scholarly journals How I do it: minimally invasive resection of a sub-ependymoma of the fourth ventricle

2020 ◽  
Author(s):  
Marco V. Corniola ◽  
Torstein R. Meling
Keyword(s):  
Minimally Invasive ◽  
Surgical Management ◽  
Fourth Ventricle ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Midline Incision ◽  
En Bloc

Abstract Background A 54-year-old female was referred to our clinic with a lesion of the lower fourth ventricle extending to the median aperture. Here, we report the use a minimally invasive sub-occipital approach (MISA) as a safe and effective surgical management. Method We performed a MISA using a short midline incision and a 1-cm sub-occipital craniectomy. Dissection of the lesion was performed, and “en bloc” resection could be achieved. The lesion was confirmed to be a grade I sub-ependymoma. Conclusion MISA can be safely used when confronted to a lesion of the lower fourth ventricle.

Minimally Invasive Endoscopy-Assisted Approach for En Bloc Resection of Septal Tumors

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
Anuraag Parikh ◽  
Justin Cohen ◽  
Monica Tadros ◽  
Rahmatullah Rahmati
Keyword(s):  
Minimally Invasive ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc

485 MINIMALLY INVASIVE EN-BLOC OESOPHAGECTOMY: ANALYSIS OF THE OUTCOMES ALONG A LEARNING CURVE

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
F Di Maggio ◽  
A Lee ◽  
Z Vrakopoulou ◽  
H Deere ◽  
A Botha
Keyword(s):  
Survival Rate ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Hospital Stay ◽  
Open Surgery ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Margins ◽  
En Bloc ◽  
Minimally Invasive Oesophagectomy

Abstract   Minimally invasive oesophagectomy is technically demanding but benefits perioperative morbidity and intra-hospital mortality. We previously described open total adventitial resection of the cardia (TARC) as an optimal anatomical resection technique for lower oesophageal and gastro-esophageal junction cancers. We wanted to investigate whether the peri-operative benefits of minimally invasive techniques, along with en-bloc resection of the primary tumour, translate into long term survival benefit in a specialized high volume center along a surgeon learning curve. Methods Data from 198 consecutive patients undergoing oesophagectomy by a single surgeon was collected prospectively. Patient stratification was made to chronologically reflect four main stages of our learning curve: open surgery, Laparoscopic Ivor Lewis, laparoscopy/thoracoscopy with mini-thoracotomy and laparoscopic TARC. Primary outcomes included five-year survival rate, operating time, hospital stay, specimen lymphnodes. Peri-operative complications and mortality are also described. 45 patients had open surgery; laparoscopy (n = 50) was initiated after two years, and thoracoscopy (n = 56) introduced after case 94. MIO was performed for the last 47 patients. Patients in all groups had similar demographics, histological diagnosis, preoperative and pathological staging. Results 158 patients were male (79.8%); age was 63 +/− 10 years. Overall five-year survival rate was 45%; perioperative mortality rate was 1.5% (n = 3); 13 patients were returned to theatre. Hospital stay was 22+/−23 days. Specimen lymph nodes were 21+/− 8. Resection margins were negative (ACP) in 193 cases (97.4%). Five-year survival rates during the 4 phases were 38.6%, 44.9%, 42.8% and 59% respectively, showing a benefit trend towards the end of the learning curve (p = 0.03). Specimen lymph nodes were: open = 20.5+/−9.5; Lap = 19.5+/− 7; mini-tho = 19.9+/− 7; MIO = 25+/− 10 (p = 0.027). Resection margins were > 1 mm in 68.1%(open), 67.3%(lap), 64.2%(mini-tho) and 79.5(MIO). Conclusion Laparoscopic en-bloc resection of cancers of the OGJ requires a long learning curve. Proficiency gains along this learning curve affects oncological quality of oesophageal resectional surgery and benefits patients survival after minimally invasive oesophagectomy.

Parathyroid carcinoma. Mini-series of patients successfully treated with minimally invasive surgery using intra-operative PTH assays, and literature review.

2009 ◽  
Vol 54 (2) ◽  
pp. 58-58
Author(s):  
OO Komolafe ◽  
AG McMinn ◽  
JC Doughty ◽  
CR Wilson
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Single Case ◽  
Radical Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Parathyroid Cancer ◽  
En Bloc ◽  
Initial Surgery

Parathyroid cancer is a rare cause of primary hyperparathyroidism, with a surgeon anecdotally expected to see a single case in his/her entire career. In our unit, however, we have treated three patients recently. The accepted optimal treatment of parathyroid cancer is radical resection at the initial surgery, but a low index of suspicion means that most parathyroid cancers are not identified pre- or intra-operatively. This results in the majority of patients having inadequate surgery. All three patients were treated by minimally invasive surgery, with radical en bloc resection based on intra-operative suspicion of malignancy. Pre-operative imaging guides the neck exploration, and intra-operative PTH assays confirm excision of the source of excess PTH. All patients have remained well with no recurrence to date. We review the literature on parathyroid cancer, and suggest features that point to a parathyroid tumour being malignant.

Minimally Invasive En Bloc Resection of Massive Obstructive Atrial Tumour

2016 ◽  
Vol 32 (12) ◽  
pp. 1575.e21-1575.e23
Author(s):  
Claudia L. Cote ◽  
Nasser Alkhamees ◽  
Martin Goldbach ◽  
Rodrigo Bagur ◽  
Michael W.A. Chu
Keyword(s):  
Minimally Invasive ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc

scholarly journals Surgical management of rare benign tumors of the sternum

2021 ◽  
Vol 11 (3) ◽  
pp. 88-94
Author(s):  
Andrei I Gritsiuta
Keyword(s):  
Giant Cell ◽  
Surgical Management ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Benign Tumors ◽  
Giant Cell Tumors ◽  
En Bloc ◽  
Synthetic Materials ◽  
Long Term Follow Up

Primary benign tumors of the sternum are an exceedingly rare entity. Surgical techniques regarding intervention for these lesions are not clearly defined in the literature given their scarcity. Operative techniques include en-bloc resection of the tumor, and this has proven to be successful in preventing local recurrence despite benign nature of the lesion. Given the often extensive defect created by the excision, reconstruction is frequently necessary; depending on the size of the defect, either autologous bone grafting or the use of synthetic materials may be indicated. This study serves to present two cases of rare primary benign tumors of the sternum, giant cell tumors and osteoma spongiosum and to summarize the available literature. We present a review of the literature of 17sternal giant cell tumor cases reported so far including our patient and unique case of osteoma spongiosum of the sternum, that discusses their surgical management, as well as reconstructive techniques that provided an excellent clinical result and a lack of recurrence on long term follow-up.

scholarly journals Mediastinal herniation of the biliary tract leading to bile duct obstruction following oesophagectomy

2018 ◽  
Vol 100 (8) ◽  
pp. e211-e213
Author(s):  
A Laliotis ◽  
T Hettiarachchi ◽  
F Rashid ◽  
A Hindmarsh ◽  
V Sujendran
Keyword(s):  
Bile Duct ◽  
Surgical Management ◽  
Standard Treatment ◽  
Locally Advanced ◽  
Significant Risk ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Abdominal Organs ◽  
Increased Risk

Surgical management of oesophageal and gastro-oesophageal junction malignancies is one of the most challenging situations confronting the surgeon. Attaining a complete circumferential resection margin of lower-third oesophageal and gastro-oesophageal junction locally advanced carcinomas requires en-bloc resection of the hiatus and all the peri-oesophageal tissue and pleura. This results in an increased risk of herniation of the abdominal organs through the enlarged hiatus, which carries significant risk of morbidity and mortality. The incidence of this complication is higher than has been reported. Surgical management of symptomatic hernias is the standard treatment while criteria for managing asymptomatic hernias are less clear. We report a rare case of a late mediastinal herniation of the pancreas and bile duct, leading to obstructive jaundice following oesophagectomy which was treated successfully in our unit.

scholarly journals En bloc resection of a thoracic chordoma is possible using minimally invasive anterior access: An 8-year follow-up

2016 ◽  
Vol 7 (01) ◽  
pp. 138-140 ◽  
Author(s):  
Anand Goomany ◽  
Jake Timothy ◽  
Craig Robson ◽  
Abhay Rao
Keyword(s):  
Minimally Invasive ◽  
Thoracic Spine ◽  
Interbody Fusion ◽  
Traditional Approach ◽  
Tumor Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Perioperative Morbidity ◽  
First Case

ABSTRACTThoracic spine chordomas are a rare clinical entity and present several diagnostic and management challenges. Posterior debulking techniques are the traditional approach for the resection of thoracic tumors involving the vertebral body. Anterior approaches to the thoracic spine enable complete tumor resection and interbody fusion. However, this approach has previously required a thoracotomy incision, which is associated with significant perioperative morbidity, pain, and the potential for compromised ventilation and subsequent respiratory sequelae. The extreme lateral approach to the anterior spine has been used to treat degenerative disorders of the lower thoracic and lumbar spine, and reduces the potential complications compared with the anterior transperitoneal/transpleural approach. However, such an approach has not been utilized in the treatment of thoracic chordomas. We describe the first case of an en bloc resection of a thoracic chordoma via a minimally invasive eXtreme lateral interbody fusion approach.

Surgical Treatment for Right Colon Cancer Directly Invading the Duodenum

2009 ◽  
Vol 75 (5) ◽  
pp. 385-388
Author(s):  
Yuan Lianwen ◽  
Zhou Jianping ◽  
Shu Guoshun ◽  
Liu Dongcai ◽  
Zhou Jiapeng
Keyword(s):  
Colon Carcinoma ◽  
Surgical Management ◽  
Management Strategies ◽  
Perioperative Period ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Right Colon ◽  
En Bloc ◽  
Right Colon Cancer ◽  
Duodenal Invasion

Right colon carcinoma with duodenal invasion is rare, and optimal management remains controversial. Twenty patients demonstrating right-colon carcinoma directly invading the duodenum presented at the Second Xiangya Hospital between 1990 and 2006. Different surgical management strategies were selected based on duodenal involvement, and patient outcomes were evaluated. There was no perioperative death in this series, but three major complications presented during the perioperative period: one case of duodenal stenosis and two duodenal leaks due to gastric or duodenal drainage. Eight of 13 patients treated by en bloc resection survived more than 3 years, including one 10-year survivor and four 5-year survivors. Of the seven patients treated with palliative resection, no patients survived more than 18 months. In conclusion, duodenal invasion by a right-sided colon carcinoma does not necessarily represent incurable disease. If carefully applied based on the extent of duodenal invasion, active surgical management is very useful for improving patient prognosis without increasing the risks associated with surgery.

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