scholarly journals Surgical Treatment of Benign Retrorectal Masses in Adults: A Retrospective Study

2021 ◽  
Vol 12 (8) ◽  
pp. 54-59
Author(s):  
Hüseyin Bilge ◽  
Ömer Başol ◽  
Abdullah Oğuz

Background: Tumors that occur in the retrorectal space are called retrorectal tumors. These tumors arise from various tissues. Late symptoms may therefore outweigh diagnosis and treatment. Therefore, the surgery becomes difficult. Aims and Objectives: Our study aims to reveal the difficulties in the diagnosis of retrorectal tumors, radiological diagnostic methods, and safe surgical excision surgical techniques. Materials and Methods: Twelve patients operated for retrorectal tömür between 2014 and 2020 were included in the retrospective study. Demographic features, clinical findings, diagnostic methods, surgical treatment procedures, evaluations of preoperative/postoperative complications, pathological classifications, length of hospital stay, and duration of surgery were studied. Results: Twelve patients [9 females, 3 males; the mean age was 39.3 ± 11.8 (22-56)] due to retrorectal tumors. All lesions were evaluated preoperatively using magnetic resonance imaging (MRI). According to the preoperative examination and radiological findings; Surgical resection was performed with an anterior approach to 3 patients, a posterior approach to 4 patients, and a combined approach to 5 patients. The mean tumor size was 8 ± 2.24 cm. Immature teratoma and epidermoid cyst (n = 6) were the most common tumors. We did not have any patients with features of malignancy on final histopathology. Conclusion: Although retrorectal tumors are difficult to diagnose, it is important to suspect clinically. A good evaluation of the patients with radiological imaging facilitates the resection of the tumor surgically. Surgery of the patient in centers specialized in these tumors increases surgical success.

2015 ◽  
Vol 100 (7-8) ◽  
pp. 1177-1184 ◽  
Author(s):  
Abdullah Oguz ◽  
Abdullah Böyük ◽  
Ahmet Turkoglu ◽  
Cemil Goya ◽  
Ulas Alabalık ◽  
...  

Due to the rarity and large diversity of the primary retrorectal tumors (RTs), the diagnoses are often difficult and they can be misdiagnosed. We present our experience in light of scarce information available on the clinical manifestations of RTs. The retrospective study included 17 patients diagnosed as RTs between January 2004 and January 2014. Demographic characteristics, length of symptoms, clinical findings, diagnostic methods, evaluations on the treatment procedures and postoperative periods, pathology, complications, and length of hospital stay were recorded. A mean of 1.7 of patients were diagnosed with RTs annually in our hospital. Patients comprised 12 females and 5 males. Pain and discomfort were the most common symptoms at presentation. All the lesions were evaluated by using magnetic resonance imaging (MRI) and computed tomography (CT), and all the patients were treated operatively. Based on the preoperative MRI or CT findings, an anterior approach was performed in 7 patients, a posterior approach in 6 patients, and combined approach in 4 patients. Mean size of tumors was 9.2 ± 4.3 cm. Epidermoid cyst (n = 8) was the most common tumor. Except for 1 case of liposarcoma, 16 tumors were confirmed to be of benign nature in histologic examination. Mean length of hospital stay 12.4 ± 6.8 days. Retrorectal tumors are heterogeneous and lead to diagnostic difficulties. A high index of clinical suspicion is needed for diagnosis. Preoperative imaging may be helpful in determining the course of treatment. Total excision of a retrorectal tumor may alleviate pressure symptoms and confirm the diagnosis.


2021 ◽  
pp. 44-45
Author(s):  
Arvin Najaf ◽  
Pooyan Jalalpour ◽  
Dorsa Hadavi ◽  
Salman Azarsina

Background: Humerus shaft fracture is one of the most common orthopedic problems, accounting for approximately 5% of all fractures. This study aimed to compare the surgical treatment results of humerus shaft fractures by intramedullary nailing and palate. Methods: This study was performed as a retrospective cohort. Eighty patients were referred to the Madani hospital with humerus shaft fracture, of which 40 patients were treated with either IMN or palate methods. All patients were followed up in outpatient clinics at six weeks and 3 and 6 months. Evaluation of the results was evaluated based on performance improvement, ability to return to previous jobs after six months, time of union formation, rate of union formation, and incidence of complications. Data were analyzed using the SPSS program. Results: The mean amount of blood lost during the operation and the duration of surgery in the IMN group were signicantly lower than the DCP group (P <0.05), but there was no signicant difference between the two groups in terms of length of hospital stay (P> 0.05). On the other hand, the mean of Constant and ASES criteria and the frequency of unions in the two groups were not signicantly different (P> 0.05). Conclusion: The present study results showed that the rate of intraoperative bleeding and duration of surgery in the IMN group was signicantly lower than the DCP group. Still, there was no signicant difference between the two groups in terms of length of hospital stay and functional criteria.


2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.


2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.


2022 ◽  
Vol 26 (1) ◽  
pp. 50-56
Author(s):  
N. Ose ◽  
Y. Takeuchi ◽  
N. Kitahara ◽  
K. In ◽  
Y. Susaki ◽  
...  

BACKGROUND: The surgical treatment for non-tuberculous mycobacterial pulmonary disease (NTM-PD) has an important adjunctive role and reported outcomes have been generally good; however, the prognostic factors remain unclear.METHODS: Sixty-one patients with NTM-PD who underwent surgical resection for a therapeutic purpose from January 2000 to March 2017 at five affiliated institutions were enrolled. We explored the factors that influence complications and prognosis by retrospectively referring to the medical records.RESULTS: The mean age of the present cohort was 61.8 ± 11.4 years. The pathogen was Mycobacterium avium complex in 49 patients, M. abscessus in 5. The most common indications were refractory to medication in 39. The surgical techniques employed were lobectomy or further resection in 49, sublobar resection in 8, with video-assisted thoracoscopic surgery in 21. Sputum culture conversion rate was 95.1%. Univariate analysis of factors associated with deterioration revealed significant differences related to age (P = 0.025), pre-operative albumin level (P = 0.001) and development of postoperative complications (P = 0.037), while pre-operative albumin level alone was a significant factor in multivariate analysis (P = 0.009).CONCLUSION: Outcomes after resection were generally good in the present cases. Nutritional status, as indicated by albumin level, may affect prognosis after surgical treatment.


2021 ◽  
Vol 24 (4) ◽  
pp. 32-36
Author(s):  
D. S. Zolotukhin ◽  
I. V. Krochek ◽  
S. V. Sergiyko

The work carried out a comparative analysis of the results of surgical treatment of the epithelial-coccygeal course of ECC in 133 children aged 3 to 17 years, using laser-induced interstitial thermotherapy (LIT) and open excision. Comparative analysis was carried out according to the following criteria: duration of surgery, average time of hospital stay, duration of pain syndrome on a 10-point scale (VAS), the presence of complications in the early and late postoperative period. In the main group, the average time of hospital stay was 4.9 ± 0.3; the duration of surgical treatment was 17.2 ± 2.8 minutes. The duration of the pain syndrome was 5.3 ± 2.1 hours, and its severity was 2.7 ± 0.8 points. Average terms of epithelialization of fistulas are 3.1 ± 2.8 days. Recurrence of ECC was observed in 7 patients (11.7%), which required re-intervention. In 3 (5.0%) patients, LIT was used, and in 4 (6.7%), excision using plastics according to the Bascom method. In the comparison group, the duration of surgical treatment was 32.6 ± 5.4 minutes. The duration of inpatient treatment is 16.7 ± 1.4 days. Pain syndrome averaged 71.8 ± 11.9 hours, severity 6.5 ± 2.3 points. The number of relapses was 9 (12.3%), of which 5 (6.8%) children underwent laser treatment, and 4 (5.5%) repeated surgical excision with Bascom with recovery. This technique is an effective and minimally invasive method for treating ECC, which makes it possible to recommend this method for use in pediatric surgical practice.


1998 ◽  
Vol 8 (3) ◽  
pp. 148-152 ◽  
Author(s):  
C. H. Karabatsas ◽  
G. W. Marsh ◽  
A. M. Cook ◽  
S. D. Cook

Purpose This study was initiated to investigate the role of different therapeutic modalities in the outcome of the surgical treatment of pterygium. Methods The results of treatment of pterygia with a variety of surgical techniques were studied in 56 eyes (49 patients) operated on at Bristol Eye Hospital during a period of five years. The surgical techniques included simple excision; bare sclera; conjunctival autograft; sliding conjunctival flap; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys. Results The incidence of recurrence was 23.2% for the 43 treated primary pterygia, and 23% for the 13 recurrent pterygia. All recurrences occurred between 2.5 and 11 months postoperatively. None of the 11 cases where additional beta irradiation was used showed any recurrence or other complication within the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed significantly lower recurrence rate (p<0.001) compared to those cases treated with surgical excision alone. Conclusions Beta irradiation as a complement to surgical treatment of pterygium, is successful in treating high risk cases such as reoperations, whereas for the majority of primary pterygia surgical excision alone is adequate. Additionally, follow up of one year will reveal any recurrences.


Folia Medica ◽  
2011 ◽  
Vol 53 (4) ◽  
pp. 34-41 ◽  
Author(s):  
Hristo Shipkov ◽  
Ali Mojallal ◽  
Fabienne Braye

ABSTRACT AIM: To present and evaluate the outcomes of the posterosuperior pedicle breast reduction technique. PATIENTS AND METHODS: 200 patients were included in the present retrospective study. They were operated on between January 2006 and January 2009. The mean age was 35.9 years (range 22 to 58 years). The average notch-to-nipple distance was 35.8 cm (range, 29 to 42 cm). The mean body mass index was 27 (range, 22 to 35 cm). Results were assessed by means of self-evaluation and by an independent 5-member jury. Fifty two patients (26%) had had bariatric surgery and 48 (24%) had had abdominoplasty. None of the patients had any previous breast surgery. All patients reported dorsal and cervical pain. RESULTS: The mean follow-up period was 16 months (range, 13 to 23 months). The average weight resected was 981 g (range from 370 g to 1800 g). The average duration of surgery was 2h (range, 1.50 to 2.30 hours) and average length of hospital stay was 2.3 days (range, 2 to 4 days). The duration of the outpatient postoperative care until complete wound healing was 15.2 days (range, 13 to 20 days). There were 4 major complications (2%) (1 bilateral and 3 unilateral infections) treated by drainage and intravenous antibiotics. Twenty-two minor complications were recorded (11%) including one desquamation of the nipple-areola complex without necrosis (0.5%) delayed healing at the junction site of the inverted T incision in 21 cases (10.5%). One hundred and forty eight patients evaluated their results as “very good” (74%), 36 as “good” (18%), and 16 as “acceptable” (8%). There were no results assessed as “poor.” Fifty-eight percent of the patients found that back pain had totally resolved versus 42% who had signifi cant improvement though not complete resolution. CONCLUSIONS: The postero-superior pedicle for breast reduction is a reproducible and versatile technique. The preservation of the anterior intercostal artery perforators enhances the reliability of the vascular supply to the superior pedicle.


2016 ◽  
Vol 27 (04) ◽  
pp. 319-323 ◽  
Author(s):  
Beril Talim ◽  
İbrahim Karnak ◽  
Saniye Ekinci ◽  
Fatih Andiran ◽  
Arbay Çiftçi ◽  
...  

Aim A retrospective study was performed to evaluate the clinical features, diagnostic methods, and treatment alternatives of childhood inflammatory myofibroblastic tumors (IMTs). Patients and Methods Patients who underwent surgical treatment for IMT between 2000 and 2015 were evaluated for age, sex, presenting symptoms, physical examination findings, diagnostic methods, treatment modalities, histopathologic findings, and results of surgical treatment during long-term follow-up. Results Eleven patients who underwent surgical treatment were included in the study. Male:female ratio was 7:4 and the mean age of the patients was 6.09 years (1–10 years). Presenting symptoms were respiratory difficulty, cough (n = 7, 63.3%), abdominal pain, vomiting (n = 2, 18.8%), loss of body weight (n = 1, 9.09%), palpable mass (n = 1, 9.09%), and rectal bleeding (n = 1, 9.09%). Ultrasonography (n = 4, 36.3%) and computed tomography (n = 9, 81.1%) were used for diagnosis. Localizations of tumors were lungs (n = 5, 45.4%), mediastinum (n = 2, 18.1%), spleen (n = 1, 9.09%), neck (n = 1, 9.09%), colon (n = 1, 9.09%), and rectum (n = 1, 9.09%). The mean size of mass was 6.6 cm (2–12 cm) and six patients were diagnosed with preoperative biopsy. Lung lobectomy (right lower lobe; n = 3, right middle and lower lobe; n = 2), total resection of mass with adjacent bowel (n = 2), partial splenectomy (n = 1), total resection of neck mass (n = 1), and incomplete resection (n = 2) were the choice of surgical treatment. Incomplete resection was performed in masses closely adjacent to atrium and mediastinal structures. In histopathologic evaluation, surgical margins were free of tumor in four cases, positive in six cases, and were not reported in one case. Anaplastic lymphoma kinase (ALK) positivity was detected in six cases, negative in two cases, and was not evaluated in three cases. Two cases who had residual mass with positive ALK received chemotherapy. Mean follow-up time was 68.2 months (5 months to 12 years). During follow-up, there was no recurrence or distant metastasis. Ten patients survived and one patient was lost to follow-up. Conclusion IMT is a rare tumor of childhood with a spectrum of clinical findings because of variable localization. Surgical treatment is the first choice of treatment. Patients with residual mass and ALK positivity may require medical treatment. In our series, long-term survival of patients was favorable in patients with total resection.


2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 4S
Author(s):  
Rafael Ferreira da Silva ◽  
André Donato Baptista ◽  
Kepler Alencar Mendes de Carvalho

Introduction: Hallux valgus is a multifactorial disease, and heredity is the main associated factor. Pain and discomfort when using closed-toed shoes occur in many cases, adversely affecting quality of life. Surgical treatment is indicated when pain and disability persist after conservative treatment. Currently, more than 150 surgical techniques are described for hallux valgus correction, with no consensus regarding the best treatment. With the advent of minimally invasive techniques for hallux valgus correction, Vernois developed the percutaneous chevron osteotomy. This technique allows up to 100% lateral translation of the contact area of the osteotomy. Objective: the objective of the present study was to assess the correction of radiographic parameters, clinical improvement and potential complications of the first 30 cases of moderate and severe hallux valgus operated on at our hospital using the percutaneous chevron technique. Methods: A total of 26 patients (30 feet) underwent surgery. The following parameters were measured in the pre- and postoperative periods: the first metatarsophalangeal (MTP) angle, the intermetatarsal angle between the 1st and 2nd metatarsals (IMA), the distal metatarsal articular angle (DMAA) and the pre- and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores, with a minimum follow-up period of 6 months. Results: The mean age of the patients was 52.3 years. During the preoperative period, the mean AOFAS score was 45.6; it increased to 90.3 after the procedure, indicating a statistically significant improvement. The mean MTP angle, IMA and DMAA were 29.7°, 14.2° and 14.2° before surgery and 12.8°, 8.2° and 11.1° after surgery, respectively. The improvements in the MTP angle and the IMA were also significant. There was no decrease in angles or worsening of AOFAS scores during follow-up. Conclusion: The percutaneous chevron technique was safe and effective for correcting cases of moderate and severe hallux valgus, with significant improvements in clinical and radiological parameters and a low rate of postoperative complications.


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