Surgical management of carotid body tumor – Is Shamblin classification sufficient to predict surgical outcome?

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Y Law ◽  
YC Chan ◽  
SW Cheng
Keyword(s):  
Surgical Management ◽  
Carotid Body ◽  
Incidental Finding ◽  
Neck Mass ◽  
Complete Resection ◽  
Carotid Body Tumor ◽  
Class Iii ◽  
Surgical Interventions ◽  
Shamblin Classification

Background The study aims to conduct a review of the surgical management of carotid body tumor. Methods Consecutive patients with CBT who received surgical interventions from January 1994 to January 2014 at our institution were reviewed. Clinical, operative, pathological and follow up information were reported. Results Twenty patients (four males; median age was 36) with 21 CBT operations were recorded during the period. One patient undertook sequential operations for bilateral CBTs. Patients had 19 neck mass, 1 incidental finding and 1 facial nerve palsy. Six CBTs (28.6%) were Shamblin class I, ten (47.6%) were class II and five (23.8%) were class III. Nine CBTs had preoperative conjunctive embolization. Two operations required internal carotid artery resection and reconstruction. Four patients received subtotal resections, while 17 achieved complete resection. Complications included two major strokes, three hoarse voice and two Horner’s syndrome. Shamblin class was significant predictor of operative time, blood loss, and whether complete resection accomplished, but could not predict postoperative complication. With median follow up period of 94 months, there was no tumor recurrence found in those had complete resection. Conclusions This small cohort showed that Shamblin class was significant in predicting technical difficulties but could not predict occurrence of complications.

The challenge of stent placement within cannulation zones of Arteriovenous Fistulae

2020 ◽  
pp. 112972982095474
Author(s):  
Alexandros Mallios ◽  
Pierre Bourquelot ◽  
William C Jennings
Keyword(s):  
Surgical Management ◽  
Stent Placement ◽  
Complete Resection ◽  
Access Management ◽  
Arteriovenous Fistulae ◽  
Surgical Interventions ◽  
The Future

Background: Stent placement in the cannulation zone of AVF is becoming alarmingly frequent and sometimes in cases where surgical management would be more appropriate. When complications arise repair can be particularly challenging. We present our experience and management of this problem. Methods: We report our experience on three patients (two females and one male, mean age 72) that were referred to our department for problems related to stents placed at the cannulation segments. Results: All patients required complex surgical interventions. In two of them maintenance of access was possible but required the use of a graft. In one complete resection of the AVF and all stents was necessary, and the patient remained on dialysis through catheter. Conclusion: Stent placement at the cannulation zones may complicate access management in the future and should be avoided if possible.

scholarly journals A glomus caroticum paragangliomája és ellátása

2018 ◽  
Vol 159 (36) ◽  
pp. 1487-1492
Author(s):  
Krisztián Gál ◽  
Ifeoluwa Apanisile ◽  
István Lázár ◽  
Tünde Blaskó ◽  
Tamás Karosi
Keyword(s):  
Physical Examination ◽  
Carotid Body ◽  
Gold Standard ◽  
Neck Mass ◽  
Carotid Body Tumor ◽  
Surgical Removal ◽  
Digital Substraction Angiography ◽  
Glomus Caroticum ◽  
Pulsatile Mass ◽  
Carotid Body Tumors

Abstract: Our goal was to report a 44-year-old woman with carotid body tumor, and to give a brief and comprehensive presentation about the disease and summarize its complex management. Carotid body tumor is a rare, mostly sporadic, benign head and neck mass originating from the glomus caroticum. It occurs mostly in middle-aged women as a slowly growing, semifix, painless neck mass. The diagnosis is based upon the physical examination (pulsatile mass, Fontaine-sign) and – as the gold standard – CT-angiography. It should be established that preoperative embolisation by digital substraction angiography plays a crucial role in the treatment of carotid body tumors that should be followed by surgical removal. In case of inoperable/irresecable and residual tumors, radiotherapy is the treatment option. The patient was treated in our department in April 2017. Orv Hetil. 2018; 159(36): 1487–1492.

Surgical Management of Carotid Body Tumor and Risk Factors of Postoperative Cranial Nerve Injury

2020 ◽  
Vol 44 (12) ◽  
pp. 4254-4260
Author(s):  
Xiaolang Jiang ◽  
Gang Fang ◽  
Daqiao Guo ◽  
Xin Xu ◽  
Bin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nerve Injury ◽  
Surgical Management ◽  
Carotid Body ◽  
Cranial Nerve ◽  
Carotid Body Tumor ◽  
Cranial Nerve Injury

scholarly journals A multidisciplinary approach to carotid body tumors surgical management

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
David Fan ◽  
Stephanie Luster ◽  
Ibrahim G Eid ◽  
Abdul Saied Calvino
Keyword(s):  
Surgical Management ◽  
Carotid Body ◽  
Multidisciplinary Team ◽  
Neck Mass ◽  
Surgical Reconstruction ◽  
Cancer Center ◽  
Surgical Removal ◽  
Team Approach ◽  
Multidisciplinary Team Approach ◽  
Carotid Body Tumors

Abstract Carotid body tumors (CBTs) are rare and usually require complex surgical resection. We present a case of a large 7-cm CBT successfully treated in a community cancer center using a multidisciplinary team approach. A 32-year-old male referred for surgical evaluation of an asymptomatic right neck mass. CT angiography showed a 7-cm tumor encasing the carotid vessels, including the bifurcation (Shamblin III). Preoperative angiography and embolization were performed by interventional radiology. The patient underwent surgical removal of the CBTs and required surgical reconstruction with a common carotid to internal carotid bypass using a polytetrafluoroethylene interposition graft. The hypoglossal nerve, vagus nerve and glossopharyngeal nerve were identified, meticulously dissected and preserved. The patient did well after surgery and recovered with no complications. This report examines the diagnosis, preoperative workup and surgical management of CBTs using a multidisciplinary team approach.

scholarly journals Impact of gender on the prognosis of carotid body tumor after surgical resection

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Huanrui Hu ◽  
Yuwei Xiang ◽  
Bin Huang ◽  
Ding Yuan ◽  
Yi Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Carotid Body ◽  
Tumor Size ◽  
Survival Rates ◽  
Carotid Body Tumor ◽  
Overall Survival Rate ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Shamblin Classification

Abstract Background Carotid body tumors (CBTs) are rare neuroendocrine neoplasms, but the prognosis of patients with resected CBTs has seldom been elucidated. This study was conducted to investigate the association between variables, especially sex, and the prognosis of carotid body tumor resection. Methods This was a large-volume single-center retrospective cohort study. Patients who were diagnosed with CBTs between 2009 and 2020 at our center were analyzed retrospectively. Their preoperative, surgical, and follow-up data were collected, and the association between variables and outcomes of CBT resection was assessed by correlation analysis, multivariate logistic regression, and multivariate Cox regression as appropriate. Results A total of 326 patients (66.6% were females) were included. Males developed larger CBTs than females (4.3 ± 1.8 cm vs. 3.8 ± 1.4 cm, P = .003). Males were more likely to develop succinate dehydrogenase B (SDHB) mutations (P = .019) and had worse relapse-free survival rates (P = .024). Although tumor size and Shamblin classification had positive relationships with neurological complications and intraoperative blood loss, they did not affect the overall survival rate of patients, which was only influenced by remote metastasis (P = .007) and local recurrence (P = .008). Conclusions Compared to females, males with CBT resection were found to have more SDHB mutations and worse relapse-free survival rates, which may lead to the deterioration of prognosis. Tumor size and Shamblin classification cannot predict the overall survival rate of patients with excised CBTs. Graphical abstract

Surgical Treatment of Intracardiac-Extending Intravenous Leiomyomatosis: A Single Center Experience

2016 ◽  
Vol 19 (3) ◽  
pp. 094
Author(s):  
Yang Li ◽  
Nan Yang ◽  
Long Lu ◽  
Fengxia Ma ◽  
Jianmin Yao
Keyword(s):  
Surgical Management ◽  
Circulatory Arrest ◽  
Pelvic Mass ◽  
Complete Removal ◽  
Complete Resection ◽  
Intravenous Leiomyomatosis ◽  
Hospital Data ◽  
Single Center Experience ◽  
Few Data

<strong>Background:</strong> Few data were known on surgical management of intracardiac-extending in patients with intravenous leiomyomatosis (IVL).<br /><strong>Methods:</strong> From June 2007 to December 2014, six women (mean age, 39.3 ± 7.5 years; range, 24-55 years) with intracardiac-extending IVL were treated surgically at our hospital. Data were obtained from medical and pathological records, including characteristics of patients, surgical management, and follow-up. <br /><strong>Results:</strong> Surgery was performed successfully in all patients. Of 6 patients, 4 underwent one-stage operation and 2 underwent two-stage procedures. Circulatory arrest with hypothermia was used for a cardiotomy combined with venotomy in <br />5 patients. Complete resection was done in 5 patients. There were no perioperative deaths or complications in any of the patients. Hospital stay was 11.2 ± 2.9 days (range 7-15 days). All patients were followed-up for a mean of 41.0 ± 19.1 months (range, 17-69 months) after surgery. A recurrence of pelvic mass was found in 1 patient, but no symptoms or intravenous mass were reported. No obstruction occurred in any patient with a venotomy.<br /><strong>Conclusion:</strong> Surgery is a better therapy for IVL and complete removal has favorable outcomes.

Current concepts for the surgical management of carotid body tumor

2006 ◽  
Vol 191 (1) ◽  
pp. 104-110 ◽  
Author(s):  
Theron T. Knight ◽  
Jose Andres Gonzalez ◽  
John M. Rary ◽  
Daniel S. Rush
Keyword(s):  
Surgical Management ◽  
Carotid Body ◽  
Carotid Body Tumor

Bilateral invasive electroencephalography in patients with tuberous sclerosis complex: a path to surgery?

2011 ◽  
Vol 7 (4) ◽  
pp. 421-430 ◽  
Author(s):  
Chad Carlson ◽  
Federica Teutonico ◽  
Robert E. Elliott ◽  
Yaron A. Moshel ◽  
Josiane LaJoie ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Class I ◽  
Epileptogenic Zone ◽  
Class Iii ◽  
Intracranial Eeg ◽  
Surgical Interventions ◽  
Therapeutic Procedures

Object Many children with epilepsy and tuberous sclerosis complex (TSC) have multiple tubers on MR imaging and poorly localized/lateralized video electroencephalography (EEG) findings. Given the long-term risks associated with frequent seizures and multiple antiepileptic drugs, along with improved success in identifying focal epileptogenic zones in patients with multifocal lesions, the authors used bilateral intracranial EEG to lateralize the epileptogenic zone in patients with nonlateralizable noninvasive preoperative evaluations. Methods A retrospective analysis from January 1, 1998, to June 30, 2008, identified 62 children with TSC who were presented at a surgical conference. Of the 52 patients undergoing diagnostic or therapeutic procedures during the study period, 20 underwent bilateral intracranial EEG. The presurgical testing results, intracranial EEG findings, surgical interventions, and outcomes were reviewed. Results Fourteen of 20 patients had intracranial EEG findings consistent with a resectable epileptogenic zone. One patient is awaiting further resection. Five patients had findings consistent with a nonresectable epileptogenic zone, and 1 of these patients underwent a callosotomy. Seven patients had Engel Class I outcomes, 1 was Class II, 3 were Class III, and 3 were Class IV (mean follow-up 25 months). Conclusions Bilateral intracranial EEG can identify potential resectable seizure foci in nonlateralizable epilepsy in TSC. Although 6 of 20 patients did not undergo resection (1 patient is pending future resection), significant improvements in seizures (Engel Class I or II) were noted in 8 patients. In the authors' experience, this invasive monitoring provided a safe method for identifying the ictal onset zone.

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