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2013 | 85 | 5 | 262-270
Tytuł artykułu

Navigation with Use of Intra-Operative Ultrasound in Search for Neoplastic Lesions of Endocrine Glands

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
was to evaluate the effectiveness of intraoperative ultrasonography (IOUS) during operations of endocrine glands tumors. Material and methods. The study was conducted in patients who underwent endocrine operation in Department of Endocrine, General and Vascular Surgery, Medical University in Łódź in 2008-2011. Results. Patients with thyroid cancer recurrences:in study group we managed shorter lesion access time (10 ± 4.47 min vs 16.78 ± 8.9 min; p=0.04). Time of surgery was also shorter in study group (75 ± 30.17 minvs 85,71 ± 38.92 min), but it was not significant (p=0.46). The use of IOUS did not affect the hospitalization time (2.91 ± 1.64 days vs 3 ± 1.66 days; p=0.820), intraoperative blood loss (45.45 ± 105.96 ml vs 40 ± 82.89 ml; p=0.972) and the rate of intraoperative complications (1/11 - 9.09% vs 2/14 - 14.29%; p=1). Patients with primary hyperparathyroidism: the time of surgery (58± 22.74 min vs 65 ± 19.6 min; p=0.336) and the lesion access time (13.33 ± 7,94 min vs 17.25 ± 8.19 min; p=0.169) were shorter in study group. Hospitalization time was longer in study group (6.13 ± 5.3 days vs 4.45 ± 4.58 days; p=0.079). The rate of intraoperative complications was higher in study group (3/15 - 20% vs 2/20 - 10%; p=0.631). None of this results were statistically significant (p≤0.05). Patients who underwent open adrenalectomy: in study group we managed significantly shorter time of surgery (70 ± 44.35 min vs 80.12 ± 29.60 min; p=0.033) and shorter lesion access time (12 ± 8.88 min vs 17.37 ± 7.42 min; p=0.045). The use of IOUS did not affect the hospitalization time (5.6 ± 1.65 days vs 6.35 ± 2.38 days; p=0.429), intraoperative blood loss (110 ± 164.65 ml vs 172.5 ± 226.35 ml; p=0.442) and rate of intraoperative complications (0/10 vs 1/40; p=1). Patients who underwent videoscopicadrenalectomy: in study group we managed to get shortertime of surgery (89.44 ± 27.11 min vs 109.12 ± 33.88 min; p=0.034) and shorter lesion access time (28.61 ± 14.93 min vs 45.98 ± 20.44 min; p=0.002). Intraoperative blood loss was also significantly lower in study group (86.11 ± 157 ml vs 169.27 ± 201.04 ml; p=0.037). The use of IOUS did not affect the hospitalization time (4.39 ± 3.27 days vs 3.83 ± 3.67 days; p=0.227), the rate of intraoperative complications (0/18 vs. 2/41; p=1) and the conversion rate (2/20-10% vs. 5/46- 10.87%; p=1). Conclusions. 1.During adrenalectomies this technique facilitates finding the pathological lesion shortening the time of access to the tumor and procedure duration. 2. IOUS is useful for determining the tumor relationship with the surrounding anatomical structures. 3. IOUS isa useful technique in the assessment of adrenal tumor infiltration of vena cava. 4. The use of IOUS allows the surgeon to assess anatomical relationships in the real time, after incision and retraction of tissues. 5. During operations of thyroid cancer recurrences using this technique makes easier to find a lesion in the operated area and it is possible to asses radical of surgery. 6. The use of IOUS allows to find pathological parathyroid glands inside thyroid gland. 7. IOUS is useful in the detection of thyroid pathology during parathyroidectomy.
Wydawca

Rocznik
Tom
85
Numer
5
Strony
262-270
Opis fizyczny
Daty
wydano
2013-05-01
online
2013-06-12
Twórcy
  • Department of Endocrine, General and Vascular Surgery, Medical University in Łódź. Kierownik: prof. dr hab. K. Kuzdak
  • Department of Endocrine, General and Vascular Surgery, Medical University in Łódź. Kierownik: prof. dr hab. K. Kuzdak
Bibliografia
  • 1. Luck AJ, Maddern GJ: Intraoperative abdominal ultrasonography. B J Surg 1999; 86: 5-16.
  • 2. Sopiński J, Kuzdak K: Nawigacja przy użyciu ultrasonografii śródoperacyjnej w wideoskopowych operacjach nadnerczy. Pol Przegl Chir 2012; 84: 697-709.
  • 3. Astl J, Jablonicky P, Lastuvka P et al.: Ultrasonography (B scan) in the head and neck region. International Congress Series 2003; 1240: 1423-27.
  • 4. Desai D, Jeffrey R, McDougall R et al.: Intraoperative ultrasonography for localization of recurrent thyroid cancer. Surgery 2001; 129: 498-500.
  • 5. Karwowski J, Jeffrey B, McDougall R et al.: Intraoperative ultrasonography improves identification of reccurent thyroid cancer. Surgery 2002; 132: 924-29.
  • 6. Siperstein A, Berber E, Barbosa GF et al.: Predicting the success of limited exploration for primary hyperparathyroidism using ultrasound, sestamibi and intraoperative parathyroid hormone: analysis of 1158 cases. Ann Surg 2008; 248: 420-28.[WoS]
  • 7. Siegel B, Kraft AR , Nyhus LM et al.: Identification of parathyroid adenoma by operative ultrasonography. Arch Surg 1981; 116: 234-35.
  • 8. Norton JA, Shawker TH, Jones BL et al.: Intraoperative ultrasound and reoperative parathyroid surgery: an initial evaluation. World J Surg 1986; 10: 631.
  • 9. Kern KA , Shawker TH, Doppman JL et al.: The use of high-resolution ultrasound to locate parathyroid tumors during reoperations for primary hyperparathyroidism. World J Surg 1987; 579-85.[PubMed]
  • 10. Milas M, Stephen A, Berber E et al.: Ultrasonography for the endocrine surgeon: a valuable clinical tool that enhances diagnostic and therapeutic outcomes. Surgery 2005; 138: 1193-1201.
  • 11. Major P, Pędziwiatr M, Matłok M i wsp.: Zmiany torbielowate nadnerczy - analiza wskazań i wyników leczenia. Pol Przegl Chir 2012; 84(4): 318-27.
  • 12. Jakimowicz JJ: Intraoperative ultrasonography in open and laparoscopic abdominal surgery: an overview. Surg Endosc 2006; 20: 425-35.
  • 13. van Nieuwenhove Y. Vandaele S, Op de BeeckB et al.: Neuroendocrine tumors of pancreas. SurgEndosc 2003; 17: 1658-62.
  • 14. Long J, Choyke P, Shawker T et al.: Intraoperative ultrasound in the evaluation of tumor involvement of the inferior vena cava. J Urol 1993; 150: 13-17.
  • 15. Gołkowski F, Buziak-Bereza M, Huszno B et al: The unique case of adrenocortical malignant and functioning tumor. Exp Clin Endocrinol Diabetes 2007; 115: 401-04.
  • 16. Todd Heniford B, Iannniti D, Hale J et al.: The role of intraoperative ultrasonography during laparoscopic adrenalectomy. Surgery 1997; 122: 1068-74.
  • 17. Pautlr S, Choyke P, Pavlovich C et al.: Intraoperative ultrasound aids in dissection during laparoscopic partial adrenalectomy. J Urol 2002; 168: 1352-55.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0040
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