Short-Term Outcomes of Rectal Mucosa Sleeve Resection and Transverse Perineal Support Operation for Occult Rectal Prolapse, Rectocele and Descending Perineum: A Single Center and Single Team Experience

Background: The ganglion impar is the first pelvic ganglion of the efferent sympathetic trunk that relays pelvic and perineal nociceptive messages and therefore constitutes a therapeutic target. Objective: The objective of this single-center study was to evaluate the effectiveness of 3 repeated ganglion impar blocks in patients with chronic pelvic and perineal pain on intention-to-treat. Study Design: Retrospective single-center study. Setting: We reviewed the medical records of 83 patients with chronic refractory pelvic and perineal pain. On intention-to-treat analysis, 62 (74.7%) of the patients received 3 ganglion impar blocks. Methods: Ganglion impar block was performed with 0.75% ropivacaine via a lateral approach over the Co1-Co2 coccygeal joint with computed tomography (CT) guidance. The effectiveness of ganglion impar blocks was evaluated by visual analogue scale (VAS) before and 30 minutes after the blocks. Evaluation at least one month after the block was also performed by Patient Global Impression of Change (PGI-C). Results: A total of 220 blocks were performed, 193 (87.7%) of which were considered to be positive with immediate but transient improvement of pain by more than 50% and complete but transient pain relief after the procedure in 119 (54.1%) procedures. The variation of the VAS score before and after each block was statistically significant (P < 0.001). Similarly, the VAS score before repeated blocks was significantly improved with decreased pain intensity over time (P = 0.001). Analysis of the PGI-C one month after the block demonstrated improvement in 41% of cases in the overall population and in 43.6% of cases in the subgroup of 62 patients treated by 3 blocks. Limitations: Retrospective study, short term follow-up. Conclusions: Repeated ganglion impar blocks allowed short-term reduction of pain intensity with a moderate intermediate-term effect. Ganglion impar appears to be a useful therapeutic target to block the nociceptive message by acting on sensitization phenomena.

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Long-term outcomes of pneumonectomy, back-table lung preservation, double-sleeve resection and reimplantation for advanced central lung cancer: the Oto procedure

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezy431 ◽

2018 ◽

Vol 56 (1) ◽

pp. 213-214 ◽

Cited By ~ 1

Author(s):

Shin Tanaka ◽

Seiichiro Sugimoto ◽

Junichi Soh ◽

Takahiro Oto

Keyword(s):

Lung Cancer ◽

Locally Advanced ◽

Sleeve Resection ◽

Long Term Outcomes ◽

Short Term ◽

Lung Preservation

Abstract The technique of pneumonectomy, back-table lung preservation, double-sleeve resection and reimplantation of basal segments (the Oto procedure) has been proposed as a useful technique for the management of locally advanced central lung cancer with short-term follow-up. We report the long-term outcomes of 5 consecutive patients who underwent the Oto procedure.

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Short-term outcomes of robotic-assisted versus conventional laparoscopic radical hysterectomy for early-stage cervical cancer: A single-center study

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.13858 ◽

2018 ◽

Vol 45 (2) ◽

pp. 405-411 ◽

Cited By ~ 3

Author(s):

Keisuke Oyama ◽

Kiyoshi Kanno ◽

Ryuji Kojima ◽

Akira Shirane ◽

Shiori Yanai ◽

...

Keyword(s):

Cervical Cancer ◽

Early Stage ◽

Single Center ◽

Short Term ◽

Laparoscopic Radical Hysterectomy ◽

Robotic Assisted ◽

Conventional Laparoscopic ◽

Single Center Study ◽

Early Stage Cervical Cancer ◽

Center Study

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