COMPARISON OF LAPAROSCOPIC RESECTION OF THE KIDNEY IN RENAL TUMORS WITH AND WITHOUT THE APPLICATION OF A HEMOSTATIC SUTURE

There is proposed to refuse from the sealing of the parenchyma since the ligature method of hemostasis is an additional factor damaging the parenchyma of the kidney. In our opinion it is sufficient to perform electrohemostasis with the addition of local adhesive compositions. In the analysis of data from 2015 to 2016 on the basis of the Department of Urology of the N.N. Petrov Research Institute of Oncology there were performed 90 laparoscopic resections without ischemia and without a hemostatic suture applied to the resection area. The volume of blood loss, the duration of the operation, the volume of the functioning parenchyma of the kidney, before and after surgery, postoperative complications were estimated. With a comparative evaluation of the volume of the functioning parenchyma of the kidney before and after the operation, according to data of CT and CT-perfusion, the volume of functioning parenchyma of the resected kidney decreased only by the volume of the removed tumor. Resection of the kidney without applying a hemostatic suture to the area of resection, in conditions of hypotension, allowed improving the results of surgery relatively to kidney function in comparison with resection with the classical ligature method of hemostasis.

Download Full-text

Influence of type and volume of surgical resection on postoperative period in patients with gliomas

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2008-5-1-231-235 ◽

2008 ◽

Vol 7 (5-1) ◽

pp. 231-235

Author(s):

B. V. Martynov ◽

V. Ye. Parfenov ◽

D. V. Svistov ◽

G. Ye. Trufanov ◽

V. A. Fokin ◽

...

Keyword(s):

Postoperative Complications ◽

Surgical Resection ◽

Neurological Deficit ◽

Open Surgery ◽

Tumor Resection ◽

Neurological Status ◽

Tumor Location ◽

Tumour Resection ◽

Before And After ◽

Location Type

283 patients with gliomas were included in this study. Age, sex, neurological status and Karnovsky performance were analyzed before and after surgery, also tumor location, type and volume of surgical resection, postoperative complications were considered. Volume of tumor resection did not depend on glioma localization, excluding deep located tumors, in which case stereotactic cryotomy was performed (p < 0,01). In cases of stereotactic cryotomy postoperative neurological deficit worsening was noted in 12,5%, in patients with open biopsy and partial resection — 10,9%, and in case of total or subtotal tumor resection in 7,0% (p > 0,05). Partial gliom resection often related with postoperative complications and neurological deficit worsening then open surgery total tumour resection. Stereotactic cryotomy does not lead to bigger postoperative complications frequency in comparisons with open surgery.

Download Full-text

Immune-Related Circulating miR-125b-5p and miR-99a-5p Reveal a High Recurrence Risk Group of Pancreatic Cancer Patients after Tumor Resection

Applied Sciences ◽

10.3390/app9224784 ◽

2019 ◽

Vol 9 (22) ◽

pp. 4784

Author(s):

Vietsch ◽

Peran ◽

Suker ◽

van den Bosch ◽

Sijde ◽

...

Keyword(s):

Cancer Progression ◽

B Lymphocyte ◽

Immune Cell ◽

Tumor Resection ◽

Progression Free Survival ◽

Tumor Stroma ◽

Recurrence Risk ◽

High Serum ◽

Ductal Adenocarcinoma ◽

Before And After

Clinical follow-up aided by changes in the expression of circulating microRNAs (miRs) may improve prognostication of pancreatic ductal adenocarcinoma (PDAC) patients. Changes in 179 circulating miRs due to cancer progression in the transgenic KrasG12D/+; Trp53R172H/+; P48-Cre (KPC) animal model of PDAC were analyzed for serum miRs that are altered in metastatic disease. In addition, expression levels of 250 miRs were profiled before and after pancreaticoduodenectomy in the serum of two patients with resectable PDAC with different progression free survival (PFS) and analyzed for changes indicative of PDAC recurrence after resection. Three miRs that were upregulated ≥3-fold in progressive PDAC in both mice and patients were selected for validation in 26 additional PDAC patients before and after resection. We found that high serum miR-125b-5p and miR-99a-5p levels after resection are significantly associated with shorter PFS (HR 1.34 and HR 1.73 respectively). In situ hybridization for miR detection in the paired resected human PDAC tissues showed that miR-125b-5p and miR-99a-5p are highly expressed in inflammatory cells in the tumor stroma, located in clusters of CD79A expressing cells of the B-lymphocyte lineage. In conclusion, we found that circulating miR-125b-5p and miR-99a-5p are potential immune-cell related prognostic biomarkers in PDAC patients after surgery.

Download Full-text

Postoperative Complications Are Associated with Long-Term Changes in the Gut Microbiota Following Colorectal Cancer Surgery

Life ◽

10.3390/life11030246 ◽

2021 ◽

Vol 11 (3) ◽

pp. 246

Author(s):

Felix C.F. Schmitt ◽

Martin Schneider ◽

William Mathejczyk ◽

Markus A. Weigand ◽

Jane C. Figueiredo ◽

...

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

Gut Microbiota ◽

Gut Microbiome ◽

Tumor Resection ◽

Microbial Composition ◽

Colorectal Cancer Surgery ◽

Long Term Changes ◽

Stool Samples

Changes in the gut microbiome have already been associated with postoperative complications in major abdominal surgery. However, it is still unclear whether these changes are transient or a long-lasting effect. Therefore, the aim of this prospective clinical pilot study was to examine long-term changes in the gut microbiota and to correlate these changes with the clinical course of the patient. Methods: In total, stool samples of 62 newly diagnosed colorectal cancer patients undergoing primary tumor resection were analyzed by 16S-rDNA next-generation sequencing. Stool samples were collected preoperatively in order to determine the gut microbiome at baseline as well as at 6, 12, and 24 months thereafter to observe longitudinal changes. Postoperatively, the study patients were separated into two groups—patients who suffered from postoperative complications (n = 30) and those without complication (n = 32). Patients with postoperative complications showed a significantly stronger reduction in the alpha diversity starting 6 months after operation, which does not resolve, even after 24 months. The structure of the microbiome was also significantly altered from baseline at six-month follow-up in patients with complications (p = 0.006). This was associated with a long-lasting decrease of a large number of species in the gut microbiota indicating an impact in the commensal microbiota and a long-lasting increase of Fusobacterium ulcerans. The microbial composition of the gut microbiome shows significant changes in patients with postoperative complications up to 24 months after surgery.

Download Full-text

CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

European Radiology ◽

10.1007/s00330-021-07692-5 ◽

2021 ◽

Author(s):

Patrick Veit-Haibach ◽

Martin W. Huellner ◽

Martin Banyai ◽

Sebastian Mafeld ◽

Johannes Heverhagen ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Ct Perfusion ◽

Arterial Disease ◽

Lower Leg ◽

Therapy Control ◽

Non Invasive ◽

Before And After ◽

Invasive Method ◽

The Mean ◽

Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

Download Full-text

Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽

10.3390/cancers13102320 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2320

Author(s):

Paolo Ferroli ◽

Ignazio Gaspare Vetrano ◽

Silvia Schiavolin ◽

Francesco Acerbi ◽

Costanza Maria Zattra ◽

...

Keyword(s):

Brain Tumor ◽

Postoperative Complications ◽

Elderly Patients ◽

Performance Status ◽

Tumor Resection ◽

Patient Specific ◽

Invasive Treatment ◽

Tertiary Referral Center ◽

Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

Download Full-text

Impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer: A multicenter retrospective cohort study

Annals of Gastroenterological Surgery ◽

10.1002/ags3.12433 ◽

2021 ◽

Author(s):

Yusuke Fujita ◽

Koya Hida ◽

Nobuaki Hoshino ◽

Yoshiharu Sakai ◽

Tsuyoshi Konishi ◽

...

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Postoperative Complications ◽

Retrospective Cohort Study ◽

Primary Tumor ◽

Retrospective Cohort ◽

Tumor Resection ◽

Stage Iv ◽

Primary Tumor Resection ◽

Stage Iv Colorectal Cancer

Download Full-text

Nephrometric score based on 3D modeling (3D nephrometry score) for the probability prediction of intra- and postoperative complications for kidney surgery

Urologia Journal ◽

10.1177/03915603211036427 ◽

2021 ◽

pp. 039156032110364

Author(s):

Georgiy Andreevich Mashin ◽

Vasiliy Vladimirovich Kozlov ◽

Denis Vladimirovich Chinenov ◽

Yaroslav Nikolaevich Chernov ◽

Alexandra Vladimirovna Proskura ◽

...

Keyword(s):

Postoperative Complications ◽

Blood Loss ◽

3D Modeling ◽

Roc Analysis ◽

Linear Models ◽

Surgical Intervention ◽

Renal Tumors ◽

Discriminant Functions ◽

Nephrometry Score ◽

Probability Prediction

Aim: The purpose of the study is the development and evaluation of the informativeness of the author’s 3D nephrometric score application to predict the probability of intraoperative and postoperative complications in kidney operations. Material and methods: The study includes 264 patients who underwent surgical treatment of renal tumors, before that CT and 3D modeling were carried out. All patients underwent an analysis of the surgical intervention complexity on the C-index, PADUA, R.E.N.A.L., and developed 3D nephrometric score. To determine the set of variables that allow to classify patients, the method of discriminant analysis was used to predict the nature, volume of blood loss, duration of ischemia, and the number of complications. The sensitivity and specificity of the predictors were estimated with the help of ROC analysis. Results: Indicators have been established to classify patients according to the probability of complications, the amount of blood loss and the duration of ischemia during surgery for kidney cancer. We have created linear models that predict the development of bleeding during surgery, the volume of blood loss of more than 200 ml and the duration of ischemia more than 20 min, as well as the likelihood of complications using discriminant functions. The proposed author’s nephrometric score exceeds the capabilities of C-index, PADUA, R.E.N.A.L in many ways in blood loss and time of ischemia predicting, which allows us to recommend it for the assessment of resectability in kidney operations.

Download Full-text

Influence of Human-oriented Nursing Mode on Self-Care Ability, Unhealthy Emotion and Quality of Life of Patients with Benign Prostatic Hyperplasia

Tobacco Regulatory Science ◽

10.18001/trs.7.4.1.16 ◽

2021 ◽

Vol 7 (4) ◽

pp. 635-646

Author(s):

Feifei Peng ◽

Guangchi Xu ◽

Caihong Zhu ◽

Lanchun Sun ◽

Bo Dong ◽

...

Keyword(s):

Quality Of Life ◽

Benign Prostatic Hyperplasia ◽

Postoperative Complications ◽

Self Care ◽

Nursing Intervention ◽

Prostatic Hyperplasia ◽

The Self ◽

Nursing Satisfaction ◽

Before And After

To explore the influence of human-oriented nursing mode on the self-care ability, unhealthy emotion and quality of life of patients with benign prostatic hyperplasia (BPH), 147 patients with BPH admitted to our hospital from February 2018 to August 2019 were selected and all patients were separated into two groups on the basis of the nursing intervention mode. 77 cases in the research group (RG) were given the human-oriented nursing mode and 70 cases in the control group (CG) were given the conventional nursing mode. The bladder irrigation time (BIT), indwelling catheter time (ICT), postoperative hospitalization time (PHT) and the incidence rate of postoperative complications were observed in the two groups after nursing intervention. Before and after nursing intervention, the self-care ability of patients was evaluated in the two groups by Exercise of Self-Care Agency Scale (ESCA). In the two groups, the anxiety and depression status were evaluated by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The Quality of Life Scale for Benign Prostatic Hyperplasia Patient (BPHQLS) was applied to evaluate the quality of life in both groups before and after nursing intervention. The International Prostate Symptom Score (IPSS) was used to assess the lower urinary tract symptoms (LUTS) of patients in the two groups before and after nursing intervention. The self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction in the two groups. The BIT, ICT and PHT in RG after nursing intervention were obviously lower than those in CG, and the incidence of postoperative complications in RG was also obviously lower than that in CG (p < 0.05). The ESCA score of patients in RG after nursing intervention was significantly higher than that in CG (P < 0.05). The SAS and SDS scores of patients in RG after nursing intervention were significantly lower than those in CG (P < 0.05). The BPHQLS score in RG after nursing intervention was obviously higher than that in CG (P < 0.05). The IPSS score of patients in RG after nursing intervention was obviously lower than that in CG (p < 0.05). The nursing satisfaction score in RG after nursing intervention was obviously higher than that in CG (p < 0.05).Condusion: The application effect of the human-oriented nursing mode on patients with BPH is definite, which can improve self-care ability, unhealthy emotion and effectively ameliorate the quality of life.

Download Full-text

Acoustic voice assessment in Parkinson's disease patients submitted to posteroventral pallidotomy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000100004 ◽

2005 ◽

Vol 63 (1) ◽

pp. 20-25 ◽

Cited By ~ 19

Author(s):

Lucia Figueiredo Mourão ◽

Patrícia Maria de Carvalho Aguiar ◽

Fernando Antônio Patriani Ferraz ◽

Mara Suzana Behlau ◽

Henrique Ballalai Ferraz

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Postoperative Complications ◽

Speech Disorders ◽

Acoustic Parameters ◽

Voice Assessment ◽

Before And After ◽

Posteroventral Pallidotomy

Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence of interest in pallidotomy as an option of treatment. However, postoperative complications such as speech disorders can occur. PURPOSE: The aim of this study is to evaluate the acoustic voice in PD patients, before and after posteroventral pallidotomy. METHOD: Twelve patients with PD were submitted to neurological and voice assessments during the off and on phases, in the pre-operative, 1st and 3rd post-operative months. The patients were evaluated with the UPDRS and the vocal acoustic parameters - f0, NHR, jitter, PPQ, Shimmer, APQ (using the software MultiSpeech - Kay Elemetrics - 3700). RESULTS: The off phase UPDRS scores revealed a tendency to improvement at the 1st month and the off phase worsened. The shimmer and APQ improved. CONCLUSION: This study shows that pallidotomy has little improvement on functional use of communication of PD patients.

Download Full-text