Left-posterior approach for artery-first en bloc resection in laparoscopic distal pancreatectomy for left-sided pancreatic cancer

2020 ◽  
Vol 405 (8) ◽  
pp. 1251-1258
Author(s):  
Kazuyuki Nagai ◽  
Gozo Kiguchi ◽  
Akitada Yogo ◽  
Takayuki Anazawa ◽  
Shintaro Yagi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Distal Pancreatectomy ◽  
Posterior Approach ◽  
Laparoscopic Distal Pancreatectomy ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Left Posterior ◽  
Artery First

Myofibroma of the cervical spine presenting as brachialgia

2014 ◽  
Vol 21 (6) ◽  
pp. 916-918 ◽  
Author(s):  
Benjamin M. Davies ◽  
Daniel du Plessis ◽  
Kanna K. Gnanalingham
Keyword(s):  
Soft Tissue ◽  
Facet Joint ◽  
Surgical Excision ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
En Bloc ◽  
Left Posterior ◽  
Midline Approach

Myofibromas are rare, benign tumors of myofibroblasts. Their occurrence in adults, involving bone outside of the head and neck, is especially uncommon. The authors report the case of a 34-year-old woman who presented with left-sided brachialgia. Magnetic resonance imaging identified an expansile soft-tissue lesion of the C6–7 facet joint. En bloc resection via a left posterior midline approach was undertaken. Histopathological analysis confirmed the lesion to be a myofibroma. Brachialgia resolved following surgery and there is no evidence of recurrence at 20 months follow-up. Myofibroma is a rare cause of primary soft-tissue tumor of the spine. Surgical excision remains the mainstay of treatment.

scholarly journals En Masse Resection of Pancreas, Spleen, Celiac Axis, Stomach, Kidney, Adrenal, and Colon for Invasive Pancreatic Corpus and Tail Tumor

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Koray Kutluturk ◽  
Abdul Hamid Alam ◽  
Cuneyt Kayaalp ◽  
Emrah Otan ◽  
Cemalettin Aydin
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Tumor ◽  
Left Renal Vein ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Celiac Axis ◽  
Left Adrenal Gland ◽  
En Bloc ◽  
Extensive Surgery

Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without metastasis depends on the complete resection. Recently, distal pancreatectomy with celiac axis resection was reported as a feasible and favorable method in selected pancreatic corpus/tail tumors which had invaded the celiac axis. Additional organ resections to the celiac axis were rarely required, and when necessary it was included only a single extra organ resection such as adrenal or intestine. Here, we described a distal pancreatic tumor invading most of the neighboring organs—stomach, celiac axis, left renal vein, left adrenal gland, and splenic flexure were treated by en bloc resection of all these organs. The patient was a 60-year-old man without any severe medical comorbidities. Postoperative course of the patient was uneventful, and he was discharged on postoperative day eight without any complication. Histopathology and stage of the tumor were adenocarcinoma and T4 N1 M0, respectively. Preoperative back pain of the patient was completely relieved in the postoperative period. As a result, celiac axis resection for pancreatic cancer is an extensive surgery, and a combined en masse resection of the invaded neighboring organs is a more extensive surgery than the celiac axis resection alone. This more extensive surgery is safe and feasible for selected patients with pancreatic cancer.

Total en bloc lumbar spondylectomy

2001 ◽  
Vol 95 (2) ◽  
pp. 264-269 ◽  
Author(s):  
Eric Marmor ◽  
Laurence D. Rhines ◽  
Jeffrey S. Weinberg ◽  
Ziya L. Gokaslan
Keyword(s):  
Lumbar Spine ◽  
Posterior Approach ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Neurological Injury ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
Content Type ◽  
Bloc Spondylectomy ◽  
Anterior Posterior

✓ The authors describe a technique for total en bloc spondylectomy that can be used for lesions involving the lumbar spine. The technique involves a combined anterior—posterior approach and takes into account the unique anatomy of the lumbar spine. This technique allows for the en bloc resection of lumbar vertebral tumors, thus optimizing outcome while minimizing the risk of neurological injury. The technique is described in detail with the aid of neuroimaging studies, photographs of gross pathological specimens, and illustrations, and a discussion of other authors' experiences is provided for comparison.

scholarly journals Pancreatic malignancy in the backdrop of chronic pancreatitis: How much to push the boundaries to achieve R0 resection

2021 ◽  
Vol 12 (1) ◽  
pp. 47-51
Author(s):  
Kunal Sadanand Joshi ◽  
Sisir Bodepudi ◽  
Santhosh Kumar Ganapathi ◽  
Chandrasekar Murugesan ◽  
Jagan Balu ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Distal Pancreatectomy ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
The Body ◽  
Metastatic Spread ◽  
Pathological Examination ◽  
Jejunal Loop ◽  
En Bloc ◽  
Lateral Pancreaticojejunostomy

Abstract Tumors of the body and tail of the pancreas are often more aggressive than tumors of the head and would have often undergone metastatic spread to other organs at the time of diagnosis. Most patients with carcinoma of the body and tail of the pancreas present at a late stage. Surgery is only indicated in those patients in whom there is no evidence of metastatic spread. Surgery is often not possible in cancers of the body and tail of the pancreas if the tumor invades celiac artery. Controversy exists regarding the margin status impact of microscopic resection margin involvement (R1) after pancreaticoduodenectomy (PD) for PDAC. There are reports indicating the rate of R1 resections increases significantly after PD if pathological examination is standardized. In this report, we present the case of a 56-year-old female who had undergone lateral pancreaticojejunostomy for chronic pancreatitis 8 years ago, but has now developed malignancy of the body and tail of the pancreas involving multiple organs. This patient underwent en bloc resection involving: 1. distal pancreatectomy with jejunal loop (lateral pancreaticojejunostomy) resection; 2. splenectomy; 3. left nephrectomy; 4. total gastrectomy; and 5. segmental colectomy with reconstruction by esophagojejunostomy, jejunojejunostomy, and colocolic anastomosis. The infrequent occurrence of tumor in the distal gland and advanced tumor stage at the time of diagnosis have both combined to produce therapeutic nihilism/dilemma in the minds of many surgeons. This report highlights the decision on how much to the push limits for multi-organ resection (en bloc resection with distal pancreatectomy, gastrectomy, splenectomy, colectomy, nephrectomy) with the intent of achieving R0 status in spite of the complexity of surgery in selected patients.

En bloc hemisacrectomy and internal hemipelvectomy via the posterior approach

2014 ◽  
Vol 21 (3) ◽  
pp. 458-467 ◽  
Author(s):  
Michelle J. Clarke ◽  
Patricia L. Zadnik ◽  
Mari L. Groves ◽  
Hormuzdiyar H. Dasenbrock ◽  
Daniel M. Sciubba ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Pelvic Ring ◽  
Tumor Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Surgical Morbidity ◽  
En Bloc ◽  
Internal Hemipelvectomy

Object Traditionally, hemisacrectomy and internal hemipelvectomy procedures have required both an anterior and a posterior approach. A posterior-only approach has the potential to complete an en bloc tumor resection and spinopelvic reconstruction while reducing surgical morbidity. Methods The authors describe 3 cases in which en bloc resection of the hemisacrum and ilium and subsequent lumbopelvic and pelvic ring reconstruction were performed from a posterior-only approach. Two more traditional anterior and posterior staged procedures are also included for comparison. Results In all 3 cases, an oncologically appropriate surgery and spinopelvic reconstruction were performed through a posterior-only approach. Conclusions The advantage of a midline posterior approach is the ability to perform a lumbosacral reconstruction, necessary in cases in which the S-1 body is iatrogenically disrupted during tumor resection.

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