scholarly journals Cerebellar metastases – may surgery play a role in the presence of multiple lesions?

2017 ◽  
Vol 31 (2) ◽  
pp. 152-160
Author(s):  
M. Dabija ◽  
V. Dorobăţ ◽  
Alina Paiu
Keyword(s):  
Surgical Treatment ◽  
Life Expectancy ◽  
Operative Time ◽  
Oncological Surgery ◽  
Effective Treatment Option ◽  
Oncological Patients ◽  
Intracranial Metastases ◽  
Cerebellar Lesions ◽  
One Year

Abstract Brain metastases are the most common form of malignancy presence in the CNS having a more frequent appearance than primary brain tumors. Although secondary cerebellar tumors represent only 15% of all intracranial metastases, they are quite frequent among primary oncological patients and pose a challenge for all of the medical caretakers starting with the neurosurgeon. Among those, a small percent of patients have multiple cerebellar lesions and the therapeutic challenge turns into a medical controversy, especially when it comes to surgical treatment taking into consideration that the life expectancy is lower than one year. A key asset which we have on our side is the anatomical vicinity these lesions occur, this leading us to take into consideration eliminating as many lesions in one single operative time as possible without changing the position of the head during surgery. Based on a retrospective study which concluded that patients with resection of all lesions tend to have a longer life expectancy, and on modern concepts of risks and benefits of oncological surgery and surgery in general, we followed up on three patients presenting posterior and even multiple posterior fossa metastases, taking into consideration individual comorbidities, tumor aspects and the possibility/opportunity of surgical treatment. It turned out that surgery is a safe and effective treatment option and should not be considered harmful or aggressive especially because all of the patients which were under study had a favorable post-operative prognostic and an improved quality of life. We emphasize furthermore the importance of complete lesion resection in as few interventions as possible followed up by radiotherapy/chemotherapy as a key in prolonging these patients life expectancy taking into consideration that the outcome is directly related to the number of lesions rather to the location or volume of them.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

scholarly journals Diagnostic criteria and result of treatment of Eagle syndrome

2020 ◽  
pp. 80-86
Author(s):  
Sergey M. Pukhlik ◽  
Anatoly P. Shchelkunov ◽  
A.A. Shchelkunov
Keyword(s):  
Surgical Treatment ◽  
Clinical Signs ◽  
Symptomatic Treatment ◽  
Styloid Process ◽  
Diagnostic Methods ◽  
Number Of Patients ◽  
Facial Area ◽  
One Year ◽  
Conservative And Surgical Treatment

Relevance: Styloid process syndrome – a disease which is caused by irritation of the styloid process of the temporal bone surrounding the nerve, vascular and muscle structures. The syndrome is manifested by chronic painin deep division of the facial area referred to the root of the tongue, throat and ear, dysphagia, symptoms of circulatory disorders of the brain. Because of the low awareness of the disease practical specialists usually miss the diagnoses. Patients with different diagnoses are treated by different specialists; most often the prescribed symptomatic treatment is ineffective or does not give any result at all. The syndrome causes severe suffering to patients, reduces the quality of life. Purpose of the study: Assess the most significant clinical signs of the disease, mutual work between hypertrophied styloid process with the neurovascular neck formations, the effectiveness of conservative and surgical treatment. Materials and methods: 144 people were examined and treated by us. Of these, 103 women (71,5%), 41 men (28,5%), aged 25 to 70 years. The disease lasts from one year until 10-15 years. Tomography of the styloid processes with 3D reconstruction and contrasting of the main vessels of the neck was used. Results of the study and the discussion: we proposed a grading scale for the quality of the treatment, the five-point scale. The quality of the treatment was assessed by the number of reduction in scores and, accordingly, patient complaints. Of the total number of patients – 144 people, the success of the treatment by 0 points was assessed by 60 people (that is, absence of any symptomatology) (41,7%), 1 point – 44 (30,5%), 2-3 points – 27 (18,7%), 4-5 points – 13 (9%), that is significant effect of the treatment was not achieved. To all those people with the result of the treatment was estimated at 4-5 points, respectively, was proposed an operative method of the treatment – the resection of the styloid process from the corresponding side. Conclusions: Because of the lack of knowledge of such important topic it is necessary to improve diagnostic methods. Hypertrophy of the styloid process is not the main reason of the development of styloid syndrome; the degree of deviation of the process is important. Conservative treatment in most cases has a lasting effect, but has repeated symptoms after a certain period of time; surgical treatment should be directed to the maximal resection of styloid process for decreasing the axis pressure on the neurovascular bundle of the neck.

scholarly journals LUMBAR SPINAL STENOSIS: EVALUATION OF PAIN AND LIFE QUALITY AFTER SURGICAL TREATMENT

2019 ◽  
Vol 18 (1) ◽  
pp. 37-42
Author(s):  
Gustavo Alvarenga ◽  
João Otávio Araújo Rotini ◽  
Leonardo Yukio Jorge Asano ◽  
Vinícius Alves de Andrade ◽  
André Evaristo Marcondes Cesar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Life Quality ◽  
Case Series ◽  
Level Of Evidence ◽  
The Mean ◽  
One Year ◽  
Lumbar Spinal

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.

scholarly journals Metastatic Spine Disease: Should Patients With Short Life Expectancy Be Denied Surgical Care? An International Retrospective Cohort Study

Neurosurgery ◽  
2019 ◽  
Vol 87 (2) ◽  
pp. 303-311 ◽  
Author(s):  
Nicolas Dea ◽  
Anne L Versteeg ◽  
Arjun Sahgal ◽  
Jorrit-Jan Verlaan ◽  
Raphaële Charest-Morin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Life Expectancy ◽  
Performance Status ◽  
Spinal Metastases ◽  
Post Treatment ◽  
Baseline Performance ◽  
Significant Difference

Abstract BACKGROUND Despite our inability to accurately predict survival in many cancer patients, a life expectancy of at least 3 mo is historically necessary to be considered for surgical treatment of spinal metastases. OBJECTIVE To compare health-related quality of life (HRQOL) in patients surviving <3 mo after surgical treatment to patients surviving >3 mo to assess the validity of this inclusion criteria. METHODS Patients who underwent surgery for spinal metastases between August 2013 and May 2017 were retrospectively identified from an international cohort study. HRQOL was evaluated using generic and disease-specific outcome tools at baseline and at 6 and 12 wk postsurgery. The primary outcome was the HRQOL at 6 wk post-treatment measured by the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ). RESULTS A total of 253 patients were included: 40 patients died within the first 3 mo after surgery and 213 patients survived more than 3 mo. Patients surviving <3 mo after surgery presented with lower baseline performance status. Adjusted analyses for baseline performance status did not reveal a significant difference in HRQOL between both groups at 6 wk post-treatment. No significant difference in patient satisfaction at 6 wk with regard to their treatment could be detected between both groups. CONCLUSION When controlled for baseline performance status, quality of life 6 wk after surgery for spinal metastasis is independent of survival. To optimize improvement in HRQOL for this patient population, baseline performance status should take priority over expected survival in the surgical decision-making process.

scholarly journals Intersphincteric Resection for Low Rectal Cancer – Case Report

2016 ◽  
Vol 62 (1) ◽  
pp. 142-145
Author(s):  
Cristian Russu ◽  
Călin Molnar ◽  
Sanda Maria Copotoiu ◽  
Claudiu Sărăcuț ◽  
Mircea Gherghinescu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Multimodality Treatment ◽  
Functional Results ◽  
Radical Resection ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Cancer Case ◽  
One Year

Abstract Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

scholarly journals Management of symptomatic epilepsy after surgery due to drug resistance

2021 ◽  
Vol 17 (3) ◽  
pp. 18-24
Author(s):  
A.Ye. Dubenko ◽  
M.V. Naboka
Keyword(s):  
Drug Resistance ◽  
Surgical Treatment ◽  
Drug Treatment ◽  
Clinical Situation ◽  
Evidence Base ◽  
Symptomatic Epilepsy ◽  
Drug Resistant Epilepsy ◽  
One Year ◽  
Ilae Classification

The issue of managing patients who were operated due to drug resistance has not been accomplished not only in Ukraine, but throughout the world. But these patients exist, their number is growing, and the neurologists who observe them need a direct understanding of this process. Nowadays, there is no enough evidence base to substantiate rational recommendations regarding the post-surgical drug treatment. Despite the fact that the International League Against Epilepsy (ILAE) classification and the classification previously proposed by J. Engel Jr have many headings that indicate the improvement of patients and possible improvement in their quality of life, the treatment that has achieved seizure control can be considered successful only in patients who meet qualification point 1 according to the ILAE classification or IA according to the Engel classification, and only those who meet these criteria for at least one year. This understanding is very important when choosing further therapeutic management. Taking into account the fact that after surgical treatment the drug resistance should be overcome, further drug treatment should be carried out in the same way as in patients without drug resistant epilepsy. The issue of managing people with epilepsy who received surgical treatment due to drug resistance requires further studies, especially in the context of an increase in the number of such patients. The authors indicate that all the questions and aspects that were presented in the work are controversial and can be adjusted depending on the clinical situation.

scholarly journals SURG-43. APPLICATIONS AND RESTRICTION OF 980NM DIODE LASER FOR BRAIN TUMOR MICROSURGERY - A PIONEER CASE SERIES AND A CRITICAL REVIEW

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii212-ii212
Author(s):  
Aline Campos Paiva ◽  
João Luiz Vitorino Araujo ◽  
Renan Lovato ◽  
Márcio Krambek ◽  
José Esteves Veiga
Keyword(s):  
Brain Tumor ◽  
Blood Loss ◽  
Diode Laser ◽  
Operative Time ◽  
Case Series ◽  
Special Focus ◽  
Extensive Literature ◽  
Oncological Patients ◽  
Adjacent Structures

Abstract BACKGROUND Quality of life is essential for oncological patients. There are several tools that help surgery become more precise with less morbidity. Diode laser can cut and coagulate through thermal effect being helpful during surgery. It is a precise and useful technology that improves outcomes in neurooncology. OBJECTIVES To describe a pioneer case series of oncological use of diode laser and main applications of several types of laser in neurooncology. METHODS Detailed description of a pioneer case series of oncological patients that undergone to neurosurgical laser assisted procedures. An interventional longitudinal prospective study was conducted. Patients that had as mainly hypothesis the diagnosis of glioma or meningioma were selected. Also it was performed an extensive literature review about lasers in neurosurgery with special focus in diode laser. RESULTS There was not any paper describing the use of diode laser in neurooncology. The 980nm diode laser was used in 15 patients. The device had an easy handling. Decreased intra-operative time for hemostasis, lesser blood loss requiring less blood transfusion was observed. No post-operative complications occurred. CONCLUSIONS Diode laser is a useful tool for brain tumor surgery especially concerning hemostasis, providing decreased blood loss with lesser intra-operative duration. Surgical site coagulation is more effective causing less damage to adjacent structures specially in gliomas near eloquent regions. We consider this technique as a suitable adjuvant therapy for brain tumor surgeries providing an excellent hemostasis and helping cutting and vaporize lesion. This device makes surgery safer and decrease oncological morbidity.

scholarly journals Quality of Life in Women Subjected to Surgical Treatment of Breast Cancer Depending on the Procedure Performed within the Breast and Axillary Fossa—A Single-Center, One Year Prospective Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1339
Author(s):  
Magdalena Tarkowska ◽  
Iwona Głowacka-Mrotek ◽  
Tomasz Nowikiewicz ◽  
Aleksander Goch ◽  
Wojciech Zegarski
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
One Year

The aim of this study was to evaluate the quality of life of patients undergoing surgical treatment of breast cancer depending on the type of procedure involving the breast (mastectomy vs. breast conserving treatment) and axillary fossa (sentinel lymph node biopsy vs. axillary lymph node dissection). The prospective study was carried out in a group of 338 females undergoing breast cancer treatment. Study variables were assessed by means of a diagnostic survey using standardized QLQ C30 and BR23 questionnaires as well as the Acceptance of Illness Scale and Mini-MAC scales. The quality of life was assessed at threetime points: on the day before the surgical procedure (I assessment) as well as three and 12 months after surgery (II and III assessment). Statistically significant differences between study groups were observed in the overall quality of life subscale (I, II, III—p < 0.0001), physical functioning (I—p < 0.0001; II—p = 0.0413; III—p < 0.0001), role functioning (I—p = 0.0002; III—p < 0.0001), emotional functioning (III—p = 0.0082), cognitive functioning (I—p = 0.0112; III—p < 0.0001), social functioning (III—p < 0.0001), body image (I, II, III—p < 0.0001), and sexual functioning (I—p = 0.0233; III—p = 0.0011). In most symptomatic scales, significant (p < 0.05) differences were also noted. Mastectomy and limfadenectomy patients were significantly (p < 0.0001) more prone to present with destructive coping strategies one year after surgery. Breast conserving therapy is associated with better quality of life outcomes as compared to mastectomy. Sentinel lymph node biopsy is associated with a lower intensity of adverse changes in multiple dimensions of patients’ functioning.

scholarly journals Bariatric surgery: impact on sexuality of the obese person

2014 ◽  
Vol 41 (6) ◽  
pp. 412-420 ◽  
Author(s):  
Maria Luiza Lobato Mariano ◽  
Maria Angela Boccara de Paula ◽  
Deomir Germano Bassi ◽  
Pedro Roberto de Paula
Keyword(s):  
Surgical Treatment ◽  
Quantitative Research ◽  
Female Sexuality ◽  
Obese Person ◽  
Individual Interviews ◽  
Treatment Of Obesity ◽  
One Year ◽  
The Impact ◽  
Surgical Treatment Of Obesity

Objective: To assess the impact of surgical treatment in the sexuality of the obese.Methods: We conducted a qualitative / quantitative research with 30 patients who had undergone Fobi-Capella Roux-Y gastric bypass for at least one year. We collected data through individual interviews using a questionnaire with 10 mixed questions and one open, between May and June 2011. The objective data were quantified in absolute numbers and percentages, and the subjective ones were analyzed using the Discourse of the Collective Subject (DCS) and discussed in view of reference published on the subject.Results: 30 patients were enrolled, with a mean age 44 ± 12 years, 24 (80%) were female and six (20%) were male, 23 (77%) were married, 23 (96%) were hypertensive and eight (33%) were diagnosed with Diabetes Mellitus. After the operation, 11 (37%) individuals reported no change in the number sexual intercourses, but 19 (63%) reported that this number was altered, 16 (53%) informed increased frequency, one (3%) reported a decrease in frequency, one (3%) did not practice sexual intercourse anymore and one (3%) did not report the frequency. The central ideas (CI) raised originated four DCSs: Experience of female sexuality; No experience of female sexuality; Experience of male sexuality; and improvements of comorbidities and psychological factor.Conclusion: there are positive repercussions of physical and emotional orders of the surgical treatment of obesity, favoring the quality of life, including sexuality.

Sign in / Sign up

Export Citation Format

Share Document