The Surgical Treatment of Post-radiation Keratosis

Abstract Background Acquired Tracheo-broncho-esophageal fistulae of the adult are uncommon, severe and require a complex management associating medical, endoscopic and surgical treatment. Methods From January 2013 to December 2017, we conducted a monocentric, retrospective study on the etiology, the diagnosis and the management of acquired tracheo-broncho-esophageal fistulae. Results During the last 5 years, 29 consecutive acquired tracheo-broncho-esophageal fistulae were diagnosed in our department (23 men and 6 women), of which 2 malignant fistulae. Sixteen appeared in the early postoperative period after esophagectomy (From 7 to 63 days), and two more later at post-operative day 150 and 154 days. The other 10 tracheo-broncho-esophageal fistulae had variable etiologies: post-radiation (5), traumatic (4), severe reflux. Clinical presentation were of variable severity as well. Six patients were asymptomatic, the fistula diagnosed on systematic radiological or endoscopic examinations. The other patients had respiratory and infectious symptoms, going from iterative pneumopathy to acute respiratory distress with septic shock. The management was complex and specific to each patient, but 3 situations can be described: 1. Endoscopic treatment (7) 2. Surgical treatment, more or less followed by an endoscopic treatment (7) 3. Multiple endoscopic treatment, followed by surgery (13). Regardless of the treatment, the mortality rate was extremely high, 12 patients out of 27 dying in the early follow-up (44,4%). Conclusion The incidence of acquired tracheo-broncho-esophageal fistulae seems to be increasing, especially after esophagectomy. Their treatment is different than from the usual anastomotic fistula. Multimodal management is associated with patient death in about half of the cases. Endoscopic treatment allows the stabilisation of patients in a precarious clinical situation, but where the immediate results can be satisfactory it can later on lead to chronic and harmful situations. Surgery remains the cornerstone of the treatment. Disclosure All authors have declared no conflicts of interest.

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The surgical treatment of post-radiation recurrent basal-cell carcinoma of the face and scalp

British Journal of Plastic Surgery ◽

10.1016/s0007-1226(51)80044-4 ◽

1951 ◽

Vol 4 ◽

pp. 263-278 ◽

Cited By ~ 4

Author(s):

Randell Champion ◽

Robert Gibb

Keyword(s):

Surgical Treatment ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

The Face ◽

Post Radiation

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Radiation heart disease in a patient post treatment of Нodgkin’s lymphoma

Russian Journal of Cardiology ◽

10.15829/1560-4071-2018-9-45-47 ◽

2018 ◽

pp. 45-47

Author(s):

Е. S. Eniseeva ◽

К. V. Protasov ◽

N. L. Chernysheva ◽

E. Yu. Bagadaeva ◽

A. A. Stefanenkova

Keyword(s):

Radiation Therapy ◽

Heart Disease ◽

Surgical Treatment ◽

Female Patient ◽

Constrictive Pericarditis ◽

Clinical Case ◽

Post Treatment ◽

Hodgkin's Lymphoma ◽

Radiation Induced ◽

Post Radiation

A clinical case of radiation induced heart disease in 43 year old female patient after 15 years since radiation therapy of Hodgkin’s lymphoma. During clinical and instrumental investigation, a post-radiation constrictive pericarditis was found, comorbid with lesion of aortic, mitral and tricuspid valves. Surgical treatment of pericarditis was applied. Morphology confirmed the diagnosis.

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Successful surgical treatment of intractable post-radiation rectal bleeding

Surgical Techniques Development ◽

10.4081/std.2021.9125 ◽

2022 ◽

Vol 10 (1) ◽

Author(s):

Rezvan Mirzaei ◽

Bahar Mahjoubi ◽

Jalil Shoa ◽

Roozbeh Cheraghali ◽

Zahra Omrani

Keyword(s):

Surgical Treatment ◽

Rectal Bleeding ◽

Rectal Wall ◽

Anal Verge ◽

Metastatic Breast ◽

Main Role ◽

Anal Region ◽

Diverting Stoma ◽

Radiation Colitis ◽

Post Radiation

Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8-12 months after finishing their treatment. Endoscopic methods play the main role the treatment of bleeding caused by post-radiation colitis and proctitis. Surgical treatment is required for remained approximately 10% of patients. Here we present a 64 year old female with metastatic breast cancer, who was referred to us for intractable rectal bleeding. Total colonoscopy and rigid rectosigmoidoscopy revealed proctitis, rectal and sigmoidal telangiectasis, multiple necrotic ulcers between 15 to 30 cm from the anal verge, and also huge ishemic ulcer with patchy necrotic areas about 10 cm from the anal verge. This abnormal irradiated part was resected and then mucosectomy of the remnant rectum, both transabdominally and transanally was done. We performed pull-through technique of normal proximal colon to anal region through the remnant rectal wall and finally did coloanal anastomosis. Diverting stoma was not made because of anastomosis in anal region. With this technique we can achieve benefits such as avoidance of harsh dissection in a frozen pelvis and its consequences, we can avoid intra-abdominal anastomosis, there is no need to a diverting stoma and, most important of all, definite bleeding control.

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Human Stapes Crura: Normal Ultrastructure. Scanning Electron Microscopic Findings

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100116267 ◽

1975 ◽

Vol 33 ◽

pp. 528-529

Author(s):

M.D. Graham

Keyword(s):

Electron Microscope ◽

Surgical Treatment ◽

Scanning Electron Microscope ◽

Osmic Acid ◽

Human Cadaver ◽

Electron Microscopic ◽

Scanning Electron Microscopic ◽

Normal Human ◽

Microscopic Findings ◽

Scanning Electron

The recent development of the scanning electron microscope has added great impetus to the study of ultrastructural details of normal human ossicles. A thorough description of the ultrastructure of the human ossicles is required in order to determine changes associated with disease processes following medical or surgical treatment.Human stapes crura were obtained at the time of surgery for clinical otosclerosis and from human cadaver material. The specimens to be examined by the scanning electron microscope were fixed immediately in the operating room in a cold phosphate buffered 2% gluteraldehyde solution, washed with Ringers, post fixed in cold 1% osmic acid and dehydrated in graded alcohol. Specimens were transferred from alcohol to a series of increasing concentrations of ethyl alcohol and amyl acetate. The tissue was then critical point dried, secured to aluminum stubs and coated with gold, approximately 150A thick on a rotating stage in a vacuum evaporator. The specimens were then studied with the Kent-Cambridge S4-10 Scanning Electron Microscope at an accelerating voltage of 20KV.

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