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Pesquisa : E01.370.388.250.630 [Categoria DeCS]
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  1 / 1904 MEDLINE  
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PMID:28470359
Autor:Topuz MF; Sari M; Binnetoglu A; Dogrul R; Bugdayci O; Seker A
Endereço:Department of Otorhinolaryngology, Dumlupinar University School of Medicine, Istiklal Parish Okmeydani st. No: 10 Merkez, Kütahya, Turkey. drfatihtopuz@yahoo.com.
Título:Is endoscopic endonasal transsphenoidal surgery increases the susceptibility to rhinosinusitis.
Fonte:Eur Arch Otorhinolaryngol; 274(8):3065-3069, 2017 Aug.
ISSN:1434-4726
País de publicação:Germany
Idioma:eng
Resumo:The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis. It was a retrospective clinical study. Forty-five cases, between 2013 and 2015, planned for endoscopic endonasal transsphenoidal surgery due to hypophyseal pathology at the Neurosurgery Departments of Marmara University Hospital were evaluated retrospectively. The patients were evaluated for the changes in the anatomy of the middle concha and the effects of these changes to paranasal sinuses by paranasal computed tomographies were studied at the preoperative second week and postoperative 12 month. The Lund-Mackay scoring system was used for the evaluation of opacification in the five major paranasal sinuses and occlusion of the osteomeatal complex in the pre- and postoperative period. The Lund-Mackay scoring system was used to analyze the paranasal computed tomography of the patients at the preoperative 2 weeks and postoperative first year. According to the Lund-Mackay scoring system, no significant difference was detected between the preoperative and postoperative opacification of paranasal sinuses (p > 0.05). Besides, there was also no significant difference between the preoperative and postoperative osteomeatal complex occlusion (p > 0.05). Considering the distance between middle concha and lamina papyracea following the out-fracture of the middle concha, a significant lateralization of 0.5 mm between the preoperative and postoperative period was observed (p < 0.05). In addition, a significant change was also detected in the volume of middle concha (p < 0.05). The volume of the area between the middle concha and lamina papyracea was decreased with a statistical significance (p < 0.05). The endoscopic endonasal transsphenoidal surgery causes some variations in the structures of the middle concha, paranasal sinuses, and OMC, but these changes do not lead to significant rhinologic pathologies.
Tipo de publicação: JOURNAL ARTICLE


  2 / 1904 MEDLINE  
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PMID:29384918
Autor:Ye Y; Wang F; Zhou T; Luo Y
Endereço:Department of Neurosurgery, The 3rd Affiliated Hospital of Guangxi Traditional Chinese Medical University, Liuzhou, Guangxi Autonomous Region.
Título:Low complication rate of sellar reconstruction by artificial dura mater during endoscopic endonasal transsphenoidal surgery.
Fonte:Medicine (Baltimore); 96(52):e9422, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site. All patients were followed up for 3 months by telephone and outpatient visits.One thousand seventy three (83.7%) patients underwent sellar reconstruction using artificial dura matter patched outside the sellar region (method A), 106 (8.3%) using artificial dura matter patched inside the sellar region (method B), and 102 (8.0%) using artificial dura matter and a mucosal flap (method C). Method A was used for grade 0-1 leakage, method B for grade 1 to 2 leakage, and method C for grade 2 to 3 leakage. During the 3-month follow-up, postoperative CSF leakage was observed in 7 patients (0.6%): 2 among patients who underwent method B (1.9%) and 5 among those who underwent method C (4.9%). Meningitis was diagnosed in 13 patients (1.0%): 2 among patients who underwent method A (0.2%), 4 among those who underwent method B (3.8%), and 7 among those who underwent method C (6.7%).Compared with other reconstruction methods, sellar reconstruction surgery that only use artificial dura mater as repair material had a low rate of complications.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY


  3 / 1904 MEDLINE  
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PMID:28457065
Autor:Duek I; Bishara T; Gil Z; Cohen JT
Endereço:Head and Neck Center, Department of Otolaryngology Head and Neck Surgery.
Título:Transoral Robotic Appraoch for Resection of a Giant Hypopharyngeal Fibroma.
Fonte:Isr Med Assoc J; 19(2):121-122, 2017 Feb.
ISSN:1565-1088
País de publicação:Israel
Idioma:eng
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  4 / 1904 MEDLINE  
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PMID:28871844
Autor:Anschuetz L; Bonali M; Guarino P; Fabbri FB; Alicandri-Ciufelli M; Villari D; Caversaccio M; Presutti L
Endereço:1 Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
Título:Management of Bleeding in Exclusive Endoscopic Ear Surgery: Pilot Clinical Experience.
Fonte:Otolaryngol Head Neck Surg; 157(4):700-706, 2017 Oct.
ISSN:1097-6817
País de publicação:England
Idioma:eng
Resumo:Objective Transcanal exclusive endoscopic ear surgery requires the management of the endoscope and the surgical instruments in the external auditory canal. Bleeding in this narrow space is one of the most challenging issues, especially for novice endoscopic ear surgeons. We aim to assess the severity and occurrence of bleeding and describe strategies to control the bleeding during endoscopic ear surgery. We hypothesize that bleeding is reasonably controllable in endoscopic ear surgery. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods We retrospectively assessed 104 consecutive cases of exclusive endoscopic ear surgery at the University Hospital of Modena, Italy. The surgical videos and the patient charts were carefully investigated and analyzed. Results Hemostatic agents included injection of diluted epinephrine (1:200,000, 2% mepivacaine), cottonoids soaked with epinephrine (1:1000), mono- or bipolar cautery, washing with hydrogen peroxide, and self-suctioning instruments. The localization of bleeding in the external auditory canal was most frequently the posterior superior part, and inside of the middle ear, it was the pathology itself. Statistical analysis revealed significant differences comparing the mean arterial pressure and the type of intervention among bleeding scores. Conclusion The management of bleeding in endoscopic ear surgery is feasible through widely available hemostatic agents in reasonable frequency. This study gives an instructive overview on how to manage the bleeding in the exclusive endoscopic technique. Even the highest bleeding scores could be managed in an exclusively endoscopic technique.
Tipo de publicação: JOURNAL ARTICLE


  5 / 1904 MEDLINE  
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PMID:28847412
Autor:Routman DM; Funk RK; Tangsriwong K; Lin A; Keeney MG; García JJ; Zarka MA; Lewis JT; Stoddard DG; Moore EJ; Day CN; Zhai Q; Price KA; Lukens JN; Swisher-McClure S; Weinstein GS; O'Malley BW; Foote RL; Ma DJ
Endereço:Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota. Electronic address: routman.david@mayo.edu.
Título:Relapse Rates With Surgery Alone in Human Papillomavirus-Related Intermediate- and High-Risk Group Oropharynx Squamous Cell Cancer: A Multi-Institutional Review.
Fonte:Int J Radiat Oncol Biol Phys; 99(4):938-946, 2017 Nov 15.
ISSN:1879-355X
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: To evaluate whether historic risk categories and indications for adjuvant therapy in the pre-human papillomavirus (HPV) and pre-transoral surgery (TOS) era were associated with clinically significant relapse rates in HPV+ oropharyngeal squamous cell cancer patients undergoing TOS. METHODS AND MATERIALS: A multi-institutional retrospective review of intermediate- and high-risk HPV+ oropharyngeal squamous cell cancer patients not receiving adjuvant therapy after TOS was performed. Perineural invasion, lymphovascular invasion, T3-T4, or ≥N2 disease were considered to be intermediate-risk factors, and extracapsular extension or positive margins were considered to be high-risk features, according to established risk categories. RESULTS: Median follow-up was 42.9 months. Among all 53 patients, the 3-year cumulative incidence of relapse was 26.0%. The 3-year cumulative incidence was 11.8% in the 37 intermediate-risk patients and 52.4% in the 16 high-risk patients. On univariate analysis only high-risk status was significantly associated with an increased risk of relapse (hazard ratio 3.9; P=.018). The salvage rate for relapse was 77%, with 10 of 13 patients undergoing salvage therapy. CONCLUSIONS: Risk category was associated with clinically significant relapse rates after TOS alone in HPV+ oropharyngeal cancer, comparable to historical data and traditional indications for adjuvant therapy for all oropharyngeal cancer.
Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY


  6 / 1904 MEDLINE  
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PMID:28655074
Autor:Li GX; Li JM; Wang YN; Deng HJ; Mou TY
Endereço:Department of General Surgery, Nanfang Hospital Southern Medical University, Guangzhou 510515, China.
Título:[Single and reduced port laparoscopic surgery for colorectal cancer: current status and future perspectives].
Fonte:Zhonghua Wai Ke Za Zhi; 55(7):486-490, 2017 Jul 01.
ISSN:0529-5815
País de publicação:China
Idioma:chi
Resumo:For further maximizing the minimally invasive benefits for colorectal cancer patients, laparoscopic surgeons have been dedicating to improve the surgery through single-port (SILES) or natural orifice transluminal endoscopic surgery (NOTES), which is supported by amount of single-port devices and flexible laparoscopic instruments.Many small sample studies of single institution have suggested that SILES for colorectal cancer has similar oncological outcomes with conventional laparoscopic surgery (CLS), could improve the cosmetic results, and is more minimally invasive than CLS. However, evidences of advantages for SILES are limited, because of there has been only 4 published studies of prospective randomized clinical trial so far. Due to the technical difficulties and long learning curves, SILES and NOTES are relatively hard to be widely promoted. Thus, a balance between minimally invasive pursuit and laparoscopic technical challenge should be sought. In this way, modified SILES and reduced-port laparoscopic surgery have emerged in recent years, which might be minimally invasive solutions with lower technical demanding for laparoscopic colorectal cancer surgeries. Adding a port as the surgeon's dominant operation channel improved the collisions or overlapping of instruments with movement to reduce the technical difficulties. SILS+ 1 is safe and feasible, would be supported by more and more evidences.
Tipo de publicação: JOURNAL ARTICLE


  7 / 1904 MEDLINE  
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PMID:28655073
Autor:Ji JF; Wu AW
Endereço:Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Beijing Institute for Cancer Research, Key Laboratory of Carcinogenesis and Tanslational Research (Ministry of Education), Beijing 100142, China.
Título:[Thought of the present application situation and the future trends of minimally invasive surgery in colorectal cancer].
Fonte:Zhonghua Wai Ke Za Zhi; 55(7):481-485, 2017 Jul 01.
ISSN:0529-5815
País de publicação:China
Idioma:chi
Resumo:Laparoscopic surgery has been increasingly used in rectal cancer surgery. Though there are still some controversies, most of the research results support that the outcome is similar for rectal cancer patients with either laparoscopic or open surgery, in term of short-term such as safety and efficacy and long-term such as oncologic outcome. Standardization of laparoscopic training together with the comprehensive management concept are the prerequisites of laparoscopic rectal cancer surgery. Those doctors who do minimally invasive surgery should follow the rationale that smaller incision and sphincter preservation are secondary to safety and oncological result of the patients. It is the comprehensive management and personalized treatment that bring opportunities for the continuous development and innovation of innovative technologies and concepts, for example, non-operative treatment, endoscopic therapy, natural orifice transluminal endoscopic surgery, single incision laparoscopic surgery, and robotic surgery. And they may finally lead to better outcome and quality of life for the patients.
Tipo de publicação: JOURNAL ARTICLE


  8 / 1904 MEDLINE  
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PMID:28608958
Autor:Steinemann DC; Müller PC; Probst P; Schwarz AC; Büchler MW; Müller-Stich BP; Linke GR
Endereço:Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Título:Meta-analysis of hybrid natural-orifice transluminal endoscopic surgery versus laparoscopic surgery.
Fonte:Br J Surg; 104(8):977-989, 2017 Jul.
ISSN:1365-2168
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Hybrid natural-orifice transluminal endoscopic surgery (NOTES), combining access through a natural orifice with small-sized abdominal trocars, aims to reduce pain and enhance recovery. The objective of this systematic review and meta-analysis was to compare pain and morbidity in hybrid NOTES and standard laparoscopy. METHODS: A systematic literature search was performed to identify RCTs and non-RCTs comparing hybrid NOTES and standard laparoscopy. The main outcome was pain on postoperative day (POD) 1. Secondary outcomes were pain during the further postsurgical course, rescue analgesia, complications, and satisfaction with the cosmetic result. The results of meta-analysis in a random-effects model were presented as odds ratio (ORs) or standard mean differences (MDs) with 95 per cent confidence intervals. RESULTS: Six RCTs and 21 non-randomized trials including 2186 patients were identified. In hybrid NOTES the score on the numerical pain scale was lower on POD 1 (-0·75, 95 per cent c.i. -1·09 to -0·42; P = 0·001) and on POD 2-4 (-0·58, -0·91 to -0·26; P < 0·001) than that for standard laparoscopy. The need for rescue analgesia was reduced in hybrid NOTES (OR 0·36, 0·24 to 0·54; P < 0·001). The reduction in complications found for hybrid NOTES compared with standard laparoscopy (OR 0·52, 0·38 to 0·71; P < 0·001) was not significant when only RCTs were considered (OR 0·83, 0·43 to 1·60; P = 0·570). The score for cosmetic satisfaction was higher after NOTES (MD 1·14, 0·57 to 1·71; P < 0·001). CONCLUSION: Hybrid NOTES reduces postoperative pain and is associated with greater cosmetic satisfaction in selected patients.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
Nome de substância:0 (Analgesics, Opioid)


  9 / 1904 MEDLINE  
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PMID:28608764
Autor:Ayoub N; Thamboo A; Hwang PH; Walgama ES
Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Título:Radioanatomic Study of the Greater Palatine Canal Relevant to Endoscopic Endonasal Surgical Landmarks.
Fonte:Otolaryngol Head Neck Surg; 157(4):731-736, 2017 Oct.
ISSN:1097-6817
País de publicação:England
Idioma:eng
Resumo:Objective A radioanatomic study of surgically relevant variations in the greater palatine canal (GPC) on computed tomography (CT) was performed to determine susceptibility during endoscopic endonasal procedures. Study Design Blinded radioanatomic analysis. Setting Tertiary university hospital. Subjects and Methods Fifty consecutive paranasal CT scans (100 sides) were analyzed. Measurements were standardized to landmarks such as the inferior turbinate (IT) and floor of the nasal cavity (FNC) to assess variability and vulnerability of the nerve. Measurements included (1) incidence of maxillary sinus pneumatization posterior to the GPC, (2) distance from the posterior wall of the maxillary sinus to the GPC at the IT and FNC, (3) width of bone containing the GPC, (4) incidence of medial GPC dehiscence, and (5) angle of the GPC extending from the IT to FNC. Results Ninety-one percent of maxillary sinuses were pneumatized posterior to the GPC. The distance from the posterior wall of the maxillary sinus to the GPC was 2.8 ± 1.7 mm (range, -2.3 to 5.9) at the posterior attachment of the IT and 4.1 ± 3.1 mm (range, -6.3 to 11.9) at the FNC. The width of bone containing the GPC was 3.3 ± 1.3 mm (range, 1-8.9), and the medial bony GPC was dehiscent in 38% of cases. In the sagittal plane, the angle of the GPC between the IT and the FNC was 31.9 ± 6.9 degrees (range, 10.8-45). Conclusion The GPC has considerable anatomic variability relative to important surgical landmarks in endoscopic procedures. Preoperative review of CTs to assess vulnerability may prevent postoperative complications.
Tipo de publicação: JOURNAL ARTICLE


  10 / 1904 MEDLINE  
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PMID:28597806
Autor:Suzuki M; Nakamura Y; Ozaki S; Yokota M; Murakami S
Endereço:Department of Otorhinolaryngology,Graduate School of Medical Sciences,Nagoya City University,Japan.
Título:Sinonasal organised haematoma: clinical features and successful application of modified transnasal endoscopic medial maxillectomy.
Fonte:J Laryngol Otol; 131(8):696-701, 2017 Aug.
ISSN:1748-5460
País de publicação:England
Idioma:eng
Resumo:OBJECTIVE: Although organised haematoma often induces bone thinning and destruction similar to malignant diseases, the aetiology of organised haematoma and the optimal treatment remain unclear. This paper presents the clinical features of individuals with organised haematoma, and describes cases in which a novel modified approach was successfully applied for resection of organised haematoma in the maxillary sinus. METHOD: Pre-operative examination data were evaluated retrospectively. Modified transnasal endoscopic medial maxillectomy was employed. RESULTS: Fourteen patients with organised haematoma were treated. Contrast-enhanced computed tomography showed heterogeneous enhancement in all patients. Eight patients underwent modified transnasal endoscopic medial maxillectomy, without complications such as facial numbness, tooth numbness, facial tingling, lacrimation and eye discharge. Dissection of the apertura piriformis and anterior maxillary wall was not necessary for any of these eight patients. No recurrence was observed. CONCLUSION: Pre-operative examinations can be helpful in determining the likelihood of organised haematoma. Modified transnasal endoscopic medial maxillectomy appears to be a safe and effective method for organised haematoma resection.
Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE



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