scholarly journals MNG-08 VOLUMETRIC STUDIES IN ASYMPTOMATIC MENINGIOMAS: SLOWDOWN CASES AND GROWTH ARREST CASES

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii36-ii36
Author(s):  
Ryuichi Hirayama ◽  
Tomoyoshi Nakagawa ◽  
Toru Umehara ◽  
Chisato Yokota ◽  
Noriyuki Kijima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Growth Arrest ◽  
Surgical Excision ◽  
Volume Measurement ◽  
Female Ratio ◽  
Volume Increase ◽  
Volume Curve ◽  
Increase Rate ◽  
Mri Scans

Abstract BACKGROUND The opportunity to follow up for asymptomatic meningiomas has increased. We have reported the risk of volume increase by individual continuous volume measurement of asymptomatic meningiomas. However, We have not reached fully understanding about natural history of meningiomas. Among cases are followed up over time, there are some cases that the volume increase rates slows down or almost stops are observed. METHODS We enrolled consecutive adult patients of asymptomatic meningiomas who follow-up for 2 years or more and 3 or more MRI scans. We performed sequential volumetric measurements on 95 patients (105 lesions) who met the criteria. We classified these transient volume curve of each lesion into three groups “Growing”, “Slowdown”, and “Growth arrest” for analysis. RESULTS The average age at the first visit was 62.8 years, the average follow-up period was 61.8 months, and the male-female ratio was 20:75 (male: female). There were 67 cases (73 lesions: 70.9%) that were in increasing trend, and 19 cases of those were received resection. Eleven cases (12 lesions: 11.7%) showed a tendency of “slow down” the increase rate, and one patient who became symptomatic led to surgical excision. In 18 cases (18 lesions: 17.4%) in which almost no volume change was observed during the observation period, no cases resulted in surgical treatment. CONCLUSIONS Among the meningiomas cases that have been followed for a long time, there are not a few those increase rate of tumor volume slows or does not change. Furthermore, most of these cases did not result in surgical treatment. The presence of these “Slowdown” and “Growth arrest” cases at a certain rate may have suggested the possibility of a Gompertz curve model as the natural course of meningiomas.

Orbital Hydatid Cyst: An Interventional Case Series

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Tajamul Khan ◽  
Ibrar Hussain ◽  
Zaman Shah
Keyword(s):  
Visual Acuity ◽  
Hydatid Cyst ◽  
Teaching Hospital ◽  
Case Series ◽  
Surgical Excision ◽  
P Value ◽  
Presumptive Diagnosis ◽  
Female Ratio ◽  
Orbital Imaging

Purpose:  To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design:  Interventional case series. Place and Duration of Study:  Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods:  This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results:  Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion:  Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. Key Words:  Orbital hydatid cyst, Proptosis, Orbitotomy.

Different Therapeutic Approaches and Outcome in the Treatment of Pterygium

1998 ◽  
Vol 8 (3) ◽  
pp. 148-152 ◽  
Author(s):  
C. H. Karabatsas ◽  
G. W. Marsh ◽  
A. M. Cook ◽  
S. D. Cook
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Surgical Excision ◽  
Lamellar Keratoplasty ◽  
Therapeutic Approaches ◽  
Therapeutic Modalities ◽  
Results Of Treatment ◽  
One Year

Purpose This study was initiated to investigate the role of different therapeutic modalities in the outcome of the surgical treatment of pterygium. Methods The results of treatment of pterygia with a variety of surgical techniques were studied in 56 eyes (49 patients) operated on at Bristol Eye Hospital during a period of five years. The surgical techniques included simple excision; bare sclera; conjunctival autograft; sliding conjunctival flap; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys. Results The incidence of recurrence was 23.2% for the 43 treated primary pterygia, and 23% for the 13 recurrent pterygia. All recurrences occurred between 2.5 and 11 months postoperatively. None of the 11 cases where additional beta irradiation was used showed any recurrence or other complication within the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed significantly lower recurrence rate (p<0.001) compared to those cases treated with surgical excision alone. Conclusions Beta irradiation as a complement to surgical treatment of pterygium, is successful in treating high risk cases such as reoperations, whereas for the majority of primary pterygia surgical excision alone is adequate. Additionally, follow up of one year will reveal any recurrences.

Intraoperative Application of Mitomycin C in the Surgical Treatment of Pterygium

1998 ◽  
Vol 8 (3) ◽  
pp. 153-156 ◽  
Author(s):  
A. Demirok ◽  
S. Simsek ◽  
A. Çinal ◽  
T. Yasar
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Side Effects ◽  
Mitomycin C ◽  
Surgical Excision ◽  
Control Group ◽  
Exact Test ◽  
Pterygium Surgery ◽  
Group 1

Purpose To investigate the effectiveness of intraoperative mitomycin C in pterygium surgery. Methods The effectiveness of intraoperatively administered mitomycin C and the occurrence of postoperative complications were evaluated in 17 patients with two recurrences of pterygium. The authors employed the “bare-sclera technique” and placed a sterile sponge soaked in a 0.02% mitomycin C solution intraoperatively in the episcleral space for 3 minutes. The control group (15 patients) underwent only surgical excision. Patients were followed for 21 to 30 months. Results The pterygium recurred in one (5.9%) of the 17 patients in group 1 and in six (40%) of the 15 controls. Statistical analysis using Fisher's exact test showed a significant (p=0.027) reduction of recurrences of pterygium in the group treated intraoperatively with mitomycin C. No serious complications or side effects arose during the follow-up period. Conclusions Mitomycin C administered intraoperatively can be considered an effective treatment to improve the success rate after surgical excision.

Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours

2012 ◽  
Vol 39 (3) ◽  
pp. 300-305 ◽  
Author(s):  
M.M. Al-Qattan
Keyword(s):  
Case Reports ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Palmar Fascia ◽  
Female Ratio ◽  
Tunnel Syndrome ◽  
Current Article ◽  
Painless Mass ◽  
Male To Female

Fibroma of tendon sheath is an uncommon fibrous tumour that has a predilection for the hand. Large series from Histopathological Units report a local recurrence rate of 24% after surgical excision. In the hand/orthopaedic surgery literature, fibroma of tendon sheath was generally reported as isolated case reports with unusual presentations, such as triggering and carpal tunnel syndrome. The current article reports on a series of 23 tumours of the hands of 20 patients. These were all adults (mean age of 36 years) with a male to female ratio of 3:1. The thumb and index were the most common sites. A slow-growing painless mass was the clinical presentation in every case. Total surgical excision was ensured by excision of part of flexor sheath/palmar fascia to which the tumour was attached. Diagnosis was confirmed by the classic histological features of fibroma of tendon sheath. There were no recurrences at final follow-up 2–5 years after surgery.

Suprainguinal retroperitoneal approach for the successful surgical treatment of meralgia paresthetica

2009 ◽  
Vol 110 (4) ◽  
pp. 768-774 ◽  
Author(s):  
Olaf Alberti ◽  
Jürgen Wickboldt ◽  
Ralf Becker
Keyword(s):  
Surgical Treatment ◽  
Complete Remission ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Retroperitoneal Approach ◽  
Meralgia Paresthetica ◽  
Female Ratio ◽  
Femoral Cutaneous Nerve ◽  
The Mean

Object Neurosurgical textbooks describe an infrainguinal approach as the standard or preferred option for the surgical treatment of meralgia paresthetica (MP), the most frequent entrapment neuropathy of the lower limb. However, inhomogeneous results led the authors to adopt a suprainguinal, retroperitoneal approach for decompression of the lateral femoral cutaneous nerve. In this paper the authors' aim was to study the outcome of patients harboring MP treated via this different surgical approach. Methods The outcome of 55 consecutive patients who underwent surgery for MP via the suprainguinal retroperitoneal approach during a 15-year period was ascertained through postal questionnaires (in 47 patients) and follow-up visits (in 8 patients). The male to female ratio was 1:0.67, and the mean patient age was 50 ± 12.9 years. The mean follow-up was 3.2 ± 3.3 years. Seven of the patients underwent bilateral surgery. Results Intraoperatively the lateral femoral cutaneous nerve was consistently found in close anatomical relationship to the anterior superior iliac spine, although some variations regarding the diameter, number of branches, and underlying pathological entity were observed. Eighty-seven percent of patients showed improvement (21 patients) or complete remission (27 patients) of painful dysesthesia in the anterolateral thigh, and 13% (7 patients) remained unchanged. In addition 82% had improvement (31 patients) or complete remission (14 patients) of hypesthesia, leaving 18% with unchanged (9 patients) or worsened (1 patient) hypesthesia. In the patient-evaluated group 66% (31 of 47) were completely satisfied with the outcome, 23% (11 of 47) were partially satisfied, and 11% (5 of 47) were not satisfied with the outcome. Two cases each of recurrence, seroma, wound infection, and 1 case of hematoma requiring revision were encountered as complications. Conclusions The suprainguinal retroperitoneal approach is a viable first-choice option for the surgical relief of MP.

scholarly journals Aggressive angiomyxoma of the vulva: a case report in a Brazilian patient

2019 ◽  
Vol 5 (2) ◽  
pp. 54-57
Author(s):  
Antonio Chambo Filho ◽  
◽  
Emmanuel Nasser Vargas Araujo de Assis ◽  
Flávia de Sousa Freitas Scherre ◽  
Luciene Lage da Motta ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Surgical Excision ◽  
Aggressive Angiomyxoma ◽  
Female Ratio ◽  
Brazilian Patient ◽  
Male Female Ratio ◽  
Aggressive Tumor ◽  
The Right

Aggressive angiomyxoma is a locally aggressive tumor of mesenchymal origin. The condition predominantly affects females, with a male/female ratio of 6:1. Most cases occur during the reproductive years, with a peak between the third and fourth decades of life. The symptoms are non-specific, and the principal differential diagnosis is with Bartholin’s cysts or abscesses. The treatment of choice is surgical excision of the lesion, including evaluation of the margins. This case report refers to a 41-year old patient with an insidiously growing lesion on the right vestibular area measuring approximately 9 x 5 x 5 cm, associated with dyspareunia. Surgical excision was successful, and there have been no signs of tumor recurrence in the six months of follow-up. Differential diagnosis in cases of vulvar lesions is of the utmost importance. A detailed vulvar examination is essential to ensure early diagnosis and to reduce the rate of underdiagnosed cases of aggressive angiomyxoma

RESOURCE UTILISATION ASSOCIATED WITH SINGLE DIGIT DUPUYTREN'S CONTRACTURE TREATED WITH EITHER SURGERY OR INJECTION OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM

Hand Surgery ◽  
2014 ◽  
Vol 19 (02) ◽  
pp. 205-209 ◽  
Author(s):  
Bo Povlsen ◽  
Adrian M. Shields ◽  
Gev S. Bhabra
Keyword(s):  
Surgical Treatment ◽  
Daily Living ◽  
Surgical Excision ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Single Digit ◽  
Dupuytren's Contracture ◽  
Skin Healing ◽  
Non Surgical Treatment

The gold standard treatment for Dupuytren's contracture is surgical excision of the cord. A non-surgical treatment with collagenase clostridium histolyticum injection is available but appears costly. Objectives: To provide data on resource consumption related to surgical and non-surgical treatment for Dupuytren's contracture. Design and Participants: Twenty patients with a single digit Dupuytren's contracture, 10 treated with surgical excision, and 10 treated with a single injection of collagenase. Measurements: Minutes spent in theatre, number of follow-up appointments, time to skin healing, and patients return to normal activities of daily living. Results: The injection group was significantly better regarding theatre time (p < 0.0001), follow-up appointments (p = 0.048), skin healing time (p < 0.001), and return to normal activities of daily living (p = 0.02) than the operated group. Conclusions: There are significant personal and health economic differences between the two methods of treatment which may influence local choice.

scholarly journals Desmoplastic Fibroma Recurrence Associated with Tuberous Sclerosis in a Young Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
A. M. Espinoza-Coronado ◽  
J. P. Loyola-Rodríguez ◽  
J. H. Olvera-Delgado ◽  
J. O. García-Cortes ◽  
J. F. Reyes-Macías
Keyword(s):  
Tuberous Sclerosis ◽  
Surgical Excision ◽  
Clinical Findings ◽  
Desmoplastic Fibroma ◽  
Volume Increase ◽  
Benign Pathology ◽  
The Brain ◽  
Recurrence Frequency ◽  
Hard Consistency

Case Report. A nine-year-old patient with a diagnosis of tuberous sclerosis (with no pathological record) that showed calcifications at the brain level. Besides, the case showed the Vogt triad (epilepsy, mental retardation, and sebaceous adenoma). The patient clinically showed a volume increase of hard consistency, without suppuration and no sessile that included the following teeth 73, 74, and 75. Cone beam computed tomography (CBCT) was obtained, and it displayed a delimited unilocular lesion. After surgical excision, the histopathological report was desmoplastic fibroma (DF). It was observed that the patient had an aggressive recurrence of DF at four months after surgery treatment. Due to these clinical findings, resective osseous surgery and curettage were carried out. It is uncommon to find these two pathologies together (DF and tuberous sclerosis). Since DF is a benign pathology but very invasive and destructive, it is necessary a constant follow-up examination due to a high recurrence frequency.

scholarly journals Combined Surgical Treatment of Gynecomastia

2015 ◽  
Vol 42 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Y. Yordanov ◽  
J. M. Lasso ◽  
A. Shef
Keyword(s):  
Surgical Treatment ◽  
Surgical Excision ◽  
Aesthetic Outcome ◽  
Reliable Technique ◽  
Good Balance ◽  
Breast Enlargement ◽  
Areola Complex ◽  
Skin Excess ◽  
The Mean

Summary Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

scholarly journals Surgical treatment of left-sided infective endocarditis in Hanoi Heart Hospital

2022 ◽  
Vol 35 ◽  
pp. 124-137
Author(s):  
Nguyen Sinh Hien ◽  
Nguyen Huu Phong ◽  
Le Quang Thien
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Prosthetic Valve Endocarditis ◽  
Early Recurrence ◽  
Cross Sectional ◽  
Female Ratio ◽  
Urgent Surgery ◽  
Male Female Ratio ◽  
Heart Hospital

Objective: to evaluate the short-term outcomes of surgical treatment of left-sided infective endocarditis (IE) in Hanoi Heart Hospital. Patients and Methods: A retrospective, cross-sectional and descriptive study on all patients underwent surgery for left-sided IE from 3/2015 to 3/2019 in Hanoi Heart Hospital. Result: 56 patients underwent surgery for left-sided IE in 4 years; the mean age was 45.8 ± 16.0; male-female ratio was 3.3/1. 9 patients (16.1%) had prosthetic valve endocarditis. Preopeative blood cultures were positive in 35.7%, the mainly microorganism was Streptococcus (21.4%). Emergency and urgent surgery was performed in 14.3%; the most frequently postoperative complication was kidney failure, the in-hospital mortality rate was  5.4%. During the average follow-up time of 36.6± 14.2 months, the recurrence rate of IE was 17.8%. Conclusion: surgical treatment of left-sided infective endocarditis is still a great challenge, the early recurrence and motality rate are high.

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