34 results on '"resection surgery"'
Search Results
2. Retrospective Clinical Analysis of Epilepsy Treatment for Children with Drug-Resistant Epilepsy (A Single-Center Experience).
- Author
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Liu, Changqing, Hu, Yue, Zhou, Jian, Guan, Yuguang, Wang, Mengyang, Qi, Xueling, Wang, Xiongfei, Zhang, Huawei, Adilijiang, Aihemaitiniyazi, Li, Tiemin, and Luan, Guoming
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EPILEPSY , *CHILDREN with epilepsy , *CHILDHOOD epilepsy , *FOCAL cortical dysplasia , *TEMPORAL lobectomy , *PEDIATRIC surgery , *CHILD patients , *SURGICAL excision - Abstract
Objectives: This retrospective cohort study investigated the clinical characteristics and seizure outcomes of patients aged 1–14 years with drug-resistant epilepsy (DRE) who were treated by different typologies of therapy. Methods: Four hundred and eighteen children with DRE were recruited from Sanbo Brain Hospital of Capital Medical University from April 2008 to February 2015. The patients were divided into three groups: medication (n = 134, 32.06%), resection surgery (n = 185, 44.26%), and palliative surgery (n = 99, 23.68%) groups. Demographic characteristics were attained from medical records. All patients were followed up for at least 5 years, with seizure outcomes classified according to International League Against Epilepsy criteria. The psychological outcome was evaluated with the development quotient and Wechsler Intelligence Quotient Scale for children (Chinese version). Results: The most frequent seizure type was generalized tonic seizure in 53.83% of patients. Age at seizure onset in 54.55% of patients was <3 years. The most frequent etiologies were focal cortical dysplasia (FCD). West syndrome was the most common epilepsy syndrome. Favorable seizure outcomes at the 5-year follow-up in the medication, resection surgery, and palliative surgery groups were 5.22%, 77.30%, and 14.14%, respectively. The patients showed varying degrees of improvement in terms of developmental and intellectual outcomes post-treatment. Conclusions: Pediatric patients with DRE were characterized by frequent seizures, a variety of seizure types, and complex etiology. Recurrent seizures severely affected the cognitive function and development of children. Early surgical intervention would be beneficial for seizure control and prevention of mental retardation. Palliative surgery was also a reasonable option for patients who were not suitable candidates for resection surgery. [ABSTRACT FROM AUTHOR]
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- 2023
- Full Text
- View/download PDF
3. Endoscopic Balloon Dilation Is Cost-Effective for Crohn's Disease Strictures.
- Author
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Lee, Kate E., Lim, Francesca, Faye, Adam S., Shen, Bo, and Hur, Chin
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CROHN'S disease , *QUALITY-adjusted life years , *SURGICAL excision , *LARGE intestine , *WILLINGNESS to pay , *ENTEROSCOPY - Abstract
Background: Endoscopic balloon dilation (EBD) has emerged as an alternative intervention to manage Crohn's disease (CD) strictures. We determined the cost-effectiveness of EBD versus resection surgery for patients with short (< 4–5 cm) primary or secondary/anastomotic small or large bowel strictures. Methods: A microsimulation state-transition model analyzed the benefits and risks of EBD and resection surgery for patients with primary or anastomotic CD strictures. Our primary outcome was quality-adjusted life years (QALYs) over ten years, and strategies were compared using a willingness to pay of $100,000/QALY from a societal perspective. Costs (2021 $US) and incremental cost-effectiveness ratios (ICER) were calculated. Deterministic 1-way and probabilistic analyses assessed model uncertainty. Results: The EBD strategy cost $19,822 and resulted in 6.18 QALYs while the surgery strategy cost $41,358 and resulted in 6.37 QALYs. Surgery had an ICER of $113,332 per QALY, making EBD a cost-effective strategy. The median number of EBDs was 5 in the EBD strategy and 0 in the surgery strategy. The median number of surgeries was 2 in the surgery strategy and 1 in the EBD strategy. Of individuals who initially received EBD, 50.4% underwent subsequent surgery. One-way sensitivity analyses showed that the probabilities of requiring repeated interventions, surgery mortality (< 0.7%), and quality of life after interventions were the most influential model parameters. Probabilistic sensitivity analyses favored EBD in 50.9% of iterations. Conclusions: EBD is a cost-effective strategy for managing CD strictures. Differences in patient risk and quality of life after intervention impact cost-effectiveness. Intervention decisions should consider cost-effectiveness, patient risks, and quality of life. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
- View/download PDF
4. Retrospective Clinical Analysis of Epilepsy Treatment for Children with Drug-Resistant Epilepsy (A Single-Center Experience)
- Author
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Changqing Liu, Yue Hu, Jian Zhou, Yuguang Guan, Mengyang Wang, Xueling Qi, Xiongfei Wang, Huawei Zhang, Aihemaitiniyazi Adilijiang, Tiemin Li, and Guoming Luan
- Subjects
drug-resistant epilepsy ,children ,resection surgery ,palliative surgery ,seizure outcome ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Objectives: This retrospective cohort study investigated the clinical characteristics and seizure outcomes of patients aged 1–14 years with drug-resistant epilepsy (DRE) who were treated by different typologies of therapy. Methods: Four hundred and eighteen children with DRE were recruited from Sanbo Brain Hospital of Capital Medical University from April 2008 to February 2015. The patients were divided into three groups: medication (n = 134, 32.06%), resection surgery (n = 185, 44.26%), and palliative surgery (n = 99, 23.68%) groups. Demographic characteristics were attained from medical records. All patients were followed up for at least 5 years, with seizure outcomes classified according to International League Against Epilepsy criteria. The psychological outcome was evaluated with the development quotient and Wechsler Intelligence Quotient Scale for children (Chinese version). Results: The most frequent seizure type was generalized tonic seizure in 53.83% of patients. Age at seizure onset in 54.55% of patients was
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- 2022
- Full Text
- View/download PDF
5. Removal of epileptically compromised tissue in the frontal cortex restores oculomotor selection in the antisaccade task.
- Author
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Stigchel, Stefan, Leijten, Frans S. S., Vansteensel, Mariska J., Dijkerman, Hendrik Chris, Ramsey, Nick F., and Freudenburg, Zachary V.
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EYE movements , *VISUAL fields , *SURGICAL excision , *TISSUES , *TASKS - Abstract
The frontal cortex is heavily involved in oculomotor selection. Here, we investigated the neural correlates of eye movement selection during an antisaccade task in a young epileptic patient in whom the seizure focus included the frontal cortex and affected its function. Before resection surgery, the patient had difficulty in performing correct antisaccades towards the visual field contralateral to the seizure focus. Because the FEF is the only area in the human frontal cortex that is known to have a lateralized oculomotor function in the antisaccade task, this behavioural imbalance between the two visual fields suggests a disruption of FEF functioning by the nearby seizure focus. Electrocorticographic recordings at the seizure focus indeed showed that the seizure focus interfered with correct antisaccade performance. These results were in line with fMRI recordings revealing less task‐related frontal activity for the hemisphere of the seizure focus, possibly reflecting diminished top‐down engagement of the oculomotor system. Two months after removal of the compromised tissue, the seizures had disappeared, and antisaccade performance was the same for both visual hemifields. We conclude that a seizure focus in the frontal cortex can induce a dysfunction in the selection of eye movements, which is resolved after removal of interfering tissue. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
6. Gene expression profile of extraocular muscles following resection strabismus surgery.
- Author
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Rodríguez, Maria Angels, Sandgren Hochhard, Karin, Vicente, André, Liu, Jing-Xia, and Pedrosa Domellöf, Fatima
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GENE expression profiling , *SURGICAL excision , *EYE muscles , *IMMUNOREGULATION , *MUSCLES , *CONNECTIVE tissues ,STRABISMUS surgery - Abstract
This paper aims to identify key biological processes triggered by resection surgery in the extraocular muscles (EOMs) of a rabbit model of strabismus surgery by studying changes in gene expression. Resection surgery was performed in the superior rectus of 16 rabbits and a group of non-operated rabbits served as control. Muscle samples were collected from groups of four animals 1, 2, 4 and 6 weeks after surgery and processed for RNA-sequencing and immunohistochemistry. We identified a total of 164; 136; 64 and 12 differentially expressed genes 1, 2, 4 and 6 weeks after surgery. Gene Ontology enrichment analysis revealed that differentially expressed genes were involved in biological pathways related to metabolism, response to stimulus mainly related with regulation of immune response, cell cycle and extracellular matrix. A complementary pathway analysis and network analysis performed with Ingenuity Pathway Analysis tool corroborated and completed these findings. Collagen I, fibronectin and versican, evaluated by immunofluorescence, showed that changes at the gene expression level resulted in variation at the protein level. Tenascin-C staining in resected muscles demonstrated the formation of new tendon and myotendinous junctions. These data provide new insights about the biological response of the EOMs to resection surgery and may form the basis for future strategies to improve the outcome of strabismus surgery. • This is the first gene expression study of the response of EOMs to resection surgery. • Expression of 164; 136; 64 and 12 genes changed 1, 2, 4 and 6 weeks after resection. • These genes are related to cell cycle, extracellular matrix and immune response. • Resection surgery induces the formation of new tendon. • Connective tissue has an important role in muscle adaptation to resection surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
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7. Volume effect in paediatric brain tumour resection surgery: analysis of data from the Japanese national inpatient database.
- Author
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Shinjo, Daisuke, Matsumoto, Kimikazu, Terashima, Keita, Takimoto, Tetsuya, Ohnuma, Tetsu, Noguchi, Takashi, and Fushimi, Kiyohide
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BRAIN tumors , *CONFIDENCE intervals , *DATABASES , *HEALTH , *PEDIATRICS , *SEX distribution , *LOGISTIC regression analysis , *TREATMENT effectiveness , *RETROSPECTIVE studies , *HOSPITAL mortality , *ODDS ratio ,SURGICAL complication risk factors - Abstract
Abstract Background Paediatric brain tumours are the second most common type of malignancies that occur during childhood. Surgical resection is usually the first step in the treatment of these patients; however, evidence pertaining to a 'volume effect' in paediatric brain tumour resection surgery and the associations among the surgical volume, clinical features and treatments are not well characterised. Methods Data pertaining to paediatric patients (age ≤ 15 years) who underwent brain tumour resection surgery between April 2012 and March 2016 were retrieved from the Japanese administrative inpatient database and retrospectively analysed. Demographic characteristics, therapeutic procedures and in-hospital mortality were summarised according to the hospital surgical volume. Penalised logistic regression analysis was used to investigate the association between the hospital surgical volume and in-hospital mortality. Results A total of 1354 paediatric patients were included. About 40% of the patients were in the 11- to 15-year age group. The male:female ratio was 53:47, the overall crude in-hospital mortality was 1.8% (n = 24) and the 30-day postoperative mortality was 0.4% (n = 6). The crude mortality ratio was 3.3% in the lowest quartile and 0.8% in the highest quartile by volume. After adjusting for covariates, a higher hospital surgical volume was associated with lower in-hospital mortality (compared with 1–4 surgeries per 4 years, 15–25 surgeries, odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.05–0.90, p = 0.033; ≥26 surgeries, OR: 0.31; 95% CI: 0.08–0.96, p = 0.042). Conclusions The present study indicated a volume–outcome relationship in paediatric brain tumour resection surgery cases. Further centralisation of surgeries should be considered to achieve better outcomes. Highlights • Volume effect in paediatric brain tumour resection surgery is inconsistent. • National inpatient database and penalised likelihood model were used. • The crude in-hospital mortality ratio was 1.8%, comparable to other countries. • The study indicated a volume effect in paediatric brain tumour resection surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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8. Predictors and prevalence of COVID-19 vaccination in patients with focal epilepsy following resection surgery.
- Author
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Yang, Yuyu, Lv, Jin, He, Chenmin, Shen, Chunhong, Xu, Sha, Guo, Yi, Ding, Yao, Zheng, Zhe, Zhu, Junming, Wang, Shuang, Ding, Meiping, and Wang, Shan
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SURGICAL excision , *COVID-19 , *PARTIAL epilepsy , *COVID-19 vaccines , *PEOPLE with epilepsy , *TEMPORAL lobectomy - Abstract
• Inactivated vaccines appear to be safe for PWE following resection surgery. • Individuals with active seizures may have a reduced acceptance of vaccines. • Education and public awareness campaigns focused on promoting vaccine safety in children are required to increase COVID-19 vaccination rates. In light of the ongoing COVID-19 pandemic, vaccination has emerged as the primary and most effective solution. The aim of this study was to examine compliance rates of vaccination and explore the factors that predict vaccine uptake among patients with epilepsy (PWE) who have undergone resection surgery. To examine the variations in vaccination coverage, safety concerns, and factors influencing vaccination hesitancy among PWE who have undergone resection surgery, this study recruited patients with at least one-year follow-up. We utilized questionnaires to gather clinical characteristics and obtain information regarding COVID-19 vaccines. Among the 303 patients included in the study, a majority of 229 (75.58%) achieved a seizure-free outcome (Engel Ia). Of these patients, 178 (58.75%) received at least one dose of COVID-19 vaccine, and the vaccination rate has remained relatively consistent over the past six months. Nearly 94.95% of those who received the vaccine completed the full vaccination regimen, with the majority (n = 174, 97.75%) opting for an inactivated vaccine. Only three patients reported side effects unrelated to epilepsy, and one patient experienced a worsening of typical aura seizures within one month after vaccination. Notably, significant positive associations were observed between COVID-19 vaccine acceptance and adulthood (age 18 years or older) (OR = 1.820, 95% CI = 1.018–3.252, p = 0.043) as well as achieving a seizure-free outcome (OR = 2.823, 95% CI = 1.619–4.921, p < 0.001). Regarding the unvaccinated patients, approximately one-fifth expressed willingness to receive a future COVID-19 vaccine, while the remainder were hesitant (41.60%) or unsure (39.20%) about vaccination. These reservations mainly stemmed from concerns about the potential worsening of seizures and vaccine safety. Inactivated vaccines can be considered safe for individuals with epilepsy who have undergone resection surgery. The likelihood of being vaccinated was found to be comparatively higher among the cohort with seizure-free status or adults. To promote COVID-19 vaccination among children, it is crucial to implement comprehensive education and public awareness campaigns that emphasize the safety of vaccines. These efforts will help encourage widespread acceptance of vaccination and ensure the well-being of individuals with epilepsy. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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9. Predicting the Location of Glioma Recurrence after a Resection Surgery
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Stretton, Erin, Mandonnet, Emmanuel, Geremia, Ezequiel, Menze, Bjoern H., Delingette, Hervé, Ayache, Nicholas, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Doug, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Durrleman, Stanley, editor, Fletcher, Tom, editor, Gerig, Guido, editor, and Niethammer, Marc, editor
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- 2012
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10. Gastrinoma
- Author
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Imamura, Masayuki, Komoto, Izumi, Hubbard, Johnathan, editor, Inabnet, William B., editor, and Lo, Chung-Yau, editor
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- 2009
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11. Non-Syndromic Spinal Schwannomas: A Novel Classification
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Ibrahim Sun and M. Necmettin Pamir
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spinal schwannoma ,resection surgery ,tumor classification ,postoperative recovery ,spinal tumor ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3–0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of non-syndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients’ tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C) for tumor volume and four types (I, II, III, and IV) for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches.
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- 2017
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12. Non-Syndromic Spinal Schwannomas: A Novel Classification.
- Author
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Sun, Ibrahim and Pamir, M. Necmettin
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SPINE cancer ,SCHWANNOMAS ,TUMOR surgery - Abstract
Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3-0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of nonsyndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients' tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C) for tumor volume and four types (I, II, III, and IV) for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
13. Isolated cardiac peripheral primitive neuroectodermal tumor: A case report.
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Fan, Chengming, Kong, Demiao, Tan, Changming, and Yang, Jinfu
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- 2017
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14. Focal, Extranodal Primary Polymorphous Hemangioendothelioma Treated With Endovascular Embolization and Resection Surgery
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Alberto Caballero, Francisco Perez, Luis Alejandro Osorio-Bohorquez, Esteban Ramírez-Ferrer, and William Mauricio Riveros
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medicine.medical_specialty ,arteriography ,business.industry ,tumor-free resection margins ,polymorphous hemangioendothelioma ,medicine.medical_treatment ,General Engineering ,Neurosurgery ,extranodal ,rare vascular tumor ,resection surgery ,medicine.disease ,Surgery ,Hemangioendothelioma ,Resection ,endovascular embolization ,Oncology ,Medicine ,Embolization ,Other ,business - Abstract
A male 28-year-old patient complained of a dorsal mass that has been increasing in size in the last six months. The mass was painful, soft, no mobile, and no neurological symptoms or signs were documented. A vascular-type tumor was suspected and endovascular followed by open surgical resection was indicated. Histopathological revealed a rare case of an adult with a primary extranodal polymorphous hemangioendothelioma. Total resection was confirmed by tumor-free resection margin. The postoperative course was uneventful. Polymorph hemangioendothelioma is a rare vascular tumor. Preoperative endovascular embolization is recommended given the high vascular features of the lesion and, therefore, the high rate of bleeding during surgery, to achieve complete resection.
- Published
- 2021
15. 高龄肝癌患者肝癌切除术后并发症及预后分析.
- Author
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陈安, 杨振宇, 杜锡林, 殷祥烨, and 刘尧
- Abstract
Objective: To explore the therapeutic effect and degree of safety in aged patients with primary carcinoma of the liver undergoing radical resection. Methods: The clinical records of 63 patients (older group≥ 70years) and 98 patients (younger group<70 years) with PLC undergoing resection surgery analyzed retrospectively, and the follow-up of these patients was performed, we investigated and discussed the postoperative complications and?the clinical features or prognoses of these people. Results: The post-operative complications (POC) occurred in 23 of older group(36.5%) versus 31 in younger group(31.6%)(P>0.05), POC occurred in older group of 7 (11.1%) cases of liver failure. 2 (3.17%) cases of postoperative bleeding, 3 (4.8%) cases incision infection. 3(4.8%) cases of pleural effusion. 1 (1.5%) cases of sub-phrenic infection, 1 (1,5%)case with severe pulmonary infection. Only one patient died to the acute pulmonary embolism. The histopathology diagnosis showed there were nodes and giant mass type in aged patients, and Edmondson I-II in 33 patients, in-IV in 18. cholangiocarcinoma in 8. Mixed cellularity in 4. The cases of BCLC 0. A, B, C phase respectively has 2, 9. 35. 17. The survival rate of older group verses younger group was 82.5%vs85.7%. 34.9%vs46.3%/15.9%vs36.8% at 1, 2 and 3 years, respectively. Conclusion: Advanced age has no obvious effect on the occurrence of POC after hepatectomy and is not a contraindication to radical hepatic resection in patients over 70 years old suffering from early primary liver carcinoma, however, older group patients has lower survival rate than younger group patients in 2 and 3 year. [ABSTRACT FROM AUTHOR]
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- 2016
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16. Základy rehabilitačních technik u pacientů s dysfagií po resekcích nádorů orofaryngeální oblasti.
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Roubíčková, L., Nestávalová, H., and Dostálová, T.
- Abstract
Swallowing disorders in patients after resection of tumors in oropharyngeal region are very frequent postoperative or postirradiation problems of these patients. They can pose a life threatening problem in these patients especially due to the risk dehydration, malnutrition or aspiration bronchopneumonia. In other cases it can bring about a discomfort with decreased quality of their lives. The article briefly surveys basic therapeutic procedures, which can be applied in these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2015
17. Diagnostika a základy principů terapie dysfagie u pacientů po resekcích nádorů orofaryngeální oblasti.
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Roubíčková, L., Košľabová, E., Kysílko, M., Vosmiková, M., Sýba, J., Kavka, A., Hrušková, M., Lukeš, P., Lukešová, E., Kolář, P., and Kövári, M.
- Abstract
Log-term disorders of swallowing in patients after resection surgery in oropharyngeal region and subsequent radiotherapy or chemotherapy are encountered in about 50% of patients (7). The aim of this article is to provide a comprehensive view of the possibilities of their examination and rehabilitation. Due to the fact that majority of extensive resections in this region is performed for malignant neoplasms, this article is focused mainly on the specifics of rehabilitation of this spectrum of patients and the possibility of affecting the effects of radiotherapy. The most frequent causes of swallowing disorders after surgery in the oropharyngeal region lie in the absence of resected parts of the swallowing tract, disorders of innervation in perioperative damage to nervous nerve supply, transposition of individual parts f the swallowing tract with subsequent change of their function, consequences of postoperative cicatrices or post-irradiation changes. The controversial causes of swallowing disorders include tracheostomy cannula. [ABSTRACT FROM AUTHOR]
- Published
- 2015
18. Retrospective Clinical Analysis of Epilepsy Treatment for Children with Drug-Resistant Epilepsy (A Single-Center Experience).
- Author
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Liu C, Hu Y, Zhou J, Guan Y, Wang M, Qi X, Wang X, Zhang H, Adilijiang A, Li T, and Luan G
- Abstract
Objectives: This retrospective cohort study investigated the clinical characteristics and seizure outcomes of patients aged 1−14 years with drug-resistant epilepsy (DRE) who were treated by different typologies of therapy. Methods: Four hundred and eighteen children with DRE were recruited from Sanbo Brain Hospital of Capital Medical University from April 2008 to February 2015. The patients were divided into three groups: medication (n = 134, 32.06%), resection surgery (n = 185, 44.26%), and palliative surgery (n = 99, 23.68%) groups. Demographic characteristics were attained from medical records. All patients were followed up for at least 5 years, with seizure outcomes classified according to International League Against Epilepsy criteria. The psychological outcome was evaluated with the development quotient and Wechsler Intelligence Quotient Scale for children (Chinese version). Results: The most frequent seizure type was generalized tonic seizure in 53.83% of patients. Age at seizure onset in 54.55% of patients was <3 years. The most frequent etiologies were focal cortical dysplasia (FCD). West syndrome was the most common epilepsy syndrome. Favorable seizure outcomes at the 5-year follow-up in the medication, resection surgery, and palliative surgery groups were 5.22%, 77.30%, and 14.14%, respectively. The patients showed varying degrees of improvement in terms of developmental and intellectual outcomes post-treatment. Conclusions: Pediatric patients with DRE were characterized by frequent seizures, a variety of seizure types, and complex etiology. Recurrent seizures severely affected the cognitive function and development of children. Early surgical intervention would be beneficial for seizure control and prevention of mental retardation. Palliative surgery was also a reasonable option for patients who were not suitable candidates for resection surgery.
- Published
- 2022
- Full Text
- View/download PDF
19. Neurosurgery in canine epilepsy.
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Hasegawa, Daisuke, Saito, Miyoko, and Kitagawa, Masato
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EPILEPSY surgery , *SURGICAL excision , *NEUROSURGERY , *PARTIAL epilepsy , *EPILEPSY , *DOGS - Abstract
Epilepsy surgery is functional neurosurgery applied to drug-resistant epilepsy. Although epilepsy surgery has been established and achieves fair to good outcomes in human medicine, it is still an underdeveloped area in veterinary medicine. With the spread of advanced imaging and neurosurgical modalities, intracranial surgery has become commonplace in the veterinary field, and, therefore, it is natural that expectations for epilepsy surgery increase. This review summarizes current standards of intracranial epilepsy surgery in human medicine and describes its current status and expectation in veterinary medicine. Intracranial epilepsy surgery is classified generally into resection surgery, represented by cortical resection, lobectomy, and lesionectomy, and disconnection surgery, such as corpus callosotomy and multiple subpial transection. In dogs with drug-resistant epilepsy, corpus callosotomy is available as a disconnection surgery for generalized epilepsy. However, other types of disconnection and resection surgeries for focal epilepsy are limited to experimental studies in laboratory dogs and/or anecdotal case reports of lesionectomy, such as tumor or encephalocele removal, without epileptogenic evidence. Veterinary epilepsy surgery is a new and challenging neurosurgery field; with the development of presurgical evaluations such as advanced electroencephalography and neuroimaging, it may become more readily practiced. • Epilepsy surgery (ES) is established in humans, but not in dogs and cats. • ES is divided into resection (RS), disconnection (DS), and neurostimulation. • RS includes cortical resection, gyrectomy, lobectomy, and lesionectomy. • DS includes corpus callosotomy and multiple subpial transection. • Presurgical evaluations and strategy are important for successful ES in dogs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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20. Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution.
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Suzuki, Shuji, Hatori, Takashi, Furukawa, Toru, Shiratori, Keiko, and Yamamoto, Masakazu
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PANCREATIC cancer , *SURGICAL excision , *CYSTS (Pathology) , *CANCER invasiveness , *DUODENUM , *SMALL intestine diseases - Abstract
Aims: The aim of this study was to determine the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) of the pancreas at a single institution. Methods: We investigated 34 patients (5 males and 29 females) who underwent surgery for pathologically confirmed SPNs between 1994 and 2012. Results: Clinical symptoms were absent in 58.8% of the patients. The median tumor diameter was 42.7 mm. All tumors were successfully removed by R0 resection. Pathologically, 5.9% had duodenum invasion and 2.9% had pancreatic serosal invasion, but there was no lymph node metastasis. Radiological findings showed calcification in 39.4% of the patients, capsule formation in 51.5%, cystic components in 69.7%, solid components in 93.9% and internal bleeding in 36.4%. Immunohistochemically, neuron-specific enolase was positive in 100% of the patients, nuclear accumulation of β-catenin in 100% and CD10 in 78.8%. There were no recurrences reported at the median follow-up (67 months). Regarding gender differences, the cystic component in radiological imaging was the only significant finding among the features studied (p = 0.01). Conclusions: R0 resection with appropriate procedures appears to be sufficient for patients with SPNs, even for locally invasive tumors. There were no significant differences between genders except for the cystic component on radiological imaging. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2014
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21. Oral Nutrition as a Form of Pre-Operative Enhancement in Patients Undergoing Surgery for Colorectal Cancer
- Subjects
RESECTION SURGERY ,OLDER PATIENTS ,colorectal cancer ,EXERCISE ,prehabilitation ,RECOVERY ,CONTROLLED-TRIAL ,SARCOPENIA ,surgery ,nutrition ,POSTOPERATIVE COMPLICATIONS ,ENTERAL IMMUNONUTRITION ,MUSCLE MASS ,PHYSICAL PERFORMANCE - Abstract
Background: Nutritional status has major impacts on the outcome of surgery, in particular in patients with cancer. The aim of this review was to assess the merit of oral pre-operative nutritional support as a part of prehabilitation in patients undergoing surgery for colorectal cancer. Methods: A systematic literature search and meta-analysis was performed according to the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) recommendations in order to review all trials investigating the effect of oral pre-operative nutritional support in patients undergoing colorectal surgery. The primary outcome was overall complication rate. Secondary outcomes were incision infection rate, anastomotic leakage rate, and length of hospital stay. Results: Five randomized controlled trials and one controlled trial were included. The studies contained a total of 583 patients with an average age of 63y (range 23-88y), of whom 87% had colorectal cancer. Malnourishment rates ranged from 8%-68%. All investigators provided an oral protein supplement. Overall patient compliance rates ranged from 72%-100%. There was no significant reduction in the overall complication rate in the interventional groups (odds ratio 0.82; 95% confidence interval 0.52-1.25). Conclusion: Current studies are too heterogeneous to conclude that pre-operative oral nutritional support could enhance the condition of patients undergoing colorectal surgery. Patients at risk have a relatively lean body mass deficit (sarcopenia) rather than an absolute malnourished status. Compliance is an important element of prehabilitation. Targeting patients at risk, combining protein supplements with strength training, and defining standardized patient-related outcomes will be essential to obtain satisfactory results.
- Published
- 2018
22. Oral Nutrition as a Form of Pre-Operative Enhancement in Patients Undergoing Surgery for Colorectal Cancer : A Systematic Review
- Author
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Christianne J. Buskens, Tanja E. Argillander, Willem A. Bemelman, Edwin S. van der Zaag, Renate M. Winkels, Annette Kalf, Peter van Duijvendijk, Barbara C. van Munster, Emma R. J. Bruns, Eelco B Wassenaar, and Baukje van den Heuvel
- Subjects
Nutrition and Disease ,Colorectal cancer ,030230 surgery ,law.invention ,surgery ,0302 clinical medicine ,Randomized controlled trial ,law ,Voeding en Ziekte ,Medicine ,POSTOPERATIVE COMPLICATIONS ,MUSCLE MASS ,Young adult ,Aged, 80 and over ,Middle Aged ,RECOVERY ,Colorectal surgery ,Treatment Outcome ,Infectious Diseases ,Systematic review ,nutrition ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,ENTERAL IMMUNONUTRITION ,Colorectal Neoplasms ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Prehabilitation ,EXERCISE ,colorectal cancer ,CONTROLLED-TRIAL ,Preoperative care ,SARCOPENIA ,Young Adult ,03 medical and health sciences ,Preoperative Care ,Humans ,Aged ,VLAG ,RESECTION SURGERY ,OLDER PATIENTS ,business.industry ,General surgery ,Cancer ,prehabilitation ,medicine.disease ,Diet ,Surgery ,Controlled Clinical Trials as Topic ,PHYSICAL PERFORMANCE ,business - Abstract
Item does not contain fulltext BACKGROUND: Nutritional status has major impacts on the outcome of surgery, in particular in patients with cancer. The aim of this review was to assess the merit of oral pre-operative nutritional support as a part of prehabilitation in patients undergoing surgery for colorectal cancer. METHODS: A systematic literature search and meta-analysis was performed according to the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) recommendations in order to review all trials investigating the effect of oral pre-operative nutritional support in patients undergoing colorectal surgery. The primary outcome was overall complication rate. Secondary outcomes were incision infection rate, anastomotic leakage rate, and length of hospital stay. RESULTS: Five randomized controlled trials and one controlled trial were included. The studies contained a total of 583 patients with an average age of 63 y (range 23-88 y), of whom 87% had colorectal cancer. Malnourishment rates ranged from 8%-68%. All investigators provided an oral protein supplement. Overall patient compliance rates ranged from 72%-100%. There was no significant reduction in the overall complication rate in the interventional groups (odds ratio 0.82; 95% confidence interval 0.52 - 1.25). CONCLUSION: Current studies are too heterogeneous to conclude that pre-operative oral nutritional support could enhance the condition of patients undergoing colorectal surgery. Patients at risk have a relatively lean body mass deficit (sarcopenia) rather than an absolute malnourished status. Compliance is an important element of prehabilitation. Targeting patients at risk, combining protein supplements with strength training, and defining standardized patient-related outcomes will be essential to obtain satisfactory results.
- Published
- 2018
23. Potentially avoidable surgery in inflammatory bowel disease: what proportion of patients come to resection without optimal preoperative therapy? A guidelines-based audit.
- Author
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Gapasin, J., Van Langenberg, D. R., Holtmann, G., Hetzel, D. J., and Andrews, J. M.
- Subjects
- *
ACADEMIC medical centers , *INFLAMMATORY bowel diseases , *MEDICAL protocols , *METROPOLITAN areas , *PREOPERATIVE care , *QUESTIONNAIRES , *RETROSPECTIVE studies , *DESCRIPTIVE statistics - Abstract
Background: Recently, promulgated inflammatory bowel disease (IBD) guidelines seek to decrease the need for surgery by improving disease control. However, resection rates remain static. Aims: We therefore sought to determine the proportion of patients coming to surgery where preoperative management was not optimal according to guidelines. Methods: Case notes of all patients with resection surgery for IBD from January 2007 to March 2008 at a metropolitan teaching hospital were retrospectively reviewed. Judgement was made as to whether preoperative management was optimal or suboptimal depending on whether it met guidelines. Results: A total of 22 subjects with IBD-related resections were identified (15 males and seven females). In total, 17 had Crohn's disease (CD) (11 males) and five ulcerative colitis (UC) (four males). There were 10 smokers (nine CD and one UC). The two most common indications for surgery were inflammatory mass/abscess ( n= 8) and refractory to medical therapy ( n= 7). While all patients with known IBD (20/22) had seen a gastroenterologist in the past, five known IBD patients had resections undertaken without preoperative gastroenterologist input. Overall preoperative management was judged as optimal in only (9/22) 41%. Of those whose therapy did not meet guidelines ( n= 13), five had azathioprine at doses <2 mg/kg, one declined therapy and nine with CD were current smokers. Conclusions: Over 50% of IBD resection patients had suboptimal preoperative management, with sub-therapeutic thiopurine dosing and smoking in CD the main problems. Thus, there are significant gains to be made with better use of standard therapies, as it appears that ∼50% of resection surgery was 'potentially avoidable'. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
24. A case report of primary cardiac capillary hemangioma.
- Author
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Fan, Jidan, Liao, Xiaobo, and Zhou, Xinmin
- Published
- 2016
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- View/download PDF
25. Removal of epileptically compromised tissue in the frontal cortex restores oculomotor selection in the antisaccade task
- Author
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Van der Stigchel, Stefan, Leijten, Frans S.S., Vansteensel, Mariska J., Dijkerman, Hendrik Chris, Ramsey, Nick F., Freudenburg, Zachary V., Experimental Psychology (onderzoeksprogramma PF), Leerstoel Stigchel, Leerstoel Dijkerman, Universiteit Utrecht, Helmholtz Institute, Afd Psychologische functieleer, Experimental Psychology (onderzoeksprogramma PF), Leerstoel Stigchel, Leerstoel Dijkerman, Universiteit Utrecht, Helmholtz Institute, and Afd Psychologische functieleer
- Subjects
Frontal cortex ,Adolescent ,Eye Movements ,genetic structures ,Cognitive Neuroscience ,Behavioral neuroscience ,Cognitive neuroscience ,behavioral disciplines and activities ,Neurosurgical Procedures ,050105 experimental psychology ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,Saccades ,Humans ,0501 psychology and cognitive sciences ,antisaccades ,Brain Mapping ,Neural correlates of consciousness ,Epilepsy ,05 social sciences ,resection surgery ,Eye movement ,Frontal eye fields ,Magnetic Resonance Imaging ,Frontal Lobe ,Visual field ,Neuropsychology and Physiological Psychology ,frontal eye fields ,Female ,Electrocorticography ,Visual Fields ,Psychology ,Antisaccade task ,Neuroscience ,oculomotor selection ,Psychomotor Performance ,030217 neurology & neurosurgery - Abstract
The frontal cortex is heavily involved in oculomotor selection. Here, we investigated the neural correlates of eye movement selection during an antisaccade task in a young epileptic patient in whom the seizure focus included the frontal cortex and affected its function. Before resection surgery, the patient had difficulty in performing correct antisaccades towards the visual field contralateral to the seizure focus. Because the FEF is the only area in the human frontal cortex that is known to have a lateralized oculomotor function in the antisaccade task, this behavioural imbalance between the two visual fields suggests a disruption of FEF functioning by the nearby seizure focus. Electrocorticographic recordings at the seizure focus indeed showed that the seizure focus interfered with correct antisaccade performance. These results were in line with fMRI recordings revealing less task-related frontal activity for the hemisphere of the seizure focus, possibly reflecting diminished top-down engagement of the oculomotor system. Two months after removal of the compromised tissue, the seizures had disappeared, and antisaccade performance was the same for both visual hemifields. We conclude that a seizure focus in the frontal cortex can induce a dysfunction in the selection of eye movements, which is resolved after removal of interfering tissue.
- Published
- 2019
26. Gene expression profile of extraocular muscles following resection strabismus surgery
- Author
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André Vicente, Karin Sandgren Hochhard, Jing-Xia Liu, Maria Angels Rodríguez, and Fatima Pedrosa Domellöf
- Subjects
0301 basic medicine ,Extraocular muscles ,medicine.medical_specialty ,genetic structures ,Resection surgery ,Resection ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Ophthalmology ,Gene expression ,medicine ,Animals ,Strabismus ,business.industry ,Gene Expression Profiling ,Cell Cycle ,eye diseases ,Sensory Systems ,Immunity, Innate ,Extracellular Matrix ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Oculomotor Muscles ,030221 ophthalmology & optometry ,Rabbit model ,Oftalmologi ,Rabbits ,sense organs ,business ,Strabismus surgery - Abstract
This paper aims to identify key biological processes triggered by resection surgery in the extraocular muscles (EOMs) of a rabbit model of strabismus surgery by studying changes in gene expression. Resection surgery was performed in the superior rectus of 16 rabbits and a group of non-operated rabbits served as control. Muscle samples were collected from groups of four animals 1, 2, 4 and 6 weeks after surgery and processed for RNA-sequencing and immunohistochemistry. We identified a total of 164; 136; 64 and 12 differentially expressed genes 1, 2, 4 and 6 weeks after surgery. Gene Ontology enrichment analysis revealed that differentially expressed genes were involved in biological pathways related to metabolism, response to stimulus mainly related with regulation of immune response, cell cycle and extracellular matrix. A complementary pathway analysis and network analysis performed with Ingenuity Pathway Analysis tool corroborated and completed these findings. Collagen I, fibronectin and versican, evaluated by immunofluorescence, showed that changes at the gene expression level resulted in variation at the protein level. Tenascin-C staining in resected muscles demonstrated the formation of new tendon and myotendinous junctions. These data provide new insights about the biological response of the EOMs to resection surgery and may form the basis for future strategies to improve the outcome of strabismus surgery.
- Published
- 2019
27. The effects of physical prehabilitation in elderly patients undergoing colorectal surgery
- Subjects
RESECTION SURGERY ,OLDER PATIENTS ,ENHANCED RECOVERY ,frailty ,HOSPITAL ANXIETY ,elderly ,FAST-TRACK ,COLONIC SURGERY ,DEPRESSION SCALE ,6-MINUTE WALK TEST ,colorectal surgery ,CANCER RESECTION ,Prehabilitation ,FRAILTY - Abstract
AimPrehabilitation, defined as enhancement of the preoperative condition of a patient, is a possible strategy for improving postoperative outcome. Lack of muscle strength and poor physical condition, increasingly prevalent in older patients, are risk factors for postoperative complications. Eighty-five per cent of patients with colorectal cancer are aged over 60years. Since surgery is the cornerstone of their treatment, this review systemically examined the literature on the effect of physical prehabilitation in older patients undergoing colorectal surgery.MethodTrials and case-control studies investigating the effect of physical prehabilitation in patients over 60years undergoing colorectal surgery were retrieved from MEDLINE, EMBASE, CINAHL and the Cochrane library. Patient characteristics, the type of intervention and outcome measurements were recorded. The risk of bias and heterogeneity was assessed.ResultsFive studies including 353 patients were identified. They were small, containing an average of 77 patients and were of moderate methodological quality. Compliance rates of the prehabilitation programme varied from 16 to 97%. None of the studies could identify a significant reduction of postoperative complications or length of hospital stay. Four studies showed physical improvement (walking distance, respiratory endurance) in the prehabilitation group. Clinical heterogeneity precluded a meta-analysis.ConclusionPrehabilitation is a possible means of enhancing the physical condition of patients preoperatively. The quality of studies in older patients undergoing colorectal surgery is poor, despite the increase in elderly people with colorectal cancer. Defining specific patient groups at risk and standardizing the outcome are essential for improving the results of treatment.
- Published
- 2016
28. Focal, Extranodal Primary Polymorphous Hemangioendothelioma Treated With Endovascular Embolization and Resection Surgery.
- Author
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Ramírez-Ferrer E, Perez F, Caballero A, Riveros WM, and Osorio-Bohorquez LA
- Abstract
A male 28-year-old patient complained of a dorsal mass that has been increasing in size in the last six months. The mass was painful, soft, no mobile, and no neurological symptoms or signs were documented. A vascular-type tumor was suspected and endovascular followed by open surgical resection was indicated. Histopathological revealed a rare case of an adult with a primary extranodal polymorphous hemangioendothelioma. Total resection was confirmed by tumor-free resection margin. The postoperative course was uneventful. Polymorph hemangioendothelioma is a rare vascular tumor. Preoperative endovascular embolization is recommended given the high vascular features of the lesion and, therefore, the high rate of bleeding during surgery, to achieve complete resection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Ramírez-Ferrer et al.)
- Published
- 2021
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29. Non-Syndromic Spinal Schwannomas: A Novel Classification
- Author
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M. Necmettin Pamir, Ibrahim Sun, and Acibadem University Dspace
- Subjects
tumor classification ,medicine.medical_specialty ,Weakness ,Hospital records ,lcsh:RC346-429 ,spinal schwannoma ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,medicine ,spinal tumor ,030212 general & internal medicine ,lcsh:Neurology. Diseases of the nervous system ,Original Research ,business.industry ,Incidence (epidemiology) ,resection surgery ,Patient data ,Neurovascular bundle ,Surgery ,Neurology ,Classification methods ,Neurology (clinical) ,medicine.symptom ,business ,postoperative recovery ,030217 neurology & neurosurgery ,Non syndromic ,Neuroscience - Abstract
Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3-0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of non-syndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients' tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C) for tumor volume and four types (I, II, III, and IV) for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches.
- Published
- 2017
30. Long-Term Seizure Outcome following Resective Surgery for Epilepsy: To Be or Not to Be Completely Cured?
- Author
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Takeharu Kunieda, Hidenao Fukuyama, Sumiya Shibata, Jun Takahashi, Rika Inano, Akio Ikeda, Riki Matsumoto, Takayuki Kikuchi, Nobuhiro Mikuni, Yukihiro Yamao, and Susumu Miyamoto
- Subjects
long-term outcome ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Kaplan-Meier analysis ,Kaplan-Meier Estimate ,Hospitals, University ,Epilepsy ,Young Adult ,The 71st Annual Meeting Special Topics—Part I: Long-Term Functional Outcome of Epilepsy Surgery ,Quality of life ,Japan ,Recurrence ,medicine ,Humans ,Epilepsy surgery ,Ictal ,Young adult ,Child ,Survival analysis ,Aged ,Retrospective Studies ,business.industry ,Remission Induction ,resection surgery ,Retrospective cohort study ,longitudinal analysis ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Magnetic Resonance Imaging ,Confidence interval ,Surgery ,Treatment Outcome ,Anesthesia ,epilepsy surgery ,Quality of Life ,Anticonvulsants ,Female ,Neurology (clinical) ,business ,Follow-Up Studies - Abstract
Surgical intervention is expected to improve the quality of life in patients with intractable epilepsy by providing adequate seizure control. Although many previous studies showed various rates of seizure freedom, definite conclusions have not yet been made regarding outcomes. In order to clarify the long-term postoperative outcome for a period up to 10 years, a retrospective review of our patients was performed longitudinally by using the survival analysis method. The postoperative state of epilepsy in 76 patients who underwent resection surgery was assessed based on Engel’s criteria. In addition, Kaplan-Meier survival analysis was used to calculate the probability of seizure freedom. In this patient group, abnormal lesion were detected by MRI in 70 out of 76 cases, and the ictal onset zone was finally identified within temporal lobe in 51 cases. The most favorable outcome, defined as Engel Class Ia, was observed in 26 (37%), 24 (40%), and 18 (41%) cases at 2, 5, and 10 years after surgery, respectively. The Kaplan-Meier survival curve in the overall group estimated the probability of seizure freedom as 75% (95% confidence interval [CI] 70–80%), 67% (62–72%), and 51% (45–57%) at 2, 5, and 10 years follow up, respectively. Half of all seizure recurrences occurred within the first 2 postoperative years. In this study, we showed that long-term favorable outcome of seizure control following resection surgery can be achieved in more than half of the patients.
- Published
- 2013
31. The effects of physical prehabilitation in elderly patients undergoing colorectal surgery: a systematic review
- Author
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E. R. J. Bruns, B. van den Heuvel, Sebastiaan Festen, P. van Duijvendijk, Eelco B Wassenaar, E.S. van der Zaag, B.C. van Munster, W. A. Bemelman, Christianne J. Buskens, Surgery, and CCA - Evaluation of Cancer Care
- Subjects
medicine.medical_specialty ,ENHANCED RECOVERY ,Colorectal cancer ,Prehabilitation ,MEDLINE ,Walk Test ,frailty ,HOSPITAL ANXIETY ,CINAHL ,Cochrane Library ,elderly ,Preoperative care ,FAST-TRACK ,6-MINUTE WALK TEST ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Preoperative Care ,Medicine ,Humans ,030212 general & internal medicine ,CANCER RESECTION ,Digestive System Surgical Procedures ,Aged ,RESECTION SURGERY ,OLDER PATIENTS ,business.industry ,Gastroenterology ,Length of Stay ,medicine.disease ,Colorectal surgery ,COLONIC SURGERY ,Exercise Therapy ,DEPRESSION SCALE ,030220 oncology & carcinogenesis ,Physical therapy ,Physical Endurance ,colorectal surgery ,Fast track ,business ,Colorectal Neoplasms - Abstract
AIM: Prehabilitation, defined as enhancement of the preoperative condition of a patient, is a possible strategy for improving postoperative outcome. Lack of muscle strength and poor physical condition, increasingly prevalent in older patients, are risk factors for postoperative complications. Eighty-five per cent of patients with colorectal cancer are aged over 60 years. Since surgery is the cornerstone of their treatment, this review systemically examined the literature on the effect of physical prehabilitation in older patients undergoing colorectal surgery.METHOD: Trials and case-control studies investigating the effect of physical prehabilitation in patients over 60 years undergoing colorectal surgery were retrieved from MEDLINE, EMBASE, CINAHL and the Cochrane library. Patient characteristics, the type of intervention and outcome measurements were recorded. The risk of bias and heterogeneity was assessed.RESULTS: Five studies including 353 patients were identified. They were small, containing an average of 77 patients and were of moderate methodological quality. Compliance rates of the prehabilitation programme varied from 16 to 97%. None of the studies could identify a significant reduction of postoperative complications or length of hospital stay. Four studies showed physical improvement (walking distance, respiratory endurance) in the prehabilitation group. Clinical heterogeneity precluded a meta-analysis.CONCLUSION: Prehabilitation is a possible means of enhancing the physical condition of patients preoperatively. The quality of studies in older patients undergoing colorectal surgery is poor, despite the increase in elderly people with colorectal cancer. Defining specific patient groups at risk and standardizing the outcome are essential for improving the results of treatment.
- Published
- 2015
32. The influence of composite resin restoration on gingival tissue: a pilot study
- Author
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Bertoldi, Carlo, Martani, M., Generali, Luigi, Lucchi, A., Zaffe, Davide, and Consolo, Ugo
- Subjects
inflammation ,resection surgery ,gingival tissue ,gingival tissue, inflammation, composite cements, resection surgery ,composite cements - Published
- 2015
33. Removal of epileptically compromised tissue in the frontal cortex restores oculomotor selection in the antisaccade task.
- Author
-
Van der Stigchel S, Leijten FSS, Vansteensel MJ, Dijkerman HC, Ramsey NF, and Freudenburg ZV
- Subjects
- Adolescent, Brain Mapping, Electrocorticography, Epilepsy diagnostic imaging, Female, Frontal Lobe diagnostic imaging, Humans, Magnetic Resonance Imaging, Neurosurgical Procedures, Psychomotor Performance, Visual Fields, Epilepsy psychology, Epilepsy surgery, Eye Movements, Frontal Lobe surgery, Saccades
- Abstract
The frontal cortex is heavily involved in oculomotor selection. Here, we investigated the neural correlates of eye movement selection during an antisaccade task in a young epileptic patient in whom the seizure focus included the frontal cortex and affected its function. Before resection surgery, the patient had difficulty in performing correct antisaccades towards the visual field contralateral to the seizure focus. Because the FEF is the only area in the human frontal cortex that is known to have a lateralized oculomotor function in the antisaccade task, this behavioural imbalance between the two visual fields suggests a disruption of FEF functioning by the nearby seizure focus. Electrocorticographic recordings at the seizure focus indeed showed that the seizure focus interfered with correct antisaccade performance. These results were in line with fMRI recordings revealing less task-related frontal activity for the hemisphere of the seizure focus, possibly reflecting diminished top-down engagement of the oculomotor system. Two months after removal of the compromised tissue, the seizures had disappeared, and antisaccade performance was the same for both visual hemifields. We conclude that a seizure focus in the frontal cortex can induce a dysfunction in the selection of eye movements, which is resolved after removal of interfering tissue., (© 2017 The British Psychological Society.)
- Published
- 2019
- Full Text
- View/download PDF
34. Surgical treatment of myopic strabismus fixus: a graded approach
- Author
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Veit Sturm, Karla Chaloupka, Klara Landau, Marcel N. Menke, University of Zurich, and Sturm, V
- Subjects
10018 Ophthalmology Clinic ,Adult ,Male ,medicine.medical_specialty ,genetic structures ,Strabismus fixus ,Adolescent ,2804 Cellular and Molecular Neuroscience ,Combined recession ,610 Medicine & health ,Ophthalmologic Surgical Procedures ,2809 Sensory Systems ,Cellular and Molecular Neuroscience ,High myopia ,Acquired progressive esotropia ,Myopia ,Medicine ,Humans ,Surgical treatment ,Aged ,Retrospective Studies ,Esotropia ,business.industry ,resection surgery ,Surgical procedures ,Middle Aged ,2731 Ophthalmology ,Magnetic Resonance Imaging ,eye diseases ,Sensory Systems ,Surgery ,Ophthalmology ,Ophthalmology clinic ,Convergent strabismus fixus ,Oculomotor Muscles ,Female ,sense organs ,business ,Ophthalmologic Surgical Procedure - Abstract
Background: Surgical treatment of myopic strabismus fixus is challenging. Options for its correction range from conventional combined recession-resection surgery to innovative surgical procedures aiming to correct the deviated muscle paths. In this report we review our experience and compare the results of various surgical options for treatment of strabismus fixus. Methods: We report the surgical outcomes of nine adults with acquired strabismus fixus due to myopia with a follow-up of 1year. Patients were enrolled between May 2003 and April 2007 in this retrospective study. The surgical procedure was determined depending on the angle of deviation and extent of motility impairment. A new transposition technique was performed in one patient who had an extreme variant of strabismus fixus. Results: Combined recession-resection surgery was performed in four patients with resulting small-angle esotropia. In patients with both esotropia and hypotropia due to muscle alignment, we performed an additional upward displacement of both horizontal recti muscles combined with a myopexy of the lateral rectus muscle. The results were satisfying; in particular in one patient who had a transposition procedure a significant improvement was achieved. Conclusions: For treatment of myopic strabismus fixus, a graded approach seems advisable. Combined recession-resection surgery yields good results for smaller deviations with mildly impaired motility, additional fixation techniques need to be applied once the horizontal muscle paths are deviated, and in extreme cases, a transposition procedure is required
- Published
- 2008
- Full Text
- View/download PDF
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