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ABSTRACT: Prostate cancer is the most common malignancy in men, in general. Most patients diagnosed with prostate cancer have localized disease confined to the prostate. A small percentage of patients with aggressive tumors will progress to develop local, extracapsular tumor extension and distant metastases. The aim of prostate cancer management is to identify and treat those patients with aggressive disease before they develop locally advanced or metastatic disease, and to avoid overtreating indolent tumors, which are unlikely to be life threatening. Imaging has been shown to be valuable in local staging of prostate cancer and as an aid to the management of clinically significant disease. In this article, we discuss the different established imaging modalities and emerging techniques for prostate cancer imaging in patients with clinically localized disease who may be suitable for radical treatment.
Future Oncology 05/2011; 7(5):679-91. · 3.16 Impact Factor
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ABSTRACT: Gastric outlet obstruction is a well- recognized complication of locally advanced carcinoma of the head of the pancreas. The authors report a transoral placement of a duodenal stent over a percutaneous guide wire, inserted retrogradely through a transhepatic approach via the ampulla of Vater, in a patient in whom traditional stent placement was technically not possible. This technique allows safe duodenal stent placement for different malignant gastric outlet obstruction such as pancreatic, gastric, duodenal, and metastases to the peripancreatic region.
Journal of vascular and interventional radiology: JVIR 02/2010; 21(4):590-2. · 1.81 Impact Factor
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ABSTRACT: Development of cross-sectional imaging has led to a significant increase in diagnosis of small renal tumors. Nephron-sparing surgery has proven to be effective in the management of these small tumors. Could radiofrequency ablation be as effective in the management of these patients, after showing promising results in a selected group of patients? In this article we discuss the principles of radiofrequency ablation and present results in a selected group of patients. We also outline future perspectives of this noninvasive technique.
Future Oncology 03/2008; 4(1):103-11. · 3.16 Impact Factor
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ABSTRACT: Endoscopic assisted transaxillary first rib resection is a novel approach in the management of thoracic outlet syndrome. It allows safe identification of the different structures. The objective of our study is to assess the outcome of surgical treatment of thoracic outlet syndrome using this technique.
Between May 1999 and October 2005, 28 endoscopic assisted transaxillary first rib resections were performed on 20 patients with thoracic outlet syndrome in our vascular unit. This retrospective study included 14 females and 6 males with ages ranging between 16 and 53 years (median 37 years).
Prior to the operation, all patients had C spine X-ray and 45% (nine patients) had nerve conduction studies prior to the operation. Duration of symptoms ranged between 1 month and 15 years (median 36 months). Fifty-five percent of patients had neurological symptoms, 30% had mixed symptoms and only 15% had venous or arterial symptoms. Eight patients were given bilateral first rib excision. The average time between the two operations was 17.5 months (median 12 months). The postoperative stay in hospital ranged between 2 and 8 days (median 5 days). Follow-up ranged between 1 and 64 months (median 8 months). Eighty-two percent of patients (23 resections) had complete resolution of symptoms. Eighteen percent (5 resections) did not show any improvement of symptoms following surgery. Three complications were recorded, including haemothorax, bleeding and brachial plexus injury. The latter was due to traction injury during the operation.
Endoscopic assisted transaxillary first rib resection is a safe and effective procedure in the management of thoracic outlet syndrome. It also offers a great opportunity for teaching.
Interactive cardiovascular and thoracic surgery 11/2007; 6(5):644-6.
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ABSTRACT: Neurological injuries following aorto-iliac procedures are rare, unpredictable and cause significant morbidity. We report four cases of lower limb paralysis following aorto-iliac procedures, in which two patients suffered internal iliac occlusion and discuss potential aetiological factors.
Four male patients, age ranging between 56 and 77 years, underwent aorto-iliac procedures. Three patients underwent repair of infra-renal abdominal aortic aneurysm (2 open and 1 endovascular repair) and one patient had percutaneous angioplasty of the internal iliac artery.
All patients developed a unilateral lower limb paralysis early post procedure. Neurophysiological studies were performed in three patients and confirmed the injury to the lumbosacral plexus in two cases. MRI scan performed in two patients did not show any abnormality. In two of the cases, occlusion of one internal iliac artery was implicated as the cause of lumbo-sacral plexopathy: one with the coverage of the internal artery origin with the stent, the other due to thrombotic occlusion of common and internal iliac in arteries after an elective open repair of abdominal aortic aneurysm with a bifurcated graft. Follow up ranged between 2 and 4 months. Only one patient recovered completely; the other three were left with permanent disability.
Ischaemic neuropathy following aorto-iliac intervention, whether open or endovascular, remains a rare, unpredictable and devastating complication. When it occurs it is likely to result in permanent neurological disability. It is important to note that it may be related to internal iliac artery thrombosis.
Interactive cardiovascular and thoracic surgery 09/2007; 6(4):501-2.
