scholarly journals A New Technique for Simple Renal Cyst: Cystoretroperitoneal Shunt

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Onder Canguven ◽  
Cemal Goktas ◽  
Faruk Yencilek ◽  
Cihangir Cetinel ◽  
Selami Albayrak
Keyword(s):  
Renal Cyst ◽  
Renal Cysts ◽  
Simple Renal Cyst ◽  
Ultrasound Guided ◽  
Cyst Volume ◽  
Mean Size ◽  
The Mean ◽  
A New Technique ◽  
A Prospective Study

Purpose. To evaluate the results of patient symptoms and radiologic outcomes of cystoretroperitoneal shunt (CRS) technique in the treatment of symptomatic simple renal cysts.Patients and Methods. In a prospective study, 37 patients with a simple renal cyst were treated with ultrasound-guided percutaneous CRS-catheter. Radiological success was indicated as no recurrence of the cyst or a reduction in cyst volume by at least half.Results. CRS technique was performed successfully in 36 patients with a simple renal cyst. The mean size of all cysts decreased from 8.8 cm (range 7 to 14) to 1.7 cm (range 0 to 9; ). Symptomatic success (pain relief) was achieved in 29/36 (80.5%) of patients, and radiographic success was achieved in 23/36 (63.8%) of patients, with a median follow-up of 16 months (range 6 to 24).Conclusion. Ultrasound-guided percutaneous CRS technique for simple renal cysts is fast, safe, effective, and inexpensive.

scholarly journals Treatment of Insertional Achilles Tendinopathy With Ultrasound-Guided Intrabursal Retrocalcaneal Hyaluronic Acid Injection - A Prospective Study

2020 ◽  
Author(s):  
Omer Slevin ◽  
David Segal ◽  
Nissim Ohana ◽  
Eugene Kots ◽  
Viktor Feldman ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Univariate Analysis ◽  
Achilles Tendinopathy ◽  
Ultrasound Guided ◽  
Functional Scores ◽  
Rank 2 ◽  
The Mean ◽  
A Prospective Study ◽  
Insertional Achilles Tendinopathy

Abstract Background: Insertional Achilles tendinopathy (IAT) is a chronic degenerative enthesopathy involving fibrocartilage changes that resemble osteoarthritic changes in articular cartilage. Thus, our primary goal was to evaluate the effect of hyaluronic acid (HA) injections on IAT. Methods: Fifteen IAT ankles (14 patients) were treated with three consecutive weekly ultrasound-guided retrocalcaneal intrabursal injections of hylan G-F 20 (Synvisc®). Patients answered the "Victorian Institute of Sport Assessment – Achilles" (VISA-A) questionnaire before every injection and on 1 month and 6 months follow-up visits. Univariate analysis was performed to identify differences in functional scores. Results: The mean (VISA-A) score improved significantly following HA injections from 34.8 ± 15.2 (range, 11-63) points before the first injection to 53.6 ± 20.9 (range, 15-77) points after 1 month, and 50.7 ± 18.6 (20-75) points after 6 months. No adverse drug reactions were noted.Conclusions: Three consecutive ultrasound-guided intrabursal retrocalcaneal HA injections were found in our cohort to be beneficial in treating IAT.Trial registration: NCT02368561. Registered 23 February 2015. https://clinicaltrials.gov/ct2/show/NCT02368561?term=insertional+achilles&draw=2&rank=2

scholarly journals Laparoscopic treatment of symptomatic simple renal cysts in children: single-center experience

2018 ◽  
Author(s):  
Antonio Marte ◽  
Lucia Pintozzi
Keyword(s):  
Operating Time ◽  
Case Series ◽  
Renal Cysts ◽  
Laparoscopic Treatment ◽  
Ultrasound Guided ◽  
Cytological Examination ◽  
Single Center Experience ◽  
Urinary Tract Symptoms ◽  
The Mean

Simple renal cysts, although common in adults, are rare in children. They are usually discovered incidentally in the course of the study of other urinary tract symptoms, although they are not always asymptomatic. Renal cysts can be classified as being either simple or complex. The purpose of this review is to present our case series of simple symptomatic renal cysts treated with laparoscopy. Nineteen patients with symptomatic renal cysts (6 to 13.5 cm) were referred to our institution between January 2006 and January 2017. They comprised 12 (40.5%) females and seven (59.5%) males, aged 8 to 15, with a mean age of 12.2 years. Of these patients, nine had previously been treated unsuccessfully by ultrasound-guided aspiration/alcoholization with 95%-ethanol, between 9 and 13 months prior to the laparoscopy. Five patients had undergone one treatment and four had undergone two treatments. All of the patients were treated by laparoscopic threetrocar deroofing. The cysts were opened and the wall excised using scissors and a monopolar hook. In most cases, to better handle the edges of the cyst and obtain a better grip, a needle was used to aspirate a small amount of fluid (used for cytological examination). The wall of the cyst was excised, the cyst edges were sealed, and the perirenal fat was placed on the bottom of the cyst (wadding technique). The mean operating time was 95 minutes (range 50- 150). The postoperative course was uneventful for all of the patients. The hospital stay ranged from one to three days. All of the patients were asymptomatic following the treatment. At a mean follow-up time of 3.6 years, none of the patients had experienced a recurrence. Renal function, as assessed by a MAG3 renal scintigraphy scan, was well-preserved in all of the patients, and all of them undergo an annual ultrasound scan.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

scholarly journals Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease

2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  
Keyword(s):  
Clinical Impact ◽  
Anatomical Location ◽  
Von Hippel Lindau ◽  
Study Enrollment ◽  
Common Location ◽  
Younger Age ◽  
The Mean ◽  
A Prospective Study ◽  
Vhl Disease

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.

Matrixplasty for the Treatment of Severe Incurved Toenail with Growth Plate Deformity

2012 ◽  
Vol 102 (3) ◽  
pp. 198-204
Author(s):  
J.-Young Kim
Keyword(s):  
Growth Plate ◽  
Clinical Results ◽  
New Technique ◽  
Partial Removal ◽  
Edge Angle ◽  
Results Of Treatment ◽  
The Mean ◽  
A New Technique ◽  
Ingrown Toenails

Background: Severely incurved toenails are accompanied by deformity of the toenail growth plate. In such a condition, partial removal of the nail and nail bed and simple unfolding of the nail itself frequently result in the recurrence of symptoms. We sought to design and develop a new technique for the treatment of incurved toenail with growth plate deformity and to report the results of treating this disease entity. Methods: Forty consecutive patients (52 cases) underwent treatment of symptomatic incurved toenails with a new technique named matrixplasty. The mean ± SD patient age was 40.3 ± 18.9 years. Last follow-up was at a mean ± SD of 18.0 ± 1.3 months. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned, and patients were evaluated before treatment and at last follow-up. Patient satisfaction and the recurrence rate of the deformity were evaluated. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured before treatment and at last follow-up. The complication rate was also evaluated. Results: All of the ingrown toenails healed, and the nail deformities were corrected within 3 weeks after the procedure. None of the incurved toenails had recurred by last follow-up. The mean pretreatment AOFAS forefoot hallux score was 72.9, and it improved to 99.6 by last follow-up (P &lt; .001). Every patient was very satisfied or satisfied with the results of treatment. The mean ± SD center to edge angle of the toenail improved from 53.3° ± 9.5° to 15.3° ± 5.2° by last follow-up (P &lt; .001). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in four cases. No other complication was identified. Conclusions: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail, and this newly developed procedure showed improvement of the deformed toenail and its growth plate. (J Am Podiatr Med Assoc 102(3): 198–204, 2012)

scholarly journals A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in Day Surgery Mode

2020 ◽  
Author(s):  
Xiao-Liang Zhu ◽  
Song-Jiang Wu ◽  
Yasmeen Bano ◽  
Wen-Li Liu ◽  
Ming-Hui jiang ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Previous History ◽  
Operation Time ◽  
Renal Cysts ◽  
Day Surgery ◽  
Simple Renal Cyst ◽  
Inpatient Ward ◽  
Medical Environment ◽  
History Of ◽  
Retroperitoneal Laparoscopy

Abstract Background: Under the constraints of the increasingly tight medical environment and cost, day surgery mode has become a favorable trend and attracts attention from clinicians. Currently, there are no standards or procedures on the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in day surgery mode. We attempted to investigate the feasibility and safety criteria of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day surgery ward and to compare the advantages and the disadvantages with conventional inpatient ward mode.Methods: A total of 41 patients with unilateral simple renal cysts meeting surgical indications were enrolled in this study. To see whether patients in the day group could successfully complete the procedure and be admitted and discharged within 24 hours and to summarize the advantages and the advantages. The indexes of the operation time, time of hospitalization, postoperative complication rate, total costs of hospitalization and other indicators were compared between the two groups.Results: 41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10-12 months after surgery. The results of time of hospitalization, total costs of hospitalization and time of postoperative removal of drainage tube were statistically significant between the two groups of the day ward group and the inpatient ward group (P <0.05). Conclusions: We concluded the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients with unilateral renal cysts was safe and feasible in day surgery mode under certain indicative criteria. The criteria included patients’ age between 40 and 80 years, no previous history of abdominal surgery, CT showing a unilateral renal cyst (Bosniak I or II), preoperative ASA assessment was I or II, no contraindications to surgery or anesthesia, postoperative team management and discharge assessment. Advantage of reducing time of hospitalization and total medical cost may relieve the situation of the shortage of medical resources.

P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Karataş ◽  
B E Temiz ◽  
S Mumusoglu ◽  
H Yarali ◽  
G Bozdag
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Mean Difference ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Drop ◽  
Mean Size ◽  
The Mean ◽  
Respective Figure

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

scholarly journals 2019 IFFAS Award for Excellence Winner: Peri-Prosthetic Cysts and Alignment in Total Ankle Replacement: A 3-D, Weight Bearing Topographical Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0004
Author(s):  
Francois Lintz ◽  
Jef Mast ◽  
Nazim Mehdi ◽  
Alessio Bernasconi ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Total Ankle Replacement ◽  
Coronal Plane ◽  
Unequal Distribution ◽  
Hindfoot Alignment ◽  
Cyst Volume ◽  
Ankle Replacement ◽  
The Mean ◽  
The Difference

Category: Ankle, Ankle Arthritis Introduction/Purpose: Peri-prosthetic cysts (PPC) in Total Ankle Replacement (TAR) are a common failure cause but the mechanisms of their development remains unclear. One possible explanation could be hindfoot malalignment and subsequent unequal distribution of load inside the joint. However, how residual malalignment influences the evolution of PPC remains unclear. Computed tomography (CT) has demonstrated superiority on conventional radiography in the follow up of PPC. Weight Bearing CT (WBCT), by combining 3D imaging and weight bearing measurements seems a valid tool to investigate this further. The objective for this work was to study the effects of residual hindfoot deformity on the distribution of PPC in the coronal plane. We hypothesized that cysts would be found predominantly medially in varus configuration, and laterally in valgus configuration. Methods: Retrospective comparative study, ethics committee approved. Forty-eight cases of TAR were included, with relevant demographics. Inclusion criteria were cases of primary TAR with available WBCT imaging of their ankle as part of normal follow up. Exclusion criteria were subsequent implant revision or cyst grafting. In each case, the localization and size of PPC’s were documented and their volume calculated by approximation of the closest ellipsoid. Hindfoot alignment was evaluated by the percentage Foot Ankle Offset (FAO) (foot-length normalized 3D ratio between the midline of the foot and the center of the ankle) using a WBCT dedicated semi-automatic software. The mean FAO value with 95%CI for the population was calculated. The difference in medial and lateral cyst volume defined by their position relative to the median axis in the coronal plane was compared in varus and valgus cases by a Mann-Whitney non-parametric test for unpaired samples. Results: Demographic distributions of the series were 32% female, mean age 65 (45-85) years. Mean FAO value was 0.12% (95%CI -1.09 to 1.33). Mean follow up was 43 months (6 to 239). The mean total cyst volume per case was 1190,7 mm3. In varus cases (defined by FAO<-1.09%), the volume of medial cysts was greater than laterally by a mean 197 mm3, whereas in valgus cases (defined by FAO>1.33%), the volume of lateral cysts was greater than medially by a mean 332 mm3. The difference was statistically significant (p<0.05). There was a weak, significant positive correlation (r=0.25, p<0,001) between FAO and total cyst volume and a moderate, significant correlation (r=0,56, p<0,001) between time to follow up and total cyst volume. Conclusion: Our hypothesis was confirmed. Periprosthetic cysts volume in this series of primary TAR was found to be relatively greater medially in postoperative varus configurations and vice-versa laterally in valgus. This confirms a possible correlation between the direction of residual hindfoot malalignment and the coronal localization of PPC in TAR, although this is certainly not the only pathophysiologic factor involved in PPC onset. Weightbearing CT may be helpful in Total Ankle Replacement follow up, in order to early detect PPC development and possibly to identify situations at risk of a more rapid evolution.

scholarly journals Nephron Sparing Surgery for Renal Angiomyolipoma with Inferior Vena Cava Thrombus in Tuberous Sclerosis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Adrien Riviere ◽  
Thomas Bessede ◽  
Jean-Jacques Patard
Keyword(s):  
Inferior Vena Cava ◽  
Tuberous Sclerosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Nephron Sparing Surgery ◽  
Renal Angiomyolipoma ◽  
Nephron Sparing ◽  
Mean Size ◽  
The Mean

Introduction. Angiomyolipoma is a common benign renal tumor. It is associated with Tuberous Sclerosis Complex (TSC) in 20% of patients. Angiomyolipomas are classically multiple, bilateral, and growing; they may lead to complications such as Wunderlich syndrome or, in rare cases, to venous extension.Observation. a 74-year-old woman with TSC presented with an angiomyolipoma of the right kidney with inferior vena cava (IVC) fatty thrombus. She underwent partial nephrectomy and thrombectomy. After a 7-year follow-up there was no evidence of recurrence or metastasis and her renal function was preserved.Review of Literature. It is the 44th reported angiomyolipoma associated with IVC thrombus. The mean size of angiomyolipomas was 86.1 mm and 67.4% of patients were symptomatic. Pulmonary embolism was found in 6 patients. There were 2 cases of recurrence/metastatic outcome after radical nephrectomy and thrombectomy. They were associated with epithelioid form. The mean size of epithelioid tumors was significantly bigger than in classical angiomyolipomas (127.1 mm versus 82.6 mm,P=0.037). With a median follow-up of 12 months, 91.3% of patients were recurrence and metastasis free, with 3 cases of nephron sparing surgery.Conclusion. Nephron sparing surgery for angiomyolipoma with IVC fatty thrombus can be safely performed in TSC, even in sporadic angiomyolipoma.

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