FEATURES OF SURGICAL TREATMENT OF DISSEMINATED ECHINOCOCCOSIS OF THE ABDOMINAL CAVITY

In the surgical treatment of echinococcosis, especially disseminated echinococcosis (DE) of the abdominal cavity, the main unresolved issues are reduced to determining the volume of preoperative preparation, questions of the stages of surgical interventions, determining tactics in relation to access and choosing the most appropriate method of eliminating the residual cavity and the method of treatment of the residual cavity (RC)

Useful residual hearing despite radiological findings suggestive of anacusis

A severe malformation of the inner ear, often referred to as severe labyrinthine dysplasia or common cavity deformity, consists of an absent or dilated cochlear basal coil, wide communication with the vestibule and a tapered internal acoustic meatus and can be associated with absent hearing. We discuss two children with severe labyrinthine dysplasia as shown by computed tomography (CT) scans and, in the first case, an absent VIIIth nerve bilaterally shown by magnetic resonance imaging (MRT). In 1995, both cases were precluded from cochlear implantation, on the basis of the absent VIIIth nerve (first case) and increased risk of CSF leak during operation (second case). However, audiometric results and vocalization patterns of both children suggested the presence of some residual hearing function, while recently reported specific surgical techniques have been found to be safe and effective in the cochlear implantation of the common cavity deformity. The management of such cases should be decided on the grounds of a full audiological assessment in conjunction with the radiological features, in the light of current surgical trends shown to be safe and effective

A Retrospective Surgical Experience Regarding Open and Laparoscopic Procedures of the Hepatic Hydatid Cyst with an up to Date Complete Review of the Literature And a Focus On Original Romanian Techniques

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated – through different surgical methods, both classical and laparoscopic – for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a specific focus on the advantages brought by Romanian innovations in this field. Conclusions. Even though the classical open approach still assumes the first place among surgical procedures, modern laparoscopic techniques have earned a much appreciated place in providing positive results based on long-term assessment, with virtually no or only minor complications. In this regard the Romanian school of surgery has offered a significant contribution to this field

Nasal fibrosis: long-term follow up of four cases of eosinophilic angiocentric fibrosis

Eosinophilic angiocentric fibrosis is a rare, benign cause of submucosal thickening and fibrosis within the upper respiratory tract. It predominantly affects the nose although cases have been reported in the subglottis. We describe four cases of the disease centred around the nasal cavity, with widespread infiltration of the facial soft tissues and orbit in three of the four patients. Each underwent long term follow up. Multiple surgical resections were required with two of our patients and, to date, medical therapy has been of limited help. The disease process, with its clinical and characteristic histopathological findings, is described. We also discuss the management of the disease following a comprehensive review of, and comparison with, the few prior reported cases

Positive Surgical Margins in the 10 Most Common Solid Cancers.

A positive surgical margin (PSM) following cancer resection oftentimes necessitates adjuvant treatments and carries significant financial and prognostic implications. We sought to compare PSM rates for the ten most common solid cancers in the United States, and to assess trends over time. Over 10 million patients were identified in the National Cancer Data Base from 1998-2012, and 6.5 million had surgical margin data. PSM rates were compared between two time periods, 1998-2002 and 2008-2012. PSM was positively correlated with tumor category and grade. Ovarian and prostate cancers had the highest PSM prevalence in women and men, respectively. The highest PSM rates for cancers affecting both genders were seen for oral cavity tumors. PSM rates for breast cancer and lung and bronchus cancer in both men and women declined over the study period. PSM increases were seen for bladder, colon and rectum, and kidney and renal pelvis cancers. This large-scale analysis appraises the magnitude of PSM in the United States in order to focus future efforts on improving oncologic surgical care with the goal of optimizing value and improving patient outcomes

Surgical Management of Calcified Hydatid Cysts of the Liver

Hydatid disease of the liver is still a major cause of morbidity in Greece. Beside the common complications of rupture and suppuration, calcification of the hepatic cysts represent a not well studied, less frequent and sometimes difficult surgical problem. In the present study 75 cases with calcified symptomatic liver echinococcosis were operated on in the 1st Propedeutic Surgical Clinic between 1964 to 1996. Twenty-eight patients were male and 47 female with ages from 23 to 78 years. The diagnosis was based mainly on the clinical picture and radiological studies. In 5 cases the operative method was cystopericystectomy. We performed evacuation of the cystic cavity and partial pericystectomy and primary closure of the residual cavity in 6 cases, omentoplasty or filling of the residual cavity with a piece of muscle of the diaphragm in 4 cases and external drainage by closed tube, in 60 cases. In 12 of those with drainage, after a period of time, a second operation with easy, removal of most of the calcareous wall plaques was performed. The mortality rate was 2%

ENDOSCOPIC TYPMPANOMASTOID EXPLORATION [FUNCTIONAL ENDOSCOPIC EAR SURGERY-FEES]

Tympano mastoidectomy is usually performed using operating microscope. This study reports a case series of tympanomastoidectomy which was performed using an endoscope.Endoscopic Tympanomastoidectomy for atticoantral type of CSOM is an excellent technique for complete removal of cholesteatoma especially from inaccessible areas of middle ear cleft including facial recess, sinustympani Transmeatal removal of disease from mastoid antrum and even tip cells is possible withendoscopes. Preservation of as much of normal mucosa of the middle ear cleft is possible with thistechnique, which promotes early reaeration of the mastoid cavity leading to better hearing outcome.Soft wall reconstruction has distinctive advantage of short additional time for reconstruction procedures, restoration of self cleaning EAC, early post operative epithelisation of tympanicmembrane and the EAC. Limitation of endoscopic technique: The endoscopic technique of tympanomastoidectomy with softwall reconstruction is not possible in cases with large mastoid cavity and in ears where a thin lateral rim of bony meatal wall (that can support soft wall) is retained, because of extensive disease.Like Functional Endoscopic sinus surgery (FESS) for nose, Endoscopes have changed thetreatment concept of atticoantral disease, with complete removal of the disease andpreservation of normal mucosa, that restores the normal physiology of middle ear cleft. Thishas led to the development of new concept of Functional Endoscopic Ear Surgery (FEES) foratticoantral type of CSOM.

An implant periapical lesion associated with presence of residual root fragments: Report of case treated with apicoectomy

Indexación: Scopus.Chemicals and CAS Registry Numbers: azithromycin, 83905-01-5, 117772-70-0, 121470-24-4; chlorhexidine, 3697-42-5, 55-56-1; erythromycin, 114-07-8, 70536-18-4The present study reports a case of a periapical lesion in an implant placed in an alveolar ridge which presented a residual root fragment of a deciduous tooth. Patient attended a dental clinic because she wanted to replace the missing tooth with an implant. She reported having lost the temporary tooth for one year. The initial Cone-beam Computerised Tomography image showed an edentulous area in the #13 zone, and the presence of a fragment of the deciduous tooth. The small root fragment was removed and an implant 4.0 × 13 mm amplified was installed. Patient presented acute pain and inflammation at the implant site 20 d after the surgery when the implant was originally installed; the first periapical surgery was carried out. Four months after the first periapical surgery, in periapical x-ray a radiolucent lesion was observed surrounding the apical region of the implant with a dry sound under percussion. The second periapical surgery was carried out. Five months after the second periapical surgery, the presence of a fistula was observed clinically, while in X-ray a radiolucent lesion was observed in the apex of the implant. Implant-plasty was carried out, removing approximately 5 mm of the apical portion of the implant. This treatment was successful after 27 months' monitoring. © 2018, Scientific Publishers of India. All rights reserved.https://www.alliedacademies.org/articles/an-implant-periapical-lesion-associated-with-presence-of-residual-root-fragments-report-of-case-treated-with-apicoectomy-10489.htm

A first-in-human, randomized, controlled, subject- and reviewer-blinded multicenter study of Actamax™ Adhesion Barrier

Purpose: Post-surgical adhesions remain a significant concern following abdominopelvic surgery. This study was to assess safety, manageability and explore preliminary efficacy of applying a degradable hydrogel adhesion barrier to areas of surgical trauma following gynecologic laparoscopic abdominopelvic surgery. Methods: This first-in-human, prospective, randomized, multicenter, subject- and reviewer-blinded clinical study was conducted in 78 premenopausal women (18–46 years) wishing to maintain fertility and undergoing gynecologic laparoscopic abdominopelvic surgery with planned clinically indicated second-look laparoscopy (SLL) at 4–12 weeks. The first two patients of each surgeon received hydrogel, up to 30 mL sprayed over all sites of surgical trauma, and were assessed for safety and application only (n = 12). Subsequent subjects (n = 66) were randomized 1:1 to receive either hydrogel (Treatment, n = 35) or not (Control, n = 31); 63 completed the SLL. Results: No adverse event was assessed as serious, or possibly device related. None was severe or fatal. Adverse events were reported for 17 treated subjects (17/47, 36.2%) and 13 Controls (13/31, 41.9%). For 95.7% of treated subjects, surgeons found the device “easy” or “very easy” to use; in 54.5%, some residual material was evident at SLL. For 63 randomized subjects who completed the SLL, adjusted between-group difference in the change from baseline adhesion score demonstrated a 41.4% reduction for Treatment compared with Controls (p = 0.017), with a 49.5% reduction (p = 0.008) among myomectomy subjects (n = 34). Conclusion: Spray application of a degradable hydrogel adhesion barrier during gynecologic laparoscopic abdominopelvic surgery was performed easily and safely, without evidence of clinically significant adverse outcomes. Data suggest the hydrogel was effective in reducing postoperative adhesion development, particularly following myomectomy