05). There was no difference in postoperative morbidity secondary to venous air embolism between both groups. The mean time for craniotomy was 21 minutes in the image-guided group and 39 minutes in non-image-guided group (P = 0.036).
CONCLUSION: Volumetric image guidance provides fast and reliable three-dimensional visualization of sinus anatomy in the posterior fossa, thereby significantly increasing speed and safety in lateral suboccipital approaches.”
“Purpose: Laparoscopic partial nephrectomy has demonstrated renal functional and 5-year oncological outcomes equivalent to those of open partial nephrectomy. A remaining critique of laparoscopic
partial nephrectomy is its 10-minute longer ischemia time compared to open surgery. We present an LDC000067 price Selleck Roscovitine early unclamping laparoscopic partial nephrectomy technique that decreases ischemia time by more than 50%.
Materials and Methods: During standard laparoscopic partial nephrectomy renal reconstruction is completely performed under ischemic conditions. In our early unclamping technique only the initial parenchymal suturing is performed under ischemia with the remainder of bolstered renorrhaphy performed in the revascularized kidney. Of 100 consecutive nonrandomized patients the initial 50 underwent standard laparoscopic partial nephrectomy (group 1) and the subsequent 50 underwent early unclamping laparoscopic
partial nephrectomy (group 2).
Results: Baseline demographics (body mass
index, mean tumor size and central/hilar tumor location) and intraoperative parameters (need for pelvicaliceal repair, blood loss and operative time) were similar in the groups. However, warm ischemia time was significantly lower in group 2 (31.1 vs 13.9 minutes, p < 0.0001). In groups I and 2 ischemia time was 30 minutes or greater in 60% vs 0% of patients (p < 0.0001). Compared to group I overall complications (22% vs 16%), postoperative renal hemorrhage (4% vs 2%) and the re-intervention rate (16% vs 6%) trended lower almost in group 2 (p = not significant). No patient had a positive cancer margin, required open conversion or showed renal dysfunction.
Conclusions: This early unclamping laparoscopic partial nephrectomy technique significantly decreases ischemia time by more than 50% and also trends toward decreased complications. Our current mean ischemia time of less than 14 minutes is lower than or equivalent to that in contemporary open partial nephrectomy series.”
“OBJECTIVE: The rostral middle fossa faces the temporal pole and is the endocranial anterosuperior aspect of the greater wing of the sphenoid. Standard approaches to this region, such as the subtemporal, pterional, or orbitozygomatic approaches, require significant brain retraction or manipulation of the temporalis muscle. We report an endoscopic sublabial transmaxillary approach to this cranial base region that avoids the aforementioned pitfalls.
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