[The efficacy and safety of domestic magnetic resonance-guided laser interstitial thermotherapy in the treatment of recurrent high-grade glioma].

Sixteen patients with recurrent high-grade glioma who were treated by domestic magnetic resonance-guided laser interstitial thermotherapy (MRgLITT) in the Neurosurgery Department of Xuanwu Hospital of Capital Medical University from 1st January 2021 to 31st December 2021 were prospectively included, with 11 males and 5 females, and aged 27-74 (50±16) years. The duration of surgery, the rate of ablation after surgery, and perioperative complications were assessed. The patients were followed up every 3 months to assess survival and progression. A total of 5 WHO grade Ⅲ patients and 11 WHO grade Ⅳ patients were included. The operation time was 144 (109, 176) min, 28 targeted lesions were detected, and the ablation rate [M (Q1, Q3)] was 91.0% (87.4%, 93.3%). After surgery, 2 patients (2/16) had decreased limb muscle strength, and no perioperative death or other serious complications occurred. The median time to a complete response was 12 (5, 14) months in WHO Grade Ⅲ patients, and one died 12 months after surgery, while the median time to a complete response was 3 (1, 8) months in 11 WHO Grade Ⅳ patients, with a total of 8 deaths at the last follow-up. Therefore, domestic MRgLITT has certain efficacy and safety in the treatment of recurrent high-grade glioma, providing a new option for patients with recurrent glioma.

[Observation of efficacy and safety of stereotactic-EEG-guided three-dimensional radiofrequency thermocoagulation for the treatment of drug-resistant insular epilepsy].

Objective: To investigate the safety and efficacy of stereotactic-EEG (SEEG)-guided radiofrequency thermocoagulation (RF-TC) with three-dimensional lesioning in the treatment of drug-resistant insular epilepsy. Methods: Seven patients with drug-resistant insular epilepsy who underwent SEEG-guided RF-TC with three-dimensional ablation at the Department of Neurosurgery of Xuanwu Hospital, Capital Medical University from February 2017 to June 2019 were retrospectively enrolled. Presurgical evaluation including semiology, EEG and imaging results suggested that the epileptogenic zone was located in the insular lobe. All patients underwent SEEG recording and three-dimensional RF-TC. Postoperative follow-up was conducted by outpatient visits or telephone, the clinical efficacy was evaluated based on Engel classification and the relevant complications were documented. Results: Seven patients were followed up at 18 months after surgery. Among them, 4 were seizure free (Engel ⅠA), 2 had nondisabling simple partial seizures (Engel ⅠB) and 1 achieved 75% decrease (Engel ⅢA) in seizure frequency. Postoperative complications occurred in 3 patients which included decreased sensation in the right lower extremity, decreased strength in the right upper extremity, glossolalia, decline in memory and comprehension. No permanent neurological dysfunction was detected. Conclusion: SEEG-guided RF-TC with three-dimensional lesioning is minimally invasive, safe and effective in the treatment of drug-resistant insular epilepsy and can serve as a complementary method for resection surgery.

[Safety and short-term efficacy of domestic magnetic resonance-guided laser interstitial thermotherapy in the treatment of drug-resistant epilepsy].

Objective: To investigate the safety and short-term efficacy of domestic magnetic resonance-guided laser interstitial thermotherapy (MRgLITT) in the treatment of drug-resistant epilepsy. Methods: Patients with drug-resistant epilepsy treated with a domestic MRgLITT system in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University from October 2020 to April 2021 were prospectively enrolled. The damage volume ratio was assessed immediately after surgery, and perioperative complications were recorded and followed up. The clinical safety and short-term efficacy were evaluated using the Engel classification. Results: A total of 22 patients were included, including 12 males and 10 females, aged from 3 to 45 years old [(24±13) years]. There were 5 cases of medial temporal lobe epilepsy (MTLE), 3 cases of hypothalamic hamartoma (HH), 7 cases of focal cortical dysplasia (FCD), and 7 cases of other types, respectively. The mean operation time and blood loss was (173±49) min and (3.7±1.6) ml. The postoperative length of hospital stay was (5.5±1.8) days, and the average damage volume ratio was 92.6%. Among them, only 2 patients (FCD of the parietal lobe) showed transient contralateral limb weakness, without any serious complications such as symptomatic intracranial hemorrhage and cerebral infarction. The follow-up time was 14 to 168 days. There were 13 Engel class Ⅰ cases (59.1%), 2 Engel class Ⅱ cases (9.1%), 2 Engel class Ⅲ cases (9.1%) and 5 Engel class Ⅳ cases (22.7%), respectively. Short-term incident-free rates were MTLE 5/5and FCD4/7, respectively. Conclusion: Domestic MRgLITT system is stable, reliable and safe in the treatment of drug-refractory epilepsy, and has better short-term efficacy in MTLE and FCD patients.

Comparison between transareola singlesite endoscopic thyroidectomy and minimally invasive video-assisted thyroidectomy.

OBJECTIVES: To compare surgical outcomes between transareola single-site endoscopic thyroidectomy (TASSET) and minimally invasive video-assisted thyroidectomy (MIVAT). METHODS: Patients with thyroid nodules were randomized to TASSET (n = 24) or MIVAT (n = 24). Surgical outcomes and patient-rated cosmetic results, based on numerical (0 [worst], 10 [best]) and verbal (1 [poor], 4 [excellent]) response scales, were compared. RESULTS: There were no significant differences between groups for age, sex, indication for operation, estimated blood loss, postoperative pain and length of postoperative stay. TASSET was associated with a significantly longer mean ± SD operative time than MIVAT (156.84 ± 41.42 vs. 66.38 ± 17.58 min), and significantly improved cosmetic results according to the numerical (9.63 ± 0.60 vs 7.90 ± 1.38) and verbal response (3.8 ± 0.5 vs 3.1 ± 0.7) scales. Postoperative complaints were comparable between the two approaches, although MIVAT involved a shorter operation time. CONCLUSIONS: Patients treated with TASSET had superior cosmetic results compared with those treated with MIVAT.

An unusual presentation of multiple congenital melanocytic nevi with a limb distribution.

We report a newborn in whom multiple small congenital melanocytic nevi (MN) were noted on the right side involving the scapular area, shoulder, upper arm and forearm. Such a limb distribution of small congenital MN has never been reported in the literature.