المؤلفون: Di Perna G., Penner F., Cofano F., De Marco R., Baldassarre B. M., Portonero I., Garbossa D., Ceroni L., Pecorari G., Zenga F.

المساهمون: Di Perna G., Penner F., Cofano F., De Marco R., Baldassarre B.M., Portonero I., Garbossa D., Ceroni L., Pecorari G., Zenga F.

مصطلحات موضوعية: Adenoma, Adolescent, Adult, Aged, 80 and over, Cerebrospinal Fluid Leak, Endoscopy, Female, Human, Logistic Model, Male, Middle Aged, Neoplasm Grading, Postoperative Complication, Reconstructive Surgical Procedure, Retrospective Studie, Skull Base Neoplasm, Young Adult

الوصف: Introduction Post-operative CSF leak still represents the main drawback of Endoscopic Endonasal Approach (EEA), and different reconstructive strategies have been proposed in order to decrease its rate. Objective To critically analyze the effectiveness of different adopted reconstruction strategies in patients that underwent EEA. Materials and methods Adult patients with skull base tumor surgically treated with EEA were retrospectively analyzed. Data recorded for each case concerned patient demographics, type of surgical approach, histotype, anatomical site of surgical approach, intra-operative CSF leak grade (no leak (INL), low flow (ILFL), high flow (IHFL)), reconstructive adopted strategy, Lumbar Drain positioning, post-operative CSF leak rate and intra/post-operative complications. Results A total number of 521 patients (January 2012-December 2019) was included. Intra-operative CSF leak grade showed to be associated with post-operative CSF leak rate. In particular, the risk to observe a post-operative CSF leak was higher when IHFL was encountered (25,5%; Exp(B) 16.25). In particular, vascularized multilayered reconstruction and fat use showed to be effective in lowering post-operative CSF leaks in IHFL (p 0.02). No differences were found considering INL and ILFL groups. Yearly post-operative CSF leak rate analysis showed a significative decreasing trend. Conclusion Intra-operative CSF leak grade strongly affected post-operative CSF leak rate. Multilayer reconstruction with fat and naso-septal flap could reduce the rate of CSF leak in high risk patients. Reconstructive strategies should be tailored according also to the type and the anatomical site of the approach.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/33720937; info:eu-repo/semantics/altIdentifier/wos/WOS:000629667400041; volume:16; issue:3; firstpage:1; lastpage:18; numberofpages:18; journal:PLOS ONE; http://hdl.handle.net/2318/1838659Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85102800971

الإتاحة: https://doi.org/10.1371/journal.pone.0245119Test
http://hdl.handle.net/2318/1838659Test

المؤلفون: Tardivo V., Penner F., Garbossa D., Di Perna G., Pacca P., Salvati L., Altieri R., Grottoli S., Zenga F.

المساهمون: Tardivo V., Penner F., Garbossa D., Di Perna G., Pacca P., Salvati L., Altieri R., Grottoli S., Zenga F.

مصطلحات موضوعية: Elderly, Endoscopic surgery, Pituitary adenoma, Transsphenoidal surgery, Adenoma, Age Factor, Aged, 80 and over, Female, Human, Magnetic Resonance Imaging, Male, Pituitary Neoplasm, Retrospective Studie, Treatment Outcome

الوصف: Purpose: Along with increased life expectancy and improvements in the diagnostic tools and techniques, the number of elderly patients with symptomatic pituitary tumors being evaluated for surgery is increasing. To date, contrasting results of the safety and effectiveness of transsphenoidal surgery in patients over 65 years old were published in the medical literature. An investigation concerning the extension of resection, post operative complications and, recovery rate from endocrinological and visual symptoms in elderly patients who underwent transsphenoidal surgery for pituitary adenoma was conducted. Methods: A retrospective review, which included a series of 81 patients 65 years old or older who underwent endoscopic endonasal surgery for pituitary adenomas was analyzed. Pre operative and post operative data were collected and patients were then compared among four age groups: 65–69 years old, 70–74 years old, 75–79 years old and 80 years and over. The results were then compared with the findings from the medical literature review. Results: The statistical analysis failed to highlight any difference in terms of clinical presentation or complications among the four age groups, however there seems to be a slightly higher risk of post operative hypopituitarism in patients over 74 years old. Conclusion: The results of the study seem to confirm that transsphenoidal surgery for PA is safe and effective among patients that are 65 and over. Moreover, a partial resection is preferred over a gross total one in order to reduce the surgical risk.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/31797173; info:eu-repo/semantics/altIdentifier/wos/WOS:000500277700001; volume:23; issue:2; firstpage:92; lastpage:102; numberofpages:11; journal:PITUITARY; http://hdl.handle.net/2318/1796452Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85075948805

الإتاحة: https://doi.org/10.1007/s11102-019-01014-1Test
http://hdl.handle.net/2318/1796452Test

المؤلفون: Garbossa, D, Panciani, Pp, Fornaro, R, Crobeddu, E, Marengo, N, Fronda, C, Ducati, A, Bergui, M, Fontanella, Marco Maria

مصطلحات موضوعية: Adult, Aged, 80 and over, Male, Incidence, Endovascular Procedures, Age Factors, Intracranial Aneurysm, Aneurysm, Ruptured, Middle Aged, Subarachnoid Hemorrhage, Survival Rate, Young Adult, Treatment Outcome, Italy, Humans, Female, Aged, Follow-Up Studies, Retrospective Studies

الوصف: Subarachnoid hemorrhage (SAH) from aneurysm rupture accounts for approximately 3% of all strokes. A significant improvement in surgery and endovascular procedures has reduced mortality and morbidity. Nowadays, endovascular treatment is a viable alternative to conservative treatment in elderly patients. We designed a retrospective observational study on all endovascular procedures carried out in our department in order to evaluate the outcome in elderly patients compared with a younger cohort.A total of 378 patients with aneurysmal SAH were treated with detachable platinum coils in our department (1994-2009). Of these, 310 patients were aged 20-69 years and 68 were aged over 70 years. Data were stratified according to Hunt-Hess (H-H) grade at admission. The mean follow up was 4.8 years. The final outcome was evaluated through the Glasgow Outcome Scale (GOS).We observed a favorable outcome (GOS 5-4) in both groups of patients admitted with moderately good clinical conditions (H-H 1-3), with no statistically significant difference. In contrast, in the case of H-H grade at admission3, we observed a statistically significant poor outcome in elderly patients.We consider the endovascular treatment as first choice for elderly patients presenting with a good H-H grade at admission. Quick functional recovery and reduced hospitalization time were observed. Unlike young patients, a chance of recovery in elderly patients with H-H 4-5 is more difficult to achieve. Therefore, a conservative approach should be considered.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::e18aea69e14ddf56a3b18d83eed2b5c9Test
http://hdl.handle.net/2318/91526Test

المؤلفون: Nano, M, Levi, A. C, Borghi, F, Bellora, P, BOGLIATTO, Fabrizio, Garbossa, D, Bronda, M, Lanfranco, G, MOFFA, Federica, Dörfl, J.

المساهمون: Nano, M, A. C, Levi, Borghi, F, Bellora, P, Bogliatto, F, Garbossa, D, Bronda, M, Lanfranco, G, Moffa, F, Dörfl, J.

مصطلحات موضوعية: Adolescent, Adult, Aged, Cadaver, Female, Fetu, Human, Hypogastric Plexu, Male, Middle Aged, Rectal Neoplasm, Rectum

الوصف: The investigators studied the surgical anatomy of the main structures involved in the mobilization of the rectum (Denonvilliers' fascia, mesorectum, middle rectal artery, superior and inferior hypogastric plexuses).

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/9684122; volume:45; issue:21; firstpage:717; lastpage:726; numberofpages:10; journal:HEPATO-GASTROENTEROLOGY; http://hdl.handle.net/2318/1658002Test

الإتاحة: http://hdl.handle.net/2318/1658002Test