Efficiency and safety of sclerotherapy for recurrent nodular goiter

2020 ◽  
pp. 39-51
Author(s):  
G. V. Rodoman ◽  
I. R. Sumedi ◽  
N. V. Sviridenko ◽  
T. I. Shalaeva ◽  
M. M. Meloyan
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Nodular Goiter ◽  
Treatment Method ◽  
Age Group ◽  
Invasive Treatment ◽  
The Third ◽  
Invasive Method ◽  
Functional Autonomy

At present, patients with recurrent nodular goiter account for a significant portion of patients operated on for nodular goiter. At the same time, the comorbid background characteristic of this age group and the technical difficulties of the intervention on cicatricial tissues of the neck cause a high risk of complications of the operation, 3–7 times higher than with primary thyroid interventions. The aim of the study was to evaluate the effectiveness and safety of treatment of recurrent nodular goiter using an alternative minimally invasive method — sclerotherapy. The study included 30 patients previously operated on for nodular goiter. All had 4 courses of sclerotherapy, each included 5 sessions with a frequency of 1 session per week, followed by a follow-up period of 3 months. Polydocanol was used as a sclerosant. The analysis showed that sclerotherapy for recurrent nodular goiter allows all patients to reduce recurrent nodular formations, and in almost a third of cases, complete reduction of the nodes. On average, the decrease in the volume of thyroid residues was 9.6 ± 1.5 ml, and the size of nodular formations decreased by 17.2 ± 1.3 mm (3.7 times — from 23.6 ± 1.4 mm to 6.4 ± 0.7 mm, P <0.001). Nodes more than 3 cm, initially 19 %, ceased to be detected after the third course of sclerotherapy. In all cases, managed to eliminate hormonal imbalances in patients who initially had functional autonomy, as well as signs of compression of the neck organs. At the same time, sclerotherapy of nodules of the thyroid gland using polydocanol as a sclerosant is a safe minimally invasive treatment method, is not accompanied by severe pain and the risk of hypoparathyroidism and laryngeal paresis.

scholarly journals Transarterial Embolization of Acute Gastrointestinal Bleeding

2021 ◽  
Vol 38 (SI-1) ◽  
pp. 56-60
Author(s):  
Ayşegül İDİL SOYLU ◽  
Fatih UZUNKAYA ◽  
Ümit BELET ◽  
Hüseyin AKAN
Keyword(s):  
Minimally Invasive ◽  
Gastrointestinal Bleeding ◽  
Transarterial Embolization ◽  
Treatment Method ◽  
Invasive Treatment ◽  
Tumor Vascularity ◽  
Technical Success Rate ◽  
Acute Gastrointestinal Bleeding ◽  
Invasive Method ◽  
Polyvinyl Alcohol Particles

Transarterial embolization (TAE) is a minimally invasive treatment method developed alternative to surgery for acute gastrointestinal bleeding (AGIB). The aim of this study was to evaluate the efficacy and outcome of TAE in AGIB patients. The data of 30 patients who underwent TAE with complaint of AGIB between January 2007- May 2020 was collected retrospectively. The etiology of hemorrhage, localization and type of lesion, embolizing agent used, and postprocedural complications were recorded. Lesions were classified as pseudoaneurysm (PA), extravasation, pathological tumor vascularity and vasospasm. A total of 22 patients, 5 females, were included in the study. The most common underlying cause was tumors (n=15, 50%). The most common lesion detected on angiograms was pathological tumor vascularity. Embolizing agents used were Nbutyl-2-cyanoacrylate in five patients, coils in three patients, polyvinyl alcohol particles in six patients and microsphere in seven patients. The technical success rate was 90.9%, and two patients developed rebleeding in the early postprocedural period. TAE is a safe, effective and minimally invasive method in emergency treatment of patients with AGIB.

scholarly journals SURG-25. LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR INTRACRANIAL LESIONS: A SINGLE- INSTITUTIONAL SERIES, OUTCOMES AND REVIEW OF THE LITERATURE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi244-vi245
Author(s):  
Rocco Dabecco ◽  
Alexander Yu ◽  
Tulika Ranjan ◽  
Linda Xu ◽  
Khaled Aziz
Keyword(s):  
Minimally Invasive ◽  
Brain Metastases ◽  
Metastatic Disease ◽  
Progression Free Survival ◽  
Treatment Method ◽  
Thermal Therapy ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Laser Interstitial Thermal Therapy

Abstract INTRODUCTION Laser interstitial thermal therapy (LITT) is a minimally invasive treatment method that provides surgeons with cytoreductive techniques to treat neurosurgical conditions such as primary brain neoplasms, brain metastases, radiation necrosis, and epileptogenic lesions, many of which are located in operative corridors that would be difficult to address via open surgical or are amenable via minimally invasive approaches. Although the use of lasers is not a new concept in neurosurgery, advances in technology have enabled surgeons to perform laser treatment with the aid of real-time MRI thermography as a guide. In this report, we present our institutional series and outcomes of patients treated with LITT for 8 glial neoplasms 12 brain metastases. METHODS We retrospectively evaluated 20 patients (7 male, 13 female; age range, 28–77 years) who underwent LITT at one or more targets from 2015–2019. RESULTS In our series, all patients included had prior craniotomy for either primary glioma or metastatic disease. Mean extent of ablation (EOA) was 98% on post-op MRI. Mean progression free survival varied depending on the intracranial pathology, with the glioma cohort (5 months (SDD: 3.51)) demonstrating worse outcomes than metastatic disease (8.2 months (SDD: 4.83)). Only 1 patient experienced immediate post-operative morbidity, 1 patient experienced post-operative mortality secondary to hemorrhage. Mean follow-up was 9.7 months (SDD: 5.35), with one patient lost to follow up immediately post-procedure and excluded from the study. Average hospitalization was 2.4 days (SDD: 1.0). Mean overall survival, post-diagnosis of intracranial lesion, is more favorable for metastatic lesions (48 months (SDD: 27.14)), as compared to primary glial neoplasms (31 months SDD: 11.63)). CONCLUSION Laser interstitial thermal therapy (LITT) is a safe, minimally invasive treatment method that provides surgeons with cytoreductive techniques to treat neurosurgical conditions. In properly selected patients, this modality offers improved survival outcomes in conjunction with other salvage therapies.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

scholarly journals Minimally invasive debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis: a long‐term follow‐up study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jianbiao Xu ◽  
Leiming Zhang ◽  
Rongqiang Bu ◽  
Yankang Liu ◽  
Kai-Uwe Lewandrowski ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Intervertebral Discs ◽  
Intraoperative Ct ◽  
Long Term Follow Up ◽  
Invasive Method ◽  
Vertebral Bodies ◽  
Adjacent Segments

Abstract Background Spondylodiscitis is an unusual infectious disease, which usually originates as a pathogenic infection of intervertebral discs and then spreads to neighboring vertebral bodies. The objective of this study is to evaluate percutaneous debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis. Methods From January 2002 to May 2017, 23 patients with multilevel spondylodiscitis were treated with minimally invasive debridement and drainage procedures in our department. The clinical manifestations, evolution, and minimally invasive debridement and drainage treatment of this refractory vertebral infection were investigated. Results Of the enrolled patients, the operation time ranged from 30 minutes to 124 minutes every level with an average of 48 minutes. Intraoperative hemorrhage was minimal. The postoperative follow-up period ranged from 12 months to 6.5 years with an average of 3.7 years. There was no reactivation of infection in the treated vertebral segment during follow-up, but two patients with fungal spinal infection continued to progress by affecting adjacent segments prior to final resolution. According to the classification system of Macnab, one patient had a good outcome at the final follow-up, and the rest were excellent. Conclusions Minimally invasive percutaneous debridement and irrigation using intraoperative CT-Guide is an effective minimally invasive method for the treatment of multilevel spondylodiscitis.

scholarly journals Results and Lessons Learned on Robotic Assisted Kidney Transplantation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mireia Musquera ◽  
Lluis Peri ◽  
Tarek Ajami ◽  
Ignacio Revuelta ◽  
Laura Izquierdo ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Minimally Invasive ◽  
Late Complications ◽  
Lessons Learned ◽  
Ureteral Stenosis ◽  
Robotic Assisted ◽  
Conversion To Open Surgery ◽  
Invasive Method ◽  
The Mean

Introduction. Nowadays, minimally invasive surgery in kidney transplantation is a reality thanks to robotic assistance. In this paper, we describe our experience, how we developed the robotic assisted Kidney transplantation (RAKT) technique, and analyze our results. Material and Methods. This is a retrospective study of all RAKTs performed at our center between July 2015 and March 2020. We describe the donor selection, surgical technique, and analyze the surgical results and complications. A comparison between the first 20 cases and the following ones is performed. Results. During the aforementioned period, 82 living donor RAKTs were performed. The mean age was 47.4±13.4 and 50 (61%) were male. Mean body mass index was 25±4.7 and preemptive in 63.7% of cases. Right kidneys and multiple arteries were seen in 14.6% and 12.2%, respectively. Mean operative and rewarming time was 197±42 and 47±9.6 minutes, respectively. Five cases required conversion to open surgery because of abnormal kidney vascularization. Two patients required embolization for subcapsular and hypogastric artery bleeding without repercussion. Three kidneys were lost, two of them due to acute rejection and one because venous thrombosis. Late complications requiring surgery included one kidney artery stenosis, one ureteral stenosis, two lymphoceles, and three hernia repairs. We noticed a significant reduction in time between the first 20 cases and the following ones from 248.25±38.1 to 189.75±25.3 (p<0.05). With a mean follow-up time of 1.8 years (SD 1.3), the mean creatinine was 1.52 (SD 0.7) and RAKT graft survival was 98%. Conclusions. The robotic approach is an attractive, minimally invasive method for kidney transplantation, yielding good results. Further studies are needed to consider it a standard approach.

Uterine Artery Embolization is Advanced, Minimally Invasive Treatment for Fibroids with Intervention Procedure: A Case Report

2014 ◽  
Vol 1 (1) ◽  
pp. 47
Author(s):  
Chandrashekhar M. Gattani ◽  
Tejas P. Sadavarte ◽  
Shripad S. Kamble
Keyword(s):  
Minimally Invasive ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Posterior Wall ◽  
Contrast Study ◽  
Lower Abdomen ◽  
Artery Embolization ◽  
Invasive Treatment ◽  
Intervention Procedure

<p>Uterine Artery Embolization (UAE) has become most effective and minimally invasive alternative treatment over the past many years, especially for women with symptomatic fibroids for whom conservation of uterus is important. Here we are reporting a case of an eighteen year old, unmarried female who presented with pain in lower abdomen and pelvis, menorrhagia and she also noticed gradually increasing lump in pelvis and lower abdomen.</p><p>After clinical examination, patient was referred for radiological investigations, initially ultrasonography was performed which revealed, a large sized posterior wall uterine fibroid measuring approx. 19 x 10 x 18 cm and it was further confirmed on MRI with contrast study. UAE was carried out in order to relieve the symptoms, reduce the size of fibroid and at the same time preserve the uterus. The procedure was uneventful after follow-up for 3 months, there was partial regression in the size of fibroid.</p>

scholarly journals Computed tomography as a method of substantiating a minimally invasive approach in the treatment of esophageal injuries and their complications

2021 ◽  
Vol 25 (2) ◽  
pp. 63-73
Author(s):  
T. G. Barmina ◽  
S. N. Danielyan ◽  
L. S. Kokov ◽  
F. A.-K. Sharifullin ◽  
O. A. Zabavskaya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Pleural Empyema ◽  
Complete Information ◽  
Treatment Method ◽  
Thoracic Esophagus ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Invasive Approach ◽  
Ct Data

The purpose of the study. To analyze possibilities of computed tomography (CT) for esophageal injuries and their complications as part of a differentiated approach to the choice of a minimally invasive treatment method.Materials and methods. The results of CT scans were analyzed in 25 patients with esophageal injuries of various etiologies who were treated at the N.V. Sklifosovsky Research Institute of SP in the period 2019–2020. CT was performed with oral and intravenous bolus contrast, primarily at admission and in dynamics, a total of 77 studies.Results. In all cases, direct and indirect CT signs of esophageal damage were detected, and the degree of involvement of surrounding organs and tissues in the pathological process was assessed. Based on the data obtained, the following variants of esophageal damage and its complications were identified: intramural esophageal hematoma (2); rupture of the thoracic esophagus without the development of purulent complications (2); rupture of the thoracic esophagus complicated by the development of mediastinitis (4); rupture of the thoracic esophagus with the development of mediastinitis and pleural empyema (13); rupture of the cervical calving of the esophagus, complicated by phlegmon of the neck and descending mediastinitis (4). Different patient management tactics were used for each variant. Thus, the selection and sequence of minimally invasive interventions, such as thoracoscopic sanitation mediastinal and pleural cavity, esophageal stenting, percutaneous endoscopic gastrostomy (CEG) and endoscopic vacuum aspiration system (E-VAS), were carried out taking into account CT data, including observations in dynamics.Conclusion. CT scan for esophageal injuries allows you to get complete information about both the nature of esophageal damage and its complications, to determine their type, localization and volume. CT data allow us to justify a minimally invasive approach in the treatment of esophageal injuries, to determine the order of interventions. CT studies performed in dynamics allow us to evaluate the effectiveness of treatment and to carry out timely correction of tactics.

scholarly journals Clinical study on the Minimally Invasive Treatment of Early Necrosis of the Femoral Head with Hydroxyapatite Coated Hollow Titanium Rod Supporting the Femoral Head to Prevent Collapse

2021 ◽  
Author(s):  
Xinmin Yang ◽  
Ye Tian ◽  
Yao Yao
Keyword(s):  
Femoral Head ◽  
Minimally Invasive ◽  
Articular Surface ◽  
Onset Time ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Improvement Rate ◽  
Significant Difference ◽  
Harris Score

Abstract Background: To investigate the treatment effect of minimally invasive treatment of early osteonecrosis of femoral head (ONFH) with hydroxyapatite coated hollow titanium rod. Methods: From 1, January 2003 to 1, January 2019, 72 patients with ONFHⅡ Stage were selected. There were 50 males and 20 females, aged from 28 to 56. Onset time was 8~28 months. Lesion site: 18 left, 38 right, 16 bilateral. Causes of ONFH: 30 alcohol, 28 hormone, 9 trauma and 5 idiopathic patients. ARCO stage: 14 IIA, 33 IIB, 25 IIC. All patients underwent arthroscopic assisted minimally invasive percutaneous core decompression and bone grafting with hydroxyapatite coated titanium rod surgery. Visua Analogue Scales (VAS), Harris score and Images were used for assessing pain, hip joint function and the stability, respectively. Hip replacement was performed finally. Results: 16 patients with heavy hormone use history and femoral head collapse underwent Total Hip Resurfacing Arthroplasty (THRA) at the last follow-up. 24 months later, 8 ⅡB cases progressed to ⅡC, 2 cases were stable at ⅡC, 6 cases increased to Ⅲ, and underwent THRA. 12ⅡC cases progressed to Ⅲ, 2 cases were stable at Ⅲ, and 10 cases had articular cartilage surface collapse. THRA was administered 30 months after surgery. VAS score of individual patients increased and Harris score decreased 24 months after surgery, but there was no significant difference between the scores of 12 months and 24 months. The clinical effect of the last follow-up showed that the postoperative improvement rate of this group was 76.13%, among which the best was 100% in IIA, 79.48% in IIB, and the lowest was 58.06 in IIC. Both the patients with IIB or IIC, cases with aggravation and without change were hormonal ONFH. Conclusion: The treatment of ONFH with hydroxyapatite coated hollow titanium rod supporting the femoral head to prevent collapse is feasible. In addition to the Glucocorticoid-induced ONFH stage ⅡC outside, this method to other Ⅱ period lesions in improving the curative effect and preventing the collapse of femoral head articular surface is good and safe.

scholarly journals Minimally Invasive Full-Endoscopic Posterior Cervical Foraminotomy Assisted by O-Arm-Based Navigation

2018 ◽  
Vol 1 (21;1) ◽  
pp. E217-E223
Author(s):  
Yue Zhou
Keyword(s):  
Minimally Invasive ◽  
Symptom Duration ◽  
Foraminal Stenosis ◽  
Arm Pain ◽  
Sf 36 ◽  
Posterior Cervical Foraminotomy ◽  
Invasive Method ◽  
Foraminal Disc Herniation ◽  
Cervical Foraminotomy

Background: Navigated percutaneous endoscopic cervical discectomy (PECD) is a promising minimally invasive surgery for treating cervical spondylotic radiculopathy. PECD has been described as a safe, effective, and minimally invasive method for patients with radiculopathy, but it comes with a steep learning curve. Due to the limited field of vision, anatomic localization is difficult for surgeons until using the O-arm based navigation. In this study, patients with radiculopathy due to foraminal disc herniation or foraminal stenosis in the lower cervical spine underwent the single level full endoscopic posterior cervical foraminotomy procedure assisted by O-arm-based navigation. Objective: The purpose of this study was to evaluate the clinical, radiological outcome and the factors predicting an excellent outcome of patients who underwent full endoscopic posterior cervical foraminotomy procedure assisted by O-arm-based navigation. Study Design: A retrospective analysis of consecutively prospectively collected data. Setting: This study was conducted by a university-affiliated hospital in a major Chinese city. Methods: Forty-two patients who had single-level foraminal disc herniation or foraminal stenosis were retrospectively reviewed. Radicular arm pain was the most common presenting symptom in patients. All patients underwent full-endoscopic posterior cervical foraminotomy assisted by O-arm-based navigation. Clinical outcomes were assessed by the visual analog scale (VAS) for neck and radicular arm pain, neck disability index (NDI), and the short form-36 health survey questionnaire (SF-36) in the immediate preoperative period, immediately postoperative, and at the final follow-up. The clinical parameters and radiological parameters included cervical curvature (CA), segmental angle (SA), and range of motion (ROM), which were assessed preoperatively and at the last follow-up. Results: The mean follow-up for the patients was 15 months. There were no perioperative complications. The VAS score for radicular arm pain and neck pain and the NDI score improved significantly in all of the patients. The SF-36 score reflected significant improvement in all 8 domains. Excellent and good outcomes were achieved in 38 out of 42 patients. The cervical curvature range of motion (CA-ROM) statistically and significantly improved at the final follow-up period compared with the preoperative period. The SA was less kyphotic after PECD at the final follow-up. The postoperative CA and CA-ROM improved but did not significantly change. On the univariate analysis, patients with a symptom duration of less than 3 months had a better outcome than patients with a symptom duration of more than 3 months (excellent, 83.33% vs. 50.00%). Limitations: This was a retrospective study with medium follow-up outcomes (mean 15 months). Conclusions: The results of this study show that the full endoscopic posterior foraminotomy assisted by O-arm-based navigation is a safe and effective option for cervical radiculopathy, with the advantages of a minimally invasive method. Patients with symptom duration less than 3 months had a better outcome than patients with symptom duration more than 3 months. Key words: Minimally invasive, cervical foraminotomy, endoscopic, navigation, O-arm, percutaneous endoscopic cervical discectomy

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