Recurrent Osteoblastoma of the Hamate Bone

An osteoblastoma in a carpal bone is very rare and presents a problem of reconstruction after wide tumour excision. We report a case of recurrent osteoblastoma of the right hamate bone with involvement of the ulnar carpal bones and soft tissues that was successfully treated by en bloc resection, temporary interposition of bone cement and fixation with K-wires, followed by reconstruction with a free vascularized iliac crest flap, tailored to the exact size of the defect, in a second procedure. Rapid fusion was achieved and hand function preserved with no evidence of recurrence 3 years postoperatively.

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Thoracic composite hemangioendothelioma with neuroendocrine marker expression

Surgical Case Reports ◽

10.1186/s40792-021-01331-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Ei Miyamoto ◽

Kenji Seki ◽

Hiroyuki Katsuragawa ◽

Yuji Yoshimoto ◽

Yuki Ohsumi ◽

...

Keyword(s):

Chest Wall ◽

Spinal Canal ◽

Soft Tissues ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc ◽

Tissue Mass ◽

Neuroendocrine Marker ◽

Marker Expression ◽

The Right

Abstract Background Composite hemangioendothelioma is an extraordinarily rare form of vascular neoplasm which develops predominantly in the skins and soft tissues of the adults. Neuroendocrine marker expression in composite hemangioendothelioma is considered as specifically relevant to the more aggressive behavior. Case presentation The patient was a 71-year-old man complaining continuous back pain. Computed tomography (CT) showed that 10 cm of contrast-enhanced soft tissue mass was occurring on the right posterior chest wall and developing adjacent to the spinal canal. Via the laminectomy, the tumor end was identified and separated from the dura mater. Then, via the posterolateral thoracotomy, the en bloc resection was achieved by separating the tumor from the diaphragm and vertebras. Histologic examination showed a complex combination of epithelioid and retiform hemangioendothelioma areas which were positive for anti-synaptophysin staining. At 12-month follow-up, there were no signs of tumor recurrence on CT, and the patient had no symptom. Conclusions We achieved the complete resection of a huge thoracic neuroendocrine composite hemangioendothelioma developing adjacent to the spinal canal. The combination of the posterior lumbar laminectomy and the following posterior thoracotomy is a viable approach to radically resect a thoracic neuroendocrine composite hemangioendothelioma involving chest wall.

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A Giant retroperitoneal liposarcoma encasing entirely the right kidney: A case report and a review of nephrectomy indications

10.22541/au.163682757.72559026/v1 ◽

2021 ◽

Author(s):

Houssem Harbi ◽

Amira Akrout ◽

Mohamed Fourati ◽

Amine Zouari ◽

Nozha Toumi

Keyword(s):

Elderly Patient ◽

Case Report ◽

En Bloc Resection ◽

Bloc Resection ◽

Resection Margins ◽

En Bloc ◽

Retroperitoneal Liposarcoma ◽

R1 Resection ◽

The Right

A 68-year-old female was operated for a giant dedifferentiated retroperitoneal liposarcoma (RLS) encasing entirely the right kidney. She had an en-bloc resection of the tumor with right nephrectomy. The en-bloc resection should avoid R1 resection margins. Renal conservation is suggested if the kidney is widely displaced and for elderly patient.

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Ameloblastoma of the Maxilla and Peripheral Ameloblastomas

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948309200526 ◽

1983 ◽

Vol 92 (5) ◽

pp. 532-533 ◽

Cited By ~ 13

Author(s):

John G. Batsakis ◽

Kenneth D. McClatchey

Keyword(s):

Surgical Treatment ◽

Aggressive Behavior ◽

Soft Tissues ◽

En Bloc Resection ◽

Bloc Resection ◽

Morbidity And Mortality ◽

En Bloc ◽

Maxilla And Mandible

Ameloblastomas arising in the supraperiosteal soft tissues (peripheral ameloblastoma) and those taking origin in the maxilla have distinctively different biologic behaviors. The peripheral ameloblastoma can be successfully treated by conservative excision while en bloc resection is warranted for the maxillary ameloblastoma. The effectiveness of primary surgical treatment of an ameloblastoma of the maxilla is the key to reduce morbidity and mortality from the lesion. Anatomic differences between the maxilla and mandible and an apparent more aggressive behavior of maxillary tumors also play a role in establishing the ameloblastoma of the maxilla as the most dangerous of the ameloblastomas.

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Effectiveness of S-O Clip-Assisted Colorectal Endoscopic Submucosal Dissection

Journal of Clinical Medicine ◽

10.3390/jcm11010141 ◽

2021 ◽

Vol 11 (1) ◽

pp. 141

Author(s):

Haruka Fujinami ◽

Akira Teramoto ◽

Saeko Takahashi ◽

Takayuki Ando ◽

Shinya Kajiura ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

En Bloc Resection ◽

Bloc Resection ◽

Resection Rate ◽

Right Colon ◽

En Bloc ◽

Submucosal Dissection ◽

Colorectal Endoscopic Submucosal Dissection ◽

The Right ◽

Surgery Duration

This study aimed to assess the utility of the S-O clip during colorectal endoscopic submucosal dissection (ESD). We conducted a retrospective study on 185 patients who underwent colorectal ESD from January 2015 to January 2020. The patients were divided into two groups: before and after the introduction of the S-O clip. Forty-two patients underwent conventional ESD (CO group) and 29 patients underwent ESD using the S-O clip (SO group). We compared the surgery duration, dissection speed, en bloc resection rate, and complication rate between both groups. Compared with the CO group, the SO group had a significantly shorter surgery duration (70.7 ± 37.9 min vs. 51.2 ± 18.6 min; p = 0.017), a significantly higher dissection speed (15.1 ± 9.0 min vs. 26.3 ± 13.8 min; p < 0.001), a significantly higher en bloc resection rate (80.9% vs. 98.8%; p ≤ 0.001), and a significantly lower perforation rate (4.3% vs. 1.3%). In the right colon, the surgery duration was significantly shorter and the dissection speed was significantly higher in the SO group than in the CO group. Moreover, the rate of en bloc resection improved significantly in the right colon. S-O clip-assisted ESD reduces the procedure time and improves the treatment effects, especially in the right colon.

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Giant cell tumor cuboid: a rare case report.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.09.4029 ◽

2019 ◽

Vol 26 (09) ◽

pp. 1597-1599

Author(s):

Mukesh Kumar ◽

Masroor Ahmed ◽

Muhammad Saleem ◽

Khurram Sahar

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Skeletal Maturity ◽

Osteolytic Lesion ◽

En Bloc Resection ◽

Bloc Resection ◽

Cell Tumor ◽

En Bloc ◽

Cuboid Bone ◽

The Right

Osteoclastoma (Giant Cell Tumor) of Cuboid bone is a rare bone tumor. GCT is primarily seen in metaphyseo-epiphyseal region of long bones after skeletal maturity. This patient is a 17 years old female, presented with painful swelling of the right foot. On conventional radiographs, there is osteolytic lesion in Cuboid bone of right foot. En bloc resection and autologous bone grafting (iliac crest) was done. Patient's pain and swelling disappeared following the procedure and there is no evidence of recurrence at 18 months follow up.

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Histological Comparison of Testicular Needle Biopsy and En Bloc Samples in Abattoir Calves

Animals ◽

10.3390/ani10050918 ◽

2020 ◽

Vol 10 (5) ◽

pp. 918

Author(s):

Maike Rohländer ◽

Henning Otzen ◽

Kristina Rode ◽

Klaus Jung ◽

Marion Schmicke ◽

...

Keyword(s):

Cross Sections ◽

Needle Biopsy ◽

En Bloc Resection ◽

Bloc Resection ◽

Sample Collection ◽

En Bloc ◽

Significance Level ◽

Inner Diameter ◽

The Individual ◽

The Right

The aim of this study was to test whether a single testicular needle biopsy could provide histological results comparable to en bloc resection histology and whether one biopsy was sufficient to reflect the histology of an entire pair of testicles. Two methods of sample collection were tested on 32 bull calves aged five to eight months to compare histological parameters of needle biopsy with those of en bloc resection samples. One testicular needle biopsy of the right and three en bloc samples of both testicles were collected and compared for the number of tubular cross sections, tubules with elongated spermatids (ES), outer/inner diameter of tubules, thickness of tubular wall, and number of Sertoli cells (SC). Additionally, animal data were considered. No significant differences were found between the left and right testis or among the individual locations of en bloc samples. However, histologically significant differences (Bonferroni-adjusted significance level: p < 0.05/6 = 0.0083) were found between the needle biopsy and en bloc resection regarding the tubular cross sections per visual field (p < 0.05), the outer (p = 0.01) and inner diameter and the thickness of the tubular wall (both p < 0.01). In the SOX9 immunohistochemical staining, no significant differences (p > 0.05) could be observed for SC numbers between needle biopsy and en bloc samples. In conclusion, results of testicular needle biopsy do not have the same validity as the en bloc resection histology. Furthermore, one biopsy is insufficient to reflect the histology of the entire testicular pair.

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Two-step ESD: an option for en-bloc resection of extensive colorectal laterally spreading tumors

Endoscopy International Open ◽

10.1055/a-0887-4294 ◽

2019 ◽

Vol 07 (09) ◽

pp. E1092-E1096

Author(s):

Fabio S. Kawaguti ◽

Ossamu Okazaki ◽

Nelson T. Miyajima ◽

Vanderlei Segateli ◽

Carlos F.S. Marques ◽

...

Keyword(s):

Curative Resection ◽

En Bloc Resection ◽

Bloc Resection ◽

Second Step ◽

En Bloc ◽

Submucosal Dissection ◽

Mean Size ◽

One Step ◽

Second Procedure ◽

Laterally Spreading Tumors

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is considered feasible and safe for treatment of colorectal laterally spreading tumors (LST), However it remains a challenge in case of extensive lesions even for experts. This study aimed to describe a new method to facilitate ESD of extensive colorectal LSTs. Between July 2010 and January 2018, 140 patients underwent ESD for colorectal LSTs. Four of them were submitted to two-step ESD and were included in this retrospective study. The submucosal dissection of lesions larger than 12 cm started and continued until the medical team decided to pause the procedure and continue it in a second step. The second procedure was performed 2 days after to finish the en-bloc resection.Three patients were male, with mean age of 67.2y (± 2.2). All lesions were located in the rectum, with a mean size of 153.7 mm (± 33.8). En-bloc and curative resection were successfully achieved in all cases. Mean duration of the first step of the procedure was 255 minutes (± 61.8), and mean duration of the second step was 205 minutes (± 205). Overall mean duration of both steps was 460 minutes (± 168). Mean dissected area in the first step of the procedure was approximately 55 % of the lesion. No adverse events were observed. In conclusion, our results suggest that performing ESD in two steps could be a feasible and safe option for exceptional cases in which is not possible to finish the procedure in one step, avoiding the morbidity of surgical treatment.

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The Knack and Pitfall of the Retropancreatic Nerve Plexus Hanging Maneuver for Pancreatoduodenectomy for Pancreatic Head Carcinoma.

10.21203/rs.3.rs-75488/v1 ◽

2020 ◽

Author(s):

Naokazu Chiba ◽

Shigeto Ochiai ◽

Takahiro Gunji ◽

Toshimichi Kobayashi ◽

Kosuke Hikita ◽

...

Keyword(s):

Pancreatic Head ◽

Operation Time ◽

En Bloc Resection ◽

Bloc Resection ◽

Celiac Axis ◽

Nerve Plexus ◽

R0 Resection ◽

En Bloc ◽

Hanging Maneuver ◽

The Right

Abstract Background The efficacy of the hanging maneuver for the retropancreatic nerve plexus (RNP) to enhance the confirmation of the margin status and to facilitate en-bloc resection for pancreatoduodenectomy (PD). In this report, we present the knack and pitfall of the hanging maneuver of the RNP. MethodsThe exit of the hanging maneuver of the RNP is the left part of the superior mesenteric artery (SMA), and the entry is the cranial part of the celiac axis. The entry of the hanging maneuver was connected to the dissection line on the right side of the celiac axis. Thereafter, the tape of the hanging maneuver was pulled to the right side, and the RNP was deployed widely. Finally, the RNP was easily dissected using a sealing device other than IPDA ResultsIt is important to clarify the entrance and exit of the hanging taping in this procedure. This permitted the wide spaces between the SMA, SMV, and the resected side, and it was easier to identify the IPDA. By traction of the hanging maneuver tape, a clear line may be drawn between the resection side and the remaining side. ConclusionsWith the correct implementation of the hanging maneuver, we believe that it would be possible to obtain reliable R0 resection as well as a reduction in blood loss and operation time.

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Outstanding issues of surgical treatment of locally advanced forms of malignant tumors

Practical oncology ◽

10.31917/2104269 ◽

2020 ◽

Vol 21 (4) ◽

pp. 269-274

Author(s):

V.V. Egorenkov ◽

K.A. Andreychuk ◽

M.S. Molchanov ◽

E.V. Kuleshova

Keyword(s):

Surgical Treatment ◽

Malignant Tumors ◽

Locally Advanced ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc ◽

Considerable Uncertainty ◽

Histological Factors ◽

The Right ◽

Complete Tumor

Nowadays surgery is still the mainstay of solid tumors treatment. En Bloc resection is surgical treatment in amount of complete tumor removal. There remains considerable uncertainty about many aspects of resection boundaries, including definition and influence of anatomical and histological factors. One of the biggest challenges for the surgeon is choosing the right surgery for the «right» patient, taking into account the type of tumor and its biology.

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