“Window” Laryngoplasty: A New Combined Laser Endoscopic and Open Technique for Conservation Surgery

1994 ◽  
Vol 103 (9) ◽  
pp. 679-685 ◽  
Author(s):  
Stanley M. Shapshay ◽  
Zhi Wang ◽  
Donald F. Perrault ◽  
Elie E. Rebeiz ◽  
Michail M. Pankratov
Keyword(s):  
Carbon Dioxide Laser ◽  
Thyroid Cartilage ◽  
Muscle Flap ◽  
Functional Results ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Partial Laryngectomy ◽  
En Bloc ◽  
Pathologic Evaluation

Endoscopic laser resection of early laryngeal carcinoma is an increasingly used treatment modality; however, the limited exposure achieved and the alteration of vocal function are still major problems. A new surgical procedure, “window” laryngoplasty, has been devised and tested in an in vivo study in 6 canines with 50 days' survival. The right vocal cord was incised endoscopically with the carbon dioxide laser, and the en bloc specimen with adjacent thyroid cartilage was removed through a window approach made in the thyroid cartilage. A sternohyoid muscle flap based superiorly was inserted into the cartilaginous window to reconstruct a pseudocord with coverage of either mucosa or fascia. A diode laser soldering technique was used to secure the mucosal graft in place. Epithelial transplantation can be accomplished externally with precise endoscopic guidance for reliable placement of the pseudocord. The results show that the new technique, a combination of endoscopic and open approaches, may be a better treatment choice than standard vertical partial laryngectomy in selected patients. Advantages of this technique include adequate en bloc resection, including adjacent cartilage for pathologic evaluation, preservation of the integrity of most of the laryngeal framework, avoidance of tracheotomy, and better functional results.

scholarly journals Transoral Videolaryngoscopic Surgery (TOVS)

2021 ◽  
Author(s):  
Koji Araki ◽  
Akihiro Shiotani
Keyword(s):  
Cricoid Cartilage ◽  
Thyroid Cartilage ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Hypopharyngeal Cancer ◽  
En Bloc ◽  
Swallowing Function ◽  
Larynx Preservation ◽  
Cricoarytenoid Joint ◽  
Chemotherapy Patients

Transoral videolaryngoscopic surgery (TOVS) for laryngopharyngeal cancer developed by Shiotani et al., uses the laparoscopic surgical system and distending laryngoscope. This method enables precise procedures and en bloc resection under a good view with videoendoscope in the structurally complex laryngopharynx. The major indications are Tis-2, and selected T3 lesions of hypopharyngeal, oropharyngeal, and supraglottic laryngeal cancer. TOVS is also considered for resectable rT1 and rT2 radiation failure cases and selected T3–4 advanced cases following neoadjuvant chemotherapy. Patients with resectable lymph node metastases are treated by neck dissection. Major contraindications are cricoarytenoid joint fixation, circumferential invasion of more than half, bilateral arytenoid invasion, and invasion to the thyroid cartilage, cricoid cartilage, hyoid bone, deep pharyngeal constrictor muscle. Oncological outcomes are good in long-term survival and larynx preservation rates with sparing radiation in half of the patients. However, advanced T stage and N3 cases showed a worse prognosis. Regarding functional outcome, swallowing function can maintain in most patients. Postoperative voice impairment can occur after wound healing. TOVS has some advantages particularly for hypopharyngeal cancer, in maneuver with smaller diameter instruments and tactile sense, and in less invasiveness without a tracheostomy, compared to other transoral surgeries.

Recurrent cervical stitch sinus arising from the deep neck space after thyroidectomy: case study and review

2021 ◽  
Vol 30 (8) ◽  
pp. 612-616
Author(s):  
Hsing-Fu Chen ◽  
Marios Papadakis ◽  
Seng-Feng Jeng
Keyword(s):  
Past History ◽  
Muscle Flap ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Single Centre Study ◽  
History Of ◽  
Surgical Cure

Objective: We describe a one-stage surgical technique for the management of recurrent cervical stitch sinus after thyroidectomy. Method: A retrospective, single-centre study of all patients who were operated on because of cervical neck sinus after thyroidectomy. We provide a detailed description of our surgical approach, based on guided sinus removal after prior tract staining with methylene blue and subsequent obliteration using local strap muscle flap. Results: A total of seven patients with a mean age of 46 years were included in the study. All patients had a past history of thyroidectomy because of goitre (n=5) or thyroid cancer (n=2) which had previously been unsuccessfully debrided two or three times. Surgical sinus removal was successful in all cases and no recurrence was observed during the follow-up time. Conclusions: We conclude that a comprehensive en bloc resection down to the suture granuloma is essential in order to provide surgical cure and prevent recurrence.

Arthroscopic Removal of a Subperiosteal Osteoid Osteoma of the Talus

2007 ◽  
Vol 97 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Taner Gunes ◽  
Mehmet Erdem ◽  
Cengiz Sen ◽  
Erkal Bilen ◽  
Kursad Yeniel
Keyword(s):  
Osteoid Osteoma ◽  
Case Reports ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Ablation Techniques ◽  
Percutaneous Ablation ◽  
Pathologic Examination ◽  
En Bloc ◽  
Pathologic Evaluation ◽  
Arthroscopic Removal

We report a case of a subperiosteal osteoid osteoma on the talar neck that was removed arthroscopically. Intralesional excision, en bloc resection, and percutaneous ablation techniques have all been used for the treatment of osteoid osteoma. For intra-articular osteoid osteomas, arthroscopy-assisted removal of the tumor has been described in a few case reports. Obtaining a nidus fragment for pathologic evaluation is important during arthroscopic removal of intra-articular osteoid osteomas. Sometimes it is not possible to obtain a specimen for pathologic examination. In the present case, the osteoid osteoma on the talar neck was easily located, the nidus was completely removed, and the tumor was extirpated. (J Am Podiatr Med Assoc 97(3): 238–243, 2007)

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.

Sign in / Sign up

Export Citation Format

Share Document