Anus Neoplasms ; diagnosis ; etiology ; surgery ; Buschke-Lowenstein Tumor ; Carcinoma, Verrucous ; diagnosis ; etiology ; surgery ; Condylomata Acuminata ; etiology ; pathology ; surgery ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Male ; Middle Aged ; Papillomavirus Infections ; complications ; Penile Neoplasms ; etiology ; pathology ; surgery ; Time Factors

OBJECTIVETo explore the long-term therapeutic effects of tracheotomy on juvenile onset recurrent respiratory papillomatosis in children.

METHODSBetween 1993 and 2007, 86 cases of juvenile onset recurrent respiratory papillomatosis (JRRP) in children were encounted and divided into tracheotomy group and conventional surgery group, the clinical data of these children were retrospectively analyzed.

RESULTSThere were 29 cases in tracheotomy group, the time of carrying tracheal casing pipe was 13 - 66.5 months, the operative times of every case was 4 - 9 times (median 7), there were 27 cases with more than 2 years release after extubation. There were 2 cases with tumor dissemination into incision of trachea and endotracheal, one case lost to follow up and the other one dead. No case developed laryngotracheal stenosis and severe complication. There were 57 cases in conventional surgery group, the operation times of every case was 9 - 32 times (median 18). Fifty-three cases with no recurrence after follow up for more than one year; 2 cases with trachea tumor dissemination, and after operation, no recurrence after 2 years follow up. Two cases with endotracheal dissemination, one case lost to follow up and the other one dead. No case developed laryngotracheal stenosis and severe complication. The voice assessment result of tracheotomy group was obviously better than that in the conventional surgery group, the difference had statistical significance (χ(2) = 33.16, P < 0.005), the tumor dissemination rate of the two groups had no statistical significance (χ(2) = 0.0026, P > 0.05).

CONCLUSIONSTracheotomy significantly reduce the operative times, give the greatest degree of preservation of laryngeal function, and it do not increase the tumor dissemination into trachea. Tracheotomy is an effective method of treatment in children with a high rate of recurrence, and with poor economic conditions, and difficult to follow-up. It can improve the long-term life quality of the children.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Laryngeal Neoplasms ; surgery ; Male ; Papilloma ; surgery ; Papillomavirus Infections ; surgery ; Respiratory Tract Infections ; surgery ; Retrospective Studies ; Tracheotomy

OBJECTIVETo investigate the safety of peri-operative management on children with juvenile recurrent respiratory papilloma (JORRP).

METHODSA retrospective analysis was conducted on preoperative assessment, anesthesia methods and options, operative procedure, and postoperative airway maintenance in 28 JORRP children aged from ten months to seven years old. A total of 148 times of surgery was performed on these 28 children.

RESULTSOne hundred and nine JORRP children graded one and two-degree dyspnea underwent surgery within 24 hours and were intubated successfully in the first attempt after intravenous induction. Thirty-nine emergency operations were performed in the children graded three and four-degree dyspnea, 35 of them were intubated successfully in the first attempt after inhalation induction and 4 succeeded in the second attempt. No complications occurred in 129 JORRP children postoperatively, 17 children suffered from mild dyspnea and relieved after oxygen inhalation, 2 children were intubated and sent to intensive care unit because of postoperative hypoxemia. All JORRP children got through the peri-operative period safely. The quality of pronunciation in 101 children improved markedly and 35 suffered from slight hoarseness on the 1st postoperative day. Three children had the tracheal tube of tracheostomy removed after receiving five, four and three operations respectively. Nineteen children were followed up for 2 - 5 years. Among them, one child did not relapse 3 years after surgical management.One child suffered from laryngostenosis postoperatively. No death occurred.

CONCLUSIONComplete preoperative preparation, rational anesthesia methods, careful operative procedure and airway maintenance after surgery could increase the safety for children with recurrent respiratory papilloma.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Laryngeal Neoplasms ; surgery ; Male ; Papillomavirus Infections ; surgery ; Perioperative Care ; Respiratory Tract Infections ; surgery ; Retrospective Studies

OBJECTIVE: To investigate hypoxia tolerance of children with recurrent respiratory papillomatosis with the spread of trachea in surgical procedures without ventilation via endotracheal tube intermittently under general anesthesia. METHOD: Forty children with recurrent respiratory papillomatosis were enrolled in the observation. The duration of SpO2 from 100% to the points of 99%, 95%, 90%, 85%, the heart rate in each time point above. PaO2, PaCO2, pH valve when SpO2 was 85%, the duration of SpO2 back to 100% were recorded respectively. RESULT: Duration of SpO2 from 100% down to 99%, 95%, 90%, 85% was (168.4 +/- 58.3)s, (204.6 +/- 56.4)s, (224.8 +/- 58.9)s, (239.9 +/- 60.6)s, respectively. Heart rate was (121.6 +/- 14. 6)bpm, (123.3 +/- 15.1) bpm, (124.1 +/- 14.8)bpm, (125.0 +/- 15.1)bpm, respectively. When SpO2 was 85%, pH value was 7.22 +/- 0.05, PCO2 was (69 +/- 8.7)mmHg, PO2 was (52 +/- 7.9)mmHg. Duration of SpO2 up to 100% was (28.6 +/- 2.5)s; When SpO2 back to 100%, pH value was 7.40 +/- 0.02, PCO2 was (40.5 +/- 2.0)mmHg, PO2 was (358 +/- 104.3)mmHg. CONCLUSION Intermittent apnea during the surgical procedures in RRP children with distal spread of papillomas was safe, hypercapnia and hypoxia caused by the apnea can be corrected soon after the re-ventilation. Duration of apnea should be controlled within 3--5 minutes in each apnea-reoxygenation cycle.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Hypoxia ; physiopathology ; Male ; Monitoring, Intraoperative ; Papillomavirus Infections ; pathology ; surgery ; Respiratory Tract Infections ; pathology ; surgery ; Respiratory Tract Neoplasms ; pathology ; surgery

OBJECTIVE: To investigate the prevalence, etiology, clinical presentation and pathological features, treatment and prognosis of cervical cancer in young women. METHODS: Clinical data of 132 young women with cervical cancer were reviewed. RESULTS: Positive rate of human papillomavirus 18 was high in young women with cervical cancer. The primary clinical presentation of young patients with cervical cancer was contact bleeding of vagina, and the signs were out-expanding of cervical mass. The percentage of adenocarcinoma increased. The main treatment for cervical cancer was surgery. The patients had radical hysterectomy plus ovarian transplantation, none of whom had ovarian metastases and menopause syndrome. Prognosis of most patients was good. CONCLUSION Contact bleeding is a significant symptom in young women with cervical cancer. Surgery is first considered in the treatment. Preoperative neoadjuvant chemotherapy can be used in patients with locally advanced and late stage cervical cancer. Ovarian transplantation during operation can retain the ovary function.
Adult ; Age Factors ; Female ; Human papillomavirus 18 ; isolation & purification ; Humans ; Papillomavirus Infections ; complications ; Prognosis ; Uterine Cervical Neoplasms ; diagnosis ; surgery ; therapy ; virology ; Young Adult

BACKGROUNDJuvenile onset recurrent respiratory papillomatosis (JORRP) is a relatively rare disease. It affects the larynx in most cases. Because reports on JORRP to the lower respiratory tract (LRT) are few, we investigated clinical features of patients with a history of JORRP to analyze the risk factors of this disease.

METHODSData from 208 JORRP patients admitted to Beijing Tongren Hospital from January 2008 to December 2010 were reviewed. Gender, age at onset of symptoms, age at first surgery, duration of symptoms before the first surgical procedure, the number of surgical procedures, mean interval between surgical interventions, and the number of tracheotomies in patients with and without LRT spread of JORRP were analyzed. The data from patients with and without tracheotomy were recorded and compared. Two cases of primary tracheal papillomatosis were reviewed.

RESULTSPapillomas extension down to the LRT was observed in 46 children (22.1%). Patients with LRT papillomatosis had a shorter time from the onset of the symptoms until the first surgery, required significantly more surgical procedures, and had a shorter mean surgical interval. Tracheotomy was performed in 13/162 (8.0%) children with laryngeal papillomatosis vs. 36/46 (78.3%) children with LRT papillomatosis. After tracheotomy, 36/49 (73.5%) children developed LRT papillomatosis and 10/157 (6.4%) children who did not have a tracheotomy developed LRT papillomatosis. Patients with tracheotomy required a significantly higher number of surgical procedures. The younger the patient had a tracheotomy, the longer the duration of cannulation was.

CONCLUSIONSJORRP patients with LRT spread are prone to develop more aggressive disease. Tracheotomy resulted in a significant increase of LRT involvement.

Female ; Humans ; Infant ; Infant, Newborn ; Larynx ; pathology ; surgery ; virology ; Male ; Papillomavirus Infections ; epidemiology ; Respiratory System ; pathology ; surgery ; virology ; Respiratory Tract Infections ; epidemiology ; Risk Factors ; Software ; Tracheotomy

To observe the outcomes of Traditional Chinese Medicine combined with CO_2 laser surgery on the clinical course and serum immunological indexes of Adult onset Recurrent Respiratory Papillomatosis.69 cases of adult recurrent respiratory papilloma patients who enrolled in Beijing Tongren Hospital from September 2014 to March 2016 were divided randomly into two groups.The Chinese medicine surgery group were treated with traditional Chinese medicine combined with CO_2 laser surgery and the surgery group were treated with CO_2 laser surgery alone.All patients were followed up for more than one year.Relapse time and Derkay score were examed and analyzed between two groups before and after treatment.The detection of aperipheral blood immunoglobulin,T cell subsets,percentage of B cell and NK cell and IgG subtype examed every six month.There was no significant difference between two group in Derkay score,lesion recurrence time and the index of immunology before the treatment(>0.05).However,the recurrence time after treatment [(14.11±1.57)months]prolonged than before treatment[(10.85±2.33)months]in the experimental group.The examination of IgG [(1 539.84±388.20)mg/dl],percentage of total T lymphocytes[(85.14±22.24)%],Th cells[(47.34±19.07)%],B lymphocytes[(12.55±5.26)%]in treatment of traditional Chinese medicine was higher than that before treatment of serum IgG [(1 225.14±260.27)mg/dl],T cells [(69.68±11.12)%],Th [(41.97±10.92)%],B lymphocytes[(10.30±5.45)%].The difference was statistically significant(<0.01).The curative effect of traditional Chinese medicine combined with laser surgery for the treatment of adult recurrent respiratory papillomatosis,can effectively prolong the recurrence time of patients,improve their immune cell antiviral ability and be worthy of clinical popularization and application.
Adult ; Humans ; Laser Therapy ; Medicine, Chinese Traditional ; Neoplasm Recurrence, Local ; Papillomavirus Infections ; drug therapy ; immunology ; surgery ; Respiratory Tract Infections ; drug therapy ; immunology ; surgery

OBJECTIVE: This study was designed to explore the risk factors associated with severity of juvenile onset recurrent respiratory papillomatosis. METHOD: A retrospective study was conducted to study determinants of severe forms of juvenile recurrent onset respiratory papillomatosis. The patients were separated into different groups based on the onset age, the first recurrence of age, the first recurrence of period, gender and incision of tracheal respectively. The relationship among the lesion severity score,the involvement of the subregion, operation period and the next operation period were also explored. RESULT: It was observed that some children who recurred before 4 years old required more surgery, shorter operation period(the average, longest or shortest operation period) than those elder children, the differences were statistically (P=0. 029, 0. 003, 0. 010, 0. 039, respectively). The severity score of lesion was correlated positively with the involvement of the subregion and negatively with operation period (r=0. 914, -0. 451, respectively). Some children who diagnosed before 4 years old had to endure more severity score and shorter operation period than those older children, the differences were statistically (P= 0. 036, 0. 000, respectively). 8 cases accepted incision of tracheal, they accepted more surgery too. But the differences in the onset age, the first recurrence of age, and the operation period were not statistically. CONCLUSION The results showed that the clinical course of juvenile onset recurrent respiratory papillomatosis was closely related to the first recurrence age and period, while the severity of disease was associated to the onset age and the involvement of the subregion.
Adolescent ; Age of Onset ; Child ; Child, Preschool ; Humans ; Papilloma ; Papillomavirus Infections ; classification ; epidemiology ; surgery ; Respiratory Tract Infections ; classification ; epidemiology ; surgery ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Trachea

OBJECTIVE: To investigate the efficacy of submucosal resection by CO2 laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis. METHOD: A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibro-laryngoscope. Papilloma was resected completely including the submucosal tissure with CO2 laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately. RESULT: HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases). Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence. CONCLUSION Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.
Child ; DNA, Viral ; blood ; Human papillomavirus 11 ; isolation & purification ; Human papillomavirus 6 ; isolation & purification ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Laryngoscopes ; Lasers, Gas ; Neoplasm Recurrence, Local ; Papilloma ; diagnosis ; surgery ; virology ; Papillomavirus Infections ; diagnosis ; surgery ; Postoperative Period ; Prognosis ; Respiratory Tract Infections ; diagnosis ; surgery

OBJECTIVE: The study is to evaluate our results of patients with sinonasal inverted papilloma (SIP) undergoing endoscopic sinus surgery and to investigate the recurrence relative factors of SIP. METHOD: A retrospec- tive analysis was performed of medical records for 54 cases SIP treated with endoscopic resection. Compared to pre operation imaging evaluation and intraoperative observation, efficacy assessments included endoscopy during follow-up after operation and combined with CT examination results. RESULT: The incidence of 54 cases with ethmoid sinus, part of the lateral wall of the nasal cavity was higher. The recurrence rate was higher in the cases invaded front and/or inferior wall of maxillary sinus, frontal recess. There was no case with middle turbinate. Canceration with the same time accounted for 1.85%. CONCLUSION Misdiagnosis as polyps, the lesion sites of tumour, involving the frontal recess, front and inferior wall of maxillary sinus are the risk factors of recurrence. The preoperative accurate judgment of the primary tumor site and surgical resection completly are the most effective means of preventing recurrence. Postoperative endoscopy examination combined with CT examination is an effective means for the evaluation of recurrence.
Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; surgery ; Papillomavirus Infections ; Paranasal Sinus Neoplasms ; surgery ; Turbinates