Results Of Surgical Treatment In Patients Research Articles

Bronchogenic Cyst in the Head and Neck Region.

The objective of this study was to review the clinical characteristics and surgical treatment outcomes of patients with bronchogenic cysts in the head and neck region. A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2006 to May 2016. Eight patients with a final diagnosis of bronchogenic cyst in the head and neck region were identified based on their medical records. The most common location for the head and neck lymphatic malformations was the neck (4 patients), followed by the soft palate (1 patient), the posterior pharyngeal wall (1 patient), the floor of mouth (1 patient), and the arytenoid (1 patient). The size of the lymphatic malformations ranged from 1 to 6 cm. Bronchogenic cysts recurred in 2 patients. Both these patients were disease-free after the revision operation. No major complications resulting from the surgical intervention were observed. Bronchogenic cysts are rare congenital malformations and they can occur at various sites in the head and neck region. Bronchogenic cyst should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts.

Остеосинтез в хирургическом лечении метастазов в длинных трубчатых костях

Objectives. This study was designed to investigate the causes and risk factors of complications requiring revision surgeries after intramedullary and plate osteosynthesis of the long tubular bones affected by metastases. Methods. Surgical treatment outcomes of patients with long tubular bones metastases (n=44) were analyzed retrospectively. Twelve patients had solitary skeletal metastasis, eleven multiple, twenty one bone metastases combined with visceral metastases. The pathological fracture was diagnosed in 35 patients and the threat of the pathological fracture in 9. Intramedullary osteosynthesis was carried out in 34 cases, plate osteosynthesis in 3 cases, intramedullary osteosynthesis with alloplasty in 12 cases. Results. Application of OS in the metastatic treatment of malignant tumors in long tubular bones have allowed saving the extremity function in 75% cases; the revision organ-saving surgery was carried out in 14,6% observations; restoration of the extremity function was failed in 10,4% cases. Thirteen complications caused by bone metastases required the revision surgery. Median time was 6 months (range of 1-12 months). The causes of complications included local tumor progression, the absence of osseous consolidation and violation of the structural integrity. Risk factors of complications development which require the revision surgeries were the following: pathologic fracture (p=0,046), progressive renal cell carcinoma (p=0,013) and radiation therapy before surgery (p=0,029). In patients with the best life prognosis the complications related with violation of the metal construction integrity or bone fixation failure have developed in longer and active load on the extremity. Conclusion. Osteosynthesis appears to be an efficient method in the treatment of metastatic bone disease in the specific clinical cases. Radical surgical removal of the metastases with the elimination of the bone defect by allograft or endoprosthesis is more reasonable in case of solitary metastases of radio-resistant tumors and controlled tumor process.

Impact of sagittal balance parameters on life quality in elderly and senile patients after surgery for degenerative lumbar spine stenosis

As the life span and proportion of people over 65 years increase, the incidence of degenerative lumbar spine stenosis grows proportionally. Various parameters of the spinopelvic relationships are used to predict surgical treatment outcomes in patients with degenerative spine diseases. There are no unified protocols for evaluation, in terms of the sagittal balance, of surgical treatment outcomes in elderly patients. To study the impact of sagittal balance parameters on the life quality of elderly and senile patients after surgery for degenerative stenosis of the lumbar spine. The study included 109 patients. Decompression was performed in the first group of 53 patients. Decompression and stabilization were performed in the second group of 27 patients. In the third group of 29 patients, XLIF indirect decompression, scoliosis correction, reconstruction of disturbed spinopelvic relationships, and stabilization were carried out. We evaluated the following sagittal balance parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), and PI minus LL (PI-LL). The quality of life indicators were assessed using VAS, ODI, and SF36 scores. In the first group, there were not statistically significant differences for PT≤20° and PT>20°. A statistically significant change in the PI-LL parameter (p=0.0263) was in the first group. A decrease in PI-LL was accompanied by regression of pain (p<10-4). In the second group, comparison of the quality of life indicators revealed no statistically significant differences between PT≤20° and PT>20° as well as PI-LL≤10° and PI-LL>10 in the postoperative period. In the third group, postoperative improvement in PT (p=0.0002) and PI-LL (p=0.0008) parameters was accompanied by a decrease in pain in the legs (p=0.0002) and lumbar spine (p=0.0001). Improvement in the quality of life indicators in 48.6% of cases was achieved by decompression only; the sagittal balance parameters had no significant impact on quality of life. In 24.8% of cases, improvement in the quality of life indicators was achieved by decompression and stabilization because the dominant clinical neurological syndrome was instability. Reduced quality of life in 26.6% of patients was caused by disturbed spinopelvic relationships. Application of the XLIF technique in these patients provides statistically significant restoration of the sagittal balance parameters, PT and PI-LL, which improves quality of life.

MOBILIZATION OF SPLENIC FLEXURE DURING RECTAL RESECTION

Background. Splenic flexure mobilization (SFM) is a difficult step within both conventional and laparoscopic procedures, often associated with intra- and postoperative morbidity. Additional difficulties occur because of the lack of generally accepted methods for performing SFM. Despite many reports, the routine SFM during low rectal resections remains controversial. Aim. This paper presents the strategy for SFM used in our clinic, as well as the surgical treatment outcomes in patients who underwent low rectal resections with or without SFM. Methods. Two retrospective analyzes of the surgical procedures were made. In the first case, the results of all LS operations with SFM (n=120) were analyzed. In the second case, a retrospective analysis of the LS rectal resections was carried out (low anterior resection (LAR) with the SFM (n=32), pull-through rectal resection with the SFM (n=20) and LAR without SFM (n=94)). Results. In the first analysis, patients were divided into 4 groups: LS-left colectomy, LS-low anterior rectal resection, LS-colproctectomy, and LSpull-through rectal resection. There was no significant difference between the groups in terms of intra- and postoperative complications. In the second analysis, the differences in the operation time, blood loss and hospital stay between low rectal resections were not statistically significant. Anastomotic leakage was detected in 2 patients in the LAR with SFM group, in 8 patients (8.5 %, 8/94) in LAR without SFM group, and in 1 patient in pull-through rectal resection group (5 %, 1/20), p=0.17. Conclusions. Using the laparoscopic approach to SFM, optimal surgical outcomes can be achieved. Routine SFM during low anterior rectal resection is not necessary, because it does not lead to decreased incidence of anastomotic leakage and complications. Routine SFM during pull-through rectal resection is necessary.

Surgical treatment outcomes of glomus tumor of the finger

Abstract Objectives: This study aims to evaluate the surgical treatment outcomes in patients with a glomus tumor of the finger. Patients and Methods: A total of 45 patients (30 females, 15 males; mean age: 36.8 years; range, 16 to 58years) who were diagnosed with a glomus tumor of the finger and operated between January 2013 and March 2016 were included. All patients were evaluated in terms of the main complaint on admission, duration of diagnosis, types of operation, and postoperative complications. Results: The mean follow-up was 12 (range, 8 to 26) months.The main complaint on admission was pain increased with cold application in 30 (%66.6),a swollen fingertip in nine patients (20%), and nail deformity in six patients (13.4%). 27 lesions (60%) were located in the right and 18 lesions (40%) were located in the left hand. The mean time from admission to surgery was two years (range, six months to seven years). Based on plain radiography, concave bone erosion was present in six patients. All patients underwent preoperative magnetic resonance imaging (MRI). Subungual tumor localization was present in all patients. These patients were operated by transungual method. Postoperative recurrence was not detected in any patient. Conclusion: Glomus tumor should be considered in cases where there is severe and unexplained pain on the fingertip. Recurrence can be prevented with complete excision. Key words: Glomus tumor; magnetic resonance imaging; surgery. Level of Evidence: III

Pattern and treatment outcome of patients with achalasia cardia after Modified Heller’s Myotomy: experience from Ethiopia

Background: Although achalasia condition occurs in males and females with equal frequency, there are studies reporting that there is a male predominance even in Ethiopia. There appears to be striking international variations with significant differences between countries with respect to prevalence, occurrence in different sex and age groups and clinical features. The main objective of this study was to determine the pattern of clinical presentation and demographic characteristics and to assess the surgical treatment outcome of patients with achalasia. Methods: This was a 5-year retrospective review of medical records and theatre operation register notes of patients operated for achalasia of cardia at Tikur Anbessa Specialized Hospital, Addis Ababa. Selected socio- demographic variables, clinical presentations, radiologic imaging, post-operative course and final outcome were recorded on a structured format. Data was entered, cleaned and edited using EPI info version 3.5.1 for windows and analyzed using SPSS version 15 for windows. Frequencies, percentages, Mann-Whitney U test and Chi-square test were applied to describe and compare the difference between sex, age and dysphagia scores. Wilcoxon Signed Ranks test was used to evaluate the surgical treatment outcome after patients underwent Modified Heller’s Myotomy (MHM). Results: A total of 46 patients’ records that were operated for achalasia were reviewed, of whom 56.5% were males, 52.2% were of younger age (52.2%) with a mean of 26.4 years (Range: 14 – 65 years). Thirty eight (82.6%) patients suffered from grade 3-4 dysphagia. Higher dysphagia score, with no significant statistical difference, was predominantly seen among the young (87.5%) and female (95%) patients. Severity of symptoms of dysphagia was significantly reduced after Modified Heller’s Myotomy (P<0.0001) Conclusion: Slight predominance of male sex and younger age group was found among patients operated for achalasia. Modified Heller’s Myotomy was found to be effective in alleviating symptoms of achalasia.

Результаты хирургического лечения пациентов с местно-распространенным (pT4) немелкоклеточным раком легкого

Результаты хирургического лечения пациентов с местно-распространенным (pT4) немелкоклеточным раком легкого

Evaluation of surgical treatment outcomes in patients with laryngeal cancer during a 5-year follow-up

Evaluation of surgical treatment outcomes in patients with laryngeal cancer during a 5-year follow-up

An Analysis of Surgical Treatment Results of Patients With Tympanosclerosis.

The authors aimed to evaluate the intraoperative features and the results of postoperative hearing gain successes of patients with tympanosclerosis who were treated surgically in our clinic. A retrospective analysis was conducted on 151 ears with tympanosclerosis of 138 patients who operated because of chronic otitis media or only tympanosclerosis, between January 2007 and June 2014. They were evaluated by appealing complain, complain duration, accompanying systemic disorders, tympanic membrane condition, localization of sclerotic plaque, damage in ossicular chain, existence of cholesteatoma, operation procedure type, hearing reconstruction type, preoperative, and last postoperative audiometric findings in every frequency both bone and air way. In the group of Wielinga-Kerr Group 3 (isolated stapes fixation), no statistically significant results were found in preoperative and last postoperative audiometric findings in every frequency both bone and air conduction (BC and AC) (P > 0.05). In the Wielinga-Kerr Group some results had significant (P < 0.05) and some results had highly significant (P < 0.001). Patients with less impact on ossicular chain and limited localization of sclerotic plaques have better hearing gain. Although surgery is still controversial in tympanosclerosis; it is the most effective treatment till new effective medication is discovered.

Surgical Treatment Outcomes in Patients With Recurrent Pregnancy Loss Attributed to Septate Uterus

Surgical Treatment Outcomes in Patients With Recurrent Pregnancy Loss Attributed to Septate Uterus

Evaluation of machine learning algorithms for treatment outcome prediction in patients with epilepsy based on structural connectome data

The objective of this study is to evaluate machine learning algorithms aimed at predicting surgical treatment outcomes in groups of patients with temporal lobe epilepsy (TLE) using only the structural brain connectome. Specifically, the brain connectome is reconstructed using white matter fiber tracts from presurgical diffusion tensor imaging. To achieve our objective, a two-stage connectome-based prediction framework is developed that gradually selects a small number of abnormal network connections that contribute to the surgical treatment outcome, and in each stage a linear kernel operation is used to further improve the accuracy of the learned classifier. Using a 10-fold cross validation strategy, the first stage in the connectome-based framework is able to separate patients with TLE from normal controls with 80% accuracy, and second stage in the connectome-based framework is able to correctly predict the surgical treatment outcome of patients with TLE with 70% accuracy. Compared to existing state-of-the-art methods that use VBM data, the proposed two-stage connectome-based prediction framework is a suitable alternative with comparable prediction performance. Our results additionally show that machine learning algorithms that exclusively use structural connectome data can predict treatment outcomes in epilepsy with similar accuracy compared with “expert-based” clinical decision. In summary, using the unprecedented information provided in the brain connectome, machine learning algorithms may uncover pathological changes in brain network organization and improve outcome forecasting in the context of epilepsy.

439. The results of endoprosthetics of hip bone joint in the tumours of proximal part of the thigh bone

Background: To present the surgical treatment results of patients with primary and metastatic tumors of proximal part of the thigh bone.

Primary hepatic angiosarcoma: A retrospective analysis of 6 cases

The aim of this study was to define the clinical features and surgical treatment outcomes of patients with primary hepatic angiosarcoma. Data of the 6 patients diagnosed with primary hepatic angiosarcoma in Tianjin Medical University Cancer Institute and Hospital from January 1999 to December 2005 were retrospectively reviewed. The median age of the patients was 49 years (range 45-78 years) with a male predominance. Laboratory tests showed a mild elevation of α-fetoprotein in 2 patients, and 2 had both hepatitis B and C. Liver resection was performed in all patients. For the 5 patients who received curative liver resection, the median follow-up duration was 41 months (range 23-84 months) and the overall 1-year, 3-year and 5-year survival rates were 100.0%, 80.0% and 40.0%, respectively. One patient who underwent a palliative operation died of tumor progression a month after operation. Early diagnosis is necessary and complete surgical resection is the key to improve prognosis.

Surgical Treatment Outcomes of Patients with Bilateral Warthin Tumors in the Parotid Gland

We describe the treatment outcomes of patients with bilateral Warthin tumors in the parotid gland according to surgical methods. The medical records of ten patients with bilateral Warthin tumors in the parotid gland who underwent surgery between 2004 and 2011 were retrospectively reviewed. Ten patients were included in the study and 13 parotidectomies were performed. Patients with bilateral Warthin tumors in the parotid gland were divided into three groups according to the surgical methods used to treat these individuals. In group 1, the patients were closely observed without undergoing contralateral parotidectomy after unilateral parotidectomy. In group 2, the patients underwent concurrent bilateral parotidectomies. In group 3, the patient underwent contralateral parotidectomy 2months after unilateral parotidectomy was performed. The overall rate of transient facial nerve dysfunction was 31%. Our findings suggest that concurrent superficial parotidectomy may be an appropriate method for treating bilateral Warthin tumors in the parotid gland, at least for desired patients. The symptoms of this type of tumor and physical examination findings are frequently non-specific and present in the unilateral parotid gland. Therefore, a high degree of discernment is needed and imaging techniques are essential for the determining the correct pre-operative diagnosis.

Analysis of clinical features and treatment outcomes of patients with tuberculous otitis media and mastoiditis

To analyze the clinical features and the surgical treatment outcomes of patients with tuberculous otitis media and mastoiditis. The medical records of 16 patients (18 ears) with tuberculous otitis media and mastoiditis, who received surgery in Beijing Tongren hospital, were reviewed. The common symptoms were otorrhea and hearing loss, and 3 patients demonstrated severe sensorineural hearing loss. Three patients demonstrated a peripheral-type facial palsy. Temporal bone high resolution CT scans demonstrated the entire tympanum and mastoid air cells were occupied by soft tissue. Eleven patients demonstrated bone destruction and sequestra was found in 7 temporal bones. Contemporary pulmonary tuberculosis were diagnosed in 7 of the 16 patients. Surgical removal of disease lesions in combination with anti-tuberculosis treatment were given to 15 patients. Other than 2 cases of tuberculous otitis media and mastoiditis diagnosed by pre-operational biopsy through the perforated tympanic membrane, the remaining 14 cases were diagnosed intra-operatively or post-operatively. No relapse of tuberculosis in the middle ear and mastoid were found after follow-up for more than 1 year, except for the one case that was lost to follow-up. The 3 cases of facial nerve palsy almost recovered to normal. Clinicians should suspect tuberculous otitis media and mastoiditis if clinical findings include refractory otorrhea, total occupation of the tympanic cavity and mastoid ari cells by soft tissue, and erosion of the bone or sequestra as shown by CT. A history of tuberculosis should be asked carefully in order to differentiate tuberculous otitis media and mastoiditis. The patients who received surgery and anti-tuberculosis chemotherapy achieved more rapid healing of the ear.

Surgical Treatment Outcomes in Patients with Stage pT1a and pT1b1 Cervical Cancer

Objective: The object of this study was to assess the outcomes of surgical treatment of stage pT1a and pT1b1 cervical cancer.Method: The medical records of 59 patients at our institution with pT1a and pT1b1 cervical cancer who underwent an operation as their primary treatment between January 1996 and September 2006 were analyzed retrospectively.Results: Ten patients underwent an operation which was less aggressive than the current operative modality at our institution. Three patients had recurrence. No patients had recurrence resulting from insufficient operations. No patients had any histologic subtype of adnexal metastasis in the resected specimens. Two of the five patients with squamous cell carcinoma and lymph node metastases at the initial operation had recurrence. Only one patient had a histologic subtype of adenosquamous carcinoma. The patient with adenosquamous carcinoma had recurrence.Conclusion: The results suggest that the surgical procedure did not affect prognosis in the cases we analyzed by surgical modalities. The current evidence suggests that a patient in an early stage can undergo less aggressive surgery than the current operative modality requires.

Granulomatous mastitis: surgical outcomes.

To report the clinical and pathological features and surgical treatment outcomes of patients with granulomatous mastitis. Case series. Ankara Oncology Training and Research Hospital, between 1999-2003. Data of 16 patients with granulomatous mastitis treated surgically by total excision with disease-free margins were reviewed. Patients given additional medical therapy or treated with mastectomy because of the size and extent of the disease were excluded. The mean age of patients at the time of diagnosis was 31.8 (range: 22-45 years). All patients were diagnosed from the pathological tissue specimens obtained by surgery. Clinical and radiological examinations suggested breast carcinoma in 82.1% patients. Except one patient who developed a fistula from the incision which was treated again with surgery, no other complications were noted, including recurrence of disease during a median follow-up period of 12.8 months (range: 4-30 months). Although granulomatous mastitis is a rare benign breast disease, it usually mimics breast carcinoma both clinically and radiologically, making the diagnosis difficult and challenging. As long as good cosmetic results can be achieved, surgical excision is quick, safe and effective treatment method for idiopathic granulomatous mastitis.