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        Foramen Magnum Decompression and Duraplasty is Superior to Only Foramen Magnum Decompression in Chiari Malformation Type 1 Associated with Syringomyelia in Adults

        Mehmet Sabri Gürbüz,Mehmet Zafer Berkman,Emre Ünal,Elif Akpınar,Şevki Gök,Metin Orakdöğen,Salih Aydın 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.5

        Study Design: Retrospective cohort study. Purpose: To compare surgical results of foramen magnum decompression with and without duraplasty in Chiari malformation type 1 (CM-1) associated syringomyelia (SM). Overview of Literature: The optimal surgical treatment of CM-1 associated with SM is unclear. Methods: Twenty-five cases of CM-1 with SM were included. There were 12 patients (48%) in the non-duraplasty group and 13 patients (52%) in the duraplasty group. The rate of improvement, state of postoperative SM size, amount of tonsillar herniation, preoperative symptom duration, complications and reoperation rates were analysed. Results: The rate of clinical improvement was significantly higher with duraplasty (84.6%) than without (33.3%, p <0.05). The rate of postoperative syrinx regression was significantly higher in the duraplasty group (84.6%) than in the non-duraplasty group (33.3%, p <0.05). One case in the duraplasty group needed a reoperation compared with five cases in the non-duraplasty group (p =0.059). Conclusions: Duraplasty is superior to non-duraplasty in CM-1 associated with SM despite a slightly higher complication rate.

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        Long-term results of radiofrequency and microwave ablation of colorectal cancer liver metastasis

        Ahmet Gürkan Erdemir,Sevilay Karahan,Emre Ünal,Türkmen Turan Çiftçi,Devrim Akıncı,Şuayib Yalçın,Okan Akhan 소화기인터벤션의학회 2023 International journal of gastrointestinal interven Vol.12 No.3

        Background: Radiofrequency ablation (RFA) or microwave ablation (MWA) is effective for colorectal cancer liver metastases. We aimed to investigate the impact of different variables on survival. Methods: Sixty-four patients (142 lesions) who underwent thermoablation between January 2007 and January 2019 were retrospectively analyzed. The overall survival (OS) and liver progression-free survival (Li-PFS) were compared using Kaplan-Meier analysis. Univariable and multivariable Cox-regression were done to identify prognostic factors. Results: No significant difference was found between median OS (59.39 months) and Li-PFS (41.22 months) of patients who received MWA (n = 33); and median OS (61.00 months) and Li-PFS (53.43 months) of patients who received RFA (n = 31) (OS: P = 0.697; Li-PFS: P = 0.122). The median OS and Li-PFS were significantly decreased with lung metastases and K-ras mutations (P < 0.001). There was no correlation between prior systemic chemotherapy (n = 25) and both outcome parameters (OS: P = 0.613; Li-PFS: P = 0.665). No significant difference was observed in patients with lesions less than 30 mm diameter (n = 44) whether they received prior systemic chemotherapy (n = 17) or not (n = 27) (OS: P = 0.27; Li-PFS: P = 0.42). Similarly, in patients with a lesion of 3–5 cm diameter (n = 20; eight of them had prior chemotherapy), there was no correlation for both outcomes (OS: P = 0.069; Li-PFS: P = 0.71). The most important prognostic factor was concomitant lung metastases (hazard ratio = 3.689, P = 0.002). Conclusion: Concomitant lung metastasis and mutant K-ras were associated with shorter survival. Survival did not differ significantly regarding thermoablation technique or prior systemic chemotherapy. However, in the patient group with lung metastases, curative treatments had better survival than patients who received chemotherapy only. Additional therapeutic options should be considered in patients with concomitant lung metastasis.

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