scholarly journals EPIDURAL MORPHINE IN PEDIATRIC ONCOLOGIC SURGERY

2017 ◽  
Vol 11 (3) ◽  
pp. 170-181
Author(s):  
Nune V. Matinyan ◽  
I. A Letyagin ◽  
L. A Martynov ◽  
A. V Sotnikov ◽  
A. P Kazantsev ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Pediatric Oncology ◽  
Epidural Morphine ◽  
Malignant Tumors ◽  
Surgical Trauma ◽  
Epidural Administration ◽  
Oncologic Surgery ◽  
Nociceptive Neurons ◽  
Autonomic Blockade

Epidural administration of opioids effectively prevents the sensitization of nociceptive neurons of the posterior horn of the spinal cord, induced by surgical trauma, without the development of motor and autonomic blockade. Study includes 52 patients aged 1 month to 18 years with malignant tumors who underwent surgical treatment at the Pediatric Oncology and Hematology Research Institute, during 2009-2016 years. Surgeries were combined (thoraco-laparotomy). The method of epidural use of morphine in pediatric oncosurgery is presented.

scholarly journals Role of Caudal Epidural Block in enhanced recovery after pediatric oncologic surgery. Article

2020 ◽  
pp. 129-136
Author(s):  
N. V Matinyan ◽  
E. I Belousova ◽  
T. E Ivanova ◽  
L. A Martynov ◽  
A. P Kazantsev ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
General Anesthesia ◽  
Pediatric Oncology ◽  
Enhanced Recovery ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Epidural Block ◽  
Epidural Administration ◽  
Caudal Epidural Block ◽  
Caudal Epidural

Introduction. Enhanced recovery after surgery and the early initiation of chemotherapy is a significant advantage of laparoscopic surgeries for malignant tumors of abdominal cavity in children. Despite the extensive experience in using caudal block in pediatric patients, it has not yet been determined whether the use of ultrasound navigation provides any clinical advantage in post-operative recovery after laparoscopic surgeries in pediatric oncology. Materials and methods. The study included 40 patients of Pediatric Oncology and Hematology, Federal Blokhin National Medical Research Center, ASA II-III, who underwent laparoscopic surgeries for malignant tumors of the abdominal cavity during 2017-2019. Patients were divided randomly into 2 groups. The CB (caudal blockade) group included 23 children. In CB group caudal epidural block as a regional component of combined anesthesia was used (CB group n = 23). GA (general anesthesia) group included 17 children who underwent general anesthesia (GA group, n = 17). Results. The median of the total dose of fentanyl in the CB group was 7.29 (6; 9.25) |ig/kg, in the GA group - 10.7 (7.6; 12.5) |ig/kg (р 0.012). In the postoperative period, patients in CB group didnt require additional analgesia for 24 hours after caudal-epidural administration of morphine. After caudal-epidural administration of trimeperidin, 12 hours later. Enteral nutrition in children in the CB group was started in 4.7 0.5 hours. In the GA group, enteral nutrition in 10 (59 %) patients was started in 20 hours after the end of the surgery. 5 children developed gastrostasis, which required pharmacologic stimulation of the gastrointestinal tract. Conclusions. This study demonstrates that caudal epidural block for laparoscopic surgeries performed under ultrasound navigation provides effective analgesia in both perioperative and postoperative periods, promotes early start of enteral nutrition, minimizing the frequency of postoperative nausea and vomiting. Ultrasound navigation increases the likelihood of success and safety of the caudal epidural block.

scholarly journals Intradural ventral and ventrolateral tumors of the spinal cord: surgical treatment and results

2004 ◽  
Vol 17 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Eugene I. Slin'ko ◽  
Iyad Ischak Al-Qashqish
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Malignant Tumors ◽  
Clinical Results ◽  
Neurological Symptoms ◽  
Surgical Approaches ◽  
Intradural Extramedullary

Object To improve results of surgical treatment of ventral and ventrolateral tumors of the spinal cord, the authors analyzed surgical approaches, defined the indications for various approaches, and assessed the clinical results. Methods Between 1993 and 2004 the authors treated 360 patients: 43 of them had dorsal, 177 dorsolateral, 33 ventral, and 107 had ventrolateral intradural extramedullary tumors. Among 140 patients with intradural extramedullary ventral and ventrolateral tumors, neuromas were seen in 56 and meningiomas in 84. Of the 140 patients studied, tumors were removed totally in 102 (74%), subtotally in 30 (21%), and partially in eight (5%). After ventrolateral and dorsolateral approaches were introduced in 1996, tumors in ventral or ventrolateral locations have been removed totally or subtotally. In the group of patients with meningiomas, 41 of the lesions were the meningothelial type, 22 were transitional, 12 fibroblastic, four psammomatous, three were angiomatous, one was atypical, and one was malignant. Tumors in the neuroma group were schwannomas in 45 patients and neurofibromas in 11. Postoperatively, recovery was observed in 70 patients (50%), improvement in 53 (38%), no change in 10 (7%), and deterioration in seven (5%). At follow-up evaluation recovery was noted in 76 patients, improvement in 58, no change in four, and in two patients the neurological symptoms were worse than before the operation. Conclusions Surgical routes to extramedullary tumors should be chosen based on the location of the tumor, its spread, and the region in which it is localized.

ROLE OF ULTRASOUND IN THE DETECTION OF RECURRENT OVARIAN CANCER

2020 ◽  
Vol 6 (1) ◽  
pp. 23-31
Author(s):  
M. Alisherova ◽  
◽  
M. Ismailova
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Reproductive System ◽  
Malignant Tumors ◽  
Recurrent Ovarian Cancer ◽  
Primary Diagnosis ◽  
Female Reproductive System

Currently, there are no standard approaches to monitoring patients with ovarian cancer (OC). While the role of ultrasound (US) has been identified in the primary diagnosis of OS, it is still controversial during the subsequent surgical treatment of OC. In world statistics, ovarian cancer is consistently among the four main localizations of malignant tumors of the female reproductive system, along with tumors of the breast, body and cervix.

“Proximalization is Advancement”—Zone 3 Frozen Elephant Trunk vs Zone 2 Frozen Elephant Trunk: A Literature Review

2021 ◽  
pp. 153857442110024
Author(s):  
Rozina Yasmin Choudhury ◽  
Kamran Basharat ◽  
Syeda Anum Zahra ◽  
Tien Tran ◽  
Lara Rimmer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Literature Review ◽  
Treatment Options ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Cord Injury ◽  
Aortic Pathologies

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.

scholarly journals Surgical Treatment of Spinal Cord Vascular Malformations

2003 ◽  
Vol 9 (2_suppl) ◽  
pp. 103-105
Author(s):  
P. Tabrizi ◽  
R.P. Spetzler
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Vascular Malformations

Posterior spinal cord herniation into an extradural thoracic arachnoid cyst: surgical treatment

2006 ◽  
Vol 104 (3) ◽  
pp. 210-211 ◽  
Author(s):  
Farideh Nejat ◽  
Samira Zabihyan Cigarchi ◽  
Syed Shuja Kazmi
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Arachnoid Cyst ◽  
Spinal Cord Herniation
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