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Anterior resection

X Serra-Aracil, A Zárate, L Mora, S Serra-Pla, A Pallisera, J Bonfill, J Bargalló, A Pando, S Delgado, E Balleteros, C Pericay
PURPOSE: Compared with the open approach, laparoscopic total mesorectal excision (TME) achieves faster patient recovery, reduces morbidity rates, and shortens hospital stay. However, in laparoscopic low anterior resection (L-LAR), conversion to open surgery is required in almost 20% of cases. Transanal TME (Ta-TME) combined with laparoscopy, also called hybrid natural orifice transluminal endoscopic surgery (NOTES), is a less invasive procedure that can overcome some of the limitations of laparoscopic rectal surgery...
March 16, 2018: International Journal of Colorectal Disease
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
I S Lvov, A A Grin', M A Nekrasov, A Yu Kordonskiy, A V Sytnik
Compression of the caudal medulla oblongata and ventral portions of the spinal cord is the most dangerous complication of atlanto-axial dislocation (AAD). AIM: The study objective was to improve surgical management of patients with ventral compression of the spinal cord in the setting of AAD of various genesis. MATERIAL AND METHODS: We analyzed treatment outcomes in 250 patients with C1 and C2 injuries and diseases for the period between 2002 and 2016. Persistent ventral compression of the neural structures in the setting of AAD was detected in 34 (13...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Juliane Kupsch, Thomas Jackisch, Klaus E Matzel, Joerg Zimmer, Andreas Schreiber, Anja Sims, Helmut Witzigmann, Sigmar Stelzner
PURPOSE: Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score. METHODS: We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire...
March 15, 2018: International Journal of Colorectal Disease
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
Thomas Coquet, Michel Lefranc, Louis Chenin, Pascal Foulon, Éric Havet, Johann Peltier
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Ali S Haider, Christopher S Graffeo, Avital Perry, Lucas P Carlstrom, Terry C Burns
Insular gliomas were previously considered inoperable lesions and were typically treated via biopsy, chemotherapy and/or radiation, if not observation alone. Stereotactic biopsies of low grade insular gliomas can underestimate tumor grade or fail to establish malignancy. Moreover, the survival advantages of maximal safe resection for insular lesions are increasingly being recognized. As such, early surgical resection is increasingly being performed. As with most lesions, a differential diagnosis exists for apparent insular gliomas, with definitive diagnosis generally obtained upon resection...
January 11, 2018: Curēus
Teishiki Shibata, Motoki Tanikawa, Tomohiro Sakata, Mitsuhito Mase
Craniopharyngiomas are benign tumors and account for approximately 5.6-13% of all intracranial tumors in children. Diagnosis of pediatric craniopharyngioma is often delayed until the tumor becomes relatively large and manifests severe visual and/or endocrine disturbance. Endoscopic endonasal approaches have recently been introduced to surgery for craniopharyngioma. These techniques, however, have rarely been utilized in patients affected with craniopharyngioma as young as 1 year old. This report documents a 12-month-old male infant with sellar craniopharyngioma who presented with acute total vision loss...
March 14, 2018: Pediatric Neurosurgery
Michael Kerin Morgan, Mathew Guilfoyle, Ramez Kirollos, Gillian Z Heller
BACKGROUND: Avoiding the risk of postoperative hemorrhage after brain arteriovenous malformation (AVM) resection involves aggressive blood pressure control. Remodeling of the feeding arterial system is critical in reducing this risk. OBJECTIVE: To investigate factors predicting time to return to normal on digital subtraction angiography (DSA) after AVM resection. METHODS: For AVM in which the largest feeding artery (FA) on DSA was in the anterior circulation, the preoperative and postoperative diameter of the FA were compared with the diameter of the internal carotid artery (IC) immediately proximal to the posterior communicating artery...
March 12, 2018: Neurosurgery
Xiaodong Tang, Rongli Yang, Huayi Qu, Zhenyu Cai, Wei Guo
STUDY DESIGN: We retrospectively analyzed factors associated with spinopelvic mechanical failure after total sacrectomy. OBJECTIVE: To find the rate and type of mechanical fixation failure after total sacrectomy and to identify the associated risk factors. SUMMARY OF BACKGROUND DATA: Although rigid fixation has been achieved, mechanical failure is sometimes encountered in reconstruction after total sacrectomy. The incidence and factors associated with spinopelvic fixation mechanical failure after total sacrectomy are still not clear...
March 13, 2018: Spine
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
Robin De Roover, Wouter Crijns, Kenneth Poels, Ronald Peeters, Cédric Draulans, Karin Haustermans, Tom Depuydt
PURPOSE: Liquid fiducial markers have shown to be a promising alternative to solid gold markers in terms of imaging artifact reduction, patient comfort and compatibility with different imaging modalities. This study aims to investigate the performance of the novel BioXmark® liquid marker for state-of-the-art multi-modal imaging used in prostate cancer (PCa) radiotherapy, encompassing kV CT/CBCT, multi-parametric MRI and kV X-ray imaging. In addition, automatic detection of the liquid markers in X-ray imaging for prostate motion monitoring during treatment was investigated...
March 14, 2018: Medical Physics
Hitoshi Tonomura, Yoichiro Hatta, Masateru Nagae, Ryota Takatori, Toshikazu Kubo
A two-stage combined anterior and posterior approach is commonly used for total resection of giant spinal tumors. However, an anterior approach at the lower lumbar level is technically challenging because of the anatomy of the iliac wing, major vessels and nerves of the lumbosacral plexus. We report a case of fifth vertebral tumor treated posteriorly with a newly devised surgical procedure combined with a recapping transiliac approach. A 45-year-old female diagnosed with giant schwannoma of the fifth lumbar vertebra underwent single-stage posterior tumor resection combined with osteotomy of the lateral part of the iliac crest...
March 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Tianxiao Jiang, Su Liu, Giuseppe Pellizzer, Aydin Aydoseli, Sacit Karamursel, Pulat A Sabanci, Altay Sencer, Candan Gurses, Nuri F Ince
Functional mapping of eloquent cortex before the resection of a tumor is a critical procedure for optimizing survival and quality of life. In order to locate the hand area of the motor cortex in two patients with low-grade gliomas (LGG), we recorded electrocorticogram (ECoG) from a 113 channel hybrid high-density grid (64 large contacts with diameter of 2.7 mm and 49 small contacts with diameter of 1 mm) while they executed hand clenching movements. We investigated the spatio-spectral characteristics of the neural oscillatory activity and observed that, in both patients, the hand movements were consistently associated with a wide spread power decrease in the low frequency band (LFB: 8-32 Hz) and a more localized power increase in the high frequency band (HFB: 60-280 Hz) within the sensorimotor region...
2018: Frontiers in Neuroscience
Firas Bannout, Sheri Harder, Michael Lee, Alexander Zouros, Ravi Raghavan, Travis Fogel, Kenneth De Los Reyes, Travis Losey
The neurosurgical treatment of skull base temporal encephalocele for patients with epilepsy is variable. We describe two adult cases of temporal lobe epilepsy (TLE) with spheno-temporal encephalocele, currently seizure-free for more than two years after anterior temporal lobectomy (ATL) and lesionectomy sparing the hippocampus without long-term intracranial electroencephalogram (EEG) monitoring. Encephaloceles were detected by magnetic resonance imaging (MRI) and confirmed by maxillofacial head computed tomography (CT) scans...
March 12, 2018: Brain Sciences
F Wang, D N Feng, Y Liu, Z Liu, T Sun
Objective: To evaluate the efficacy and safety of microsurgical in the treatment of temporal lobe cerebral cavernous malformation (CCM) with epilepsy. Methods: Temporal lobe CCM patients with epilepsy admitted to our department were collected from January 2010 to September 2016. Locations of the CCM were divided into (1) lateral-lateral to the collateral sulcus; (2) mesial-mesial to the collateral sulcus. In the lateral group, patients were underwent intraoperative electrocorticography (ECoG)-guided resection of lesion and hemosiderin rim...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Mohammad Kia, Timothy M Wright, Michael B Cross, David J Mayman, Andrew D Pearle, Peter K Sculco, Geoffrey H Westrich, Carl W Imhauser
BACKGROUND: The correct amount of external rotation of the femoral component during TKA is controversial because the resulting changes in biomechanical knee function associated with varying degrees of femoral component rotation are not well understood. We addressed this question using a computational model, which allowed us to isolate the biomechanical impact of geometric factors including bony shapes, location of ligament insertions, and implant size across three different knees after posterior-stabilized (PS) TKA...
January 2018: Clinical Orthopaedics and related Research
Kenji Matsuda, Shozo Yokoyama, Tsukasa Hotta, Takashi Watanabe, Koichi Tamura, Hiromitsu Iwamoto, Yuki Mizumoto, Hiroki Yamaue
BACKGROUND: This study is intended to assess whether the use of pelvic drain reduces incidence of pelvic sepsis in the era of laparoscopic low anterior resection (LAR). PATIENTS AND METHODS: In total, 200 of consecutive patients who underwent laparoscopic LAR for rectal cancer with diverting stoma were analyzed. RESULTS: Pelvic sepsis occurred in 14 of 110 patients (12.7%) in the drain group and in 9 of 90 patients (10.0%) in the no drain group (P=0...
March 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: Although longer operative times are associated with increased postoperative morbidity, the influence of surgical residents on this association is unclear. OBJECTIVE: The purpose of this study was to evaluate whether morbidity associated with operative times in laparoscopic colorectal surgery is increased by resident training. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted using a national database...
March 8, 2018: Diseases of the Colon and Rectum
Nancy E Epstein
Background: Spinal meningiomas are found in patients typically between the ages of 75 and 84: some report the average age to be 50. They occur with an incidence of approximately 1000 patients per year in the US, are mostly single (90%) rather than multiple (10%), and arise from the spinal meninges (arachnoid/dura). Tumors are typically posterior/posterolateral (70%) in location, leaving the remaining 30% in the anterior/anterolateral spinal canal. They produce symptoms and signs of radiculopathy (nerve root) and/or myelopathy (cord compression) depending on their site of origin...
2018: Surgical Neurology International
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