scholarly journals Successful Laparoscopic Resection of Gastric Lymphangioma Under the Intraoperative Guidance of Indocyanine Green Fluorescence Imaging: A Case Report

2020 ◽  
Author(s):  
Ryosuke Umino ◽  
Masayuki Urabe ◽  
Yu Ohkura ◽  
Akikazu Yago ◽  
Shusuke Haruta ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Surgical Resection ◽  
Gastric Volume ◽  
Complete Resection ◽  
Pathological Examination ◽  
Abdominal Ultrasonography ◽  
Residual Gastric Volume ◽  
First Case ◽  
Intraoperative Guidance

Abstract Background: Gastric lymphangioma (GLA) is an extremely rare tumor without an established therapeutic strategy. Surgical resection is considered the mainstay of treatment, although there is a high risk of local recurrence if negative margins are not achieved. Thus, it would be useful to develop tools and strategies to achieve safe and complete resection. We describe our experience with the first case involving GLA resection under the intraoperative guidance of indocyanine green (ICG) fluorescence imaging, which allowed us to achieve limited but complete resection with negative margins.Case Presentation: A 51-year-old Japanese man with a history of alcoholic liver disease underwent routine abdominal ultrasonography, which incidentally detected a 20-mm tumor adjacent to the lesser curvature of the stomach. The mass was suspected to be GLA based on its polycystic appearance. After a 16-month monitoring period, the patient was referred to our hospital for further assessment because of tumor growth and involvement of the left gastric artery. We selected surgical resection to facilitate a pathological diagnosis and treatment of potential invasion to the surrounding organs. Intraoperative use of a ICG navigation system revealed lymphatic drainage from the tumor, which we used to help determine the optimal excision line and minimize the loss of gastric volume. Pathological examination confirmed complete resection with negative margins and supported a diagnosis of lymphangioma.Conclusions: We performed laparoscopic radical resection of GLA under guidance from intraoperative ICG fluorescence imaging, which allowed us to maximize residual gastric volume. Although further cases are needed to validate this strategy, it may be useful for guiding the resection of GLA.

scholarly journals Residual gastric volume evaluation with ultrasonography after ingestion of carbohydrate- or carbohydrate plus glutamine-enriched beverages: a randomized, crossover clinical trial with healthy volunteers

2017 ◽  
Vol 54 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Paulo Cesar GOMES ◽  
Cervantes CAPOROSSI ◽  
Jose Eduardo AGUILAR-NASCIMENTO ◽  
Ageo Mario Candido da SILVA ◽  
Viviane Maeve Tavares de ARAUJO
Keyword(s):  
Clinical Trial ◽  
Healthy Volunteers ◽  
Postoperative Recovery ◽  
Gastric Volume ◽  
Safe Procedure ◽  
Abdominal Ultrasonography ◽  
Residual Gastric Volume ◽  
Potential Benefits ◽  
The Mean ◽  
To Receive

ABSTRACT BACKGROUND Abbreviation of preoperative fasting to 2 hours with maltodextrin (CHO)-enriched beverage is a safe procedure and may enhance postoperative recovery. Addition of glutamine (GLN) to CHO beverages may include potential benefits to the metabolism. However, by adding a nitrogenous source to CHO beverages, gastric emptying may be delayed and increase the risk of bronchoaspiration during anesthesia. OBJECTIVE In this study of safety, we aimed at investigating the residual gastric volume (RGV) 2 hours after the intake of either CHO beverage alone or CHO beverage combined with GLN. METHODS We performed a randomized, crossover clinical trial. We assessed RGV by means of abdominal ultrasonography (US) in 20 healthy volunteers (10 males and 10 females) after an overnight fast of 8 hours. Then, they were randomized to receive 600 mL (400 mL immediately after US followed by another 200 mL 2 hours afterwards) of either CHO (12.5% maltodextrin) or CHO-GLN (12.5% maltodextrin plus 15 g GLN). Two sequential US evaluations were done at 120 and 180 minutes after ingestion of the second dose. The interval of time between ingestion of the two types of beverages was 2 weeks. RESULTS The mean (SD) RGV observed after 8 hours fasting (13.56±13.25 mL) did not statistically differ (P>0.05) from the RGV observed after ingesting CHO beverage at both 120 (16.32±11.78 mL) and 180 minutes (14.60±10.39 mL). The RGV obtained at 120 (15.63±18.83 mL) and 180 (13.65±10.27 mL) minutes after CHO-GLN beverage also was not significantly different from the fasting condition. CONCLUSION The RGV at 120 and 180 minutes after ingestion of CHO beverage combined with GLN is similar to that observed after an overnight fast.

Laparoscopic Resection of a Hepatic Epithelioid Angiomyolipoma Revealed by Indocyanine Green Fluorescence Imaging

2021 ◽  
pp. 000313482110234
Author(s):  
Kiyotaka Mochizuki ◽  
Takeshi Aoki ◽  
Tomokazu Kusano ◽  
Kodai Tomioka ◽  
Yoshihiko Tashiro ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Laparoscopic Hepatectomy ◽  
Surgical Margin ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
First Case ◽  
Indocyanine Green Fluorescence Imaging

Indocyanine green fluorescence imaging (ICG-FI)—a sensitive tool for detecting tumor localization in laparoscopic surgery—produces false positive results for benign liver tumors. This report is the first case of hepatic angiomyolipoma (HAML) treated laparoscopically with ICG-FI. We present the case of a 31-year-old woman with a liver tumor that was a 13-mm mass in the anterior superior segment. Though a benign tumor was suspected, malignant potential could not be ruled out. Therefore, minimally invasive laparoscopic resection using ICG-FI was planned. ICG, intravenously injected preoperatively, revealed the tumor’s existence. Pure laparoscopic hepatectomy with ICG-FI was performed for excisional biopsy, during which the tumor was resected with adequate surgical margins, followed by histological confirmation of HAML. In conclusion, it is suggested that laparoscopic resection with ICG-FI is an effective minimal invasive surgery for tumors that are difficult to detect, such as HAML, leading to a safe surgical margin.

Anesthesia in Carvajal syndrome; the first case report

2020 ◽  
Vol 24 (1) ◽  
pp. 105-107
Author(s):  
Sedighe Shahhosseini ◽  
Reza Aminnejad ◽  
Amir Shafa ◽  
Mehrdad Memarzade
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Surgical Resection ◽  
Genetic Disorder ◽  
Anesthetic Technique ◽  
Close Monitoring ◽  
Anesthesia Management ◽  
Rare Genetic Disorder ◽  
First Case ◽  
Anesthetic Considerations

Carvajal syndrome is a rare genetic disorder. Patients reporting for surgery pose some difficulties in anesthesia management. In this case report we present the case of a 12-year-old boy, who was a known case of Carvajal syndrome, referred for surgical resection of perianal condyloma. Close monitoring of hemodynamic status is the mainstay of anesthetic considerations in such patients. As in any other challenging scenario, it should be kept in mind that ‘there is no safest anesthetic agent, nor the safest anesthetic technique; there is only the safest anesthesiologist’. Citation: Shahhosseini S, Aminnejad R, Shafa A, Memarzadeh M. Anesthesia in Carvajal syndrome; the first case report. Anaesth pain intensive care 2020;24(1):___ DOI: https://doi.org/10.35975/apic.v24i1.

Fabrication and fluorescence imaging properties of indocyanine green-loaded poly(lactic-co-glycolic acid) nanoparticles

2021 ◽  
Author(s):  
Mayu Tayama ◽  
Tomoya Inose ◽  
Noriko Yamauchi ◽  
Kouichi Nakashima ◽  
Masayuki Tokunaga ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Glycolic Acid ◽  
Imaging Properties

scholarly journals Pyosalpinx due to Cronobacter sakazakii in an elderly woman

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Satoshi Ohira ◽  
Eri Ikeda ◽  
Kyosuke Kamijo ◽  
Tomokuni Nagai ◽  
Koji Tsunemi ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
The Elderly ◽  
Pathological Examination ◽  
Milk Formula ◽  
Adult Women ◽  
Cronobacter Sakazakii ◽  
Left Edge ◽  
Powdered Milk ◽  
First Case

Abstract Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

scholarly journals Real-time intraoperative glioma diagnosis using fluorescence imaging and deep convolutional neural networks

2021 ◽  
Author(s):  
Biluo Shen ◽  
Zhe Zhang ◽  
Xiaojing Shi ◽  
Caiguang Cao ◽  
Zeyu Zhang ◽  
...  
Keyword(s):  
Neural Networks ◽  
Real Time ◽  
Fluorescence Imaging ◽  
Convolutional Neural Networks ◽  
Frozen Section ◽  
Fluorescent Imaging ◽  
Pathological Diagnosis ◽  
Pathological Examination ◽  
Deep Convolutional Neural Networks ◽  
Fluorescence Images

Abstract Purpose Surgery is the predominant treatment modality of human glioma but suffers difficulty on clearly identifying tumor boundaries in clinic. Conventional practice involves neurosurgeon’s visual evaluation and intraoperative histological examination of dissected tissues using frozen section, which is time-consuming and complex. The aim of this study was to develop fluorescent imaging coupled with artificial intelligence technique to quickly and accurately determine glioma in real-time during surgery. Methods Glioma patients (N = 23) were enrolled and injected with indocyanine green for fluorescence image–guided surgery. Tissue samples (N = 1874) were harvested from surgery of these patients, and the second near-infrared window (NIR-II, 1000–1700 nm) fluorescence images were obtained. Deep convolutional neural networks (CNNs) combined with NIR-II fluorescence imaging (named as FL-CNN) were explored to automatically provide pathological diagnosis of glioma in situ in real-time during patient surgery. The pathological examination results were used as the gold standard. Results The developed FL-CNN achieved the area under the curve (AUC) of 0.945. Comparing to neurosurgeons’ judgment, with the same level of specificity >80%, FL-CNN achieved a much higher sensitivity (93.8% versus 82.0%, P < 0.001) with zero time overhead. Further experiments demonstrated that FL-CNN corrected >70% of the errors made by neurosurgeons. FL-CNN was also able to rapidly predict grade and Ki-67 level (AUC 0.810 and 0.625) of tumor specimens intraoperatively. Conclusion Our study demonstrates that deep CNNs are better at capturing important information from fluorescence images than surgeons’ evaluation during patient surgery. FL-CNN is highly promising to provide pathological diagnosis intraoperatively and assist neurosurgeons to obtain maximum resection safely. Trial registration ChiCTR ChiCTR2000029402. Registered 29 January 2020, retrospectively registered

scholarly journals Surgery in congenital lung malformations: the evolution from thoracotomy to VATS, 10-year experience in a single center

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kenan C. Ceylan ◽  
Güntuğ Batihan ◽  
Ahmet Üçvet ◽  
Soner Gürsoy
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
Thoracoscopic Surgery ◽  
Pathological Examination ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Simple Cyst ◽  
Cyst Excision ◽  
Congenital Lung Malformation ◽  
First Choice ◽  
Congenital Lung Malformations

Abstract Background Congenital lung malformation is an umbrella term and consist of various kind of parenchymal and mediastinal pathologies. Surgical resection is often required for diagnosis and curative treatment. We aimed to review our experience in surgical treatment for congenital lung disease and present the role of minimally invasive surgery. Methods Surgical resections performed for benign lesions of the lung and mediastinum between January 2009 and May 2019 were retrospectively analyzed. Patients who were found to have congenital lung malformation as a result of pathological examination were included in our study. Distribution characteristics of the patients according to congenital lung malformation subtypes, differences in surgical approach and postoperative results were investigated. Results A total of 94 patients who underwent surgical resection and were diagnosed with the bronchogenic cyst, sequestration, bronchial atresia, congenital cystic adenomatoid malformation (CCAM), or enteric cyst as a result of pathological examination were included the study. There were no significant differences between pathological subtypes in the postoperative length of hospital stay and drainage duration however, perioperative complication rate was higher in the sequestration group. In addition, in the first three days postoperatively, the mean pain score was found to be lower in the VATS group compared to thoracotomy. Conclusions Congenital lung malformations consist of a heterogeneous group of diseases and the surgical treatment in these patients can range from a simple cyst excision to pneumonectomy. Video-assisted thoracoscopic surgery should be considered as the first choice in the surgical treatment of these patients in experienced centers.

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