Laparoscopic treatment of liver hydatid cysts

A large number of liquid oral medicines contain sugars and there is concern for the dental health of children requiring this medication long-term for chronic medical problems. Ninety-four chronically sick children aged 2-17 years taking sugar-based or sugar-free liquid oral medication for 1 year or more, and their 92 siblings were dentally examined. The medical problems of the sick children included epilepsy, cystic fibrosis, chronic renal failure, asthma, recurrent urinary tract infections, cardiac disease and chronic constipation. Ordinal logistic regression analysis compared differences between sick children and their healthy siblings and showed the only significant confounding factors related to dental health to be age (for dmfs p = 0.013, DMFS p < 0.001) and exposure to fluoridation (for DMFS p = 0.0097, DFS (approximal) p = 0.013). Children taking long-term liquid oral medicines had significantly more caries of deciduous anterior teeth than their siblings (p = 0.046).     

Laparoscopic removal of dermoid cysts

Benign dermoid cysts between 1.5 and 6 cm in diameter were laparoscopically removed in 9 premenopausal women. Cystectomy was performed in eight patients, and unilateral oophorectomy in one. Surgical and postoperative complications were not observed. Chemical peritonitis due to the dermoid contents can be avoided, provided, careful lavage of the peritoneal cavity is performed.     

Laparoscopic approach excision of mesenteric cysts

The authors reports a case of a young woman suffering from mesenteric cyst. The incidence of these lesions is 1 to 100,000 admissions in adult patients and 1 to 20,000 admissions in pediatric age. These cysts, with retroperitoneal and omental cysts, have a similar etiopathogenesis as lymphatic ectopic tissue. In the majority of cases these cysts are asymptomatic and often the diagnosis is intraoperative. In this case the cyst was removed successfully with laparoscopic approach. This mini-invasive method allows a complete and radical excision of the cyst and reduces postoperative hospital stay and morbidity.     

Laparoscopic Lin operation for the treatment of polycystic liver disease

Non parasitic hepatic cysts are a clinical entity that is often associated with polycystic kidney disease. We report the case of a 75 year-old woman who presented with symptomatic but non complicated polycystic liver disease. The treatment consisted of laparoscopic fenestration of a large simple cyst located in the left hepatic lobe. The postoperative course was uneventful and the patient remains free of symptoms at 18-months follow-up. Selected patients with symptomatic but uncomplicated polycystic liver disease and favourable anatomy benefit from laparoscopic fenestration of the cysts with low morbidity and hospital stay.     

Nonparasitic cysts of the liver: results and options of surgical treatment

Nonparasitic cysts of the liver (NPHC) are highly variable in respect to appearance and therapeutic approach. The treatment of these cysts varies according to the nature and appearance of the disease. Based on the variable nature of disease and the various therapeutic options, all of which were attempted in our patients, the most suitable mode of treatment for different forms of NPHC are discussed. Ninety-one patients with NPHC who had been treated surgically from 1977 through 1995 were examined retrospectively. Asymptomatic peripheral cysts measuring up to 10 cm do not require further treatment. Computed tomography (CT)-guided aspiration (n = 9) should be regarded as a palliative measure. Within a short period, CT-guided aspiration led to recurrence of symptoms in seven of our patients. Standard treatment of NPHC is fenestration with widest possible excision of the cystic wall, which can be performed laparoscopically (n = 10) or by the conventional surgical mode (n = 54). One patient was initially operated by the laparoscopic technique but developed bleeding, which necessitated conversion to the open mode. Three patients underwent synchronous laparoscopic cholecystectomy. Recurrence rates were similar: 11% in the laparoscopically treated group and 13% in the group that underwent conventional open surgery. Conventional surgical treatment was always successful in cases of solitary cysts. However, in cases of multiple cysts measuring more than 5 cm, conventional surgery was followed by recurrence of symptoms in 26% of patients (7/27), who then had to undergo a second operation. Partial resection of the liver (n = 9) was successfully performed in cases of polycystic disease (n = 5) with concomitant enlargement of the organ as well as in cases of large solitary cysts of the left lobe of the liver (n = 4). In patients in whom we found that the cysts communicated with the ductal system (n = 3), we performed a cystojejunostomy to drain the bile. The complication rate was low. In addition to frequent postoperative ascites, which necessitated no further intervention, we observed infectious complications in four patients. Twenty patients (22%) expired during a mean follow-up period of 6.2 years. Interestingly, deaths were frequently associated with malignancy (11/20). After fenestration of multiple cysts measuring > 5 cm, the patients are at high risk for recurrence. Hence partial resection of the liver is an excellent therapeutic alternative in selected patients with polycystic disease and massive enlargement of the organ in whom the disease could not be controlled by simple fenestration. The results of this study show that laparoscopic fenestration should replace the conventional surgical technique as the gold standard in cases of NPHC because the laparoscopic technique is less stressful for the patient and is associated with a rate of success similar to that of the conventional technique.     

Laparoscopic excision of benign dermoid cysts with controlled intraoperative spillage

Due to the risk of aseptic peritonitis associated with intraoperative rupture of dermoid cysts, many surgeons are reluctant to remove the lesions laparoscopically. In our series, 12 dermoid cysts were removed laparoscopically. Intraoperative spillage occurred in all cases and was managed with copious lavage. None of the patients experienced postoperative morbidity associated with peritonitis, indicating that intraoperative spillage of dermoid cysts is not associated with morbidity as long as vigorous lavage is performed.     

Surgical treatment of parasitic cysts

An interesting case with both antegrade and retrograde intussusception in an infant is reported. There was no apparent predisposing cause.     

Diagnosis and treatment of breast cysts

Streptomyces brunneofungs 118 and S.griseolus 224 were isolated from natural objects and shown to synthesize ammonium specific products belonging to macrotetrolide compounds. Gradient extraction was applied to the mycelium and it was demonstrated that the compounds were rather labile both in the native cells and on synthetic carriers and could be hydrolyzed by aqueous solutions of acetone and ethanol to various linear oligomers of narctinic acids. Acetone mainly stabilized the monomer and dimer fragments whereas in the ethanol extracts a complete set of the oligomers (from the monomer to the tetramer) was detectable. Graident extract of suspension of the microbial intact cells is useful in the study of some properties and the primary identification of biologically active hydrophobic products even at the early stages of their isolation.     

Phonosurgical treatment of vocal cord cysts

INTRODUCTION: Functional-traumatic lesions of the vocal folds include mucous stranding, "nodular" lesions, polyps, cysts, contact hyperplasia and haematoma [1]. They all appear at the predilection sites of the vocal fold, at the junction between the anterior and middle thirds, slightly below the free edge. Vocal fold cysts are also located at the predilection site. They interfere with the glottic closure and vibration process. The treatment consists of surgical enucleation. This paper is aimed to present our results with direct and indirect surgical procedures. MATERIAL AND METHOD: A series of 63 vocal fold cysts was operated by the use of direct microlaryngoscopy (DML), indirect microlaryngoscopy (IMS) and videostroboscopy (IVCS). RESULTS: Over a 10-year period 1550 surgical procedures were performed for benign lesions of the vocal folds, including 63 cases of vocal fold cysts (4.1%). A very satisfactory phonusurgical result was obtained. Recovery of the vibration pattern was after DML procedures within 3 weeks in 66.6% of patients, while it was apparently faster after indirect operations. The latter were performed only for minor cystic lesions, and therefore direct and indirect procedures cannot be compared to vibration recovery. DISCUSSION: A careful surgical manipulation is required for the enucleation of vocal fold cysts, sparing the local tissue. DML is used in the majority of cases, while indirect procedures can be used only in minor lesions, where enucleation is not possible.     

Surgical treatment of hepatic hydatid cysts

Ciliated cells from the nasal mucosa of normal persons were collected in culture medium and exposed to either oxymetazoline without preservatives, oxymetazoline with preservatives, xylometazoline with preservatives, or sham (culture medium). There was a significant decrease in ciliary beat frequency only by the two drugs with preservatives after 20 min. After substitution of the test media with culture medium ciliary action did not recover in any group.     

Laparoscopic treatment of duodenal diverticulum

A patient with a history of intermittent and intense pain in the upper abdomen secondary to an ulcer of a duodenal diverticulum underwent laparoscopic treatment. The diverticulum measured 2.5 cm in diameter and it was located on the lateral wall of the second portion of the duodenum. The diverticulum was inverted and the duodenal muscular defect was closed with interrupted sutures. Ambulation and a clear liquid diet was started on the same day as the operation, and the patient was discharged on the first postoperative day.     

Laparoscopic treatment of genitofemoral neuralgia

Isolated human neutrophils produced no detectable (< 10 nM) nitric oxide (NO) before or after activation with phorbol 12-myristate 13-acetate (PMA) or a chemotactic peptide, N-formyl-L-methionyl-L-leucyl-L-phenylalanine. Physiological levels of NO (1 microM) added before or after neutrophil activation had no effect on their respiratory burst oxygen consumption. Neutrophils activated with PMA caused very rapid breakdown of exogenously added NO. NO breakdown rates recorded at 250 nM NO were 0.09 +/- 0.02 and 3.77 +/- 0.23 nmol NO/min/10(6) cells (n = 3) before and after activation respectively and addition of copper-zinc superoxide dismutase during activation significantly decreased this rate (1.06 +/- 0.09 nmol NO/min/10(6) cells (n = 3)), suggesting that superoxide (O2-) production was mainly responsible for the NO breakdown. These results suggest that activation of human neutrophils in vivo will dramatically decrease surrounding NO levels, potentially causing vasoconstriction, platelet aggregation and adhesion and peroxynitrite (ONOO-) formation.     

Laparoscopic treatment of inguinal hernia

It is always important to treat conditions which may be cancerous with respect and, where there is suspicion, to take biopsies for histological examination. A hoarse voice may, in addition, be a sign of tuberculosis of the larynx, and the clinical appearance can be similar to a carcinoma. Preoperative chest x-ray (not always performed) and an awareness by the histologist of such a possibility are important now that this condition is increasing in frequency in parallel with conditions where immunological status is compromised.