Incidence and Operative Excision of Presacral Masses: An Institutional Analysis

2015 ◽  
Vol 81 (12) ◽  
pp. 1237-1239
Author(s):  
David J. Hiller ◽  
Gregory S. Waters ◽  
Jaime L. Bohl
Keyword(s):  
Standard Deviation ◽  
Posterior Approach ◽  
Multimodality Imaging ◽  
Care Center ◽  
Tertiary Care ◽  
Digital Rectal Examination ◽  
Surgical Excision ◽  
Palpable Mass ◽  
Rectal Pain ◽  
Multiple Imaging

Presacral masses are rare lesions that encompass a broad range of pathologic findings. Most presacral masses are benign. The aim of this study was to analyze the clinical presentation, pathology, and surgical treatment of presacral masses at a single academic institution over a decade. In this retrospective study, we reviewed all surgically excised presacral tumors between 2003 and 2013. Clinical and pathologic data were recorded. Thirteen patients had surgical excision of a presacral mass. The median age was 42 years (standard deviation ± 19.7) and average follow-up was 11.9 months (standard deviation ± 17.5). The majority of patients were symptomatic. Forty-six per cent (6/13) had sacral or rectal pain. Thirty-eight per cent (5/13) of patients had a palpable mass on digital rectal examination. Sixty-nine per cent of patients had an MRI, 84.6 per cent a CT, and 61.5 per cent multimodality imaging. Most presacral masses were benign (10/13,77%). Twenty-three per cent (3/13) were malignant. A majority were excised via posterior approach (9/13, 69%), but 31 per cent (4/13) required an anterior or combined approach. Presacral masses are rare, even at a high-volume tertiary care center. They are commonly evaluated with a multiple imaging modalities, are most likely benign, and can be excised via posterior approach.

scholarly journals Surgical Management and Early Outcome of Encephalocele

2021 ◽  
Vol 10 (1) ◽  
pp. 42-45
Author(s):  
Prakash Kafle ◽  
Mohan Raj Sharma ◽  
Sushil Krishna Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Clinical Profile ◽  
Bony Defect ◽  
Female Ratio ◽  
Early Outcome ◽  
Good Outcome ◽  
Occipital Encephalocele

Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.

Voice and Swallowing Dysfunction in Neurofibromatosis 2

2017 ◽  
Vol 158 (3) ◽  
pp. 505-510 ◽  
Author(s):  
Simon R. Best ◽  
Julie Ahn ◽  
Shannon Langmead ◽  
Vaninder Dhillon ◽  
Alexander T. Hillel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Velopharyngeal Insufficiency ◽  
Neurofibromatosis 2 ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Swallowing Dysfunction

Objective Neurofibromatosis 2 (NF2) is a neuro-oncologic condition that presents with bilateral vestibular schwannomas of the cerebellopontine angle (CPA). Voice and swallowing impairment can occur from direct involvement or compression of the vagus nerve or as the result of surgical excision of CPA tumors. The objectives in this study are to (1) assess the prevalence of voice and swallowing impairments and (2) analyze the effects of vagal dysfunction in patients with NF2. Study Design Cross-sectional. Setting Academic tertiary care center. Subjects and Methods Patients at a neurofibromatosis center were mailed Voice Handicap Index and Sydney Swallow Questionnaire surveys. Stroboscopic, voice, and swallowing evaluations were performed for patients who elected to participate in screening exams. Results There were high rates of self-assessed and objective voice and swallowing handicaps in this population. Fourteen of 40 (35%) patients had a self-assessed voice handicap, and 20 of 40 (50%) patients had a self-assessed swallow handicap. Vocal fold motion impairment (VFMI) was observed in 22 of 31 (71%) patients examined, with 27 of 62 (44%) possible vocal cords affected. Velopharyngeal insufficiency (45%) and piriform sinus pooling or residue (39%) were seen in a significant percentage of patients. There was a significant relationship between vocal cord motion impairment and CPA surgical intervention ipsilateral to the impairment ( P = .002). The presence of VFMI was strongly associated with voice ( P = .002) and swallowing ( P = .01) impact on quality of life. Conclusion Speech and swallowing impairments are highly prevalent in patients with NF2, cause significant impact on quality of life, and are most commonly related to surgical interventions in the CPA region.

scholarly journals Endovascular Treatment of Right Heart Masses Utilizing the AngioVac System: A 6-Year Single-Center Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Aashish Katapadi ◽  
Lauren Richards ◽  
William Fischer ◽  
Suhail Q. Allaqaband ◽  
Tanvir Bajwa ◽  
...  
Keyword(s):  
Retrospective Studies ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Outcome Data ◽  
Right Heart ◽  
Vacuum Aspiration ◽  
System A ◽  
Risk Patients ◽  
Single Center Observational Study

Objective. To describe our institution’s experience with the AngioVac system. Background. Intracardiac and intravascular masses previously required surgical excision, but now, there are a number of minimally invasive options. With the advent of vacuum aspiration, more specifically the AngioVac System (AngioDynamics, NY, USA), there exists a system with both low mortality and minor complications. However, the number of retrospective studies remains limited. Outcome data for high-risk patients are also limited. Methods. Data were collected and analyzed in patients who underwent AngioVac therapy at our tertiary care center from January 2014 to December 2020. Results. Our results demonstrated a 93.3% intraoperative success rate and a 100% intraoperative survival rate. However, a number of complications, including but not limited to hematomas, anemia, and hypotension, occurred, as described below. Conclusions. Our experiences demonstrated good outcomes and continue to support the usefulness of the AngioVac System. The data also support the use of AngioVac as a treatment option for the debulking or removal of right heart masses in critically ill patients.

scholarly journals Extra-Gonadal Teratomas in Atypical Sites in Neonates and Children – Our Experience and Review of the Literature

2021 ◽  
pp. 1-7
Author(s):  
Biswanath Mukhopadhyay ◽  
Madhumita Mukhopadhyay ◽  
Kartik Chandra Mandal ◽  
Chhanda Das ◽  
Brati Mukhopadhyay ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Clinical Presentation ◽  
Care Center ◽  
Mature Teratoma ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Floor Of The Mouth ◽  
Retroperitoneal Tumors ◽  
Long Term Follow Up

Background: Extra-gonadal teratomas are rare tumors in Pediatric surgical practice. We studied the teratomas of atypical sites attended in our tertiary care center. Aim: Aim of the study was to find out the incidence of pediatric teratomas in atypical sites, clinical presentation and histological variation. Material and Methods: Over 15 years (January 2005 to December 2020), 29 cases of pediatric teratomas in atypical sites were studied. These sites included neck (number-one), retroperitoneum (number-fourteen), adrenal gland (number-two), renal (number-two), gastric(number-three), pancreas (number-one), pulmonary (number-one), floor of the mouth(number-one), oral (number-two), abdominal wall (numberone) and the mesentery (number-one). Patients were treated in the Department of Pediatric Surgery and specimens were reviewed in the Department of Pathology. Age, sex, clinical presentation, investigations (all patients had complete blood examination and alpha-fetoprotein) and imaging (USG of the local part and CECT as guided by the organ of involvement). Results: 29 pediatric teratomas in uncommon sites were reviewed. Out of 14 cases of retroperitoneal teratoma, three were immature. Cervical teratoma in a neonate was mature. Three cases of gastric teratomas were reported as mature. Two cases of adrenal teratomas also showed the histological features of mature teratoma. Renal teratomas (two) were benign. One each of pulmonary teratoma, pancreas and floor of the mouth were reported as mature. Two patients presented with oral teratoma were reported as mature teratomas. One patient had teratoma arising from the abdominal wall and was resected completely (mature teratoma). Teratoma arising from the mesentery also underwent complete resection. Conclusion: A small percentage of Pediatric teratomas occur in atypical sites. In our series, retroperitoneal tumors were predominant. Early surgical excision is the treatment of choice. Malignant change is known to occur in Pediatric teratoma and the patients need long term follow-up.

scholarly journals A clinical study involving anatomical distribution, pathological patterns and differentiation degrees in population with small bowel tumor

2019 ◽  
Vol 6 (7) ◽  
pp. 2401
Author(s):  
Anil Akulwar ◽  
Akshay Akulwar ◽  
Siddarth Rao ◽  
Ravinder Narang
Keyword(s):  
Small Bowel ◽  
Bowel Wall ◽  
Care Center ◽  
Tertiary Care ◽  
Socioeconomic Background ◽  
Wall Thickening ◽  
Palpable Mass ◽  
Female Ratio ◽  
Causative Agents ◽  
Bowel Wall Thickening

Background: Occurrence of tumor of small bowel is very rare but the burden is in growing state in both more and less economically countries because of consumption of tobacco chewing by youngsters.Methods: The present studies include diagnosis and treatment of patients reported at tertiary care center of each districts of Vidarbha region and nearby districts for a schedule of six years.Results: Data refers to female predilection with male to female ratio of 0.75:1. The mean age of incidence for men and women recorded were 35±20.23 and 57±17.91 years respectively. Pain in abdomen was recorded as primary sign in 92.86% cases along with change in bowel habits in 85.71%. Anemia found was related to loss of weight and appetite. Melena and diarrhea were also significant in 65.29 and 14.95% of patients along with presence of mucus in stool in one patient. Pallor and palpable mass in abdomen was characteristic in 42.86% and 14.29% cases. Bowel wall thickening in 71.4% and bowel mass in 28.6% were examined by computer tomography. Intra-abdominal lymphadenopathy along with bowel wall thickening and bowel mass were noticed in one patient. Liver secondary were seen in 3 patients (21.43%). Ileum was most susceptible site of tumor with development of adenocarcinoma malignancy.Conclusions: Improvement in socioeconomic background, literacy and awareness regarding causative agents helps to control percentage of incidence.

scholarly journals A clinical study involving anatomical distribution, pathological patterns and differentiation degrees in population with small bowel tumor

2018 ◽  
Vol 6 (1) ◽  
pp. 149
Author(s):  
Akshay Akulwar ◽  
Anil Akulwar ◽  
Siddarth Rao ◽  
Ravinder Narang
Keyword(s):  
Small Bowel ◽  
Bowel Wall ◽  
Care Center ◽  
Tertiary Care ◽  
Socioeconomic Background ◽  
Wall Thickening ◽  
Palpable Mass ◽  
Female Ratio ◽  
Causative Agents ◽  
Bowel Wall Thickening

Background: Occurrence of tumor of small bowel is very rare but the burden is in growing state in both more and less economically countries because of consumption of tobacco chewing by youngsters.Methods: These studies include diagnosis and treatment of patients reported at tertiary care center of each districts of Vidarbha region and nearby districts for a schedule of six years.Results: Data refers to female predilection with male to female ratio of 0.75:1. The mean age of incidence for men and women recorded were 35+/-20.23 and 57+/-17.91 years respectively. Pain in abdomen was recorded as primary sign in 92.86% cases along with change in bowel habits in 85.71%. Anemia found was related to loss of weight and appetite. Malena and diarrhea were also significant in 65.29 and 14.95% of patients along with presence of mucus in stool in one patient. Pallor and palpable mass in abdomen were characteristic in 42.86% and 14.29% cases. Bowel wall thickening in 71.4% and bowel mass in 28.6% were examined by computer tomography. Intra-abdominal lymphadenopathy along with bowel wall thickening and bowel mass were noticed in one patient. Liver secondaries were seen in 3 patients (21.43%). Ileum was most susceptible site of tumor with development of adenocarcinoma malignancy.Conclusions: Improvement in socioeconomic background, literacy and awareness regarding causative agents helps to control percentage of incidence.

Hip Dysplasia Is Not More Common in W-Sitters

2020 ◽  
Vol 59 (12) ◽  
pp. 1074-1079
Author(s):  
Susan A. Rethlefsen ◽  
Nicole M. Mueske ◽  
Alexander Nazareth ◽  
Oussama Abousamra ◽  
Tishya A. L. Wren ◽  
...  
Keyword(s):  
Cohort Study ◽  
Standard Deviation ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hip Dysplasia ◽  
Care Center ◽  
Tertiary Care ◽  
Online Resources ◽  
Tertiary Care Center ◽  
Negative Effects

Parents are frequently cautioned by therapists, teachers, physicians, and online resources about potential negative effects of w-sitting in children (including hip dysplasia), despite lack of evidence. To examine relationships between w-sitting and hip dysplasia, a prospective cohort study was conducted of 104 patients (196 hips), aged 9.9 (standard deviation = 5.7) years, who underwent hip/pelvis radiography at a pediatric tertiary care center. Measures of hip dysplasia were taken from radiographs. Parents/patients completed a questionnaire regarding the patients’ sitting habits. Associations between hip dysplasia and w-sitting were analyzed statistically. About 48/104 parents/patients (46%) reported current or past w-sitting: 11/104 (11%) current, preferred position; 23/104 (22%) current, nonpreferred position, 14/104 (13%) w-sat in past, and 56/104 (54%) never w-sat. There was no difference in measures of hip dysplasia ( P > .12) or hip dysplasia frequency between w-sitters (9%) and non-w-sitters (10%; P = .81), or among w-sitting persistence groups ( P = .26). W-sitting in children is not associated with hip dysplasia.

Sign in / Sign up

Export Citation Format

Share Document