scholarly journals Treatment of juvenile angiofibromas: 18-year experience of a single tertiary centre in Spain

2012 ◽  
Vol 50 (1) ◽  
pp. 95-103
Author(s):  
Fernando Lopez ◽  
Vanessa Suarez ◽  
Maria Costales ◽  
Carlos Suarez ◽  
Jose L. Llorente
Keyword(s):  
Surgical Approach ◽  
Early Stage ◽  
Tumour Size ◽  
Vascular Supply ◽  
Open Approach ◽  
Tertiary Centre ◽  
Preauricular Approach ◽  
Conventional Open Approach ◽  
Open Surgical Approach

Background: The management of juvenile angiofibroma (JA) has changed during the last decades but it still continues to be a challenge. The objective of this study was to review the used treatment and our outcomes. Methods: From 1992 to 2010, 48 cases of JA were treated at our department. Charts were reviewed for standard demographic, tumour size and location, vascular supply and results of embolization, surgical approach, operative results, adjuvant therapies, recurrence and postoperative follow-up. Results: Most tumours were Andrews-Fisch stages III and IV and surgery was used as the main treatment in all cases. We used an open surgical approach in 37 (77%) patients and 11 (23%) were treated endoscopically. The most common open approach used in this series was the subtemporal-preauricular approach. Until 1995, all tumours were operated on by a conventional open approach. Afterwards, early-stage tumours were operated on through an endoscopic approach. Ten patients were treated through surgery followed by radiosurgery. Two (4%) patients had recurrent disease. Conclusions: These tumours should be treated at centres with expertise in skull base surgery to achieve complete surgical resections with low morbidity. Radiosurgery after surgery seems to be a valuable option in the long-term control of some extended JAs.

scholarly journals Treatment of juvenile angiofibromas: 18-year experience of a single tertiary centre in Spain

2012 ◽  
Vol 50 (1) ◽  
pp. 95-103
Author(s):  
Fernando Lopez ◽  
Vanessa Suarez ◽  
Maria Costales ◽  
Carlos Suarez ◽  
Jose L. Llorente
Keyword(s):  
Surgical Approach ◽  
Early Stage ◽  
Tumour Size ◽  
Vascular Supply ◽  
Open Approach ◽  
Tertiary Centre ◽  
Preauricular Approach ◽  
Conventional Open Approach ◽  
Open Surgical Approach

Background: The management of juvenile angiofibroma (JA) has changed during the last decades but it still continues to be a challenge. The objective of this study was to review the used treatment and our outcomes. Methods: From 1992 to 2010, 48 cases of JA were treated at our department. Charts were reviewed for standard demographic, tumour size and location, vascular supply and results of embolization, surgical approach, operative results, adjuvant therapies, recurrence and postoperative follow-up. Results: Most tumours were Andrews-Fisch stages III and IV and surgery was used as the main treatment in all cases. We used an open surgical approach in 37 (77%) patients and 11 (23%) were treated endoscopically. The most common open approach used in this series was the subtemporal-preauricular approach. Until 1995, all tumours were operated on by a conventional open approach. Afterwards, early-stage tumours were operated on through an endoscopic approach. Ten patients were treated through surgery followed by radiosurgery. Two (4%) patients had recurrent disease. Conclusions: These tumours should be treated at centres with expertise in skull base surgery to achieve complete surgical resections with low morbidity. Radiosurgery after surgery seems to be a valuable option in the long-term control of some extended JAs.

scholarly journals Open surgical approach to management of rhino-orbito-cerebral mucormycosis

2021 ◽  
Vol 8 (1) ◽  
pp. 64
Author(s):  
Sunil K. C. ◽  
Praveen Kumar B. Y. ◽  
Ramesh Bhoomannavar ◽  
Rishabh Jain
Keyword(s):  
Surgical Approach ◽  
Effective Means ◽  
Tertiary Care ◽  
Wound Dehiscence ◽  
Open Approach ◽  
Cross Sectional ◽  
Temporal Fossa ◽  
Co Morbidity ◽  
Facial Swelling ◽  
Open Surgical Approach

<p class="abstract"><strong>Background: </strong>Since December 2019, when novel corona virus (COVID 19) was reported, it has spread widely to cause a pandemic. Rhino-orbito-cerebral Mucormycosis (ROCM), an opportunistic fungal infection caused by the order Mucorales and class Zygomycetes has led to an epidemic in our country.</p><p class="abstract"><strong>Methods: </strong>This prospective cross sectional study was conducted at a 1200 bed tertiary care teaching hospital in Mysore. All patients of ROCM who presented to us for treatment were selected for the study after informed consent. Only those patients who were operated via open approach were included.</p><p class="abstract"><strong>Results:</strong> Median age of the patients was 50 years (SD±10). 49 were male patients (67.1%). Diabetes mellitus was the most common underlying co-morbidity seen in 71 patients (97.3%). Facial pain (100%) and facial swelling (90.4%) were the most common presenting complaint. KOH positivity from nasal swab for Mucormycosis was positive in only 37 patients (50.7%). Traditional inaccessible areas to endoscope like the premaxilla, lateral orbit cavity, infra temporal fossa and hard palate were tackled by the open surgical approach route. Advantages of open surgical approach being the access to areas which are traditionally difficult to approach via the endoscope, aggressive debridement is possible which might be challenging endoscopically. Complications like wound dehiscence, oro-antral fistula, osteomyelitis and abscess were noted in our study.</p><p class="abstract"><strong>Conclusions: </strong>Open surgical approach offers a very viable, affordable and a very effective means for aggressive surgical debridement of infection and reduce mortality associated with ROCM.</p><p> </p>

scholarly journals P-OGC72 Morbidity following oesophagectomy: the long-term re-operation rate after surgical resection in a Scottish tertiary centre

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Siobhan Chien ◽  
Lewis Gall ◽  
Khurram Khan ◽  
Andrew Macdonald ◽  
Carol Craig ◽  
...  
Keyword(s):  
Wound Infection ◽  
Early Stage ◽  
Locally Advanced ◽  
Wound Complications ◽  
Patient Demographics ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Operation Rate ◽  
Key Factor

Abstract Background Oesophagectomy remains the best curative option for early stage or locally advanced cancers of the oesophagus and gastro-oesophageal junction. The long-term morbidity associated with oesophagectomy is poorly understood. This study aimed to describe re-operation rates for oesophagectomy-related complications, performed beyond 90 days from index oesophagectomy. Methods A retrospective cohort study of all oesophagectomies performed in a single tertiary centre between 01 January 2010 and 31 December 2019 was performed. Electronic records were interrogated and patients dichotomised into two groups, with patients that underwent re-operation at ≥ 90 days after oesophagectomy for complications directly related to the index procedure compared to patients who did not have further surgery. All endoscopic interventions were excluded from analysis. The median length of follow-up was 34 months (IQR 20-67). Results 343 patients were eligible for analysis. Patient demographics and index operative approach were similar between the two groups. Beyond 90 days from surgery, 8.7% of patients (30/343) required a further operation for complications directly related to oesophagectomy. The median time to re-operation was 15.5 months (IQR 12-29). 28 out of a total of 38 re-operations performed (73.7%) were for wound complications (including 15 incisional hernia repairs and 7 excision of stitch sinus). Development of a wound infection in the immediate post-operative period was associated with an increased rate of later re-operation (16.7% vs. 4.8%, p = 0.022). Conclusions A small but significant number of patients require re-operation following oesophagectomy beyond 90 days of surgery. This should form part of the pre-operative informed consent discussion in order to fully appraise patients and manage expectations. Reducing the incidence of early wound infection appears to be a key factor.

423 OUTCOME OF LAPAROSCOPIC SURGERY FOR THE MANAGEMENT OF CORROSIVE STRICTURE OF THE OESOPHAGUS

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
A Javed ◽  
A Agarwal ◽  
N Kumar
Keyword(s):  
Laparoscopic Surgery ◽  
Contrast Study ◽  
Open Approach ◽  
Endoscopic Dilatation ◽  
Long Term Outcomes ◽  
Colonic Conduit ◽  
Short And Long Term ◽  
Corrosive Stricture ◽  
Conventional Open Approach

Abstract   The surgical treatment for a corrosive stricture of the oesophagus, after failed endoscopic dilatation, often involves oesophageal replacement using a gastric or a colonic conduit. This is traditionally done via the conventional open approach. The objective of this study was to ascertain short and long term outcomes of Laparoscopic gastric (LGP) and colon pull up (LCP) for the treatment of corrosive stricture of the oesophagus Methods Retrospective study of patients of corrosive oesophageal stricture, who, following a failed endoscopic dilatation, underwent a laparoscopic gastric or colon pullup between Jan 2011 and November 2019. All patients were evaluated with an upper endoscopy/contrast study to determine upper level and extent of stricture. Stomach was the preferred conduit, colon was used when either stomach was involved in the scarring process or in high pharyngeal strictures. Early and late postoperative outcomes were ascertained. Results During the study period, 254 patients with corrosive stricture oesophagus were managed surgically. Of these 50 underwent LGP and 10 underwent a LCP and these formed the study group. Mean age was 22.4 (2–42) years. The mean operative time (174.6 ± 43 and 322 ± 63 min) and blood loss (58.6 ± 23.9 and 108 ± 30.8 mL) for LGP and LCP respectively. Four patients developed mild respiratory infection. Eight patients developed cervical anastomotic leak. One patient had a colojejunal leak and another leak from the gastric tube staple line which was managed with drainage and antibiotics. At a mean followup of 51 months all patients were euphagic. Conclusion Laparoscopic surgery for corrosive strictures of oesophagus is safe and provides good short and long term outcomes.

Quiste de colédoco Todani Iva. Reporte de caso y revisión de la literatura

2021 ◽  
Vol 64 (3) ◽  
pp. 37-42
Author(s):  
Rodolfo Iván Lara-Ruiz ◽  
Mauricio de la Concha Tiznado ◽  
Oscar Mendoza-Valencia ◽  
Adrián Fernando Pérez-González ◽  
Edmundo Arias-Gómez
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Choledochal Cyst ◽  
Surgical Approach ◽  
Biliary Tree ◽  
Imaging Studies ◽  
High Clinical Suspicion ◽  
History Of ◽  
Open Surgical Approach

Biliary tree dilations are unusual congenital malformations that may involve the entire bile circulation and, they are common during the first life decade. Most cases initiate with jaundice and chronic abdominal pain which localizes in right upper quadrant. High clinical suspicion accompanied by imaging studies are essential for diagnosisHigh suggestive clinic associated with imaging studies are essential for diagnosis. Treatment has evolved until today complete cyst resection has become the treatment of choice, since it presents a good response, although without being free from long-term complicationsTreatment has been evolving being at the present time cyst complete resection the gold standard in treatment although without being exempt from long-term complications. We present the case of a 27-year-old male patient with a history of 3 months onset epigastric abdominal pain diagnosed as Todani IVa common bile duct choledochal cyst by magnetic resonance imaging. It is performed Open surgical management was performed with total resection of the cyst and biliodigestive Roux-en-Y diversiona total cyst resection with Roux-en-Y biliodigestive bypass by open surgical approach without any complications. He was discharged 7 days post-op. A review of the literatura focused on the surgical approach and management of similar cases was carried out. We carry out bibliography review focused on surgical approach and management of similar cases. Keywords: Bile duct dilation; choledochal cyst; Todani IVa; jaundice.

Bilateral Condylar Fracture: A Case Treated with a Conservative Myofunctional Approach

2020 ◽  
Vol 44 (6) ◽  
pp. 464-468
Author(s):  
Antonio Bedoya-Rodriguez ◽  
German O Ramirez-Yanez
Keyword(s):  
Case Report ◽  
Surgical Approach ◽  
Clinical Case ◽  
Conservative Approach ◽  
Condylar Fracture ◽  
Long Term Consequences ◽  
Condylar Fractures ◽  
Open Surgical Approach

Mandibular condylar fractures in a growing child may cause long-term consequences. A conservative approach has been recommended to permit the remodelling of the condyles as well as to re-establishing the mandibular dynamics and oral functions. This case report presents a bilateral mandibular condylar fracture in an 11 years old girl treated with myofunctional appliances in combination with exercises. The successful results from this clinical case support a conservative approach when treating mandibular condylar fractures in a growing child instead of an open surgical approach.

Intraoperative, postoperative and long-term oncosurgical safety of therapeutic mammaplasty

2013 ◽  
Vol 154 (33) ◽  
pp. 1291-1296 ◽  
Author(s):  
László Romics Jr. ◽  
Sophie Barrett ◽  
Sheila Stallard ◽  
Eva Weiler-Mithoff
Keyword(s):  
Recurrence Rate ◽  
Tumour Size ◽  
Breast Conservation ◽  
Malignant Lesion ◽  
Surgical Techniques ◽  
Incomplete Resection ◽  
Immediate Reconstruction ◽  
Oncological Safety

Introduction: (Pre)malignant lesion in the breast requiring mastectomy conventionally may be treated with breast conservation by using oncoplastic breast surgical techniques, which is called therapeutic mammaplasty. However, no reliable data has been published so far as regards the oncological safety of this method. Aim: The aim of the authors was to analyse the oncological safety of therapeutic mammaplasty in a series of patients. Method: 99 patients were treated with therapeutic mammaplasty and data were collected in a breast surgical database prospectively. Results were analysed with respect to intraoperative, postoperative and long-term oncological safety. Results: Incomplete resection rate was 14.1%, which correlated with tumour size (p = 0.023), and multifocality (p = 0.012). Time between surgery (therapeutic mammaplasty) and chemotherapy was similar to time between conventional breast surgeries (wide excision, mastectomy, mastectomy with immediate reconstruction) and chemotherapy (mean 29–31 days; p<0.05). Overall recurrence rate was 6.1%, locoregional recurrence rate was 2% during 27 month (1–88) mean follow-up. Conclusions: Since literature data are based on relatively short follow-up and low patient number, it is highly important that all data on therapeutic mammaplasty is collected in a prospectively maintained breast surgical database in order to determine true recurrence after long-follow-up. Orv. Hetil., 2013, 154, 1291–1296.

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