A case of successful surgical treatment of patient with adrenal cyst using 3-d modeling

2020 ◽  
Vol 28 (4) ◽  
pp. 530-535
Author(s):  
Ivan Andreev ◽  
Alexander Kolsanov ◽  
Sergey Katorkin ◽  
Evgeniy Shestakov ◽  
Leonid Lichman

Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.

2004 ◽  
Vol 51 (2) ◽  
pp. 61-68 ◽  
Author(s):  
A. Dziki ◽  
P. Galbfach

Crohn?s disease is a chronic bowel condition, which can present as a number of different clinical and pathological presentations, depending on localization and activity of the inflammatory process. The aethiology of the disease has not been explained .In each case the treatment should be individually tailored depending on the type of the changes. The indications for surgical intervention are continuous bleedings, recurrent ileus, perforation of the intestine, abscesses, fistulas, failure of pharmacological treatment, resistance to steroids and steroid dependence. In case of the mild type of the disease with few symptoms pharmacological treatment is the right choice In case of the mild type of the disease with few symptoms pharmacological treatment is the right choice process. In malign form of Crohn?s disease lack of improvement after 7-10 days of intensive treatment is generally accepted indication for surgical treatment. Fulminant form of the disease is still a clear-cut indication for immediate surgical intervention. Decision on surgical intervention is more difficult and controversial when patient presents with series of subileus recurrences subsiding after conservative treatment. Patients with stenotic form of Crohn?s disease usually require multiple operations most of which are bowel resections. Patients with stenotic form of Crohn?s disease usually require multiple operations most of which are bowel resections therapy. External and internal asymptomatic fistulas should be treated conservatively. The timing of surgical treatment is essential in Crohn?s disease however the prevention from recurrences is also fundamental. It is well proved that preventive administration of 5-ASA (especially mesalazine) and metronidazol can reduce the risk of early recurrences after surgery.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
David G. Deckey ◽  
Andrea Fernandez ◽  
Nina J. Lara ◽  
Steve Taylor ◽  
Jamal McClendon ◽  
...  

Background. Teratomas in the pediatric population are most commonly found in the sacrococcygeal region. Pediatric intraspinal teratomas, however, are an exceedingly rare central nervous system (CNS) neoplasm. The clinical presentation of these intraspinal neoplasms can vary significantly and thus can be difficult to identify in infants less than one year of age where verbal expression and motor development are still lacking. Case Description. A 7-month-old, previously healthy male presented with a thoracic scoliosis and an asymptomatic right midupper thoracic spinal prominence present since birth. MRI revealed an extensive heterogenous mass in the right epidural space from T5-T6 and the right paravertebral space, resulting in severe spinal stenosis. Outcome. Complete resection of the tumor, including a three-level neurotomy, was achieved by posterior decompression/laminectomy. The final tumor was consistent with a mature teratoma. The surgical resection was performed without any immediate complications. Conclusions. Extramedullary epidural teratomas are exceptionally rare tumors in the pediatric population. Clinical presentation can be ambiguous, particularly in an infant. MRI was useful in suggesting a teratoma as a potential diagnosis and for postoperative surveillance for recurrence. However, histopathological analysis remains the gold standard for definitive diagnosis. Surgical resection is the mainstay of treatment, especially in the setting of cord compression and progressive loss of motor function. Close follow-up is crucial to monitor for progressive spinal deformity or recurrence.


2007 ◽  
Vol 135 (7-8) ◽  
pp. 401-406
Author(s):  
Aleksandar Mikic ◽  
Biljana Obrenovic-Kircanski ◽  
Mladen Kocica ◽  
Mile Vranes ◽  
Vesna Lackovic ◽  
...  

Introduction Cardiac myxomas are the most frequent primary tumors of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavorable localization, myxomas are considered "functionally malignant" tumors. Diagnosis of cardiac myxoma necessitates surgical treatment. Objective To analyze: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumor basis solving) on early, and late outcomes. Method From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Center of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1?16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. Results In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8?3.8 cm (range: 1?1 cm to 9?8 cm) and 6?4 cm (range: 3?2 cm to 9?5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late survival rates (91.3%) were excellent; 4) there were no relapses during the follow-up period. Conclusion Localization, size and consistency had no influence on the preoperative symptomatology. Excellent survival rate with significant functional improvement, rare postoperative complications and no recurrences, justify the applied strategies of surgical approach and tumor basis solving in our series.


2016 ◽  
Vol 7 (4) ◽  
pp. 153-158
Author(s):  
Nataliia N Sadovnikova ◽  
Vlidimir A Shereshevsky ◽  
Natalia V Prisich ◽  
Vladimir V Brzesky ◽  
Dmitriy Yu Li

Objectives of publication:presentation of a rare clinical observation from our own practice.Key points:colobomatous orbital cyst with microphthalmos — rare anomaly of an embryonal development of an eyeball, it is formed owing to “filling” of an optic nerve with the intraocular liquid coming to him from a vitreous chamber through сoloboma of disk because of violation of hydrodynamics in a forward segment of an eye. Usually this anomaly is combined with microphthalmic eye, though cases of a colobomatous cyst with a normal size of an eyeball, and also with other anomalies of development of an eye (inferior uveoretinal coloboma, prepupillary membrane, corneal opacity) are described.Сlinical observation:during 2015 in our department there were two children to whom after the carried-out inspection the diagnosis of a colobomatous cysts of optic nerve has been exposed. Concerning the first child waiting tactics has been recognized expedient, at repeated surveys in 1 and 4 months of any dynamics in the ophthalmologic status it hasn’t been revealed. To the second child because of the expressed exophthalmos with lagophthalmia, with perforation threat, surgical intervention – a puncture and drainage of a cyst of an optic nerve is performed. After operation the correct situation and mobility of an eyeball were restored, xerotic changes of a cornea and conjunctiva have decreased.Conclusions:from the pathogenetic mechanism of cystous formation of an orbit, it is more logical to specify the clinical diagnosis a mention in him an optic nerve – “сolobomatous cysts of optic nerve”. Surgical treatment depends on the sizes of cyst, degree of exophthalmos and existence of complications.


1997 ◽  
Vol 5 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Gu Chun Jiu ◽  
Bao Wei Ke ◽  
Guo Bin Xun ◽  
Yuan Hong ◽  
Xiu Zhong Yi

During a 16-year period from 1980 to 1996, 101 patients with primary cardiac tumors underwent surgery at the 1st Affiliated Hospital of China Medical University, which represented 2.44% of 4142 open-heart surgical cases during this period. Most tumors were benign; 94 were myxomas, 2 were fibromas, and 1 was a hemangioma. Three myxomas were in the right atrium and 91 were in the left atrium. The 4 malignant tumors comprised 2 mesothelioma, 1 histiocytoma, and 1 right atrial malignant myxoma. All benign tumors were completely excised with 4.95% mortality. Only 1 malignant tumor was completely excised. In our experience, the long-term result of surgical treatment of benign cardiac tumors is excellent, whereas the prognosis for patients with malignant cardiac tumors is very poor. The incidence of malignant tumors was lower than in other studies.


2021 ◽  
Vol 29 (1) ◽  
pp. 67-74
Author(s):  
I.Y. Zherka ◽  
◽  
K.P. Zhiliayeva ◽  
L.V. Naumenka ◽  
Zh.V. Kaliadzich ◽  
...  

Objective. To assess the effectiveness and feasibility of using an intraoperative navigation system based on augmented reality technology in the surgical treatment of intra-orbital tumors. Methods. Two patients with intra-orbital tumors were operated on with the application of the intraoperative navigation system. The virtual volumetric model was designed on the basis of files in the Digital Imaging and Communications in Medicine (DICOM) format, taking into account the fact that the quality of reconstruction depends on the quality of the input data and the accuracy of the reconstruction system. The required structures and parameters of color rendering for inclusion in the model were selected taking into consideration a specific clinical situation. Then the model was subjected to processing and modification to facilitate visualization. The prepared and optimized model was loaded into Microsoft HoloLens2 augmented reality glasses. In the preoperative period, using the possibilities of full screen image zoom and rotation of 3D model, the planning of the surgical intervention was carried out with the participation of all members of the surgical team. Intraoperatively, a 3D skull model was superimposed on the patient along bony landmarks (lower orbital edge and nasal bones). Surgical access and surgery were performed in the projection of the visualized tumor. Results. In the first case, the surgical planningas the preoperative method of pre-visualising asurgical intervention was used by means of the possibilities of model zooming and rotating; a detailed preoperative tumor assessment was made. In the second case, the navigation system was used in the process of diagnostic orbitotomy to facilitate the access to the tumor. Conclusion. Augmented reality allows highly detail visualization of individual anatomical models. Models are interactive, adaptive to real time and manipulating does not require the special skills. The technologies are flexible and can be programmed to perform a number of tasks (diagnostics, preoperative planning and intraoperative navigation). Models might be used for surgical training of surgeons to possess the skills. What this paper adds For the first time, the possibility of a navigation system application based on augmented reality technology in the surgical treatment of intra-orbital tumors has been shown. The technique has been found to be useful both in the preoperative planning and during surgical intervention.


2017 ◽  
Vol 5 (1) ◽  
pp. 63-70
Author(s):  
Olga E. Agranovich ◽  
Igor A. Komolkin ◽  
Alyona Ju. Dimitrieva

Poland’s syndrome is a rare congenital condition classically characterized by partial or complete absence of chest muscles on one side of the body and usually webbing of the fingers of the hand on the same side. There may also be rib (aplasia or hypoplasia) and chest bone abnormalities, which may be noticeable due to less fat under the skin. Breast and nipple abnormalities may also occur, and underarm hair is sometimes sparse or abnormally placed. In most cases, the abnormalities in the chest area do not cause health problems or affect movement. Poland’s syndrome most often affects the right side of the body and occurs more frequently in males than in females. The etiology is unknown; however, interruption of the embryonic blood supply to the arteries that lie under the collarbone (subclavian arteries) is the prevailing theory. There are many methods of operative correction because of the polymorphic clinical features of this syndrome. We gathered data on the etiology, pathogenesis, and clinical presentation of Poland’s syndrome and reviewed the existing surgical treatment options.


Cardiology ◽  
2020 ◽  
pp. 1-10
Author(s):  
Jing Zhang ◽  
Li Zhang ◽  
Lin He ◽  
He Li ◽  
Yuman Li ◽  
...  

Idiopathic enlargement of the right atrium (IERA) is a rare cardiac anomaly, and only sporadic cases have been reported. Little is known about its clinical relevance, and inconsistencies in medical and surgical management remain among different settings. In this paper, we systematically reviewed the published cases of the IERA in terms of clinical presentation, diagnosis, and management. A total of 153 cases of IERA were covered. Arrhythmia, dyspnea, and palpitation were found to be the most common clinical manifestations. It tends to be associated with life-threatening complications and sudden cardiac death. Diagnosis was mostly established by using echocardiography. Presenting symptoms, abnormal ECG findings, and therapeutic modalities were significantly related to the prognosis of IERA. Symptomatic patients were significantly more likely to have poor outcomes than asymptomatic patients (<i>p</i> = 0.044), and conservative treatment was more associated with adverse outcomes compared to surgical resection (<i>p</i> = 0.016). In conclusion, IERA, although rare, tends to be associated with potential life-threatening complications and sudden cardiac death. Echocardiography is the most common diagnostic modality. Surgical resection is indicated for symptomatic patients.


Author(s):  
Moses Charles Dsouza ◽  
Vikram M. Shivappagoudar ◽  
. Spurthi ◽  
Laviena Mallela

Middle lobe syndrome refers to a clinical condition that is characterized by recurrent or chronic collapse of the middle lobe of the right lung. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role in the pathogenesis of this condition. MLS can be obstructive or non-obstructive; the management varies according to the aetiology. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection while most patients with non-obstructive aetiology respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. We present a case of MLS who was managed conservatively in our ICU but did not respond and required surgical intervention later. 


2018 ◽  
pp. 22-26
Author(s):  
N. A. Buralkina ◽  
G. A. Vlasov ◽  
A. V. Veredchenko ◽  
V. V. Chursin ◽  
A. V. Asaturova ◽  
...  

The article deals with the clinical case of a patient with giant uterine myoma. It presents the features of surgical intervention and postoperative management of the patient. In the publication, the authors discuss the issues concerning the scope of the surgery in patients with large and giant uterine myomas and prognosis of reproductive outcomes in this cohort of women.


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