排序方式： 共有11条查询结果，搜索用时 62 毫秒
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Beard Rachel E. Khan Sidrah Troisi Roberto I. Montalti Roberto Vanlander Aude Fong Yuman Kingham T. Peter Boerner Thomas Berber Eren Kahramangil Bora Buell Joseph F. Martinie John B. Vrochides Dionisios Shen Chengli Molinari Michele Geller David A. Tsung Allan 《World journal of surgery》2020,44(3):887-895
World Journal of Surgery - To assess long-term oncologic outcomes of robotic-assisted liver resection (RLR) for colorectal cancer (CRC) metastases as compared to a propensity-matched cohort of... 相似文献
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Andrew J. Swearingen Bora Kahramangil Rosebel Monteiro Vikram Krishnamurthy Judy Jin Joyce Shin Allan Siperstein Eren Berber 《Surgery》2018,163(4):807-810
Background
Primary aldosteronism causes hypertension and hypokalemia and is often surgically treatable. Diagnosis includes elevated plasma aldosterone, suppressed plasma renin activity, and elevated aldosterone renin ratio. Adrenalectomy improves hypertension and hypokalemia. Postoperative plasma aldosterone and plasma renin activity may be useful in documenting cure or failure.Method
A retrospective analysis of patients who underwent adrenalectomy for primary aldosteronism from 2010 to 2016 was performed, analyzing preoperative and postoperative plasma aldosterone, plasma renin activity, hypertension, and hypokalemia. The utility of postoperative testing was assessed. Clinical cure was defined as improved hypertension control and resolution of potassium loss. Biochemical cure was defined as aldosterone renin ratio reduction to <23.6.Results
Forty-four patients were included; 20 had plasma aldosterone and plasma renin activity checked on postoperative day 1. In the study, 40/44 (91%) were clinically cured. All clinical failures had of biochemical failure at follow-up. Postoperative day 1aldosterone renin ratio <23.6 had PPV of 95% for clinical cure. Cured patients had mean plasma aldosterone drop of 33.1?ng/dL on postoperative day 1; noncured patient experienced 3.9?ng/dL increase. A cutoff of plasma aldosterone decrease of 10?ng/dL had high positive predictive value for clinical cure.Conclusion
Changes in plasma aldosterone and plasma renin activity after adrenalectomy correlate with improved hypertension and hypokalemia. The biochemical impact of adrenalectomy manifests as early as postoperative day 1. We propose a plasma aldosterone decrease of 10?ng/dL as a criterion to predict clinical cure. 相似文献8.
Background
Although parathyroid glands have been found to exhibit autofluorescence with near-infrared fluorescence imaging, it is unknown if autofluorescence characteristics vary between hyperfunctioning and normofunctioning glands. The hypothesis was that pattern of autofluorescence exhibited by hyperfunctioning versus normofunctioning parathyroid glands would be different.Methods
This is an Institutional Review Board–approved, prospective clinical study. Patients underwent bilateral neck exploration for primary hyperparathyroidism, during which autofluorescence from each gland was assessed with near-infrared fluorescence imaging. Pattern and intensity of autofluorescence between hyperfunctioning and normofunctioning parathyroid glands were compared.Results
Overall, 199 parathyroid glands were identified in 50 patients (single gland disease, n?=?31; multigland disease, n?=?19). Autofluorescence was detected from 96% (n?=?192) of parathyroid glands, all of which exhibited a higher intensity autofluorescence than the background tissues. Parathyroid gland location was revealed by near-infrared fluorescence imaging before dissection in 26% (n?=?52). A total of 77 glands that were large or firm were excised and 122 were preserved because of normal appearance. Hyperfunctioning parathyroid glands had a lower mean normalized autofluorescence intensity than normofunctioning parathyroid glands (1.8, and 2.6, respectively, P < .001). Moreover, hyperfunctioning parathyroid glands more often exhibited a heterogeneous pattern of autofluorescence (75% and 5%, respectively, P < .001). On multivariate analysis, only parathyroid gland hyperfunction correlated with normalized autofluorescence intensity. On receiver operative characteristic curve, optimal cutoff of normalized autofluorescence intensity to differentiate hyperfunctioning from normofunctioning parathyroid glands was 2.0.Conclusion
Our results indicate that hyperfunctioning and normofunctioning parathyroid glands exhibit different patterns of autofluorescence in hyperparathyroidism. Given these findings, autofluorescence pattern could be implemented as another adjunctive parameter for gland assessment during parathyroid exploration. 相似文献9.
Background
Microwave thermosphere ablation is a new treatment modality that creates spherical ablation zones using a single antenna. This study aims to analyze local recurrence associated with this new treatment modality in patients with malignant liver tumors.Methods
This is a prospective clinical study of patients who underwent microwave thermosphere ablation of malignant liver tumors between September 2014 and March 2017. Clinical, operative, and oncologic parameters were analyzed using Kaplan-Meier survival and Cox proportional hazards model.Results
One hundred patients underwent 301 ablations. Ablations were performed laparoscopically in 87 and open in 13 patients. Pathology included neuroendocrine liver metastasis (n = 115), colorectal liver metastasis (n = 100), hepatocellular cancer (n = 21), and other tumor types (n = 65). Ninety-day morbidity was 7% with one not procedure-related mortality. Median follow-up was 16 months with 65% of patients completing at least 12 months of follow-up. The rate of local tumor recurrence rate per lesion was 6.6% (20/301). Local tumor, new hepatic, and extrahepatic recurrences were detected in 15%, 40%, and 40% of patients, respectively. Local recurrence rate per pathology was 12% for both colorectal liver metastasis (12/100) and other metastatic tumors (8/65). No local recurrence was observed to date in the neuroendocrine liver metastasis and in the limited number of patients with hepatocellular cancers. Tumor size >3?cm and tumor type were independent predictors of local recurrence.Conclusion
This is the first study to analyze local recurrence after microwave thermosphere ablation of malignant liver tumors. Short-term local tumor control rate compares favorably with that reported for radiofrequency and other microwave technologies in the literature. 相似文献10.
Bora Kahramangil Fernando Dip Fares Benmiloud Jorge Falco Martin de La Fuente Silvina Verna Raul Rosenthal Eren Berber 《Annals of surgical oncology》2018,25(4):957-962