scholarly journals Ameloblastoma em maxila: sugestão de abordagem cirúrgica

2019 ◽  
Vol 7 (12) ◽  
Author(s):  
Thalles Moreira Suassuna ◽  
Júlio Leite de Araújo-Júnior ◽  
Tácio Candeia Lyra ◽  
Joaquim Celestino da Silva-Neto ◽  
José Wilson Noleto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Surgical Approach ◽  
Femoral Condyle ◽  
Meta Analysis ◽  
Infratemporal Fossa ◽  
Le Fort ◽  
Maxillary Defect ◽  
Le Fort I ◽  
Head Neck

Introdução: O ameloblastoma é um tumor benigno, localmente invasivo, originário do epitélio odontogênico e é a neoplasia odontogênica mais comum. Apresentam crescimento lento e sua ocorrência na maxila é pouco frequente. Objetivo: Discutir os métodos de tratamento para os ameloblastomas em maxila e demonstrar a utilidade da osteotomia Le Fort I na abordagem destas lesões. Material e Método: Estudo descritivo de relato de caso. Resultados: Observou-se a erradicação da lesão com uma abordagem de baixa morbidade e que permitiu bom resultado estético e funcional. Conclusão: A ressecção é o método mais indicado para tratamento dos ameloblastomas sólidos, e a sua realização utilizando a osteotomia Le Fort I podem trazer vantagens tanto no trans quanto no pós-operatório.Descritores: Ameloblastoma; Maxila; Osteotomia de Le Fort.ReferênciasKreppel M, Zöller J. Ameloblastoma - Clinical, radiological, and therapeutic findings. Oral Dis. 2018;24(1-2):63-6.Taylor EM, Wu W, Kamali W, Ferraro P, Upton N, Lin J et al. Medial femoral condyle flap reconstruction of a maxillary defect with a 3D printing template. J Reconstr Microsurg Open. 2017;2:e63-8.Menezes LM, Souza CEL, Carneiro JT, Silva Kataoka MS, Júnior SDMA, Pinheiro, JDJV. Maxillary ameloblastoma in an elderly patient: report of a surgical approach. Hum Pathol. 2017;10:25-9.Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G. Ameloblastoma of the jaws: Management and recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis. 2017;134(1):7-11. Milman T, Ying GS, Pan W, LiVolsi V. Ameloblastoma: 25 year experience at a single institution. Head Neck Pathol. 2016;10(4):513-20.Pogrel MA, Montes DM. Is there a role for enucleation in the management of ameloblastoma? Int J Oral Maxillofac Surg. 2009;38(8):807-12.Antonoglou GN, Sándor GK. Recurrence rates of intraosseous ameloblastomas of the jaws: a systematic review of conservative versus aggressive treatment approaches and meta-analysis of non-randomized studies. J Craniomaxillofac Surg. 2015;43(1):149-57.Almeida RA, Andrade ES, Barbalho JC, Vajgel A, Vasconcelos BC. Recurrence rate following treatment for primary multicystic ameloblastoma: systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2016;45(3):359-67.Rizzitelli A, Smoll N, Chae M, Rozen WM, Hunter-Smith DJ. Incidence and overall survival of malignant ameloblastoma. PLoS One. 2015;10(2):e0117789.Nastri AL, Wiesenfeld D, Radden BG, Eveson J, Scully C. Maxillary ameloblastoma: a retrospective study of 13 cases. Br J Oral Maxillofac Surg. 1995;33(1):28-32.Guha A, Hart L, Polachova H, Chovanec M, Schalek P. Partial maxillectomy for ameloblastoma of the maxilla with infratemporal fossa involvement: A combined endoscopic endonasal and transoral approach. J Stomatol Oral Maxillofac Surg. 2018;119(3):212-15.Quick-Weller J, Koch F, Dinc N, Lescher S, Baumgarten P, Harter P et al. Intracranial ameloblastoma arising from the maxilla: an interdisciplinary surgical approach. J Neurol Surg A Cent Eur Neurosurg. 2017;78(5):582-87.Abtahi MA, Zandi A, Razmjoo H, Ghaffari S, Abtahi SM, Jahanbani-Arkadani H et al. Orbital invasion of ameloblastoma: a systematic review apropos of a rare entity. J Curr Ophthalmol. 2018;30(1):23-34.Bettoni J, Neiva C, Fanous A, Olivetto M, Demarteleire S, Demarteleire C et al. Brain ameloblastoma: metastasis or local extension report of a case and literature review. J Stomatol Oral Maxillofac Surg. 2018;119(5):436-39.Yang R, Liu Z, Peng C, Cao W, Ji T. Maxillary ameloblastoma: factors associated with risk of recurrence. Head Neck. 2017;39(5):996-1000.Kamalpathey LCK, Sahoo MGNK, Chattopadhyay CPK, Issar MY. Access Osteotomy in the Maxillofacial Skeleton. Ann Maxillofac Surg. 2017;7(1):98-103.Alexander R, Weber WD, Theodos LV, Friedman JS. The treatment of large benign maxillary tumors via Le Fort I downfracture: report of two cases and review of the literature. J Oral Maxillofac Surg. 1992;50(5):515-7.Catunda IS, Melo AR, Medeiros Júnior R, Queiroz IV, Neto F, Leão JC. Osteotomia Le Fort I: Aspectos de interesse no tratamento de nasoangiofibroma juvenil. Rev cir traumatol buco-maxilo-fac. 2011;11(4):9-12.Symington OG, Caminiti MF. Le Fort 1 down fracture approach for the treatment of a posterior maxillary ameloblastoma. J Can Dent Assoc. 1995;61(12):1048-52.Iwaki LC, Tolentino ES, Lustosa RM, Jacomacci WP, Casaroto AR, Leite PC et al. Le Fort I osteotomy for the removal of a rare unicystic ameloblastoma lesion in the maxillary sinus. Gen Dent. 2016;64(3):16-9.

scholarly journals Systematic review and meta-analysis on juvenile primary spontaneous pneumothorax: Conservative or surgical approach first?

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250929
Author(s):  
Chun-Shan Hung ◽  
Yang-Ching Chen ◽  
Ten-Fang Yang ◽  
Fu-Huan Huang
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Surgical Approach ◽  
Spontaneous Pneumothorax ◽  
Meta Analysis ◽  
Optimal Choice ◽  
Primary Spontaneous Pneumothorax ◽  
First Line ◽  
Mean Differences ◽  
Meta Analyses

Background Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles. Materials and methods We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15–3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later. Conclusions Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax.

scholarly journals Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis

2021 ◽  
Vol 15 (5) ◽  
pp. e0009365
Author(s):  
Mohammad Al-Saeedi ◽  
Ali Ramouz ◽  
Elias Khajeh ◽  
Ahmad El Rafidi ◽  
Omid Ghamarnejad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Surgical Approach ◽  
Cystic Echinococcosis ◽  
Treatment Effectiveness ◽  
Meta Analysis ◽  
P Value ◽  
Recurrence Rates ◽  
Biliary Leakage

Background In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy. Methods A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732). Results Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9–23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5–13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6–9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8–1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1–6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years. Conclusion Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.

scholarly journals Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1899
Author(s):  
Alessandro Rizzo ◽  
Margherita Nannini ◽  
Annalisa Astolfi ◽  
Valentina Indio ◽  
Pierandrea De Iaco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Locoregional Recurrence ◽  
Early Stage ◽  
Meta Analysis ◽  
Distant Recurrence ◽  
Uterine Leiomyosarcoma ◽  
Primary Surgery ◽  
Locoregional Recurrence Rate ◽  
Meta Analyses

Background: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Materials and Methods: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. Results: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.

scholarly journals Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

2020 ◽  
Vol 30 (8) ◽  
pp. 3073-3083 ◽  
Author(s):  
Walid El Ansari ◽  
Ayman El-Menyar ◽  
Brijesh Sathian ◽  
Hassan Al-Thani ◽  
Mohammed Al-Kuwari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Publication Bias ◽  
Surgical Approach ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

Systematic review with meta-analysis: the global recurrence rate of Helicobacter pylori

2017 ◽  
Vol 46 (9) ◽  
pp. 773-779 ◽  
Author(s):  
Y. Hu ◽  
J.-H. Wan ◽  
X.-Y. Li ◽  
Y. Zhu ◽  
D. Y. Graham ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Recurrence Rate ◽  
Meta Analysis

Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Isabelle Holscher ◽  
Tijs J van den Berg ◽  
Koen M A Dreijerink ◽  
Anton F Engelsman ◽  
Els J M Nieveen van Dijkum
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Weighted Mean ◽  
Curative Surgery ◽  
Endocrine Society ◽  
Time To Recurrence ◽  
The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, &lt;2 years of follow-up, &lt;10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 &lt; 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

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