scholarly journals Endoscopic removal of cysticercal cysts within the fourth ventricle: technique and results

1999 ◽  
Vol 6 (4) ◽  
pp. E10 ◽  
Author(s):  
Marvin Bergsneider
Keyword(s):  
Blood Loss ◽  
Fourth Ventricle ◽  
Treatment Options ◽  
Primary Treatment ◽  
Endoscopic Procedure ◽  
Surgical Removal ◽  
Endoscopic Removal ◽  
Suboccipital Craniotomy ◽  
Cerebrospinal Fluid Shunting ◽  
Postoperative Discomfort

There is no consensus as to the optimum management of patients who harbor cysticercal cysts within the fourth ventricle. Compared with the alternative treatment options of anthelmintic medication and/or cerebrospinal fluid shunting, the surgical removal of the cyst has the advantage of eliminating the inflammatory nidus and potentially obviating the need for a complication-prone shunt. Here, an endoscopic surgical approach is described and proposed as a superior alternative to the suboccipital craniotomy for removal of a fourth ventricle cyst. A retrospective analysis was conducted to compare five consecutive endoscopic cases with eight previous consecutive cases in which a suboccipital craniotomy was performed to remove fourth ventricle cysticercal cysts. Comparisons are made with regards to success in removing the cyst, length of operation, surgical blood loss, postoperative discomfort, and complications. A detailed description of the endoscopic technique is given. Endoscopic removal of all cysts within the fourth ventricle was successful in each case. The mean length of operative times was shorter and the blood loss was reduced with the endoscopic procedure compared with the suboccipital craniotomy (2.5 ± 0.8 hours and 5.3 ± 2.2 hours [p = 0.02], 19 ± 4ml and 269 ± 203 ml [p = 0.02], respectively). The endoscopic procedure was safe and associated with less postoperative discomfort in most patients. In properly selected patients, the endoscopic removal of cysticercal cysts located within the fourth ventricle is superior to the suboccipital craniotomy and should be considered as the primary treatment for this condition.

Endoscopic removal of cysticercal cysts within the fourth ventricle

1999 ◽  
Vol 91 (2) ◽  
pp. 340-345 ◽  
Author(s):  
Marvin Bergsneider
Keyword(s):  
Fourth Ventricle ◽  
Treatment Options ◽  
Primary Treatment ◽  
Surgical Removal ◽  
Endoscopic Removal ◽  
Content Type ◽  
Suboccipital Craniectomy ◽  
The Mean ◽  
Optimum Management ◽  
Fine Print

✓ There is no consensus as to the optimum management of patients who harbor cysticercal cysts within the fourth ventricle. Compared with the alternative treatment options of anthelmintic medication and/or cerebrospinal fluid shunt placement, the surgical removal of the cyst has the advantage of eliminating the inflammatory nidus and potentially obviating the need for a complication-prone shunt. Here, an endoscopic surgical approach is described and proposed as an alternative to the standard suboccipital craniectomy for removal of cysticercal cysts within the fourth ventricle.A retrospective analysis of five consecutive endoscopic cases was performed. Endoscopic removal of all cysts within the fourth ventricle was successful in each case. The mean length of operative time was short and blood loss was insignificant. The endoscopic procedure was safe and associated with minimal postoperative discomfort in most patients.In properly selected patients, the endoscopic removal of cysticercal cysts located within the fourth ventricle should be considered as the primary treatment for this condition.

Antrochoanal Polyps in Children

2001 ◽  
Vol 15 (5) ◽  
pp. 321-325 ◽  
Author(s):  
Laura J. Orvidas ◽  
Charles W. Beatty ◽  
Amy L. Weaver
Keyword(s):  
Treatment Options ◽  
Surgical Removal ◽  
Antrochoanal Polyp ◽  
Endoscopic Removal ◽  
Endoscopic Procedures ◽  
Telephone Interviews ◽  
Presenting Symptoms ◽  
First Recurrence ◽  
Mean Time

Although relatively rare, antrochoanal polyps represent one of the most common types of polyp diagnosed in children without cystic fibrosis. In an attempt to better define this entity and discuss treatment options, the histories and operative reports of all 25 children (aged 17 years and younger) diagnosed with an antrochoanal polyp between 1970 and 1997 at our institution were reviewed. All 25 children complained of nasal obstruction on presentation; other presenting symptoms included rhinorrhea (48%), snoring (36%), and mouth breathing (32%). All 25 patients were noted to have a mass in the nose on examination, and 16 (64%) also had a mass noted in the nasopharynx. All but 1 patient underwent surgical removal of the polyp: intranasal avulsion only, 2 patients; Caldwell-Luc procedures, 10 patients; intranasal procedures, 8 patients; and endoscopic procedures, 4 patients. Mean time to first recurrence was 44.5 months. Seven patients (29%) who underwent excision at our institution experienced recurrence, 3 after endoscopic procedures and 4 after intranasal procedures (with or without Caldwell-Luc; 1 of these patients had a second recurrence). Complications were unusual and included bleeding after pack removal (8.3%) and facial paresthesias (10%). Follow-up ranged from 2 days to almost 27 years and was aided by telephone interviews. We conclude that surgical treatment of these lesions is safe and effective. Endoscopic removal may result in a higher recurrence rate.

scholarly journals The Combination Therapy of Dissolution Using Carbonated Liquid and Endoscopic Procedure for Bezoars: Pragmatical and Clinical Review

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Kohei Ogawa ◽  
Kenya Kamimura ◽  
Ken-ichi Mizuno ◽  
Yoko Shinagawa ◽  
Yuji Kobayashi ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Combination Therapy ◽  
Clinical Review ◽  
Foreign Bodies ◽  
Length Of Hospital Stay ◽  
Endoscopic Procedure ◽  
Surgical Removal ◽  
Endoscopic Removal ◽  
Effective Removal ◽  
Ulcerative Lesions

Bezoars are relatively rare foreign bodies of gastrointestinal tract and often cause ileus and ulcerative lesions in the stomach and subsequent bleeding and perforation due to their size and stiffness. Therefore, the removal of bezoars is essential and recent development of devices, the endoscopic removal procedure, is often applied. However, due to their stiffness, simple endoscopic removal failed in not a few cases, and surgical removal has also been used. Recently, the efficacy of a combination therapy of endoscopic procedure and dissolution using carbonated liquid has been reported. To develop the safe and effective removal procedure, we carefully reviewed a total of 55 reported cases in this study including our 3 additional cases, successfully treated with dissolution with endoscopic fragmentation. In summary, the data showed the efficiency in the combination therapy, treating the larger size of bezoar and reducing the length of hospital stay. To the best of our knowledge, this is the largest pragmatical and clinical review for the combination therapy of dissolution and endoscopic treatment for bezoars. This review should help physicians to manage bezoars more efficiently.

CONTEMPORARY TREATMENT APPROACH OF SQUAMOUS CELL SKIN CANCER: REVIEW

2019 ◽  
Vol 65 (1) ◽  
pp. 7-15
Author(s):  
Aleksey Belyaev ◽  
Georgiy Prokhorov ◽  
Zamira Radzhabova ◽  
Olga Baykalova
Keyword(s):  
Skin Cancer ◽  
Squamous Cell ◽  
New Technologies ◽  
Treatment Options ◽  
Epidermoid Carcinoma ◽  
Surgical Removal ◽  
Cochrane Central Register ◽  
Epithelial Tumor ◽  
Randomized Controlled Studies ◽  
Skin Malignancy

The incidence of skin cancer is a steady increasing around the world. Tumors of epithelial origin occupy the first place in the structure of all skin malignancy. Epidermoid carcinoma is the most malignant epithelial tumor of the skin and mucous membranes with squamous differentiation. Generally, squamous cell carcinoma is successfully treated by surgical and radiological methods. Often a different kind of plastic defect reconstructions are required after surgical removal. The incidence of epidermoid carcinoma increases with age (average age of patients falls on 65 years) therefore variants of treatment options is limited by comorbidities. However, surgical oncologist do not have enough date and randomized controlled studies on this theme. Minimally invasive methods, especially cryothechnology are increasingly used, but unfortunately their advantage requires additional evidence. We suppose Inclusion in the conventional treatment of new technologies may possibly improve the results of treatment. We reviewed the literature, summarizing data on various methods of treating squamous cell skin cancer. Comprehensive and systematic search was based on MedLine, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus and PubMed among original articles for the period from January 1974 to October 2018.

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children's Hospital experience

2011 ◽  
Vol 8 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Manish N. Shah ◽  
Alex A. Kane ◽  
J. Dayne Petersen ◽  
Albert S. Woo ◽  
Sybill D. Naidoo ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Open Surgery ◽  
Operating Time ◽  
Endoscopic Procedure ◽  
Sagittal Craniosynostosis ◽  
Helmet Therapy ◽  
Age At Surgery ◽  
The Mean ◽  
Strip Craniectomy

Object This study investigated the differences in effectiveness and morbidity between endoscopically assisted wide-vertex strip craniectomy with barrel-stave osteotomies and postoperative helmet therapy versus open calvarial vault reconstruction without helmet therapy for sagittal craniosynostosis. Methods Between 2003 and 2010, the authors prospectively observed 89 children less than 12 months old who were surgically treated for a diagnosis of isolated sagittal synostosis. The endoscopic procedure was offered starting in 2006. The data associated with length of stay, blood loss, transfusion rates, operating times, and cephalic indices were reviewed. Results There were 47 endoscopically treated patients with a mean age at surgery of 3.6 months and 42 patients with open-vault reconstruction whose mean age at surgery was 6.8 months. The mean follow-up time was 13 months for endoscopic versus 25 months for open procedures. The mean operating time for the endoscopic procedure was 88 minutes, versus 179 minutes for the open surgery. The mean blood loss was 29 ml for endoscopic versus 218 ml for open procedures. Three endoscopically treated cases (6.4%) underwent transfusion, whereas all patients with open procedures underwent transfusion, with a mean of 1.6 transfusions per patient. The mean length of stay was 1.2 days for endoscopic and 3.9 days for open procedures. Of endoscopically treated patients completing helmet therapy, the mean duration for helmet therapy was 8.7 months. The mean pre- and postoperative cephalic indices for endoscopic procedures were 68% and 76% at 13 months postoperatively, versus 68% and 77% at 25 months postoperatively for open surgery. Conclusions Endoscopically assisted strip craniectomy offers a safe and effective treatment for sagittal craniosynostosis that is comparable in outcome to calvarial vault reconstruction, with no increase in morbidity and a shorter length of stay.

scholarly journals Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis

2017 ◽  
Vol 9 (3) ◽  
pp. 79-87 ◽  
Author(s):  
Marilla Dickfos ◽  
Robert Franz
Keyword(s):  
Total Thyroidectomy ◽  
Surgical Management ◽  
Medical Therapy ◽  
Clinical Status ◽  
Case Series ◽  
Primary Treatment ◽  
Surgical Removal ◽  
Efficient Treatment ◽  
Select Group ◽  
Small Subgroup

ABSTRACT Introduction Amiodarone can be a life-saving medication; however, it can also cause amiodarone-induced thyrotoxicosis (AIT). Though rare, AIT is a complex and life-threatening side effect, which can cause significant cardiac dysfunction and lead to cardiac failure. Primary treatment is with thionamides, perchlorates, and steroids. However, a small subgroup does not respond and their cardiovascular function continues to deteriorate. This select group is referred for a semi-elective total thyroidectomy. Without surgical removal of their thyroid gland, these patients will continue to deteriorate, with a 30 to 50% mortality rate for those not operated on. Aim The aim of this case series was to assess for any indicators as to when these patients should be referred for total thyroidectomies and the efficacy of this method of treatment. Materials and methods A case series of patients with AIT treated with a total thyroidectomy from 1998 to 2015 was used to assess the efficacy of and indicators for surgery. Results Total thyroidectomy results in efficient and significant improvement in the patient's biochemistry and symptoms. The patient's symptoms and options for medical therapy have an influence on the duration of the trial of medical therapy. Conclusion Surgery is an effective and efficient treatment for AIT. However, there does not appear to be a specific indicator for when this treatment should be instigated. A case-by-case approach should be adopted when treating these complicated patients. Clinical significance Clinicians should see surgery as an effective and efficient treatment for AIT. The timing of surgery should be assessed on a case-by-case basis considering the patient's clinical status and therapeutic options and not as a last resort. How to cite this article Dickfos M, Franz R. Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis. World J Endoc Surg 2017;9(3):79-87.

Teratoma of the fourth ventricle

1973 ◽  
Vol 38 (3) ◽  
pp. 355-357 ◽  
Author(s):  
Robert J. Morelli
Keyword(s):  
Fourth Ventricle ◽  
Rare Case ◽  
Surgical Removal ◽  
Malignant Teratoma ◽  
Content Type ◽  
Fine Print

✓ The author reports a rare case in which a primary malignant teratoma presented as an obstructing mass in the fourth ventricle. The tumor was not cystic but well encapsulated, and a gross total surgical removal was accomplished. A fatal recurrence occurred within 3 months.

Opioid-Sparing Analgesics in Chronic Pain Management

2017 ◽  
Author(s):  
Maricela Schnur ◽  
Michael Fitzsimons ◽  
Fangfang Xing
Keyword(s):  
Chronic Pain ◽  
Treatment Options ◽  
Primary Treatment ◽  
Opioid Therapy ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Prescription Opioid ◽  
Antiinflammatory Drugs ◽  
Opioid Sparing ◽  
Pharmacologic Treatments ◽  
Chronic Pain Therapy

Chronic pain impacts the lives of millions of people in significant medical and psychosocial ways. Pharmacologic treatments are steering away from chronic opioid therapy due to serious side effects, an epidemic of prescription opioid abuse, and a lack of clear long-term benefit.  Therefore, nonopioid medications such as nonsteroidal antiinflammatory drugs, acetaminophen, tricyclic antidepressants, lidocaine patch, and anticonvulsants are important opioid-sparing or primary treatment options. Agents such as capsaicin, cannabis, botulinum toxin, and ketamine are less frequently prescribed adjuncts that are under active investigation to determine their roles in chronic pain therapy. Understanding the research can help the clinician determine the risks and benefits of these medications for their patients. In the future, dose and delivery optimization, combination therapy, elucidating the biology of pain, and developing novel agents will improve pharmacologic approaches to treatment.          

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