Fat transfer after parotidectomy: fat resorption rates, aesthetic and functional outcomes of en-bloc fat graft versus lipofilling technique

Abstract Background Autologous fat grafting (AFG) has been employed in surgical practice as a filling method. However, controversies remain on the specifics of this technique. So far, few relevant experimental large animal studies have objectively assessed factors related to AFG integration. Objectives This study utilized an experimental, medium-sized animal model to compare the feasibility of AFG collected employing 2 different techniques with instruments of distinct thicknesses. Methods Twenty minipigs (Sus scropha domesticus) were subjected to AFG harvesting via en bloc resection utilizing 3- (Group I) and 5-mm-diameter (Group II) round punch blades (PBs) and liposuction (LS) with 3- (Group III) and 5-mm-diameter cannulas (Group IV). Both samples were grafted intramuscularly (biceps femoralis). Hematoxylin and eosin staining was employed to identify intact adipocytes, fat necrosis, fibrosis, inflammation, and oil cysts. Immunohistochemical staining (perilipin-A, tumor necrosis factor alfa, and cluster of differentiation number 31) was utilized to quantify the feasibility of adipocytes, tissue necrosis, and neoangiogenesis, respectively. Results Hematoxylin and eosin analysis showed that fat necrosis and histiocyte presence were significantly lower in the AFG harvested utilizing a PB than in LS. For perilipin-A, a statistical difference was observed between subgroups I and III (P = 0.001) and I and IV (P = 0.004). Instrument diameter had no effect on graft integration in comparisons between groups II and III (P = 0.059) and II and IV (P = 0.132). Conclusions In this experimental study, fat collected utilizing a PB demonstrated higher adipocyte viability than fat collected with LS. The diameter of the collection instruments, whether PB or LS, had no effect on graft integration.

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Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation

Case Reports in Ophthalmological Medicine ◽

10.1155/2018/8954193 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Biljana Kuzmanović Elabjer ◽

Mladen Bušić ◽

Daliborka Miletić ◽

Mirjana Bjeloš ◽

Borna Šarić ◽

...

Keyword(s):

Choroidal Melanoma ◽

Single Stage ◽

Long Term Results ◽

Fat Graft ◽

En Bloc ◽

Orbital Implant ◽

Absorbable Sutures ◽

Previously Treated ◽

Socket Reconstruction

We would like to present a surgical technique of orbital socket reconstruction using oversized dermis fat graft and 22 mm silicone orbital implant in a single-stage after extended enucleation in two patients with massive local recurrence of anteriorly located choroidal melanoma previously treated with endoresection. Orbital tissues en bloc were removed leaving conjunctival lining only at the fornices. Simultaneously, the 22 mm silicone sphere was implanted deeply into the orbit and covered with the oversized dermis fat graft of 30 mm in height and 35 mm in length with 20 mm of the fat thickness. The graft was sutured to the residual forniceal conjunctiva with interrupted 6/0 absorbable sutures overlapping conjunctiva with the graft edge for 2 mm to facilitate the epithelization. Epithelization was completed in two months, leaving well-formed fornices with good fitting of the prosthesis. The key point of orbital socket reconstruction after extended enucleation is to restore conjunctival lining prior to volume. Thus, whenever facing a massive volume and conjunctival lining loss, simultaneous insertion of the 22 mm silicone sphere deep into the orbit combined with oversized dermis fat graft is, in our opinion, the method of choice. It proved to be safe and effective with favourable long-term results.

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Photodynamic Diagnosis-Assisted En Bloc Transurethral Resection of Bladder Tumor for Nonmuscle Invasive Bladder Cancer: Short-Term Oncologic and Functional Outcomes

Journal of Endourology ◽

10.1089/end.2020.0371 ◽

2020 ◽

Author(s):

Makito Miyake ◽

Nobutaka Nishimura ◽

Tomomi Fujii ◽

Tatsuki Miyamoto ◽

Kota Iida ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Functional Outcomes ◽

Bladder Tumor ◽

Invasive Bladder Cancer ◽

Photodynamic Diagnosis ◽

Short Term ◽

En Bloc ◽

Nonmuscle Invasive Bladder Cancer

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Preliminary experience with new thulium fiber laser in totally-en-bloc, low-power enucleation of the prostate: postoperative safety and early functional outcomes

European Urology Open Science ◽

10.1016/s2666-1683(21)00717-5 ◽

2021 ◽

Vol 32 ◽

pp. S13

Author(s):

C.M. Scoffone ◽

C. Casablanca ◽

D. Peretti ◽

C.M. Cracco

Keyword(s):

Low Power ◽

Fiber Laser ◽

Functional Outcomes ◽

En Bloc ◽

Thulium Fiber Laser

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Intralesional Resection of Primary and Metastatic Sarcoma Involving the Spine: Outcome Analysis of 59 Patients

Neurosurgery ◽

10.1097/00006123-200112000-00001 ◽

2001 ◽

Vol 49 (6) ◽

pp. 1277-1287 ◽

Cited By ~ 51

Author(s):

Mark H. Bilsky ◽

Patrick J. Boland ◽

Katherine S. Panageas ◽

James M. Woodruff ◽

Murray F. Brennan ◽

...

Keyword(s):

Functional Outcomes ◽

Tumor Recurrence ◽

Spinal Instrumentation ◽

Surgical Approaches ◽

Outcome Analysis ◽

Tumor Control ◽

Local Tumor ◽

En Bloc ◽

Intralesional Resection ◽

Locally Recurrent

ABSTRACT OBJECTIVE Surgery plays an important role in achieving local tumor control and cure for primary and metastatic tumors of the spine. As has been established with regard to sarcomas at extraspinal sites, these goals may best be achieved by en bloc resection with negative histological margins. Unfortunately, sarcomas of the spine often present with tumor patterns that are amenable only to intralesional resection, if neurological preservation is a priority. This study is a retrospective analysis of the long-term outcomes of patients who had operations for sarcomas of the spine using modern surgical approaches, intralesional resections, and spinal instrumentation. METHODS Between 1985 and 1997, 59 patients had spinal operations for sarcoma involving the extrasacral spine. Data regarding tumor histology, grade, surgical indications, patterns of spinal tumor involvement, and neurological and functional outcomes were reviewed at presentation and at tumor recurrence. RESULTS Thirty-five patients underwent a single operation, and 24 patients required reoperation for locally recurrent tumors. At presentation, only nine patients (15%) had tumors that were amenable to marginal or wide resections. Functional outcomes after initial spinal surgery and after operations performed at first tumor recurrence showed that 95% of patients had maintained or regained ambulation. Intradural extension of tumor was seen in 5 of 12 patients who had three or more operations for locally recurrent disease. The median survival from first spine operation was 18 months, and the median event-free interval between the first and second spine operations was 13 months. CONCLUSION Surgery for sarcoma of the spine is useful for maintaining or improving neurological and functional outcomes, but local tumor recurrences are common. Because of the anatomy of the tumor at presentation and concern for neurological preservation, few patients are candidates for marginal or wide resections.

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