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Previous Surgical Procedures (previous + surgical_procedure)

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Medical Sciences	100%

Selected Abstracts

Considerations in the revision of previous surgical procedures

ENDODONTIC TOPICS, Issue 1 2005
WILLIAM P. SAUNDERS
The microbial etiology of periradicular periodontitis requires that efforts must be made to eliminate infection from the root canal system and the periradicular tissues. Periradicular surgery is an option of endodontic re-treatment when non-surgical root canal treatment and re-treatment fails. Unfortunately, surgery is not always successful for a number of reasons including, extraradicular infection, associated marginal periodontal disease, inability to seal the root canal system from the periradicular tissues, anatomical anomalies and poor surgical technique. This paper reviews the use of re-surgery in the treatment of failed surgical cases, discussing some of the problems that may be encountered and how they may be managed. [source]

Carcinomas arising in multilocular thymic cysts of the neck: a clinicopathological study of three cases

HISTOPATHOLOGY, Issue 1 2004
C A Moran
Aims :,To report three cases of primary carcinoma of the neck arising in multilocular thymic cysts (MTC). Methods and results :,The patients were three men aged 47, 50 and 52 years who presented with a painless neck mass of several weeks' duration. The patients had no history of previous surgical procedures or of malignancy elsewhere. The tumours in all three patients were located on the right lateral side of the neck; all patients underwent complete surgical resection of the mass. Grossly, the tumours were cystic and measured between 20 and 30 mm in greatest diameter. Histologically, the tumours showed cyst walls lined by squamous epithelium. The cyst walls contained prominent germinal centres with lymphoid hyperplasia, cholesterol cleft granulomas, and scattered keratinized structures reminiscent of Hassall's corpuscles. In addition, a neoplastic cellular proliferation composed of round to oval cells arranged in sheets and originating from the lining of the cystic structures was present. The neoplastic cells showed moderate amounts of eosinophilic cytoplasm, round nuclei, and, in some areas, prominent nucleoli. Mitotic figures were easily found, and cellular pleomorphism was present in several areas. In two cases the tumours showed features of basaloid carcinoma of the thymus, while in one case the pattern was that of squamous cell carcinoma. Immunohistochemical studies for keratin showed a strong positive reaction in the tumour cells, while leucocyte common antigen strongly stained the lymphoid background. Follow-up information obtained in two patients showed them to be alive 6 months after initial diagnosis. One patient was lost to follow-up. Conclusion :,The cases described here represent an unusual variant of carcinoma arising in multilocular thymic cyst in the neck region. [source]

4234: Glaucoma considerations in OOKP

ACTA OPHTHALMOLOGICA, Issue 2010
N AL RAQQAD
Purpose To study the incidence and prognosis of glaucoma in OOKP eyes and to evaluate methods for detection and treatment of glaucoma following osteo-odonto-keratoprosthesis surgery. Methods Retrospective analysis of 49 consecutive patients treated at the national OOKP referral centre in Brighton, UK between November 1996 and September 2009. Data were collected over a 3 month period from December 2009 giving a minimum of 6 months follow up (range: 6 months to 13 years). Data collected include: age at surgery, primary diagnosis, previous surgical procedures (corneal grafts), family history of glaucoma, serial post-operative cup-disc ratios and visual fields, glaucoma procedures at any stage, and any OOKP complications. Results A total of 49 patients were included in the study with age ranging from 19 to 88 years (mean 53.5). 14 (28.5%) patients had pre-existing glaucoma, 25(51%) patients had glaucoma by the end of the study. 12(24.5%) patients developed de novo increase in intraocular pressure. Of the 49 patients, 5 underwent cyclodialysis ,4 had cyclodiode laser treatment, 4 underwent ECP, 5 had a glaucoma tube inserted and 4 had detachment and reattachment of their recti muscles (VRDR ± MRDR). All patients were treated with oral acetozolamide 250mg once daily (except one who is allergic). Sublingual timolol was used in three patients, one of experienced severe side effects and the treatment had to be stopped. Systemic betablockers were used in 3 patients. Conclusion Glaucoma is one of the major complications of osteo-odonto-keratoprosthesis. It is difficult to monitor and treat in the OOKP eye. Various treatment modalities have been used. Many patients require long term oral medications and many are not adequately controlled and should have surgical treatment the results of which are not satisfactory. VRDR might represent a safer surgical method to control glaucoma in OOKP eyes. [source]

Treatment of resistant anal fissure with advancement anoplasty

COLORECTAL DISEASE, Issue 6 2002
N. J. Kenefick
Abstract Objective The primary aim of this study was to assess the outcome of advancement anoplasty in the treatment of chronic anal fissure, resistant to conventional therapy. The secondary aim was to evaluate the anal resting pressure in these patients with resistant fissures. Patients and methods Over a five-year period eight patients (2 male, median age 55 years, range 20,74) with resistant anal fissure were referred from 6 centres. They had endured symptoms for a median of 8 years (range 2,20) and had undergone a median of 2 previous surgical procedures (range 1,3), including lateral sphincterotomy and anal dilatation. Anorectal physiological testing was performed on all patients who then underwent advancement anoplasty. The outcome was analysed retrospectively. Results Pre-operative anorectal physiological testing showed a significantly lowered median maximal anal resting pressure of 42 mm H2O (range 12,72 mm H2O, normal range > 60 mm), P = 0.03. All patients underwent advancement anoplasty. At a median of seven months follow-up (range 2,22) seven of eight patients had healed their fissure and were asymptomatic. The median healing time was four months (range 2,6). Conclusion Patients with chronic anal fissure, resistant to conventional therapy, may be successfully treated by advancement anoplasty. Healing time however, may be prolonged. In this series patients had a decreased anal resting pressure rather than anal hypertonia. [source]