scholarly journals Successful Surgical Intervention of Strangulated Ileus with a Simple Cut of the External Iliac Vein without Vein Reconstruction

2021 ◽  
pp. 846-851
Author(s):  
Takanori Hishikawa ◽  
Shoji Oura ◽  
Masafumi Tomita
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Node Dissection ◽  
Bilateral Oophorectomy ◽  
External Iliac Vein ◽  
Ischemic Change ◽  
Leg Edema ◽  
The Right

A 67-year-old woman with epigastralgia was referred to our hospital. The patient had undergone hysterectomy, bilateral oophorectomy, omentectomy, and radical pelvic and para-aortic lymph node dissection for her ovarian cancer 6 years before. Despite the gastrointestinal decompression therapy under the presumed diagnosis of adhesive ileus, computed tomography scans taken 3 days after the onset of epigastralgia showed marked dilatation of the small intestine and an oval high-density mass, that is, thrombi, in the right femoral vein. Aggravation of ileus with the thrombi in the femoral vein made us to treat the patient with surgery. Intraoperative findings showed that the terminal ileum was strangulated by a gap between the exposed right external iliac vein and artery presumably formed by pelvic lymph node dissection. Distal ileum strangulated by the gap, however, showed no ischemic change with no surgically available peritoneum left around the external iliac vein. To prevent the pulmonary embolism and the recurrence of this type of ileus due to both the thrombi and the persistent gap, we released the strangulated ileum with a simple cut of the external iliac vein without vein reconstruction. The patient recovered uneventfully and was discharged on the 13th day after operation. The patient has been well with nominal right leg edema. In this situation, that is, internal hernia caused by external iliac vessels with thrombi in the femoral vein and no leg edema, a simple cut of the external iliac vein without vein reconstruction is a feasible treatment option.

scholarly journals Chyle Leak after Right Axillary Lymph Node Dissection in a Patient with Breast Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Ankita Sarawagi ◽  
Jessica Maxwell
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Ductal Carcinoma ◽  
Tissue Expander ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Chyle Leak ◽  
The Right

Background. A female patient was diagnosed with a right-sided chyle leak following right skin sparing mastectomy, axillary lymph node dissection, and immediate tissue expander placement in the setting of invasive ductal carcinoma status post neoadjuvant chemotherapy. Summary. Our patient underwent a level I and II right axillary lymph node dissection followed by an axillary drain placement. On the first postoperative day, a change from serosanguinous to milky fluid in this drain was noted. The patient was diagnosed with a chyle leak based on the milky appearance and elevated triglyceride levels in the fluid. While chyle leaks are rare after an axillary dissection and even rarer to present on the right side, it is a complication of which breast surgeons should be aware. The cause of this complication is thought to be due to injury of the main thoracic duct, its branches, the subclavian duct, or its tributaries. Management is usually conservative; however, awareness of this potential complication even on the right side is of the utmost importance Conclusion. Chyle leaks are an uncommon complication of axillary node dissections and even rarer for them to present on the right side. It can be diagnosed by monitoring the drainage for changes in appearance and volume and by conducting supporting laboratory tests. Conservative management is generally suggested.

PS02.004: THE FEASIBILITY AND EFFECTIVENESS OF ‘TOTAL ENDOSCOPIC 2.5 FIELD LYMPH NODE DISSECTION’ IN TREATMENT OF THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 120-121
Author(s):  
Bin Zheng ◽  
Ruopeng Hong ◽  
Shuliang Zhang ◽  
Taidui Zeng ◽  
Hao Chen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Node Dissection ◽  
Recurrent Laryngeal Nerves ◽  
The Right

Abstract Background Due to the difficulty of dissection, surgical trauma, postoperative complications and other factors, the promotion of 3-field lymph node dissection is subject to certain restrictions. We try to explore and summarize a method of lymph node dissection, ‘endoscopic 2.5 lymph node dissection ’, that is, thoracoscopy combined with laparoscopic radical abdominal field, chest field and lower cervical paraesophageal lymph nodes (including 101 group below thyroid artery). Methods Retrospective analysis of 240 patients with thoracic esophageal squamous cell carcinoma from November 1, 2015 to December 31, 2017. All patients underwent endoscopic 2.5-field lymphadenectomy. The average age is (58.2 ± 9.5) years old. During the thoracoscopic part, when we do the lymphadenectomy along recurrent laryngeal nerves in the upper mediastimun and lower neck, we used a combination of ‘esophageal suspension method’, ‘lymph node rolling dissection method’ and ‘multi-angle pulling method’ to reveal the lymph nodes (Figure 1). Surgical related factors were collected and analyzed. Continuous follow-up was performed to record the recurrence and metastasis of patients and postoperative survival. Results Lymphadenectomy level of the right recurrent laryngeal nerve could reach the level above the right inferior thyroid artery, and the left could reach the level of 101 station. All operations were successfully completed. The incidence of pulmonary infection was 11.7%, the incidence of anastomotic leakage was 1.3%, the hoarseness rate was 7.9% and the incidence of chylothorax was 4.2%. The average number of total, abdominal and thoracic lymph nodes dissected were higher than the number of guidelines requirement and most of the previous literature. The average postoperative hospital stay was 8.4 days. The local recurrence rate, metastasis rate and survival rate of all the patients were not inferior to those reported in the past. Conclusion In patients with thoracic esophageal squamous cell carcinoma, the use of ‘total endoscopic 2.5-field lymph noede dissection’, could expand the range of lymph node dissection, and reached the super-thoracic and lower cervical level, which is beneficial to improve the degree of dissection along the recurrent laryngeal nerves. The procedure is safe and feasible, the results of short-term follow-up results are good, and it is worth further promotion. Disclosure All authors have declared no conflicts of interest.

scholarly journals A Mediastinoscopic Approach With Bilateral Cervicopneumomediastinum in Radical Thoracic Esophagectomy

2017 ◽  
Vol 102 (5-6) ◽  
pp. 278-283
Author(s):  
Yutaka Tokairin ◽  
Yasuaki Nakajima ◽  
Kenro Kawada ◽  
Akihiro Hoshino ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Mediastinal Lymph Node ◽  
Bronchial Artery ◽  
Recurrent Nerve ◽  
Open Approach ◽  
Node Dissection ◽  
Radical Esophagectomy ◽  
The Right

We previously reported the performance of “mediastinoscopic esophagectomy with lymph node dissection” (MELD) under pneumomediastinum using a transcervical and transhiatal approach, as a method of radical esophagectomy. The procedure included the dissection of the left tracheobronchial lymph nodes (106tbL). We described our technique for dissecting the upper mediastinal lymph nodes. We revealed that the 106tbL lymph nodes were almost completely retrieved but that the upper thoracic paraesophageal lymph nodes (105) and the right recurrent nerve lymph nodes (106recR) were not completely retrieved. We are therefore of the opinion that a right cervical pneumomediastinal approach is necessary to achieve total dissection. We herein describe a case that was surgically treated using a bilateral cervicopneumomediastinal approach. A 68-year-old male patient was referred to our institution to undergo treatment for lower thoracic esophageal squamous cell carcinoma. The right recurrent nerve was first identified using an open approach. Pneumomediastinum was then initiated to allow for the 105 and 106recR lymph nodes to be completely dissected along the right mediastinal pleura, the right vagus nerve, the proximal portion of the azygos vein, and the right bronchial artery. The left recurrent nerve lymph nodes (106recL) and 106tbL lymph nodes were dissected as described previously. In order to perform bilateral upper mediastinal lymph node dissection and esophagectomy, a bilateral cervicopneumomediastinal approach is needed.

scholarly journals A rare case of anatomical variation of the femoral artery and vein

2020 ◽  
Vol 9 (2) ◽  
pp. 1826-1830
Author(s):  
B. Ba ◽  
T. Touré ◽  
A. Kanté ◽  
M. Koné ◽  
K.D. Kouamenou ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Rare Case ◽  
Great Saphenous Vein ◽  
Anatomical Variation ◽  
Femoral Vein ◽  
Iliac Vein ◽  
External Iliac Vein ◽  
Medial Side ◽  
Femoral Vessels ◽  
The Right

During a dissection of the two femoral trigons in a female corpse, about 14 years old, we discovered on the right side, the deep artery of the thigh arising from the medial side of the femoral artery and passed in front of the femoral vein above the mouth of the great saphenous vein; on both sides, there was the presence of a collateral canal which communicated the external iliac vein with the femoral vein on the right, on the left, it communicated the external iliac vein with the quadricipital vein. The lower part of the femoral vein was duplicated on both sides, but on the right, there was an interconnecting channel between the two trunks of the duplication. Variations of the femoral vessels are very frequent and can be responsible for an incident during the practice of certain gestures at the level of the femoral trigon such as: catheterization of the femoral artery or vein, the treatment of femoral hernias. Key words: Deep thigh artery, collateral venous canal, external iliac vein, anatomic variations.

scholarly journals The Lymph Node Metastasis and Lymph Node Dissection in Cancer of the Right Colon.

1992 ◽  
Vol 45 (6) ◽  
pp. 823-828
Author(s):  
S. Yamaguchi ◽  
S. Ohki ◽  
T. Jo ◽  
S. Imai ◽  
K. Matsuo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Right Colon ◽  
Node Metastasis ◽  
The Right

scholarly journals Thyroid Carcinoma Showing Thymic-Like Differentiation Causing Fracture of the Trachea

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Aikaterini Marini ◽  
Meletios Kanakis ◽  
Konstantinos Valakis ◽  
Nikolaos Laschos ◽  
Maria Chorti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Regional Lymph Node ◽  
Node Dissection ◽  
En Bloc ◽  
Thymic Tissue ◽  
Regional Lymph Node Dissection ◽  
The Right

Thyroid carcinoma showing thymic-like differentiation (CASTLE) comprises a rare neoplasm of the thyroid gland which arises from ectopic thymic tissue or remnants of brachial pouches. CASTLE is regarded as an indolent neoplasm with a favorable prognosis, irrespective of its metastatic potential. Diagnosis is difficult as clinicopathological features have not been yet well-defined. Radiological findings are not specific and only immunohistochemical positivity for CD5 and CD117 staining is highly suggestive of CASTLE. Despite lack of universally accepted treatment recommendations, the mainstay treatment includes thyroidectomy and systematic lymph node dissection. We report a case of CASTLE tumour with very uncommon characteristics developed in a 76-year-old man, who presented with rapidly deteriorating dyspnea and severe cough, resulting in respiratory failure. At surgery, a suspicious looking tumour arising from the upper pole of the right lobe of the thyroid gland, surrounding the trachea and displacing the right common carotid artery, was identified. The patient underwent en bloc resection of the tumour with the thyroid gland and regional lymph node dissection. This is the first reported case of CASTLE causing tracheal ring fracture.

scholarly journals Prevention of Breast Cancer-Related Lymphedema Using the Lymphatic Microsurgical Preventive Healing Approach: A Case Report

2021 ◽  
Author(s):  
Min Suk Park ◽  
Jin A Yoon ◽  
Jae Woo Lee ◽  
Joo Hyoung Kim
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Axillary Vein ◽  
Node Dissection ◽  
Breast Cancer Related Lymphedema ◽  
The Right

Breast cancer-related lymphedema is a major complication of breast cancer surgery. The lymphatic microsurgical preventive healing approach, a surgical technique that can prevent breast cancer-related lymphedema, creates a lymphovenous bypass between the damaged axillary lymphatics during axillary lymph node dissection and the axillary vein. We report a case using the unilateral lymphatic microsurgical preventive healing approach in a patient with bilateral breast cancer. A 58-year-old woman diagnosed with bilateral invasive ductal carcinoma underwent a bilateral nipple-sparing mastectomy. The lymphatic microsurgical preventive healing approach was performed on the left side after axillary lymph node dissection; the lymphatic microsurgical preventive healing approach was not performed after axillary sentinel lymph node biopsy on the right side. Six months after the surgery, MD Anderson Cancer Center stage 2 lymphedema was observed in the lymphography images of the right arm, where the lymphatic microsurgical preventive healing approach had not been performed.

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