scholarly journals Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Rutger J. Franken ◽  
Daan E. Moes ◽  
Yair I. Z. Acherman ◽  
Eric J. Derksen
Keyword(s):  
Minimally Invasive ◽  
Good Condition ◽  
Invasive Treatment ◽  
Elevated Pressures ◽  
Abdominal Symptoms ◽  
Free Air ◽  
Peritoneal Perforation ◽  
Chest X Ray ◽  
Endoscopic Microsurgery ◽  
Peritoneal Entry

Transanal endoscopic microsurgery (TEM) is a minimally invasive treatment modality for a variety of rectal lesions. Due to its minimally invasive nature, TEM has emerged as a safe method. Among most threatening complications are hemorrhage and peritoneal perforation. We report on two patients who demonstrated intra-abdominal free air on an erect chest X-ray after TEM procedure without other findings of a pneumoperitoneum. We hypothesize that due to the combination of elevated pressures in the retroperitoneal cavity and decreased integrity of the retroperitoneal barrier, insufflated CO2gas can diffuse into the intraperitoneal cavity. Conservative treatment should be considered in patients with free intra-abdominal air postoperatively. However, there should be no suspicion of peritoneal entry during the procedure and the patient should be in generally good condition without severe abdominal symptoms.

scholarly journals Laser interstitial thermotherapy (LITT) for the treatment of tumors of the brain and spine: a brief review

2021 ◽  
Vol 151 (3) ◽  
pp. 429-442
Author(s):  
Clark Chen ◽  
Ian Lee ◽  
Claudio Tatsui ◽  
Theresa Elder ◽  
Andrew E. Sloan
Keyword(s):  
Brain Tumors ◽  
Minimally Invasive ◽  
Radiation Necrosis ◽  
Spinal Metastasis ◽  
Clinical Approach ◽  
Invasive Treatment ◽  
Primary Indication ◽  
Interstitial Thermotherapy ◽  
The Brain

Abstract Introduction Laser Interstitial Thermotherapy (LITT; also known as Stereotactic Laser Ablation or SLA), is a minimally invasive treatment modality that has recently gained prominence in the treatment of malignant primary and metastatic brain tumors and radiation necrosis and studies for treatment of spinal metastasis has recently been reported. Methods Here we provide a brief literature review of the various contemporary uses for LITT and their reported outcomes. Results Historically, the primary indication for LITT has been for the treatment of recurrent glioblastoma (GBM). However, indications have continued to expand and now include gliomas of different grades, brain metastasis (BM), radiation necrosis (RN), other types of brain tumors as well as spine metastasis. LITT is emerging as a safe, reliable, minimally invasive clinical approach, particularly for deep seated, focal malignant brain tumors and radiation necrosis. The role of LITT for treatment of other types of tumors of the brain and for spine tumors appears to be evolving at a small number of centers. While the technology appears to be safe and increasingly utilized, there have been few prospective clinical trials and most published studies combine different pathologies in the same report. Conclusion Well-designed prospective trials will be required to firmly establish the role of LITT in the treatment of lesions of the brain and spine.

scholarly journals EAU, AUA and NICE Guidelines on Surgical and Minimally Invasive Treatment of Benign Prostate Hyperplasia: A Critical Appraisal of the Guidelines Using the AGREE-II Tool

2021 ◽  
pp. 1-10
Author(s):  
Dmitry Enikeev ◽  
Vincent Misrai ◽  
Enrique Rijo ◽  
Roman Sukhanov ◽  
Denis Chinenov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Options ◽  
Stakeholder Involvement ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Agree Ii ◽  
Prostate Hyperplasia ◽  
Assessment Score ◽  
Nice Guideline ◽  
Agree Ii Tool

<b><i>Objective:</i></b> To critically appraise the methodological rigour of the clinical practice guidelines (CPGs) vis-à-vis BPH surgery as used by specialist research associations in the US, Europe and UK, and to compare whether the guidelines cover all or only some of the available treatments. <b><i>Methods:</i></b> The current guidelines issued by the EUA, AUA and NICE associations have been analyzed by 4 appraisers using the AGREE-II instrument. We also compared the recommendations given in the guidelines for surgical and minimally invasive treatment to find out which of these CPGs include most of the available treatment options. <b><i>Results:</i></b> According to the AGREE II tool, the median scores of domains were: domain 1 scope and purpose 66.7%, domain 2 stakeholder involvement 50.0%, domain 3 rigor of development 65.1%, domain 4 clarity of presentation 80.6%, domain 5 applicability 33.3%, domain 6 editorial independence 72.9%. The overall assessment according to AGREE II is 83.3%. The NICE guideline scored highest on 5 out of 6 domains and the highest overall assessment score (91.6%). The EAU guideline scored lowest on 4 out of 6 domains and has the lowest overall assessment score (79.1%). <b><i>Conclusions:</i></b> The analyzed CPGs comprehensively highlight the minimally invasive and surgical treatment options for BPH. According to the AGREE II tool, the domains for clarity of presentation and editorial independence received the highest scores. The stakeholder involvement and applicability domains were ranked as the lowest. Improving the CPG in these domains may help to improve the clinical utility and applicability of CPGs.

Therapy and regeneration-combined bone cements for minimally invasive treatment of neoplastic bone defects

2021 ◽  
Author(s):  
Yu Qu ◽  
Hui Zhuang ◽  
Meng Zhang ◽  
Yufeng Wang ◽  
Dong Zhai ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Minimally Invasive ◽  
Tumor Cells ◽  
Bone Tumor ◽  
Tumor Resection ◽  
Bone Defects ◽  
Bone Cements ◽  
Invasive Treatment ◽  
Calcium Phosphate Cements ◽  
Bone Tumor Resection

Although calcium phosphate cements (CPC) have been clinically used to repair bone defects caused by bone tumor resection, traditional CPC cannot kill the remaining tumor cells after surgery and prevent...

Short-Term Radiographic Outcomes of Calcaneus Fractures Treated With 2-Incision, Minimally Invasive Approach

2019 ◽  
Vol 40 (9) ◽  
pp. 1060-1067
Author(s):  
Snow B. Daws ◽  
Kaitlin Neary ◽  
Gregory Lundeen
Keyword(s):  
Minimally Invasive ◽  
Sensory Nerve ◽  
Case Series ◽  
Fracture Reduction ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Calcaneus Fractures ◽  
Böhler’S Angle

Background: The treatment of displaced, intra-articular calcaneus fractures is controversial. The extensile lateral approach has been historically preferred because it provides excellent exposure and visualization for fracture reduction. However, soft tissue complications with this approach can lead to poor outcomes for patients. Recently, there has been an interest in the minimally invasive treatment of calcaneus fractures. The purpose of the present study was to determine the radiographic reduction of displaced, intra-articular calcaneus fractures and the rate of complications using a 2-incision, minimally invasive approach. Methods: A dual-incision, minimally invasive approach with plate and screw fixation was utilized for the treatment of 32 patients with displaced, intra-articular calcaneus fractures. Preoperative and postoperative calcaneal measurements were taken to assess fracture reduction. Additionally, a retrospective chart review was performed to assess for complications. Results: The mean preoperative Bohler’s angle measurement was 12.9 (range, –5 to 36) degrees and the final postoperative Bohler’s angle was 31.7 (range, 16-40) degrees. One patient (3.1%) had postoperative numbness related to the medial incision in the calcaneal branch sensory nerve distribution. Two patients (6.2%) had a wound infection treated with local wound care and oral antibiotics, while 1 patient (3.1%) had a deep infection that required a secondary surgery for irrigation and debridement. Two patients (6.2%) returned to the operating room for removal of symptomatic hardware. Conclusion: Operative fixation of displaced, intra-articular calcaneus fractures treated with a 2-incision, minimally invasive approach resulted in acceptable fracture reduction with a minimal rate of complications. Level of Evidence: Level IV, retrospective case series.

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