• Title/Summary/Keyword: surgical patients

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Breast Lymphoma Treatment Outcomes in a Pakistani Population: 20 Years of Experience at a Single Center

  • Bano, Razia;Zafar, Waleed;Khan, Amina Iqbal;Fiaz, Sohaib Adil;Abid, Mahwish;Chaudhary, Mohammad Zulqarnain;Siddique, Neelam;Khan, Huma Majeed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3631-3635
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    • 2016
  • Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.

Needle aspiration as therapeutic management for suppurative cervical lymphadenitis in children

  • Baek, Mee-Young;Park, Kyung-Hee;We, Ju-Hee;Park, Su-Eun
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.801-804
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    • 2010
  • Purpose: This study aimed to evaluate the usefulness of the needle aspiration alternative to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage. Methods: From January 1998 to June 2008, we retrospectively reviewed 38 children treated with needle aspiration as management with suppurative cervical lymphadenitis instead of open surgical drainage. Results: All 38 children underwent only 1 puncture. Two patients (5.2%) out of 38 patients experienced reformation of an abscess and all recovered completely after re-treatment with antibiotics. Minor complications were detected in 2 patients (5.2%). One complication originated from remnant necrotic tissue and the other involved formation of a small scar in two patients, which resolved spontaneously. There were no major complications. Conclusion: Needle aspiration can be a simple, safe, and effective alternative procedure to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage.

The Results of Combined Therapeutic Modalities for Hepatoblastoma (간모세포종에서 복합치료의 성적)

  • Han, Ai-Ri;Oh, Jung-Tak;Han, Seok-Joo;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.37-41
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    • 2001
  • In hepatoblastoma, encouraging cure rates have been achieved with recent advances in chemotherapy and surgical techniques, The aim of this study is to evaluate the role of combined therapeutic modalities and surgical resection in hepatoblastoma. Fifteen cases of hepatoblastoma were treated from January 1993 to August 2000. Six patients had resectable tumors at initial diagnosis. All underwent surgical resection and in four patients postoperative adjuvant chemotherapy was needed. Nine out of 15 patients had unresectbale tumors at initial diagnosis, and preoperative chemotherapy was applied. There was one operative mortality and 14 patients showed good prognosis after surgery. Although various treatment modalities should be combined for the unresectable hepatoblastoma. surgical resection remains the major curative procedure.

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Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

  • Jung, Junho;Lim, Hae Soo;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.57-61
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    • 2018
  • Purpose: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine $A_{2A}$ receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. Materials and Methods: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. Result: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. Conclusion: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

Unruptured Intracranial Aneurysms with Oculomotor Nerve Palsy : Clinical Outcome between Surgical Clipping and Coil Embolization

  • Nam, Kyoung-Hyup;Choi, Chang-Hwa;Lee, Jae-Il;Ko, Jun-Gyeong;Lee, Tae-Hong;Lee, Sang-Weon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.109-114
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    • 2010
  • Objective : To evaluate the clinical outcome of coil embolization for unruptured intracranial aneurysm (UIA) with oculomotor nerve palsy (ONP) compared with surgical clipping. Methods : A total of 19 patients presented with ONP caused by UIAs between Jan 2004 and June 2008. Ten patients underwent coil embolization and nine patients surgical clipping. The following parameters were retrospectively analyzed to evaluate the differences in clinical outcome observed in both coil embolization and surgical clipping : 1) gender, 2) age, 3) location of the aneurysm, 4) duration of the symptom, and 5) degree of ONP. Results : Following treatment, complete symptomatic recovery or partial relief from ONP was observed in 15 patients. Seven of the ten patients were treated by coil embolization, compared to eight of the nine patients treated by surgical clipping (p = 0.582). Patient's gender, age, location of the aneurysm, size of the aneurysm, duration of symptom, and degree of the ONP did not statistically correlate with recovery of symptoms between the two groups. No significant differences were observed in mean improvement time in either group (55 days in coil embolization and 60 days in surgical clipping). Conclusion : This study indicates that no significant differences were observed in the clinical outcome between coil embolization and surgical clipping techniques in the treatment of aneurysms causing ONP. Coil embolization seems to be more feasible and safe treatment modality for the relief and recovery of oculomotor nerve palsy.

Surgical Outcomes of Kommerell Diverticulum

  • Kwon, Young Kern;Park, Sung Jun;Choo, Suk Jung;Yun, Tae Jin;Lee, Jae Won;Kim, Joon Bum
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.346-352
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    • 2020
  • Background: We aimed to assess the clinical outcomes of patients who underwent surgical repair of Kommerell diverticulum (KD) with individualized surgical methods. Methods: A retrospective analysis was performed of adult patients (aged ≥17 years) who underwent surgery to treat KD between June 2008 and October 2019. Results: Nine patients (median age, 45 years; range, 19-67 years; 7 men) underwent surgical repair. The indications for surgical therapy were acute aortic dissection in 2 patients, the presence of compressive symptoms due to dilated KD in 4 patients, and aneurysm growth in 3 patients. Various surgical techniques were used: (1) resection of the diverticulum stump and revascularization of the aberrant subclavian artery (n=3), (2) one-stage total-arch replacement including the diverticulum segment (n=3), and (3) hybrid repair (n=3). Early mortality occurred in 1 case of hybrid repair. Transient paraparesis occurred in a patient who underwent total arch repair as part of complicated acute aortic dissection. During follow-up (median duration, 30 months; range, 7-130 months), no late death or associated aortic complications were documented. All survivors were free from symptoms and had no abnormal findings on follow-up computed tomography. Conclusion: With a customized surgical approach and appropriate consideration of patient-specific anatomy and associated comorbidities, KD can be repaired with favorable outcomes.

ANALYSIS OF PROSTHODONTIC AND SURGICAL TREATMENT OF ACQUIRED PALATAL DEFECT AFTER MAXILLECTOMY (상악절제술 후 외과적 재건과 보철적 치료의 비교)

  • Kwon, Ho-Beom;Hong, Jong-Rak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.143-151
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    • 2007
  • One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (${\alpha}$=.05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

Effect of the Exchange of Saline Used in Surgical Procedures on Surgical Site Infection (수술에 사용하는 생리식염수의 교환이 수술부위감염에 미치는 효과)

  • 조옥연;윤혜상
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.467-476
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    • 2004
  • Purpose: The purpose of this study was to identify the effect of the exchange of saline used in surgical procedures on surgical site infections. Method: Patients with stomach cancer were assigned to the experimental group or to the control group by random sampling, respectively. The experimental group received an exchange of saline during the operation right after the excision of the stomach in a gastrectomy but the control group did not. Data were collected from the medical charts of 34 patients from Dec. 1, 2002 through May 31, 2003. Result: The surgical site infection rate of the experimental group was 5.9% while surgical site infection rate of the control group was 17.6%. In total, the surgical site infection rate was 11.8%. The experimental group maintained a normal level of WBC on post operative day 3; however, the control group, showed an increase of WBC on post operative day 3. Conclusion: The exchange of saline used in an operation immediately after the excision of the stomach in a gastrectomy decreases the contamination level of saline used in the operation, and can prevent surgical patients from a surgical site infection.

The effect of non-surgical treatment in gingival enlargement (치은비대에서 비외과적 치료의 효과)

  • Kim, Sang-Jun;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Periodontal and Implant Science
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    • v.39 no.1
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    • pp.103-108
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    • 2009
  • Purpose: It is well recognized that gingival enlargement is induced by unwanted effect associated with three major drugs/drug groups - phenytoin, cyclosporine, and the calcium channel blockers. The present case report describes the effect and limitation of non-surgical treatment in gingival enlargement cases. Materials and methods: Three cases included 2 drug-influenced gingival enlargement patients and a idiopathic gingival fibromatosis patient. For the drug-influenced gingival enlargement patients, the medication was replaced with other medication. And then, all the patients were treated non-surgically. Results: Drug-influenced gingival enlargements had been reduced after non-surgical treatment and the results were well-maintained. In the idiopathic gingival fibromatosis case, non-surgical treatment resulted in only limited reduction of gingival enlargement, and surgical periodontal treatment was unavoidable. Conclusion: These case reports indicated that non-surgical periodontal treatment with change in medication was effective in the treatment of drug-influenced gingival enlargements. Non-surgical approach can be considered as the primary management to reduce the gingival enlargement. If non-surgical treatment encounters a limitation, surgical treatment should be considered.

Diffuse-Type Histology Is Prognostic for All Siewert Types of Gastroesophageal Adenocarcinoma

  • Kelly M Mahuron;Kevin M Sullivan;Matthew C Hernandez;Yi-Jen Chen;Joseph Chao;Laleh G Melstrom;I. Benjamin Paz;Jae Yul Kim;Rifat Mannan;James L. Lin;Yuman Fong;Yanghee Woo
    • Journal of Gastric Cancer
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    • v.24 no.3
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    • pp.267-279
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    • 2024
  • Purpose: The optimal treatment for gastroesophageal junction adenocarcinoma (GEJA) remains controversial. We evaluated the treatment patterns and outcomes of patients with locally advanced GEJA according to the histological type. Materials and Methods: We conducted a single-institution retrospective cohort study of patients with locally advanced GEJA who underwent curative-intent surgical resection between 2010 and 2020. Perioperative therapies as well as clinicopathologic, surgical, and survival data were collected. The results of endoscopy and histopathological examinations were assessed for Siewert and Lauren classifications. Results: Among the 58 patients included in this study, 44 (76%) were clinical stage III, and all received neoadjuvant therapy (72% chemoradiation, 41% chemotherapy, 14% both chemoradiation and chemotherapy). Tumor locations were evenly distributed by Siewert Classification (33% Siewert-I, 40% Siewert-II, and 28% Siewert-III). Esophagogastrectomy (EG) was performed for 47 (81%) patients and total gastrectomy (TG) for 11 (19%) patients. All TG patients received D2 lymphadenectomy compared to 10 (21%) EG patients. Histopathological examination showed the presence of 64% intestinal-type and 36% diffuse-type histology. The frequencies of diffuse-type histology were similar among Siewert groups (37% Siewert-I, 36% Siewert-II, and 33% Siewert-III). Regardless of Siewert type and compared to intestinal-type, diffuse histology was associated with increased intraabdominal recurrence rates (P=0.03) and decreased overall survival (hazard ratio, 2.33; P=0.02). With a median follow-up of 31.2 months, 29 (50%) patients had a recurrence, and the median overall survival was 50.5 months. Conclusions: Present in equal proportions among Siewert types of esophageal and gastric cancer, a diffuse-type histology was associated with high intraabdominal recurrence rates and poor survival. Histopathological evaluation should be considered in addition to anatomic location in the determination of multimodal GEJA treatment strategies.