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Newly developed histological tray for the application of identifying exact lymph node dissections in uro-logical surgical oncology
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作者 Istvan Buzogany Laszlo Vaczi +4 位作者 Zsolt Domjan Fariborz Bagheri Attila Kiss Alex Dakay Tamas Ferenc Molnar 《Health》 2013年第10期1629-1633,共5页
In any urologic cancer surgery, lymph node dissection and its processing play a significant role in staging and management of the patients. Accordingly, precise handling of the dissected lymph nodes is important for h... In any urologic cancer surgery, lymph node dissection and its processing play a significant role in staging and management of the patients. Accordingly, precise handling of the dissected lymph nodes is important for histopathological work-up. The authors have developed a lymph node plastic tray shaping the abdomen and pelvis in which the dissected lymph nodes are placed in its determined location. This can be applied for any urologic cancer surgery. The research was designed to test the usage of a new histological tray. The objective was to assess how helpful it was for the surgical team and in the pathological process. The newly developed lymph node tray has been applied in 150 urological cancer surgeries and its efficacy and outcome have been evaluated in all these cases by involved doctors and assistants. This new tray simplifies lymph node removing and identification (staging), making it safer and quicker in any uro-oncological surgery. It facilitates the work of the pathologist and the flow of reliable information along the surgeon—pathologist-oncologist team. With usage of the tray, lymph node dissections are more structured by methodical means compared to any of the present methods. 展开更多
关键词 Lymph Node Dissection Urogenital surgical oncology TNM System Safety and Hazards Histological Tray
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Indocyanine green:The guide to safer and more effective surgery
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作者 Pietro Fransvea Maria Michela Chiarello +2 位作者 Valeria Fico Maria Cariati Giuseppe Brisinda 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期641-649,共9页
In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyan... In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal surgery.They also highlight future perspectives of the use of indocyanine green in mini-invasive surgery.Indo-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in humans.It can be administered in-travenously or intra-arterially.Since its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and burns.For these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant surgery.Co-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic leakage.The regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient outcomes.Using the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic leak.The use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency scenarios.However,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine green guided surgery into standard practice. 展开更多
关键词 Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery surgical oncology
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Role of immunotherapy in gastric cancer with liver metastasis
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作者 Bogdan Gafton Stefan Morarasu Gabriel Dimofte 《World Journal of Clinical Oncology》 2024年第11期1383-1389,共7页
Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary s... Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary site for metastatic spread,with the peritoneum,lungs,and bones also being common targets.With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions,the options to treat metastatic gastric cancer have expanded.This diversified therapeutic approach is designed to enhance patient quality of life and prolong survival,showcasing the progress in treatment modalities for individuals with gastric cancer and liver metastases. 展开更多
关键词 Gastric cancer IMMUNOTHERAPY Liver metastases Metastatic gastric cancer oncology surgical oncology
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Laparoscopic vs open approach to resection of hepatocellular carcinoma in patients with known cirrhosis:Systematic review and meta-analysis 被引量:18
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作者 Ahmed Twaij Philip H Pucher +3 位作者 Mikael H Sodergren Tamara Gall Ara Darzi Long R Jiao 《World Journal of Gastroenterology》 SCIE CAS 2014年第25期8274-8281,共8页
AIM: To review the currently available literature comparing laparoscopic to open resection of hepatocellular carcinoma (HCC) in patients with known liver cirrhosis.
关键词 LAPAROSCOPIC Hepatocellular carcinoma CIRRHOSIS Hepatic resection Surgery HEPATOBILIARY surgical oncology
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Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma:When and how? 被引量:6
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作者 Tudor Mocan Adelina Horhat +6 位作者 Emil Mois Florin Graur Cristian Tefas Rares Craciun Iuliana Nenu Mihaela Spârchez Zeno Sparchez 《World Journal of Gastrointestinal Oncology》 SCIE 2021年第12期2050-2063,共14页
Hilar cholangiocarcinoma (hCCA) is a primary liver tumor associated with a dimprognosis. The role of preoperative and palliative biliary drainage has long beendebated. The most common techniques are endoscopic retrogr... Hilar cholangiocarcinoma (hCCA) is a primary liver tumor associated with a dimprognosis. The role of preoperative and palliative biliary drainage has long beendebated. The most common techniques are endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic biliary drainage (PTBD);however, recently developed endoscopic ultrasound-assisted methods are gainingmore atention. Selecting the best available method in any specific scenario iscrucial, yet sometimes challenging. Thus, this review aimed to discuss theavailable techniques, indications, perks, pitfalls, and timing-related issues in themanagement of hCCA. In a preoperative setting, PTBD appears to have someadvantages: low risk of postprocedural complications (namely cholangitis) andbetter priming for surgery. For palliative purposes, we propose ERCP/PTBDdepending on the experience of the operators, but also on other factors: the levelof bilirubin (if very high, rather PTBD), length of the stenosis and the presence ofcholangitis (PTBD), ERCP failure, or altered biliary anatomy. 展开更多
关键词 Hilar cholangiocarcinoma Endoscopic biliary drainage Percutaneous biliary drainage Endoscopic ultrasound biliary drainage surgical oncology
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Trends in the management of anorectal melanoma:A multiinstitutional retrospective study and review of the world literature 被引量:1
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作者 Josh Bleicher Jessica N Cohan +6 位作者 Lyen C Huang William Peche T Bartley Pickron Courtney L Scaife Tawnya L Bowles John R Hyngstrom Elliot A Asare 《World Journal of Gastroenterology》 SCIE CAS 2021年第3期267-280,共14页
BACKGROUND Anorectal melanoma(ARM)is a rare disease with a poor prognosis.Evidence on optimal treatment is limited and surgical management varies widely.We hypothesized that the frequency of abdominoperineal resection... BACKGROUND Anorectal melanoma(ARM)is a rare disease with a poor prognosis.Evidence on optimal treatment is limited and surgical management varies widely.We hypothesized that the frequency of abdominoperineal resection used as primary treatment of ARM has decreased over the past several decades.AIM To update our understanding of outcomes for patients with ARM and analyze management trends around the world.METHODS This is a multi-institutional,retrospective study of patients treated for ARM at 7 hospitals.Hospitals included both large,academic,tertiary care centers and smaller,general community hospitals.Using prospectively maintained institutional tumor registries,we identified 24 patients diagnosed with ARM between January 2000 and May 2019.We analyzed factors prognostic for recurrence and survival.We then used Cox regression to measure overall survival(OS)and melanoma-specific survival.We also performed a literature review to assess trends in surgical management and outcomes.RESULTS Of the 24 patients diagnosed with ARM,12(50.0%)had local,8(33.3%)regional,and 4(16.7%)distant disease at diagnosis.Median time to recurrence was 10.4 mo[interquartile range(IQR)7.5-17.2]with only 2 patients(9.3%)not developing recurrence following surgical resection.Median OS was 18.8 mo(IQR 13.5-33.9).One patient is still alive without recurrence at 21.4 mo from diagnosis;no other patient survived 5 years.Primary surgical management with abdominoperineal resection(APR)vs wide excision(WE)did not lead to differences in OS[hazard ratio=1.4(95%CI:0.3-6.8)].Review of the literature revealed geographic differences in surgical management of ARM,with increased use of WE in the United States and Europe over time and more frequent use of APR in Asia and India.There was no significant improvement in survival over time.CONCLUSION There is wide variation in the management of ARM and survival outcomes remain poor regardless of approach.Surgical management should aim to minimize morbidity. 展开更多
关键词 MELANOMA Anorectal melanoma Literature review Melanoma surgery surgical oncology Colorectal surgery
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How to select elderly colorectal cancer patients for surgery: a pilot study in an Italian academic medical center 被引量:4
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作者 Giampaolo Ugolini Francesco Pasini +4 位作者 Federico Ghignone Davide Zattoni Maria Letizia Bacchi Reggiani Daniele Parlanti Isacco Montroni 《Cancer Biology & Medicine》 SCIE CAS CSCD 2015年第4期302-307,共6页
Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years o... Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or undertreatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC.Methods: Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk factors.Results: Forty-six patients were studied. The median follow-up time after surgery was 4.6 years(range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived(4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go(TUG), Eastern Cooperative Group Performance Status(ECOG PS), Instrumental Activities of Daily Living(IADLs), Vulnerable Elders Survey(VES-13) scoring systems were significantly associated with increased long term mortality risk.Conclusion: Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients. 展开更多
关键词 Elderly geriatric assessment surgical oncology risk assessment screening tools colorectal cancer(CRC)
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Giant cellular leiomyoma in the broad ligament of the uterus:A case report
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作者 Jiao Yan Yu Li +2 位作者 Xing-Yu Long Dao-Cheng Li Si-Jin Li 《World Journal of Clinical Cases》 SCIE 2022年第34期12696-12702,共7页
BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,... BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,it is still difficult to achieve a preoperative diagnosis.The majority of cellular leiomyomas are diagnosed by histopathology after surgery.We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.CASE SUMMARY A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time.The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause,and complained of frequent abdominal pain and low-grade fever.Computed tomography of the abdomen showed a solid cystic mass(29.4 cm×18.8 cm×37.7 cm)in the pelvis and abdomen.Moreover,routine blood test results indicated a baseline cancer antigen 125(CA-125)level of 187.7 U/mL and C-reactive protein of 109.58 mg/L.Subsequently,retrograde hysterectomy and bilateral adnexectomy were performed in this patient.On histopathologic examination of the surgical specimen,a rare cellular leiomyoma in the broad ligament was diagnosed.CONCLUSION Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment,differential diagnosis,and surgical management. 展开更多
关键词 surgical oncology Cellular leiomyoma in the broad ligament Uterine leiomyoma Retrograde abdominal hysterectomy Case report
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Diagnostic biopsy of cutaneous melanoma, sentinel lymph node biopsy and indications for lymphadenectomy
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作者 Efstathios T Pavlidis Theodoros E Pavlidis 《World Journal of Clinical Oncology》 CAS 2022年第10期861-865,共5页
The incidence of cutaneous melanoma appears to be increasing worldwide and this is attributed to solar radiation exposure.Early diagnosis is a challenging task.Any clinically suspected lesion must be assessed by compl... The incidence of cutaneous melanoma appears to be increasing worldwide and this is attributed to solar radiation exposure.Early diagnosis is a challenging task.Any clinically suspected lesion must be assessed by complete diagnostic excision biopsy(margins 1-2 mm);however,there are other biopsy techniques that are less commonly used.Melanomas are characterized by Breslow thickness as thin(<1 mm),intermediate(1-4 mm)and thick(>4 mm).This thickness determines their biological behavior,therapy,prognosis and survival.If the biopsy is positive,a wide local excision(margins 1-2 cm)is finally performed.However,metastasis to regional lymph nodes is the most accurate prognostic determinant.Therefore,sentinel lymph node biopsy(SLNB)for diagnosed melanoma plays a pivotal role in the management strategy.Complete lymph node clearance has undoubted advantages and is recommended in all cases of positive SLN biopsy.A PET-CT(positron emission tomography-computed tomography)scan is necessary for staging and follow-up after treatment.Novel targeted therapies and immunotherapies have shown improved outcomes in advanced cases. 展开更多
关键词 surgical oncology Malignant melanoma Skin cancer Cutaneous melanoma Sentinel lymph node biopsy Complete lymph node dissection
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Is it possible to adopt the same oncological approach in urgent surgery for colon cancer?
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作者 Bruno Yuki Yoshida Raphael L C Araujo +1 位作者 José Francisco M Farah Alberto Goldenberg 《World Journal of Clinical Oncology》 CAS 2022年第11期896-906,共11页
BACKGROUND Locoregional complications may occur in up to 30%of patients with colon cancer.As they are frequent events in the natural history of this disease,there should be a concern in offering an oncologically adequ... BACKGROUND Locoregional complications may occur in up to 30%of patients with colon cancer.As they are frequent events in the natural history of this disease,there should be a concern in offering an oncologically adequate surgical treatment to these patients.AIM To compare the oncological radicality of surgery for colon cancer between urgent and elective cases.METHODS One-hundred and eighty-nine consecutive patients with non-metastatic colon adenocarcinoma were studied over two years in a single institution,who underwent surgical resection as the first therapeutic approach,with 123 elective and 66 urgent cases.The assessment of oncological radicality was performed by analyzing the extension of the longitudinal margins of resection,the number of resected lymph nodes,and the percentage of surgeries with 12 or more resected lymph nodes.Other clinicopathological variables were compared between the two groups in terms of sex,age,tumor location,type of urgency,surgical access,staging,compromised lymph nodes rate,differentiation grade,angiolymphatic and perineural invasion,and early mortality.RESULTS There was no difference between the elective and urgency group concerning the longitudinal margin of resection(average of 6.1 in elective vs 7.3 cm in urgency,P=0.144),number of resected lymph nodes(average of 17.7 in elective vs 16.6 in urgency,P=0.355)and percentage of surgeries with 12 or more resected lymph nodes(75.6%in elective vs 77.3%in urgency,P=0.798).It was observed that the percentage of patients aged 80 and over was higher in the urgency group(13.0%in elective vs 25.8%in urgency,P=0.028),and the early mortality was 4.9%in elective vs 15.2%in urgency(P=0.016,OR:3.48,95%CI:1.21–10.06).Tumor location(P=0.004),surgery performed(P=0.016)and surgical access(P<0.001)were also different between the two groups.There was no difference in other clinicopathological variables studied.CONCLUSION Oncological radicality of colon cancer surgery may be achieved in both emergency and elective procedures. 展开更多
关键词 Colorectal cancer Intestinal obstruction Intestinal perforation surgical oncology Lymph node excision
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Modern surgical approach to hepatocellular carcinoma
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作者 Paolo Magistri Gian Piero Guerrini +1 位作者 Stefano Di Sandro Fabrizio Di Benedetto 《Hepatobiliary Surgery and Nutrition》 SCIE 2023年第6期953-955,共3页
We are glad to contribute with an editorial on the important topic of therapeutic opportunities for hepatocellular carcinoma(HCC).The increasing diffusion of minimally invasive approaches to the liver and the growing ... We are glad to contribute with an editorial on the important topic of therapeutic opportunities for hepatocellular carcinoma(HCC).The increasing diffusion of minimally invasive approaches to the liver and the growing experience worldwide have progressively changed our curative strategies for patients affected by primary and metastatic liver tumors(1). 展开更多
关键词 Robotic surgery minimally invasive liver surgery(MILS) surgical oncology liver transplant living donor liver transplantation(LDLT)
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