Experience with the Resection of Parapharyngeal Cancers via the Infratemporal Fossa Approach

1986 ◽  
Vol 94 (3) ◽  
pp. 291-301 ◽  
Author(s):  
Peter G. Smith ◽  
Daniel E. Sharkey
Keyword(s):  
Internal Carotid ◽  
Infratemporal Fossa ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
Upper Aerodigestive Tract ◽  
En Bloc ◽  
Curative Intent ◽  
Cranial Fossa

Between 1982 and 1984, a modified Infratemporal fossa approach was used to resect cancers with extensive primary or secondary Involvement of the Infratemporal fossa and parapharynx in 10 patients. Nine patients exhibited persistent or recurrent disease of the upper aerodigestive tract and posterior cranial fossa following planned, curative-Intent therapy; the remaining patient had a carcinoma ex-pleomorphic adenoma of the deep lobe of the parotid gland with a significant Infratemporal fossa extension. Considered to have “unresectable” tumors, by traditional methods, 7 of the 10 patients underwent an en-bloc resection of their lesions with tumor-free margins. Tumor was present at the margins of the specimens in the other 3 patients. Two of the 10 patients died early in the postoperative period of medical complications. Another died 5 months postoperatively of a tumor-Induced Internal carotid artery rupture at the level of the foramen lacerum. A fourth patient died of his disease 6 months following his resection. One patient is alive, but has metastatic meningioma 2 years after surgery. The 5 remaining patients are without evidence of disease, with a mean follow up of 2 years. Indications for and refinements of the operative technique, particularly those related to the repair of such extensive ablative defects, are outlined on the basis of this early experience.

The Surgical Management of Advanced Malignancies of the Parotid Gland

1989 ◽  
Vol 101 (6) ◽  
pp. 633-640 ◽  
Author(s):  
George P. Katsantonis ◽  
William H. Friedman ◽  
Barry N. Rosenblum
Keyword(s):  
Parotid Gland ◽  
Infratemporal Fossa ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Operative Morbidity ◽  
Lateral Skull Base ◽  
Advanced Malignancies ◽  
Ulcerative Lesions

Advanced malignancies of the parotid gland frequently Invade the parapharyngeal space and the Infratemporal fossa. The majority of these lesions have not been cured by surgery and/or radiotherapy, and palliation or cure can only be achieved by en bloc resection of this region. Stylohamular dissection is a systematic method for en bloc resection of the Infratemporal fossa and lateral skull base. From January 1980 until December 1987, 18 patients with advanced parotid malignancies underwent stylohamular dissection. Pathologic examination revealed the following diagnosis: Adenocarcinoma (7), squamous cell carcinoma (5), high-grade mucoepidermoid carcinoma (2), metastatic adenocarcinoma (1), fibrosarcoma (1), malignant hemangiopericytoma (1), and melanoma (1). Nine patients In this series are alive after a mean follow-up period of 3.5 years (range 1 to 9 years). Three patients are dead of uncontrolled local disease and three of distant metastasis. Three patients died of unrelated causes. All patients except the three who had uncontrolled disease experienced marked palliation from their pain, trismus, and unmanageable ulcerative lesions after surgery. The operative morbidity was relatively low.

scholarly journals Carotid Reconstruction With Bovine Carotid Heterograft After En Bloc Resection of Squamous Cell Carcinoma With Direct Internal Carotid Invasion

2015 ◽  
Vol 62 (3) ◽  
pp. 801-802
Author(s):  
Eric B. Trestman ◽  
Pablo De Los Santos ◽  
Evan Garfein ◽  
Thomas Ow ◽  
Evan C. Lipsitz ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Internal Carotid ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc

scholarly journals Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases

2021 ◽  
Vol 09 (02) ◽  
pp. E258-E262
Author(s):  
Christian Suchy ◽  
Moritz Berger ◽  
Ingo Steinbrück ◽  
Tsuneo Oyama ◽  
Naohisa Yahagi ◽  
...  
Keyword(s):  
Case Series ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Published Data ◽  
Low Grade ◽  
Recurrence Rates ◽  
En Bloc ◽  
Long Term Follow Up

Abstract Background and study aims We previously reported a case series of our first 182 colorectal endoscopic submucosal dissections (ESDs). In the initial series, 155 ESDs had been technically feasible, with 137 en bloc resections and 97 en bloc resections with free margins (R0). Here, we present long-term follow-up data, with particular emphasis on cases where either en bloc resection was not achieved or en bloc resection resulted in positive margins (R1). Patients and methods Between September 2012 and October 2015, we performed 182 consecutive ESD procedures in 178 patients (median size 41.0 ± 17.4 mm; localization rectum vs. proximal rectum 63 vs. 119). Data on follow-up were obtained from our endoscopy database and from referring physicians. Results Of the initial cohort, 11 patients underwent surgery; follow-up data were available for 141 of the remaining 171 cases (82,5 %) with a median follow-up of 2.43 years (range 0.15–6.53). Recurrent adenoma was observed in 8 patients (n = 2 after margin positive en bloc ESD; n = 6 after fragmented resection). Recurrence rates were lower after en bloc resection, irrespective of involved margins (1.8 vs. 18,2 %; P < 0.01). All recurrences were low-grade adenomas and could be managed endoscopically. Conclusions The rate of recurrence is low after en bloc ESD, in particular if a one-piece resection can be achieved. Recurrence after fragmented resection is comparable to published data on piecemeal mucosal resection.

scholarly journals Parathyroid carcinoma

2006 ◽  
Vol 63 (8) ◽  
pp. 765-769
Author(s):  
Aleksandar Filipovic ◽  
Ivan Paunovic ◽  
Dragutin Savjak ◽  
Tamara Zivkovic
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Disease Recurrence ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Endocrine Tumors ◽  
En Bloc ◽  
Histologic Diagnosis ◽  
Serum Pth

Background. Parathyroid carcinoma is the least frequent malignancy among endocrine tumors. In the most reported series of patients with primary hyperparathyroidism the incidence of carcinoma is less than 1%. Recognition by a surgeon that the parathyroid tumor is malignant, and the performance of an adequate en bloc removal of primary lesion, with histologic diagnosis offer the best treatment of a patient with this unusual malignancy. Case report. We reported a 30-year-old patient with parathyroid carcinoma, primary hyperparathyroidism, and recurrent nephrocalcinosis. Marked hypercalcemia, low serum phosphorus, and substantial elevation of serum parathyroid hormone indicated a diagnosis of primary hiperparathyroidism. General symptoms were anorexia, muscle weakness, back pain and depression. Ultrasonography done before the surgery revealed a 2 cm upper left parathyroid gland with solid and cystic areas. The neck exploration was done with en block resection of the tumor. A histopathological evaluation confirmed the diagnosis of parathyroid carcinoma. Over more than a three-year-follow-up, the patient had no evidence of the disease recurrence and his serum PTH and calcium levels remained within the normal. Conclusion. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Preoperative diagnosis remains a challenge. Radical en bloc resection of the tumor is the treatment of choice for this malignancy.

En Bloc Resection of the Duodenum for Locally Advanced Right Colon Adenocarcinoma

2007 ◽  
Vol 73 (10) ◽  
pp. 1063-1066 ◽  
Author(s):  
Ahmad N. Hakimi ◽  
David K. Rosing ◽  
Bruce E. Stabile ◽  
Beverley A. Petrie
Keyword(s):  
Colon Cancer ◽  
Locally Advanced ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Morbidity And Mortality ◽  
Right Colon ◽  
En Bloc ◽  
Adjacent Structures ◽  
Duodenal Invasion

Direct invasion of colorectal adenocarcinoma into adjacent structures occurs frequently, but only rarely is the duodenum involved. This study was undertaken to assess the safety and efficacy of en bloc resection of locally advanced right colon carcinoma invading the duodenum. A retrospective review of 49 patients with locally advanced colon cancer, surgically managed between 2000 and 2005, was performed. Forty-six patients underwent en bloc resection of colon and adjacent organs not involving the duodenum. Three patients with duodenal invasion underwent en bloc partial duodenectomy. The mean operative blood loss, length of stay, postoperative morbidity, and mortality compare favorably between these two groups of patients. Of the 46 patients with en bloc resection of other organs, 27 are alive at 12 to 60 months follow up. Two patients with duodenal invasion are alive without recurrence at 15 and 20 months follow up. En bloc resection of colon cancer invading the duodenum can be performed safely because morbidity and mortality rates are comparable to those attending extended resections of other locally advanced colon carcinomas. Overall survival in patients who underwent surgery with curative intent justifies en bloc duodenal resection in selected patients.

scholarly journals En bloc resection of skull base tumor including internal carotid artery. Preoperative evaluation of cerebral blood flow.

1998 ◽  
Vol 24 (3) ◽  
pp. 320-324
Author(s):  
Yoshitaka OKAMOTO ◽  
Zensei Matsuzaki ◽  
Atsushi KAMIJYO ◽  
Jun OGINO ◽  
Yoshishige NAGASEKI ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Preoperative Evaluation ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Skull Base Tumor ◽  
En Bloc

scholarly journals Mandibular periosteal (juxtacortical) chondrosarcoma

2009 ◽  
Vol 20 (5) ◽  
pp. 428-433 ◽  
Author(s):  
Elisângela Maria Cunha Costa ◽  
Bárbara Lima Lucas ◽  
Mariana Reis Silva ◽  
Renata Hinhug Vilarinho ◽  
Paulo Rogério de Faria ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bone Surface ◽  
En Bloc ◽  
Grade Ii ◽  
Well Differentiated ◽  
Slow Growing ◽  
Tomography Scan

Periosteal (juxtacortical) chondrosarcoma (PC) is a well-differentiated malignant cartilage-forming tumor arising from the external bone surface, especially in long bones. The therapy of choice is en-bloc resection and, in general, its prognosis is good. This paper reports a rare case of PC affecting the mandible of a 41-year-old man. The lesion presented as a slow-growing-painless swelling that lasted 2 months. Computed tomography scan showed a tumoral mass arising from the external bone surface, extending into the adjacent soft tissue presenting patchy regions of popcorn-like calcifications. A final diagnosis of PC (grade II) was rendered after biopsy. Hemimandibulectomy was undertaken followed by complementary radiotherapy with 70 Gy. Although no episodes of recurrence or metastasis had been noticed after 18 months of follow-up, the patient died and causa mortis could not be established.

Therapeutic strategy involving endoscopic resection for cN0 superficial carcinoma of the esophagus.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 1-1
Author(s):  
T. Iizuka ◽  
D. Kikuchi ◽  
S. Hoteya
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Additional Treatment ◽  
En Bloc ◽  
Carcinoma Of The Esophagus ◽  
Secondary Hemorrhage ◽  
Long Term Follow Up

1 Background: With the progress in endoscopic submucosal dissection (ESD) which enables en bloc resection irrespective of the size of lesion, a therapeutic strategy has become feasible whereby ESD is undertaken first, followed by considering additional treatment based on the results of histologic exploration. In this study, we attempted to clarify the clinical results in patients who had undergone additional treatment after endoscopic resection (ER) for cN0 superficial carcinoma. Methods: Of 140 patients diagnosed as having T1a-MM-SM2 lesions of squamous cell carcinoma of the esophagus who had undergone ER between January 1998 and March 2010, 83 patients who received additional treatment after ER (surgery, 27 pts; chemoradiotherapy [CRT], 56 pts.) were the subjects of this study. The mean duration of observation was 45.1 months. Results: The en bloc resection rate was 86%. There were 5 patients (6%) who had complications associated with ER, including perforation in 2 patients, secondary hemorrhage in a patient and pneumonia in 2 patients. Complications associated with additional treatment were noted in 13 patients (15.6%), including secondary hemorrhage, recurrent laryngeal nerve paralysis and pulmonary infarction in one patient each, pneumonia in 3, grade ≥ 3 myelosuppression in 5, and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and radiation pneumonitis in one patient each. Long-term follow-up revealed no local recurrence and no patients who experienced late toxicity due to CRT. The tumor recurred in 4 patients, the site of recurrent lesion being the mediastinum in 3 patients and the cervical lymph node in one patient, of whom 2 patients died of the primary disease. The 5-year survival rate was 88.4%. Conclusions: Endoscopic resection plus additional treatment for superficial carcinoma of the esophagus did not entail the development of any serious complications; thus, such combined treatment was safe and feasible. The long-term follow-up results were fairly gratifying, and ER with subsequent additional treatment is considered to be valid for patients with cN0 superficial carcinoma of the esophagus. No significant financial relationships to disclose.

En Bloc Resection of Lamina and Ossified Ligamentum Flavum in the Treatment of Thoracic Ossification of the Ligamentum Flavum

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. 1181-1186 ◽  
Author(s):  
Lian-shun Jia ◽  
Xiong-sheng Chen ◽  
Sheng-yuan Zhou ◽  
Jiang Shao ◽  
Wei Zhu
Keyword(s):  
Evaluation System ◽  
Ligamentum Flavum ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Neurological Dysfunction ◽  
Thoracic Myelopathy ◽  
En Bloc ◽  
Improvement Rate ◽  
The Mean

Abstract OBJECTIVE We performed a retrospective patient chart review to determine the feasibility and safety of en bloc resection of lamina and ossified ligamentum flavum in the treatment of thoracic ossification of ligamentum flavum (OLF). METHODS From January 2000 to June 2006, 36 patients with thoracic OLF underwent en bloc resection of lamina and ossified ligamentum flavum by a burr-grinding technique. The range of resection included one lamina superior and one lamina inferior to the diseased segments. Ossified dura mater was removed if present, and simultaneous repair was carried out. RESULTS The mean preoperative Japanese Orthopedic Association (JOA) score (an evaluation system for thoracic myelopathy with a total score of 11 points) was 5 points (range, 3–9 points). The mean JOA score at the last follow-up visit (mean follow-up period, 3.9 years) was 8.44 points (range, 6–11 points). The range of improvement was from 2 to 6 points, and the mean improvement rate was 60.5% (range, 33.3%–100%). No postoperative aggravation of neurological dysfunction, leakage of cerebrospinal fluid (CSF), wound infection, kyphosis, or recurrence occurred. A CSF cyst found in one patient 3 weeks postoperatively was absorbed automatically after 10 months. CONCLUSION The en bloc resection technique described here is both safe and effective.

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