scholarly journals Laparoscopic radical antegrade modular pancreatosplenectomy: preliminary experience with 10 cases

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ren-Chao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
R0 Resection ◽  
Regional Lymph Nodes ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract Background The radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy (LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS. Methods From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables, postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected. Results LRAMPS was performed successfully in all the patients. The median operative time was 235 min (range 212–270 min), with an EBL of 120 ml (range 100–200 ml). Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days (range 9–24 days).The median count of retrieved lymph nodes was 15 (range 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection. Median follow-up time was 11 months (range 3–14 m). Two patients developed disease recurrence (pancreatic bed recurrence and liver metastasis) 9 months, 10 months after surgery, respectively. Others survived without tumor recurrence or metastasis. Conclusions LRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2020 ◽  
Author(s):  
Renchao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
R0 Resection ◽  
Regional Lymph Nodes ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract BackgroundThe radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS.MethodsFrom December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables, postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.ResultsLRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212–270 min), with an EBL of 120 ml(range,100–200 ml). Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days (range, 9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection. Median follow-up time was 11 months (range, 3–14 m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis.ConclusionsLRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2021 ◽  
Author(s):  
Renchao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract BackgroundThe radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS.Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results：LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．ConclusionsLRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2020 ◽  
Author(s):  
Ren-Chao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract Background: The radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS. Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results: LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．Conclusions: LRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Hybrid volumetric-modulated arc therapy for postoperative breast cancer including regional lymph nodes: the advantage of dosimetric data and safety of toxicities

2020 ◽  
Vol 61 (5) ◽  
pp. 747-754
Author(s):  
Yoshiko Doi ◽  
Minoru Nakao ◽  
Hideharu Miura ◽  
Shuichi Ozawa ◽  
Masahiro Kenjo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Irradiation Dose ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Conformity Index ◽  
Regional Lymph Nodes ◽  
Dosimetric Data ◽  
Arc Therapy

ABSTRACT To improve the homogeneity and conformity of the irradiation dose for postoperative breast cancer including regional lymph nodes, we planned Hybrid volumetric-modulated arc therapy (VMAT), which combines conventional tangential field mainly for the chest area and VMAT mainly for the supraclavicular area and marginal zone. In this study, we compared the dosimetric impact between traditional 3D conformal radiotherapy (3DCRT) and Hybrid VMAT and observed toxicities following Hybrid VMAT. A total of 70 patients indicated between October 2016 and December 2017 were included. The prescribed dose was 50 Gy/25 fractions. For the dosimetric impact, 3DCRT and Hybrid VMAT plans were compared in each patient with respect to the dosimetric parameters. Toxicities were followed using the Common Terminology Criteria for Adverse Events version 4.0. The median follow-up duration was 319 days. For the dosimetric impact, the homogeneity index (HI) and conformity index (CI) of PTV were significantly improved in the Hybrid VMAT plan compared with that in the 3DCRT plan (HI, 0.15 ± 0.07 in Hybrid VMAT vs 0.41 ± 0.19 in 3DCRT, P < 0.001; CI, 1.61 ± 0.44 in Hybrid VMAT vs 2.10 ± 0.56 in 3DCRT, P < 0.001). The mean irradiated ipsilateral lung dose was not significantly different in both plans (12.0 ± 2.4 Gy in Hybrid VMAT vs 11.8 ± 2.8 Gy in 3DCRT, P < 0.533). Regarding toxicity, there were no patients who developed ≥grade 3 acute toxicity and ≥grade 2 pneumonitis during the follow-up. Hybrid VMAT for postoperative breast cancer including regional lymph nodes was a reasonable technique that improved the homogeneity and conformity of the irradiation dose to the planning target volume while keeping the irradiation dose to organs at risk to a minimum.

scholarly journals Accuracy of Ultrasound Examination of Loco-Regional Lymph Nodes in Breast Cancer Follow-Up and Its Role in the Axillary Surgical Management

2014 ◽  
Vol 03 (01) ◽  
pp. 5-11
Author(s):  
Jacopo Nori ◽  
Icro Meattini ◽  
Dalmar Abdulcadir ◽  
Elisabetta Giannotti ◽  
Diego De Benedetto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Surgical Management ◽  
Ultrasound Examination ◽  
Regional Lymph Nodes

scholarly journals Transcatheter and intraoperative device closure of atrial septal defect in infants under three years of age

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yangyang Han ◽  
Xiquan Zhang ◽  
Fengwei Zhang
Keyword(s):  
Atrial Septal Defect ◽  
Hospital Stay ◽  
Clinical Data ◽  
Septal Defect ◽  
Postoperative Hospital Stay ◽  
Device Closure ◽  
Young Infants ◽  
Group A ◽  
Group B

Abstract Background Transcatheter and intraoperative device closures have been widely used in the treatment of secundum atrial septal defect (ASD). However, for young infants with ASD, device closure remains controversial, and such treatment features limited data. We compared the clinical data and follow-up results of percutaneous and intraoperative device closure for ASD to evaluate the feasibility, safety, and efficacy of both treatments in infants under 3 years of age. Methods From September 2010 to September 2018, 186 children under 3 years of age with significant secundum ASD were included in this study. A total of 88 and 98 patients were divided into groups A (transcatheter device closure) and B (intraoperative device closure), respectively. The clinical data and follow-up results of the two groups were analyzed retrospectively. Result The mean age and weight of patients in group A were significantly higher than those in group B. The proportion of complex ASDs (multiples or rims deficiency) and the device/weight ratio in group B were significantly higher than those in group A. Successful closure was obtained in 86 (97.7%) and 96 (98.0%) infants in groups A and B, respectively, with two failed cases in each group (2.3% vs 2%). The rate of periprocedural complications reached 13.6 and 26.5% for groups A and B (P = 0.058), respectively. The durations of the procedure and postoperative hospital stay in group A were significantly shorter than those in group B (P < 0.05). Excellent follow-up results were observed in both groups. At present, no death nor major complications have occurred. Symptoms either resolved completely or improved significantly for all symptomatic infants. No residual shunts at the 6th month of follow-up evaluation were observed. Patients with failure to thrive gained weight appropriately for age, and the structure and hemodynamic parameters significantly improved during follow-up. Conclusion Transcatheter and intraoperative device closure are feasible, effective, and safe methods for the treatment of ASDs in infants under 3 years of age. Considering improved cosmetic effect and the short duration of the procedure and postoperative hospital stay, transcatheter is preferred for patients with appropriate conditions. Intraoperative device closure can be performed as an alternative to percutaneous closure, particularly for infants with large, complex ASDs, young age, or low-body weight.

Periarticular plasma cell tumors in cats

2021 ◽  
pp. 030098582110486
Author(s):  
Linden E. Craig ◽  
Danielle E. Lieske
Keyword(s):  
Lymph Nodes ◽  
Aggressive Behavior ◽  
Median Survival ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Small Samples ◽  
Regional Lymph Nodes ◽  
Biopsy Specimens ◽  
The Masses

This report describes periarticular plasma cell tumors with abundant amyloid in 11 cats. The tarsus was the most commonly affected joint (10/11), and the masses were often circumferential around the tarsal joint, involving the dermis and subcutis. The 2 cases in which synovium was examined had neoplastic cells expanding the synovium. Three of the 5 cases staged radiographically had bony lysis of the affected joint. Cutaneous biopsy specimens often consisted of more amyloid than plasma cells, making the diagnosis difficult on small samples. Follow-up information was available in 7 cases; in those cases, the median survival was 194 days (range 53–671 days). Four cases had confirmed metastases, most often to regional lymph nodes, liver, and spleen. Although canine cutaneous plasma cell tumors are typically benign, those with abundant amyloid surrounding the joints of cats may involve deeper tissues and have a more aggressive behavior. These tumors can be difficult to diagnose due to low cellularity and abundant amyloid.

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