Surgery for urological cancer

2020 ◽  
pp. 175-272
Author(s):  
Suzanne Biers ◽  
Noel Armenakas ◽  
Alastair Lamb ◽  
Stephen Mark ◽  
John Reynard ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Approaches ◽  
Urological Cancer ◽  
Urological Cancers ◽  
Patient Preparation

This chapter covers various surgical procedures for dealing with different urological cancers. For each method, it takes the reader through diagnosis, indications for the procedure, assessment and staging, patient preparation, and surgical approaches, then closure, and any other potential issues. Each topic is highly illustrated, to aid understanding for unfamiliar procedures.

scholarly journals Outcomes in urological cancer are strongly influenced by route to diagnosis

2017 ◽  
Vol 10 (1_suppl) ◽  
pp. 9-13
Author(s):  
Jayne L Douglas-Moore ◽  
Luke Hounsome ◽  
Julia Verne ◽  
Roger Kockelbergh
Keyword(s):  
General Practitioner ◽  
Cancer Case ◽  
Urological Cancer ◽  
Emergency Presentation ◽  
Urological Cancers ◽  
Recorded Data ◽  
Cancer Outcome ◽  
And Gender ◽  
The Impact ◽  
First Time

Introduction: The Routes to Diagnosis study has recorded data on new cancer diagnoses since 2006. The route to diagnosis of urological cancer influences outcomes and factors including gender, age and deprivation are implicated in affecting the way in which patients present. Materials and methods: Data were obtained from the National Cancer Intelligence Network Routes to Diagnosis study. Every new cancer case is assigned to one of eight routes of diagnosis, seven of which are applicable to urological cancers. Data from 2006 to 2013 are described in this report. Results: Two week wait is the most common route to diagnosis of bladder and testicular cancer compared to prostate, renal and penile malignancy in which routine general practitioner referral was the most common route. Two week wait referrals are associated with the best survival, and emergency presentations with the worst. Emergency presentation increases with advancing age but is also noted to be a significant route to diagnosis in patients less than 50 years. Bladder and renal cancer are more common in men but the route to diagnosis varies with gender. Increasing deprivation increases emergency presentation but has minimal effect on two week wait and routine general practitioner referrals. Conclusion: National data on the impact of route to diagnosis of urological malignancy have been described for the first time. The effect of age and gender on route to diagnosis and consequently cancer outcome has been noted. To enable earlier diagnosis attention must focus on extremes of age, patients with penile cancer and the most deprived patients.

Other surgical approaches in the management of osteoarthritis

2016 ◽  
Author(s):  
Jonas Bloch Thorlund ◽  
L. Stefan Lohmander
Keyword(s):  
Stem Cells ◽  
Surgical Treatment ◽  
Adverse Events ◽  
Surgical Procedures ◽  
Joint Replacement ◽  
Hip Arthroscopy ◽  
Surgical Techniques ◽  
Risk Of Bias ◽  
Surgical Approaches ◽  
Surgical Treatments

Joint replacement is often considered the surgical treatment for patients with osteoarthritis (OA). However, several other surgical treatments, of which some are more frequently performed, have been advocated for patients with OA in order to relieve symptoms, stall progression, and avoid or postpone joint replacement. This chapter briefly describes the most common procedures such as knee and hip arthroscopy and knee and hip osteotomy. It also reviews the evidence for the efficacy of these treatments compared with non-surgical alternatives, which is frequently insufficient due to lack of controlled low-risk-of-bias studies. The risk of adverse events is also reported when data is available. Some of the more recent surgical techniques such as implantation of chondrocytes or stem cells are also described and discussed but their utility for treating osteoarthritis remains uncertain. There is a great need for continued innovation and development of surgical techniques for managing in particular the earlier stages of osteoarthritis. To reduce the risk of future costly failures, a stepwise introduction of new surgical procedures and devices must be encouraged.

scholarly journals The Large Focal Isolated Chondral Lesion

2021 ◽  
Author(s):  
Jorge Chahla ◽  
Brady T. Williams ◽  
Adam B. Yanke ◽  
Jack Farr
Keyword(s):  
Surgical Procedures ◽  
Young Patients ◽  
Osteochondral Allograft ◽  
Surgical Approaches ◽  
Arthroscopic Debridement ◽  
Comprehensive Understanding ◽  
First Line ◽  
Algorithmic Approach ◽  
Chondral Lesions ◽  
Chondral Defects

AbstractFocal chondral defects (FCDs) of the knee can be a debilitating condition that can clinically translate into pain and dysfunction in young patients with high activity demands. Both the understanding of the etiology of FCDs and the surgical management of these chondral defects has exponentially grown in recent years. This is reflected by the number of surgical procedures performed for FCDs, which is now approximately 200,000 annually. This fact is also apparent in the wide variety of available surgical approaches to FCDs. Although simple arthroscopic debridement or microfracture are usually the first line of treatment for smaller lesions, chondral lesions that involve a larger area or depth require restorative procedures such as osteochondral allograft transplantation or other cell-based techniques. Given the prevalence of FCDs and the increased attention on treating these lesions, a comprehensive understanding of management from diagnosis to rehabilitation is imperative for the treating surgeon. This narrative review aims to describe current concepts in the treatment of large FCDs through providing an algorithmic approach to selecting interventions to address these lesions as well as the reported outcomes in the literature.

Hearing Results in Surgery for Primary Petrous Apex Lesions

1994 ◽  
Vol 111 (3P1) ◽  
pp. 250-257
Author(s):  
Gerard J. Gianoli ◽  
Ronald G. Amedee
Keyword(s):  
Skull Base ◽  
Surgical Procedures ◽  
Hearing Preservation ◽  
Petrous Apex ◽  
Surgical Approaches ◽  
Hearing Improvement ◽  
Profound Hearing Loss ◽  
Hearing Results ◽  
Treatment Plans ◽  
Alternative Procedures

Hearing preservation is a frequently mentioned phrase in the growing field of skull base surgery. Many authors have attempted to identify prognostic factors for successful hearing preservation, and many have suggested alternative procedures for preserving serviceable hearing. Few have mentioned hearing improvement with skull base surgical procedures. In this article we present the hearing results of 25 surgical procedures for primary petrous apex lesions. These Include 13 cholesterol granulomas, 5 cholesteatomas, 4 mucoceles, and 3 eosinophilic granulomas. Surgical approaches included 14 transmastoid/infralabyrinthine, 6 transphenoid, 3 suboccipital, and 2 transmastoid/translabyrinthine. Hearing was maintained In 14 patients (56%), Improved in 9 patients (36%), and worse in 1 patient with nonserviceable hearing before surgery (4%); 1 patient had profound hearing loss before surgery (4%). Results of this review should have significant implications on the choice of surgical approach for petrous apex lesions. Additionally, the standard method of determining salvageable hearing for most skull base procedures may not apply for this specific group of lesions. Implications for future treatment plans will be discussed in detail.

Imaging of the Knee Following Repair of Focal Articular Cartilage Lesions

2018 ◽  
Vol 22 (04) ◽  
pp. 377-385 ◽  
Author(s):  
Christoph Rehnitz ◽  
Marc-André Weber ◽  
Felix Wuennemann
Keyword(s):  
Surgical Procedures ◽  
Clinical Presentation ◽  
Surgical Approaches ◽  
Cartilage Defects ◽  
Osteochondral Lesions ◽  
Postoperative Imaging ◽  
Chondrocyte Implantation ◽  
Postoperative Findings ◽  
Articular Cartilage Lesions ◽  
Autologous Chondrocyte

AbstractFocal chondral or osteochondral lesions of the knee are common lesions involving either the cartilage layers or the cartilage layers and the subchondral bone. Despite their heterogeneous clinical presentation, they are important risk factors for the premature development of osteoarthritis. Therefore, early detection of osteochondral lesions and focal cartilage defects is crucial. In symptomatic (osteo-)chondral lesions, numerous therapeutic strategies, ranging from conservative treatment to surgical procedures such as marrow stimulation, osteochondral autograft transplantation, or autologous chondrocyte implantation are available. Musculoskeletal radiologists should be familiar with these surgical procedures, the evaluation of the postoperative findings as well as the possible complications when interpreting postoperative imaging studies. This review article describes the different surgical approaches to focal osteochondral lesions of the knee with emphasis on postoperative imaging findings and the pitfalls possibly encountered by the radiologist.

scholarly journals Surgical approaches to tumors and epileptogenic zones close to Wernicke's area

1995 ◽  
Vol 53 (3b) ◽  
pp. 587-591 ◽  
Author(s):  
Arthur Cukiert ◽  
Gary Gronich ◽  
Raul Marino Jr
Keyword(s):  
Local Anesthesia ◽  
Surgical Procedures ◽  
Local Anesthetic ◽  
Clinical Presentation ◽  
Brain Regions ◽  
Cortical Mapping ◽  
Surgical Approaches ◽  
Low Grade ◽  
Severe Morbidity ◽  
Wernicke’S Area

Surgical procedures near to language related brain regions may cause severe morbidity in relation to speech. Operations performed under local anesthesia and intraoperative cortical mapping may minimize these risks. Six patients with tumors near the Wernicke's area were treated (2 low-grade astrocytomas, 1 ganglioglioma, 1 xanthoastrocytoma, 1 metastasis, 1 glioblastoma). Their clinical presentation consisted of epilepsy (n=4) and dysphasia (n=2). The skin and periosteum were infiltrated with local anesthetic and an ample craniotomy was performed. Cortical stimulation with an unipolar electrode was then carried out with concomitant speech testing (mainly comprehension and sequential speech). After mapping, the best surgical approach aiming to avoid the mapped area was elected. In 5 cases the resection was total and in 1, partial (glioblastoma). There was a transitory (10 days) worsening of the pre-operative deficit in 1 case (glioblastoma). In 3 patients, the speech areas were displaced: posteriorly (n=2) or anteriorly (n=l). Surgical procedures under local anesthesia are safe and may avoid post-operative language disturbances in patients with tumors near to Wernicke's area.

scholarly journals Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)

2020 ◽  
Vol 06 (03) ◽  
pp. e145-e152
Author(s):  
Gabriele Naldini ◽  
Filippo Caminati ◽  
Alessandro Sturiale ◽  
Bernardina Fabiani ◽  
Danilo Cafaro ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Therapy Group ◽  
Reoperation Rate ◽  
Hemorrhoidal Disease ◽  
Surgical Approaches ◽  
Published Data ◽  
Success Rates ◽  
New Classification ◽  
Group B ◽  
Surgical Treatments

Abstract Introduction The introduction and diffusion of new techniques for hemorrhoidal surgery have made it clear how much Goligher classification is inadequate in the modern times, lacking in any correlation between anatomical and clinical features to a surgical procedure. The aim of the study was to evaluate if the application of a new classification of hemorrhoidal diseases might lead to an improvement in the postoperative surgical outcomes. Methods From January 2014 to December 2015, all patients undergoing surgery for hemorrhoidal disease were enrolled. The procedures performed were based upon a new anatomical/clinical–therapeutic classification (A/CTC) considering these items: anatomical presentation, symptom types and frequency, associated diseases, and available surgical treatments and their related contraindications. The new classification identified four groups: A (outpatient), B, C, and D (surgical approaches). The overall outcomes were assessed and then stratified by surgical groups. These data were then analyzed in comparison with the published data about all the surgical procedures performed. Results A total of 381 patients underwent surgery and they were stratified as follows: Group B (39), C (202), and D (140). Group B underwent Doppler-guided dearterialization with mucopexies or tissue selective therapy, Group C stapled procedures, and Group D hemorrhoidectomy. The mean follow-up was 30 months. The overall outcomes were: success rate 92.4%, recurrences 7.6%, postoperative complications 4.8%, long-term complications 5.4%, and reoperation rate 2.7%. The success rates stratified by groups were: B, 85%); C, 91.4%; and D, 95.7%. Conclusion The A/CTC proved to be useful in stratifying the patients and choosing the proper treatment for each case. This classification seems to improve the outcome of different surgical procedures if compared with those already published.

Riflessioni: Concerning demographic projections of urological cancer

1992 ◽  
Vol 59 (4) ◽  
pp. 9-12 ◽  
Author(s):  
A.P. Rimondi
Keyword(s):  
Cancer Control ◽  
The Elderly ◽  
Incidence Rates ◽  
Urological Cancer ◽  
Crude Incidence ◽  
Demographic Projections ◽  
Actual Risk ◽  
Urological Cancers ◽  
Age Range ◽  
Actual Size

Changes in cancer incidence over time are the results of 2 factors. The first is the size and composition of the populations in the different areas: incidence rates are closely related to age, so any ageing of the populations will produce an increase in the crude incidence rates. The second factor is a change in the actual risk of different cancers, generally expressed as some form of age-standardized rate. The incidence rates and numbers of cases of urological cancers (excluding testicular cancer) are estimated in our province upon the actual size of the population and upon the projections of the same to the year 2015. Due to an increasing life-span, substantial increases in incidence rates were observed in the “elderly” group, especially in the age range 55–74 and over 75. The implications for cancer control and treatment will be discussed.

Reper intraocular lens with artificial iris: implantation techniques and outcomes

2021 ◽  
pp. 112067212110056
Author(s):  
Rino Frisina ◽  
Chiara Sofia De Biasi ◽  
Luigi Tozzi ◽  
Irene Gius ◽  
Davide Londei ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Simultaneous Treatment ◽  
Artificial Iris ◽  
Implantation Techniques ◽  
Exact Position ◽  
Fixation Points ◽  
The Stability

The authors describe the surgical techniques to implant a novel intraocular lens with artificial iris (Reper) in patients affected by traumatic aphakia and aniridia. Two surgical approaches are proposed: implantation by suture-loaded cartridge and “open sky” implantation combined with penetrating keratoplasty. The method of establishing the exact position of the scleral fixation points and the pre-assembly of the suture of Reper before its implantation are the main novel proposed surgical procedures. The rationale is to minimize surgical procedures in the anterior chamber and to prevent knot loosening and lens tilting. The simultaneous treatment of aphakia and aniridia with a single prosthesis, the stability of the Reper and the functional, anatomical and aesthetic outcomes obtained are the highlighted advantages in this study.

scholarly journals Surgical Anatomy and Approaches to the Anterior Thoracolumbar Spine Region

2018 ◽  
Vol 23 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Andrei F. Joaquim ◽  
Leonardo Giacomini ◽  
Enrico Ghizoni ◽  
Fábio Araújo Fernandes ◽  
Marcelo L. Mudo ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Surgical Procedures ◽  
Thoracolumbar Spine ◽  
Lumbar Vertebrae ◽  
Surgical Anatomy ◽  
Surgical Approaches ◽  
Efficacy And Safety ◽  
Anatomical Features ◽  
Anatomical Knowledge

We review the surgical anatomy of the thoraco-lumbar spine region located between the eleventh thoracic and the second lumbar vertebrae (T11-L2). Anatomical features of muscular, vascular and neural structures important to surgical approaches are described in details. We also discuss surgical nuances of the transthoracic retroperitoneal and the lateral retropleural approaches. We conclude that anatomical knowledge is important to improve the efficacy and safety of surgical procedures in the thoraco-lumbar spine region.

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