Complex Regional Pain Syndrome, Types I and II
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Surgical intervention is a treatment that is reserved until all other modalities of treatment have been attempted. In all cases, the criterion for surgical intervention would be repetitive successes with repeat sympathetic blocks. The most commonly employed surgical interventions are resection of the lower third of the stellate ganglion and resection of the upper two thoracic ganglia; however, some surgeons resect the second through fifth thoracic ganglia in an attempt to treat upper-extremity difficulties. There are four surgical approaches to upper extremity sympathectomies (Allen & Morety, 1982): Above the clavicle (anterior cervical approach)Posterior resection of the transverse processes of ribs 2 and 3, and proximal section of ribs 2 and 3Anterior transpleural entry through the pectoralis muscle to the third intercostal space, pressing the lung, to reach the operative areaThe axillary approach, which is through a transaxillary incision over the second intercostal space
The obesity epidemic and American culture
Anna Bellisari in The Anthropology Of Obesity in the United States, 2016
Surgery is currently the most effective but also the most drastic way to treat obesity, the last hope for individuals with severe obesity who have not been able to lose weight using standard methods. The demand for bariatric surgery (also called gastric surgery) has greatly increased in recent years. The number of surgeries performed annually rose from 16,000 in 2000 (Kohn et al. 2009) to 220,000 in 2008 (healthgrades.com). Membership in the American Society for Bariatric Surgery grew from 258 in 1998 to 2,500 in 2009 (Gagner et al. 2009). And although the mechanism accounting for its success is only partially understood, bariatric surgery is now also used to treat adolescents with obesity as well as adults (Inglefinger 2011; Paulus et al. 2015). Techniques are constantly improving, and laparoscopic procedures, which are less complicated than open surgery, are now the most commonly performed types in the US and Canada (Cottam et al. 2003).
Prostate Cancer
Mary J. Marian, Gerard E. Mullin in Integrating Nutrition Into Practice, 2017
For early-stage disease, or tumors that are confined to the prostate, treatment options most common are surgery (radical prostatectomy), radiation therapy, or active surveillance. The radical prostatectomy is the gold standard of treatment, which all other forms of treatment are compared to. Like any major surgery, there is a risk of infection, bleeding, heart problems, and even death. Removal of the prostate also carries with it the risk of impotence and urinary incontinence [2]. Radiation includes targeting the tumor with external-beam radiation therapy and brachytherapy, the practice of implanting radioactive seeds directly into the tumor [4]. Active surveillance is choosing to delay treatment until it is evident that the cancer may be growing or changing. This is a viable option for men with early-stage disease since the cancer may grow so slowly that it may not cause problems within a man’s lifetime. In this way, men are able to avoid treatment costs and complications. Prostate cancer patients are considered to be at low nutrition risk. They infrequently present with nutritional compromise and their treatment causes minimal nutrition-impact symptoms.
Surgical waiting times and all-cause mortality in patients with non-metastatic renal cell carcinoma
Published in Scandinavian Journal of Urology, 2022
Andreas Karlsson Rosenblad, Pernilla Sundqvist, Ulrika Harmenberg, Mikael Hellström, Fabian Hofmann, Anders Kjellman, Britt-Inger Kröger Dahlin, Per Lindblad, Magnus Lindskog, Sven Lundstam, Börje Ljungberg
The updated TNM 2017 classification system [26] was used for tumour staging. RCC type was classified as clear cell, papillary, chromophobe, or other. Tumour size was defined as the maximal tumour diameter measured by tomographic imaging. Surgical treatment was dichotomised as open or non-open surgery, with the latter including laparoscopy or robot-assisted laparoscopy. Ablation treatment (n = 425, 4.3%) was classified as a non-open surgical treatment. Age at surgery was calculated as the time from the date of birth to the date of surgery, while the SWTs were calculated as the times from the date of radiological diagnosis to the dates of surgery (WRS) and treatment decision (WRT) and from the date of treatment decision to the date of surgery (WTS), respectively. Time to follow-up was measured as the time from the date of surgery to the date of death or censoring, with the latter occurring if the participant emigrated, changed PIN or was still alive at the end of follow-up on 9 December 2021.
Macrophage infiltration promotes regrowth in MYCN-amplified neuroblastoma after chemotherapy
Published in OncoImmunology, 2023
Anders Valind, Bronte Manouk Verhoeven, Jens Enoksson, Jenny Karlsson, Gustav Christensson, Adriana Mañas, Kristina Aaltonen, Caroline Jansson, Daniel Bexell, Ninib Baryawno, David Gisselsson, Catharina Hagerling
Once high-risk neuroblastoma patients complete the rapid-COJEC therapy regimen, they undergo surgery to achieve complete removal of any remaining primary tumor. The time from completed treatment to surgery is typically a couple of weeks to allow recuperation. We hypothesized that, during the interval between chemotherapy and surgery, surviving tumor cells could proliferate in cooperation with macrophages. To explore whether inhibition of macrophage recruitment could prevent tumor regrowth we used an in vivo neuroblastoma PDX–COJEC model and anti-CSF1R, inhibiting the recruitment of macrophages.36 Dissociated organoids from the PDX#3 model were subcutaneously (s.c.) injected into the flank of nude mice (Figure 5a).39 COJEC treatment was administered for three weeks. After chemotherapy, the tumors were allowed to regrow for three weeks without or with intraperitoneal (i.p.) treatment with anti-CSF1R, inhibiting the recruitment of macrophages.40,41 All PDX tumors treated with COJEC shrank during the treatment period and started to regrow once the treatment ended. Importantly, the anti-CSF1R treatment, which impaired macrophage infiltration (Figure 5d,e and Supplementary Fig 5a-c), prevented the regrowth of the tumors (Figure 5b,c). In line with the abovementioned data, the POST tumors in this experiment had increased expression of CCL2 than the untreated tumors (Figure 5f).
Enhanced Recovery after arthroplasty surgery
Published in Acta Orthopaedica, 2020
Terminology for accelerated postoperative functional recovery of patients after arthroplasty surgery has changed from fast track surgery, rapid recovery surgery, enhanced recovery after surgery (ERAS), as well as initiatives like getting it right first time (GRIFT). All aim to have the most favorable treatment course (i.e. optimal benefit/risk balance) for the patient after surgery, in the shortest length of hospital stay (LOS). But enhanced recovery is more than just reducing length of hospital stay, admitting patients the day of surgery, mobilize them within 3-6 hours after surgery and get patients in control of daily living activities. The aim of this perioperative and rehabilitation enhanced recovery period is to “cure” a patient from its pathology or symptoms including the stress invoked by the treatment as such. For that matter, great diversity exists after arthroplasty surgery, some patients perform excellent, and are referred to as examples of “best practice” outcome, while others are worse after surgery not expected by the patient or clinician.
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