scholarly journals Factors influencing the development of recurrence and continued growth of primary extramedullary tumors removed using Nd:YAG laser

2021 ◽  
Vol 18 (4) ◽  
pp. 91-100
Author(s):  
Ivan Alexeevich Eliseenko ◽  
Sergey Grigorievich Struts ◽  
Vitaliy Leonidovich Lukinov ◽  
Vyacheslav Vladimirovich Stupak
Keyword(s):  
Cauda Equina ◽  
Prognostic Indicator ◽  
Long Term Results ◽  
Clinical Factors ◽  
Primary Tumors ◽  
Extramedullary Tumor ◽  
Significant Prognostic Indicator ◽  
Primary Neoplasms ◽  
Grade Ii

Objective. To assess the significance of clinical factors of extramedullary tumors and new methods of their resection as potential predictors of their recurrence and continued growth.Material and Methods. The long-term results of removal of primary extramedullary tumors in 412 patients operated on in 1998–2014 were analyzed comparing the use of standard methods of microsurgical technique for tumor removal (277 patients) and of those with additional use of neodymium laser radiation (135 patients).Results. The use of laser technologies for resection of extramedullary tumors can significantly reduce the number of their recurrences and continued growth, along with other clinical factors is a significant prognostic indicator in determining the nature of the disease course and can be a predictor of their occurrence. The most reliable clinical factors determining the prognosis of a decrease in the incidence of recurrences and continued growth when using laser techniques of surgical resection were repeated operations (p = 0.002), the presence of ependymomas of the cone and cauda equina (p = 0.017), operations for primary tumors in the thoracic spine (p = 0.039) and extramedullary tumors with Grade I anaplasia (p = 0.007). An increase in the number of these conditions was associated with operations on the cervical spine (p = 0.027), the presence of a tumor with Grade II anaplasia (p = 0.007), and a primary extramedullary tumor involving more than three vertebrae (p = 0.017).Conclusion. The use of the laser is indicated for reoperations when removing neoplasms, that have arisen as a result of recurrence or continued growth of extramedullary tumors of any level and length after removal of primary neoplasms with a Grade I malignancy confirmed by intraoperative cytological examination involving no more than three vertebrae in the thoracic, lumbar and sacral spine and during resection of ependymomas with extramedullary growth.

Early matched sibling hematopoietic cell transplantation for adult AML in first remission using an age-adapted strategy: long-term results of a prospective GOELAMS study

Blood ◽  
2012 ◽  
Vol 119 (12) ◽  
pp. 2943-2948 ◽  
Author(s):  
Bruno Lioure ◽  
Marie C. Béné ◽  
Arnaud Pigneux ◽  
Anne Huynh ◽  
Patrice Chevallier ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Hematopoietic Cell Transplantation ◽  
Chronic Gvhd ◽  
Long Term Results ◽  
Younger Patients ◽  
First Remission ◽  
Matched Sibling ◽  
Grade Ii

Abstract The LAM2001 phase 3 trial, involving 832 patients with acute myeloid leukemia (AML; median: 46 years) proposed HLA-identical sibling allograft HSCT for all patients with an identified donor. The trial compared reduced-intensity conditioning (RIC) for patients older than 50 years of age (N = 47) and myeloablative conditioning for younger patients (N = 117). BM HSCT was performed in the younger patients, while the older ones received a consolidation course, followed by peripheral blood allo-HSCT using RIC. The incidence of grade II-IV acute GVHD, was 51.9% (95% confidence interval [CI]: 42.1-61.8) and 11.3% (1.6-21.2) after myeloablative or RIC, respectively (P < .0001) and that of chronic GVHD 45.8% (95% CI: 34.8-56.7) and 41.7% (24.7-58.6; NS). Cumulative incidence of nonrelapse mortality at 108 months was 15.8% (95% CI: 9.8-23.2) for myeloablative, and 6.5% (0.2-16.2) for RIC (NS). CI of relapse at 108 months was 21.7% (95% CI: 13.9-28.6) and 28.6% (16.5-43.4; NS). Overall survival at 108 months was 63.4% (95% CI: 54.6-72.2) and 65.8% (52.2-72.2), respectively, after myeloablative or RIC (NS). RIC peripheral blood stem cell allo-HSCT is prospectively feasible for patients between the ages of 51 and 60 years without excess of relapse or nonrelapse mortality, and compares favorably with myeloablative marrow allo-HSCT proposed to younger patients. This study was registered at clinicaltrials.gov as no. NCT01015196.

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
Keyword(s):  
Laser Radiation ◽  
Tumor Resection ◽  
Relative Number ◽  
Neodymium Laser ◽  
Long Term Results ◽  
Primary Tumors ◽  
Classical Technique ◽  
Long Term Follow Up ◽  
Microsurgical Techniques

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.

Infiltrating ependymomas of the cauda equina

1974 ◽  
Vol 41 (4) ◽  
pp. 446-448 ◽  
Author(s):  
Michael Scott
Keyword(s):  
Cauda Equina ◽  
Conservative Surgery ◽  
Long Term Results ◽  
Content Type ◽  
Radical Removal ◽  
Benign Course ◽  
Fine Print

✓ The author reports the long-term results of combined conservative surgery and radiotherapy in the treatment of three patients with infiltrating papillary ependymomas Of the cauda equina. Seventeen to 20 years later they have relatively minimal complaints and dysfunction. This long benign course emphasizes the folly of attempting radical removal with its potential for serious mutilation of the cauda equina.

Long-term results of surgical treatment for redundant roots of the cauda equina

1985 ◽  
Vol 78 (3-4) ◽  
pp. 105-107 ◽  
Author(s):  
A. Pau ◽  
S. Turtas ◽  
E. Sehrbundt Viale ◽  
M. Brambilla ◽  
G. Campus ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cauda Equina ◽  
Long Term Results

Long-term Results of Hemorrhoidal Artery Ligation

2016 ◽  
Vol 82 (3) ◽  
pp. 216-220
Author(s):  
İbrahim Yilmaz ◽  
Dursun ÖZgÜR Karakaş ◽  
İlker SÜCÜLlÜ
Keyword(s):  
Short Form ◽  
Long Term Results ◽  
Artery Ligation ◽  
Superior Rectal Artery ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
Grade Ii ◽  
Visual Analogous Scale

Aim of this study is to assess the efficacy, safety, and long-term results of doppler-guided hemorrhoidal artery ligation procedure with a 7-year follow-up period for treatment of grade II and III degree hemorrhoidal diseases. The procedure was performed by a specially designed proctoscope to locate and ligate all terminal branches of superior rectal artery. Patients were followed up at postoperative 1st week and 3rd, 12th, and 24th months by physical examination and 7th year by phone questionnaire using Short Form-36. Between November 2006 and May 2007, 50 patients (29 females, mean age = 38.2) underwent this procedure. All patients discharged at operation day and mean return to work was 2.5 days. There were no major complications and mean postoperative Visual Analogous Scale at first week was 1.72. At 24th month, 44 (88%) and 38 (76%) patients at 7th year were symptom free. Doppler-guided hemorrhoidal artery ligation is a safe, effective, and outpatient procedure, which can be the treatment of choice for second- and third-degree hemorrhoidal diseases with satisfactory long-term results.

scholarly journals Recent trends in management of haemorrhoids

2017 ◽  
Vol 4 (4) ◽  
pp. 1276
Author(s):  
S. Asif Ali ◽  
Mohammad Fazelul Rahman Shoeb
Keyword(s):  
Postoperative Complications ◽  
Fecal Incontinence ◽  
Long Term Results ◽  
Male Preponderance ◽  
Grade Ii ◽  
Recent Trends ◽  
Comparative Results ◽  
Dilatation Group ◽  
Clinical Conditions

Background: Haemorrhoids are common clinical conditions. Their treatment is one of the most challenging situations in the field of general surgery. In this study, we compared and evaluated the results and postoperative complications of Lords dilatation procedure and haemorrhoidectomy.Methods: The study evaluates comparative results of Lords dilatation procedure and haemorrhoidectomy. This study was conducted over a period of 1 year from January 1984 to December 1984. It includes 40 patients with haemorrhoids who attended surgical OPD of Krishnarajendra Hospital, Mysore. These 40 patients were selected randomly and divided into two groups of 20 patients each (Lords dilatation group and haemorrhoidectomy group). All parameters including clinical, physical and baseline investigations for all patients were recorded and finally analysed.Results: The age of the patients ranged from 20-70 years. Male preponderance was observed (7:1). The commonest symptoms were mass per rectum (90% and 85%) and bleeding P/R (85%), pain during defecation (85% and 70%) in Lords dilatation and haemorrhoidectomy groups respectively. Protoscopic examination revealed the presence of grade II haemorrhoids in most of the patients in both the groups, 45% and 65% respectively. Postoperative complications including pain, sphincter incontinence, bleeding and urinary retention is high in haemorrhoidectomy group as compared to Lords dilatation group. Recurrence of haemorrhoids (5%) and fecal incontinence (5%) was observed in Lords dilatation group after 6 months of treatment.Conclusions: Haemorrhoidectomy for treatment of hemorrhoids offers the best immediate and long term results compared to Lords dilatation. 

Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas

2009 ◽  
Vol 111 (5) ◽  
pp. 1069-1077 ◽  
Author(s):  
Pietro Scarone ◽  
Delphine Leclerq ◽  
Françoise Héran ◽  
Gilles Robert
Keyword(s):  
Contrast Enhancement ◽  
Long Term Results ◽  
Subtotal Resection ◽  
Mr Images ◽  
Superior Orbital Fissure ◽  
Simpson Grade ◽  
Grade Ii ◽  
Sphenoorbital Meningioma

Object The authors analyzed the long-term results and radiological aspects of sphenoorbital meningioma (with emphasis on exophthalmos) in a series of 30 patients who underwent resection. Methods Data obtained in all 30 patients who underwent surgery for typical sphenoorbital meningioma at the authors' institution between June 1994 and September 2005 were analyzed retrospectively. The exophthalmos index (EI) was measured on preoperative MR images and/or CT scans and compared between the early and last follow-up examinations. All patients were women 35–74 years of age (median 51 years). Exophthalmos was the presenting symptom in 28 patients (93%), and was observed on preoperative MR images in all patients. The median duration of symptoms before surgery was 10 months (2–120 months). Results Total resection (Simpson Grade I) was not achieved in these patients because of the impossibility of resecting the dura mater in the superior orbital fissure without causing significant complications. Subtotal resection (Simpson Grade II) was obtained in 90% of patients, and in 3 patients (10%) a portion of the tumor was deliberately left in place because of extensive macroscopic infiltration of the cavernous sinus and/or extraocular muscles (Simpson Grade III). No patient died. Radiological evaluation at a median follow-up of 61 months (range 17–136 months) showed no contrast enhancement in 14 patients (47%), residual contrast enhancement without evolution in 13 (43%), and recurrence (new contrast enhancement) in 3 (10%). The EI was improved at the first radiological follow-up (median 12 months) in 27 patients (90%), and at the last radiological follow-up (median 61 months) in 28 patients (93%). In the interval between the first and final imaging follow-up, the EI improved in only 8 patients (20%), worsened in 15 patients (50%), and showed no variation in 7 patients (30%). Conclusions Sphenoorbital meningiomas are insidious tumors with slow progression. Even when exophthalmos is not clinically evident, it is always present on preoperative MR imaging. Total resection is not possible due to superior orbital fissure invasion, but subtotal resection (Simpson Grade II) can assure long-term stability due to the nonevolutive nature of most residual tumors. Exophthalmos improves at early radiological follow-up, but may worsen again as time passes.

scholarly journals Balloon-assisted coiling of intracranial aneurysms using the Eclipse 2L double lumen balloon

2020 ◽  
Vol 26 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Raoul Pop ◽  
Oana Harsan ◽  
Ioan Martin ◽  
Dan Mihoc ◽  
Johann Sebastian Richter ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Posterior Circulation ◽  
Long Term Results ◽  
Complication Rates ◽  
Double Lumen ◽  
Unruptured Intracranial Aneurysms ◽  
Wide Range ◽  
Grade Ii

Background Eclipse 2L is a new double lumen balloon microcatheter for neurovascular use, with several design features that separate it from previous generation devices. We aimed to report our initial experience of balloon-assisted coiling of intracranial aneurysms using the Eclipse 2L balloon. Materials and methods Retrospective single-center review of patients who underwent balloon-assisted coiling with the Eclipse 2L balloon, for ruptured or unruptured intracranial aneurysms between 1 June 2016 and 31 December 2018. Cases with adjunctive use of stents and recurrences of previously embolized aneurysms were excluded. Patient files were used to extract aneurysm characteristics, complications, immediate and long-term results. Results We identified 120 patients with 126 aneurysms, of which 83 (65.8%) unruptured. Average aneurysm size was 5.9 mm (standard deviation 3.2 mm), with a dome-to neck-ratio of 1.7 (SD 0.6). Most aneurysms (79.3%) were wide necked. Immediate angiographic exclusion (Raymond-Roy grade I–II) was obtained in 95.1% of cases (81.7% grade I and 13.4% grade II). Procedural morbidity was 3.2% with no procedural mortality. Follow-up imaging was available for 115 aneurysms (91.2%). After an average follow-up period of 8.9 months (SD 7.3 months), 96.5% of aneurysms presented class I–II occlusion. Two aneurysms (1.7%) were retreated during follow-up. Conclusion Balloon-assisted coiling using the Eclipse 2L double lumen balloon is feasible for aneurysms in a wide range of locations in the anterior and posterior circulation. The angiographic results and complication rates compare favorably with previously published studies.

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