scholarly journals EP.WE.490Influence of age on post-operative outcomes from adrenalectomy for phaeochromocytoma

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
S A Mir ◽  
M J Lansdown ◽  
Emma Collins ◽  
Sheila Fraser
Keyword(s):  
Tumour Size ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Outcome Data ◽  
En Bloc ◽  
Operative Outcomes ◽  
Vasoactive Medication ◽  
Level 3

Abstract Methods A retrospective search of institutional databases for histologically and biochemically confirmed cases of phaeochromocytoma, at a single tertiary care institution, from 2012 to 2020. Clinical parameters, adrenal function, intra and postoperative data were obtained. Patients > 60 years were classified as elderly and outcome data within 30 days of operation compared to < 60 years. Results Patients > 60 years constituted 31% (n = 17) of the cohort, mean age 70 ± 6 versus 43 ± 13 years for < 60 years (n = 38). There was no difference in tumour size, 4 ± 2.5 cm and 4.6 ± 2.6, p = 0.3. Frequency of laparoscopic resection was similar at 65% in both groups. Intra-operatively 5% of < 60 years required blood transfusion compared to none in > 60 years group with 12% in older group undergoing en-bloc resection and nephrectomy and 6% experiencing cardiac dysrhythmias. Postoperatively all patients were managed in level two care except 7% of < 60 years requiring level 3 care reflecting extent and complexity of resection. There was no difference in requirement and duration of vasoactive medication or length of stay in level 2, 1.6 ±1.2, 1.6 ±1.0 days. Proportion of patients graded ASA 3 in > 60 years was 53% compared with 41% in < 60 years. Postoperative complications in > 60 were 29% vs 13%, p = 0.003, with HAP being commonest. Length of hospital stay was also significantly longer at 5.8 ± 2.4 versus 4.5 ± 2.2, p = 0.02. There was no mortality. Conclusions Age of the patient alone does not influence post-operative outcomes from adrenalectomy in phaeochromocytoma.

scholarly journals Myoepithelioma of nasal septum: a rare minor salivary gland tumour

2019 ◽  
Vol 12 (10) ◽  
pp. e230926
Author(s):  
Govind Gourh ◽  
Ripu D Arora ◽  
Nighat Hussain ◽  
Nitin Nagarkar
Keyword(s):  
Salivary Glands ◽  
Tumour Size ◽  
Minor Salivary Gland ◽  
Benign Neoplasm ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Contrast Enhanced Ct ◽  
Minor Salivary Gland Tumour

Myoepithelioma is rare benign neoplasm, usually involves salivary glands and very less often seen in minor salivary glands of nose. Clinically it resembles like other tumour masses and thus posed challenge to clinician and pathologist. It becomes very difficult to diagnose due to its varied presentation and propensity for malignant transformation. We reported a case of a male patient with pink fleshy mass in the left nose with epistaxis and nasal obstruction. Preliminary biopsy and contrast-enhanced CT were done to delineate tumour size and type and then patient underwent endoscopic en-bloc resection. Histopathology and immunohistochemistry were found to be consistent for myoepithelioma. No recurrence was seen during a 6-month follow-up period. Its rarity should be a part of differential diagnosis among nasal tumours. Many of the tumour recurrences are associated with incomplete surgical resection so wide local excision with regular follow-up is essential for this rare entity.

scholarly journals Underwater endoscopic mucosal resection for en bloc resection of a neuroendocrine tumor in the duodenal bulb

Endoscopy ◽  
2021 ◽  
Author(s):  
Hugo Uchima ◽  
Alberto Diez-Caballero ◽  
Jaume Capdevila ◽  
Mercé Rosinach ◽  
Alfredo Mata ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Endoscopic Mucosal Resection ◽  
Duodenal Bulb ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Mucosal Resection

scholarly journals Fibrin glue: Novel submucosal injection agent for endoscopic submucosal dissection

2021 ◽  
Vol 09 (03) ◽  
pp. E319-E323
Author(s):  
Madoka Takao ◽  
Yoshitaka Takegawa ◽  
Toshitatsu Takao ◽  
Hiroya Sakaguchi ◽  
Yoshiko Nakano ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Fibrin Glue ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Submucosal Injection ◽  
Submucosal Dissection ◽  
Vitro Model ◽  
Histopathologic Findings

Abstract Background and study aims Adequate mucosal elevation by submucosal injection is crucial for patient safety and efficiency during endoscopic submucosal dissection (ESD). This study aimed to evaluate the efficacy of fibrin glue (FG) as a long-lasting submucosal injection agent and to evaluate the technical feasibility of FG injection for ESD. Materials and methods To compare the capabilities of different agents in maintaining submucosal evaluation, we injected FG, hyaluronic acid solution, and normal saline into the porcine gastric specimen that was incised into approximately 5 × 5 cm squares. Then, we measured the height of submucosal elevations over time. Moreover, three hypothetical lesions from the resected porcine stomach underwent ESD with FG injection. Thereafter, we conducted macroscopic and histopathologic analyses. Results FG maintained the greatest submucosal elevation among all the injection agents. Three ESD procedures were performed with en bloc resection. Both macroscopic and histopathologic findings showed a thick FG clot on the ulcers. Conclusions The FG solution can be potentially used as an ESD submucosal injection agent in an in vitro model.

scholarly journals Colorectal endoscopic submucosal dissection using the pocket-creation method with single clip traction: a feasibility study

2021 ◽  
Vol 09 (05) ◽  
pp. E653-E658
Author(s):  
Tatsuma Nomura ◽  
Yoshikazu Hayashi ◽  
Takaaki Morikawa ◽  
Masahiro Okada ◽  
Hisashi Fukuda ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Major Axis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Success Rates ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Mucosal Incision ◽  
Axis Length ◽  
Colorectal Endoscopic Submucosal Dissection

Abstract Background and study aims The pocket-creation method (PCM) facilitates dissection of the central part of a tumor. We previously developed the PCM with clip traction (PCM-CT) to facilitate opening the mucosal pocket, which otherwise could become cumbersome. In the present study, we aimed to examine the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD). Patients and methods PCM-CT was performed on 30 patients with early colorectal tumors from October 2019 to April 2020. PCM-CT allows efficient opening of the mucosal pocket by using the PCM to dissect the center of the lesion and then apply traction with a single clip after making a circumferential mucosal incision. Results The median specimen major axis length, ESD time, ESD speed, and en bloc resection rate were 48 mm, 84 minutes, 20 mm2/min, and 100 % (30/30), respectively. The success rates for the traction clip and median single-clip-traction time were 100 % (30/30) and 1.5 minutes, respectively. Conclusions Colorectal ESD using PCM-CT is a simple and promising method.

Higher rate of en bloc resection with underwater than conventional endoscopic mucosal resection: A meta-analysis

2021 ◽  
Author(s):  
Georgios Tziatzios ◽  
Paraskevas Gkolfakis ◽  
Konstantinos Triantafyllou ◽  
Lorenzo Fuccio ◽  
Antonio Facciorusso ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Meta Analysis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Mucosal Resection

scholarly journals Anchoring the snare tip is a feasible endoscopic mucosal resection method for small rectal neuroendocrine tumors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeongseok Kim ◽  
Jisup Kim ◽  
Eun Hye Oh ◽  
Nam Seok Ham ◽  
Sung Wook Hwang ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Neuroendocrine Tumors ◽  
Similar Efficacy ◽  
En Bloc Resection ◽  
Lesion Size ◽  
Bloc Resection ◽  
En Bloc ◽  
Delayed Bleeding ◽  
Mucosal Resection ◽  
The Mean

AbstractSmall rectal neuroendocrine tumors (NETs) can be treated using cap-assisted endoscopic mucosal resection (EMR-C), which requires additional effort to apply a dedicated cap and snare. We aimed to evaluate the feasibility of a simpler modified endoscopic mucosal resection (EMR) technique, so-called anchored snare-tip EMR (ASEMR), for the treatment of small rectal NETs, comparing it with EMR-C. We retrospectively evaluated 45 ASEMR and 41 EMR-C procedures attempted on small suspected or established rectal NETs between July 2015 and May 2020. The mean (SD) lesion size was 5.4 (2.2) mm and 5.2 (1.7) mm in the ASEMR and EMR-C groups, respectively (p = 0.558). The en bloc resection rates of suspected or established rectal NETs were 95.6% (43/45) and 100%, respectively (p = 0.271). The rates of histologic complete resection of rectal NETs were 94.1% (32/34) and 88.2% (30/34), respectively (p = 0.673). The mean procedure time was significantly shorter in the ASEMR group than in the EMR-C group (3.12 [1.97] vs. 4.13 [1.59] min, p = 0.024). Delayed bleeding occurred in 6.7% (3/45) and 2.4% (1/41) of patients, respectively (p = 0.618). In conclusion, ASEMR was less time-consuming than EMR-C, and showed similar efficacy and safety profiles. ASEMR is a feasible treatment option for small rectal NETs.

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