure for a variety of tissues. Gastroesophageal reflux 4. Differential diagnosis is vast and includes chronic pelvic pain syndrome, urolithiasis, retained foreign body, pelvic joint dysfunction, surgical clip migration and erosion at the level of the urethrovesical anastomosis, ... His past surgical history was relevant for robotic RP performed 10 months before for a Gleason 3+4 prostate cancer while his past medical history was unremarkable. Results: The patient self-reported incidence of post prostatectomy incontinence (any degree), impotence, and bladder neck contracture or stricture was 72.2, 87.4, and 25.9%, respectively. There are some suggestions about the mechanisms of the migration process, but the details are still unclear. A transpeerineal approach was used to perform an hydrodissection of the rectovesical space at the level of the surgical clip combined with local injection of mepivacaine and betametasone. Preoperative comorbidities associated with microvascular disease may contribute to the development of bladder neck contracture (BNC) by alteration of anastomotic healing. El modelo predictivo desarrollado tiene utilidad meramente teórica ya que no abarca la totalidad de los factores que pueden influir en la aparición de la estenosis. World J Gastroenterol. [Endoclip on the cystic duct after laparoscopic cholecystectomy]. BMJ Case Rep. 2013 Feb 27;2013:bcr2012007982. Surgical Clips left inside after gallbladder surgey. I am now recovering from yet another procedure in Oct 13 where one of the surgical clips had to be surgically removed. 2003 Jun;180(6):1557-60. We describe the case of a patient complaining of chronic perineal pain occurred soon after robotic RP, refractory to conventional medical therapy and exacerbated by the sitting position. The patient was discharged 2 days postoperatively. The median (range) follow-up was 44 (12-233) months. Surgical staples need to stay in for a few days or up to 21 days (in some cases) before they can be removed. Your gallbladder collects and stores bile — a digestive fluid produced in your liver.A cholecystectomy is a common surgery, and it carries only a small risk of complications. Misinformed: There are not parts of a gallbladder to leave behind. VIP is nearly equal to traditional retro-pubic prostatectomy, with certain outstanding advantages. Pathologic stage (continuous variable) was the only factor to significantly predict incontinence and no factor could predict impotence or bladder neck contracture/stricture in univariate analysis. Zinc–magnesium alloy is a promising candidate for use as a bioabsorbable medical device in the urinary tract. A 69-year-old male underwent a radical retropubic prostatectomy for prostate cancer.  |  We present a rare postoperative complication occurring after a laparoscopic radical prostatectomy with nerve-sparing procedure carried out with the placement of 3 Weck Hem-o-lok-L clips in the right neurovascular bundle, in a patient with clinically localized prostate cancer. The RALP patients had no bladder neck reconstruction or mucosal eversion and their anastomosis was by the continuous suture 'parachute' technique. PurposeMetallic medical devices are typically constructed from non-bioabsorbable metals that remains in the body and causes considerable complications. A cystolithotripsy for a bladder stone was performed until the surface of it was broken. Cholecystectomy, that is removal of the gallbladder, is usually considered a safe operation, however there is a small risk of The reported rate of incontinence requiring protection was 39.0% and only 2.4% had persistent bladder neck contracture/stricture. On multivariate analysis, non-nerve sparing (P = 0.003) and a surgical date before 1992 (P < 0.001) were significant predictors of BNC. Abdominal ultrasonographic examination and computed tomography (CT) demonstrated a bladder stone that was 7 mm in diameter. Cystoscopy revealed a Hem-o-lok clip in the bladder, near the vesicourethral anastomotic site. However, these metallic medical devices are typically constructed from non-bioabsorbable metals (e.g., titanium), which remain in the body permanently after the completion of surgery. Their ease of use, rapid application, and reliability have helped to advance the techniques of laparoscopy. We report a rare post-operative complication, the migration of a HOLC into the bladder leading to calculus formation after RARP. In the final matched cohort, 375 patients were included for analysis. Men with BNCs had higher median preoperative prostate-specific antigen (PSA) levels (6.7 vs 5.7 mg/dL; P = 0.009) and were more likely to have PSA failure after RRP (30% vs 16%, P < 0.001). Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. No patient became incontinent as a result of the treatment for BNC.Conclusions. Nippon Hinyōkika Gakkai zasshi. 2019 Jul-Sep;15(3):192-197. doi: 10.4103/jmas.JMAS_53_18. Demographic, preoperative, operative, and tumor factors did not reliably predict patient-reported morbidity in this series. Abdominal ultrasonographic examination and computed tomography (CT) demonstrated a bladder stone that was 7 mm in diameter. Join ResearchGate to discover and stay up-to-date with the latest research from leading experts in, Access scientific knowledge from anywhere. At 3 postoperative years, follow-up ultrasonography revealed a small round mass in the bladder. Several comorbidities associated with microvascular disease are significant risk factors for development of BNC after RP. Journal of endourology / Endourological Society. Rarely one or more clips can get displaced. The patient required a laparotomy to retrieve the bile duct stones due to the distal stricture, and another laparotomy was necessary to remove the penetrating clips, which were deeply embedded in the bile duct wall. The occurrence of persistent perineal pain caused by surgical clips has rarely been described after radical prostatectomy (RP). We present the case of a bladder lithiasis that developed around a metallic clip five years after radical retropubic prostatectomy. (A) Lateral view of cystography: a surgical metal clip can be seen in contact with the urethra (arrow). We report a rare post-operative complication, the migration of a HOLC into the bladder leading to calculus formation after RARP. The number of specimens with positive surgical margins was significantly lower in the LigaSure group than in the Hem-o-lok group (24.8 vs 40.8%, p = 0.002). All the reported cases presented symptoms such as LUTS (2,4, The Hem-o-lok clips (HOLC) is frequently used for hemostasis of the lateral pedicles in robot-assisted prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP). Examining our last 500 patients there was a contemporary BNC rate of <1%. We analyzed data from 488 patients with prostatic cancer who underwent radical prostatectomy performed by seven surgeons in seven hospitals, including 365 open radical prostatectomies (ORPs), 99 laparoscopic radical prostatectomies (LRPs), and 24 robot-assisted, Abstract The use of Hem-o-Lok clips is well described for control of the lateral pedicles in robot-assisted laparoscopic prostatectomy. A retrospective review identified 231 hands with PAPD-B in 132 newborns treated with surgical clips between January 1, 1996, and November 30, 2010, having a minimum of 2 years of follow-up. Current cigarette smoking in particular is a strong predictor. Gallbladder Surgery Malpractice Laparoscopic cholecystectomy (gallbladder removal) became popular in the late 1980s, and quickly became one of the most common surgical procedures in America. Sub cutaneous emphysema at port site, mediastinum and neck may be noticed at the conclusion of surgery. There was no BNC in the RALP group, whilst 9% of the ORP group developed a BNC (P < 0.005). A 78-year-old man was treated with laparoscopic partial nephrectomy for a 4 cm tumour in the lower pole of the left kidney. The patient was a 75-year-old man with localized prostate cancer who underwent laparoscopic radical prostatectomy in July 2009. 2020 Jan-Mar;24(1):e2019.00053. From 1983 to 2007, 4132 men underwent RRP for prostate cancer by one surgeon. The patient was treated conservatively. The Hem-o-lok clips (HOLC) is frequently used for hemostasis of the lateral pedicles in robot-assisted prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP). 2014 Apr 28;20(16):4827-9. doi: 10.3748/wjg.v20.i16.4827. Surgery-associated complications include bleeding, bile duct injury, and retained stones. However, non-focal positive surgical margins and biochemical recurrence-free survival rates at 1 year postoperatively were not significantly different (11.2 vs 18.4%, p = 0.075 and 91.2 vs 92.8%, p = 0.565, respectively). Incision of the bladder neck can be performed through a variety of methods (cold knife, knife with electrocautery, holmium laser) with or without the injection of antifibrotic agents (mitomycin C). doi: 10.1136/bcr-2012-007982. Then, we implanted zinc and zinc–magnesium alloy rings formed by the wires into rat bladder. The RALP 'parachute' technique, which expands the anastomosis towards the bladder, appears to protect against BNC. Surgery to repair the mitral valve of the heart is considered to be a relatively safe medical procedure, although complications may sometimes arise. Nuestro propósito fue estudiar los factores de riesgo de estenosis de cuello vesical asociada a prostatectomía radical por carcinoma prostático en nuestro centro. KUB showing a surgical clip within the radio-opaque density in the pelvis (arrow). The remaining patients required periodic dilation to maintain an adequate urine flow. Metal clip migration was associated with 2 (8%) of the 25 RRP cases of bladder neck contracture and both (100%) of the RRP cases of bladder stone. On repeat cystoscopy 3 months later, a further Hem-o-Lok device was found eroded through the vesicourethral anastomosis and was successfully removed with the aid of a holmium laser. Risk factors including prior transurethral prostatectomy (TURP), estimated blood loss (EBL), and operative time (OR time) were also evaluated. We prepared zinc–magnesium alloy wires with various proportions of magnesium and investigated the strength, shape retention, formability, and absorbability of these novel materials. The ORP patients had a conventional stomatization and 'racquet handle' repair of the bladder if necessary, with mucosal eversion and a direct circular interrupted 'end-to-end' suture anastomosis between the bladder and urethra. This site needs JavaScript to work properly. Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. To date, this is the only reported case of intravesical migration and subsequent calculus formation with a spontaneous expulsion. The japanese journal of urology. Migration of metal clips into the urinary tract is rare. Three months later, he was referred to our hospital for pollakisuria and spontaneous hematuria. The purpose of this study was to determine the incidence of patient-self reported post prostatectomy incontinence, impotence, bladder neck contracture or stricture, better, same or worse quality of life and willingness for same treatment again in a large group of radical prostatectomy (RP) patients and to determine if these morbidities are predictable with demographic, surgical or prostate cancer (PC) factors. If multiple attempts at endoscopic management fail, open reconstruction may be required. Design: A retrospective review identified 231 hands with PAPD-B in 132 newborns treated with surgical clips between January 1, 1996, and November 30, 2010, having a minimum of 2 years of follow-up. Advanced features are temporarily unavailable 2011 and 2018 were retrospectively reviewed and analyzed from 1983 to,. 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