scholarly journals Strategy to preserve function in lower limbs tumors resection. Vascular competence in multidisciplinary approach

2020 ◽  
Author(s):  
Andrea Ascoli Marchetti ◽  
Lorenzo Di Giulio ◽  
Fabio Massimo Oddi ◽  
Bernardo Orellana Davila ◽  
Riccardo Ciattaglia ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Vascular Anatomy ◽  
Radical Resection ◽  
Lower Limbs ◽  
Multiplanar Reconstructions ◽  
Limb Edema ◽  
Long Term Result ◽  
Term Evaluation ◽  
Multidisciplinary Perspective

Abstract IntroductionAll possible strategy should be adopted to preserve limb function during the definitive removal operation in the case of limbs sarcoma. Multidisciplinary perspective seems to be the ideal choice. The aim of the study is to report our experience gained in collaboration with the IFO oncology orthopedic division and with the operating units of Orthopedics A and B of our institution, reporting the type of intervention, results and complications of the procedures performed.Material and methodsFrom 2011 to 2019, were treated 32 patients affected by primitive and secondary musculoskeletal neoplasm with a mean age of 44 years (14-67 years) in 28 cases (87.5%) were required revascularization. Women accounted for 46.9% (15/32), 53.1% were men (17/32). The preoperative study included a biopsy of the lesion and ultrasonography and CTA with multiplanar reconstructions for the evaluation of the vascular anatomy and neoplasia extension.ResultsThe average postoperative follow-up was 20.1 months. The reconstruction of the vessels has been implemented in 14/32 (43.7%) mainly using the autologous saphenous contralateral vein. The use of the prosthesis was performed in the others cases (with PTFE and Dacron K prosthesis). In 5 cases (15.6%) the patients had lower limb edema, with a distance venous patency of 26/32 (81.2%) and arterial patency of 100%. We had no mortality at 30 days. Two patients underwent VAC therapy. No amputations were performed at 30 days. In 14 patients was performed perioperative chemotherapy or radiotherapy.ConclusionsA long-term evaluation is needed to determine the implications at distance, in patients undergoing radical resection of cancer in which are necessary for skills vascular surgery. The long term result is conditioned by the prognosis of neoplasm. The multidisciplinary approach is always requested.

scholarly journals ENDOVENOUS LAZER COAGULATION: LONG-TERM RESULT - CRITERION OF TRUTH

2018 ◽  
Vol 3 (4) ◽  
pp. 27-30
Author(s):  
A G Shalashov ◽  
A V Kazantsev
Keyword(s):  
Varicose Veins ◽  
Intraoperative Complications ◽  
Lower Limbs ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Result ◽  
Varicose Disease

Objectives - to study the long-term results of endovenous laser coagulation in patients with varicose veins of the lower extremities. Material and methods. The study included 241 patients with varicose disease of the lower limbs veins, who underwent surgical treatment using the method of endovenous laser coagulation. Results. The technical success of the operation was achieved in all cases, which was confirmed by color duplex scanning. There were no intraoperative complications. Long-term outcome was studied in 174 (72.2%) patients in the period up to 5 years. During the follow-up period the GSV occlusion signs were detected in 168 (96.4%) patients, partial recanalization of the GSV was registered in 6 (3.5%) patients.

scholarly journals NEUROORTHOPEDICAL APPROACH TO THE CORRECTION OF EQUINES CONTRACTURE IN PATIENTS WITH SPASTIC PARALYSIS

2014 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
Valery Vladimirovich Umnov ◽  
Alexei Vasilievich Zvozil
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Spastic Paralysis ◽  
Triceps Muscle ◽  
Post Surgery ◽  
Long Term Result ◽  
Long Term Follow Up ◽  
Short Run ◽  
Operation Results

The frequency of recurrent contractures of the joints of the lower limb after their correction by means of tendon-muscle plasty remains significant. Therefore, the search for effective ways to correct contractures with the most resistant long-term result is relevant. The objective of the study is to improve treatment outcomes of equinus contracture in children with spastic paralysis. Materials and methods. We analyzed the results of correction of contractures in joints of lower limbs in 40 patients with cerebral palsy and the influence of spasticity of patognomonic muscles on them. The mean age was 6 years 7 months. In addition, for the correction of hypertonus of triceps muscle of tibia, the 330 lower limb segments were performed selective neurotomy of appropriate motor branches of the general tibial nerve. This operation in 304 cases was combined with achilloplastics or Strayer operation. Results. A mean degree of correlation between the degree of contracture in the ankle and increased tone of triceps tibia was determined (r value ranged from 0.451 to 0.487). Short-term results of the combined neuroorthopedic method for correction of contractures were good in estimating within 1 year post surgery, but a study of its short-run effect requires long-term follow-up.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

Custom Presurgical Planning for Midfacial Reconstruction

2020 ◽  
Vol 36 (06) ◽  
pp. 696-702
Author(s):  
Nolan B. Seim ◽  
Enver Ozer ◽  
Sasha Valentin ◽  
Amit Agrawal ◽  
Mead VanPutten ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Functional Performance ◽  
Three Dimensional ◽  
Free Tissue Transfer ◽  
Long Term Effects ◽  
Presurgical Planning ◽  
Dental Rehabilitation ◽  
Midface Reconstruction ◽  
Reconstructive Algorithm

AbstractResection and reconstruction of midface involve complex ablative and reconstructive tools in head and oncology and maxillofacial prosthodontics. This region is extraordinarily important for long-term aesthetic and functional performance. From a reconstructive standpoint, this region has always been known to present challenges to a reconstructive surgeon due to the complex three-dimensional anatomy, the variable defects created, combination of the medical and dental functionalities, and the distance from reliable donor vessels for free tissue transfer. Another challenge one faces is the unique features of each individual resection defect as well as individual patient factors making each preoperative planning session and reconstruction unique. Understanding the long-term effects on speech, swallowing, and vision, one should routinely utilize a multidisciplinary approach to resection and reconstruction, including head and neck reconstructive surgeons, prosthodontists, speech language pathologists, oculoplastic surgeons, dentists, and/or craniofacial teams as indicated and with each practice pattern. With this in mind, we present our planning and reconstructive algorithm in midface reconstruction, including a dedicated focus on dental rehabilitation via custom presurgical planning.

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