To suture or not to suture? Does globe immobilisation technique affect clinical outcome in stereotactic radiosurgery for uveal melanoma?
| العنوان: | To suture or not to suture? Does globe immobilisation technique affect clinical outcome in stereotactic radiosurgery for uveal melanoma? |
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| المؤلفون: | Matthias W. R. Radatz, John Yianni, Hibba Quhill, Ian G. Rennie, Paul Rundle, Sachin M. Salvi |
| المصدر: | British Journal of Neurosurgery. :1-4 |
| بيانات النشر: | Informa UK Limited, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Mortality rate, medicine.medical_treatment, Melanoma, Enucleation, Eye movement, General Medicine, Extraocular muscles, medicine.disease, eye diseases, Radiosurgery, Surgery, medicine.anatomical_structure, Suture (anatomy), medicine, Clinical significance, sense organs, Neurology (clinical), business |
| الوصف: | Introduction Stereotactic radiosurgery (SRS) is a valuable treatment option for uveal melanoma, offering excellent tumour control rates and eye preservation. Its efficacy relies upon accurate localisation of the tumour, which is challenging in the mobile eye. Various methods of globe immobilisation have been used, including non-invasive devices, such as eye movement tracking and suction cups, but common practice is to use local anaesthetic block with or without transconjunctival suturing of the extraocular muscles. Some studies have suggested that the addition of muscle suturing to local anaesthetic block provides better immobilisation of the globe, when compared to anaesthetic block alone. Controversy exists regarding the clinical relevance of this observation and ocular oncologists differ in their choice of immobilisation technique. Methods In order to establish if the addition of muscle suturing to local anaesthetic block improves clinical outcomes, we performed a retrospective review of all cases that underwent SRS for uveal melanoma over a 10-year period (May 2008 to May 2018). Based on surgeon preference, all patients received either local anaesthetic block plus muscle suturing (Group A) or local anaesthetic block alone (Group B) to induce globe akinesia. Outcomes assessed were primary treatment failure, tumour recurrence, secondary enucleation and death rate. Results In our cohort of 290 eyes; 118 patients were in group A and 172 patients were in group B. There were no cases of primary treatment failure in either group. With a minimum of 24 months follow-up, only 3 patients experienced tumour recurrence (1 in group A and 2 in group B). There was no significant difference in recurrence, enucleation and all-cause death rates between the two groups. Conclusion Our retrospective review suggests that although extraocular muscle suturing may be considered by some units to provide superior globe immobilisation for SRS, it does not alter the clinical outcome. |
| تدمد: | 1360-046X 0268-8697 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::43cd84c3ece2fec08a5b17bb268d0ade https://doi.org/10.1080/02688697.2021.1958147 |
| رقم الأكسشن: | edsair.doi.dedup.....43cd84c3ece2fec08a5b17bb268d0ade |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 1360046X 02688697 |
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