ABSTRACT
BACKGROUND: The purpose of this study was to investigate the potential of a combination of 3D mixed-reality visualization of medical images using CarnaLife Holo (MedApp, Poland) system as a supporting tool for innovative, minimally invasive surgery/irreversible electroporation-IRA, Nano-Knife), microwave ablation (MWA)/for advanced gastrointestinal tumors. Eight liver and pancreatic tumor treatments were performed. In all of the patients undergoing laparoscopy or open surgery volume and margin were estimated by preoperative visualization. In all patients, neoplastic lesions were considered unresectable by standard methods. METHODS: Preoperative CT or MRI were transformed into holograms and displayed thanks to the HoloLens 2. During operation, the surgeon's field of view was augmented with a 3D model of the patient's relevant structures. RESULTS: The intraoperative hologram contributed to better presentation of tumor size and locations, more precise setting of needles used to irreversible electroporation and for determining ablation line in case of liver metastases. Surgeons could easily compare the real patient's anatomy to holographic visualization just before the operations. CONCLUSIONS: The combination of 3D mixed-reality visualization using CarnaLife Holo with IRA, MWA and next systemic treatment (chemotherapy) might be a new way in personalized treatment of advanced cancers.
Subject(s)
Electroporation/methods , Gastrointestinal Neoplasms/surgery , Imaging, Three-Dimensional/methods , Liver Neoplasms/surgery , Pancreatic Neoplasms/surgery , Radiofrequency Ablation/methods , Adult , Aged , Female , Holography , Humans , Laparoscopy , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , Precision Medicine/methods , Surgery, Computer-Assisted/methodsABSTRACT
UNLABELLED: Non-variceal upper gastrointestinal bleeding (UGIB) is a common problem in everyday clinical practice. While treating patients affected by UGIB, the estimation of the risk of complications is very important. The Rockall Score is one of the methods used in clinical practice that allows doing that. The aim of this paper is to assess the usefulness of the aforementioned scoring system while treating patients with UGIB. MATERIAL AND METHODS: The analysis included, 651 patients with nonvariceal UGIB. The average age of the group was 62.86+16.96 years. Each patient was subjected to the retrospective analysis according to the Rockall Scale's criteria. Then the entire group was divided into the complication risk groups according to the obtained amount of points (low<3, moderate 3 to 8, high>8). After dividing into groups the effort has been taken to find a relationship between Rockall Score points and the occurrences of individual complications. RESULTS: Mortality among the respondents amounted to 11.36%. The hospitalization of 97.70% patients with <3 points on the scale progressed without complications (p<0.001; X2=22.90). In the moderate risk group the highest frequency of re-bleeding and need for surgery were observed. Whereas among patients with >8 points the mortality of 78.95% was noted. CONCLUSIONS: Rockall Score is a simple and useful method for assessing prognosis for patients with the non-variceal UGIB. The highest scores are obtained by the patients with a great risk of demise. Rockall Score may be used for classifying patients to appropriate risk groups.
Subject(s)
Gastrointestinal Hemorrhage/classification , Gastrointestinal Hemorrhage/epidemiology , Risk Assessment/methods , Aged , Comorbidity , Female , Gastrointestinal Hemorrhage/surgery , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Predictive Value of Tests , Prognosis , Recurrence , Retrospective Studies , Survival Rate , Upper Gastrointestinal TractABSTRACT
AIM: The aim was to determine the outcome from percutaneous sclerosing treatment of solitary non-parasitic hepatic cysts. METHODS: The results of treatment of patients with symptomatic solitary non-parasitic hepatic cysts treated between 1995 and 2000 were reviewed. RESULTS: There were 23 women and one man with a median (range) age of 59 (34-79) years. The median (range) diameter of the cysts was 10 (5-24) cm. Five patients were treated by laparoscopic fenestration ab initio as they also required a cholecystectomy because of gallstones. The remaining 19 patients underwent percutaneous sclerotherapy. In one just aspiration was successful without further treatment. In six contrast leaked from the cyst and five of these had laparoscopic fenestration. Twelve patients had sclerosant treatment with good results at a median (range) follow-up of 35 (6-60) months in 10 patients. Good results were also obtained in 10 of the 12 patients who had fenestration.