scholarly journals The surgical treatment of retroperitoneal echinococcosis: the experience of a single center

2020 ◽  
Author(s):  
Jingyu He ◽  
Chuang Yang ◽  
Yiwen Qiu ◽  
Wentao Wang
Keyword(s):  
Surgical Treatment ◽  
Radical Surgery ◽  
Rare Condition ◽  
Radical Resection ◽  
High Rate ◽  
Resection Group ◽  
Group A ◽  
Group B ◽  
Surgical Group

Abstract Background Echinococcosis refers to a worldwide epidemic of zoonotic parasites that commonly affect the human liver, lungs, and omentum and can be classified as cystic echinococcosis (CE) and alveolar echinococcosis (AE).Retroperitoneal echinococcosis (RE) is a rare condition that is associated with a high mortality and disability rate. Because RE manifests in a concealed and deep location, and can often involve several important organs, it is associated with a high rate of misdiagnosis, a high risk of surgery, and is extremely difficult to manage. Methods This was a retrospective analysis of the characteristics and surgical management of patients diagnosed with RE in our hospital between 2012 and 2019. Results Between 2012 and 2019, 1257 cases of echinococcosis and 121 cases of RE were diagnosed in our hospital. Of these, 68 cases involved surgical treatment, 53 involved non-surgical treatment, and 12 cases were lost to follow-up (four cases in the surgical group and eight cases in the non-surgical group). Thus, 109 cases were followed-up. RE cases were divided according to different treatment methods into a radical resection group (Group A, 31 cases), a non-radical resection group (Group B, 37 cases), and a non-surgical group (Group C, 53 cases). We carried out a detailed analysis of the 109 cases experiencing surgical intervention with effective follow-up; there were 31 cases of radical resection (Group A), 33 cases of non-radical resection (Group B). Conclusions Our analysis found that RE is rare and can occur at any age; the cystic form is common and often involves multiple organs. The liver is the most commonly affected organ and is associated with serious complications. The rate of radical resection for RE is low, and multiple organ resection is often required; there is a high incidence of postoperative complications. Radical resection is the first line of treatment of RE, although non-radical surgery can benefit most patients. It is important to emphasize the importance of the first round of surgery, particularly in cases involving hepatic echinococcosis. If the lesion can be removed radically during the first round of surgery, then radical surgery should be performed.

FA02.08: LONG FOLLOW UP OF BARRETT’S TREATMENT, CLINICAL OR SURGICAL TREATMENT, WHICH ONE BRING BETTER RESULTS TO BARRETT’S EPITHELIUM?

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 5-5
Author(s):  
Sergio Szachnowicz ◽  
Andre Duarte ◽  
Edno Bianchi ◽  
Ary Nasi ◽  
Julio Mariano Rocha ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Columnar Epithelium ◽  
Clinical Group ◽  
Multiple Biopsies ◽  
Group A ◽  
Group B ◽  
Surgical Group

Abstract Background Background: Barrett’ s esophagus is a complication of severe gastroesophageal reflux disease. The major concern aspect is its association to dysplasia and esophageal adenocarcinoma. Endoscopic surveillance of patients treated surgically or clinically allows early detection of cancer. Aim: Compare clinical and surgical treatment of Barrett's esophagus. Methods Methods: from January 1980 to December 2017, 565 patients with Barrett's esophagus were followed up at our service. 214 were submitted to Nissen fundoplication and 221 to clinical treatment with PPI. These 434 patients were submitted to a long follow up with routine endoscopic examination each 2 years with multiple biopsies. The statistical analysis was performed through Fisher's exact test and Propensity score regarding epidemiologic and epithelium data. Results Comparing the surgical group (Group A) and the clinical group (Group B), we could observe the development of 11 Adenocarcinoma, 3 in the group A e 8 in group B. Any grade of dysplasia was observed in 9 patients of the group B, and six of them developed adenocarcinoma. The clinical group showed a tendency to develop more adenocarcioma and dysplasia than the surgical group (P = 0.38) and statistically significant increase in the development of dysplasia (P = 0032). 16% of patients in Group A showed progression in Columnar epithelium length against 20% in Group B (ns). 23,4% of the patients in group A keep symptoms and use of PPI, and 28.7 in group B (ns). Conclusion In our series as in many recent data in international literature, the surgical treatment for GERd in patients with Barrett's esophagus seems to be a good option to keep the columnar epithelium without progression to dysplasia or adenocarcinoma, with good control of the symptoms and the length of the Barrett's esophagus. Disclosure All authors have declared no conflicts of interest.

scholarly journals Influence of Ulnar Bow Sign on Surgical Treatment of Missed Bado Type I Monteggia Fracture in Children

2020 ◽  
Author(s):  
Shijie Liao ◽  
Tiantian Wang ◽  
Qian Huang ◽  
Yun Liu ◽  
Rongbin Lu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Radial Head ◽  
Monteggia Fracture ◽  
Type I ◽  
Ulnar Osteotomy ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Stable Reduction

Abstract PurposeThe present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children.MethodsThis study is a retrospective review of 24 patients between November 2010 and March 2019. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. The mean interval between injury onset and surgery was five months (range: 2–12 months). The average age of participants at the time of surgery was 6.4 years (range: 3–10 years). We evaluated the maximum ulnar bow (MUB) and MUB position (P-MUB) via radiography. The patients were divided into middle group (group A: 14 cases, MUB located at 40% to 60% of the distal ulna) and distal group (group B: 10 cases, MUB located at 20% to 40% from the distal end of the ulna) based on P-MUB. The mean period of follow-up was 37 months (range: 6–102 months).ResultsAt the last follow-up, all the children showed stable reduction of the radial head, and the flexion function of elbow joint improved after operation (P<0.05). Group A presented a larger the ratio of maximum ulnar bow(R-MUB) and angle of ulnar osteotomy(OA) than group B (P<0.05). There was statistically significant difference between group A and Group B in the P-MUB (P < 0.05). The osteotomy angle was positively correlated with the R-MUB (R2 =0.497,P=0.013), The osteotomy angle was positively correlated with the P-MUB (R2=0.731,P=0.000), The R-MUB is proportional to the P-MUB (R2 =0.597,P=0.002). The regression equation of P-MUB and osteotomy angle: Angle=7.064+33.227* P-MUB (R2=0.459, P =0.000).ConclusionWhen the ulnar bow is positioned at the middle ulna, a stable reduction of radial head need to be achieved through a larger angle in the ulnar osteotomy. If the position of maximum ulnar bow (P-MUB) is closer to the middle of the ulna or the ratio of maximum ulnar bow (R-MUB) is larger, the osteotomy angle is larger.

scholarly journals Surgical versus Conservative Management of Granular Myringitis: A single-centre Randomized Control Trial

2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Granulation Tissue ◽  
Randomized Control Trial ◽  
Simple Random Sampling ◽  
Secondary Outcome ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68

Prognostic value of non-ischemic ring-like left ventricular scar pattern in patients with apparently idiopathic ventricular arrhythmias: a CMR imaging study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Nucifora ◽  
D Muser ◽  
S Castro ◽  
R Casado Arroyo ◽  
D Benhayon ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Prognostic Significance ◽  
Imaging Study ◽  
Left Ventricular ◽  
High Rate ◽  
Life Threatening ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Background The presence of left ventricular (LV) late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) has been correlated to life-threatening arrhythmic events in patients with apparently idiopathic ventricular arrhythmias (VAs). Aim of the present study was to investigate the prognostic significance of a specific LV-LGE phenotype characterized by a subepicardial/midmyocardial “ring-like” pattern of fibrosis. Methods Out of a total of 518 consecutive patients with apparently idiopathic VAs who underwent CMR study, 79 (15%) had evidence of LV-LGE. Of these, 23 (4%) patients had LV LGE with ring-like pattern, defined as subepicardial or midmyocardial LGE involving at least 3 contiguous segments in the same slice (group A), while 56 (11%) patients had LV LGE with no ring-like pattern (group B). The remaining 439 patients had no LGE (group C). The end-point of the study was a composite SCD, resuscitated cardiac arrest and nonfatal episodes of ventricular fibrillation or documented sustained ventricular tachycardia. Results Group A patients were more frequently males compared to groups B and C (96% vs. 79% vs. 52%; p&lt;0.01) and had more frequently a family history of SCD and/or cardiomyopathy (30% vs. 11% vs. 5%; p&lt;0.01). All patients in Group A showed VAs with a predominant RBBB morphology vs. 38 (68%) patients in Group B and 65 (15%) in Group C (p&lt;0.01). During a follow-up of 63±39 months, the composite outcome occurred in 13 patients (57%) in Group A vs. 11 (20%) in Group B and 2 (1%) in Group C (p&lt;0.01). Conclusion In patients with apparently idiopathic VAs, a nonischemic LV-LGE with a ring-like pattern at CMR is associated with a high rate of malignant arrhythmic events during follow-up. Funding Acknowledgement Type of funding source: None

scholarly journals Neo-adjuvant chemotherapy followed by surgery versus definitive chemo radiation as treatment for localized carcinoma cervix

2016 ◽  
Author(s):  
S. Singh ◽  
V. Goel ◽  
V. Talwar ◽  
S. Raina ◽  
S. Mitra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Common Cancer ◽  
Group A ◽  
Group B ◽  
Disease Free

Background: Cervical cancer is ranked as the most common cancer in Indian women, second most common cancer worldwide and the leading cause of death in the developing countries. In the developing countries majority of the patients are diagnosed at locally advanced stages. The standard treatment of locally advanced cervical cancer is concomitant chemoradiation (CTRT) using platinum based chemotherapy. However, some randomized studies have shown improved results for patients receiving neoadjuvant chemotherapy (NACT) followed by surgical resection in comparison to patient receiving radiation alone. The present study was designed to compare response to the treatment and survival of and NACT followed by radical surgery (RS) with CTRT in the patients of uterine cervix of a tertiary cancer care centre. Patients and Methods: Retrospective study was performed in locally advanced/advance stage patients of cervix UTERI registered in the institute between years 2009 to 2013. Patients were included in the two groups, group A consists of 89 patients who have received NACT + RS and 67 patients in group B who have received CTRT. Clinical records were reviewed with particular reference to presenting complaint, clinical stage, response to the therapy, disease free survival and overall survival. Statistical analysis was done using SPSS version 22. Results: In the neoadjuvant group (group A) (n=89) the median age of patients was 53 years (range 31-80 years), most of the patients (70%) were presented with complaint of postmenopausal bleeding. Of the total patients, 69 (77.5%) underwent to radical surgery and 5 (8.5%) received radiotherapy after NACT. From 69 patients, who had undergone to surgery, 54 (78.3%) had also received radiation. The overall response to induction chemotherapy was 84%. In the chemo radiation group (group B) (n=65) median age was 56 years (33-75 years). Vaginal bleeding (34%) followed by postmenopausal bleeding (32%) was major presenting complaint in this group. Overall response to the complete treatment was 91%. The median follow up time was 14.3 months in group A and 12.2 months in group B. The disease free survival for NACT group was 32 months (95% CI 26.8-36.5) whereas for CTRT group it was 28 months (95% CI 23.5-33) with 12 and 13 recurrences per group (p = .226). In NACT group overall survival was 46.2 months (95% CI 44-48.3) and for CTRT group it was 38.3 months (95%CI 36.6-40) with 3 and 2 deaths per group (p=.883). Conclusion: Present study shows comparable results, with no difference in survival between both the groups. However, NACT + RS group had showed better disease free and overall survival than another group. Further studies should be performed with larger number of patients and longer duration of follow up.

scholarly journals Can vein patch interposition after sapheno-femoral ligation prevent postoperative neovascularization at the saphenofemoral junction?

2018 ◽  
Vol 5 (6) ◽  
pp. 2022
Author(s):  
Asser Abd El-Hamid Goda
Keyword(s):  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Subcutaneous Tissue ◽  
Repeated Surgery ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Saphenofemoral Junction ◽  
Surgical Group

Background: Majority of recurrence of varicose veins following both primary and repeated surgery was attributable to neovascularization. The aim of this study was to evaluate the efficacy and safety of the new natural origin anatomical barrier (vein patch) in decreasing neovascularization after initial surgery.Methods: The study included 50 patients with primary varicose vein and incompetence of SFJ. The patients are divided randomly into 2 groups, group (A) (conventional surgical group) and group (B) (barrier technique group), each one included 25 patients. In group (A) SFJ ligation with ligation of all the tributaries and stripping of great saphenous vein (GSV) in the thigh portion was done. In group (B), after conventional surgical procedure was done vein patch was taken from striped LSV. The vein patch was applied on the cribriform fascia opening. This barrier of vein patch is reinforced by good tight subcutaneous tissue suture.Results: Neovascularization was seen on duplex in 4 (16%) limbs of group (A) conventional surgical group at one year follow up, but in group (B) barrier technique group neovascularization was seen only in one (4%) limb. Groin infection was registered in 3 (12%) limbs, 2 (8%) of them in group (A) conventional surgical group and the third one (4%) in the group (B) barrier technique group.Conclusions: Vein patch interposition after correctly SFJ ligation seems to lower the incidence of neovascularisation after one year. This technique may constitute additional option to prevent recurrence.

Postoperative radiotherapy (RT) with or without chemotherapy (CT) in anaplastic astrocitoma (AA) patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13046-e13046
Author(s):  
Sonia Brugnara ◽  
Lucianna Russo ◽  
MariaChiara DiPasquale ◽  
Michele Nagliati ◽  
Gianpaolo Basso ◽  
...  
Keyword(s):  
Radical Surgery ◽  
Postoperative Radiotherapy ◽  
Consecutive Series ◽  
Median Dose ◽  
Limited Sample ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time

e13046 Background: Although the evidence for the benefit of adding temozolamide (TMZ) to RT is limited to glioblastoma patients (pts), there is currently an increased tendency toward a combined RT + TMZ approach also in AA patients. Methods: We report in this study the survival outcome of 2 groups of pts, treated at in 2 different periods at our institution with RT after surgery ± CT. GROUP A (years 1984-2001): pts treated with surgery followed by RT; GROUP B (YEARS 2004-2009): pts treated with surgery followed by radical RT and CT according to the STUPP’s protocol; Results: Data were retrospectively collected on a consecutive series: GROUP A: 17 pts: 10 Males (M), 7 Females (F); median age 50 years (range: 31-65). Ten out of 17 pts received radical surgery and 7 subtotal surgery. All were treated with postoperative RT, median dose 5082 cGy (range: 2160-6300). The mean time between surgery and beginning of RT was 44.7 days (range 20-87). GROUP B: 17 pts: 10 M, 7 F; median age 44 years (25-72). Eleven out 17 pts received radical surgery and 6 subtotal surgery. All were treated with postoperative RT, median dose 5800 cGy (range: 4000-600). The mean time between surgery and beginning of RT was 56.3 days (range 26-111). All patients received TMZ 75 mg/mq for a median of 6 weeks (range 3-7), followed by adjuvant treatment with TMZ (200 mg/mq) for a median of 5 cycles (range 0-13). At a median follow-up of 45 mos , the median OS was 29.1 mos for the group A and 49,1 mos for the group B. Among pts treated with RT + CT after surgery, median OS was significantly longer (p= 0.03), compared to those treated with only RT after surgery. Conclusions: The limited sample sizes of 2 groups and differences such as the median RT dose and the median time between surgery and RT, does not allow any conclusion. However, our data suggest that the combined RT-CT treatment is feasible in AA pts after surgery and may possibly contribute to a prolonged control of disease. These suggestions should be explored in a prospective randomized trial.

Lesionectomy versus electrophysiologically guided resection for temporal lobe tumors manifesting with complex partial seizures

1995 ◽  
Vol 83 (2) ◽  
pp. 231-236 ◽  
Author(s):  
Rashid Jooma ◽  
Hwa-shain Yeh ◽  
Michael D. Privitera ◽  
Maureen Gartner
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe ◽  
Analysis Of Covariance ◽  
Temporal Lobectomy ◽  
Epileptogenic Zone ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Group A ◽  
Group B

✓ Complex partial seizures associated with tumors and other mass lesions are readily diagnosed by modern imaging techniques but their optimum surgical treatment remains unresolved. Lesionectomy has been reported to produce seizure outcomes equal to outcomes after resection that ablates the epileptogenic cortex with the lesion. However, some evidence suggests that when the lesion is in the temporal lobe, simple excision of the tumor or lesion more often fails to control seizures. After retrospectively reviewing the records of 30 patients with complex partial seizures and temporal lobe tumors who underwent surgical treatment at the University of Cincinnati hospitals (1985–1992), the authors divided them into two groups: Group A (16 patients) underwent lesionectomy only and Group B (14 patients) received surgical treatment for seizures with electroencephalographic delineation of the epileptogenic zone and resection of the lesion. Seizure control was best achieved in Group B patients with 13 (92.8%) seizure free at follow up (mean 52 months). Only three (18.8%) of the Group A patients became seizure free after lesionectomy at follow up (mean 33 months). In eight Group A patients, who underwent temporal lobectomy as a second procedure after lesionectomy failed to control seizures, five (62.5%) became seizure free. Group B patients had a longer duration of seizures and were more likely to have lesions smaller than 2.5 cm compared with Group A. Analysis of covariance demonstrated that the differences in outcome between the groups remained significant even with adjustment for the variation in duration of seizures (p = 0.0006) and size of tumor (p = 0.0001). Based on this study, the authors found that the probable relief from seizures caused by a temporal lobe lesion is greater if the region of epileptogenicity, usually the amygdalohippocampal complex, is resected along with the tumor in a temporal lobectomy.

scholarly journals A comparative study between results of different modalities of management of cervical intraepithelial neoplasia I

2021 ◽  
Vol 53 (1-2) ◽  
pp. 8-12
Author(s):  
Eti Saha ◽  
Fouzia Begum ◽  
Zannatul Ferdous Jesmin ◽  
Muckti Kaniz Fatema
Keyword(s):  
Early Stage ◽  
Expectant Management ◽  
High Rate ◽  
Treatment Modalities ◽  
P Value ◽  
Stage Of Development ◽  
Group A ◽  
Group B ◽  
Cold Coagulation

Background: Carcinoma cervix is a preventable disease. It runs a long preinvasive stage, such as Normal - CIN I - CIN II - CIN III - Cancer cervix. It can be prevented at early stage of development with proper diagnosis, treatment & follow up. A major portion of CIN I spontaneously regress but some need treatment. Obiective: The purpose of this study was to determine the frequency of abnormal colposcopic findings during the 1 year follow up period in patients of CIN I treated with cold coagulation, LEEP and expectant management. Materials and Methods: This retrospective study was conducted in colposcopic centre of Khulna medical college hospital, Khulna, Bangladesh from January 2018 to December 2019. After confirmation of CIN I, ladies were arranged in three groups according to their treatment modalities - Expectant management (group A), Cold coagulation (group B) & LEEP (group C). They were reexamined with colposcopy after 6 months, or after one year of first visit. Persistence or reappearance of CIN was assayed & correlation between colposcopic results during follow up of different groups was analysed. Results: Total 195 ladies were diagnosed colposcopically as CIN I. Of them 75 women were confirmed by histological examination. Among 75 ladies, 25 ladies received no treatment, grouped as group A. Forty ladies treated with cold coagulation falls in group B, whereas 10 ladies who treated with LEEP were grouped as group C. Distribution of age, parity, monthly income, education, marital age, age at first delivery was similar in different group. During follow up persistence of disease were found in 2(13.3%) ladies who did not receive any form of treatment, 3(10.7%) who were treated with cold coagulation (p value 0.333) and 1(12.5%) lady who received treatment with LEEP (p value 0.667), were not significant. Conclusion: Colposcopic surveillance without treatment appears reasonable in treating CIN I because of the high rate of spontaneous regression of CIN 1, but adherence to the follow up should be emphasized to the patients during the follow up visits. Bang Med J Khulna 2020: 53 : 8-12

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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