Articles de revues : « Intraoperative evaluation »

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Li, Wenping, et Mary K. Sidawy. « Intraoperative Cytologic Evaluation ». Pathology Case Reviews 15, n^o 5 (septembre 2010) : 143–47. http://dx.doi.org/10.1097/pcr.0b013e3181f66064.

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Mays, Bradley W. « Intraoperative Carotid Evaluation ». Archives of Surgery 135, n^o 5 (1 mai 2000) : 525. http://dx.doi.org/10.1001/archsurg.135.5.525.

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Elliott, Robin M., Robert R. Shenk, Cheryl L. Thompson et Hannah L. Gilmore. « Touch Preparations for the Intraoperative Evaluation of Sentinel Lymph Nodes After Neoadjuvant Therapy Have High False-Negative Rates in Patients With Breast Cancer ». Archives of Pathology & ; Laboratory Medicine 138, n^o 6 (1 juin 2014) : 814–18. http://dx.doi.org/10.5858/arpa.2013-0281-oa.

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Context.— The use of a touch preparation for intraoperative sentinel lymph node diagnosis has become a preferred method of many pathologists because of its reported high sensitivity and rapid turnaround time. However, after neoadjuvant chemotherapy many lymph nodes have significant treatment-related changes that may affect the diagnostic accuracy of the intraoperative evaluation. Objective.— To determine the accuracy of touch preparation for the intraoperative diagnosis of metastatic breast carcinoma in the neoadjuvant setting. Design.— We reviewed retrospectively the results of intraoperative evaluations for 148 different sentinel lymph nodes from 63 patients who had undergone neoadjuvant chemotherapy for invasive breast cancer at our institution. The intraoperative touch preparation results were compared with the final pathology reports in conjunction with relevant clinical data. Results.— Use of touch preparation for the evaluation of sentinel lymph nodes intraoperatively after neoadjuvant therapy was associated with a low sensitivity of 38.6% (95% confidence interval [CI], 24.4–54.5) but high specificity of 100% (95% CI, 96.5–100). There was no difference in sensitivity rates between cytopathologists and noncytopathologists in this cohort (P = .40). Patients with invasive lobular carcinoma and those who had a clinically positive axilla before the initiation of neoadjuvant therapy were the most likely to have a false-negative result at surgery. Conclusions.— Intraoperative touch preparations should not be used alone for the evaluation of sentinel lymph nodes in the setting of neoadjuvant therapy for breast cancer because of low overall sensitivity.

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Sato, H., A. Hyodo, Y. Matsumaru, I. Anno, T. Kato, T. Nose, T. Kamezaki, E. Kobayashi et A. Tsukada. « The Evaluation of Preoperative Embolization of Meningioma ». Interventional Neuroradiology 3, n^o 2_suppl (novembre 1997) : 101–5. http://dx.doi.org/10.1177/15910199970030s220.

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To evaluate the efficacy of preoperative embolization of meningioma, we examined the correlation between the angiographic disappearance of the tumor blush after the embolization and the volume of blood loss and transfusion intraoperatively. Preoperative embolization of meningioma with intravascular neurosurgery was attempted for 42 trials, 41 cases from July 1989 to December 1995. There were no major complications attributed to the embolization procedure. As a subjective assessment in 23 cases the information from the surgeon following the operation was obtained. The angiographic disappearance of the tumor blush and reducing of the bleeding from tumor could be considered to be statiscally significant (p<0.05). As an objective assessment in 37 cases following operation, the volume of both intraoperative blood loss and blood transfusion was examined. The angiographic disappearance of the tumor blush and reduced intraoperative blood transfusion could be also considered to be statiscally significant (p<0.05), otherwise reduced intraoperative blood loss failed to reach the significance level. In this study the efficacy of preoperative embolization of meningioma has been especially shown to reduce intraoperative blood transfusion significantly, therefore it is very useful to increase the chance of complete tumor removal with more safely and less invasively.

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Creager, Andrew J., Jo Ann Shaw, Peter R. Young et Kim R. Geisinger. « Intraoperative Evaluation of Lumpectomy Margins by Imprint Cytology With Histologic Correlation ». Archives of Pathology & ; Laboratory Medicine 126, n^o 7 (1 juillet 2002) : 846–48. http://dx.doi.org/10.5858/2002-126-0846-ieolmb.

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Abstract Background.—Several well-controlled studies have demonstrated significantly increased local recurrence rates in patients with low-stage breast carcinoma treated with breast conservation therapy in whom focally positive margins were not reexcised. Imprint cytology is a rapid technique for evaluating surgical margins intraoperatively, thus allowing reexcisions to be performed during the initial surgery. The large majority of studies on the use of intraoperative imprint cytologic examination of breast conservation therapy margins have been performed at university-based academic centers. Objective.—To evaluate the utility of intraoperative imprint cytologic evaluation of breast conservation therapy margins in a community hospital setting. Methods.—We retrospectively reviewed the intraoperative imprint cytology margins of 141 lumpectomy specimens that had been obtained from 137 patients between May 1997 and May 2001. Results.—We evaluated 758 separate margins. On a patient basis, the sensitivity was 80%, the specificity was 85%, the positive predictive value was 40%, the negative predictive value was 97%, and the overall accuracy was 85%. There were no cytologically unsatisfactory margins. Conclusions.—Imprint cytology is an accurate, simple, rapid, and cost-effective method for determining the margin status of breast conservation therapy specimens intraoperatively in the community hospital setting. This method allows a survey of the entire surface area of the lumpectomy specimen, which is not practical using frozen section evaluation.

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Guarda, Luis A. « Intraoperative cytologic diagnosis : Evaluation of 370 consecutive intraoperative cytologies ». Diagnostic Cytopathology 6, n^o 4 (1990) : 235–42. http://dx.doi.org/10.1002/dc.2840060403.

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TEMEL, Hakan, Bilge KARSLI, Nurten KAYACAN, Yesim CETİNTAS et Zekiye BİGAT. « Evaluation of Intraoperative Fluid Management ». Akdeniz Medical Journal 8, n^o 1 (1 janvier 2022) : 33–41. http://dx.doi.org/10.53394/akd.1037455.

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Qui[ntilde]ones-Baldrich, William J., Stanley Ziomek, Theodore C. Henderson et Wesley S. Moore. « Intraoperative fibrinolytic therapy : Experimental evaluation ». Journal of Vascular Surgery 4, n^o 3 (septembre 1986) : 229–36. http://dx.doi.org/10.1067/mva.1986.avs0040229.

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LoCicero, Joseph, Jerod M. Loeb, James W. Frederiksen et Lawrence L. Michaelis. « Intraoperative evaluation of ventricular tachycardia ». Journal of Thoracic and Cardiovascular Surgery 97, n^o 1 (janvier 1989) : 152. http://dx.doi.org/10.1016/s0022-5223(19)35141-4.

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DYESS, DONNA LYNN, BILLIE W. BRUNER, CYNTHIA A. DONNELL, JOHN J. FERRARA et RANDALL W. POWELL. « Intraoperative Evaluation of Intestinal Ischemia ». Southern Medical Journal 84, n^o 8 (août 1991) : 966–69. http://dx.doi.org/10.1097/00007611-199108000-00008.

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Nijhawan, Niraj, et Bruce D. Spiess. « THE INTRAOPERATIVE EVALUATION OF HEMOSTASIS ». Anesthesiology Clinics of North America 17, n^o 4 (décembre 1999) : 733–47. http://dx.doi.org/10.1016/s0889-8537(05)70131-0.

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Isringhaus, H. « Intraoperative evaluation of coronary anatomy ». International Journal of Cardiac Imaging 4, n^o 1 (mars 1989) : 59–61. http://dx.doi.org/10.1007/bf01795126.

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Holder, Kenneth N., et I.-Tien Yeh. « Intraoperative Evaluation of Margin Status ». Pathology Case Reviews 15, n^o 5 (septembre 2010) : 148–55. http://dx.doi.org/10.1097/pcr.0b013e3181f66188.

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Quiñones-Baldrich, William J., Stanley Ziomek, Theodore C. Henderson et Wesley S. Moore. « Intraoperative fibrinolytic therapy : Experimental evaluation ». Journal of Vascular Surgery 4, n^o 3 (septembre 1986) : 229–36. http://dx.doi.org/10.1016/0741-5214(86)90191-6.

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Digby, Richard, Piravin Ramakrishnan, Saad Moughal, Arundhati Chakrabarty et Ryan Mathew. « QLTI-19. EVALUATION OF INTRA-OPERATIVE BRAIN TUMOUR DIAGNOSTIC SERVICES – A LARGE TERTIARY UK CENTRE EXPERIENCE ». Neuro-Oncology 24, Supplement_7 (1 novembre 2022) : vii238. http://dx.doi.org/10.1093/neuonc/noac209.921.

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Abstract INTRODUCTION Brain tumour intraoperative diagnosis (smear cytology, frozen section) is a commonly performed, routine diagnostic service. Currently, samples must be transported from the operating room (OR) to pathology, impacting turnaround time (TAT), carbon emissions (if cross-site), and motivation for repeat sampling. We performed a broad evaluation of current practice in a large, tertiary, UK brain tumour centre, to identify potential gains in real-time tissue diagnosis. METHODS All brain tumour samples (n=228) sent for intraoperative diagnosis in 2021 were analysed retrospectively. TAT was assessed by capturing different timepoints along the pathway. Concordance between diagnoses at the following stages was determined: preoperatively based on radiology, intraoperatively (frozen section or smear), provisional paraffin and final integrated. Additionally, we anonymously surveyed neurosurgeons’ opinions (n=18) on the current service. RESULTS The mean (±SD) specimen transportation time was 10.6±2.0 minutes, with an estimated total TAT of 30-60 minutes. Intraoperative diagnosis provided a slightly higher rate of concordance with provisional paraffin diagnosis than preoperative radiological diagnosis (89.5% vs 86.3%). Non-concordance was most commonly due to non-representative sampling (e.g., predominantly necrotic), with no repeat sample being sent/available intraoperatively. Prevailing neurosurgical opinion of the intraoperative diagnostic service was dissatisfaction or neutrality (50% and 39% of respondents), with a minority being positive (11%). Reasons for this included: intraoperative delay due to TAT (47%), perceived inaccuracy of results (41%), and perceived reduced out-of-hours availability (56%). CONCLUSIONS Current brain tumour intraoperative diagnostic practice relies on physical sample transportation and manual processing; the resultant long TAT causes surgeon dissatisfaction and dissuades repeat analysis in the case of non-representative sampling. Real-time tissue diagnostic technologies such as OR-sited probe-based confocal endomicroscopy, scanners and Raman spectroscopy should be considered to facilitate faster and repeated examination. The latter may have additional benefits in real-time expert pathology feedback, tumour margin-zone analysis and increased extent of resection.

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Erickson-DiRenzo, Elizabeth, C. Kwang Sung, Allen L. Ho et Casey H. Halpern. « Intraoperative Evaluation of Essential Vocal Tremor in Deep Brain Stimulation Surgery ». American Journal of Speech-Language Pathology 29, n^o 2 (8 mai 2020) : 851–63. http://dx.doi.org/10.1044/2019_ajslp-19-00079.

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Purpose Essential vocal tremor (EVT) is a prevalent and difficult-to-manage voice disorder. There is evidence that deep brain stimulation (DBS) of the ventral intermediate nucleus (Vim) of the thalamus may be beneficial for treating EVT. The objective of this preliminary investigation was to conduct intraoperative voice assessments during Vim-DBS implantation in order to evaluate immediate voice outcomes in medication-refractory essential tremor patients with co-occurring EVT. Method Seven adult subjects diagnosed with EVT undergoing Vim-DBS surgery participated in this investigation. Voice samples of sustained vowels were collected by a speech-language pathologist preoperatively and intraoperatively, immediately following Vim-DBS electrode placement. Voice evaluation included objective acoustic assessment of the rate and extent of EVT fundamental frequency and intensity modulation and subjective perceptual ratings of EVT severity. Results The rate of intensity modulation, extent of fundamental frequency modulation, and perceptual rating of EVT severity were significantly reduced intraoperatively as compared to preoperatively. Moderate, positive correlations were appreciated between a subset of acoustic measures and perceptual severity ratings. Conclusions The results of this study demonstrate a speech-language pathologist can conduct intra-operative evaluation of EVT during DBS surgery. Using a noninvasive, simple acoustic recording method, we were able to supplement perceptual subjective observation with objective assessment and demonstrate immediate, intraoperative improvements in EVT. The findings of this analysis inform the added value of intraoperative voice evaluation in Vim-DBS patients and contribute to the growing body of literature seeking to evaluate the efficacy of DBS as a treatment for EVT.

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Stovgaard, Elisabeth Specht, Tove Filtenborg Tvedskov, Anne Vibeke Lænkholm et Eva Balslev. « Cytokeratin on Frozen Sections of Sentinel Node May Spare Breast Cancer Patients Secondary Axillary Surgery ». Pathology Research International 2012 (9 mai 2012) : 1–5. http://dx.doi.org/10.1155/2012/802184.

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Background. The feasibility and accuracy of immunohistochemistry (IHC) on frozen sections, when assessing sentinel node (SN) status intraoperatively in breast cancer, is a matter of continuing discussion. In this study, we compared a center using IHC on frozen section with a center not using this method with focus on intraoperative diagnostic values. Material and Methods. Results from 336 patients from the centre using IHC intraoperatively were compared with 343 patients from the center not using IHC on frozen section. Final evaluation on paraffin sections with haematoxylin-eosin (HE) staining supplemented with cytokeratin staining was used as gold standard. Results. Significantly more SN with isolated tumor cells (ITCs) and micrometastases (MICs) were found intraoperatively when using IHC on frozen sections. There was no significant difference in the number of macrometastases (MACs) found intraoperatively. IHC increased the sensitivity, the negative predictive value, and the accuracy of the intraoperative evaluation of SN without decreasing the specificity and positive predictive value of SN evaluation. Conclusions. IHC on frozen section leads to the detection of more ITC and MIC intraoperatively. As axillary lymph node dissection (ALND) is performed routinely in some countries when ITC and MIC are found in the SN, IHC on frozen section provides valuable information that can lead to fewer secondary ALNDs.

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Gür, EO, M. Haciyanli, S. Karaisli, S. Haciyanli, E. Kamer, T. Acar et Y. Kumkumoglu. « Intraoperative nerve monitoring during thyroidectomy : evaluation of signal loss, prognostic value and surgical strategy ». Annals of The Royal College of Surgeons of England 101, n^o 8 (novembre 2019) : 589–95. http://dx.doi.org/10.1308/rcsann.2019.0087.

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Introduction Intraoperative neural monitoring of the recurrent laryngeal nerve has been widely used to avoid nerve injury during thyroidectomy. We discuss the results of the change in surgical strategy after unilateral signal loss surgeries using intermittent intraoperative neural monitoring in a high-volume referral centre. Materials and methods Details of consecutive patients who underwent thyroidectomy with intermittent intraoperative neural monitoring between January 2014 and December 2017 were prospectively recorded and retrospectively reviewed. Loss of signal was defined as recurrent laryngeal nerve amplitude level lower than 100 μV during surgery. The rate of loss of signal and change in surgical strategy during the operation were evaluated. Results Loss of signal was detected in 25 (5.4%) of 456 patients for whom intermittent intraoperative neural monitoring was performed. Four patients had anatomic nerve disruption and surgery was completed by an experienced endocrine surgeon making use of intraoperative neural monitoring with continuous vagal stimulation. Staged thyroidectomy was performed on 16 patients with unilateral loss of signal in whom the nerves were intact visually. Postoperative vocal cord paralysis was encountered in 18 of 21 (85.7%) patients with loss of signal, and 16 of 18 (88.8%) were improved during the follow-up period. Patients’ voices were subjectively normal to the surgeon postoperatively in 9 of 21 (42.8%) patients who were found to have loss of signal with intact nerves. Conclusions Intraoperative neural monitoring can be used safely in thyroid surgery to avoid recurrent laryngeal nerve injury. It enables the surgeon to diagnose recurrent laryngeal nerve injury intraoperatively to estimate the postoperative nerve function and to modify the surgical strategy to avoid bilateral vocal cord paralysis.

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Rosengarth, Katharina, Delin Pai, Frank Dodoo-Schittko, Katharina Hense, Teele Tamm, Christian Ott, Ralf Lürding et al. « A Novel Language Paradigm for Intraoperative Language Mapping : Feasibility and Evaluation ». Journal of Clinical Medicine 10, n^o 4 (8 février 2021) : 655. http://dx.doi.org/10.3390/jcm10040655.

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(1) Background—Mapping language using direct cortical stimulation (DCS) during an awake craniotomy is difficult without using more than one language paradigm that particularly follows the demand of DCS by not exceeding the assessment time of 4 s to prevent intraoperative complications. We designed an intraoperative language paradigm by combining classical picture naming and verb generation, which safely engaged highly relevant language functions. (2) Methods—An evaluation study investigated whether a single trial of the language task could be performed in less than 4 s in 30 healthy subjects and whether the suggested language paradigm sufficiently pictured the cortical language network using functional magnetic resonance imaging (fMRI) in 12 healthy subjects. In a feasibility study, 24 brain tumor patients conducted the language task during an awake craniotomy. The patients’ neuropsychological outcomes were monitored before and after surgery. (3) Results—The fMRI results in healthy subjects showed activations in a language-associated network around the (left) sylvian fissure. Single language trials could be performed within 4 s. Intraoperatively, all tumor patients showed DCS-induced language errors while conducting the novel language task. Postoperatively, mild neuropsychological impairments appeared compared to the presurgical assessment. (4) Conclusions—These data support the use of a novel language paradigm that safely monitors highly relevant language functions intraoperatively, which can consequently minimize negative postoperative neuropsychological outcomes.

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Espaillat-Rijo, Luis, Lauren Siff, Alexandriah N. Alas, Sami A. Chadi, Stephen Zimberg, Sneha Vaish, G. Willy Davila, Matthew Barber et Eric A. Hurtado. « Intraoperative Cystoscopic Evaluation of Ureteral Patency ». Obstetrics & ; Gynecology 128, n^o 6 (décembre 2016) : 1378–83. http://dx.doi.org/10.1097/aog.0000000000001750.

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Kakagia, Despoina, Demetrios Tamiolakis, Alexandra Grekou, Spyros Vavetsis, Maria Lambropoulou et Nikolaos Papadopoulos. « Intraoperative Cytological Evaluation of Marjolin Ulcers ». Oncology Research and Treatment 29, n^o 1-2 (2006) : 21–24. http://dx.doi.org/10.1159/000089914.

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Regenbogen, Scott E. « Intraoperative Performance Evaluation in Colorectal Surgery ». Seminars in Colon and Rectal Surgery 22, n^o 4 (décembre 2011) : 210–16. http://dx.doi.org/10.1053/j.scrs.2011.06.012.

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Biggers, Robert D. « Intraoperative endoscopic evaluation of suprapubic urethropexy ». Urology 29, n^o 3 (mars 1987) : 268–70. http://dx.doi.org/10.1016/0090-4295(87)90068-9.

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Stringham, Jack, Jeff Pettey et Randall J. Olson. « Evaluation of variables affecting intraoperative aberrometry ». Journal of Cataract & ; Refractive Surgery 38, n^o 3 (mars 2012) : 470–74. http://dx.doi.org/10.1016/j.jcrs.2011.09.039.

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Behling, Felix, Christina Fodi, Irina Gepfner-Tuma, Kathrin Machetanz, Mirjam Renovanz, Marco Skardelly, Antje Bornemann et al. « CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence ». Cancers 12, n^o 12 (3 décembre 2020) : 3620. http://dx.doi.org/10.3390/cancers12123620.

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The detection of the infiltrative growth of meningiomas into CNS tissue has been integrated into the WHO classification as a stand-alone marker for atypical meningioma. However, its prognostic impact has been questioned. Infiltrative growth can also be detected intraoperatively. The prognostic impact of the intraoperative detection of the central nervous system tissue invasion of meningiomas was analyzed and compared to the histopathological assessment. The clinical data of 1517 cases with follow-up data regarding radiographic recurrence was collected. Histopathology and operative reports were reviewed and invasive growth was seen during resection in 23.7% (n = 345) while histopathology detected it in 4.8% (n = 73). The histopathological and intraoperative assessments were compatible in 63%. The prognostic impact of histopathological and intraoperative assessment was significant in the univariate but not in the multivariate analysis. Both methods of assessment combined reached statistical significance in the multivariate analysis (p = 0.0409). A score including all independent prognostic factors divided the cohort into three prognostic subgroups with a risk of recurrence of 33.8, 64.7 and 88.5%, respectively. The intraoperative detection of the infiltrative growth of primary meningiomas into the central nervous system tissue can complement the histopathological assessment of CNS invasion. The combined assessment is an independent prognostic factor regarding tumor recurrence and allows a risk-adapted tumor stratification.

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Joseph, Ryan, Russell Wagner et Brian Webb. « Evaluation of Intraoperative Ligamentous Injury During Total Knee Arthroplasty Involving Resident Training ». Texas Orthopaedic Journal 1, n^o 1 (31 mars 2015) : 45–50. http://dx.doi.org/10.18600/toj.010106.

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Thind, Harjot, Douglas A. Hardesty, Joseph M. Zabramski, Robert F. Spetzler et Peter Nakaji. « The role of microscope-integrated near-infrared indocyanine green videoangiography in the surgical treatment of intracranial dural arteriovenous fistulas ». Journal of Neurosurgery 122, n^o 4 (avril 2015) : 876–82. http://dx.doi.org/10.3171/2014.11.jns14947.

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OBJECT The successful treatment of an intracranial dural arteriovenous fistula (dAVF) requires complete obliteration of blood flow through the fistulous point. Surgical ligation is often used along with endovascular techniques. Digital subtraction angiography (DSA) can be used to confirm fistula obliteration; however, this technique can be cumbersome intraoperatively and difficult to correlate anatomically with the surgical field. Near-infrared indocyanine green (ICG) videoangiography has been described as a complementary tool for this purpose. METHODS The authors examined intracranial dAVF cases in which microscope-integrated intraoperative ICG videoangiography was used to identify and/or confirm obliteration of the dAVF during surgery. Retrospective evaluation of all intracranial dAVF cases treated with surgical ligation over a 10-year period at the Barrow Neurological Institute (n = 47) revealed 28 cases in which ICG videoangiography was used. The results were compared with findings on preoperative and intraoperative or postoperative DSA. RESULTS ICG videoangiography successfully confirmed the fistulous point intraoperatively in 96% (22/23) of the cases. It also revealed complete obliteration of fistulas, comparable to intraoperative or postoperative DSA, in 91% (21/23) of the cases. The false-negative rate of ICG was 8.7% (2/23), which is similar to the false-negative rate of intraoperative DSA alone (10.5% [2/19]). CONCLUSIONS Microscope-based ICG videoangiography provides real-time information about the intraoperative anatomy of dAVFs. In addition, it can confirm complete obliteration of a fistula. This technique may be useful during dAVF surgery as an independent form of angiography or as an adjunct to intraoperative or postoperative DSA.

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Heggy, Eslam Ragab, Sherif Mamdouh Abbas, Atef Galal Abd El Mawla, Mina Adolf et Ahmed Fetouh. « Intraoperative Awareness during General Anesthesia : Experience in 200 Patients in “185’s Hospital for Emergency Surgeries and Burn”. (An Observational Questionnaire-based Study) ». Open Access Macedonian Journal of Medical Sciences 8, B (20 juin 2020) : 429–34. http://dx.doi.org/10.3889/oamjms.2020.4453.

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BACKGROUND: General anesthesia (GA) is a complex state of hypnosis, amnesia, and suppression of stress response to stimuli and production of a quiet surgical field. Awareness under GA considered as unexpected and undesirable complication which can be source of pain and torture for many individuals after surgery. AIM: The aim of the study was to evaluate the incidence of intraoperative awareness during general anesthesia in emergency operations using Brice questionnaire. METHODS: Two hundred patients were included and undergone emergency operations under GA at Cairo University’s Hospitals. Intravenous induction then inhalational maintenance of anesthesia with muscle relaxant was commenced, basic vital signs were monitored and kept within normal range. Depth of anesthesia was manipulated and kept adequate intraoperatively according to patient’s clinical status. At the end of surgery, patients were fully reversed and extubated fully awake then transferred to the recovery room, then data were collected. RESULTS: Data analysis showed 110 (55%) men and 90 (45%) women. Two hours postoperatively, one patient (0.5%) reported intraoperative awareness, while 199 patients (99.5%) remembered nothing intraoperatively. CONCLUSION: The incidence of intraoperative awareness in our emergency hospital is relatively fair and clinical evaluation of anesthesia depth is an effective measure to detect and prevents intraoperative awareness.

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Tang, Gordon, C. Michael Cawley, Jacques E. Dion et Daniel L. Barrow. « Intraoperative angiography during aneurysm surgery : a prospective evaluation of efficacy ». Journal of Neurosurgery 96, n^o 6 (juin 2002) : 993–99. http://dx.doi.org/10.3171/jns.2002.96.6.0993.

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Object. Indications for intraoperative angiography during aneurysm surgery remain unclear. To define its use, the authors report the results of a prospective study in which this modality was used in all patients undergoing surgery for intracranial aneurysms. Methods. Intraoperative angiography was performed prospectively in the surgical treatment of 517 consecutive aneurysms regardless of the lesion's location, size, or complexity. In 64 (12.4%) of 517 aneurysms intraoperative angiography findings prompted a change in surgical treatment. Residual aneurysm (47%) was the most frequent finding leading to clip revision. In 44% of cases, intraoperative angiography revealed vessel compromise. Surgery for aneurysms of the proximal internal carotid artery (ICA) was the most frequently altered, with lesions located at the superior hypophyseal artery (SHA) and clinoidal region having the highest revision rates, eight (40%) of 20 and eight (44%) of 18, respectively. Aneurysm size predicted the need for revision; giant aneurysms (> 24 mm) underwent revision in nine (29%) of 31 cases, whereas large aneurysms (15–24 mm) were revised in 12 (22%) of 54 cases. In a multivariate logistic regression model, factors related to increased revision rates included the SHA and clinoidal locations, as well as giant and large size. Ninety-five patients underwent both intraoperative and postoperative angiography. Five discrepancies were noted (95% accuracy); four were flow-related and one involved a previously unrecognized residual aneurysm. Complications attributable to intraoperative angiography occurred in 0.4% of cases. Conclusions. Proximal ICA location and large aneurysm size significantly predicted revision of surgery following intraoperative angiography. Unexpected findings, even in less complex locations, are frequently identified on intraoperative angiography. Low complication rates, high accuracy, and the unexpected need for clip readjustments favor a more widespread use of intraoperative angiography.

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Wawroschek, F., H. Wengenmair, T. Wagner, J. Kopp, R. Dorn, S. Gröber, P. Heidenreich et H. Vogt. « Sentinel lymph node diagnostic in prostate carcinoma : Part I : Technique and clinical evaluation ». Nuklearmedizin 41, n^o 02 (2002) : 95–101. http://dx.doi.org/10.1055/s-0038-1625646.

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Summary Aim: Evaluation of the significance of lymphoscintigraphy and intraoperative probe measurement for the identification of the sentinel lymph node (SLN) in prostate cancer. Patients and method: In 117 patients with prostate cancer scintigrams in various projections were acquired till approximately 6 hours p.i. after ultrasound guided transrectal intraprostatic injection of 99mTc-Nanocoll ®. On the following day the SLNs were identified in the operation theatre with a gamma probe and removed. Pelvic standard lymph node dissection followed SLNE. Results: In three of 117 patients with preoperative lymphoscintigraphy no SLN was scintigraphically detectable. These three patients had antecedent transurethral resection of the prostate. In 113 of the residual 114 patients SLN could be intraoperatively localized. In the mean four SLNs per patient were removed. 28 of 117 patients had pelvic lymph node metastases. In 25 cases SLN were right-positive, in one false-negative and in one intraoperatively not detectable. In one patient we found macrometastasis of up to 4 cm diameter (one SLN was tumour positive). In 15 cases only the SLN was bearing tumour. Conclusion: The SLNE with preoperative lymphoscintigraphy and intraoperative gamma probe measurement is suitable for detecting lymph node metastasis in prostate cancer. SLNE is superior to the surgical techniques commonly used in pelvic lymphadenectomy.

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Kühne, Lars-Uwe, Robert Binczyk et Friedrich-Christian Rieß. « Comparison of intraoperative versus intraoperative plus postoperative hemoadsorption therapy in cardiac surgery patients with endocarditis ». International Journal of Artificial Organs 42, n^o 4 (25 février 2019) : 194–200. http://dx.doi.org/10.1177/0391398819831301.

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Infective endocarditis is caused by a bacterial infection of the endocardial surface, and despite improvements in surgical interventions and antimicrobial therapy, mortality remains high. Recently published data suggest that intraoperative hemoadsorption therapy might represent a promising treatment option; however, randomized data still lack, and a comparative study on the intraoperative versus intraoperative plus postoperative use of CytoSorb has not yet been performed. We hypothesized that patients developing intraoperative renal failure benefit from additional postoperative CytoSorb treatment in terms of outcome. We examined the application of hemoadsorption therapy in 20 endocarditis patients separated into two groups: (1) sole intraoperative versus (2) intraoperative plus postoperative treatment, with regard to inflammatory and hemodynamic status, the postoperative course including development of complications, extent of extracorporeal organ support, and outcome. Despite an obviously more pronounced disease severity in the intraoperative plus postoperatively treated patients as evidenced by a higher initial European System for Cardiac Operative Risk Evaluation score, higher reoperation rate, longer cardiopulmonary bypass times, a worse inflammatory status, and perioperative development of acute renal failure, we observed a clear and comparable stabilization in hemodynamics and inflammatory parameters in both groups. More importantly and despite a higher rate of postoperative complications and a longer intensive care unit stay, patients from the intraoperative plus postoperative group showed an equal intensive care unit and 90-day survival compared to patients treated only intraoperatively. Our data suggest that postoperative continuation of hemoadsorption treatment might be beneficial in patients with endocarditis who develop perioperative renal failure in combination with severe hemodynamic instability and high-grade intraoperative findings.

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Giglio, Alexandra, Briana Miller, Erin Curcio, Yen-Hong Kuo, Brian Erler, James Bosscher, Verda Hicks et Karim ElSahwi. « Challenges to Intraoperative Evaluation of Endometrial Cancer ». JSLS : Journal of the Society of Laparoscopic & ; Robotic Surgeons 24, n^o 2 (2020) : e2020.00011. http://dx.doi.org/10.4293/jsls.2020.00011.

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Sidwell, Richard A. « Intraoperative Teaching and Evaluation in General Surgery ». Surgical Clinics of North America 101, n^o 4 (août 2021) : 587–95. http://dx.doi.org/10.1016/j.suc.2021.05.006.

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IKEDA, Yoshihiro, Seiki MATSUNO, Taro KODERA, Masao KOBARI, Hirotake HISANO, Sumitomo KATO, Hidemi YAMAUCHI, Toshio SATO et Shogo YAMADA. « Evaluation of intraoperative irradiation for pancreatic cancer. » Japanese Journal of Gastroenterological Surgery 19, n^o 5 (1986) : 942–47. http://dx.doi.org/10.5833/jjgs.19.942.

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Abel, Martin D., Rick A. Nishimura, Mark J. Callahan, Kai Rehder, Duane M. Ilstrup et A. Jamil Tajik. « Evaluation of Intraoperative Transesophageal Two-dimensional Echocardiography ». Anesthesiology 66, n^o 1 (1 janvier 1987) : 64–68. http://dx.doi.org/10.1097/00000542-198701000-00012.

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Berrio Valencia, Marta Ines, et Abigayel Joschko. « Intraoperative transesophageal echocardiogram evaluation for liver transplantation ». Korean Journal of Anesthesiology 72, n^o 4 (1 août 2019) : 385–86. http://dx.doi.org/10.4097/kja.d.18.00331.

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Caudle, Abigail S. « Intraoperative Pathologic Evaluation with Targeted Axillary Dissection ». Annals of Surgical Oncology 25, n^o 11 (27 juillet 2018) : 3112–14. http://dx.doi.org/10.1245/s10434-018-6666-4.

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Copeland, Benjamin J., Harold C. Pillsbury et Craig A. Buchman. « Prospective Evaluation of Intraoperative Cochlear Implant Radiographs ». Otology & ; Neurotology 25, n^o 3 (mai 2004) : 295–97. http://dx.doi.org/10.1097/00129492-200405000-00016.

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Shamir, Micha, Meir Leibergal et Charles Weissman. « Intraoperative Evaluation of a Prototype Warming System ». Anesthesiology 96, Sup 2 (septembre 2002) : A590. http://dx.doi.org/10.1097/00000542-200209002-00590.

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Martelli, Sandra, Stefano Zaffagnini, Barbara Falcioni et Maurilio Marcacci. « Intraoperative kinematic protocol for knee joint evaluation ». Computer Methods and Programs in Biomedicine 62, n^o 2 (avril 2000) : 77–86. http://dx.doi.org/10.1016/s0169-2607(99)00055-3.

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Ammar, Tameshwar, et Steven Konstadt. « Intraoperative transesophageal echocardiographic evaluation of mitral regurgitation ». Journal of Cardiothoracic and Vascular Anesthesia 10, n^o 3 (avril 1996) : 397–405. http://dx.doi.org/10.1016/s1053-0770(96)80106-6.

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Lazar, Jason M., Richard H. Smith et William C. Scott. « Intraoperative evaluation of a bicuspid aortic valve ». Journal of Cardiothoracic and Vascular Anesthesia 11, n^o 2 (avril 1997) : 253–55. http://dx.doi.org/10.1016/s1053-0770(97)90224-x.

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Wysluch, A., P. Maurer, I. Stricker, M. Kunkel, K. D. Wolff et F. Hölzle. « O.486 Intraoperative evaluation of bony margins ». Journal of Cranio-Maxillofacial Surgery 36 (septembre 2008) : S122. http://dx.doi.org/10.1016/s1010-5182(08)71610-x.

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Sugawara, Yasuhiko, Toshihiko Ikegami, Toshiyuki Namba, Hideo Kimura, Kazuto Inoue, Keiichi Kubota, Yasushi Harihara et al. « Intraoperative evaluation of small-calibre arterial reconstructions ». Ultrasound in Medicine & ; Biology 23, n^o 3 (janvier 1997) : 473–76. http://dx.doi.org/10.1016/s0301-5629(97)80001-4.

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Qin, Huanlong, Chaohong Lin et Xiulong Zhang. « Evaluation of intraoperative radiotherapy for gastric carcinoma ». Chinese Journal of Clinical Oncology 2, n^o 1 (février 2005) : 516–20. http://dx.doi.org/10.1007/bf02739743.

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Walter, William R., E. Stephen Amis, Seymour Sprayregen et Linda B. Haramati. « Intraoperative Radiography for Evaluation of Surgical Miscounts ». Journal of the American College of Radiology 12, n^o 8 (août 2015) : 824–29. http://dx.doi.org/10.1016/j.jacr.2015.03.005.

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Fischer, C., V. Ibanez et F. Mauguière. « Evaluation of BAEP changes in intraoperative monitoring ». Electroencephalography and Clinical Neurophysiology 61, n^o 3 (septembre 1985) : S67. http://dx.doi.org/10.1016/0013-4694(85)90281-0.

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Schwartz, Richard B., Liangge Hsu, Peter McL Black, Eben Alexander Iii, Terence Z. Wong, Roman A. Klufas, Thomas Moriarty et al. « Evaluation of intracranial cysts by intraoperative MR ». Journal of Magnetic Resonance Imaging 8, n^o 4 (juillet 1998) : 807–13. http://dx.doi.org/10.1002/jmri.1880080409.

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Jellinek, David, Doreen Jewkes et Lindsay Symon. « Noninvasive Intraoperative Monitoring of Motor Evoked Potentials under Propofol Anesthesia : Effects of Spinal Surgery on the Amplitude and Latency of Motor Evoked Potentials ». Neurosurgery 29, n^o 4 (1 octobre 1991) : 551–57. http://dx.doi.org/10.1227/00006123-199110000-00011.

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Abstract We present the results of intraoperative monitoring of motor evoked potentials from 34 patients undergoing spinal surgery under total anesthesia with intravenously administered propofol. intraoperative recording was performed with transcranial electrical stimulation. Two groups of patients were studied: 1) a control population of 26 patients undergoing lumbar discectomy for prolapsed intervertebral disc, all of whom had normal preoperative motor conduction; and 2) a population of 8 patients undergoing neurosurgical procedures for spinal tumor (5 patients) and spinal arteriovenous malformation (3 patients), all of whom had abnormal preoperative neurological signs and abnormal preoperative motor conduction. In the first group, electromyographic responses were recorded intraoperatively either from the 2nd dorsal interosseous muscle of the hand (5 patients) or from the 1st dorsal interosseous muscle of the foot (21 patients). In the second group, responses were recorded intraoperatively either from the 1st dorsal interosseous muscle of the foot (7 patients) or from the anterior tibial muscle (1 patient). Intraoperative monitoring of motor function was successful in 88.5% of the patients in the control group. Propofol anesthesia caused a reduction in response amplitude to 7% of baseline values obtained from conscious relaxed subjects. Intraoperative monitoring was successful in 87% of the patients in the pathological group. We observed significant changes in both amplitude (>50%) and/or onset latency (>3 ms) from the intraoperative baseline that indicated cither improvement (3 patients) or deterioration (2 patients) in motor conduction within minutes of surgical maneuvers anticipated to alter spinal cord function. Only permanent complete loss of intraoperative motor conduction (1 patient) correlated with a significant change in the postoperative neurological state. We conclude 1) that changes in latency as well as amplitude are useful evaluation criteria of intraoperative motor evoked potentials, and 2) that even in the presence of significant intraoperative deterioration in motor conduction, subsequent recovery of motor conduction toward baseline values during anesthesia is a favorable prognostic sign.

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Ardeshiri, Ardeshir, Christian Radina, Martin Edlauer, Ardavan Ardeshiri, Alfred Riepertinger, Andreas Nerlich, Jörg-Christian Tonn et Peter A. Winkler. « Evaluation of new radiolucent polymer headholder pins for use in intraoperative computed tomography ». Journal of Neurosurgery 111, n^o 6 (décembre 2009) : 1168–74. http://dx.doi.org/10.3171/2009.1.jns08862.

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Object With the introduction of intraoperative CT (iCT) scanning, neurosurgeons can now obtain images of the brain during surgery, offering the possibility of intraoperative resection control and monitoring of potential intraoperative complications. The combination of iCT with neuronavigation makes it possible to update the reference scans intraoperatively when necessary. However, the headholder pins normally used for iCT scanning still show artifacts. In the present study, new polymer pins, producing nearly no artifacts in laboratory tests, are compared with the usual pins with regard to their mechanical and artifact behavior to evaluate their potential use in the clinical routine. Methods Pins made of different materials (titanium, Macor, silicon nitride, zirconium oxide, sapphire, polyetheretherketone, and polyparaphenylene copolymer) were used for the fixation of 10 cadaveric heads. Special force sensors measured the fixation pressure of the pins, and histological analysis revealed the penetration depth. Computed tomography scans of a head phantom, fixed with the different pins, were obtained to reveal artifact behavior. Results All pins were biocompatible. Pins did not differ significantly in fixation pressures and mechanical behavior. Penetration depths were comparable (maximum 1.4 mm) and did not cause opening of the diploe. Polymer pins made of polyparaphenylene showed the best results in artifact behavior in CT scans. Conclusions The authors' results demonstrate that the new polymer pins are comparable in their mechanical behavior to the usual pins but superior in artifact behavior. Therefore, their use in the clinical routine of iCT scanning will be beneficial for the surgeon.

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