Staged Operations: The Equilibrium Stage

2007 ◽  
pp. 323-408
Keyword(s):  
Staged Operations

scholarly journals Anaplastic pilocytic astrocytoma of the cerebellum presenting with conus medullaris drop metastasis

2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Jared F. Sweeney ◽  
Vaibhav Chumbalkar ◽  
Michael D. Staudt ◽  
Pouya Entezami ◽  
Jiang Qian ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Complete Understanding ◽  
First Case ◽  
Spine Imaging ◽  
Drop Metastasis ◽  
Cerebellar Mass ◽  
Definition Of ◽  
Staged Operations

Due to its rarity, a complete understanding of the clinical behavior, pathogenesis, and diagnostic definition of anaplastic pilocytic astrocytoma (APA) is currently lacking. The optimal clinical management and use of adjuvant therapies has yet to be defined. We present a 64 year-old-female with progressive headaches, dysarthria, and ataxia, who was found to have right cerebellar mass. A gross total resection was achieved through two staged operations. Pathology demonstrated focal areas of necrosis, tumor infiltration, and increased mitotic activity most consistent with APA. Adjuvant chemotherapy and stereotactic radiosurgery were administered. Approximately two years later, the patient presented with symptoms of cauda equina syndrome, and lumbar spine imaging demonstrated a large intradural mass at the conus medullaris with diffuse leptomeningeal enhancement. A biopsy was performed and was consistent with metastatic APA. APA may rarely progress to metastatic disease, most frequently involving the leptomeninges of the posterior fossa and cervical spine. This report represents the first case of metastases distal to the cervicomedullary junction.

scholarly journals Hypoplastic left heart syndrome: from fetus to fontan

2018 ◽  
Vol 28 (11) ◽  
pp. 1275-1288 ◽  
Author(s):  
Peter P. Roeleveld ◽  
David M. Axelrod ◽  
Darren Klugman ◽  
Melissa B. Jones ◽  
Nikhil K. Chanani ◽  
...  
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Care Management ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Critical Care Management ◽  
Cardiac Intensive Care ◽  
Left Heart Syndrome ◽  
Staged Operations ◽  
Cavopulmonary Connection ◽  
Undergo Heart Transplantation

AbstractThe care of children with hypoplastic left heart syndrome is constantly evolving. Prenatal diagnosis of hypoplastic left heart syndrome will aid in counselling of parents, and selected fetuses may be candidates forin uterointervention. Following birth, palliation can be undertaken through staged operations: Norwood (or hybrid) in the 1st week of life, superior cavopulmonary connection at 4–6 months of life, and finally total cavopulmonary connection (Fontan) at 2–4 years of age. Children with hypoplastic left heart syndrome are at risk of circulatory failure their entire life, and selected patients may undergo heart transplantation. In this review article, we summarise recent advances in the critical care management of patients with hypoplastic left heart syndrome as were discussed in a focused session at the 12th International Conference of the Paediatric Cardiac Intensive Care Society held on 9 December, 2016, in Miami Beach, Florida.

New simple low-cost surgical approach to complex jejuno-ileal atresia

2020 ◽  
Vol 50 (2) ◽  
pp. 124-129
Author(s):  
Pradyumna Pan
Keyword(s):  
Surgical Treatment ◽  
Low Cost ◽  
Distal Segment ◽  
Necrotising Enterocolitis ◽  
Ileal Atresia ◽  
Feeding Jejunostomy ◽  
Tertiary Centre ◽  
Tube Plugging ◽  
Second Procedure ◽  
Staged Operations

We report our experience of staged operations in the surgical treatment of complex jejuno-ileal atresia. Our study examined transgastric deflation of the proximal segment and feeding jejunostomy through the distal segment as a first stage followed by a definitive restoration of continuity secondarily at a tertiary centre over a period of three years. A cohort of 21 cases were studied. None suffered with intestinal perforation or volvulus. Tube plugging was seen in three patients who were relieved by flushing. Tube replacement was not required. One patient developed necrotising enterocolitis and died. Sepsis was seen in three. The age at the second operation was 56.2 ± 6.6 days. There was no complication after this second procedure. We therefore recommend this staged management for complex jejuno-ileal atresia, but suggest further studies.

Staged Operations for a Crawford Type II Thoracoabdominal Aortic Aneurysm With Subacute Contained Rupture and Massive Right Hemothorax

2006 ◽  
Vol 20 (3) ◽  
pp. 401-404
Author(s):  
Michal Miller ◽  
Edward A. Pascoe ◽  
Randolph P. Guzman ◽  
Ian R. Thomson ◽  
Robert M. Friesen
Keyword(s):  
Aortic Aneurysm ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Type Ii ◽  
Staged Operations

An 18-year experience in total colonic aganglionosis: from staged operations to primary laparoscopic endorectal pull-through

2009 ◽  
Vol 44 (12) ◽  
pp. 2352-2354 ◽  
Author(s):  
Sing-Tak Cheung ◽  
Yuk-Him Tam ◽  
Hoi-Man Chong ◽  
Kin-Wai Chan ◽  
Wai-Cheung Mou ◽  
...  
Keyword(s):  
Total Colonic Aganglionosis ◽  
Pull Through ◽  
Staged Operations

Treatment Failure and Leg Amputation Among Patients With Foot Osteomyelitis

2016 ◽  
Vol 15 (4) ◽  
pp. 303-312 ◽  
Author(s):  
Neal R. Barshes ◽  
Cezarina Mindru ◽  
Chester Ashong ◽  
Maria Rodriguez-Barradas ◽  
Barbara W. Trautner
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Cox Regression ◽  
Consensus Definition ◽  
Primary Wound Closure ◽  
Lower Treatment ◽  
Artery Disease ◽  
Leg Amputation ◽  
Staged Operations

We sought to identify factors associated with treatment failure and leg amputations among those patients who presented with foot osteomyelitis. Characteristics, treatments, and outcomes for all patients treated for probable or definite foot osteomyelitis (per consensus definition) between January 2011 and March 2015 were reviewed. Multivariate Cox regression models were used to identify risk factors for treatment failure (unanticipated resection of additional bone or leg amputation) and of leg amputation alone. A total of 184 episodes of foot osteomyelitis met inclusion criteria. Treatment failure occurred in 53 (28.8%) and leg amputation in 21 (11.4%). Risk factors for treatment failure included severe/unaddressed peripheral artery disease, homelessness, Pseudomonas aeruginosa or Escherichia coli bone isolates, serum albumin <2.8 mg/dL, hallux involvement, insulin therapy, 60 or more pack-years smoking, and <7 days of directed antibiotic therapy for a positive bone margin. Delayed primary wound closure (ie, staged operations) had significantly lower treatment failure risk. Unanticipated resection of bone was not associated with leg amputation. Foot osteomyelitis treatment failure is common. Various factors can help identify those at risk for treatment failure and/or leg amputation, and further studies should focused whether initial management or follow-up should change when these factors are present.

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