ABSTRACT
Hippocampal sclerosis, also known as Ammon horn sclerosis or mesial temporal sclerosis, is usually associated with intractable epilepsy and characterized by specific patterns of neuronal loss and gliosis in the medial temporal lobe structures. Hippocampal sclerosis manifests clinically as epilepsy, often intractable epilepsy; in most cases, this condition is surgically treatable. As the most common histological diagnosis in adult patients subjected to epilepsy surgery, hippocampal sclerosis is characterized by complex pathogenesis and requires a multidisciplinary approach to its diagnosis and treatment. This article reviews the pathologic features, natural history, pathogenesis, and electroclinical and MRI signs of hippocampal sclerosis.
Subject(s)
Epilepsy, Temporal Lobe , Hippocampus , Magnetic Resonance Imaging , Epilepsy, Temporal Lobe/diagnostic imaging , Epilepsy, Temporal Lobe/physiopathology , Epilepsy, Temporal Lobe/therapy , Hippocampus/diagnostic imaging , Hippocampus/physiopathology , HumansABSTRACT
AIM: This publication will describe our own experience of using the ERBEJET2(®) water-jet dissector during surgical interventions for rectal cancer. METHOD: We utilized the water-jet dissection technique to obtain tissue specimens in 10 patients with rectal cancer. All patients thus underwent nerve-sparing low anterior resection of the rectum along with para-aortic lymphadenectomy. No intraoperative complications were registered. The postoperative period went uncomplicated in all patients. No dysuria was observed. Obtained tissue specimens were examined morphologically. Macroscopic examination included assessments of the preservation of the rectal fascia propria and the amount of cellular tissue along the anterior, posterior, and lateral surfaces of the rectum. We performed microscopy of the circumferential resection margin to characterize the surgical clearance and the intensity and depth of damage to the mesorectal tissue. On morphological examination, the quality of mesorectal excision was found to be good (Grade 3) in all 10 patients. RESULTS: As the results of our study demonstrate, the depth of lateral tissue damage is minimal with the water-jet dissector. CONCLUSION: Water-jet dissectors have their own place in the long list of armamentarium used in surgical interventions performed for rectal cancer and contribute to improving oncological and functional outcomes of surgical treatment in this patient population.
Subject(s)
Dissection/instrumentation , Lymph Node Excision , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Aged , Aorta , Blood Loss, Surgical , Dissection/adverse effects , Dissection/methods , Fascia/injuries , Female , Humans , Length of Stay , Male , Middle Aged , Neoplasm, Residual , Operative Time , Rectum/injuriesABSTRACT
The surgical management of colorectal metastasis is becoming a widespread practice in oncology. Synchronous resection of metastasis together with invaded major vessels (aorta) is still considered an extremely aggressive procedure. We demonstrate that en bloc resection of invaded aorta and paraaortic lymph node metastasis can be safely performed. The literature from experiences with similar techniques is also discussed.
