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Intraoperative mapping

L X Quan, H X An, D X Wang
OBJECTIVE: To observe the effects of 0.4 μg/(kg×h) dose of dexmedetomidine on intra-operative wake-up test in children patients undergoing scoliosis surgery. METHODS: Sixty patients for posterior scoliosis correction (ASA I-II, aged 5-16 years) from March 2013 to April 2015 were enrolled in this prospective, double-blinded, randomized, placebo-controlled study, The patients were randomly classified into two groups to receive dexmedetomidine (group RD, n=30) or saline solution (group R, n=30)...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Elisa Tardelli, Sara Mazzarri, Domenico Rubello, Marta Gennaro, Lorenzo Fantechi, Valerio Duce, Antonella Romanini, Sotirios Chondrogiannis, Duccio Volterrani, Patrick M Colletti, Gianpiero Manca
Melanoma is an important public health problem, and its incidence is increasing worldwide. The disease status of regional lymph nodes is the most important prognostic factor in early-stage melanoma patients. Sentinel lymph node biopsy (SLNB) was introduced in the early 1990s as a less invasive procedure than complete lymph node dissection to allow histopathologic evaluation of the "sentinel lymph node" (SLN), which is the first node along the lymphatic pathway from a primary tumor. Sentinel lymph node biopsy has minimal complication risks compared with standard complete lymph node dissection...
October 5, 2016: Clinical Nuclear Medicine
Angela Collarino, Sergi Vidal-Sicart, Germano Perotti, Renato A Valdés Olmos
This review discusses the state-of-the-art of sentinel lymph node mapping in gynaecological malignancies, including cervical cancer, endometrial cancer, and vulvar cancer, with an emphasis on new technological advances. For this objective, PubMed/MEDLINE was searched for relevant studies about the sentinel lymph node procedure in gynaecology. In particular, the use of preoperative lymphatic mapping with lymphoscintigraphy and single photon emission tomography/computed tomography (SPECT/CT) was identified in 18 studies...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
O R Brouwer, H G van der Poel, R F Bevers, E J van Gennep, S Horenblas
This review aims to discuss the current state-of-the-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B)...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
Benita Tamrazi, Melike Pekmezci, Mariam Aboian, Tarik Tihan, Christine M Glastonbury
RATIONALE AND OBJECTIVES: Pituitary macroadenomas are predominantly benign intracranial neoplasms that can be locally aggressive with invasion of adjacent structures. Biomarkers of aggressive behavior have been identified in the pathology literature, including the proliferative marker MIB-1. In the radiology literature, diffusion weighted imaging and low ADC values provide similar markers of aggressive behavior in brain tumors. The purpose of this study was to determine if there is a correlation between ADC and MIB-1 in pituitary macroadenomas...
October 12, 2016: Pituitary
Peter Milos, Kerstin Metcalf, Patrick Vigren, Hans Lindehammar, Malin Nilsson, Sverre Boström
Awake craniotomy for brain tumours  Awake neurosurgery is a useful method in lesions near eloquent brain areas, particularly low-grade gliomas.The aim is to maximise tumour resection and preserve neurological function. We performed 40 primary awake surgeries and 8 residual surgeries. Patients were operated awake throughout the procedure or with a laryngeal mask and general anaesthesia during the opening stage and then awake during intracerebral surgery. Language and motor function were mapped with direct cortical stimulation, motor evoked potential and standardised neurological testing...
October 11, 2016: Läkartidningen
Thijs C D Rettig, Linda M Peelen, Guillaume S C Geuzebroek, Wilton A van Klei, Christa Boer, Jan Willem van der Veer, Jan Hofland, Ewoudt M W van de Garde, Peter G Noordzij
OBJECTIVE: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). DESIGN: Retrospective analysis. SETTING: Tertiary-care hospital. PARTICIPANTS: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. INTERVENTIONS: None...
July 30, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Fabio Martinelli, Antonino Ditto, Giorgio Bogani, Mauro Signorelli, Valentina Chiappa, Domenica Lorusso, Edward Haeusler, Francesco Raspagliesi
STUDY OBJECTIVE: To report on detection-rate (DR) of sentinel-nodes (SLNs) in endometrial-cancer (EC) patients after hysteroscopic injection of indocyanine-green (ICG) and Laparoscopic near-infrared (L-NIR) fluorescence mapping. DESIGN: Prospectively collected data. DESIGN: classification: Canadian Task Force II-2 SETTING: Gynecologic oncology referral center. PATIENTS: Consecutive patients with apparent early-stage endometrioid EC scheduled for surgical treatment: total-laparoscopic-hysterectomy, bilateral salpingo-oophorectomy, SLNs mapping...
October 7, 2016: Journal of Minimally Invasive Gynecology
Nico Sollmann, Moritz F Goblirsch-Kolb, Sebastian Ille, Vicki M Butenschoen, Tobias Boeckh-Behrens, Bernhard Meyer, Florian Ringel, Sandro M Krieg
BACKGROUND: For the navigation of transcranial magnetic stimulation (TMS), various techniques are available. Yet, there are two basic principles underlying them all: electric-field-navigated transcranial magnetic stimulation (En-TMS) and line-navigated transcranial magnetic stimulation (Ln-TMS). The current study was designed to compare both methods. METHODS: To explore whether there is a difference in clinical applicability, workflow, and mapping results of both techniques, we systematically compared motor mapping via En-TMS and Ln-TMS in 12 patients suffering from brain tumors...
October 8, 2016: Acta Neurochirurgica
Sebastian Ille, Nico Sollmann, Vicki M Butenschoen, Bernhard Meyer, Florian Ringel, Sandro M Krieg
BACKGROUND: The resection of left-sided perisylvian brain lesions harbours the risk of postoperative language impairment. Therefore the individual patient's language distribution is investigated by intraoperative direct cortical stimulation (DCS) during awake surgery. Yet, not all patients qualify for awake surgery. Non-invasive language mapping by repetitive navigated transcranial magnetic stimulation (rTMS) has frequently shown a high correlation in comparison with the results of DCS language mapping in terms of language-negative brain regions...
September 29, 2016: Acta Neurochirurgica
Y Q Yao, Y H Liu, Z Y Fan, J H Chen, C J Dong
Objective: To evaluate the clinical effect and safety of oxycodone hydrochloride in the anesthesia for percutaneous radiofrequency ablation (PRFA) in hepatocellular carcinoma. Methods: Between March and December 2015, 60 cases of hepatocellular carcinoma patients undergoing percutaneous radiofrequency ablation surgery in Peking University Cancer Hospital were randomly divided into three groups: oxycodone group (group Q), fentanyl group (group F) and dezocine group (group D), 20 cases in each group. Respectively intravenously injection oxycodone 0...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
J Hinojosa, S Gil-Robles, B Pascual
Insula and paralimbic region represent a common location for gliomas in adulthood. However, limbic and paralimbic tumors are rare in children. Reports of pediatric insular tumors are scarce in literature, and most of them are included in adult's series, so their management and outcome can be outlined only after extracting data from these reports. Due to their predominantly low grade, they usually have a benign course for some time, what make them ideal candidates for total resection. However, their intricate location and spread to key areas, including the temporal lobe, make them a surgical challenge...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Michael Co, Ava Kwong
INTRODUCTION: Sentinel lymph node (SLN) biopsy is currently the gold standard of treatment in early breast cancers. Identification of SLNs by preoperative scintigraphy has been carried out to improve the detection of SLNs intraoperatively, but the evidence of its cost-effectiveness is lacking. Here, we analyze the cost-effectiveness of the utilization of scintigraphy in detection of SLNs. PATIENTS AND METHODS: Clinical and operative details were retrieved from a prospectively maintained database...
August 27, 2016: Clinical Breast Cancer
Tugan Bese, Veysel Sal, Fuat Demirkiran, Ilker Kahramanoglu, Nedim Tokgozoglu, Sennur Ilvan, Ovgu Aydin, Metin Hallac, Betul Vatankulu, Gokhan Demirayak, Hasan Turan, Macit Arvas
OBJECTIVE: The goal of this study was to evaluate the combination of sentinel lymph node (SLN) mapping and F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scan in detection of lymph node involvement in patients with endometrioid endometrial cancer (EEC). METHODS/MATERIALS: Ninety-five patients with EEC who had preoperative PET/CT imaging and underwent SLN mapping were retrospectively analyzed. Methylene blue dye was used and injected to the cervix at 3- and 9-o'clock positions (a total of 4 mL)...
September 2016: International Journal of Gynecological Cancer
Jason K Hsieh, Jarrod E Dalton, Dongsheng Yang, Ehab S Farag, Daniel I Sessler, Andrea M Kurz
BACKGROUND: Intraoperative hypotension may contribute to perioperative strokes. We therefore tested the hypothesis that intraoperative hypotension is associated with perioperative stroke. METHODS: After institutional review board approval for this case-control study, we identified patients who had nonneurological, noncardiac, and noncarotid surgery under general anesthesia at the Cleveland Clinic between 2005 and 2011 and experienced a postoperative stroke. Control patients not experiencing postoperative stroke were matched in a 4-to-1 ratio using propensity scores and restriction to the same procedure type as stroke patients...
October 2016: Anesthesia and Analgesia
Mai Shibuya, Toshihiko Satake, Reiko Nakasone, Marina Ogawa, Mayu Muto, Kazutaka Narui, Kazunori Yasumura, Takashi Ishikawa, Jiro Maegawa
BACKGROUND: A free fascioadipocutaneous flap obtained from the medial thigh is suitable for breast reconstruction in Asian women with a small-to-moderate breast size. In this region, both a medial circumflex femoral artery perforator flap (MCFAp flap) and a posterior medial thigh perforator flap (PMTp flap) are options, based on perforators from the deep femoral vessels. Here, we evaluated the anatomic basis of the medial circumflex femoral artery (MCFA) perforators from the medial circumflex femoral vessels...
September 13, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Ian Solsky, Alex Edelstein, Michael Brodman, Ronald Kaleya, Meg Rosenblatt, Calie Santana, David L Feldman, Patricia Kischak, Donna Somerville, Santosh Mudiraj, I Michael Leitman, Peter Shamamian
BACKGROUND: Morbid obesity can complicate perioperative management. Best practice guidelines have been published but are typically followed only in bariatric patients. Little is known regarding physician awareness of and compliance with these clinical recommendations for nonbariatric operations. Our study evaluated if an educational intervention could improve physician recognition of and compliance with established best practices for all morbidly obese operatively treated patients. METHODS: A care map outlining best practices for morbidly obese patients was distributed to all surgeons and anesthesiologists at 4 teaching hospitals in 2013...
September 9, 2016: Surgery
Lixin Chin, Bruce Latham, Christobel M Saunders, David D Sampson, Brendan F Kennedy
Surgical treatment of breast cancer aims to identify and remove all malignant tissue. Intraoperative assessment of tumor margins is, however, not exact; thus, re-excision is frequently needed, or excess normal tissue is removed. Imaging methods applicable intraoperatively could help to reduce re-excision rates whilst minimizing removal of excess healthy tissue. Optical coherence elastography (OCE) has been proposed for use in breast-conserving surgery; however, intraoperative interpretation of complex OCE images may prove challenging...
September 12, 2016: Journal of Biophotonics
Samaresh Das, Ali Al-Mashani, Neelam Suri, Neeraj Salhotra, Nilay Chatterjee
An awake craniotomy is a continuously evolving technique used for the resection of brain tumours from the eloquent cortex. We report a 29-year-old male patient who presented to the Khoula Hospital, Muscat, Oman, in 2016 with a two month history of headaches and convulsions due to a space-occupying brain lesion in close proximity with the left motor cortex. An awake craniotomy was conducted using a scalp block, continuous dexmedetomidine infusion and a titrated ultra-low-dose of propofolfentanyl. The patient remained comfortable throughout the procedure and the intraoperative neuropsychological tests, brain mapping and tumour resection were successful...
August 2016: Sultan Qaboos University Medical Journal
Guillaume Herbet, Sylvie Moritz-Gasser, Morgane Boiseau, Sophie Duvaux, Jérôme Cochereau, Hugues Duffau
Neurological insults that damage the left hemisphere are frequently associated with a variety of language disorders. Of these, lexical retrieval impairments are the most commonly observed, and often constitute the residual but lasting disturbance in patients with good functional outcomes. The current study was specifically designed to understand the anatomical factors that prevent full recovery of lexical retrieval in patients having undergone a neurosurgery for a left diffuse low-grade glioma, with a special focus on white matter disconnection...
September 6, 2016: Brain: a Journal of Neurology
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