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Excisional Surgery (excisional + surgery)
Selected AbstractsSINOTOMY VERSUS EXCISIONAL SURGERY FOR PILONIDAL SINUSANZ JOURNAL OF SURGERY, Issue 7 2007Dietrich Doll MD, LtCOL No abstract is available for this article. [source] SACROCOCCYGEAL PILONIDAL DISEASE: SINOTOMY VERSUS EXCISIONAL SURGERY, A RETROSPECTIVE STUDYANZ JOURNAL OF SURGERY, Issue 3 2007M. Ezzedien Rabie Pilonidal disease is a disease of relatively young people, the exact aetiology of which is unknown. Treatment options vary from simple incision to complex flap procedures. Each method has its advocates and they all have a variable recurrence rate. The multiplicity of procedures testifies to the lack of an optimal treatment method. The objective of this study is to compare sinotomy, that is, simply laying the sinus open with the more popular radical surgery, where the sinus-bearing tissues are excised. Patients who were admitted to Aseer Central Hospital, Saudi Arabia with a pilonidal sinus or abscess, in the period from April 1999 to January 2005, were identified. The medical records were reviewed and data related to the patient characteristics, disease process and the procedures carried out were noted. Identified patients were contacted by phone to check recurrence of the disease and their abidance to instructions regarding regular hair removal from the area. Eighty-one patients were included in the study. The median age was 24.2 years (range 16,60 years). There were 9 women and 72 men. All procedures were carried out under general anaesthesia except sinotomy, which was carried out under general or local anaesthesia. The surgical procedure was incision and drainage of abscess in 16 cases (19.8%), excision with primary closure in 29 cases (35.8%), excision by the open method in 15 cases (18.5%), sinotomy in 14 cases (17.3%) and rhomboid flap construction in 8 cases (9.9%). The overall recurrence rate was 26.9%, and the mean hospital stay was 4.1 days. Sinotomy had a low recurrence rate (12.5%) and a short hospital stay (2.8 days). Sinotomy has the advantages of simplicity, the possibility of operating under local anaesthesia, with an acceptable recurrence rate. We recommend sinotomy for pilonidal sinus and abscess alike, both in primary and recurrent cases. [source] Is Curettage Useful Prior to Performing Mohs or Excisional Surgery?DERMATOLOGIC SURGERY, Issue 2 2000How Do You Use It? [source] Hemangiomas: Evaluation and TreatmentDERMATOLOGIC SURGERY, Issue 5 2001Scott M. Dinehart MD Background. Hemangiomas are common skin tumors of infancy that have undergone recent changes in nomenclature, methods of evaluation, and treatment. Objective. To review the nomenclature, epidemiology, evaluation, and treatment of common hemangiomas. Methods. A literature search was conducted utilizing MEDLINE and the Cochrane library databases. Text search words used were "hemangioma" and "infancy." The clinical experience of the authors was also used to formulate the review. Results. There have been many advances in nomenclature and therapeutic options for children with hemangiomas. Hemangiomas are proliferative tumors of infancy that should be distinguished from structural malformations, such as port-wine stains and lymphangiomas. Conclusion. Natural involution remains a viable treatment option for the majority of patients with uncomplicated hemangiomas. Excisional surgery, laser, and pharmacologic remedies are indicated for a subset of complicated hemangioma patients. [source] Back to Basics: The Subcutaneous Island Pedicle FlapDERMATOLOGIC SURGERY, Issue 12p2 2004Janie M. Leonhardt MD Background. Optimal aesthetic reconstruction of cutaneous defects following excisional surgery is largely dependent on the availability of regional donor tissue that shares a likeness of the original tissue in color, texture, sebaceous quality, and thickness. The island pedicle flap is a useful tool in facial reconstruction because it minimizes regional anatomic distortion and optimizes tissue match. Objective. The objective was to review four locations where the island pedicle flap is a well-suited closure tool. Methods. We review flap planning and specific modifications of the island pedicle flap at four sites of closure, reinforcing its role as an important tool in facial reconstruction. Results. Through careful planning and implementation, the island pedicle flap may be used on the nasal tip, the nasal ala, the upper cheek, and the upper lip for closures with much success. Conclusion. The island pedicle flap remains an important tool in the armamentarium for surgeons in the repair of facial defects. [source] Locoregional Cutaneous Metastases of Malignant Melanoma and their ManagementDERMATOLOGIC SURGERY, Issue 2004Ingrid H. Wolf MD The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery. In contrast, locoregional metastases of malignant melanoma (satellites, in-transit metastases) are metastases around a primary melanoma or between a primary melanoma and regional lymph nodes. They represent intralymphatic or hematogenous spread of neoplastic cells. We present a variety of available treatment options and discuss especially topical imiquimod as a novel approach for the palliative treatment of locoregional cutaneous melanoma metastases in selected patients. [source] Topical treatment of intraepithelial penile carcinoma with imiquimodCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2003G. Micali Summary Intraepithelial penile carcinoma (IPC) is an in situ carcinoma of the penis, which can be difficult to diagnose. Current treatments include excisional surgery, Mohs' micrographic surgery, cryotherapy, carbon dioxide laser therapy and topical 5-fluorouracil. We report two cases of men with 12,18 month histories of IPC (Bowen's disease, squamous cell carcinoma in situ) that were previously unsuccessfully treated with antifungals and antibiotics. Treatment with imiquimod 5% cream for 8,10 weeks was effective in both cases with no clinical evidence of relapse at 4 and 6 months. Both patients experienced adverse effects, resulting in temporary discontinuation of treatment. [source] What factors affect lymph node yield in surgery for rectal cancer?COLORECTAL DISEASE, Issue 5 2004C. C. Thorn Abstract Objective The detection of lymph node metastases is of vital importance in patients undergoing excisional surgery for rectal cancer as it provides important prognostic information and facilitates decision-making with regards to adjuvant therapy. It has been suggested that patients in whom only a small number of nodes are present in the excised specimen have a worse prognosis, presumably due to inadequate lymphadenectomy and consequent understaging of the disease. The aim of this study was to determine which factors affect the yield of lymph nodes. Methods This was a retrospective study of patients who had undergone a resection for histologically proven adenocarcinoma of the rectum. The total number of lymph nodes identified in the excised specimen was recorded in each case. A multivariate analysis was performed to ascertain whether this number was significantly influenced by any of several variables. Results A total of 167 patients were studied (M:F ratio 107 : 60, median age 70 years). The median number of lymph nodes contained within the resected specimen was 16 (interquartile range 10,21). On univariate analysis a significantly higher yield of lymph nodes was obtained with tumours in the middle third of the rectum (P = 0.007), larger tumours (P < 0.001), more locally advanced tumours according to both pT staging (P = 0.001) and Dukes' staging (P = 0.020), an increased number of involved nodes (P = 0.003) and examination by a specialist histopathologist (P = 0.003). On multivariate analysis the only significant variables were tumour size (P = 0.021), number of positive nodes (P = 0.007) and histopathologist (P = 0.021). Conclusions The number of lymph nodes identified within the excised specimen in patients undergoing resection of a rectal cancer positively correlates with the size of the tumour and is also dependent on the examining histopathologist. In addition, in node-positive patients the number of involved nodes increases with increasing lymph node yield. [source] | ||||||||||||||||||||||