scholarly journals Influence of neodymium laser radiation on the frequency of recurrence and continued growth of extramedullary tumors

2021 ◽  
Vol 18 (3) ◽  
pp. 77-85
Author(s):  
I. A. Eliseenko ◽  
S. G. Struts ◽  
V. V. Stupak

Objective. To assess the effect of neodymium laser radiation on the recurrence rate and continued growth of primary extramedullary tumors on the basis of clinical data obtained in the long-term follow-up period in operated patients with extramedullary tumors.Material and Methods. The long-term results of surgical treatment of two groups of patients (n = 412) with primary extramedullary tumors operated on from 1998 to 2014 were studied and systematized. Patients of comparison group (n = 277; 67.2 %) underwent removal of tumors using standard microsurgical techniques, and the neoplasms in patients of the study group (n = 135; 32.8 %) were removed with additionally used neodymium (Nd:YAG) laser.Results. The use of the developed laser technologies for the resection of extramedullary intracanal primary tumors made it possible to reliably reduce the relative number of recurrence and continued growth from 11.1 % to 1.2% compared with patients treated with standard surgery methods. The proportion of recurrences was 3.5 %, all of them were detected only in the group with the classical technique of tumor resection (p <0.01).Conclusion. The use of a neodymium laser as an additional technology to the classical microsurgical resection of extramedullary tumors is effective for the prevention of their recurrence and continued growth.

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 424 ◽  
Author(s):  
Shang-Yu Wang ◽  
Chiao-En Wu ◽  
Chun-Chi Lai ◽  
Jen-Shi Chen ◽  
Chun-Yi Tsai ◽  
...  

Background: Neoadjuvant imatinib therapy has been proposed for routine practice with favorable long-term results for patients with locally advanced gastrointestinal stromal tumors (GISTs). However, clarification of the optimal duration, safety, and oncological outcomes of neoadjuvant imatinib use before surgical intervention remains necessary. Methods: We prospectively analyzed the treatment outcomes of 51 patients with locally advanced, nonmetastatic GISTs treated with neoadjuvant imatinib followed by surgery. The optimal duration was defined as the timepoint when there was a <10% change in the treatment response or a size decrease of less than 5 mm between two consecutive computed tomography scans. Results: Primary tumors were located in the stomach (23/51; 45%), followed by the rectum (17/51; 33%), ileum/jejunum (9/51; 18%), and esophagus (2/51; 4%). The median maximal shrinkage time was 6.1 months, beyond which further treatment may not be beneficial. However, the maximal shrinkage time was 4.3 months for the stomach, 8.6 months for the small bowel and 6.9 months for the rectum. The R0 tumor resection rate in 27 patients after neoadjuvant imatinib and surgery was 81.5%, and 70.4% of resection procedures succeeded in organ preservation. However, 10 of 51 patients (19.6%) had complications following neoadjuvant imatinib use (six from imatinib and four from surgery). Conclusion: Our analysis supports treating GIST patients with neoadjuvant imatinib, which demonstrated favorable long-term results of combined therapy. However, careful monitoring of complications is necessary. The optimal duration of neoadjuvant imatinib use before surgical intervention is, on average, 6.1 months.


2021 ◽  
Author(s):  
Marta Aguilar Pérez ◽  
Elina Henkes ◽  
Victoria Hellstern ◽  
Carmen Serna Candel ◽  
Christina Wendl ◽  
...  

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.


2021 ◽  
Vol 11 (1) ◽  
pp. 204589402098639
Author(s):  
Wu Song ◽  
Long Deng ◽  
Jiade Zhu ◽  
Shanshan Zheng ◽  
Haiping Wang ◽  
...  

Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis is often delayed, and optimal treatment remains unclear. The aim of this study is to report our experience in the surgical management of this disease. Between 2000 and 2018, 17 patients underwent operations for PAS at our center. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, the postoperative outcomes, and the long-term results. The mean age at operation was 46.0 ± 12.4 years (range, 26–79 years), and eight (47.1%) patients were male. Six patients underwent tumor resection alone, whereas the other 11 patients received pulmonary endarterectomy (PEA). There were two perioperative deaths. Follow-up was completed for all patients with a mean duration of 23.5 ± 17.6 months (1–52 months). For all 17 patients, the median postoperative survival was 36 months, and estimated cumulative survival rates at 1, 2, 3, and 4 years were 60.0%, 51.4%, 42.9%, and 21.4%, respectively. The mean survival was 37.0 months after PEA and 14.6 months after tumor resection only ( p = 0.046). Patients who had no pulmonary hypertension (PH) postoperatively were associated with improved median survival (48 vs. 5 months, p = 0.023). In conclusion, PAS is often mistaken for chronic pulmonary thromboembolism. The prognosis of this very infrequent disease remains poor. Early detection is essential for prompt and best surgical approach, superior to tumor resection alone, and PEA surgery with PH relieved can provide better chance of survival.


2008 ◽  
Vol 19 (10) ◽  
pp. 1074-1080 ◽  
Author(s):  
Matteo Chiapasco ◽  
Giacomo Colletti ◽  
Eugenio Romeo ◽  
Marco Zaniboni ◽  
Roberto Brusati

2018 ◽  
Vol 1 (1) ◽  
pp. 27-30
Author(s):  
Mihaela Olaru ◽  
Cornelia Nitipir

AbstractMyxofibrosarcoma or myxoid malignant fibrous histiocytoma is one of the most common sarcomas of the limb. It is usually treated multimodally. Most frequent sites of metastasis are the bone, lung and lymph nodes. The present paper is a case report of a 65-year-old male with myxofibrosarcoma of the fibularis longus muscle, for which he first underwent surgery - tumor resection with appropriate margins. The tumor was staged pT2b cN0 cM0. Postoperative PET-CT revealed metabolically inactive pulmonary nodules. Two months after surgery, he underwent adjuvant radiotherapy, a total dose of 60 Gy and 6 courses of chemotherapy (doxorubicin and ifosfamide). Pulmonary nodules have been stationary on all subsequent imagistic studies. He is free of recurrence on long-term follow-up.


2020 ◽  
Vol 7 (12) ◽  
pp. 189-198
Author(s):  
Zeynep Başağaoğlu Demirekin ◽  
Yavuz Findik ◽  
S. Süha Turkaslan ◽  
Timuçin Baykul ◽  
Merve Erken

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Mirzafaraz Saeed ◽  
Hari Hullur ◽  
Amro Salem ◽  
Abbas Ali ◽  
Yousif Sahib ◽  
...  

Introduction. The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Methods. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results. There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F=19.8, p<0.001 and F=8.9, p=0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F=8.5, p=0.019 and F=8.3, p=0.013, resp.). Conclusion. Early surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.


2018 ◽  
Vol 52 (5) ◽  
pp. 335-343 ◽  
Author(s):  
Federico Fontana ◽  
Edoardo Macchi ◽  
Filippo Piacentino ◽  
Larissa Nocchi Cardim ◽  
Giuseppe De Marchi ◽  
...  

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.


Neurosurgery ◽  
2006 ◽  
Vol 58 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Iris Zachenhofer ◽  
Stefan Wolfsberger ◽  
Martin Aichholzer ◽  
Alexander Bertalanffy ◽  
Karl Roessler ◽  
...  

Abstract OBJECTIVE: Surgical resection of cranial base meningiomas is often limited owing to involvement of crucial neural structures. Within the last 2 decades Gamma Knife radiosurgery (GKRS) has gained increasing importance as an adjunct treatment after incomplete resection and as an alternative treatment to open surgery. However, reports of long-term results are still sparse. We therefore performed this study to analyze the long-term results of GKRS treatment of cranial base meningiomas, following our previously published early follow-up experience. METHODS: A retrospective analysis of the medical files for Gamma Knife and surgical treatments, clinicoradiological findings, and outcome was carried out focusing on tumor control, clinical course, and morbidity. RESULTS: Between 1992 and 1995, we treated 36 patients with cranial base meningiomas using GKRS (male:female ratio, 1:5; mean age, 59 yr; range, 44–89 yr). Twenty-five patients were treated with GKRS after open surgery, and 11 patients received GKRS alone. Tumor control, neurological outcomes, and adverse effects were analyzed after a long-term follow-up period (mean, 103 mo; range, 70–133 mo) and compared with our previous results after an early follow-up period (mean, 48 mo; range, 36–76 mo). Control of tumor growth was achieved in 94% of patients. Compared with the early follow-up period, the late neuroradiological effects of GKRS on cranial base meningiomas were continuing tumor shrinkage in 11 patients (33%), stable tumor size in 20 patients (64%) and tumor progression in two meningiomas (6%). The neurological status improved in 16 patients (44%), remained stable in 19 patients (52%), and deteriorated in one patient (4%). Adverse side effects of GKRS were found only during the early follow-up period. CONCLUSION: Our data confirm that GKRS is not only a safe and effective treatment modality for cranial base meningiomas in short-term observation, but also in a mean long-term follow-up period of more than 8 years. Tumor shrinkage and clinical improvement also continued during the longer follow-up period.


Sign in / Sign up

Export Citation Format

Share Document