scholarly journals Clinical Study on the Efficacy of Laparoscopic Hepatectomy and Its Influence on the Expression of Serum VEGF, FGF, and Immune Function

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Zhengyong Tang ◽  
Yi Tang ◽  
Tianqi Liu ◽  
Rongjun Liu ◽  
Shaowei Xie ◽  
...  
Keyword(s):  
Partial Hepatectomy ◽  
Patient Survival ◽  
Malignant Tumors ◽  
Surgical Stress ◽  
Laparoscopic Hepatectomy ◽  
Bed Rest ◽  
Postoperative Recovery ◽  
Operative Field ◽  
Perioperative Safety

Liver cancer is one of the most common malignant tumors. Partial hepatectomy is the most basic and effective treatment for hepatocellular carcinoma because of its high operative effect and perioperative safety. Open surgery is the most traditional hepatectomy. Although it can completely remove tumor lesions and prolong patient survival, it has disadvantages such as large trauma and long postoperative recovery time. Meanwhile, long-term bed rest can increase the risk of complications such as venous thrombosis and infection. The advantages of laparoscopic partial hepatectomy, such as clear operative field, simple operation, little trauma, light surgical stress, quick postoperative recovery, and low complications, can avoid damage to vital organs, blood vessels, and nerves, which has been widely accepted and recognized in clinical practice.

scholarly journals CRITICAL EVALUATION OF LONG-TERM RESULTS OF MALIGNANT HEPATIC TUMORS TREATED BY MEANS CURATIVE LAPAROSCOPIC HEPATECTOMY

2017 ◽  
Vol 30 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Sergio Renato PAIS-COSTA ◽  
Sergio Luiz Melo ARAÚJO ◽  
Olímpia Alves Teixeira LIMA ◽  
Sandro José MARTINS
Keyword(s):  
Overall Survival ◽  
Tumor Recurrence ◽  
Malignant Tumors ◽  
Laparoscopic Hepatectomy ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Colorectal Metastases ◽  
Free Survival ◽  
Disease Free

ABSTRACT Background: Laparoscopic hepatectomy has presented great importance for treating malignant hepatic lesions. Aim: To evaluate its impact in relation to overall survival or disease free of the patients operated due different hepatic malignant tumors. Methods: Thirty-four laparoscopic hepatectomies were performed in 31 patients with malignant neoplasm. Patients were distributed as: Group 1 - colorectal metastases (n=14); Group 2 - hepatocellular carcinoma (n=8); and Group 3 - non-colorectal metastases and intrahepatic cholangiocarcinoma (n=9). The conversion rate, morbidity, mortality and tumor recurrence were also evaluated. Results: Conversion to open surgery was 6%; morbidity 22%; postoperative mortality 3%. There was tumor recurrence in 11 cases. Medians of overall survival and disease free survival were respectively 60 and 46 m; however, there was no difference among studied groups (p>0,05). Conclusion: Long-term outcomes of laparoscopic hepatectomy for treating hepatic malignant tumors are satisfactory. There is no statistical difference in relation of both overall and disease free survival among different groups of hepatic neoplasms.

scholarly journals Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Caterina Giannitto ◽  
Lorenzo Preda ◽  
Valeria Zurlo ◽  
Luigi Funicelli ◽  
Mohssen Ansarin ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Malignant Tumors ◽  
Postoperative Recovery ◽  
Common Cancer ◽  
Different Types ◽  
Prior Surgery ◽  
Short And Long Term

Head and neck squamous cell carcinoma is the sixth most common cancer diagnosed worldwide and the eighth most common cause of cancer death. Malignant tumors of the oral cavity, oropharynx, and larynx can be treated by surgical resection or radiotheraphy with or without chemotheraphy and have a profound impact on quality of life functions, including swallowing. When surgery is the chosen treatment modality, the patient may experience swallowing impairment in the oral and pharyngeal phases of deglutition. A videofluoroscopic study of swallow enables the morphodynamics of the pharyngeal-esophageal tract to be accurately examined in patients with prior surgery. These features allow an accurate tracking of the various phases of swallowing in real time, identifying the presence of functional disorders and of complications during the short- and long-term postoperative recovery. The role of imaging is fundamental for the therapist to plan rehabilitation. In this paper, the authors aim to describe the videofluoroscopic study of swallow protocol and related swallowing impairment findings in consideration of different types of surgery.

Modern Possibilities of Organ-Preserving Treatment in Children with Intraocular Retinoblastoma

2018 ◽  
Vol 5 (3) ◽  
pp. 175-187 ◽  
Author(s):  
O. V. Gorovtsova ◽  
T. L. Ushakova ◽  
V. G. Polyakov
Keyword(s):  
Drug Delivery ◽  
Survival Rate ◽  
Cancer Therapy ◽  
Neoadjuvant Chemotherapy ◽  
Patient Survival ◽  
Focal Therapy ◽  
Local Drug Delivery ◽  
Large Size ◽  
Intraocular Retinoblastoma

Retinoblastoma is one of highly curable diseases; today the total 5-year survival rate in patients with retinoblastoma exceeds 95%. The article summarizes the current world experience on treatment of patients with intraocular retinoblastoma. The treating skills of intraocular malignant tumor in children are a balance between the patient’s life and the preservation of an eye and its visual functions. The complex and challenging task is the treatment of common intraocular retinoblastoma groups «C», «D», «E» when the large size or localization of the tumor does not allow performing the local (focal) destruction of the tumor. As a rule, in such cases neoadjuvant chemotherapy (CT) is performed at the first stage in order to reduce the size of the tumor for further focal therapy. However, the analysed data on the effectiveness of neoadjuvant CT in combination with focal or radiotherapy demonstrated the limited possibilities of the proposed therapy. Local drug delivery in cancer therapy became a real breakthrough in the organ-preserving treatment of children with large intraocular retinoblastoma. The most widely used current methods of local drug delivery are intravitreal (IVitC) and selective intra-arterial chemotherapy (SIAC) as monotherapy or in combination with neoadjuvant CT and focal therapy which significantly increased the percentage of preserved eyes without radiotherapy administration or damage to the patient survival. The review discusses the different IVitC and SIAC techniques, chemotherapy schemes, dosages of chemotherapy, immediate and long-term complications of treatment.

scholarly journals Long-term Outcomes after Laparoscopic Hepatectomy for Hepatocellular Carcinoma

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S146
Author(s):  
D. Kilburn ◽  
D. Cavallucci ◽  
U. Leung ◽  
M. Siriwardhane ◽  
R. Bryant ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Laparoscopic Hepatectomy ◽  
Long Term Outcomes

scholarly journals Long-Term Tacrolimus Blood Trough Level and Patient Survival in Adult Liver Transplantation

2021 ◽  
Vol 11 (2) ◽  
pp. 90
Author(s):  
Chih-Yang Hsiao ◽  
Ming-Chih Ho ◽  
Cheng-Maw Ho ◽  
Yao-Ming Wu ◽  
Po-Huang Lee ◽  
...  
Keyword(s):  
Patient Survival ◽  
Trough Level ◽  
Medical Center ◽  
Term Survival ◽  
Blood Concentrations ◽  
Long Term Survival ◽  
Tacrolimus Level ◽  
Cox's Model ◽  
The Impact

Tacrolimus is the most widely used immunosuppressant in liver transplant (LT) patients. However, the ideal long-term target level for these patients is unknown. This retrospective study aimed to investigate the impact of tacrolimus blood concentration five years after LT on long-term patient survival outcomes in adult LT recipients. Patients who underwent LT between January 2004 and July 2014 at a tertiary medical center were included in this study (n = 189). The mean tacrolimus blood concentrations of each patient during the fifth year after LT were recorded and the overall survival rate was determined. A multivariate analysis of factors associated with long-term survival was conducted using a Cox’s model. The median follow-up period was 9.63 years, and 144 patients (76.2%) underwent live donor LT. Sixteen patients died within 5 years of LT. In the Cox’s model, patients with a mean tacrolimus blood trough level of 4.6–10.2 ng/mL had significantly better long-term survival than those with a mean tacrolimus blood trough level outside this range (estimated hazard ratio = 4.76; 95% confidence interval: 1.34–16.9, p = 0.016). Therefore, a tacrolimus level no lower than 4.6 ng/mL would be recommended in adult LT patients.

scholarly journals Correctable biliary atresia and cholangiocarcinoma: a case report of a 63-year-old patient

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Masaki Nio ◽  
Motoshi Wada ◽  
Hideyuki Sasaki ◽  
Hiromu Tanaka ◽  
Masatoshi Hashimoto ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Liver Tumors ◽  
Malignant Tumors ◽  
Porta Hepatis ◽  
Case Presentation ◽  
Cancer Occurrence ◽  
Long Term Survivors ◽  
Near Future

Abstract Background Although cancer occurrence following surgery for biliary atresia has gradually increased, the development of cholangiocarcinoma in a native liver survivor of biliary atresia is extremely rare. Case presentation A 3-month-old female patient with the correctable type of biliary atresia underwent a cystoduodenostomy. At 16 years of age, she underwent multiple surgeries including lysis of intestinal adhesions, ileostomy, and gastrojejunostomy at another hospital. At 54 years of age, she underwent lithotomy at the porta hepatis, resection of the residual cystic bile duct with gallbladder, and hepaticojejunostomy in Roux-en-Y fashion. As she approached the age of 63, her computed tomography scan showed no liver tumors. In the following year, she developed cholangiocarcinoma at the porta hepatis and underwent chemotherapy. However, the cancer progressed, and she died before she reached the age of 64 years. Conclusions Cholangiocarcinoma is extremely rare in patients with biliary atresia. However, physicians should follow up patients with biliary atresia as closely as possible, as malignant tumors secondary to biliary atresia may increase in number in the near future because of the growing number of long-term survivors with biliary atresia.

scholarly journals Diagnosis and Multimodality Management of Cushing’s Disease: A Practical Review

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Gabriel Zada
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Patient Survival ◽  
Clinical Laboratory ◽  
Management Strategies ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
First Line ◽  
Stepwise Approach

Cushing’s Disease is caused by oversecretion of ACTH from a pituitary adenoma and results in subsequent elevations of systemic cortisol, ultimately contributing to reduced patient survival. The diagnosis of Cushing’s Disease frequently involves a stepwise approach including clinical, laboratory, neuroimaging, and sometimes interventional radiology techniques, often mandating multidisciplinary collaboration from numerous specialty practitioners. Pituitary microadenomas that do not appear on designated pituitary MRI or dynamic contrast protocols may pose a particularly challenging subset of this disease. The treatment of Cushing’s Disease typically involves transsphenoidal surgical resection of the pituitary adenoma as a first-line option, yet may require the addition of adjunctive measures such as stereotactic radiosurgery or medical management to achieve normalization of serum cortisol levels. Vigilant long-term serial endocrine monitoring of patients is imperative in order to detect any recurrence that may occur, even years following initial remission. In this paper, a stepwise approach to the diagnosis, and various management strategies and associated outcomes in patients with Cushing’s Disease are discussed.

SP6.1.11 The Effect of the Enhanced Recovery Programme for Liver Surgery on Long Term Survival

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kalaiyarasi Arujunan ◽  
Abdulwarith Shugaba ◽  
Harmony Uwadiae ◽  
Joel Lambert ◽  
Georgios Sgourakis ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Liver Surgery ◽  
Patient Survival ◽  
Enhanced Recovery ◽  
Readmission Rates ◽  
Term Survival ◽  
Significant Difference

Abstract Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on long term survival has yet to be established. The aim of this study was to determine the effect of the ERPLS on 5-year patient survival. Methods This was a retrospective study of patients who underwent liver resection for colorectal liver metastasis (CRLM) between January 2011 and December 2016 at a regional hepatobiliary centre. The cohort comprised of 60 pre-ERPLS and 60 post-ERPLS patients. The primary outcome was 5-year patient survival. The secondary outcomes were length of stay (LOS), postoperative complications and 90-day readmission rates. Multivariate analysis was performed to identify independent predictors of overall survival. Results There was no significant difference in the age (p = 0.960), gender (p = 0.332) and type of resection (p = 0.198) between both groups. ERPLS was not an independent predictor for overall survival (Gehan Wilcoxon Test, p = 0.828). There was no significant difference in the LOS (p = 0.874) and 90-day readmission rates (p = 0.349). Major postoperative complications (>3a Clavien-Dindo classification) were significantly less in the ERPLS group (p = 0.02). On multivariate analysis, positive resection margins and major postoperative complications were independent predictors for overall survival. Conclusions ERPLS does not seem to have an effect on long term patient survival. However, it appears to reduce the rate of major postoperative complications. LOS and 90-day readmission rates were not influenced by ERPLS.

Craniopharyngioma in adults and children: a study of 122 surgical cases

2002 ◽  
Vol 97 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Rémy Van Effenterre ◽  
Anne-Laure Boch
Keyword(s):  
Patient Survival ◽  
Postoperative Radiotherapy ◽  
Clinical Signs ◽  
Functional Results ◽  
Recurrence Risk ◽  
Tumor Removal ◽  
Content Type ◽  
Adults And Children ◽  
Fine Print

Object. This work is devoted to a 25-year retrospective study of 122 cases of craniopharyngiomas in adults and children treated and followed by the same neurosurgeon (R.V.E.). In this homogeneous series, the aim was total microsurgical removal of the tumor, without postoperative radiotherapy. Methods. The operation was performed via a frontopterional approach in 112 cases and a transsphenoidal approach in 10 cases. The tumor removal was considered total in 59%, subtotal in 29%, and partial in 12%. The surgical mortality rate was 2.5%. Even when tumor removal was not complete, radiotherapy was not systematically administered; it was reserved for cases of recurrence. The authors have studied clinical signs, operative characteristics, and ophthalmological, endocrinological, and functional outcomes, as well as recurrence risk and long-term patient survival. The mean follow-up period was 7 years. The functional results in these patients were excellent in 85%, good in 9%, fair in 5% (usually because of ophthalmological sequelae), and poor in 1%. Tumors recurred in 29 patients, but the salvage treatment, by operation or radiotherapy, was successful in 83%. The actuarial patient survival rate was 92% after 5 years and 85% after 10 years. Conclusions. These results compared favorably with the data reported in the literature, suggesting that radical surgery of craniopharyngiomas allows good outcome in terms of survival, full recovery, and quality of life for both adults and children.

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