Ninety-one Cases of Tumors of the Anus and Anal Canal.

Ninety-one cases of tumors of anus and anal canal, treated in the Surgical Department of the National Cancer Institute of Milan from 1930 to 1965, are discussed. The series consists of 56 females and 35 males; the age of the patients ranges from 31 to 84 years. The distribution of the cases in relation to the age of the patients shows that the highest frequency of tumors was observed in the group of patients of 61–70 years. Twenty-seven patients presented inguinal metastatic nodes; in 18 of them metastases were bilateral. Nineteen patients (20.19 %) presented advanced tumors and could not be radically treated; 33 (36.3 %) underwent radiological treatment; 37 (40.6 %) were amenable to radical surgery: of these, in 26 a perineal resection and in 10 cases an abdomino-perineal resection were performed. In 2 of the last 10 cases a pelvic lymphadenectomy was also performed; in 5 of the patients radically operated a dissection of inguinal nodes was done. A regular follow-up was possible for 29 of the 37 patients radically treated: the 5 years survival rate for the two groups, perineal and abdomino-perineal resection, was of 48 per cent and 50 per cent respectively.

Download Full-text

Biological and Histological Assessment of the Hepatoportoenterostomy Role in Biliary Atresia as a Stand-Alone Procedure or as a Bridge toward Liver Transplantation

Medicina ◽

10.3390/medicina57010016 ◽

2020 ◽

Vol 57 (1) ◽

pp. 16

Author(s):

Raluca-Cristina Apostu ◽

Vlad Fagarasan ◽

Catalin C. Ciuce ◽

Radu Drasovean ◽

Dan Gheban ◽

...

Keyword(s):

Liver Transplantation ◽

Survival Rate ◽

Biliary Atresia ◽

Smooth Muscle Actin ◽

Term Survival ◽

Surgical Department ◽

Screening Programs ◽

Age At Surgery ◽

Native Liver

Background and objectives: In patients with biliary atresia (BA), hepatoportoenterostomy (HPE) is still a valuable therapeutic tool for prolonged survival or a safer transition to liver transplantation. The main focus today is towards efficient screening programs, a faster diagnostic, and prompt treatment. However, the limited information on BA pathophysiology makes valuable any experience in disease management. This study aimed to analyze the evolution and survival of patients with BA referred for HPE (Kasai operation) in our department. Materials and Methods: A retrospective analysis was performed on fourteen patients with BA, diagnosed in the pediatric department and further referred for HPE in our surgical department between 2010 and 2016. After HPE, the need for transplantation was assessed according to patients cytomegalovirus (CMV) status, and histological and biochemical analysis. Follow-up results at 1–4 years and long term survival were assessed. Results: Mean age at surgery was 70 days. Surgery in patients younger than 60 days was correlated with survival. Jaundice’s clearance rate at three months was 36%. Total and direct bilirubin values had a significant variation between patients with liver transplants and native liver (p = 0.02). CMV was positive in eight patients, half with transplant need and half with native liver survival. Smooth muscle actin (SMA) positivity was proof of advanced fibrosis. The overall survival rate was 79%, with 75% for native liver patients and an 83% survival rate for those with liver transplantation. Transplantation was performed in six patients (43%), with a mean of 10 months between HPE and transplantation. Transplanted patients had better survival. Complications were diagnosed in 63% of patients. The mean follow-up period was six years. Conclusions: HPE, even performed in advanced cirrhosis, allows a significant survival, and ensures an essential time gain for patients requiring liver transplantation. A younger age at surgery is correlated with a better outcome, despite early CMV infection.

Download Full-text

STAGE IB2–IIIB CERVICAL CANCER: NEOADJUVANT CHEMOTHERAPY, RADICAL SURGERY AND PATIENT SURVIVAL

Siberian Journal of Oncology ◽

10.21294/1814-4861-2021-20-3-82-89 ◽

2021 ◽

Vol 20 (3) ◽

pp. 82-89

Author(s):

D. L. Ovodenko ◽

G. N. Khabas ◽

Yu. M. Kreinina ◽

A. A. Seregin ◽

O. I. Aleshikova ◽

...

Keyword(s):

Cervical Cancer ◽

Survival Rate ◽

Neoadjuvant Chemotherapy ◽

Radical Surgery ◽

Disease Free Survival ◽

Cytostatic Drugs ◽

Free Survival ◽

Long Term Treatment ◽

Disease Free

The aim of the study was to evaluate the five-year survival rate in patients with stage ib2–iiib cervical cancer treated with neoadjuvant chemotherapy and radical surgery.Material and Methods. Long-term treatment outcomes were studied in 173 patients with histologically-verified stage ib2–iiib cervical squamous cell carcinoma. The patients underwent neoadjuvant chemotherapy using intravenous infusion of cytostatic drugs (n=106) and intra-arterial infusion of cytostatic drugs in combination with embolization of tumor-feeding arteries (n=67). Patients with resectable tumors underwent radical surgery. Disease-free survival was assessed.Results. The median follow-up time was 66 months, and the maximum follow-up period was 144 months. 160 (92.5 %) patients underwent radical surgery after chemotherapy. 55 (34.4 %) patients did not receive adjuvant radiation therapy. The five-year disease-free survival rate was 79.6 %.Conclusion. For the group of patients with locally advanced cervical cancer, who achieved respectability following neoadjuvant chemotherapy, radical surgery could be performed. Chemotherapy followed by radical surgery can improve disease-free survival rates in patients with stage ib2–iiib cervical cancer.

Download Full-text

Radical Surgery for Liver Hydatid Cyst

Journal of Medical and Surgical Research ◽

10.46327/msrjg.1.000000000000011 ◽

2014 ◽

pp. 30-36

Author(s):

Hadj Omar El Malki ◽

Amine Souadka ◽

Badr Serji ◽

Amine Benkabbou ◽

Raouf Mohsine ◽

...

Keyword(s):

Hydatid Cyst ◽

Radical Surgery ◽

Postoperative Bleeding ◽

Morbidity Rate ◽

Endemic Country ◽

Recurrence Rates ◽

Surgical Department ◽

Liver Hydatid Cyst ◽

Surgical Unit

Background and aims: Surgery is the basic treatment for liver hydatid cyst (LHC). Radical procedures (pericystectomy (PK) and hepatic resection (HR)) offers better results in selected cases cases than conservative approaches. Aims of this study were to evaluate the results of Radical surgery for LHC and and to determine witch of these two procedures is safe in experienced hepato-biliary surgical unit in endemic countries. Methods: A retrospective cohort study of 143 patients with liver hydatid cyst who underwent radical procedures at a single surgical department in an endemic country were reviewed. Mortality, morbidity and recurrence rates have been analyzed. Results: Thirty-two patients (22.4%) had a HR and 111 patients (77.6%) had a PK. Mortality rate was 1.4% (n=2) in HR group. Overall morbidity rate was 18.9% and vs 28.1% respectively in PK and HR group (p=.26). Postoperative bleeding occurred in 1.8% in PK group vs 3.1% in HR group (p=.535) and specific LHC operative complication occurred in 17.1% in PK group vs 28.1% in HR group (p=.167). Recurrence rate of LHC was 6.3% in PK group vs 6.6% in HR group (p=.999) after a median follow up of 108 months (54-144) vs 89 months (44-135) respectively. Conclusion: Radical surgery for LHC is safe. Each of PK and HR had a specific indication. A good screening of patient's guarantied a good outcome. Keywords: Liver, Hydatid Cyst, Morocco, Radical Surgery.

Download Full-text

Clinicopathological and Prognostic Characteristics of Hepatoid Adenocarcinoma of the Stomach

10.21203/rs.3.rs-56055/v1 ◽

2020 ◽

Author(s):

Chenxu Liu ◽

Yanru Qin ◽

Zhiwei Chang ◽

Wenjia Wang ◽

Chen Liu ◽

...

Keyword(s):

Lymph Node ◽

Survival Rate ◽

Distant Metastasis ◽

Radical Surgery ◽

Vascular Involvement ◽

Radical Gastrectomy ◽

Hepatoid Adenocarcinoma ◽

Factors Affecting ◽

D2 Lymph Node Dissection

Abstract Objectives The aim of this study is to analyze the clinical and pathological features of HAS and investigate the factors affecting prognosis.Methods From January 2014 to May 2020, 31 patients were diagnosed as HAS in in the First Affiliated Hospital of Zhengzhou University. The clinicopathologic features and the relevant prognosis of these patients were analyzed.Results Of the 31 patients, 23 were male, with a median age of 62 years. And among the 31 patients, 22 patients underwent a radical gastrectomy and a D2 lymph node dissection. During the follow up period, 18 patients died of the disease. The median OS (mOS) was 28 months. The 1-year survival rate was 55%, the 3-year survival rate was 47%, and the 5-year survival rate was 34%. An elevated CA125 level, distant metastasis, and radical surgery were associated with the prognosis of HAS, and distant metastasis is an independent prognostic risk factor for survival. Conclusion HAS had a poor prognosis because of its frequent vascular involvement, and lymph node and liver metastasis. Aggressive multimodal treatment comprising radical gastrectomy and adjuvant chemotherapy is warranted.This article describes the Clinicopathological of Hepatoid Adenocarcinoma of the Stomach and through survival analysis, the factors affecting the patient’s prognosis were studied.

Download Full-text

Anal canal mixed adenoneuroendocrine carcinoma in a young patient misdiagnosed as anal abscess

BMJ Case Reports ◽

10.1136/bcr-2021-244737 ◽

2021 ◽

Vol 14 (9) ◽

pp. e244737

Author(s):

Roberta Tutino ◽

Enrico Battistella ◽

Luca Bonariol ◽

Marco Massani

Keyword(s):

Gastrointestinal Tract ◽

Anal Canal ◽

Young Patient ◽

Stable Disease ◽

Radical Surgery ◽

Neuroendocrine Neoplasms ◽

Anal Abscess ◽

Rare Tumours ◽

Histological Specimen

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumours of gastrointestinal tract, extremely rare in anal canal. We report a case of misdiagnosed MiNEN in a 38-year-old woman initially conservatively treated for a supposed anal fistula. In a second proctological evaluation, biopsy of the anal neoformation was performed and the histological specimen diagnosed a MiNEN. The complete staging showed a disseminate disease and the patient started a chemotherapy schedule. After 6 months, stable disease was revealed at the last imaging performed and radical surgery was offered to the patient that is actually on oncological follow-up without recurrence at 1 year.

Download Full-text

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.14 ◽

2011 ◽

pp. 114-118

Author(s):

Nhu Hiep Pham ◽

Huu Thien Ho ◽

Anh Vu Pham ◽

Van Nghia Tran

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

Central Hospital ◽

Surgical Department ◽

A New Technique ◽

Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

Download Full-text

Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04205-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jake von Hintze ◽

Mika Niemeläinen ◽

Harri Sintonen ◽

Jyrki Nieminen ◽

Antti Eskelinen

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Survival Rate ◽

Knee Arthroplasty ◽

Revision Total Knee Arthroplasty ◽

Patient Reported ◽

Total Knee ◽

Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

Download Full-text

Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121994919 ◽

2021 ◽

Vol 9 (5) ◽

pp. 232596712199491

Author(s):

Alberto Grassi ◽

Gian Andrea Lucidi ◽

Giuseppe Filardo ◽

Piero Agostinone ◽

Luca Macchiarola ◽

...

Keyword(s):

Survival Rate ◽

Case Series ◽

Final Analysis ◽

Activity Level ◽

Long Term Results ◽

Level Of Evidence ◽

Unicompartmental Knee Arthroplasties ◽

Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

Download Full-text

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

Foot & Ankle International ◽

10.1177/1071100721995427 ◽

2021 ◽

pp. 107110072199542

Author(s):

Daniel Corr ◽

Jared Raikin ◽

Joseph O’Neil ◽

Steven Raikin

Keyword(s):

Survival Rate ◽

Case Series ◽

Return To Sport ◽

Osteochondral Lesions ◽

Long Term Outcomes ◽

Level Of Evidence ◽

Additional Surgery ◽

Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

Download Full-text

Is salvage radiotherapy optimal to patients with occult cervical cancer undergoing inadvertent simple hysterectomy? A propensity score-matched analysis of a nationwide clinical oncology database

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa251 ◽

2021 ◽

Author(s):

Yanhong Wang ◽

Yi Ouyang ◽

Jingjing Su ◽

Lihua Xiao ◽

Zhigang Bai ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Propensity Score ◽

Radical Surgery ◽

Figo Stage ◽

Salvage Radiotherapy ◽

Radiotherapy Group ◽

Surgery Group ◽

Group Matching

Abstract Objective We used National Cancer Institute’s Surveillance, Epidemiology and End Result database to assess the role of salvage radiotherapy for women with unanticipated cervical cancer after simple hysterectomy. Methods Patients with non-metastatic cervical cancer and meeting inclusion criteria were divided into three groups based on treatment strategy: simple hysterectomy, salvage radiotherapy after hysterectomy and radical surgery. Parallel propensity score-matched datasets were established for salvage radiotherapy group vs. simple hysterectomy group (matching ratio 1: 1), and salvage radiotherapy group vs. radical surgery group (matching ratio 1:2). The primary endpoint was the overall survival advantage of salvage radiotherapy over simple hysterectomy or radical surgery within the propensity score-matched datasets. Results In total, 2682 patients were recruited: 647 in the simple hysterectomy group, 564 in the salvage radiotherapy group and 1471 in the radical surgery group. Age, race, histology, grade, FIGO stage, insured and marital status and chemotherapy were comprised in propensity score-matched. Matching resulted in two comparison groups with neglectable differences in most variables, except for black race, FIGO stage III and chemotherapy in first matching. In the matched analysis for salvage radiotherapy vs. simple hysterectomy, the median follow-up time was 39 versus 32 months. In the matched analysis for salvage radiotherapy vs. radical surgery, the median follow-up time was 39 and 41 months, respectively. Salvage radiotherapy (HR 0.53, P = 0.046) significantly improved overall survival compared with simple hysterectomy, while salvage radiotherapy cannot achieve similar overall survival to radical surgery (HR 1.317, P = 0.045). Conclusions This is the largest study of the effect of salvage radiotherapy on overall survival in patients with unanticipated cervical cancer. Salvage radiotherapy can improve overall survival compared with hysterectomy alone, while cannot achieve comparable survival to radical surgery.

Download Full-text