We report on our experiences with internal hemipelvectomy followed by an implantation of a endoprosthetic pelvic replacement (EPR) performed in 15 patients over a period of 15 years. Our primary aim was to determine the implications for this procedure because of its high rate of complications. Due to the malignant character of the disease and the biomechanical stress on the anatomical region, the demands on the surgeon are high. The most important factor is a sufficiently wide resection of the primary tumour because most are chondrosarcomata which do not respond to other therapies. In addition, the malignant character of the tumour has the greatest influence on the long-term results. Internal hemipelvectomy and endoprosthetic pelvic replacement are accompanied by a high rate of operative and postoperative complications Nevertheless, nearly full anatomical and functional reconstruction can be obtained provided a medium level of function is accepted. Follow-up results of the remaining six still living patients were evaluated by means of three different scoring systems. All patients had only a medium score but emphasised subjective acceptance of the endoprosthetic pelvic replacement even when removal was necessary later on. Because of the lower functional outcome of alternative operative procedures such as pseudarthroses and arthrodeses and problems with the replantation of autoclaved autografts or implantation of an allograft, internal hemipelvectomy combined with endoprosthetic pelvic replacement is the treatment of choice for these specific acetabular lesions, provided a complete resection is feasible. Otherwise, an external hemipelvectomy is necessary because even alternative limb-salvaging procedures must incorporate the same complete resection of the tumour. In cases of metastatic lesions, internal hemipelvectomy and endoprosthetic pelvic replacement are indicated relatively because of the systemic character of the disease. The procedure should be considered only when resection of a solitary metastasis enables a cure and/or prolongation of life with an improved quality of life.
All three agents were effective in preventing adhesions when compared to the control group. Nevertheless, ADA seemed the most effective except when considering clinical applicability, in which case FS seemed to offer the greatest advantage.
Establishing a preoperative diagnosis of DI is still problematic. Aggressive treatment and close monitoring of patients with an ISS > 13, an RTS < or = 11, an age > or = 48 years, or a postoperative complication may decrease morbidity and mortality.
Ganglioneuromas (GNs) are benign, slow growing and well differentiated neuroectodermal neoplasias. They are derived from developing neuronal cells of the sympathetic nervous system. They occur mostly in children and are located in the posterior mediastinum, retroperitoneum. We present a case of incidental solitary polypoid ganglioneuroma of the colon. A 70 year old woman underwent colonoscopy for colon cancer screening. She has no abdominal or intestinal symptoms. In hepatic flexure of the colon a spherical polypoid lesion that was 1.4 cm in diameter was detected endoscopically. Biopsy was taken from the polyp. The histopathology revealed a biphasic polypoid tumor with ganglion cells and schwannian stroma on hematoxylin and eosin stain. Final histopathological diagnosis was polypoid ganglioneuroma of the colon. Ganglioneuromatous polyposis and diffuse ganglioneuromatosis are associated with several systemic syndromes. Solitary GNs are generally asymptomatic. Treatment of GNs depends on their size, location, and clinical findings such as bleeding or obstruction. Prognosis is usually excellent. Polypectomy is curative for polypoid GN. However the patients with ganglioneuromatous polyposis and diffuse form may need colectomy.
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