Ultrasound-Guided Mechanical Fragmentation of Sialoliths

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P48-P48
Author(s):  
Urban Geisthoff ◽  
Steffen Maune
Keyword(s):  
Therapeutic Option ◽  
Secondary Treatment ◽  
Sublingual Gland ◽  
Line Treatment ◽  
Ultrasound Guided ◽  
Stone Fragmentation ◽  
A New Technique ◽  
Mechanical Fragmentation ◽  
Minimally Invasive Methods ◽  
Residual Stones

Objective Assess the efficacy of ultrasound-guided mechanical intraductal stone fragmentation and removal of sialoliths (SonoFragmentation). SonoFragmentation has been described recently as a new technique for the treatment of sialolithiasis (Surg Endosc 2006;20(4):690–4). Methods Retrospective analysis of cases treated within the last 3 years. Results SonoFragmentation was used as a 2nd line treatment in 22/28 cases. 10 patients were free of stones (parotid gland [PG]: 2x, submandibular gland [SMG]: 7x, sublingual gland: 1x; in 2 cases sialendoscopy was additionally used). Residual stones persisted in 12 patients (PG: 2x, SMG: 10x). 6 patients with sialolithiasis of the GP were primarily treated with the technique. 4 of those patients were cured. Reasons for failure were lacking accessibility of the stone by the forceps (9x), impossibility to grasp the stone (5x) and/or the concomitant grabbing of soft tissue together with the stone (3x). Conclusions The efficacy of SonoFragmentation as a secondary treatment after failure of other minimally invasive methods is about 50% (10/22). Additionally, it is a promising primary therapeutic option (cure: 4/6 patients).

scholarly journals Patient profiles as an aim to optimize selection in the second line setting: the role of aflibercept

2021 ◽  
Author(s):  
B. González Astorga ◽  
F. Salvà Ballabrera ◽  
E. Aranda Aguilar ◽  
E. Élez Fernández ◽  
P. García-Alfonso ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Therapeutic Option ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Effective Therapeutic Option ◽  
Line Setting ◽  
First Line Treatment

AbstractColorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient’s profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.

Endoscopic Ultrasound-Guided Bilioduodenal Anastomosis: A New Technique for Biliary Drainage

Endoscopy ◽  
2001 ◽  
Vol 33 (10) ◽  
pp. 898-900 ◽  
Author(s):  
M. Giovannini ◽  
V. Moutardier ◽  
C. Pesenti ◽  
E. Bories ◽  
B. Lelong ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
New Technique ◽  
Ultrasound Guided ◽  
A New Technique

scholarly journals Indications for repeated enema reduction of intussusception in children

2014 ◽  
Vol 142 (5-6) ◽  
pp. 320-324 ◽  
Author(s):  
Dragana Vujovic ◽  
Marija Lukac ◽  
Aleksandar Sretenovic ◽  
Tamara Krstajic ◽  
Vesna Ljubic ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Therapeutic Option ◽  
Operative Procedure ◽  
Predictor Variable ◽  
Symptom Duration ◽  
Ultrasound Guided ◽  
Abdominal Emergency ◽  
Presenting Symptoms ◽  
Intussusception Reduction ◽  
Enema Reduction

Introduction. Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is nonoperative hydrostatic or air enema reduction. Objective. The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods. From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months), 102 (95%) patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results. Successful treatment by hydrostatic saline enemas had 58/102 (57%) patients. Success in reduction was greater if symptom duration was <24 hours (54/62 cases; 87%, p<0.001), compared with >24 hours, (4/45 cases; 9%). Despite failed initial attempts, enema reduction was reattempted in 12 patients, with success in 7/12 (60%) patients. Children with symptom duration >24 hours had a greater risk of requiring surgery (41/45 cases; 91%, p<0.001), including 5 (5%) patients with ileo-ileal intussusceptions. Conclusion. The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications.

scholarly journals An Appraisal of Anatomical and Limited Hepatectomy for Regional Hepatolithiasis

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Hui Jiang ◽  
Hong Wu ◽  
Ying-long Xu ◽  
Jing-zhou Wang ◽  
Yong Zeng
Keyword(s):  
Bile Leakage ◽  
Hepatic Function ◽  
Morbidity And Mortality ◽  
Line Treatment ◽  
First Line ◽  
Liver Remnant ◽  
Function Recovery ◽  
Recurrent Stone ◽  
First Line Treatment ◽  
Residual Stones

Aim. Determination of first line treatment with limited hepatectomy or Anatomical hepatectomy provides better clinical outcome. Methods. Immediate and long-term outcomes of 106 patients who underwent partial hepatectomy for RH at our institution from January 2001 to February 2005 were analyzed retrospectively. Clinical end-points included time to recovery of hepatic function, residual stones, infection of the liver remnant, bile leakage, recurrent stones, morbidity, and mortality. Results. LH was performed in 59 patients and AH in 47 patients as first-line treatment. The time of hepatic function recovery was not statistically different between the two groups (). However, Patients in AH group suffered from less residual stones (), less infection of the raw surface of liver remnant (), and less bile leakage (), with a median follow-up of months (range 3–48), and AH group suffered a less recurrent stone rate (). No difference in morbidity, and mortality rates between the two groups. Conclusion. AH is a safe and effective treatment for RH, with a fair rate of surgical complications, it should be considered as first-line treatment of RH.

scholarly journals First Approach to the Management of Orthopedic Injuries of the Hindfoot

2021 ◽  
Vol 3 (4) ◽  
pp. 01-03
Author(s):  
Claribel Pazos
Keyword(s):  
Soft Tissue ◽  
Platelet Rich Plasma ◽  
Therapeutic Option ◽  
Clinical Problem ◽  
Regenerative Therapy ◽  
Orthopedic Injuries ◽  
A New Technique ◽  
Methods Of Treatment ◽  
Common Clinical Problem ◽  
Anatomical Area

Hindfoot pain is a common clinical problem that can be due to multiple alterations, it can appear due to bone or soft tissue causes, it is established in a small anatomical area. There are different methods of treatment for these conditions, ranging from simple guidelines in lifestyle to surgery. In this work, patients are divided into four groups with different treatment methods, each group was assigned a different therapeutic option, which will increase its degree of invasion as the number of the group increases. Infiltration with platelet-rich plasma (PRP) is a new technique of cell regenerative therapy and was applied in one of the groups, taking advantage of the regenerative, healing and anti-inflammatory properties of the mentioned therapy.

scholarly journals Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review

2020 ◽  
Vol 12 ◽  
pp. 175883592091530
Author(s):  
Melissa Bersanelli ◽  
Matteo Brunelli ◽  
Letizia Gnetti ◽  
Umberto Maestroni ◽  
Sebastiano Buti
Keyword(s):  
Systematic Review ◽  
Renal Carcinoma ◽  
Clear Cell ◽  
Therapeutic Option ◽  
Comparable Efficacy ◽  
Line Treatment ◽  
Clear Cell Renal Carcinoma ◽  
First Line ◽  
Cell Renal Carcinoma ◽  
First Line Treatment

Background: Effective systemic treatment of non-clear cell renal carcinoma (nccRCC) is still an unmet clinical need, with few studies to support an evidence-based approach. To date, the only recommended standard first-line treatment is sunitinib. Pazopanib may also be used in nccRCC but its place in therapy is not clearly established. It has comparable efficacy and better tolerability than sunitinib in clear cell renal carcinoma. Our objective was to review the use of pazopanib in metastatic nccRCC. Methods: We conducted a systematic review according to PRISMA guidelines. Any type of study reporting the use of pazopanib in metastatic renal cell carcinoma including cases with non-clear cell histology was eligible. Results: In all, 15 studies were included in our analysis, including a total of 318 nccRCC patients treated with pazopanib. Most studies were retrospective ( n = 12); three were prospective trials. The specific outcomes of nccRCC patients were reported by four studies. Pazopanib alone as first-line treatment gave overall response rates ranging from 27% to 33%, disease control rates of 81–89%, median progression free survival of 8.1–16.5 months and median overall survival of 17.3–31.0 months. Grade 3–4 adverse events rates were 21–55%. Conclusion: The present review provides for the first time a systematic summary of evidence about the possible use of pazopanib as first-line treatment for nccRCC, with a favorable outcome despite the low strength of evidence. Pazopanib could be considered as a possible therapeutic option in this setting.

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