Nd:YAG Laser surgery of lung metastases

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Andreas Kirschbaum
Keyword(s):  
Lung Metastases ◽  
Mediastinal Lymph Node ◽  
Operation Time ◽  
Lung Parenchyma ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
Nd:Yag Lasers ◽  
Large Numbers ◽  
Node Metastases ◽  
Nd:Yag Laser Surgery

Abstract:Lung metastases occur during the course of the disease in many types of cancer. If the basic disorder is under control and there are no distant or mediastinal lymph node metastases, removal of the lung metastases can improve long-term survival. Lung metastases are non-anatomically removed from the healthy patient if they have not infiltrated any central bronchi or blood vessels. Nd:YAG lasers are particularly suitable for this. They cut the lung parenchyma and at the same time coagulate the resected surface. This means that large numbers of lung metastases can be removed with little bleeding. Modern Nd:YAG lasers (wavelength 1318 nm) are more efficient to use because the laser power is greater (80–100 W). This shortens the operation time and makes the resected surfaces more airtight. Consequently, resection zones on the surface need no longer to be sutured. The mortality and morbidity of the operations are low. Nd:YAG lasers are now indispensable in the surgical treatment of lung metastases.

Is Hepatopancreatoduodenectomy an Acceptable Operation for Biliary Cancer?

2018 ◽  
Vol 84 (5) ◽  
pp. 703-711
Author(s):  
Eung Chang Lee ◽  
Sung-Sik Han ◽  
Seung Duk Lee ◽  
Sang-Jae Park
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Survival Rates ◽  
Operation Time ◽  
Morbidity Rate ◽  
R0 Resection ◽  
Term Survival ◽  
Mortality And Morbidity

Hepatopancreatoduodenectomy (HPD) is usually indicated for the resection of locally advanced bile duct (BD) cancer or gallbladder (GB) cancer. Previous studies have demonstrated a favorable survival rate in BD cancer patients after HPD if R0 resection is achieved. By contrast, the benefit of HPD for GB cancer remains controversial. This study aimed to analyze the outcomes of GB and BD cancer after HPD. Between January 2004 and December 2013, a total of 22 patients underwent HPD for BD (n = 14) or GB cancer (n = 8). We analyzed the survival, mortality, morbidity, and prognostic factors. After HPD, the mortality rate was 4.5 per cent and the morbidity rate was 68.2 per cent. Pancreatic fistula occurred in 50.0 per cent of the patients (grade A, 40.9%; grade B, 9.1%). Liver failure did not occur. The 1-, 3-, and 5-year survival rates for BD cancer patients were 57.1, 17.9, and 17.9 per cent and those for GB cancer patients were 62.5, 25.0, and 25.0 per cent, respectively ( P = 0.768). In BD cancer, significant prognostic factors were tumor size, portal vein invasion, multiple lymph node metastases, and operation time. Furthermore, BD cancer patients with three or more of risk factors showed poorer survival than those with fewer than three risk factors. HPD for GB and BD cancer can be performed with acceptable mortality and morbidity rates. GB cancer patients who underwent HPD showed comparable survival rates compared with BD cancer patients. Long-term survival can be achieved in selected patients with BD cancer.

Surgery Combined With Peritonectomy Procedures and Intraperitoneal Chemohyperthermia in Abdominal Cancers With Peritoneal Carcinomatosis: A Phase II Study

2003 ◽  
Vol 21 (5) ◽  
pp. 799-806 ◽  
Author(s):  
O. Glehen ◽  
F. Mithieux ◽  
D. Osinsky ◽  
A.C. Beaujard ◽  
G. Freyer ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Complete Resection ◽  
Morbidity Rate ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
Peritonectomy Procedures ◽  
Experienced Team

Purpose: To evaluate the tolerance of peritonectomy procedures (PP) combined with intraperitoneal chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis (PC), a phase II study was carried out from January 1998 to September 2001. Patients and Methods: Fifty-six patients (35 females, mean age 49.3) were included for PC from colorectal cancer (26 patients), ovarian cancer (seven patients), gastric cancer (six patients), peritoneal mesothelioma (five patients), pseudomyxoma peritonei (seven patients), and miscellaneous reasons (five patients). Surgeries were performed mainly on advanced patients (40 patients stages 3 and 4 and 16 patients stages 2 and 1) and were synchronous in 36 patients. All patients underwent surgical resection of their primary tumor with PP and IPCH (with mitomycin C, cisplatinum, or both) with a closed sterile circuit and inflow temperatures ranging from 46° to 48°C. Three patients were included twice. Results: A macroscopic complete resection was performed in 27 cases. The mortality and morbidity rates were one of 56 and 16 of 56, respectively. The 2-year survival rate was 79.0% for patients with macroscopic complete resection and 44.7% for patients without macroscopic complete resection (P = .001). For the patients included twice, two are alive without evidence of disease, 54 and 47 months after the first procedure. Conclusion: IPCH and PP are able to achieve unexpected long-term survival in patients with bulky PC. However, one must be careful when selecting the patients for such an aggressive treatment, as morbidity rate remains high even for an experienced team.

Pre-surgical assessment of mediastinal lymph node metastases in Stage IA non-small-cell lung cancers

2020 ◽  
Vol 68 ◽  
pp. 61-67
Author(s):  
Yong Wang ◽  
Yeqing Zhu ◽  
Rowena Yip ◽  
Dong-Seok Lee ◽  
Raja M. Flores ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Stage Ia ◽  
Node Metastases ◽  
Mediastinal Lymph Node Metastases

scholarly journals Comparison of Sleeve Lobectomy for Lung Cancer Using Mini-Thoracotomy and an Optimized Robot-Assisted Technique

2021 ◽  
Vol 20 ◽  
pp. 153303382110515
Author(s):  
Tao Shaolin ◽  
Feng Yonggeng ◽  
Kang Poming ◽  
Mei Longyong ◽  
Shen Cheng ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Operation Time ◽  
Intercostal Space ◽  
Large Sample Size ◽  
Sleeve Lobectomy ◽  
Term Survival ◽  
Robotic Assisted ◽  
Posterior Axillary Line ◽  
Pain Scores ◽  
Mini Thoracotomy

Objective: To evaluate the clinical significance of an optimized approach to improve surgical field visualization and simplify anastomosis techniques using robotic-assisted sleeve lobectomy for lung or bronchial carcinoma. Method: A total of 26 consecutive patients who underwent sleeve lobectomy between January 2017 and April 2020 were enrolled in the study. The cohort included 11 cases of robotic-assisted surgery (RAS group) and 15 cases of mini-thoracotomy (MT group). RAS was performed via an exclusive optimized approach utilizing the “3 to 4-6 to 8/9” four-port technique. Retrieved demographical and clinical data included operation time, anastomosis time, blood loss, chest drainage time and volume, postoperative pain scores, complications, white blood cell (WBC) levels, and duration of hospital stay and follow-up. Results: No cases of perioperative death were recorded. Compared to MT group, the RAS group had a similar anastomosis time (30.82  ±  6.08 vs 33.20  ±  7.73 min, respectively, p > 0.05) and shorter operation time (189.73  ±  36.41 vs 225.33  ±  38.19 min, respectively, p < 0.05). The RAS group had lower pain scores (4.23  ±  0.26 vs 4.91  ±  0.51, p < 0.05), lower levels of WBC (p < 0.05), and no anastomotic complications postoperatively. The RAS and MT groups demonstrated a successful bronchus reconstruction with low risk of angulation (1/11 vs 1/15, p > 0.05) and satisfactory disease-free survival (eight cases, 72.73% and 12 cases, 80%, respectively). Conclusion: The optimized approach to RA sleeve lobectomy is convenient and efficient and provides satisfactory clinical outcomes. Further study with a large sample size and evaluation of long-term survival are warranted. Key points: (i) we present a novel, convenient, and efficient approach for robotic-assisted sleeve lobectomy, ie, “3 to 4-6 to 8/9” four-port technique. The optimized approach for RA sleeve lobectomy is convenient and efficient and provides satisfactory clinical outcomes; (ii) details for the “3 to 4-6 to 8/9” four-port method: the assistant port was located at the fourth intercostal space. The 1-cm camera port was inserted at the sixth intercostal space in the posterior axillary line. The 0.5-cm da Vinci ports of the instrument arms were placed at the third intercostal space in the anterior axillary line and the eighth or ninth intercostal space in the posterior axillary line. The patient cart was inserted from the back of the patient's head and shoulders at 75° to the longitudinal line.

scholarly journals The Value of Paratracheal Lymphadenectomy in Esophagectomy for Adenocarcinoma of the Esophagus or Gastroesophageal Junction: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Amaia Gantxegi ◽  
B. Feike Kingma ◽  
Jelle P. Ruurda ◽  
Grard A. P. Nieuwenhuijzen ◽  
Misha D. P. Luyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Gastroesophageal Junction ◽  
Transthoracic Esophagectomy ◽  
Mediastinal Lymphadenectomy ◽  
Node Metastases ◽  
Upper Mediastinum ◽  
Mediastinal Lymph Node Metastases

Abstract Background The role of upper mediastinal lymphadenectomy for distal esophageal or gastroesophageal junction (GEJ) adenocarcinomas remains a matter of debate. This systematic review aims to provide a comprehensive overview of evidence on the incidence of nodal metastases in the upper mediastinum following transthoracic esophagectomy for distal esophageal or GEJ adenocarcinoma. Methods A literature search was performed using Medline, Embase and Cochrane databases up to November 2020 to include studies on patients who underwent transthoracic esophagectomy with upper mediastinal lymphadenectomy for distal esophageal and/or GEJ adenocarcinoma. The primary endpoint was the incidence of metastatic nodes in the upper mediastinum based on pathological examination. Secondary endpoints were the definition of upper mediastinal lymphadenectomy, recurrent laryngeal nerve (RLN) palsy rate and survival. Results A total of 17 studies were included and the sample sizes ranged from 10-634 patients. Overall, the median incidence of upper mediastinal lymph node metastases was 10.0% (IQR 4.7-16.7). The incidences of upper mediastinal lymph node metastases were 8.3% in the 7 studies that included patients undergoing primary resection (IQR 2.0-16.6), 4,4% in the 1 study that provided neoadjuvant therapy to the full cohort, and 10.6% in the 9 studies that included patients undergoing esophagectomy either with or without neoadjuvant therapy (IQR 8.9-15.8%). Data on survival and RLN palsy rates were scarce and inconclusive. Conclusions The incidence of upper mediastinal lymph node metastases in distal esophageal adenocarcinoma is up to 10%. Morbidity should be weighed against potential impact on survival.

The Role of Positron Emission Tomography in Evaluating Mediastinal Lymph Node Metastases in Non–Small-Cell Lung Cancer

2001 ◽  
Vol 2 (3) ◽  
pp. 229-233 ◽  
Author(s):  
James D. Luketich ◽  
David M. Friedman ◽  
Carolyn C. Meltzer ◽  
Chandra P. Belani ◽  
David W. Townsend ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Mediastinal Lymph Node ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Node Metastases ◽  
Mediastinal Lymph Node Metastases
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