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Post operative CT

Alison F Ward, Timothy Lee, Jennifer B Ogilvie, Kepal N Patel, Karen Hiotis, Costas Bizekis, Michael Zervos
One to two percent of ectopic parathyroid adenomas are found in the lower mediastinum and often these are best accessed via a sternotomy or thoracotomy. Video-assisted thoracoscopic surgery (VATS) is an alternative approach with less surgical trauma, decreased morbidity, shorter hospital stays, and superior cosmetic results. Ten years after the first VATS resection of an ectopic mediastinal parathyroid, a robot-assisted thoracoscopic approach was described. Here we describe a series of five robot assisted complete thymectomies in patients with primary hyperparathyroidism due to mediastinal ectopic parathyroid adenomas...
October 22, 2016: Journal of Robotic Surgery
Jung Jae Park, Byong Chang Jeong, Chan Kyo Kim, Seong Il Seo, Keumhee C Carriere, Minji Kim, Byung Kwan Park, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi
PURPOSE: To evaluate postoperative outcome of cystic renal cell carcinoma (RCC) defined on preoperative computed tomography (CT), and to find the optimal cut-off of cystic cystic proportion in association with patients' prognosis. MATERIAL AND METHODS: In this institutional review board-approved study with waiver of informed consent, a total of 1315 patients who received surgery for single RCC with pre-operative CT were enrolled. The cystic proportion of RCC was determined on CT...
October 17, 2016: Journal of Urology
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
Markus Hoffmann, Asita Fazel, Kai-Gerrit Mews, Petra Ambrosch
OBJECTIVES: To underline the value of the microendoscopic CO2 -Laser assisted treatment (MEDCO2 ) of Zenker's diverticulum by investigating a large patient cohort treated in a single medical center. DESIGN: Retrospective Cohort Study of consecutive patients. SETTING: Dept. of Otorhinolaryngology, Head & Neck Surgery, Christian-Albrechts-University Kiel, Germany. PARTICIPANTS: 227 patients with Zenkers' diverticulum were treated by MEDCO2 and the results were compared with those reported in the literature for the open transcervical approach (OTA) and the endoscopic staple-assisted esophagodiverticulostomy (ESED)...
October 19, 2016: Clinical Otolaryngology
Brad Meulenkamp, C Ryan Martin, Nicholas Desy, Paul Duffy, Rob Korley, Shannon Puloski, Richard Buckley
OBJECTIVES: To define the incidence, risk factors and anatomic location of articular malreductions in operatively treated lateral tibial plateau fractures DESIGN:: Prospective Cohort Study SETTING:: Academic Level 1 Trauma CentrePatients/Participants: Study subjects were patients entered into a prospective cohort study of tibial plateau fractures. INTERVENTIONS: Surgical Fixation of tibial plateau fractures and post-operative computed tomography (CT) scans. MAIN OUTCOME MEASURES: The primary outcome was incidence of articular malreduction...
October 7, 2016: Journal of Orthopaedic Trauma
Helen M Heneghan, Claire Donohoe, Jessie Elliot, Zuhair Ahmed, Vinod Malik, Narayamasamy Ravi, John V Reynolds
OBJECTIVE: The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN: A prospective cohort study. BACKGROUND: nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients' operative intervention...
November 2016: Annals of Surgery
Manish Soneja, S Achintya, Neeraj Nischal, Piyush Ranjan, Surabhi Vyas, Sudheer Arava, S K Sharma
A large proportion of patients with retroperitoneal fibrosis (RPF) have been labelled as having idiopathic RPF historically. Recent reports of a subset of these patients having a fibro-inflammatory condition with characteristic histology and good response to therapy has helped in renewed understanding of an old disease. A 40 year old man presented with vague abdominal discomfort of 5 months duration. Ultrasound examination revealed soft tissue thickening with calcification over lower abdominal aorta. CT scan characterized the lesion as a retroperitoneal mass encasing the aorta with an associated lesion in upper pole of left kidney...
June 2016: Journal of the Association of Physicians of India
Alexandre Hardy, Philippe Loriaut, Benjamin Granger, Ahmed Neffati, Audrey Massein, Laurent Casabianca, Hugues Pascal-Moussellard, Antoine Gerometta
PURPOSE: The arthroscopic Latarjet procedure has provided reliable results in the treatment of anterior shoulder instability. However, this procedure remains technically challenging and is related to several complications. The morphology of the coracoid and the glenoid are inconsistent. Inadequate coracoid and glenoid preparing may lead to mismatching between their surfaces. Inadequate screws lengthening and orientation are a major concern. Too long screws can lead to suprascapular nerve injuries or hardware irritation, whereas too short screws can lead to nonunions, fibrous unions or migration of the bone block...
October 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ran Schwarzkopf, Erik Schnaser, Taiki Nozaki, Yasuhito Kaneko, Michael J Gillman
INTRODUCTION: Patient-specific implants and instruments (PSI) have been used in both knee and shoulder replacements due to the perceived benefits of improved surgical accuracy and efficiency. The proposed benefits of using a PSI in total hip arthroplasty (THA) are numerous and include reduction of operative time and improved mechanical and anatomical alignment leading to increased implant longevity, increased stability, and clinical outcomes. We describe a novel patient-specific instrumentation and a surgical method that may improve directed resection of acetabular bone and accurate cup placement during THA...
October 6, 2016: Surgical Technology International
Filip Jonkergouw, Florence Allé, Karim Chellaoui, Jos Vander Sloten, Dieter Vangeneugden
The performance of implant placement technologies are often evaluated based on their achieved post-operative implant alignment. Therefore accurate assessment techniques are necessary to compare pre-operatively planned implant positions with the corresponding post-operatively placed implant positions in total knee arthroplasty. This paper describes a CT based 3D measurement method for evaluation of implant positioning accuracy comparing post-operative implant position to the corresponding pre-operative planned implant position using 3D virtual models...
October 7, 2016: Medical Engineering & Physics
Oui Sik Yoo, Yong Seuk Lee, Myung Chul Lee, Jae Hong Park, Jae Won Kim, Doo Hoon Sun
BACKGROUND: After open wedge high tibial osteotomy (OWHTO), the proximal fragment resembles the anatomy of the proximal tibia that is aligned in the anterior-posterior direction and the distal fragment resembles the anatomy of the mid shaft that is aligned in the proximal-distal direction. In addition, the medial portion of the proximal fragment becomes aligned medially and the medial portion of the distal fragment, laterally, depending on the magnitude of the posterior opening gap. Therefore, there would be a mismatch between the post-correction bony surface and the previous pre-contoured plate geometry...
October 10, 2016: BMC Musculoskeletal Disorders
Eric S Daniel, Anastasia E Dean, Mingjoe Lim, Mobin Master, Peter Gibbs, Ian Faragher
BACKGROUND: Studies have suggested a benefit from extended venous thromboprophylaxis post-operatively in colorectal cancer with an assumed base rate of zero venous thromboembolic events prior to treatment. We aim to establish the incidence of pulmonary embolism in patients with newly diagnosed stage III or IV colorectal cancer prior to any treatment. METHOD: Consecutive patients presenting to a single health service with a new diagnosis of stage III or IV colorectal cancer were identified from a prospective database, for the period between January 2011 and September 2014...
October 9, 2016: ANZ Journal of Surgery
Dario Amore, Francesco S Cerqua, Fabio Perrotta, Antonio Cennamo, Carlo Curcio
INTRODUCTION: The mediastinal bronchogenic cysts represents 50%-60% of mediastinal cysts and rarely occurs in the posterior mediastinum. The final surgical resection is indicated for symptomatic patients and is recommended for some asymptomatic patients in order to establish the diagnosis and to avoid any subsequent complications. CASE PRESENTATION: We report a case of 17 years-old male suffering from bronchogenic cysts of the mediastinum. The patient was admitted to our hospital complaining with dry chough and dyspnea; CT scan showed a cystic mass in posterior mediastinum...
September 23, 2016: International Journal of Surgery Case Reports
Fara Uccelli, F Gavazzi, G Capretti, M Virdis, M Montorsi, A Zerbi
Enucleation (EN) and middle pancreatectomy (MP) have been proposed as a treatment for G1 and G2 pancreatic neuroendocrine tumors (PNET). The aim of this study is to analyze the outcomes of parenchyma-sparing surgery (PSS) for PNET in an Italian high-volume center. All patients with a histological diagnosis of PNET who underwent surgical resection in our center between January 2010 and January 2016 were included in the study. Demographic, perioperative, and discharge data were collected in a prospective database...
October 5, 2016: Updates in Surgery
Mohamed Said Abbas, Mohammad Najm AlBerawi, Issam Al Bozom, Nissar F Shaikh, Khalid Yacout Salem
BACKGROUND Pituitary macroadenoma is a common benign tumor that usually presents with visual field defects or hormonal abnormalities. Cerebral infarction can be a complication of a large pituitary adenoma. We report a rare case of bilateral anterior cerebral arteries infarcts by a large pituitary macroadenoma with apoplexy. CASE REPORT A 48-year-old male patient presented with altered conscious level and sudden loss of vision for one-day duration. Magnetic resonance imaging of the brain showed a large seller and suprasellar hemorrhagic mass of pituitary origin, with associated bilateral areas of diffusion restriction in the frontal parasagittal regions, consistent with infarctions...
October 6, 2016: American Journal of Case Reports
Ke-Kang Sun, Song Xu, Jinzhen Chen, Gang Liu, Xiaojun Shen, Xiaoyang Wu
Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms that arise in the gastrointestinal tract, accounting for ~1% of gastric malignancies. The present study reports the case of a GIST of the stomach in a 75-year-old man who presented with abdominal distension and anorexia for 1 month. Gastroscopy was unremarkable. Ultrasound and computed tomography (CT) scans showed a giant intraabdominal cystic lesion of unknown origin. The lesion was initially believed to be a duplication cyst, a pancreatic pseudocyst or a liver cyst in the pre-operative diagnosis...
October 2016: Oncology Letters
A McBrearty, K McCallion, R J Moorehead, I McAllister, K Mulholland, R Gilliland, W J Campbell
BACKGROUND: In patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management.(1) The need for restaging afterwards has been questioned as it may be difficult to interpret imaging due to local tissue effects of chemoradiotherapy. The purpose of this study was to determine if restaging affected the management of patients receiving long-course chemoradiotherapy for rectal cancer. METHODS: A retrospective review of patients with rectal cancer discussed at the South Eastern Health and Social Care Trust Lower Gastrointestinal Multi-Disciplinary Team Meeting (LGIMDT) in 2013 who had received long-course chemoradiotherapy was performed...
September 2016: Ulster Medical Journal
L Spencer-Gardner, J Pierrepont, M Topham, J Baré, S McMahon, A J Shimmin
AIMS: Accurate placement of the acetabular component during total hip arthroplasty (THA) is an important factor in the success of the procedure. However, the reported accuracy varies greatly and is dependent upon whether free hand or navigated techniques are used. The aim of this study was to assess the accuracy of an instrument system that incorporates 3D printed, patient-specific guides designed to optimise the placement of the acetabular component. PATIENTS AND METHODS: A total of 100 consecutive patients were prospectively enrolled and the accuracy of placement of the acetabular component was measured using post-operative CT scans...
October 2016: Bone & Joint Journal
Sandra G J Boccard, Pedro Rebelo, Binith Cheeran, Alexander Green, James J FitzGerald, Tipu Z Aziz
BACKGROUND: Deep Brain Stimulation (DBS) is a well-established treatment to reduce tremor, notably in Parkinson Disease. DBS may also be effective in posttraumatic tremor, one of the most common movement disorders caused by head injury. However, these cohorts of patients often have multiple lesions that may impact the outcome depending on which fibre tracts are affected. CASE DESCRIPTION: A 20-year-old man presented after road traffic accident with severe closed head injury and polytrauma...
September 29, 2016: World Neurosurgery
Jonathan P Riley, Andrew B Boucher, Denise S Kim, Daniel L Barrow, Matthew R Reynolds
BACKGROUND: Transorbital intracranial penetrating trauma (TIPT) with a retained intracranial foreign body is a rare event lacking a widely-accepted diagnostic and therapeutic algorithm. Intraoperative catheter angiography (IOA) has been advocated by some authorities to rule out cerebrovascular injury prior and/or subsequent to removal of the object, but no standard of care currently exists. CASE DESCRIPTION: A 19-year-old male was involved in a construction site accident whereby a framing nail penetrated the left globe, traversed the lateral bony orbit, and terminated in the mid-temporal lobe...
September 28, 2016: World Neurosurgery
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