Loco-Regional Treatment with Surgical Intervention in Mesothelioma: What Is the Role of Enhancing Local Control Approaches?

Abstract Background The guidelines suggest close co-operation between TLE operating team and cardiac surgery and its key role in the management of life-threatening complications remains unquestionable. But the role of cardiac surgeon seems to be much more extended. Purpose We have analysed the role of cardiac surgery in treatment of patients undergoing TLE procedures. Methods Using standard non-powered mechanical systems we have extracted ingrown PM/ICD leads from 3207 pts (38,7% female, average age 65,7-y) during the last 14 years. Non-infectious TLE indications were in 66,4% of patients. 46% had PM DDD system, 19% PM SSI, 22% ICD, 9% CRT, 4% other systems. In 12% of patients abandoned leads were found. 8% of patients had one lead, 54% - two, 15% - three and 4% - 4–6 leads in the heart. An average dwell time of all leads was 91,5 mth. The lead entry side was left in 96% of patients, right in 3% and both – 4%. Results Procedural success 96,1%, clinical success - 97,8%, procedure-related death 0,2%. Major complications appeared in 1,9% (cardiac tamponade 1,2%, haemothorax 0,2%, tricuspid valve damage 0,3%, stroke, pulmonary embolism <1%). Conclusions Rescue cardiac surgery (for severe haemorrhagic complications) is still the most frequent reason of surgical intervention (1,1%). The second area of co-operation includes supplementary cardiac surgery after (incomplete) TLE (0,8%). The third one is connected with reconstruction or replacement of tricuspid valve, which can be affected by ingrown lead or damaged during TLE procedure (0,5%). Implantation of the complete epicardial system during any surgical intervention (rescue or delayed) should be considered as a supplementation of the operation (0,65%). Some of patients after TLE need implantation of epicardial leads for permanent epicardial pacing (0,6%) and some only left ventricular lead to rebuild permanent cardiac resynchronisation (0,5%). The single experience of large TLE centre indicates the necessity of close co-operation with cardiac surgeon, whose role seems to be more comprehensive than a surgical stand-by itself. Table 1 Funding Acknowledgement Type of funding source: None

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Advanced Endoscopic Tools

Digestive Disease Interventions ◽

10.1055/s-0041-1729765 ◽

2021 ◽

Author(s):

Eleanor C. Fung

Keyword(s):

Gastrointestinal Bleeding ◽

Hospital Stay ◽

Surgical Intervention ◽

Length Of Hospital Stay ◽

Therapeutic Endoscopy ◽

Full Thickness ◽

Evolution And Development ◽

Improved Outcomes ◽

Endoscopic Clips

AbstractThe advent and success of therapeutic endoscopy has expanded the utilization of endoscopy as an effective alternative to surgical intervention in some cases with decreased morbidity, improved outcomes, and shortened length of hospital stay. Gastrointestinal bleeding, perforations, leaks, fistulas, and strictures have become increasingly managed by endoscopy with the evolution and development of endoscopic tools for effective closure of full-thickness gastrointestinal defects, dilation, and hemostasis. This article reviews the characteristics and role of endoscopic clips, stents, dilation balloons, endoscopic knives, and suturing devices.

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To the clinic of infected ulcers of the stomach and duodenum

Kazan medical journal ◽

10.17816/kazmj76829 ◽

1927 ◽

Vol 23 (5) ◽

pp. 516-523

Author(s):

S. A. Grosman ◽

M. M. Brailovsky

Keyword(s):

Clinical Manifestation ◽

Surgical Intervention ◽

Secondary Infection ◽

Practical Interest ◽

Point Of View ◽

French School

We will not touch the controversial question of the role of infection in the genesis of ulcers and will adopt the point of view of the French school (Duval, Roux, Montier, Girault), for which the concept of an infected ulcer is only a concept of a pathological-anatomical and clinical nature, related to the concept of the evolution of an already existing ulcer, depending on its secondary infection. This evolution of the ulcer, in the presence of a new ingredient of infection, creates some peculiarities in its clinical manifestation,-peculiarities which, in suitable cases, can and must be taken into account both in the choice of time and in the choice of method of surgical intervention. Thus, the question under consideration by us has not only theoretical character, but, as we will try to state below, acquires also a certain practical interest.

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Importance of anatomo-topographic peculiarities for endoscopic diagnosis and treatment of Sphenoiditis

Kazan medical journal ◽

10.17816/kazmj82714 ◽

1995 ◽

Vol 76 (1) ◽

pp. 38-40

Author(s):

M. K. Mikhailov ◽

L. G. Svatko ◽

V. N. Krasnozhen ◽

S. B. Mosikhin

Keyword(s):

Surgical Intervention ◽

Anterior Wall ◽

Endoscopic Diagnosis ◽

Diagnosis And Treatment ◽

Case Record ◽

Endoscopic Method

The results of anatomo-topographic investigation of 100 clinoid sinuses obtained in autopsy of 50 dead persons are given. The relations of clinoid sinuses with posterior cells of ethmoidal labyrinth are found, the location of natural anastomoses of sinuses on the anterior wall is defined. The case record of the patient with sphenoiditis after endoscopic surgical intervention is given. The role of endoscopic method for diagnosis and treatment of sphenoiditis is shown.

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Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients

Clinical & Translational Oncology ◽

10.1007/s12094-019-02168-x ◽

2019 ◽

Vol 22 (5) ◽

pp. 670-680

Author(s):

M. J. Cambra ◽

F. Moreno ◽

X. Sanz ◽

L. Anglada ◽

M. Mollà ◽

...

Keyword(s):

Retrospective Study ◽

Local Control ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Conserving Surgery ◽

Boost Radiotherapy

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Perforation of the jejunum diverticulum: the role of CT examination

Medical Visualization ◽

10.24835/1607-0763-2019-3-66-76 ◽

2019 ◽

pp. 66-76

Author(s):

I. V. Platitsyn ◽

A. V. Kondratyev ◽

A. V. Panin ◽

E. M. Shubarkina ◽

A. L. Maslov

Keyword(s):

Small Intestine ◽

Acute Abdomen ◽

Research Methods ◽

Clinical Case ◽

Laparoscopic Resection ◽

Surgical Intervention ◽

Everyday Practice ◽

Correct Interpretation ◽

Common Causes

Uncomplicated diverticula of the small intestine are asymptomatic, extremely rare in everyday practice and, most often, are detected already with the development of complications such as perforation and abscess formation. Diagnosis of complicated diverticula of the small intestine is difficult due to many other, more common causes of acute abdomen, insufficient use of the capabilities of the methods of radiation diagnosis, the lack of application and correct interpretation of the results of instrumental and special research methods. The article presents a clinical case of perforation of the jejunum diverticulum. The results of effective MDCT diagnosis and successful surgical intervention are presented: laparoscopic resection of the jejunum with the formation of the primary hardware intracorporeal enteroentero-anastomosis side by side.

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A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team

Case Reports in Pediatrics ◽

10.1155/2017/8952428 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Elliott J. Carande ◽

Samuel J. Bilton ◽

Satish Adwani

Keyword(s):

Marfan Syndrome ◽

Surgical Intervention ◽

Rare Condition ◽

Mitral Valve Regurgitation ◽

Left Ventricular ◽

Cardiac Complications ◽

Chromosome 15 ◽

Fibrillin 1 ◽

Neonatal Marfan Syndrome

Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS.

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Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

Rare Tumors ◽

10.4081/rt.2011.e48 ◽

2011 ◽

Vol 3 (4) ◽

pp. 150-152 ◽

Cited By ~ 17

Author(s):

Sumita Bhatia ◽

Leszek Miszczyk ◽

Martine Roelandts ◽

Tan Dat Nguyen ◽

Tom Boterberg ◽

...

Keyword(s):

Radiation Therapy ◽

Giant Cell ◽

Local Control ◽

Symptom Relief ◽

Significant Proportion ◽

Rare Cancer ◽

Giant Cell Tumors ◽

Number Of Patients ◽

Cancer Network

The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB) has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow-up was 8.0 years. Five year local control was 85%. Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity.

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