Surgery

2月 12, 2015

Management of a Severe Form of Verneuil’s Disease in Its Genitoperineal Localisation in Bobo-Dioulasso

Read  full  paper  at:http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53926#.VNxhVSzQrzE

The authors report a severe form of genitoperineal localisation of Verneuil’s disease managed in a surgical environment, having evolved favorably with improvement of the patient’s quality of life, but persistence of unsightly skin scars. They insist on the unexceptional nature of this disease whose prognosis is reserved, sometimes leaving severe functional sequelae. The long evolution of the disease with prolonged hospitalization in a professionally active young patient and the extension of suppurations to the perineal, scrotal and inguinal regions was the features of this observation. After wide excision of the lesions with antibiotic associated with local care, evolution had taken to complete wound healing with improved quality of life and a recovery of his professional activity.

Cite this paper

Cyprien, Z. , Adama, O. , Timothée, K. , Edgar, O. , Boukary, D. , Ibrahim, T. , Drissa, B. , Bakary, S. , Delphine, Y. and Simon, T. (2015) Management of a Severe Form of Verneuil’s Disease in Its Genitoperineal Localisation in Bobo-Dioulasso. Open Journal of Urology, 5, 13-18. doi: 10.4236/oju.2015.52003.

References

[1] Soudan, D. (2001) La maladie de Verneuil: Diagnostic-Formes Cliniques. Le courrier de colo-proctologie, 2, 17-19.
[2] Bilali, S., Todi, V., Bilali, V. and Habibaj, J. (2012) Surgical Treatment of Chronic Suppurativa in the Gluteal and Perineal Regions. Actachirluqosl, 59, 91-95.
[3] Dandy, F.W. and Margesson, I.J. (2010) Hidradenitissuppurativa. Dermatolclin, 28, 779-793.
[4] Mooij, J.E., Van’t Oost, L., Leenarts, M.F. and Mekkes, J.R. (2011) Treatment Options in Severe Hidradenitis Suppurativa. Nederlands Tijdscrift Voor Geneeskunde, 155, Article ID: A1912.
[5] Buimer, M.G., Wobbes, T. and Klinkenbijl, J.H. (2009) Hidradenitissuppurativa. British Journal of Surgery, 96, 350-360. http://dx.doi.org/10.1002/bjs.6569
[6] Soudan, D. (2006) Thierry du Puy-Montbrun. Maladie de Verneuil. Hépato-Gastro-Oncologie Digestive, 13, 1-9.
[7] Pigot, F. (2001) La maladie de Verneuil. Le courrier de colo-proctologie, 2, 17-19.
[8] Lamfichekh, N., Dupond, A.S., Runser, C., Humbert, P. and Mantion, G. (2001) Traitement chirurgical de la maladie de Verneuil: 15 cas. Annale de dermatologie et vénéréologie, 128, 127.
[9] Chen, M.L., Odom, B. and Santucci, R.A. (2014) Surgical Management of Genitoperineal Hidradenitis Suppurativa in Men. Urology, 83, 1412-1417.
[10] Tamant, J.C., Bruant-Rodier, C., Nunziata, J.F. and Wilk, A. (2013) Dégénérescence de maladie de Verneuil en carcinome épidermoide: à propos de 2 cas et revue de la littérature. Annales de chirurgie plastique esthetique, 51, 82-86.                                                                                       eww150212lx
12月 29, 2014

Colorectal Cancer Surgery in Extreme Elderly Population

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52682#.VKC8gcCAM4

Author(s)

Javier Gallego Plazas1*, Elena Asensio1, Juan C. Navalon2, Inmaculada Lozano1, Jose M. Navarro2, Guillermo Ricote1, Montse Olcina2, Almudena Cotes1, Henry M. Ore1, Alejandra Magdaleno1, Maria C. Ors1, Maria J. Escudero1, Miguel A. Morcillo2

Affiliation(s)

1Servicio de Oncología Médica, Hospital General Universitario de Elche-Hospital Vega Baja, Alicante, Espana.
2Servicio de Cirugía General, Hospital Vega Baja, Alicante, Espana.

ABSTRACT

Background: Colorectal cancer surgery in extreme elderly population (380 years) is a growing problem and a subject in question. Experiences and results in this scenario are limited. Methods: Medical records of patients 380 years old hospitalized in General Surgery Department in Vega Baja Hospital between January 1st 2008 and December 31st 2012 were retrospectively reviewed. Patients diagnosed with colorectal cancer (CRC) were selected. Data regarding comorbidities, treatment performed, complications and survival were collected. Results: 95 patients (74 colon, 21 rectum) were identified: median age 83.0 years (80 – 93), 64.2% males. 93.7% of patients were operated on: median hospital and post-operative stay of 11 and 9 days, respectively; curative intention surgery 82.1%. 4.2% of patients were treated with interventionist procedures, and 2.1% of patients in a conservative way. 17.9% and 4.2% of patients came up with early and late complications, respectively. Early and late mortality occurred in 9.5% and 3.2% of patients, respectively. By March 2014, with a median follow up of 43.8 months, median overall survival for colorectal cancer patients was 2.7 years (95%IC, 2.0 – 3.2). Univariaye Cox Regresion analysis revealed the presence of cardiomyopathy (p = 0.024), the presence of chornic kidney disease (p = 0.025), the presence of comorbidities (vs absence) (0.026), the number of comorbidities (0.034), type of admission (p = 0.001), treatment with surgery (p = 0.001) and the incidence of early (p = 0.004) or late complications (p = 0.023) associated to overall survival with statically significance. Multivariate Cox Regression analysis showed number of comorbidities (HR = 1.104; 95%CI: 0.851 – 1.431; p = 0.456), treatment with surgery (HR = 4.928; 95%CI: 1.815 – 13.385; p = 0.002), programmed admission into hospital (HR = 2.316; 95%CI: 1.298 – 4.133; p = 0.004), and the incidence of late complications (HR = 4.629; 95%CI: 1.279 – 16.750; p = 0.020) independently associated with overall survival. Interaction test between number of comorbidities and early complication was performed (HR = 1.453; 95%CI: 0.971 – 2.175; p = 0.070). Conclusions: In our experience surgery for CRC patients may increase overall survival even in an extreme elderly population (380 years). Nevertheless when considering surgery for CRC in this subgroup of patients, factor such as type of admission into hospital and comorbidities should be taken into account in order to optimize treatment results in the effort to individualize CRC management in this growing population.

KEYWORDS

Colorectal, Cancer, Surgery, Elderly

Cite this paper

Plazas, J. , Asensio, E. , Navalon, J. , Lozano, I. , Navarro, J. , Ricote, G. , Olcina, M. , Cotes, A. , Ore, H. , Magdaleno, A. , Ors, M. , Escudero, M. and Morcillo, M. (2015) Colorectal Cancer Surgery in Extreme Elderly Population. Journal of Cancer Therapy, 6, 12-20. doi: 10.4236/jct.2015.61002.

References

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11月 14, 2014

Rate of Recurrence of Non-Small Cell Lung Cancer in Patients Treated with Percutaneous Ablation

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51369#.VGVZIGfHRK0

ABSTRACT

Background: Percutaneous ablation therapy as a treatment for non-small cell lung cancer (NSCLC) has been increasingly utilized. There is little data on long term efficacy. Because of this we reviewed the rate of recurrence of all ablation procedures done at our institution for the last 6 years. Methods: A total of 36 patients underwent 43 percutaneous procedures from July 2008 until January 2014 at our institution. There were 9 patients treated with radiofrequency ablation (RFA) and 27 treated withmicrowave ablation (MWA) for Stage I NSCLC. Each patient was reviewed to determine if there was a recurrence, the time to recurrence and the characteristics of the original cancer possibly predisposing the procedure to failure. Results: There were 8 recurrences in 9 patients undergoing RFA occurring at a median time of 842 days (range 425 – 1568) after their procedure. MWA was utilized in 27 patients for 34 procedures with 11 patients experiencing recurrences at a median time of 487 days (range 168 – 845). The median follow up time for the RFA patients was 1631 days (4.46 years) and for the MWA patients 751 days (2.06 years). Of the RFA recurrences, 5 involved systemic spread of their cancer and 3 were limited to site recurrences only. Of the MWA recurrences, 5 involved systemic spread of their cancer, 2 had chest wall recurrences and 4 were limited to site recurrences only.

Cite this paper

S. Regmi, N. , Heber, B. and W. Klena, J. (2014) Rate of Recurrence of Non-Small Cell Lung Cancer in Patients Treated with Percutaneous Ablation. Advances in Lung Cancer, 3, 75-81. doi: 10.4236/alc.2014.34011.

References

[1] Alexander, E.S. and Dupuy, D.E. (2013) Lung Cancer Ablation: Technologies and Techniques. Seminars in Interventional Radiology, 30, 141-150. http://dx.doi.org/10.1055/s-0033-1342955
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10月 28, 2014

Congenital Granular Cell Lesion: A Case Report

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50796#.VE8L3lfHRK0

ABSTRACT

The congenital granular cell lesion is a rare disease that affects newborns. We present a case of a patient with nodular lesions that were located on the anterior part of the maxillary alveolar. The surgical resection of the one lesion and its histological and immunohistochemical study were made.

Cite this paper

Paulo, D. , Barbosa, B. , Ibiapina, J. , Rebelo, A. , Carvalho, T. and Santos, L. (2014) Congenital Granular Cell Lesion: A Case Report. Case Reports in Clinical Medicine, 3, 566-569. doi: 10.4236/crcm.2014.310123.

References

[1] Azevedo, R.A., Galli, G.B., Pereira, C.L. and Pires, M.S.M. (2005) Epúlide Congênita. RGO, Porto Alegre, 53, 206-209.
[2] Chami, R.G. and Wang, H.S. (1986) Large Congenital Epulis of Newborn. Journal of Pediatric Surgery, 21, 929-930. http://dx.doi.org/10.1016/S0022-3468(86)80091-4
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http://dx.doi.org/10.1097/00005537-200211000-00005                                                  eww141028lx
10月 27, 2014

Congenital Granular Cell Lesion: A Case Report

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50796#.VE3cP1fHRK0

ABSTRACT

The congenital granular cell lesion is a rare disease that affects newborns. We present a case of a patient with nodular lesions that were located on the anterior part of the maxillary alveolar. The surgical resection of the one lesion and its histological and immunohistochemical study were made.

Cite this paper

Paulo, D. , Barbosa, B. , Ibiapina, J. , Rebelo, A. , Carvalho, T. and Santos, L. (2014) Congenital Granular Cell Lesion: A Case Report. Case Reports in Clinical Medicine, 3, 566-569. doi: 10.4236/crcm.2014.310123.

References

[1] Azevedo, R.A., Galli, G.B., Pereira, C.L. and Pires, M.S.M. (2005) Epúlide Congênita. RGO, Porto Alegre, 53, 206-209.
[2] Chami, R.G. and Wang, H.S. (1986) Large Congenital Epulis of Newborn. Journal of Pediatric Surgery, 21, 929-930. http://dx.doi.org/10.1016/S0022-3468(86)80091-4
[3] Menéndy, O.R. (1989) Estomatologia Pediátrica. In: Tommasi, A.F., Ed., Diagnóstico em Patologia Bucal, Vol. 2, Pancast Editorial, São Paulo, 559-586.
[4] McGuire, T.P., Gomes, P.P., Freilich, M.M. and Sándor, G.K. (2006) Congenital Epulis: A Surprise in the Neonate. Journal of the Canadian Dental Association, 72, 747-750.
[5] Yavuzer, R., Ataoglu, O. and Sari, A. (2001) Multiple Congenital Epulis of the Alveolar Ridge and Tongue. Annals of Plastic Surgery, 47, 199-202.
http://dx.doi.org/10.1097/00000637-200108000-00017
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http://dx.doi.org/10.1097/00005537-200211000-00005                                                             eww141027lx
10月 27, 2014

The Palmar Cutaneous Branch of the Median Nerve: A Detailed Morphometric Study

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50821#.VE2ZIFfHRK0

ABSTRACT

Damage to the palmar cutaneous branch of the median nerve (PCBMN) is a potential complication of surgery at the volar aspect of the wrist. The aim of this study was to determine the relationships of the PCBMN to both surface and bony landmarks using reliable methods. Ten pairs of forearms from cadavers aged 73 to 98 years were dissected. The PCBMN was identified and its course and relationships documented. The situation of the PCBMN was quantified relative to the distal wrist crease, bistyloid line, scaphoid tubercle, radial styloid process and flexor carpi radialis tendon. A PCBMN was identified on 90% of sides. The PCBMN arose from the radial aspect of the median nerve 52.4 (SD 31.0) mm from the bistyloid line and entered the transverse carpal ligament 10.9 (SD 9.5) mm proximal to the bistyloid line. At the level of the distal wrist crease the PCBMN was located 0.6 to 7.5 mm (mean 4.5; SD 1.9 mm) from the ulnar aspect of the flexor carpi radialis tendon. The inter- and intra-observer reliability of the measurement methods ranged from ICC 0.96 to 1.00. Detailed morphometric data of the PCBMN relative to bony landmarks contribute to knowledge of the spatial relationships of the PCBMN to inform the precision of surgical incisions.

Cite this paper

Richards, O. , Border, S. , Bolton, C. and Webb, A. (2014) The Palmar Cutaneous Branch of the Median Nerve: A Detailed Morphometric Study. Forensic Medicine and Anatomy Research, 2, 101-106. doi: 10.4236/fmar.2014.24017.

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[23] Carare, et al. (2006) Personal Communication.                                                                 eww141027lx
10月 22, 2014

Embryonal Rhabdomyosarcoma of the Uterine Cervix: Two Cases Report and Literature Review

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50622#.VEcHqFfHRK0

ABSTRACT

Introduction: Embryonal rhabdomyosarcoma (RMS) of the uterine cervix is a rare and extremely aggressive malignant entity. However, prognosis seems to be improved with the use of multimodality approach treatment. Cases: We report the cases of 50- and 51-year-old women, presenting with vaginal bleeding and mass. The two patients underwent radical surgery. Histological examination revealed RMS of uterine cervix. Treatment was effective in the first case but despite the chemotherapy, the second patient died two months later. Discussion and Conclusions: The prognosis of the cervical embryonal RMS depends on clinical and histological features. The current treatment protocols are based on trials done on pediatric patients. Studies on embryonal RMS treatment and outcomes are limited in women over forty years. In patients with unfavorable prognosis characteristics, the multimodality approach including surgery, adjuvant chemo and radiotherapy can be effective. Otherwise, surgery alone can effectively be proposed.

Cite this paper

Abdeljalil, K. , Asma, B. , Kouira, M. , Faten, H. , Sawssen, M. , Samir, H. , Mohamed, B. , Habib, E. and Hedi, K. (2014) Embryonal Rhabdomyosarcoma of the Uterine Cervix: Two Cases Report and Literature Review. Open Journal of Obstetrics and Gynecology, 4, 868-873. doi: 10.4236/ojog.2014.414122.

References

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[20] Wieneer, E., Wharam, M., Vietti, T.J., et al. (1995) The Third Intergroup RMS Study. Journal of Clinical Oncology, 13, 610-630.                                                                                                                                   eww141022lx
10月 10, 2014

Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48786#.VDdQhFfHRK0

ABSTRACT

Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: Weachieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those relatedto the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2%(n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in adeveloping country. Morbidity and mortality is high. Improved diagnostic tools are needed.

Cite this paper

Traoré, A. , Dembélé, B. , Togo, A. , Kanté, L. , Konaté, M. , Diakité, I. , Laurence, S. , Karembé, B. , Diarra, A. , Traoré, A. , Diango, M. and Diallo, G. (2014) Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries. Surgical Science, 5, 363-367. doi: 10.4236/ss.2014.58059.

References

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http://dx.doi.org/10.1093/clinids/23.3.486
[2] Roehrborn, A., Thomas, L., Potreck, O., Ebener, C., Ohmann, C., Goretzki, P.E., et al. (2002) The Microbiology of Postoperative Peritonitis. Clinical Infectious Diseases, 33, 1513-1519.
http://dx.doi.org/10.1086/323333
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http://dx.doi.org/10.1007/s00268-003-7067-8
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[13] Mulari, K. and Leppaniemi, A. (2004) Severe Secondary Peritonitis Following Gastrointestinal Tract Perforation. Scandinavian Journal of Surgery, 93, 204-208.
[14] Robert, R., Hutchins, M.S., Paul Gunning, M., et al. (2004) Relaparotomy for Suspected Intraperitoneal Sepsis after Abdominal Surgery. World Journal of Surgery, 28, 137-141.
http://dx.doi.org/10.1007/s00268-003-7067-8
[15] Bader, F.G., Schroder, M., Kujath, P., et al. (2009) Diffuse Postoperative Peritonitis—Value of Diagnostic Parameters and Impact of Early Indication for Relaparatomy. European Journal of Medical Research, 14, 491-496. http://dx.doi.org/10.1186/2047-783X-14-11-491
[16] Augustin, P., Kermarrec, N., Muller-Serieys, C., et al. (2010) Risk Factors for Multidrug Resistant Bacteria and Optimization of Empirical Antibiotic Therapy in Postoperative Peritonitis. Critical Care, 14, R20.
[17] Montravers, Ph., El Housseini, L. and Rekkit, R. (2004) Les péritonites postopératoires: Diagnostic et indication des réinterventions. Réanimation, 13, 431-435.
[18] Gainant, A. (2000) Prévention des déhiscences anastomotiques en chirurgie colorectale. Journal de Chirurgie, 137, 45-50.
[19] Bohnen, J., Boulanger, M., Meakins, J. and Mc Lean, P. (1983) Prognosis in Generalised Peritonitis: Relation to Cause and Risk Factors. Archives of Surgery, 118, 285-290.
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[20] Degremont, R., Brehant, O. and Fuks, D. (2011) Prise en charge des péritonites sus-mésocoliques postopératoires par drainage de Lévy (drain hélisonde). Journal de Chirurgie Viscérale, 148, 327-335. http://dx.doi.org/10.1016/j.jchirv.2011.03.014
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http://dx.doi.org/10.1016/j.jchir.2009.08.018                                                                           eww141010lx
10月 8, 2014

Ocular Complications of Strabismus Surgery

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50173#.VDSnZVfHRK0

ABSTRACT

Background: To evaluate ocular complications of strabismus surgery at the Department of Strabismus and Neuroophthalmology in our clinic. Methods: The medical records of patients who underwent strabismus surgery between March 1999 and February 2013 were retrospectively reviewed. Patients with minor ocular complications such as wound irregularities, conjunctivitis, subconjunctival hemorrhage, and less than six-month follow-up periods were excluded from the study. Employed strabismus surgeries included recessions, resections, muscle advancements, inferior oblique myectomies, and muscle transpositions. Results: Our case series are comprised of 1468 patients who underwent strabismus surgery. The ages of the patients ranged from 6 to 80 years. Recognized primary ocular complications were noted in eight patients (0.5%). Scleral perforation with retinal break was observed in one myopic patient during retrobulbar anesthesia. Medial rectus rupture occurred during medial rectus recession in one patient with chronic complete sixth nerve palsy. Conjunctival cyst occured postoperatively in one patient with partially refractive accommodative esotropia who had bilateral medial rectus recession. Corneal dellen developed postoperatively in five patients with exotropia. Conclusion: Ocular complications of strabismus surgery are usually treatable. Damage to ocular structures can be prevented by meticulous surgical approach. Close postoperative follow-up is required in all cases.

Cite this paper

Yurdakul, N. and Koç, F. (2014) Ocular Complications of Strabismus Surgery. Surgical Science, 5, 397-402. doi: 10.4236/ss.2014.59064.

References

[1] Bradbury, J.A. and Taylor, R.H. (2013) Severe Complications of Strabismus Surgery. Journal of American Association for Pediatric Ophthalmology and Strabismus, 17, 59-63.
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http://dx.doi.org/10.3928/01913913-20100818-02                                                                             eww141008lx
9月 19, 2014

Review of the Literature and Case Report of Surgical Treatment of a Neglected Dislocation of Hamate

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=49817#.VBuI8FfHRK0

Review of the Literature and Case Report of Surgical Treatment of a Neglected Dislocation of Hamate.

ABSTRACT

Introduction: Hamate dislocation is an uncommon injury, and there are only 17 reported cases in the literature. Ten of them are isolated injuries, and in 7 cases the hamate dislocation is a part of other injuries of the hand. Hamate dislocation can be caused by both direct and indirect forces, or as a part of complex injury of the wrist and hand. Case Report: A case report of a 26-year-old man who presented with a machine injury to his hand with a volar hamate dislocation which was initially missed in the Emergency department as a volar lacerated wound of the hand and was subsequently discovered in the Orthopaedic clinic 6 weeks later. Conclusion: This is only the second report in literature of a neglected hamate dislocation being surgically treated and the 18th reported case of a hamate dislocation over the last 130 years. The direction of dislocation depends on the direction of force applied. Surgical treatment with fixation is optimal even for neglected cases. There was no incidence of avascular necrosis of hamate reported, reflecting the almost equal volar and dorsal blood supply of the hamate.

Cite this paper

Kumar, K. , Kawas, A. , Abraham, T. and de Kesel, R. (2014) Review of the Literature and Case Report of Surgical Treatment of a Neglected Dislocation of Hamate. Open Journal of Orthopedics, 4, 243-248. doi: 10.4236/ojo.2014.49040.
References

 

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