Pub Date : 2016-01-01DOI: 10.5455/aces.20151012124201
A. Manenti, E. Pavesi, A. Farinetti, D. Colasanto
Background: Splenic vein obstruction can lead to left-sided portal hypertension, which is a rare segmental portal hypertension condition, often caused by inflammatory or neoplastic disease of the pancreas. Today, adequate study by cross-sectional imaging, e.g., ultrasound and computed tomography, allows the identification of particular features of the venous collateral pathways that favor the development of gastroesophageal varices. Methods: A retrospective study of 15 cases of left-sided portal hypertension secondary to complete thrombosis of the splenic vein was performed, with special attention to the morphodynamic conditions predicting the development of gastroesophageal varices. Results: In patients with left-sided portal hypertension, gastroesophageal varices were greatly favored by two conditions: collateral pathways directed to the gastric fundus and hypertension in the left gastric vein. This last condition typically occurs when the left gastric vein inflows into an already obstructed splenic trunk, or in the case of concomitant portal hypertension. On the contrary, patients with left-sided portal hypertension and collaterals connected with the left renal or adrenal veins have minor risk of gastroesophageal varices. Conclusions: In every case of left-sided portal hypertension, upper digestive endoscopy and close follow-up are recommended. Besides, computed tomography can demonstrate particular conditions directly favoring gastroesophageal varices, and aid in selection of the appropriate therapeutic decisions.
{"title":"Left-sided portal hypertension revisited -","authors":"A. Manenti, E. Pavesi, A. Farinetti, D. Colasanto","doi":"10.5455/aces.20151012124201","DOIUrl":"https://doi.org/10.5455/aces.20151012124201","url":null,"abstract":"Background: Splenic vein obstruction can lead to left-sided portal hypertension, which is a rare segmental portal hypertension condition, often caused by inflammatory or neoplastic disease of the pancreas. Today, adequate study by cross-sectional imaging, e.g., ultrasound and computed tomography, allows the identification of particular features of the venous collateral pathways that favor the development of gastroesophageal varices. Methods: A retrospective study of 15 cases of left-sided portal hypertension secondary to complete thrombosis of the splenic vein was performed, with special attention to the morphodynamic conditions predicting the development of gastroesophageal varices. Results: In patients with left-sided portal hypertension, gastroesophageal varices were greatly favored by two conditions: collateral pathways directed to the gastric fundus and hypertension in the left gastric vein. This last condition typically occurs when the left gastric vein inflows into an already obstructed splenic trunk, or in the case of concomitant portal hypertension. On the contrary, patients with left-sided portal hypertension and collaterals connected with the left renal or adrenal veins have minor risk of gastroesophageal varices. Conclusions: In every case of left-sided portal hypertension, upper digestive endoscopy and close follow-up are recommended. Besides, computed tomography can demonstrate particular conditions directly favoring gastroesophageal varices, and aid in selection of the appropriate therapeutic decisions.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"211-215"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20151019114717
K. Duman, Y. Ozdemir, O. Dandin
‘Pilonidal sinus’ disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired) have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms.
{"title":"Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features -","authors":"K. Duman, Y. Ozdemir, O. Dandin","doi":"10.5455/ACES.20151019114717","DOIUrl":"https://doi.org/10.5455/ACES.20151019114717","url":null,"abstract":"‘Pilonidal sinus’ disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired) have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"228-232"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20150826033718
A. Kudva, B. Lakshminarayana, P. Addala, Prasad Seetharama
Background: Chronic groin pain is a major cause of post-operative morbidity in open inguinal mesh hernia repair. Neurectomy is a well-established treatment modality. This study was performed to evaluate the neurosensory outcomes of prophylactic neurectomy in open mesh hernia repair. Aim: To assess the incidence of inguinodynia in patients undergoing open mesh hernia repair And to study, the neurosensory outcomes of sacrificing the ilioinguinal nerve in comparison to the group in which a nerve is identified and preserved. Materials and methods: A prospective double-blinded study was performed at Kasturba Medical College, Manipal from September 2008 to December 2009. The ilioinguinal nerve was either preserved or sacrificed according to the surgeon’s choosing. Pain and hyposthesia were studied at defined timed intervals by a single observer. Results: 105 inguinal hernia mesh repairs were enrolled into the study. Nerve excision was done in 44 patients and preserved in 61 patients. Ninety patients were followed till six months. At post-operative day 1, all patients in both the groups had pain and 15.2% had numbness. Chronic post surgical inguinodynia was seen in 16.7% of the population in the study group and numbness in 5.6% of the study population at six months. Conclusion: The severity of pain in the neurectomy group was less than the control group. There were no significant differences in the neurosensory outcomes of prophylactic ilioinguinal neurectomies in open mesh hernia repair compared to nerve preservation and hence prophylactic neurectomy is presently the choice of most surgeons.
{"title":"A randomised control study on neurosensory outcomes of ilioingunal neurectomy in Lichtenstein’s hernia repair -","authors":"A. Kudva, B. Lakshminarayana, P. Addala, Prasad Seetharama","doi":"10.5455/ACES.20150826033718","DOIUrl":"https://doi.org/10.5455/ACES.20150826033718","url":null,"abstract":"Background: Chronic groin pain is a major cause of post-operative morbidity in open inguinal mesh hernia repair. Neurectomy is a well-established treatment modality. This study was performed to evaluate the neurosensory outcomes of prophylactic neurectomy in open mesh hernia repair. Aim: To assess the incidence of inguinodynia in patients undergoing open mesh hernia repair And to study, the neurosensory outcomes of sacrificing the ilioinguinal nerve in comparison to the group in which a nerve is identified and preserved. Materials and methods: A prospective double-blinded study was performed at Kasturba Medical College, Manipal from September 2008 to December 2009. The ilioinguinal nerve was either preserved or sacrificed according to the surgeon’s choosing. Pain and hyposthesia were studied at defined timed intervals by a single observer. Results: 105 inguinal hernia mesh repairs were enrolled into the study. Nerve excision was done in 44 patients and preserved in 61 patients. Ninety patients were followed till six months. At post-operative day 1, all patients in both the groups had pain and 15.2% had numbness. Chronic post surgical inguinodynia was seen in 16.7% of the population in the study group and numbness in 5.6% of the study population at six months. Conclusion: The severity of pain in the neurectomy group was less than the control group. There were no significant differences in the neurosensory outcomes of prophylactic ilioinguinal neurectomies in open mesh hernia repair compared to nerve preservation and hence prophylactic neurectomy is presently the choice of most surgeons.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"94-99"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20151202095233
S. Camara, R. Sonam, Sadamoudou Traore, Y. Tao, I. Souare, A. B. Barry, Omar Banafei, O. Balde, Ibrahima Sanoh, Quinu Chen, Jing Tao, Xiang Li, Yang Ming, Q. Qi, Dong Ming, Cui Jing, Huang Ming, Heshui Wu, Chun-you Wang
The aim of the study was to focus attention on the age of the young man under investigation. The onset age of chronic pancreatitis normally ranges from 30-40 years old. However, a young Chinese patient of just 23-years-old underwent an operation in order to treat chronic pancreatitis caused by stones and its post-operative outcome determined with the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).
{"title":"Chronic pancreatitis located in the pancreatic duct of a 23-year-old patient - What can be done? -","authors":"S. Camara, R. Sonam, Sadamoudou Traore, Y. Tao, I. Souare, A. B. Barry, Omar Banafei, O. Balde, Ibrahima Sanoh, Quinu Chen, Jing Tao, Xiang Li, Yang Ming, Q. Qi, Dong Ming, Cui Jing, Huang Ming, Heshui Wu, Chun-you Wang","doi":"10.5455/ACES.20151202095233","DOIUrl":"https://doi.org/10.5455/ACES.20151202095233","url":null,"abstract":"The aim of the study was to focus attention on the age of the young man under investigation. The onset age of chronic pancreatitis normally ranges from 30-40 years old. However, a young Chinese patient of just 23-years-old underwent an operation in order to treat chronic pancreatitis caused by stones and its post-operative outcome determined with the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20131203123228
R. Kundu, N. Singhal, U. Handa, R. Punia, H. Mohan
Objective: To evaluate the changes in the number of Langerhans Cells (LC) observed in the epithelium of smokeless tobacco (SLT-induced) lesions. Methods: Microscopic s ct ons from biopsies carried ut in the b ccal mucosa of twenty patients, who were chronic users of smokeless tobacco (SLT), were utilized. For the control group, twenty non-SLT users of SLT with normal mucosa were selected. The sections were studied with routine coloring and were immunostained for S-100, CD1a, Ki-67 and p63. These data were statistically analyzed by the Student’s t-test to investigate the differences in the expression of immune markers in normal mucosa and in SLT-induced leukoplakia lesions. Results: There was a significant difference in the immunolabeling of all markers between normal mucosa and SLT-induc d lesions (p<0.001). The leukoplaki lesions in chronic SLT users demonstrated a significant increase in the number of Langerhans cells and in the absence of epithelial dysplasia. Conclusion: The increase in the number of these cells represents the initial stage of leukoplakia.
{"title":"Signet ring gastric carcinoma with scalp metastasis: A case report","authors":"R. Kundu, N. Singhal, U. Handa, R. Punia, H. Mohan","doi":"10.5455/ACES.20131203123228","DOIUrl":"https://doi.org/10.5455/ACES.20131203123228","url":null,"abstract":"Objective: To evaluate the changes in the number of Langerhans Cells (LC) observed in the epithelium of smokeless tobacco (SLT-induced) lesions. Methods: Microscopic s ct ons from biopsies carried ut in the b ccal mucosa of twenty patients, who were chronic users of smokeless tobacco (SLT), were utilized. For the control group, twenty non-SLT users of SLT with normal mucosa were selected. The sections were studied with routine coloring and were immunostained for S-100, CD1a, Ki-67 and p63. These data were statistically analyzed by the Student’s t-test to investigate the differences in the expression of immune markers in normal mucosa and in SLT-induced leukoplakia lesions. Results: There was a significant difference in the immunolabeling of all markers between normal mucosa and SLT-induc d lesions (p<0.001). The leukoplaki lesions in chronic SLT users demonstrated a significant increase in the number of Langerhans cells and in the absence of epithelial dysplasia. Conclusion: The increase in the number of these cells represents the initial stage of leukoplakia.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"190-193"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70763621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20140719055828
R. Sena, M. Weiss, A. T. Abreu, Luisa Pires Costa, RO Peixoto, Camila Couto Gomes, A. Braga, Felipe Couto Gomes, C. Gomes
Situs inversus totalis, a rare congenital recessive autosomal malformation described in humans by Fabricius, in 1600, is characterised by the viscera’s transposition. It presents the incidence of approximately one case to each 10.000-20.000 newborns. The main etiology is still unknown and when the abdominal and thoracic visceral commitment is associated, including dextrocardia, it is described as situs inverses totalis. We report the case of a female patient, 16-years-old, who came to the Digestive Surgical Department, in hospital Therezinha de Jesus, Juiz de Fora – MG – Brazil, complaining of pain in the left hypochondrium, associated to nauseas and vomiting. The patient mentioned that she had been suffering for 4 months and that the pain worsened in the previous 2 days. At the general clinical examination, she presented a cardiac focus ausculta in the right hemithorax, however, without abnormalities. The abdomen was flat, without surgical scars, ventral or inguinal hernias. There was hyperthermia, pain in the deep palpation on the left hypochondrium, associated guarding and rebound tenderness. The patient told that she had a previous diagnosis of situs inversus totalis. The aim of this case report is to describe a patient with cholecystitis associated with situs inversus totalis, who was previously aware of her congenital abnormality. Moreover, we review some aspects for the correct diagnosis, and propose recommendations for a safe laparoscopic cholecystectomy.
完全性倒位是一种罕见的先天性隐性常染色体畸形，由fabicius于1600年在人类中描述，其特征是脏器的移位。该病的发病率约为每1万至2万名新生儿中有1例。主要病因尚不清楚，当腹部和胸部脏器病变(包括右心)合并时，称为完全性倒位。我们报告一名16岁的女性患者，她来到巴西Juiz de Fora - MG - Brazil的therzinha de Jesus医院的消化外科，主诉左侧胁肋疼痛，伴有恶心和呕吐。病人说她已经疼痛了4个月，前两天疼痛加重。在一般临床检查中，她在右半胸出现心脏焦点听诊，但未见异常。腹部平坦，无手术疤痕，腹疝或腹股沟疝。有热疗，深触诊左侧胁肋疼痛，伴有守卫性和反跳性压痛。病人说她以前被诊断为完全性倒位。本病例报告的目的是描述一个病人胆囊炎与完全性倒位相关，谁是以前意识到她的先天性异常。此外，我们回顾了正确诊断的一些方面，并提出了安全的腹腔镜胆囊切除术的建议。
{"title":"Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls -","authors":"R. Sena, M. Weiss, A. T. Abreu, Luisa Pires Costa, RO Peixoto, Camila Couto Gomes, A. Braga, Felipe Couto Gomes, C. Gomes","doi":"10.5455/ACES.20140719055828","DOIUrl":"https://doi.org/10.5455/ACES.20140719055828","url":null,"abstract":"Situs inversus totalis, a rare congenital recessive autosomal malformation described in humans by Fabricius, in 1600, is characterised by the viscera’s transposition. It presents the incidence of approximately one case to each 10.000-20.000 newborns. The main etiology is still unknown and when the abdominal and thoracic visceral commitment is associated, including dextrocardia, it is described as situs inverses totalis. We report the case of a female patient, 16-years-old, who came to the Digestive Surgical Department, in hospital Therezinha de Jesus, Juiz de Fora – MG – Brazil, complaining of pain in the left hypochondrium, associated to nauseas and vomiting. The patient mentioned that she had been suffering for 4 months and that the pain worsened in the previous 2 days. At the general clinical examination, she presented a cardiac focus ausculta in the right hemithorax, however, without abnormalities. The abdomen was flat, without surgical scars, ventral or inguinal hernias. There was hyperthermia, pain in the deep palpation on the left hypochondrium, associated guarding and rebound tenderness. The patient told that she had a previous diagnosis of situs inversus totalis. The aim of this case report is to describe a patient with cholecystitis associated with situs inversus totalis, who was previously aware of her congenital abnormality. Moreover, we review some aspects for the correct diagnosis, and propose recommendations for a safe laparoscopic cholecystectomy.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70764079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20140304011652
Raghunath Prabhu, Neha Kumar, Sakshi Sadhu, R. Shenoy, K. Vaidya
Basal cell adenoma (BCA) of the salivary glands is a rare benign tumor resembling pleomorphic adenoma, but with a prominent basaloid cell layer. The majority of these tumors arise in the parotid glands and account for only 1% of all salivary gland epithelial tumors. We report one such case of a swelling in the floor of the mouth in a 55-year-old female where BCA is the most likely diagnosis; however, histological variation does show a similarity to malignant adenoid cystic carcinoma, thereby making the diagnosis difficult. The incidence of malignancy is relatively higher in the submandibular, sublingual and minor salivary glands. Approximately, 85% of sublingual gland tumors are malignant. Thus, we should be more careful when making a diagnosis in minor salivary gland tumors.
{"title":"Basal cell adenoma of the salivary gland: Cribriform type, a rare case with review of literature -","authors":"Raghunath Prabhu, Neha Kumar, Sakshi Sadhu, R. Shenoy, K. Vaidya","doi":"10.5455/ACES.20140304011652","DOIUrl":"https://doi.org/10.5455/ACES.20140304011652","url":null,"abstract":"Basal cell adenoma (BCA) of the salivary glands is a rare benign tumor resembling pleomorphic adenoma, but with a prominent basaloid cell layer. The majority of these tumors arise in the parotid glands and account for only 1% of all salivary gland epithelial tumors. We report one such case of a swelling in the floor of the mouth in a 55-year-old female where BCA is the most likely diagnosis; however, histological variation does show a similarity to malignant adenoid cystic carcinoma, thereby making the diagnosis difficult. The incidence of malignancy is relatively higher in the submandibular, sublingual and minor salivary glands. Approximately, 85% of sublingual gland tumors are malignant. Thus, we should be more careful when making a diagnosis in minor salivary gland tumors.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"246-249"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70764281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20140110084919
D. Avila, R. S. Molon, M. A. Lawall, R. Bianco, Consolaro, A. Consolaro
A 55-year-old female presented with a 10 years history of swelling in the front part of her neck, and a persistent headache for the past 4 months. During the course of her hospital stay, she developed right upper limb monoplegia. An examination showed that she had papillary carcinoma thyroid in an euthyroid state. Further work-up revealed a solitary pulmonary nodule on the left lower lobe, right ventricular tumor thrombus in the heart, and hemorrhagic metastases involving the left cerebral and cerebellar hemispheres. Total thyroidectomy with bilateral functional and central neck dissection was performed. Postoperatively, the patient received radioiodine ablation with I131 for lung and brain metastases, and remnant ablation for primary treatment. She has received regular follow-up care for the past 3 months.
{"title":"Papillary carcinoma thyroid with rare metastases: A case report and review -","authors":"D. Avila, R. S. Molon, M. A. Lawall, R. Bianco, Consolaro, A. Consolaro","doi":"10.5455/ACES.20140110084919","DOIUrl":"https://doi.org/10.5455/ACES.20140110084919","url":null,"abstract":"A 55-year-old female presented with a 10 years history of swelling in the front part of her neck, and a persistent headache for the past 4 months. During the course of her hospital stay, she developed right upper limb monoplegia. An examination showed that she had papillary carcinoma thyroid in an euthyroid state. Further work-up revealed a solitary pulmonary nodule on the left lower lobe, right ventricular tumor thrombus in the heart, and hemorrhagic metastases involving the left cerebral and cerebellar hemispheres. Total thyroidectomy with bilateral functional and central neck dissection was performed. Postoperatively, the patient received radioiodine ablation with I131 for lung and brain metastases, and remnant ablation for primary treatment. She has received regular follow-up care for the past 3 months.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"238-241"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70764391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20150810031232
R. Aktimur, Ali Kağan Gökakın, K. Deveci, M. Atabey
Objective: Compared to open surgery; laparoscopic cholecystectomy has become the standard of care for the treatment of cholelithiasis at any age over the last two decades. In the present study, the aim was to identify and to compare the rates and reasons involved in conversion to open procedure in elective surgery for cholelithiasis in geriatric patients over the course of fourteen years. Methods: To assess the possible differences in the conversion rates and reasons over time, 207 patients over 65 years of age undergoing elective laparoscopic cholecystectomy for chronic cholecystitis were analyzed in two groups - the first ten years (n=141) and the last four years (n=66). Acute cholecystitis, gallbladder malignancy and/or polyps were excluded. Demographic characteristics, comorbidities, history of previous abdominal surgery, preoperative endoscopic retrograde cholangiopancreatography (ERCP) and the reasons and rates involved in conversion to open cholecystectomy were all analyzed. Results: In male and female patients, the conversion rate was 18.8% and 5.07 %, respectively (p=0.02). In the first ten years, the conversion rate was 11.3%, while in last four years, it was 6.1% (p=0.230). In first ten years, 62.5% of the reason for conversion was found to be dense pericholecystic adhesions related, but in last four years, this rate decreased notably to 25%. Conclusions: Although there was no statistical significance, in last four years, surgeons seemed to more easily overcome difficult cholecystectomies.
{"title":"Conversion to open surgery in the era of laparoscopic cholecystectomy: Changing rates and reasons in geriatric patients","authors":"R. Aktimur, Ali Kağan Gökakın, K. Deveci, M. Atabey","doi":"10.5455/ACES.20150810031232","DOIUrl":"https://doi.org/10.5455/ACES.20150810031232","url":null,"abstract":"Objective: Compared to open surgery; laparoscopic cholecystectomy has become the standard of care for the treatment of cholelithiasis at any age over the last two decades. In the present study, the aim was to identify and to compare the rates and reasons involved in conversion to open procedure in elective surgery for cholelithiasis in geriatric patients over the course of fourteen years. Methods: To assess the possible differences in the conversion rates and reasons over time, 207 patients over 65 years of age undergoing elective laparoscopic cholecystectomy for chronic cholecystitis were analyzed in two groups - the first ten years (n=141) and the last four years (n=66). Acute cholecystitis, gallbladder malignancy and/or polyps were excluded. Demographic characteristics, comorbidities, history of previous abdominal surgery, preoperative endoscopic retrograde cholangiopancreatography (ERCP) and the reasons and rates involved in conversion to open cholecystectomy were all analyzed. Results: In male and female patients, the conversion rate was 18.8% and 5.07 %, respectively (p=0.02). In the first ten years, the conversion rate was 11.3%, while in last four years, it was 6.1% (p=0.230). In first ten years, 62.5% of the reason for conversion was found to be dense pericholecystic adhesions related, but in last four years, this rate decreased notably to 25%. Conclusions: Although there was no statistical significance, in last four years, surgeons seemed to more easily overcome difficult cholecystectomies.","PeriodicalId":30641,"journal":{"name":"Archives of Clinical and Experimental Surgery","volume":"5 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70765012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5455/ACES.20151006071751
K. Taneja, Sumiti Gupta, A. Chauhan, R. Kalra, Aditi Arora, S. Arora, R. Sen
Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth-most common malignancy worldwide. Despite advances in radiotherapy and surgical treatment, survival rates have not changed significantly in the last 40 years. Molecular markers are currently being identified that can determine prognosis preoperatively by routine tumor biopsy, lead- ing to improved management of HNSCC patients. Aim: The aim of the present study was to demonstrate the expression of p53 and bcl2 proteins in squamous cell carcinoma of head and neck (HNSCC) and to correlate the expression of p53 and bcl2 with clinical staging (AJCC) and WHO histological grading of SCC. Materials and methods: The study population comprised 50 cases of HNSCC. Tissue sections from these cases were subjected to hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining using p53 and bcl2, and a comparative analysis of the results was performed. Cases of colon carcinoma and benign lymphoid hyperplasia were used as positive controls for p53 and bcl2, respectively. Results: Positivity for p53 was recorded in 30 cases (30/50), while positivity for bcl2 was recorded in 44 cases (44/50). Positivity for p53+/bcl2+ coexpression was seen in 28 cases (28/50). The frequency of p53 expression was associated with tumor histologic grade (p=0.02), increasing lymph node involvement (p=0.01), and clinical stage (p=0.038). The frequency of bcl2 expression was associated with histological grade (p=0.02) and increasing lymph node involvement (p=0.028), but not with clinical stage (p=0.242). Moreover, the combined p53+/bcl2+ expression was significantly associated with histo- logical grade (p=0.02) and lymph node involvement (p=0.01). Conclusion: Study of p53 and bcl2 expression may provide clinicians with more exact information in order to evaluate tumor aggressiveness and survival rates.
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