scholarly journals Disease presentation and surgical treatment of patients with foreign-body granulomas and ASIA syndrome: case series

2021 ◽  
Vol 48 (4) ◽  
pp. 366-372
Author(s):  
Javier Lopez-Mendoza ◽  
Edgar Vargas-Flores ◽  
Nicole Mouneu-Ornelas ◽  
Carlos Altamirano-Arcos
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Foreign Body ◽  
Surgical Removal ◽  
En Bloc ◽  
Polymer Injection ◽  
Presenting Symptoms ◽  
En Bloc Excision ◽  
Bloc Excision

Background The result of illicit polymer injection is chronic inflammation with foreign-body granuloma (FBG) formation. Treatment can be divided into medical and surgical. Some patients develop severe complications with need surgical treatment. This study aims to describe patients who underwent surgical removal of the FBGs and autoimmune/inflammatory syndrome induced by adjuvants (ASIA); additionally, we evaluated the quality of life after surgery.Methods In this retrospective single-center study, the authors examined data of patients who underwent surgical removal of FBG caused by illicit polymer injection for cosmetic purposes and confirmed ASIA from 2015 to 2020 by three different surgical approaches. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, treatment strategies, histopathology reports and quality of life.Results The cohort included 11 female patients with FBGs and ASIA. The most affected anatomical zones were the combination of gluteal region, thighs and legs (40%); and thighs with legs (20%). Main presentation was: skin hyperpigmentation (90.9%), skin induration (63.6%), chronic fatigue (63.6%), and ulcers (36.4%). Surgical modalities consisted of: ultrasonic-assisted liposuction in four patients (36.4%); open en bloc excision and primary closure in four patients (36.4%); and open en bloc excision and microsurgical reconstruction in three patients (27.2%). The postoperative quality of life visual analog scale score was 83.9.Conclusions ASIA treatment represents a challenge for the plastic surgeon. Adequate surgical treatment emphasizing, when possible, the total or near-total resection of the FBG must be performed to improve ASIA evolution.

Outcomes and Complications of Surgical Removal of Foreign Body Granulomas Due to Illicit Polymer Injection for Cosmetic Purposes

2021 ◽  
Author(s):  
Francisco J López-Mendoza ◽  
Mario Moran ◽  
Nicole Mouneau
Keyword(s):  
Foreign Body ◽  
Postoperative Complications ◽  
Primary Closure ◽  
Statistical Significance ◽  
Surgical Removal ◽  
En Bloc ◽  
Polymer Injection ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Type Of Surgery

Abstract Background There are several local complications associated with subcutaneous injection of illicit polymers, including: injection-site deformity, granulomas, and skin changes. Objectives To compare the postoperative complications and symptom flare in patients undergoing surgical excision of foreign-body granulomas. Methods We retrospectively examined data of patients who underwent surgical removal of foreign-body granulomas caused by polymer injection for cosmetic purposes with UAL, en bloc excision with primary closure, skin grafts, or free flaps during 2014–2020. Data collected included demographic and operative parameters. Postoperative complications, symptom flare, and time to flare were reported. Relationship between type of surgery and complications, symptom flare, and time to flare was determined through statistical analysis. Results The final cohort included 49 surgeries (42 primary and 7 secondary) in 35 patients. Overall complication rate was 28.9%, with no significant intergroup differences (30.8%, 20%, 66.7%, and 40%; p = 0.328). Wound dehiscence and skin burns were the main complications. An overall symptom flare of 35.1% in surgical treated areas over a mean period of 28.49 months was reported. Chi-squared test indicated statistical significance between type of surgery and symptom flare (p = 0.004) and between complications and flare (p = 0.013). Kaplan–Meier test for flare was statistically significant (p = 0.006) after comparison of the four groups. Conclusions Rate of postoperative complications was similar for each type of surgery. However, en bloc excision and reconstruction by either primary closure or free flap was associated with a significantly decreased rate of symptom flare and a longer symptom-free period.

scholarly journals POSSIBILITIES OF USING CRYOSURGICAL METHOD IN TREATMENT OF DEPTH BRAIN TUMORS

2016 ◽  
Vol 175 (1) ◽  
pp. 11-17
Author(s):  
A. I. Kholyavin ◽  
V. B. Nizkovolos ◽  
B. V. Martynov ◽  
D. V. Svistov ◽  
A. D. Anichkov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Brain Tumor ◽  
Surgical Treatment ◽  
Surgical Removal ◽  
Tumor Localization ◽  
Brain Areas ◽  
Pet Ct ◽  
Stereotactic Guidance

Cryosurgical method is used in treatment of patients with glial tumors which localized in depth and functionally meaningful brain areas. These patients are generally considered as inoperable and receive conservative treatment. Their prognosis has become worse as compared to the patients whose brain tumor is available for surgical removal. The authors used a multiway stereotactic destruction of tumors by cryosurgical cannula, which is inserted in bone cutter opening using manipulator. MR-imaging and PET/CT of brain were applied for stereotactic guidance. The majority of patients who underwent this operation didn’t noticed any loss of quality of life. The rates of survival were higher than corresponding indicators for patients who were treated only by chemo- or radiation therapy and the rates were equal to the patients underwent the radical operations. Thus, the multiway stereotactic cryodestruction is a new, safe and effective method of surgical treatment for the patients with tumor localization in such areas, that their location blocked an application of traditional surgical removal by open method.

scholarly journals Diagnosis and surgical treatment of heart valve non-mixoma tumors

2014 ◽  
Vol 95 (6) ◽  
pp. 821-830 ◽  
Author(s):  
A Yu Kiprenskiy ◽  
M A Nechayenko ◽  
L M Kuznetsova ◽  
D N Fyodorov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Heart Valves ◽  
Heart Defects ◽  
Artery Bypass ◽  
Clinical Signs ◽  
Diagnostic Procedures ◽  
Surgical Removal ◽  
Primary Tumors

Aim. To study the clinical, diagnostic, surgical and morphological features of non-mixoma primary tumors of the heart valves, the possibilities of their early diagnosis and to develop an optimal surgical approach. Methods. The surgical treatment of 331 patients with tumors of the heart was analysed, of which 45 (13.6%) were radically distant primary tumors of the heart valves including 33 (73.3%) myxoma and 12 (26.7%) non-myxoma tumors. Among considered in this study 12 non-myxoma tumors 9 cases were papillary fibroelastoma, 1 - neurolemmoma, 1 - lipoma, 1 - fibroma. Results. The leading non-invasive preoperative diagnostic procedures for non-myxoma primary tumors of the heart valves were transthoracic and transoesophageal echocardiographic studies, the sensitivity of which were 91.7 and 100% respectively. In unclear cases, a computer and magnetic resonance imaging were used. Additionally, electrocardiography, phonocardiography, radiological methods were performed, clinical and biochemical blood tests were analysed. Intraoperative revision and morphological verification ensures the establishment of tumors final clinical diagnosis. Patients with non-myxoma tumors of the heart valves had polymorphic symptomatic picture which included circulatory failure, false angina, arrhythmias, clinical signs imitating heart defects, embolic syndrome, dizziness and/or syncope, causeless fever. Surgical removal of the 12 non-myxoma tumor was performed by cardiopulmonary bypass and pharmacological cold cardioplegia, in 4 cases, the intervention combined with the replacement of the affected valves by artificial prostheses, in 1 case - coronary artery bypass grafting. Hospital mortality of patients was zero. Quality of life of operated patients was rated as good in 9 (75%) patients, satisfactory - in 2 (16.7%), unsatisfactory - in 1 (8.3%) patients, which was due to the death of the patient 13 months after removal of neurolemmoma in connection with multiple metastasis in the brain and spinal cord. Conclusion. Timely surgical intervention helped to stabilize the functional state of the patients, to create a favorable prognosis to improve the quality of life and increase its length.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

2020 ◽  
pp. 1-8
Author(s):  
S. Patel ◽  
M. Clancy ◽  
H. Barry ◽  
N. Quigley ◽  
M. Clarke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Post Surgery ◽  
Axis I ◽  
Patients With Epilepsy ◽  
The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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