Large traumatic basal ganglia hematoma: surgical treatment versus conservative management

2020 ◽  
Vol 64 (2) ◽  
Author(s):  
Humain Baharvahdat ◽  
Babak Ganjifar ◽  
Hamid Etemadrezaie ◽  
Ali Gorji
Keyword(s):  
Surgical Treatment ◽  
Basal Ganglia ◽  
Conservative Management

scholarly journals Neutrophil to Lymphocyte Count Ratio Has a Close Association With Severe Acute Colonic Diverticulitis in Patients Undergoing Surgical Treatment

2017 ◽  
Vol 102 (11-12) ◽  
pp. 514-521
Author(s):  
TaeHoon Kim ◽  
Tong Moon ◽  
Jin Yoon ◽  
SangSu Park ◽  
YongSeog Jang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Management ◽  
Lymphocyte Count ◽  
Acute Diverticulitis ◽  
White Blood Cells ◽  
Colonic Diverticulitis ◽  
Count Ratio ◽  
Co Morbidity ◽  
Acute Colonic Diverticulitis

Objective: To investigate the diagnostic potential of neutrophil-to-lymphocyte count ratio (NLCR) for acute diverticulitis. Summary of Background Data: We evaluated NLCR in patients with acute colonic diverticulitis who were treated with conservative and surgical treatments. Methods: A total of 205 patients who underwent surgical treatment or conservative management of acute diverticulitis between 2012 and 2016 were reviewed. Patients' age; sex; hospital days; co-morbidity; complication; period of use of antibiotics; treatment method; body temperature; and initial laboratory results such as neutrophil count, lymphocyte count, NLCR, and serum levels of C-reactive protein (CRP) were assessed. Results: The median ages of the conservative and surgical treatment groups were 46 and 68 years, respectively. Median CRP and glucose levels were high in acute colonic diverticulitis patients who underwent surgical treatment (P < 0.001, P < 0.001). Albumin level was low in the surgical treatment group (P < 0.001). NLCR was significantly different in both groups (conservative management vs surgical treatment, 4.1 mg/L versus 8.5 mg/L; P < 0.001). Median white blood cells was 11.36 × 109/L in the conservative management group and 14.0 × 109/L in the surgical treatment group, with no significance (P = 0.071). Multivariate analysis revealed that NLCR >10.21 [odds ratio (OR) = 5.613, P = 0.022]; CRP >17.23 mg/L (OR = 4.241, P = 0.006); and albumin ≤3.5 (OR = 4.192, P = 0.036) were significant for acute colonic diverticulitis patients. Conclusion: NLCR, CRP, and albumin levels were significantly associated with acute colonic diverticulitis in the surgical treatment group, and NLCR was the most powerful predictive marker of severe acute colonic diverticulitis.

Quality of life with special respect to depression after surgical treatment of hypertensive basal ganglia hemorrhage

2010 ◽  
Vol 58 (1) ◽  
pp. 74 ◽  
Author(s):  
Jian Hai ◽  
Lin Zhang ◽  
Zhang Wang ◽  
Jue-Feng Wan ◽  
Qing-Gang Pan
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Basal Ganglia ◽  
Basal Ganglia Hemorrhage ◽  
Special Respect

scholarly journals What is the main problem in the conservative management of complicated appendicitis? A meta-analysis

2020 ◽  
Author(s):  
Chi Zhang ◽  
Xuemeng Ren ◽  
Peng Gao
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Meta Analysis ◽  
Operation Time ◽  
Complicated Appendicitis ◽  
Management Group ◽  
Hospitalization Time ◽  
Standardized Treatment ◽  
The Difference

Abstract Background: As one of the classified groups of appendicitis, complicated appendicitis has no standardized treatment methods for adults.Method: The efficacy of surgical treatment and conservative treatment for complicated appendicitis was evaluated based on the literatures systematically searched on PubMed, Cochrane and Web of Science. A focus was given to important aspects, such as the outcomes of the length of stay, operation time, postoperative complications and unplanned additional interventions. Result: A total of 14 studies were involved in the meta-analysis, which included 845 patients in the immediate operation group (IO) and 756 patients in the conservative management group (CM). The total hospitalization time for patients with surgical treatment was decreased by 1 day (WMD= -1.29, 95% CI [-2.42, -0.16], P= 0.03< 0.05) compared to that of patients with conservative treatment. The incidence of unplanned additional interventions in patients who underwent emergency surgery is lower than that of patients with conservative treatment (OR=0.18, 95%CI [0.11, 0.30], P<0.00001). Compared to patients with conservative treatment, patients who received surgery are more likely to develop complications such as wound infection (OR=2.41, 95%CI [1.08, 5.38], P=0.03<0.05) and intestinal obstruction (OR=4.14, 95%CI [2.21, 7.75], P<0.00001). The incidence of abdominal abscess in patients with surgery treatment was lower than that of patients with conservative treatment, but the difference was not statistically significant (OR=0.9, 95%CI [0.54, 1.47], P=0.66>0.05). Conclusion: In treating complicated appendicitis, patients who received immediate operation, when compared to patients managed under conservative treatment, have shorter hospitalization time and less unplanned interventions; hence significantly reduce the likelihood of readmission. This can decrease the requirements for follow-up treatments and ultimately lower the consumption of medical resources.

P–339 Fertility treatment and live birth are still possible following the unexpected diagnosis of endometrial carcinoma/complex hyperplasia - provided that there is careful multidisciplinary team involvement

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
D Roche ◽  
F Martyn ◽  
M Wingfield
Keyword(s):  
Surgical Treatment ◽  
Endometrial Carcinoma ◽  
Embryo Transfer ◽  
Live Birth ◽  
Conservative Management ◽  
Endometrial Adenocarcinoma ◽  
Case Series ◽  
Endometrial Biopsy ◽  
Fertility Treatment ◽  
Fertility Clinic

Abstract Study question Is it safe for young women to delay hysterectomy for endometrial carcinoma or complex hyperplasia, have fertility treatment and carry a pregnancy to term? Summary answer Fertility treatment and livebirth are possible after a diagnosis of endometrial carcinoma or complex hyperplasia but close co-operation between fertility and gynae-oncology services is key. What is known already While predominantly a disease of postmenopausal women, 7% of cases of endometrial adenocarcinoma or complex hyperplasia occur in women under 40 years. The standard surgical treatment is hysterectomy, which is curative in the majority of cases. In younger women wishing to preserve fertility, conservative treatment may be considered. The fertility outcomes in this population are not well reported, possibly because fertility preservation is not always discussed or considered when faced with the devastating diagnosis of cancer or pre-cancer in the younger woman or because of concerns regarding the impact of pregnancy or ovarian stimulation on a predominantly oestrogen sensitive tumour. Study design, size, duration This case series retrospectively evaluated the outcomes of 6 women with endometrial adenocarcinoma or complex hyperplasia who attended Merrion Fertility Clinic, Dublin from 2013 to 2020 and who were managed conservatively. These women initially presented with a history of infertility for which they underwent routine ultrasonography, which then led to hysteroscopy and endometrial biopsy. The histopathology of all 6 women showed an incidental finding of endometrial adenocarcinoma or complex hyperplasia. Participants/materials, setting, methods Patient files and a fertility clinic online database were reviewed to identify those with a diagnosis of endometrial carcinoma or complex hyperplasia. Their treatment course and reproductive outcomes were followed up, as was there eventual definitive surgical treatment. Main results and the role of chance Six women attending our service over a 7 year period were found to have endometrial adenocarcinoma or hyperplasia. They ranged in age from 34 to 46(mean 39). All were nulliparous. Four of the women had adenocarcinoma and 2 had complex hyperplasia. One woman, aged 41, with grade II endometrial adencocarcinoma was deemed unsuitable for conservative management by the gynaecological oncology team. She underwent urgent total abdominal hysterectomy and is well. The remaining 5 women proceeded with conservative management with oral or local progesterone therapy for 6 to 12 months. This resulted in an inactive endometrium on follow-up endometrial biopsy. Once disease regression was achieved, assisted reproduction in the form of in-vitro fertilization (IVF) was advised to ensure minimal time to pregnancy. Two of the women conceived using own egg IVF and two with donor eggs. All were successful in achieving at least one live birth. One had twins and one had 2 singletons, from a fresh and a frozen embryo transfer. The 6th woman has embryos frozen but has not yet had embryo transfer. Two of the 6 women ultimately had a hysterectomy, while 4 continue to be followed up with 6 monthly endometrial biopsies and progesterone therapy. Limitations, reasons for caution This study is limited by the small sample size. However, this paper reports on a niche subset of the population and finding larger sample sizes would be difficult to obtain. Wider implications of the findings: This case series illustrates the favourable outcome of pregnancy with IVF after either systemic or local progesterone therapy in early stage endometrial adenocarcinoma or complex hyperplasia. Early involvement of a fertility specialist may prove highly valuable in cases of fertility sparing treatment to increase each patient’s potential for pregnancy. Trial registration number Not applicable

Arteriovenous malformation in the basal ganglia

1974 ◽  
Vol 41 (2) ◽  
pp. 244-247
Author(s):  
Ivan I. Ribaric
Keyword(s):  
Surgical Treatment ◽  
Basal Ganglia ◽  
Arteriovenous Malformation ◽  
Operative Approach ◽  
Content Type ◽  
Fine Print

✓ The author reports the successful surgical treatment of an arteriovenous malformation of the basal ganglia. Follow-up angiography verified that the single supplying artery had been clipped. The operative approach to the malformation is discussed.

Peroral drainage of post-traumatic sialocoeles: report of three cases

2009 ◽  
Vol 123 (8) ◽  
pp. 922-924 ◽  
Author(s):  
O Edkins ◽  
A C van Lierop ◽  
J J Fagan ◽  
D E Lubbe
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Simple Procedure ◽  
Minimal Risk ◽  
Initial Management ◽  
Parotid Duct ◽  
Post Traumatic

AbstractObjective:To discuss the technique and outcome of this simple procedure and the management of post-traumatic parotid sialocoeles, and to review the literature regarding this condition.Case report:We report the successful surgical treatment, by peroral drainage, of three patients with post-traumatic parotid sialocoele resistant to conservative management.Discussion:We discuss the method and outcome of the surgical procedure performed, along with the causes, presentation and management of parotid sialocoele.Conclusion:Correct initial management of a parotid duct injury may prevent the formation of a sialocoele. When conservative treatment of post-traumatic parotid sialocoele fails, we advocate the surgical technique described in this report as it is effective, simple and carries minimal risk to the patient.

Laser interstitial thermal therapy as a novel treatment modality for brain tumors in the thalamus and basal ganglia

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Jason L. Schroeder ◽  
Symeon Missios ◽  
Gene H. Barnett ◽  
Alireza Mohammad Mohammadi
Keyword(s):  
Surgical Treatment ◽  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Brain Tumors ◽  
Minimally Invasive ◽  
Thermal Therapy ◽  
Neurological Deficits ◽  
Tumor Cell Death ◽  
Primary Tumors ◽  
Laser Interstitial Thermal Therapy

AbstractIntroduction:Deep-seated hemispheric brain tumors pose unique challenges for surgical treatment. These tumors are often considered inoperable and when surgery is undertaken significant, serious, morbidity and even mortality may complicate the outcome. Laser interstitial thermal therapy (LITT) is a minimally invasive alternative to traditional open surgery that affects tumor cell death by producing a zone of thermal tissue damage that can be monitored and controlled with the aid of real-time magnetic resonance thermography.Subjects and methods:A retrospective review of six patients treated with LITT at the Cleveland Clinic between 5/2011 and 8/2013 was performed. We evaluated clinical patient data and pre-, intra-, and post-operative magnetic resonance imaging (MRI) data for correlation.Results:Six patients were treated with a total of eight separate LITT procedures for their thalamic (n=5) or basal ganglia (n=1) tumors. All tumors were histologically malignant and five were primary tumors. Pre- and post-operative neurological deficits were recorded. The two patients that underwent multiple procedures were retreated for different reasons – one due to insufficient coverage and the other due to tumor recurrence. Sustained post-operative neurological deficits were observed after three procedures and one patient died within 2 days of surgery from a thalamic hemorrhage.Conclusions:LITT is a minimally invasive surgical treatment that can lead to successful ablation of tumors of the thalamus or basal ganglia. However, this treatment has the potential for neurological morbidity or even mortality and as such further studies are needed to evaluate the true risk vs. reward potential for LITT with regard to treating deep-seated tumors.

scholarly journals What is The Main Problem in The Conservative Management of Complicated Appendicitis? A Meta-Analysis.

2020 ◽  
Author(s):  
Chi Zhang ◽  
Xuemeng Ren ◽  
Peng Gao
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Meta Analysis ◽  
Operation Time ◽  
Complicated Appendicitis ◽  
Management Group ◽  
Hospitalization Time ◽  
Standardized Treatment ◽  
The Difference

Abstract Background: As one of the classified groups of appendicitis, complicated appendicitis has no standardized treatment methods for adults.Method: The efficacy of surgical treatment and conservative treatment for complicated appendicitis was evaluated based on the literatures systematically searched on PubMed, Cochrane and Web of Science. A focus was given to important aspects, such as the outcomes of the length of stay, operation time, postoperative complications and unplanned additional interventions. Result: A total of 14 studies were involved in the meta-analysis, which included 845 patients in the immediate operation group (IO) and 756 patients in the conservative management group (CM). The total hospitalization time for patients with surgical treatment was decreased by 1 day (WMD= -1.29, 95% CI [-2.42, -0.16], P= 0.03< 0.05) compared to that of patients with conservative treatment. The incidence of unplanned additional interventions in patients who underwent emergency surgery is lower than that of patients with conservative treatment (OR=0.18, 95%CI [0.11, 0.30], P<0.00001). Compared to patients with conservative treatment, patients who received surgery are more likely to develop complications such as wound infection (OR=2.41, 95%CI [1.08, 5.38], P=0.03<0.05) and intestinal obstruction (OR=4.14, 95%CI [2.21, 7.75], P<0.00001). The incidence of abdominal abscess in patients with surgery treatment was lower than that of patients with conservative treatment, but the difference was not statistically significant (OR=0.9, 95%CI [0.54, 1.47], P=0.66>0.05). Conclusion: In treating complicated appendicitis, patients who received immediate operation, when compared to patients managed under conservative treatment, have shorter hospitalization time and less unplanned interventions; hence significantly reduce the likelihood of readmission. This can decrease the requirements for follow-up treatments and ultimately lower the consumption of medical resources.

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