excision surgery

  • 文章类型: Journal Article
    膀胱子宫内膜异位症占尿路子宫内膜异位症病例的70-85%。约1%的子宫内膜异位症患者发生尿路子宫内膜异位症。潜在的病因和发病机制尚未完全了解,但是有几个合理的理论。除了典型的疼痛症状,患有膀胱子宫内膜异位症的人可能会出现几种泌尿道症状。这些症状的表现可以具有复杂的途径和过程。影像学检查诊断膀胱子宫内膜异位症是准确的,临床医生应注意无症状肾脏丢失的风险。管理应以症状为指导;药物和手术选择都是可行的。手术管理提供了潜在的确定性治疗。通过膀胱刮除或膀胱部分切除术进行的切除术可以很好地改善症状,严重并发症和复发率相对较低。
    Bladder endometriosis accounts for 70-85% of urinary tract endometriosis cases. Urinary tract endometriosis occurs in approximately 1% of those living with endometriosis. Underlying aetiology and pathogenesis are not fully understood, but there are several plausible theories. As well as the typical pain symptoms, those with bladder endometriosis can experience several urinary tract symptoms. The manifestation of these symptoms can have complex pathways and processes. Imaging is accurate in the diagnosis of bladder endometriosis and clinicians should be mindful of the risk of silent kidney loss. Management should be guided by symptoms; both medical and surgical options are feasible. Surgical management offers potentially definitive treatment. Excisional surgery via bladder shave or partial cystectomy offers good improvement in symptoms with relatively low rates of serious complications and recurrence.
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  • 文章类型: Case Reports
    足病医生和骨科医生应警惕长期发展,足部有血管放射学特征的高发性软肿块,提示早期发现血管球瘤,及时清除质量,提供疼痛缓解和改善患者的生活质量。
    血管球瘤是指一组罕见的良性血管周围肿瘤,起源于称为血管球球体的神经肌动脉结构。这些肿瘤的特点是疼痛的性质和主要分布在四肢,主要是手指,手和脚。尽管如此,诊断通常是经过几年的症状经验,因为病变大多很小,不明显,并具有可变的演示文稿。放射学检查尤其是磁共振成像对诊断肿瘤过程非常有用,然而,确认只能通过组织学分析获得。治疗是纯手术,在大多数情况下都是成功的。在这里,我们描述了一个中年男性患者的足背侧血管球瘤。
    UNASSIGNED: Podiatrists and orthopedists should be vigilant for chronically evolving, hyperalgic soft lumps in the foot with vascular radiological features, prompting early detection of glomus tumor, timely mass removal, providing pain relief and improving patient\'s quality of life.
    UNASSIGNED: Glomus tumors refers to a rare group of benign perivascular neoplasms that originate from a neuromyoarterial structure called a glomus body. These tumors are characterized by their painful nature and predominant distribution in the extremities mainly the fingers, the hands and the feet. Nonetheless, the diagnosis is usually made after several years of symptoms experience as the lesions are mostly small, not palpable, and have variable presentations. Radiological workup especially with magnetic resonance imaging is very useful for diagnosing the tumoral process, however, confirmation can only be obtained by histological analysis. The treatment is purely surgical, and it is successful in most cases. Herein, we describe a case of glomus tumor of the foot dorsal side among a middle age male patient.
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  • 文章类型: Case Reports
    大多数牙源性肿瘤是骨内生长。外周牙源性纤维瘤表现为牙龈上生长缓慢且坚硬的肿胀。它在下颌骨上比在上颌区域更常见。它可以在上颚或舌部以及下颚的唇或颊表面上找到。它通常不会溃疡。最常见的类型是外周牙源性纤维瘤,是牙周软组织的良性牙源性肿瘤。在这个案例报告中,一名53岁的男性外周牙源性纤维瘤患者接受激光治疗.
    Most odontogenic tumors are intraosseous growths. A peripheral odontogenic fibroma presents as a slow-growing and firm swelling on the gingiva. It develops more commonly on the mandibular than the maxillary region. It can be found on either the palatal or lingual and on the labial or buccal surface of the jaw. It usually does not ulcerate. The most common type is a peripheral odontogenic fibroma, which is a benign odontogenic neoplasm of the periodontal soft tissues. In this case report, a 53-year-old male patient with peripheral odontogenic fibroma was treated using a laser.
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  • 文章类型: Journal Article
    介绍在芯针活检(CNB)诊断的导管内乳头状瘤(IDP)的管理仍然存在争议。我们报告了我们在CNB上确定的国内流离失所者的经验,我们的机构升级为非典型性/恶性肿瘤的比率以及放射学/病理学特征,这可能允许选择手术以及安全观察.方法该研究是对2012年至2019年在巴基斯坦一家三级保健医院的患者记录的回顾性回顾。使用社会科学统计软件包(SPSS)分析数据,版本21.0(IBMCorp.,Armonk,NY).使用Pearson卡方检验评估各种患者因素之间的关联。结果本研究共纳入55例女性国内流离失所者,平均年龄54.67±15.57岁。在CNB上,69.1%(n=38)的患者有不典型的IDP,而30.9%(n=17)的患者有不典型的IDP,单个国内流离失所者是切除活检中最常见的病变。总的来说,在所有被CNB诊断的国内流离失所者中,只有4/55(7.3%)显示升级(3/4为DCIS,1/4显示不典型)切除活检,所有这些升级病例在最初的CNB上都没有表现出非典型性。结论CNB鉴定的IDP病例很少在切除后升级,因此所有病例的常规切除可能是不必要的。应根据放射学-病理学结果进行适当的患者选择。必须切除在影像学上有可疑发现的人以及在CNB上显示异型的人。
    Introduction Management of intraductal papillomas (IDPs) diagnosed on core needle biopsy (CNB) remains controversial. We report our experience of IDPs identified on CNB, our institutional rates of upgradation to atypia/malignancy as well as radiologic/pathologic features that may allow selection for surgery as well as those for safe observation. Methods The study is a retrospective review of patient records from 2012 to 2019, at a tertiary care hospital in Pakistan. Data was analyzed using Statistical Package for Social Sciences (SPSS), version 21.0 (IBM Corp., Armonk, NY). Associations between various patient factors were assessed using Pearson\'s chi-square test. Results This study included a total of 55 female patients with IDPs, with a mean age of 54.67 ± 15.57 years. On CNB, 69.1% (n = 38) of patients had IDP without atypia while 30.9% (n = 17) had IDP with atypia, with single IDPs being the most common lesions on excisional biopsy. Overall, of all CNB-diagnosed IDPs, only 4/55 (7.3%) demonstrated upgradation (3/4 to DCIS, 1/4 showed atypia) on excisional biopsy, and all these upgraded cases had failed to demonstrate atypia on initial CNB. Conclusion CNB-identified cases of IDPs are rarely upgraded on excision and thus routine excision in all cases may be unnecessary. Appropriate patient selection based on radiology-pathology findings should be done. Those with suspicious findings on imaging as well as those that demonstrate atypia on CNB must be excised.
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  • 文章类型: Case Reports
    肠系膜囊肿,通常是良性和无症状的,是腹部检查期间偶然发现的非特异性症状。它们通常起源于小肠的肠系膜,mesocolon,或者腹膜后.本文报道了一例罕见的22岁男性,肠系膜囊肿表现为右下腹部肿块。超声检查显示不均匀的集合,导致手术切除。组织病理学意外发现起源于肠系膜的性腺外卵黄囊瘤(YST),一种罕见的常被误诊为囊肿。YST,主要存在于性腺中,很少在性腺外报告。这项研究有助于原发性腹膜YST的有限文献,讨论临床病理参数并介绍详细病例。性腺外生殖细胞肿瘤的发病机制,包括YST,仍在辩论,胚胎发育过程中生殖细胞的迁移和停滞是一种普遍的理论。性腺外YST的组织病理学检查反映性腺YST,具有各种图案。免疫组织化学,对诊断至关重要,显示SALL-4,磷脂酰肌醇蛋白聚糖-3,PLAP,法新社,还有PANCK.SALL-4是性腺外YST最敏感的标记。该病例强调了准确的术后组织病理学和免疫组织化学在区分肠系膜YST和囊肿中的重要性。误诊会影响预后。性腺外YST的罕见性强调了在临床实践中需要全面理解和认识。这项研究为诊断和管理提供了宝贵的见解,揭示了外科病理学的挑战性方面。
    Mesenteric cysts, typically benign and asymptomatic, are incidental findings during abdominal investigations for nonspecific symptoms. Their origin is commonly in the mesentery of the small bowel, mesocolon, or retroperitoneum. This paper reports a rare case of a 22-year-old male with a mesenteric cyst presenting as a right lower abdominal mass. Ultrasonography revealed a heterogenous collection, leading to surgical excision. Histopathology unexpectedly revealed an extragonadal yolk sac tumor (YST) originating in the mesentery, a rarity often misdiagnosed as a cyst. YST, primarily found in gonads, is infrequently reported extragonadally. This study contributes to the limited literature on primary peritoneal YST, discussing clinicopathological parameters and presenting a detailed case. The pathogenesis of extragonadal germ cell tumors, including YST, remains debated, with migration and stagnation of germ cells during embryonic development proposed as a prevalent theory. Histopathological examination of extragonadal YST mirrors gonadal YST, featuring various patterns. Immunohistochemistry, crucial for diagnosis, reveals positive expression for SALL-4, glypican-3, PLAP, AFP, and panCK. SALL-4 emerges as the most sensitive marker for extragonadal YST. This case underscores the importance of accurate postoperative histopathology and immunohistochemistry in distinguishing mesenteric YST from cysts, as misdiagnosis can impact prognosis. The rarity of extragonadal YST emphasizes the need for comprehensive understanding and recognition in clinical practice. The study contributes valuable insights into diagnosis and management, shedding light on a challenging aspect of surgical pathology.
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  • 文章类型: Journal Article
    放置膨体聚四氟乙烯(ePTFE,商品名Gore-Tex®)用于子宫内膜瘤≥3cm的膀胱切除术和子宫内膜异位症切除术后的粘连预防。
    在一家三级护理中心进行了一项前瞻性队列研究。56名妇女符合这项研究的资格,并接受了手术。在受影响的卵巢周围扩展的聚四氟乙烯放置是自我选择的。纳入分析标准为病理证实的子宫内膜瘤≥3cm,手术时没有子宫切除术,术后调查完成≥1年,缺乏避免怀孕的策略。ePTFE组18名妇女和对照组11名妇女符合纳入标准进行分析。ePTFE组18名妇女中的16名和对照组11名妇女中的7名受到不孕症的影响。绝对妊娠率和累积4年妊娠率,这是基于生存分析,使用生命线和调整不同的随访时间,是为所有女性以及仅为不孕症女性计算的。
    与没有聚四氟乙烯的女性相比,使用膨化聚四氟乙烯的女性的4年累积妊娠率高(85%与65%,p=0.69)。与无聚四氟乙烯的女性相比,使用膨化聚四氟乙烯的女性在手术前不孕女性的4年累积妊娠率高(83%vs.33%,p=0.89)。
    有一致的趋势,虽然没有统计学意义,与没有ePTFE的女性相比,使用ePTFE的女性的怀孕率,特别是在使用ePTFE之前有不孕史的人。这是首次研究子宫内膜异位症手术期间针对附件的粘连预防策略如何影响妊娠率。使用膨化聚四氟乙烯的妊娠率上升的趋势,特别是有不孕史的患者,很有希望,值得与更大的团体进一步研究。
    UNASSIGNED: Pregnancy rates after the placement of expanded polytetrafluoroethylene (ePTFE, trade name Gore-Tex®) for adhesion prevention following cystectomy of endometriomas ≥3 cm and excision of endometriosis were analyzed in this pilot study.
    UNASSIGNED: A prospective cohort study was performed at a single tertiary care center. 56 women qualified for the study and underwent surgery. Expanded polytetrafluoroethylene placement around affected ovaries was self-selected. Inclusion criteria for analysis were pathology-confirmed endometrioma ≥3 cm, no hysterectomy at time of surgery, ≥1 year of postoperative survey completion, and absence of strategies to avoid pregnancy. 18 women in the ePTFE group and 11 women in the control group met inclusion criteria for analysis. 16 of the 18 women in the ePTFE group and 7 of the 11 women in the control group were affected by infertility. Absolute pregnancy rates and cumulative 4-year pregnancy rates, which are based on survival analysis using lifetables and adjust for varying follow-up times, were calculated for all women as well as for women with infertility only.
    UNASSIGNED: High cumulative 4-year pregnancy rates were observed for women with expanded polytetrafluoroethylene compared to women without (85% vs. 65%, p = 0.69). High cumulative 4-year pregnancy rates for women with infertility prior to surgery were observed for women with expanded polytetrafluoroethylene compared to women without (83% vs. 33%, p = 0.89).
    UNASSIGNED: There are consistent trends, although not statistically significant, seen in pregnancy rates for women with ePTFE compared to women without, particularly in those with a history of infertility prior to ePTFE use. This is the first study examining how adhesion prevention strategy targeting the adnexa during surgery for endometriosis affects pregnancy rates. The trend towards increased pregnancy rates with expanded polytetrafluoroethylene use, particularly in patients with a history of infertility, is promising and warrants further study with larger groups.
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  • 文章类型: Case Reports
    皮肤角是一种罕见的,过度角化,突出的病变,可以发现大多在阳光照射的皮肤区域。病变的底部可以揭示潜在的恶性肿瘤。它们也可能与几种良性或恶性前皮肤病有关。需要对病变的底部进行活检和组织病理学分析以确认诊断。管理取决于潜在的疾病;然而,手术切除是首选的治疗方法。
    A cutaneous horn is a rare, hyperkeratotic, projecting lesion that can be mostly found in sun-exposed areas of the skin. The base of the lesions can reveal an underlying malignancy. They can also be associated with several benign or pre-malignant dermatologic conditions. A biopsy of the base of the lesion and histopathological analysis are needed to confirm the diagnosis. Management depends on the underlying disease; however, surgical excision is the preferred treatment method.
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  • 文章类型: Journal Article
    目的:评估和比较切除和博来霉素注射治疗成人喉血管瘤(ALHs)的效果。
    方法:在2012年6月至2021年3月期间,我们部门纳入了29例不同病例的26例ALH患者。一些患者接受了不止一次的治疗。研究了29例用博来霉素注射或切除治疗的ALH病例,以评估两种治疗方法的疗效。三个月后,使用管腔收缩评分(从1到4)来评估治疗效果。
    结果:ALH切除组成功切除ALH,ALHs没有复发.博莱霉素注射组的平均管腔收缩评分为2.95。ALH切除组的管腔收缩评分高于博来霉素注射组。
    结论:博来霉素注射和切除都是治疗位于类胡萝卜素上的ALHs的安全有效的方法。在ALH暴露良好并且可以完全去除的情况下,ALH切除手术是治疗位于类芳烃上的ALH的首选方法。
    OBJECTIVE: To evaluate and compare the results of the excision and bleomycin injection treatment methods for adult laryngeal hemangiomas (ALHs) located on the arytenoids.
    METHODS: Twenty-six ALH patients in 29 different cases were enrolled in the study at our department between June 2012 and March 2021. Some patients were treated more than once. Twenty-nine cases of ALH treated with either bleomycin injection or excision were studied to assess the efficacy of both treatments. A lumen constriction score (from 1 to 4) was used to evaluate the therapeutic effect three months later.
    RESULTS: The ALHs in the ALH excision group were resected successfully, and the ALHs did not recur. The mean lumen constriction score for the bleomycin injection group was 2.95. The lumen constriction score for the ALH excision group was higher than that of the bleomycin injection group.
    CONCLUSIONS: Both bleomycin injection and excision are safe and effective treatments for ALHs located on the arytenoids. On the condition that the ALH is well exposed and can be completely removed, ALH excision surgery is the preferable method to treat ALHs located on the arytenoids.
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  • 文章类型: Case Reports
    肠系膜囊肿是罕见的良性腹部病变,在3%的报告病例中具有恶性转化的风险。大多数囊肿是无症状的,偶然或在其并发症的治疗期间被诊断出来。在大多数情况下,它们来自小肠的肠系膜,其次是中结肠。我们提供了一例20岁女性腹部肠系膜囊肿的病例报告。
    Mesenteric cysts are rare benign abdominal lesions that possess the risk of malignant transformation in 3% of reported cases. Most cysts are asymptomatic and diagnosed incidentally or during the management of their complications. In the majority of cases, they arise from the mesentery of the small bowel, followed by the mesocolon. We present a case report of a 20-year-old female with an abdominal mesenteric cyst.
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  • 文章类型: Case Reports
    脂肪瘤生长缓慢,良性间充质肿块。大多数脂肪瘤很小,重量只有几克;然而,如果它们的尺寸变得异常大,它们被称为巨大脂肪瘤。由于罕见的大小和位置,很少观察到乳房的巨大脂肪瘤,文献中提供的病例报告很少。这里,我们报告了一个48岁的女性患者,在她的右乳房巨大的肿块。患者接受了手术切除肿块的组织学检查,证实了巨大的乳腺脂肪瘤的诊断。
    Lipomas are slow-growing, benign mesenchymal masses. Most lipomas are small, weighing only a few grams; however, if their size becomes exceptionally large, they are called giant lipomas. Giant lipoma of the breast is infrequently observed due to the rarity of size and location, with very few case reports available in the literature. Here, we report the case of a 48-year-old female patient who presented with a painless, huge lump in her right breast. The patient underwent surgical removal of the mass with a histologic examination confirming the diagnosis of a giant breast lipoma.
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