Endoscopic Management of Anterior Skull Base Lesions: Experience of Tertiary Care Center in India

Abstract Objective and Study Esophageal stenosis is the most common morbidity associated with congenital esophageal atresia (EA). There is no consensus regarding the endoscopic management of strictures in terms of timing and techniques of dilations. The aim of this study is to describe the endoscopic management of esophageal stenosis in children with EA admitted to our tertiary care center. Methods A retrospective descriptive single-center study was conducted. Data were collected of all patients diagnosed with EA admitted to the ‘Women's and Children's Hospital’ of Verona, Italy, between 2004 and 2017. Results Thirty-seven patients with EA were admitted to our center between 2004 and 2017. Twenty of them were excluded for insufficient data. All patients underwent surgical correction within 2 months of life. An endoscopic control with upper gastrointestinal endoscopy was performed in all of them. Eleven (65%) subjects had tracheoesophageal fistula. All of them had type C EA. Three (18%) had long-gap EA. Eleven patients (65%), 8 with Type C EA and 3 with Type A EA, underwent endoscopic dilation. Semirigid Savary-Giliard bougies were used in most of them. Pneumatic dilation with balloon was performed only in one case. Nine (81%) needed more than one dilation due to anastomotic stricture recurrence. In 3 of the 11 subjects (27%) more than 3 dilations were necessary. Two of them had long-gap EA. The median age of first endoscopic dilation was 3 months (range: 1–12 months). The median age of the last dilation was 6 months (range: 1–18 months). One of the 11 patients who underwent dilations (Type C EA with long gap) underwent surgical retreatment due to fistula recurrence. Six of the 17 subjects (35%) enrolled developed long-term complications. Conclusion Our data confirmed that anastomotic stricture is frequent in patients with EA who underwent surgical correction. Endoscopic management of stenosis is a safe and effective procedure that leads to a limited number of complications. Side effects are more likely to occur in patients with long-gap EA. Timing of dilations and endoscopic technique should be defined by international guidelines in order to improve patient's outcome.

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Analysis of endoscopic management of occluded metal biliary stents at a single tertiary care center

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2008.03.1064 ◽

2008 ◽

Vol 68 (4) ◽

pp. 676-682 ◽

Cited By ~ 36

Author(s):

Jason N. Rogart ◽

Ara Boghos ◽

Federico Rossi ◽

Hashem Al-Hashem ◽

Uzma D. Siddiqui ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Endoscopic Management ◽

Tertiary Care Center ◽

Biliary Stents

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Endoscopic Management of Food Impaction in the Upper Gastrointestinal Tract: A Tertiary Care Center Experience

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.03.820 ◽

2007 ◽

Vol 65 (5) ◽

pp. AB330 ◽

Cited By ~ 1

Author(s):

Igal Khorshidi ◽

Leon S. Maratchi ◽

Sammy Ho

Keyword(s):

Gastrointestinal Tract ◽

Care Center ◽

Tertiary Care ◽

Upper Gastrointestinal Tract ◽

Endoscopic Management ◽

Tertiary Care Center ◽

Food Impaction ◽

Upper Gastrointestinal

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Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center

Clinical Endoscopy ◽

10.5946/ce.2020.017 ◽

2020 ◽

Vol 53 (6) ◽

pp. 727-734 ◽

Cited By ~ 1

Author(s):

Suprabhat Giri ◽

Sridhar Sundaram ◽

Harish Darak ◽

Sanjay Kumar ◽

Shobna Bhatia

Keyword(s):

Care Center ◽

Tertiary Care ◽

Bile Leak ◽

Endoscopic Management ◽

Tertiary Care Center

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Incidence of Bile Leak After Orthotopic Liver Transplantation and Efficacy of Endoscopic Management-Results From a Tertiary Care Center

Gastroenterology ◽

10.1016/s0016-5085(11)61853-2 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-451

Author(s):

Brian Moloney ◽

Savio Reddymasu ◽

Kavous Pakseresht ◽

Tuba Esfandyari ◽

Richard Gilroy ◽

...

Keyword(s):

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Care Center ◽

Tertiary Care ◽

Bile Leak ◽

Endoscopic Management ◽

Tertiary Care Center

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Changing Paradigms in Sinus and Skull Base Surgery as the COVID-19 Pandemic Evolves: Preliminary Experience from a Single Italian Tertiary Care Center

10.22541/au.158991690.02815207 ◽

2020 ◽

Author(s):

Alberto D Arosio MD

Keyword(s):

Skull Base ◽

Skull Base Surgery ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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Anterior Skull Base Sarcomas: Report of Characteristics and Outcomes at a Tertiary Care Cancer Center

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1722667 ◽

2021 ◽

Author(s):

Sallie Long ◽

Panagiotis Asimakopoulos ◽

Marlena McGill ◽

Marc A. Cohen ◽

Snehal G. Patel ◽

...

Keyword(s):

Skull Base ◽

Small Sample Size ◽

Care Center ◽

Tertiary Care ◽

Small Sample ◽

Anterior Skull Base ◽

Cancer Center ◽

Adjuvant Radiation ◽

Low Grade ◽

High Grade

Abstract Objective This study was aimed to describe our institutional experience on characteristics and treatment outcomes of sinonasal sarcomas invading the anterior skull base. Design Present study is a retrospective review. Setting The study was conducted at an academic cancer care center. Participants Thirty-one patients with skull base sarcomas treated with primary surgery from 1979 to 2015 were identified for this study from a preexisting database. Main Outcome Measures Survival and recurrence outcomes using the Kaplan–Meier method were the focus areas of the study. Results The median age was 44 years (range: 13–69 years). Twenty patients were male (64.5%). Twenty-nine patients underwent open craniofacial resection (93.5%) and two patients underwent endoscopic resection (6.5%). The majority of tumors were staged pT4 (77.4%). The most common pathologies were leiomyosarcoma (19.4%), osteosarcoma (16.1%), and chondrosarcoma (12.9%). Of those with known margin status, 10 patients had positive/close margins (32.2%) and 16 patients had negative margins (51.6%). Most tumors were high grade (74.2%). Twenty-three patients (74.2%) received adjuvant radiation and four patients (12.9%) received adjuvant chemotherapy. There were nine postoperative complications (29%) including one mortality and three cerebrospinal fluid leaks. There were 10 local, 2 regional, and 5 distant recurrences over a median follow-up of 74 months (range: 1–300 months). The 5-year disease-specific survival (DSS) was 69.8%. The 5-year locoregional recurrence-free probability (RFP) was 63.2% and the 10-year distant RFP was 71.7%. The 5-year DSS for high grade tumors was 64.2 and 85.7% for low grade tumors (p = 0.117). Conclusion This study contributes an updated analysis of anterior skull base sarcomas. Five-year DSS is approximately 70%. Analysis of survival outcomes based on grade, tumor size, and other factors is limited by small sample size and the rarity of these tumors.

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