Search results for "Superior hypogastric plexu"
showing 6 items of 6 documents
Pain Mechanisms Involved and Outcome in Advanced Cancer Patients with Possible Indications for Celiac Plexus Block and Superior Hypogastric Plexus Bl…
2002
Aims and Background There is controversy about the role of neurolytic sympathetic blocks in advanced cancer, when pain syndromes may assume other characteristics, with a possible involvement of structures other than visceral. The aim of the present study was to assess the pain characteristics and the analgesic response of a consecutive sample of home care patients with pancreatic and pelvic pain, which would have possible indications for a celiac plexus block and a superior hypogastric block, respectively. Methods From January 1999 to December 1999, 400 consecutive advanced cancer patients were surveyed for a prospective longitudinal survey. We considered only patients who had pancreatic ca…
The Laparoscopic Approach to Control Intractable Pelvic Neuralgia: From Laparoscopic Pelvic Neurosurgery to the LION Procedure
2007
OBJECTIVE: To present different aspects and advantages of the laparoscopic approach to the pelvic nerves aimed at treating intractable pelvic neuralgia. METHODS: We report on a nonconsecutive series of 7 patients with different types and etiologies of chronic pelvic neuralgia, all of whom underwent laparoscopy. In all 7 cases, the neuralgia was refractory to medical management and had profound socioeconomic consequences for the patients. RESULTS: Techniques of laparoscopic transperitoneal neurolysis of several pelvic somatic nerves are described but also our technique of laparoscopic implantation of neuroprothesis for neuromodulation on somatic pelvic nerves or on autonomic pelvic nerves as…
Influence of identification and preservation of pelvic autonomic nerves in rectal cancer surgery on bladder dysfunction after total mesorectal excisi…
2003
PURPOSE: Given the improvement in oncologic outcome after the introduction of total mesorectal excision for the treatment of rectal cancer, the objective of the present study was to determine the frequency of identification and preservation of the pelvic autonomic nerves and to identify a possible link between postoperative micturition disturbances and the extent of the radical resection. METHODS: Between March 1997 and December 2001, 150 patients with adenocarcinoma of the rectum (≤16 cm from the anal verge) underwent surgery, with sphincter preservation in 112 cases (74.7 percent). Sixty-three patients (42 percent) were classified as American Society of Anesthesiologists Stage III and two…
Sympathetic blocks for visceral cancer pain management: A systematic review and EAPC recommendations.
2015
The neurolytic blocks of sympathetic pathways, including celiac plexus block (CPB) and superior hypogastric plexus block (SHPB) , have been used for years. The aim of this review was to assess the evidence to support the performance of sympathetic blocks in cancer patients with abdominal visceral pain. Only comparison studies were included. All data from the eligible trials were analyzed using the GRADE system. Twenty-seven controlled studies were considered. CPB, regardless of the technique used, improved analgesia and/or decrease opioid consumption, and decreased opioid-induced adverse effects in comparison with a conventional analgesic treatment. In one study patients treated with superi…
Neuromodulation of the superior hypogastric plexus: a new option to treat bladder atonia secondary to radical pelvic surgery?
2009
Abstract Background The aim of this study is to report on the impact of neuromodulation to the superior hypogastric plexus in patients with bladder atonia secondary to pelvic surgery. Methods In 4 consecutive patients with bladder atonia secondary to pelvic surgery, we performed a laparoscopic implantation of a neurostimulator—LION procedure—to the entire superior hypogastric plexus. Results Of the 4 reported patients, 3 are able to partially void or empty their bladder. Conclusions If the presented results could be obtained in further patients and maintained in long-term follow-up, the LION procedure to the superior hypogastric plexus could change the management of bladder function in pati…
Pelvic Autonomic Nerve Preservation during Total Mesorectal Excision (TME) from Werner Kneist
2017
According to the German guideline for “Colorectal Cancer,” total mesorectal excision (TME) removes the cancer located at the central and lower thirds of the rectum and the pelvic floor while preserving the superior hypogastric plexus (SHP), the hypogastric nerves, and the inferior hypogastric plexus (IHP) (recommendation level A, level of evidence 1b, strong consensus). Intraoperative nerve damage is to be avoided to preserve postoperative quality of life with the premise of radical surgery. It is particularly necessary to preserve autonomously controlled urogenital and anorectal functions. Among other things, this presumes a fundamental understanding of current events on surgical topograph…