scholarly journals LAPAROSCOPIC ADRENALECTOMY IN SURGICAL TREATMENT OF ADRENANOCORTICAL CARCINOMA

2019 ◽  
Vol 21 (1) ◽  
pp. 75-78
Author(s):  
A V Krivosheev ◽  
T A Britvin ◽  
M E Beloshitsky

Relevance of research: аdrenalectomy remains the only method of potentially radical treatment of adrenocortical carcinoma (AСС), and the complete resection is considered one of the leading factors in the prognosis of disease. The question of the possibility and feasibility of using video- endoscopic technologies in the treatment of patients with ACC is still being discussed. Objective: the purpose of our study was to evaluate the effectiveness of laparoscopic adrenalectomy in the treatment of ACC patients. Material and methods: the study is based on the analysis of the results of diagnostics and surgical treatment of 12 patients who underwent laparoscopic adrenalectomy and verified ACC during histological and immunohistochemical studies. Results: stage I were verified (according to the ENSAT) in 4 cases, in 4 - II stage, and in 4 - III stage. The median of tumor size was 4.9 cm. Intraoperative and postoperative complications did not occur. In all cases, the R0-resection was confirmed by morphological examination. The median patient follow-up was 71 months (1; 141), during this period 11 patients were alive, 1 patient, who had surgery in stage III died of disease progression (distant metastases) 49 months after surgery. During the follow-up period tumor recurrence did not occur. Overall 5-year survival was 75% (95% CI; 30-95%). Conclusion: despite the small number of patients included in this study, satisfactory immediate results (absence of complications, R0-resection) and long-term results allow us to consider video- endoscopic surgery as an effective treatment for patients with ACC.

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Mirzafaraz Saeed ◽  
Hari Hullur ◽  
Amro Salem ◽  
Abbas Ali ◽  
Yousif Sahib ◽  
...  

Introduction. The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Methods. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results. There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F=19.8, p<0.001 and F=8.9, p=0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F=8.5, p=0.019 and F=8.3, p=0.013, resp.). Conclusion. Early surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.


2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Ronald F. Young ◽  
Francisco Li ◽  
Sandra Vermeulen ◽  
Robert Meier

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.


Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 860-864 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Franco M. Gagliardi ◽  
Aldo Fortuna

Abstract The clinical findings and the results of surgical treatment in 16 patients with spinal dermoid or epidermoid tumors are reported. In 9 patients the tumor capsule adhered so tightly to the nervous tissue that part of it was left in situ. In a follow-up study ranging from 5 to 30 years with a mean of 14.2 years only 1 patient had a recurrence of the tumor and 10 patients resumed a normal working life.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4521-4521
Author(s):  
Kei Hosoda ◽  
Mizutomo Azuma ◽  
Chikatoshi Katada ◽  
Kenji Ishido ◽  
Masahiro Niihara ◽  
...  

4521 Background: In the phase 2, open-label, KDOG1001 (UMIN000003642) study, neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and S-1 (DCS), followed by gastrectomy with D2 lymph node dissection for high-risk advanced gastric cancer showed feasibility of DCS therapy with an enough R0 resection rate of 90%. Here we present long-term results after a minimum follow-up of 3 years. Methods: Patients with bulky node metastasis (bulky N), linitis plastica (type 4), or large ulcero-invasive-type tumors (type 3) received up to four 28-day cycles of DCS neoadjuvant chemotherapy (docetaxel at 40 mg/m2, cisplatin at 60 mg/m2 on day 1, and S-1 at 40 mg/m2 twice daily for 2 weeks) followed by gastrectomy with D2 lymphadenectomy. This analysis presents the final preplanned assessment of outcomes after 3 years. Primary endpoint was R0 resection rate. Secondary endpoints included overall survival (OS), progression free survival (PFS), completion rate of the protocol treatment, and pathological response rate (pRR) of DCS NAC. Results: Of 40 patients enrolled from May 2010 through January 2017, 7 (17.5%) had bulky N, 18 (45.0%) had type 4, and 16 (40%) had large type 3 with 1 (2.5%) having both large type 3 and bulky N2. All included patients underwent preoperative DCS chemotherapy followed by surgery with D2 lymphadenectomy with 32 (80%) completed postoperative S-1 therapy for 1 year. After a median follow-up for surviving patients of 67 mo (range, 36 mo to 110 mo) at the last follow-up in January 2020, 3-year OS was 78% [95% confidence interval (CI) 62–88%], while 3-year PFS was 63% (95% CI 47–76%). Completion rate of the protocol treatment was 62.5% (25/40) with pRR of 57.5% (23/40). In bulky N2, 3-y OS was 86% and 3-y PFS was 71% with pRR of 100%. In type 4, 3-y OS was 67% and 3-y PFS was 50% with pRR of 44%. In large type 3, 3-y OS was 88% and 3-y PFS was 75% with pRR of 56%. Patients with type 4 had significantly worse OS and PFS than those with the other types [HR 7.20 (95% CI 2.23–32.21) and HR 3.00 (95% CI 1.21–8.19)]. Conclusions: Preoperative chemotherapy with up to four cycles of DCS followed by gastrectomy plus adjuvant S-1 therapy is a promising treatment strategy for patients with bulky node metastasis, type 4 and large type 3 gastric cancers. For type 4 cancer, further improvement of treatment strategy is needed. Clinical trial information: 000003642 .


2015 ◽  
Vol 174 (2) ◽  
pp. 70-76
Author(s):  
A. F. Romanchishen ◽  
K. V. Vabalaite

The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.


2018 ◽  
Vol 3 (4) ◽  
pp. 20-26
Author(s):  
S A Ivanov ◽  
M V Kenarskaya ◽  
K A Panfilov

Objectives - optimization of hepatic echinococcosis treatment schemes based on the data analysis of the immediate and long-term results. Material and methods. The study included 373 clinical cases of patients with liver echinococcosis who received treatment in 2005-2018 in Samara Regional Clinical Hospital n. a. V.D. Seredavin. 342 patients underwent a traditional operation, the surgical puncture was performed in 31 patient. Starting from 2003 all patients received the antirelapse chemotherapy with albendazole according to the WHO's recommendations in the postoperative period. Results. The treatment tactics in patients with liver hydatidosis was defined according to the parasite's developmental stage, its localization, and the size of liver cyst. The traditional surgery was successful after one operation in more than 93% of cases, postoperative mortality was 1.46%, the number of postoperative complications - 12.5%, the number of relapses in 5 year follow-up period was 6.8%. In 31 patients we used the puncture surgery treatment of hepatic echinococcosis PAIR and PEVAC-methods. Conclusion. Modern approach to hepatic echinococcosis treatment should provide differentiated


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4465-4465 ◽  
Author(s):  
Jimena Cannata-Ortiz ◽  
Concepción Nicolás ◽  
Ana García-Noblejas ◽  
Javier Lopez ◽  
Pilar Sabin ◽  
...  

Abstract Introduction: Indolent B cell non-Hodgkin lymphomas are entities without curative treatment nowadays. However, survival has significantly improved since the incorporation of immunomodulatory agents and now immunochemotherapy has become the gold standard. Most treatment strategies use progression free survival (PFS) as a surrogate marker for overall survival (OS), although updated long term results are frequently lacking. Since 1990 our group introduced IFNα-2b to Bagley’s CVP induction regimen, for naïve indolent NHL (LNH-pro study). Herein we report our long term results. Aim: To evaluate long term outcome and late toxicities of patients who received immunochemotherapy with IFN α-2b plus CVP. Patients and Methods: From February 1990 to November 2001, patients from 7 Spanish institutions were included. Induction therapy consisted of Cyclophosphamide (400 mgs/m2 po) and Prednisone (100 mg/m2 po) daily for 5 days, Vincristine (1.4mg/m2 iv) on day 1, and subcutaneous IFN α-2b (3 MU/m2, three times a week, for a total of 36 doses). Patients received the number of cycles necessary to achieve maximum response. Updated clinical data were retrieved from participating centres up to March 2012. Results. A hundred and seventy patients with low-grade NHL were analyzed. Included entities were: 65% grade 1-2 follicular lymphoma (FL), 21% lymphocytic lymphoma and 14% marginal zone lymphoma. Median age was 56 yo (range 22-78 yo), elevated LDH and β2-microglobuline were 13.6% and 26% respectively, 57.6% had bone marrow involvement and 7.6% bulky disease (>7cm). According to FLIPI, 33% were high risk, 40% intermediate and 27% low risk FL. Median number of cycles was 6, and overall response rate achieved was 90%, with 68% complete remissions. Median follow up of surviving patients was 12.5 years (range 3-21 ys), with only 14.7% of patients lost to follow-up. Median PFS for all patients was 12.5 years (95% CI 10.5 – 14.5 years) and not reached for FL patients (20-year PFS of 63%; 95%CI: 54-72%). Median OS has not been reached, with a 20-year OS of 59.7% (CI 95%, 50.5-69%) for all low-grade NHL patients and 62% (IC 95%, 50-74%) for FL patients. Long-term toxicity is detailed in table 1. Incidence of secondary malignancies is 13.5%. At time of analysis, 57 out of 170 patients have died (33.5%), mainly due to lymphoma (58% of patients) and other non-lymphoma events (42%). Table Secondary malignancies 23 cases (13.5%) - MDS / AML 3 cases - Solid tumors 18 cases - Dermatologic neoplasia 2 cases Causes of death Number of patients (%) Induction toxicity events 4 (7%) Lymphoma progression / relapse 29 (51%) Secondary malignancies 9 (16%) Other non-lymphoma events 15 (26%) - Miocardiopathy 4 - Chronic Pulmonary disease 3 - Hepatic failure 2 - Brain traumatic injury 1 - Unknown cause 5 Figure 1 Figure 1. Conclusions: Our results confirm that immunochemotherapy with IFN α-2b plus CVP regimen induces a median PFS of 12.5 years and a 20-year OS of 59.7% (median not reached). With a median follow-up of 12.5 years, 58 % died due to lymphoma, 16% from secondary malignancies and 26% for non-lymphoma events. These results highlight the importance of performing long term follow-up in order to assess the real survival benefit of any treatment. Disclosures No relevant conflicts of interest to declare.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 150-151
Author(s):  
Takashi Ui ◽  
Hirofumi Fujii ◽  
Yoshinori Hosoya ◽  
Alan Lefor ◽  
Hiroyuki Yamaguchi ◽  
...  

Abstract Background Although preoperative docetaxel, cisplatin, and fluorouracil (DCF) therapy is reportedly effective in patients with advanced esophageal squamous cell cancer (ESCC), long-term results after preoperative DCF therapy are not well known. We retrospectively reviewed the long-term results after preoperative DCF therapy. Methods This study includes 63 patients with advanced thoracic esophageal carcinoma (excluding T4 tumors) receiving preoperative chemotherapy between February 2010 and February 2014. All patients were intended to receive two courses of treatment every four weeks, or three courses every three weeks. Patients underwent curative surgery four to five weeks after completing chemotherapy. Results Radical resection was performed in 58 patients (92%). R0 resection was completed in 48 patients (83%). The 5-year overall survival and progression free survival were 55% [95% confidential interval, 0.41–0.66] and 0.46% [0.34–0.58], respectively. Recurrences occurred in 34 patients (54%). Distant metastases developed in 13/48 (27%) after R0 resection. Chemotherapy-related adverse events included G4 hematotoxicity (n = 50, 79%, neutrophil < 500), febrile neutropenia (n = 16, 25%), and G3 non-hematotoxicity (n = 15, 24%). Conclusion These results suggest that preoperative DCF therapy may be effective and improve the long-term outcomes in patients with advanced esophageal carcinoma. Disclosure All authors have declared no conflicts of interest.


HAND ◽  
1977 ◽  
Vol os-9 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Peter M. Brown

Syndactyly is classified and the principles of its surgical treatment discussed. The notes of eighty-five patients who had 222 webs between them were reviewed. A long term follow-up was carried out on thirty-two of these patients who had seventy-six clefts separated. The sexual and anatomical distribution of the syndactyly was investigated. The results of surgery were assessed including complications, and the relationship of complications to the type of graft used and the age at operation. It is suggested that complicated syndactyly is often separated at too early an age.


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