scholarly journals SURGICAL MANAGEMENT OF INTRACRANIAL MENINGIOMAS

2007 ◽  
Vol 14 (01) ◽  
pp. 170-176
Author(s):  
TARIQ AHNIAD ◽  
INAMULLAH ASGHAR ◽  
AKMAL HUSSAIN ◽  
Sibef Hasan ◽  
Habib Sultan
Keyword(s):  
Surgical Management ◽  
Total Removal ◽  
Medical College ◽  
Simpson Grade ◽  
Intracranial Meningiomas ◽  
Grade Ii ◽  
One Year ◽  
Study Setting ◽  
Neurovascular Structures

Objective: To study the surgical management and outcome of patients having intracranial meningiomas. Design: A retrospective study. Setting: The Department of Neurosurgery Punjab Medical College & Allied Hospital, Faisalabad. Duration From April 2004 to October 2005. Materials & Methods:Thirty patients suffering from intracranial meningiomas diagnosed on CT-scan and managed surgically were included in this study. Simpson grade I removal was possible in 21 patients. Grade II removal was done in Three patients while grade 111 removal was possible in four patients, grade IV removal was done in one patient and grade V in one patient. Post operative XRT was given in cases having grades II, 111, IV and V removal. Follow up was done at six monthly intervals. Outcome was assessed as Good .Fair, and poor depending upon clinical and radiological examinations. RESULTS: Out of 30 patients only one had recurrence after one year of follow up which was removed surgically and postoperative XRT was given.Twenty four patients had good outcome while 5 patients had fair outcome and one had poor outcome. CONCLUSION. Study showed that Simpson grade 1 removal of tumor is still effective treatment in the management of meningiomas. Postoperative XRT is used in Simpson grade 2, 3, 4 and 5 in which gross total removal is not possible due to involvement of neurovascular structures.

scholarly journals Rapid recurrence of a malignant meningioma: case report

2017 ◽  
Vol 31 (2) ◽  
pp. 178-181
Author(s):  
Oguz Baran ◽  
Sima Sayyahmeli ◽  
Taner Tanriverdi ◽  
Pamir Erdincler
Keyword(s):  
Short Report ◽  
Malignant Meningioma ◽  
Total Removal ◽  
Ki 67 ◽  
Simpson Grade ◽  
Surgery Patient ◽  
Extent Of Surgery ◽  
Grade Ii ◽  
The Right

Abstract This short report presents a case that developed rapid recurrence of a malignant meningioma. The meningioma was located on the right temporal lobe and total removal (Simpson grade-II) was performed. Radiotherapy was not given and the lesion recurred within four months. The MIB-1 (Ki-67) index was 30 % and the tumor fulfilled all the criteria of anaplasia. After the second surgery, patient was transferred to the Radiation Oncology for radiotherapy. Should we questioned the extent of surgery? Neurosurgeons should be careful and close follow-up the patients with malignant meningioma.

scholarly journals Evaluation of surgical outcome of giant intracranial meningiomas

2020 ◽  
Vol 35 (1) ◽  
Author(s):  
Ramy Teama ◽  
Mohamed Adawy ◽  
Mohamed Emara
Keyword(s):  
Surgical Outcome ◽  
Intraoperative Complications ◽  
Intracranial Meningioma ◽  
Surgical Removal ◽  
Study Group ◽  
Main Body ◽  
Total Removal ◽  
Large Size ◽  
Intracranial Meningiomas

Abstract Background The surgery of giant intracranial meningiomas (GIM) is difficult due to its large size, prominent vascularity, including and limiting visualization of various neurovascular structures, and severe cerebral edema. In this study, we will evaluate the surgical outcome of giant meningiomas according to our experience at our hospital in management of giant intracranial meningioma. Main body A retrospective analysis of 48 patients with histologically proven meningioma (≥ 6-cm diameter) who underwent surgical treatment at Benha University hospitals over a period of 5 years (June 2014/June 2019) is presented. Details regarding clinical presentation, imaging findings, surgical results and complications, and follow-up status were collected. The study group was composed of 41 females and 7 males. The age of the study group ranged from 38 to 69 years with an average of 49 years. The mean follow-up period was 36 months. Different approaches were used according to tumor location with the aim of gross total removal. Gross total removal was achieved in 90% of cases (43 cases). There were 2 cases with intraoperative complications not related to surgery. Recurrence was present in 4 cases. Mortality in this series was 4% (2 cases) with no reported intraoperative mortality. Conclusion Management of giant intracranial meningioma is a relatively common practice in neurosurgical centers in developing countries with the aim of radical total surgical removal being the first and most optimum option. Large size makes surgery difficult, but young age, meticulous surgical techniques, proper localization, trying to minimize operative time, and Simpson grade are of special value. Interdisciplinary cooperation is essential to avoid the common complications like pulmonary embolism (PE), postoperative hematoma in tumor bed that leads to bad surgical outcome.

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

Non-surgical management of an extraoral cutaneous sinus tract of odontogenic origin

2020 ◽  
Vol 13 (7) ◽  
pp. e234699
Author(s):  
Lynn Lilly Varghese ◽  
Auric Bhattacharya ◽  
Praveena Sharma ◽  
Abhishek Apratim
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Dental Pulp ◽  
Complete Resolution ◽  
Sinus Tract ◽  
Odontogenic Origin ◽  
One Year ◽  
Minimal Scar ◽  
Cutaneous Sinus

Chronic apical periodontitis associated with dental pulp necrosis is the main cause of odontogenic extraoral cutaneous sinus openings. These tracts are often initially misdiagnosed unless the treating clinician considers a dental aetiology. This case report of a 19-year-old woman describes the diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin. Non-surgical conservative endodontic therapy was opted as the involved teeth were restorable. One month after the completion of obturation, there was closure of the sinus tract. One year follow-up showed complete resolution of the sinus tract with minimal scar formation.

A pilot study of myeloablative (MA) autologous stem Cell (Auto SCT) followed by reduced intensity (RI) allogeneic transplantation (AlloSCT) in children with relapsed/refractory(R/R) Hodgkin’s disease (HD)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20007-20007
Author(s):  
M. Bradley ◽  
L. Baldinger ◽  
M. Bhatia ◽  
J. Garvin ◽  
D. George ◽  
...  
Keyword(s):  
Allogeneic Transplantation ◽  
Grade Ii ◽  
Refractory Lymphoma ◽  
Grade 3 ◽  
One Year ◽  
Involved Field ◽  
Involved Field Radiotherapy ◽  
Median Cell

20007 Background: Allo SCT may benefit patients with R/R HD by providing a graft vs lymphoma effect. Peggs et al (Lancet 2005) demonstrated durable engraftment and reduced non relapse mortality (NRM) in HD pts post RI Allo SCT. Carella et al (JCO2000) and Gutman et al (BMT2005) demonstrated the success of MA Auto SCT followed by RI AlloSCT in adults with refractory lymphoma. We investigated the feasibility of MA Auto SCT followed by RI Allo SCT in children with R/R HD. Methods: MA conditioning prior to AutoSCT was CTX 1,500 mg/m2 x 4 d, BCNU 100 mg/m2 x 3d, VP-16 800 mg/m2 x 3d. AlloSCT conditioning was fludarabine 30 mg/m2 x 5d, busulfan 3.2 mg/kg x 2d, and R ATG 2 mg/kg x 4d (unrel. donor). CD20+ patients received rituximab (375 mg/m2/wk x4) and all pts received involved field radiotherapy (IFRT). Results: Ten pts have enrolled, 2 pts did not proceed (parental withdrawal) to RI AlloSCT (Donors: 1 MRD, 2 MUD, 5 UCB). Median time to RI AlloSCT after MA Auto SCT was 142 d (97–219). The median cell dose was 3.43 x 107 TNC/kg for UCB grafts (n=5). Engraftment was achieved at a median of 20.5 d for PMN and 46.5 d for PLT. Donor chimerism reached ≥ 95% in all pts by day 100 with a median follow up of 703d (128–2025). Toxicities were grade (3) hematuria (n=1), (3–4) infection (n=7), (4) pulmonary fibrosis (n=1), (4) hearing loss (n=1), (4) neurotoxicity (n=1). GVHD: grade II-III aGVHD (3/8), cGVHD (3/8). Six patients are alive and NED post allo SCT. There has been one NRM (cGVHD) and one relapse mortality. The OS at one year is 66.7%. Conclusions: MA AutoSCT followed by RI AlloSCT is feasible and well tolerated in pediatric pts with R/R HD. A larger study with longer follow up is required to determine if this approach will reduce relapse, long term toxicity and/or improve survival. No significant financial relationships to disclose.

Prolactin-Secreting Adenomas: Surgical Results and Long-Term Follow-up

Neurosurgery ◽  
1989 ◽  
Vol 24 (5) ◽  
pp. 736-743 ◽  
Author(s):  
Giulio Maira ◽  
Carmelo Anile ◽  
Laura De Marinis ◽  
Antonino Barbarino
Keyword(s):  
Empty Sella ◽  
Surgical Removal ◽  
Total Removal ◽  
Efficacious Treatment ◽  
Transsphenoidal Microsurgery ◽  
Long Term Follow Up ◽  
Grade Ii ◽  
Adenomatous Tissue

ABSTRACT Transsphenoidal surgery is an efficacious treatment for patients with prolactin (PRL)-secreting adenomas, even if disrupted pituitary-hypothalamic relationships may persist and/or a recurrence of the PRL-secreting tumor can occur. In this paper, we analyze the long-term follow-up of 119 consecutively treated women who underwent transsphenoidal microsurgery for PRL-secreting adenomas. Apparent total removal of the tumor was achieved in 98 patients who had enclosed tumors (58 with Grade-I tumors and 40 with Grade II). In the remaining patients, the removal was considered partial. Persistent normal basal PRL levels were achieved in 61 patients who had apparent total removal of the adenoma (44 with Grade I tumors and 17 with Grade II). Of the remaining 37 patients in whom surgical removal of the adenomatous tissue was thought to be total, 30 had persistent nonevolutive, high PRL levels ranging from 21 to 196 ng/ml, without clinical and radiological signs of tumor regrowth, and 7 with PRL levels ranging from 56 to 560 ng/ml had a recurrence of the PRL-secreting tumor. These data seem to indicate that a slightly elevated postsurgical PRL value does not imply that tumoral tissue is still present. Nontumoral conditions (i.e., a secondary empty sella) could induce functional hyperprolactinemia.

Early versus late surgical management of complicated appendicitis in children: A statewide database analysis with one-year follow-up

2018 ◽  
Vol 53 (7) ◽  
pp. 1339-1344 ◽  
Author(s):  
Saurabh Saluja ◽  
Tianyi Sun ◽  
Jialin Mao ◽  
Shaun A. Steigman ◽  
P. Stephen Oh ◽  
...  
Keyword(s):  
Surgical Management ◽  
Complicated Appendicitis ◽  
Database Analysis ◽  
One Year

scholarly journals Sacrocolpopexy in management of vaginal vault prolapse

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Javed Iqbal ◽  
Fauzia Nausheen ◽  
Fozia Ali Bhatti ◽  
Arif Tajammul Khan ◽  
Shahida Sheikh
Keyword(s):  
Operation Time ◽  
Abdominal Hysterectomy ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Vault Prolapse ◽  
Abdominal Sacrocolpopexy ◽  
Estimated Blood Loss ◽  
One Year ◽  
Study Setting

Aims & Objectives: To review the efficacy of Sacrocolpopexy in the management of vaginal vault prolapse Study Design: Interventional study. Setting & Population: Department of Obstetrics & Gynaecology, Jinnah Hospital, Lahore. Women with vaginal vault prolapse after hysterectomy. Methods and Main-outcome measures: Abdominal Sacrocolpopexy using proline mesh. Follow-up in these patients were carried out at one week, four weeks, six months, and one year. Results: Sacrocolpopexy was carried out in ten patients for vaginal vault prolapse after vaginal (6) and abdominal hysterectomy (4). The mean age was 49.8 years. Parity was between P3 - P6 (Mean parity 4.3). Mean operation time was 79.3 minutes. Estimated blood loss was less than 200m1. No intra-operative or post-operative complications occurred in any case. Conclusion: Abdominal sacrocolpopexy is effective and safe in the treatment of vaginal vault prolapse. This procedure has high success rate in correcting prolapse without a time dependent decrease in efficacy.

scholarly journals DORSAL WRIST GANGLION

2016 ◽  
Vol 23 (03) ◽  
pp. 246-250
Author(s):  
Yousaf Jan ◽  
Waqas Ahmad ◽  
Shaukat Hussain ◽  
Muhammad Shah ◽  
Ahmad Din
Keyword(s):  
Surgical Excision ◽  
Success Rates ◽  
Research Committee ◽  
Patients With Cancer ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Study Setting ◽  
Dorsal Wrist Ganglion

Objectives: To evaluate and compare the effect of aspiration plus methylprednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution,complications and recurrence. Study Design: Prospective study. Setting: Surgical wardHayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology:After taking permission from ethical and research committee. Included patients were all adult ofboth gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabeteswere excluded from the study. The patients were divided in two groups: Group A includedpatients for aspiration and injection treatment, while Group B included patients underwentsurgical excision. All the patients were followed for complete resolution of ganglion, anycomplications of treatment and recurrence within one year. Follow up arranged at 7th day, 1,3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65%(n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years.Group A and group B patients had overall success rates of 75% and 95%, with recurrence of25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain wasreported by 70% (n=28), while in the surgical excision group, all the patients experienced mildto moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion:Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatmentbecause of high success and low recurrence rate. As injection-aspiration treatment

scholarly journals Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India

2017 ◽  
Vol 4 (5) ◽  
pp. 1653
Author(s):  
Mohd Hamid Shafique Ahmed ◽  
Bankar S. S. ◽  
Gosavi V. S. ◽  
Dalavi S. B. ◽  
Gurav P. D.
Keyword(s):  
Wound Infection ◽  
Surgical Management ◽  
Surgical Procedures ◽  
Clinical Profile ◽  
Medical College ◽  
History Of ◽  
Male Patients ◽  
A Prospective Study ◽  
Age Range

Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.

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