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Palliative surgery

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https://www.readbyqxmd.com/read/28809036/clinical-investigation-of-38-cases-of-oral-mucosal-melanoma-a-multicentre-retrospective-analysis-in-japan
#1
Shin-Ichi Yamada, Hiroshi Kurita, Takahiro Kamata, Tadaaki Kirita, Michihiro Ueda, Tetsuro Yamashita, Yoshihide Ota, Mitsunobu Otsuru, Nobuhiro Yamakawa, Masaya Okura, Tomonao Aikawa, Souichi Yanamoto, Masahiro Umeda
BACKGROUND/OBJECTIVES: The aim of the present study was to investigate treatment modalities and outcomes in oral mucosal melanoma. METHODS: The clinical and pathological data of 38 consecutive patients with oral mucosal melanoma were retrospectively analyzed. Patients' characteristics were analyzed and overall survival (OS) rates were calculated. RESULTS: Sixteen patients had stage III (42%), 19 IVA (50%), and three had stage IVC (8%) disease...
August 15, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28807628/vertebral-alveolar-echinococcosis-a-case-report-systematic-analysis-and-review-of-the-literature
#2
REVIEW
Thomas Raphael Meinel, Bruno Gottstein, Vanessa Geib, Marius Johann Keel, Ruggero Biral, Markus Mohaupt, Jan Brügger
Alveolar echinococcosis caused by Echinococcus multilocularis is an infrequent zoonosis with a high degree of disability, morbidity, and mortality, especially in disease clusters of the northern hemisphere. The diagnosis is complicated by extended incubation time, diverse clinical manifestations, and mimicking of differential diagnoses. The primary organ affected is the liver, but extrahepatic disease is possible, with vertebral involvement in only a few dozen cases described worldwide. Although vertebral alveolar echinococcosis seems to be rare, it might be under diagnosed, and it might be seen more often as the number of people with immunocompromised conditions increases...
August 11, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28803550/palliative-end-ileostomy-and-gastrojejunostomy-for-a-metastatic-distal-transverse-colonic-malignancy-complicated-by-a-proximal-duodenocolic-fistula-a-case-report
#3
Gnanaselvam Pamathy, Umesh Jayarajah, Yapa Hamillage Hemantha Gunathilaka, Sivasuriya Sivaganesh
BACKGROUND: Fistulae between the colon and upper gastrointestinal tract are distressing and uncommon complications of malignancies involving this region. We report a case of a middle-aged man with a locally advanced and metastatic distal transverse colon malignancy who presented with a duodenocolic fistula proximal to the primary tumor and underwent palliative surgery. CASE PRESENTATION: A 50-year-old Sri Lankan man presented to our hospital with a history of feculent vomiting of 1 week's duration preceded by worsening constipation and abdominal fullness of 2 months' duration...
August 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28801200/perioperative-mortality-for-patients-with-a-hip-fracture
#4
Bassey Nkanang, Martyn Parker, Emily Parker, Richard Griffiths
INTRODUCTION: Studies on mortality following hip fracture surgery have hitherto focused on the 30 day to 1 year period and beyond. This study focuses on the immediate perioperative period. It examines mortality rates, patient characteristics, operative details and post-operative complications. PATIENTS AND METHODS: A retrospective study of a hip fracture database in a large District General Hospital in the United Kingdom, from 1986 to 2015. A dataset of 9393 patients was identified, including patients undergoing surgery for curative and palliative purposes, over fifteen years of age and with no upper age limit imposed...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#5
REVIEW
Andrea Bartoli, Y El Hassani, B Jenny, S Momjian, C M Korff, M Seeck, S Vulliemoz, K Schaller
Hemispherotomy is an established surgical technique to cure or palliate selected, mostly young patients suffering from refractory epilepsy. However, a few patients continue to have seizures despite the surgical hemispherical disconnection. We present a case series of patients who underwent redo hemispherotomy after a first unsuccessful hemispherical disconnection and provide a roadmap for subsequent workup and treatment. The institutional database of epilepsy surgery was reviewed. Twenty-four patients who underwent hemispherotomies for refractory epilepsy were identified between 2007 and 2016...
August 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28797851/palliative-care-development-in-georgia
#6
Nina Kiknadze, Pati Dzotsenidze
Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home but oral morphine is not available for patients in the hospital...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28794500/para-aortic-lymph-node-metastases-in-pancreatic-cancer-should-not-be-considered-a-watershed-for-curative-resection
#7
Sebastian Hempel, Verena Plodeck, Franz Mierke, Marius Distler, Daniela E Aust, Hans-Detlev Saeger, Jürgen Weitz, Thilo Welsch
No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28792794/squamous-cell-carcinoma-of-the-penis-with-pulmonary-metastasis-and-paraneoplastic-hypertrophic-osteopathy-in-a-dog
#8
Victoria Jenkins, Carlos Henrique de Mello Souza, Louis-Phillippe de Lorimier, Evandro de Toledo-Piza
Squamous cell carcinoma of the penis was diagnosed by incisional biopsy of a penile mass in a 12 yr old intact male beagle dog presenting with hemorrhagic discharge from the prepuce. Penile amputation, orchiectomy with scrotal ablation, and scrotal urethrostomy were performed. Hypertrophic osteopathy secondary to pulmonary metastatic disease occurred 10 mo after the surgery. Palliative treatment with piroxicam was administered and led to complete resolution of the clinical signs of the pain. Sixteen months following surgery, the dog presented with significant dyspnea and anorexia and was euthanized due to poor prognosis...
August 9, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28791679/effect-of-age-on-rates-of-palliative-surgery-and-chemotherapy-use-in-patients-with-locally-advanced-or-metastatic-gastric-cancer
#9
S D Nelen, M van Putten, V E P P Lemmens, K Bosscha, J H W de Wilt, R H A Verhoeven
BACKGROUND: This study assessed trends in the treatment and survival of palliatively treated patients with gastric cancer, with a focus on age-related differences. METHODS: For this retrospective, population-based, nationwide cohort study, all patients diagnosed between 1989 and 2013 with non-cardia gastric cancer with metastasized disease or invasion into adjacent structures were selected from the Netherlands Cancer Registry. Trends in treatment and 2-year overall survival were analysed and compared between younger (age less than 70 years) and older (aged 70 years or more) patients...
August 9, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#10
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#11
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28783102/the-pulmonary-circulation-in-the-single-ventricle-patient
#12
REVIEW
Amanda Hauck, Nicolas Porta, Steven Lestrud, Stuart Berger
In recent decades, survival of children with complex congenital heart disease has improved considerably. Specifically, children with a variety of congenital heart defects resulting in 'single ventricle' physiology can now undergo palliative surgery that allows survival beyond the neonatal period, and in many cases into adulthood, despite having a single functional ventricular pumping chamber supplying both the pulmonary and systemic circulation. Our growing understanding of the functionally univentricular heart has resulted in freedom from Fontan failure of >50% at 25 years post-Fontan...
August 7, 2017: Children
https://www.readbyqxmd.com/read/28780403/forgotten-not-yet-cardiogenic-brain-abscess-in-children-a-case-series-based-review
#13
Suhas Udayakumaran, Chiazor U Onyia, R Krishnakumar
INTRODUCTION: Brain abscess is a significant cause of morbidity in patients with uncorrected or partially palliated congenital cyanotic heart disease (CCHD). Unfortunately, in the developing world, the majority of the patients with CCHD remain either uncorrected or partially palliated. Furthermore, a risk of this feared complication also exists even among those undergoing staged corrective operations in the interval in between operations. There have been no recent articles in the literature on surgical outcomes of management of cardiogenic brain abscess in children...
August 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#14
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777648/ablation-of-musculoskeletal-metastases
#15
A Nicholas Kurup, Jonathan M Morris, Matthew R Callstrom
OBJECTIVE: The purpose of this article is to summarize the evidence supporting thermal ablation of musculoskeletal metastases on the basis of clinical application and to describe an approach to percutaneous ablative treatment, including patient workup, procedural strategy and techniques, and postablation follow-up. CONCLUSION: Percutaneous ablation of musculoskeletal metastases may result in significant pain palliation, prevention of morbidity from skeletal-related events, and local tumor control...
August 4, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28775172/diagnostic-value-of-targeted-next-generation-sequencing-in-patients-with-suspected-pancreatic-or-periampullary-cancer
#16
Babs G Sibinga Mulder, J Sven D Mieog, Arantza Farina Sarasqueta, Henricus Jm Handgraaf, Hans F A Vasen, Rutger-Jan Swijnenburg, Saskia A C Luelmo, Shirin Feshtali, Akin Inderson, Alexander L Vahrmeijer, Bert A Bonsing, Tom van Wezel, Hans Morreau
AIMS: Radiological imaging and morphological assessment of cytology material have limitations for preoperative classification of pancreatic or periampullary lesions, often resulting in surgical resection without definitive diagnosis. Our prospective study aims to define the diagnostic value of targeted next-generation sequencing (NGS) of DNA from cytology material. METHODS: Patients with a suspect pancreatic or periampullary lesion underwent standard diagnostic evaluation including preoperative morphological cytology assessment...
August 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28774381/first-in-human-closed-chest-transcatheter-superior-cavopulmonary-anastomosis
#17
Kanishka Ratnayaka, John W Moore, Rodrigo Rios, Robert J Lederman, Sanjeet R Hegde, Howaida G El-Said
BACKGROUND: In the care of patients with congenital heart disease, percutaneous interventional treatments have supplanted many surgical approaches for simple lesions, such as atrial septal defect. By contrast, complex congenital heart defects continue to require open-heart surgery. In single-ventricle patients, a staged approach is employed, which requires multiple open-heart surgeries and significant attendant morbidity and mortality. A nonsurgical transcatheter alternative would be attractive...
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28770295/inclusion-of-pet-ct-into-planning-of-primary-or-neoadjuvant-chemoradiotherapy-of-esophageal-cancer-improves-prognosis
#18
Jan-Christopher Metzger, Daniel Wollschläger, Matthias Miederer, Peter Vaupel, Markus Moehler, Heinz Schmidberger, Arnulf Mayer
BACKGROUND: PET-CT is widely used for both the staging and planning of primary or neoadjuvant chemoradiotherapy for esophageal cancer. Inclusion of PET-CT information into radiotherapy planning often leads to substantial modifications of the target volume. In the case of detection of distant metastases, it may also result in a switch to a palliative treatment approach. This spares patients from therapy-related toxicities that provide no clinical benefit. However, due to a lack of studies, it is currently unclear whether the advantages of PET-CT also translate into a measurable improvement in patient survival...
August 2, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28767610/clinicopathological-features-surgical-treatments-and-survival-outcomes-of-patients-with-small-bowel-adenocarcinoma
#19
Shuisheng Zhang, Wei Yuan, Jianwei Zhang, Yingtai Chen, Cuiling Zheng, Jie Ma, Qinglong Jiang, Yajie Zhao, Quan Xu, Chengfeng Wang
To date, because of their rarity, the clinicopathological features and surgical outcomes of small bowel adenocarcinomas (SBAs) have been insufficiently explored. We evaluated the clinicopathological features and long-term outcomes of patients who underwent surgery for SBA.This retrospective study (from 1999 to 2016) examined patients with SBA treated surgically at the China National Cancer Center/Cancer Hospital. Clinicopathological features, preoperative evaluation, surgical treatment, and outcome parameters were reviewed and analyzed...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28766200/keynote-address-at-the-american-society-of-breast-surgeons-18th-annual-meeting-current-and-future-application-of-intraoperative-radiotherapy-iort-in-the-curative-and-palliative-treatment-of-breast-cancer
#20
Frederik Wenz
Intraoperative radiotherapy (IORT) is increasingly used worldwide. Breast cancer is the most rapidly growing indication for IORT, approaching 70-80% of cases in most centers. This report reviews the theoretical background and clinical use of IORT for primary and metastasized breast cancer. There are established applications such as tumor bed boost during breast-conserving surgery followed by whole breast radiotherapy or IORT as a form of accelerated partial-breast irradiation (APBI) for selected patients. Novel applications such as IORT for vertebral or brain metastases are presented as well as technological developments, widening the spectrum of potential clinical applications for IORT...
August 1, 2017: Annals of Surgical Oncology
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