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Intraoperative mapping

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https://www.readbyqxmd.com/read/29351666/intraoperative-identification-and-preservation-of-verbal-memory-in-diffuse-gliomas-a-matched-pair-cohort-study
#1
Juan Martino, Elsa Gomez, Enrique Marco de Lucas, David Mato, Javier Vázquez-Bourgon
BACKGROUND: Recent glioma surgery series with intraoperative electrical stimulation (IES) language mapping have demonstrated high rates of postoperative memory impairment, raising a question regarding the efficacy of this approach to preserve memory. OBJECTIVE: To evaluate if intraoperative identification and preservation of verbal memory sites with IES mapping in diffuse gliomas in eloquent areas consistently protect patients from long-term postoperative decline in short-term memory...
January 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29347887/cryo-assisted-resection-en-bloc-and-cryoablation-in-situ-of-primary-breast-cancer-coupled-with-intraoperative-ultrasound-guided-tracer-injection-a-preliminary-clinical-study
#2
Nikolai N Korpan, Kecheng Xu, Philipp Schwarzinger, Masashi Watanabe, Gerhard Breitenecker, Le Pivert Patrick
The aim of the study was to perform cryosurgery on a primary breast tumor, coupled with simultaneous peritumoral and intratumoral tracer injection of a blue dye, to evaluate lymphatic mapping. We explored the ability of our strategy to prevent tumor cells, but not that of injected tracers, to migrate to the lymphovascular drainage during conventional resection of frozen breast malignancies. Seventeen patients aged 51 (14) years (mean [standard deviation]), presenting primary breast cancer with stage I to IV, were randomly selected and treated in The Rudolfinerhaus Private Clinic in Vienna, Austria, and included in this preliminary clinical study...
January 1, 2018: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/29346829/intraoperative-seizures-in-awake-craniotomy-for-perirolandic-glioma-resections-that-undergo-cortical-mapping
#3
Chikezie Ikechukwu Eseonu, Jordina Rincon-Torroella, Young M Lee, Karim ReFaey, Punita Tripathi, Alfredo Quinones-Hinojosa
BACKGROUND:  Perirolandic motor area gliomas present invasive eloquent region tumors within the precentral gyrus that are difficult to resect without causing neurologic deficits. STUDY AIMS:  This study evaluates the role of awake craniotomy and motor mapping on neurologic outcome and extent of resection (EOR) of tumor in the perirolandic motor region. It also analyzes preoperative risk factors for intraoperative seizures. METHODS:  We evaluated 57 patients who underwent an awake craniotomy for a perirolandic motor area eloquent region glioma...
January 18, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29346633/intraoperative-epicardial-focal-pulmonary-venous-electrocardiography-in-patients-with-atrial-fibrillation
#4
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: In patients referred to off-pump coronary artery bypass grafting, pulmonary vein isolation (PVI) may be used for those with persistent atrial fibrillation (AF), an alternative to the Maze procedure. However, the success rate of PVI in persistent AF is limited. The study assesses the prognostic value of focal epicardial electrocardiography of the pulmonary veins (PVs) for surgical ablation results. METHODS: We mapped 140 PV in 35 cases undergoing off-pump coronary artery bypass grafting...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29344213/sentinel-lymph-node-mapping-in-gynecological-oncology
#5
Jiang Du, Yaling Li, Qing Wang, Nasra Batchu, Junkai Zou, Chao Sun, Shulan Lv, Qing Song, Qiling Li
The intraoperative mapping of sentinel lymph nodes (SLNs) is part of the treatment strategy for a number of types of tumor. To retrospectively compare results from the mapping of pelvic SLNs for gynecological oncology, using distinct dyes, the present review was conducted to determine the clinical significance of SLN mapping for gynecological oncology. In addition, the present study aimed at identifying an improved choice for SLN mapping tracers in clinical application. Each dye exhibits demerits when applied in the clinical environment...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#6
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29305911/tms-uncovers-details-about-sub-regional-language-specific-processing-networks-in-early-bilinguals
#7
Sini Hämäläinen, Niko Mäkelä, Viljami Sairanen, Minna Lehtonen, Teija Kujala, Alina Leminen
Despite numerous functional neuroimaging and intraoperative electrical cortical mapping studies aimed at investigating the cortical organisation of native (L1) and second (L2) language processing, the neural underpinnings of bilingualism remain elusive. We investigated whether the neural network engaged in speech production over the bilateral posterior inferior frontal gyrus (pIFG) is the same (i.e., shared) or different (i.e., language-specific) for the two languages of bilingual speakers. Navigated transcranial magnetic stimulation (TMS) was applied over the left and right posterior inferior gyrus (pIFG), while early simultaneous bilinguals performed a picture naming task with their native languages...
January 3, 2018: NeuroImage
https://www.readbyqxmd.com/read/29302490/a-systematic-review-of-intraoperative-process-mapping-in-surgery
#8
REVIEW
Ru Dee Chung, David J Hunter-Smith, Robert T Spychal, Venkat V Ramakrishnan, Warren Matthew Rozen
Process mapping has been identified as a strategy to improve surgical efficiency but has been inconsistently applied in the literature and underutilised in surgical practice. In this journal, we recently described our utilisation of these approaches when applied to breast reconstruction. We showed that in surgery as complex as autologous breast reconstruction, process mapping can improve efficiency, and may improve surgical teaching, education and audit. The intraoperative period specifically is an area that can be applied not only to breast reconstruction, but to a much broader range of surgical procedures...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302477/concordance-between-preoperative-computed-tomography-angiographic-mapping-and-intraoperative-perforator-selection-for-deep-inferior-epigastric-artery-perforator-flap-breast-reconstructions
#9
Vivian B Boer, Jan J van Wingerden, Carolien F Wever, Joost J Kardux, Michiel R Beets, Hester J van der Zaag-Loonen, Willem J Theuvenet
Background: Preoperative imaging for perforator identification prior to a deep inferior epigastric artery perforator (DIEP) flap elevation for breast reconstruction has many advantages. Currently, computed tomography (CT) angiography provides good visualization of the perforators and their course, and is thus the imaging technique of choice. The primary aim of this study was to determine the concordance between the perforators identified preoperatively and the perforators ultimately selected intraoperatively, with a standardized protocol, in a single institution...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29301040/where-and-when-to-cut-fluorescein-guidance-for-brain-stem-and-spinal-cord-tumor-surgery-technical-note
#10
Eric Suero Molina, Walter Stummer
BACKGROUND: Spinal cord and brain stem lesions require a judicious approach with an optimized trajectory due to a clustering of functions on their surfaces. Intraoperative mapping helps locate function. To confidently locate such lesions, neuronavigation alone lacks the desired accuracy and is of limited use in the spinal cord. OBJECTIVE: To evaluate the clinical value of fluoresceins for initial delineation of such critically located lesions. METHODS: We evaluated fluorescein guidance in the surgical resection of lesions with blood-brain barrier disruption demonstrating contrast enhancement in magnet resonance imaging in the spinal cord and in the brain stem in 3 different patients...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29290809/near-infrared-intraoperative-imaging-of-thoracic-sympathetic-nerves-from-preclinical-study-to-clinical-trial
#11
Kunshan He, Jian Zhou, Fan Yang, Chongwei Chi, Hao Li, Yamin Mao, Bengang Hui, Kun Wang, Jie Tian, Jun Wang
The sympathetic nervous system controls and regulates the activities of the heart and other organs. Sympathetic nervous system dysfunction leads to disease. Therefore, intraoperative real-time imaging of thoracic sympathetic nerves (ITSN) would be of great clinical significance for diagnosis and therapy. The aim of this experimental study was to evaluate the feasibility and validity of intraoperative ITSN using indocyanine green (ICG). METHODS: ITSN using ICG was performed on 10 rabbits to determine its feasibility...
2018: Theranostics
https://www.readbyqxmd.com/read/29284872/effects-of-dexmedetomidine-on-intraoperative-hemodynamics-and-propofol-requirement-in-patients-undergoing-laparoscopic-cholecystectomy
#12
Avneesh Khare, Satya Prakash Sharma, Mangi Lal Deganwa, Mamta Sharma, Nitesh Gill
Background: Despite multiple benefits, laparoscopic surgery always poses anesthetic challenge due to significant alteration of hemodynamics. Various pharmacological agents have been used for the same with variable response. Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics and propofol requirement using bispectral index (BIS) in laparoscopic cholecystectomy...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284856/proseal-laryngeal-mask-airway-versus-cuffed-endotracheal-tube-for-laparoscopic-surgical-procedures-under-general-anesthesia-a-random-comparative-study
#13
Suchita Shailesh Parikh, Shivam Bipin Parekh, Chaula Doshi, Varsha Vyas
Context: The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries. Aims: To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia. Settings and Design: A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29261148/advances-in-brain-tumor-surgery-for-glioblastoma-in-adults
#14
REVIEW
Montserrat Lara-Velazquez, Rawan Al-Kharboosh, Stephanie Jeanneret, Carla Vazquez-Ramos, Deependra Mahato, Daryoush Tavanaiepour, Gazanfar Rahmathulla, Alfredo Quinones-Hinojosa
Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival...
December 20, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29248292/long-term-outcomes-after-near-infrared-sentinel-lymph-node-mapping-in-non-small-cell-lung-cancer
#15
Christopher S Digesu, Krista J Hachey, Denis M Gilmore, Onkar V Khullar, Hisashi Tsukada, Brian Whang, Lucian R Chirieac, Robert F Padera, Michael T Jaklitsch, Yolonda L Colson
OBJECTIVE: To report the first analysis of long-term outcomes using near-infrared (NIR) image-guided sentinel lymph node (SLN) mapping in non-small cell lung cancer (NSCLC). METHODS: Retrospective analysis of patients with NSCLC enrolled in 2 prospective phase 1 NIR-guided SLN mapping trials, including an indocyanine green (ICG) dose-escalation trial, was performed. All patients underwent NIR imaging for SLN identification followed by multistation mediastinal lymph node sampling (MLNS) and pathologic assessment...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29246825/mohs-micrographic-surgery-and-dermatopathology-concordance-an-analysis-of-1421-mohs-cases-over-17-years
#16
Katarina Kesty, Omar P Sangueza, Barry Leshin, John G Albertini
BACKGROUND: The success of Mohs micrographic surgery depends on the surgeon's ability to correctly interpret intraoperative frozen sections. OBJECTIVE: This retrospective study analyzed the rate of concordance between Mohs surgeons and dermatopathologists in reading slides from Mohs surgery cases. METHODS: A dermatopathologist reviewed all the frozen sections and the corresponding Mohs map for every 30th Mohs case at a practice employing 6 different Mohs surgeons from 2001-2017...
December 12, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29241451/energetic-performance-analysis-of-staged-palliative-surgery-in-tricuspid-atresia-using-vector-flow-mapping
#17
Mao Kinoshita, Koichi Akiyama, Keiichi Itatani, Ayahiro Yamashita, Maki Ishii, Atsushi Kainuma, Yoshinobu Maeda, Takako Miyazaki, Masaaki Yamagishi, Teiji Sawa
BACKGROUND: Staged palliative surgery markedly shifts the balance of volume load on a single ventricle and pulmonary vascular bed. Blalock-Taussig shunt necessitates a single ventricle eject blood to both the systemic and pulmonary circulation. On the contrary, bidirectional cavopulmonary shunt release the single ventricle from pulmonary circulation. CASE PRESENTATION: We report a case of tricuspid atresia patient who underwent first palliative surgery and second palliative surgery...
December 14, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29241174/surgery-of-insular-gliomas
#18
Hugues Duffau
For a long time, surgery within the insular lobe, especially in cases of intrinsic tumors, was considered as too dangerous. Even though such interventions are still challenging, resection of insular glioma became more popular during the past decade. First of all, this has happened due to better understanding of the functional anatomy of this complex brain region, combined with an improved knowledge of its connectivity. Furthermore, development of advanced intraoperative techniques, especially functional brain mapping with direct electrical stimulation, resulted in increased safety of procedures...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29241173/surgical-management-of-gliomas-in-eloquent-cortex
#19
Sherise D Ferguson, Ian E McCutcheon
Gliomas located in eloquent cortex impose a unique surgical obstacle. The oncological benefit of aggressive resection must be balanced with preservation of functional tissue and optimization of surgical outcome. Technical advances in preoperative functional imaging, refinement of intraoperative mapping, and conceptual understanding of cerebral plasticity have significantly improved the outcome of this patient population.
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29241172/neurophysiological-monitoring-and-awake-craniotomy-for-resection-of-intracranial-gliomas
#20
Taiichi Saito, Manabu Tamura, Mikhail F Chernov, Soko Ikuta, Yoshihiro Muragaki, Takashi Maruyama
Aggressive resection of intracranial gliomas has a positive impact on patients' prognosis, but is associated with a risk of neurological complications. For preservation of brain functions and avoidance of major postoperative morbidity various methods of intraoperative neurophysiological monitoring have been introduced into clinical practice. At present, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), brainstem auditory evoked potentials (BAEP), and electrocorticography (ECoG) are used routinely during neurosurgical procedures...
2018: Progress in Neurological Surgery
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