Comparison between posterior lumbar interbody fusion and transforaminal lumbar interbody fusion in the management of lumbar spondylolisthesis.

BACKGROUND: Lumbar spondylolisthesis is a relatively common cause of low back and lower extremity pain. The most common type, degenerative lumbar spondylolisthesis (DLS), is a disease that causes stenosis of the spinal canal. Two surgical methods of treatment are widely accepted, namely posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). MATERIALS AND METHODS: Between 2015 and 2017, the findings of 333 consecutive DLS patients who underwent surgical decompression with instrumented fusion were analyzed in a prospective study at the Department of Neurosurgery University Hospital and Faculty of Medicine at Safarik University in Kosice. The PLIF and TLIF procedures were performed in 214 and 119 patients, respectively. The clinical results and quality of life were compared. RESULTS: In comparison with PLIF, the TLIF procedures show better results as to the mean time of surgery (118.61±24.74 vs 147.56±38.62 min), blood loss (271.74±104.45 vs 361.23±142.78ml) and number of blood transfusions (6 vs 38); p=0.015, p=0.023, and p=0.001, respectively. PLIF and TLIF groups were compared as to the number of cases with nerve root injuries (14 vs 2), dural tear (17 vs 3), wound infections (8 vs 3) and reoperations (15 vs 2); p=0.04, p=0.04, p=0.55 and p=0.03, respectively. The quality of life at follow-up examinations significantly improved as measured with VAS and ODI (p=0.001). CONCLUSION: This research found that both surgical techniques, TLIF and PLIF, are suitable for DLS treatment. The two methods differed in postoperative complications which were less frequent in TLIF. There were no significant differences in the postoperative quality of life (Tab. 5, Ref. 19). Text in PDF www.elis.sk.

Significance of lymph node micrometastasis in pancreatic cancer patients.

UNLABELLED: BACKGROUND /AIMS: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. METHODS: Between January 2006 and December 2010 at the First Department of Surgery in Kosice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical lymphadenectomy were subjected to immunohistochemical staining to detect occult micrometastasis. A comparison of the median survival rate in groups of patients with immunohistochemistry-positive and -negative lymph nodes was performed. RESULTS: Radical pancreatic resection with standard radical lymphadenectomy was performed on 64 pancreatic cancer patients. The median survival time was 15 months. Out of the 319 histopathologically negative lymph nodes (34 patients), 134 lymph nodes were classified as immunohistochemistry positive (21 patients). The median survival rate in the group of patients with immunohistochemistry-negative lymph nodes was 23 months, but in the group of patients with immunohistochemistry-positive lymph nodes it was 14 months. There was a statistically significant difference between these 2 groups of patients (p ≤ 0.01). CONCLUSION: The immunohistochemical examination of histopathologically negative lymph nodes can lead to positive lymph node detection. The presence of lymph node micrometastasis could predict the survival rate.