Resection of intraventricular and parenchy-mal tumors remains a relatively infrequent practice owing to the limiting factors of hemorrhage, deteriorating visibility, length of operation and the limited range of available instruments.
A dual-portal approach has been piloted that uses one channel for illumination and visualization, and the other for the passage of instruments; complete resection was achieved in five out of six patients, one case being abandoned in favor of open operation due to hemorrhage . Although there was no immediate reported morbidity, the potential hazards of multiple cortical punctures were a cause for concern. Extensive endoscopic resection of deep-seated parenchymal brain tumors has remained the practice of a very small number of committed neurosurgeons, often using highly sophisticated image-guided stereotaxy and laser ablation, or ultrasound guidance. Notwithstanding the high level of skill and elegance involved, the absence of any randomized trial data regarding disease-free remission or survival makes it difficult to evaluate and define the role of this technology in tumor management.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.