scholarly journals Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

2020 ◽  
Author(s):  
Qiannan Huang ◽  
Jianguo Li ◽  
Qingjing Zeng ◽  
Lei Tan ◽  
Rongqin Zheng ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Liver Cancer ◽  
Abdominal Surgery ◽  
Thermal Ablation ◽  
Malignant Tumors ◽  
Intestinal Fistula ◽  
Previous Abdominal Surgery ◽  
Artificial Ascites ◽  
Major Complications ◽  
Technical Efficacy

Abstract BackgroundTo evaluate the feasibility and effectiveness of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery.MethodsThirty-nine patients with a total of 40 liver malignant tumors were enrolled between January 2016 and June 2019. All had histories of hepatectomy, splenectomy, cholecystectomy, and intestinal surgery. The distance between the tumor and the gastrointestinal tract was < 5 mm. Normal saline was used as artificial ascites to protect the gastrointestinal tract during thermal ablation. The success rate of the procedure, incidence of major complications, and the technical efficacy of ablation were recorded. Patients were followed for local tumor progression (LTP), and overall survival (OS).ResultsThe use of artificial ascites was successful in 38 of the 40 procedures (95%). Major complications occurred in two of the 39 patients (5.1%) following the procedure. One was an intestinal fistula that occurred in a failed case and was associated with an infection. The other was a liver abscess that occurred in a successful case. The technical efficacy of ablation was 100% (40/40 procedures). The median follow-up was 20 months. The 1-, 2-, and 3-year LTP rates were 2.9%, 5.7% and 5.7%. The 1-, 2-, and 3-year OS rates were 97.1%, 86.8% and 69.5%.ConclusionIn patients with previous abdominal surgery, artificial ascites is feasible and effective for assisting thermal ablation of liver cancer adjacent to the gastrointestinal tract.Co-first authors: Qiannan Huang #, Jianguo Li # contributed equally to this article and should be considered co-first authors.Co-corresponding authors: Xuqi He *, Kai Li * contributed equally to this article and should be considered co-corresponding authors.

scholarly journals Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

2020 ◽  
Author(s):  
Qiannan Huang ◽  
Jianguo Li ◽  
Qingjing Zeng ◽  
Lei Tan ◽  
Rongqin Zheng ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Liver Cancer ◽  
Abdominal Surgery ◽  
Thermal Ablation ◽  
Malignant Tumors ◽  
Intestinal Fistula ◽  
Previous Abdominal Surgery ◽  
Artificial Ascites ◽  
Major Complications ◽  
Technical Efficacy

Abstract Background To evaluate the feasibility and effectiveness of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery. Methods Thirty-nine patients with a total of 40 liver malignant tumors were enrolled between January 2016 and June 2019. All had histories of hepatectomy, splenectomy, cholecystectomy, and intestinal surgery. The distance between the tumor and the gastrointestinal tract was < 5 mm. Normal saline was used as artificial ascites to protect the gastrointestinal tract during thermal ablation. The success rate of the procedure, incidence of major complications, and the technical efficacy of ablation were recorded. Patients were followed for local tumor progression (LTP), and overall survival (OS). Results The use of artificial ascites was successful in 38 of the 40 procedures (95%). Major complications occurred in two of the 39 patients (5.1%) following the procedure. One was an intestinal fistula that occurred in a failed case and was associated with an infection. The other was a liver abscess that occurred in a successful case. The technical efficacy of ablation was 100% (40/40 procedures). The median follow-up was 16 months. The 1-, 2-, and 3-year LTP rates were 2.9%, 5.7% and 5.7%. The 1-, 2-, and 3-year OS rates were 97.1%, 86.8% and 69.5%. Conclusion In patients with previous abdominal surgery, artificial ascites is feasible and effective for assisting thermal ablation of liver cancer adjacent to the gastrointestinal tract.

scholarly journals Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

2020 ◽  
Author(s):  
Qiannan Huang ◽  
Jianguo Li ◽  
Qingjing Zeng ◽  
Lei Tan ◽  
Rongqin Zheng ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Liver Cancer ◽  
Abdominal Surgery ◽  
Thermal Ablation ◽  
Malignant Tumors ◽  
Intestinal Fistula ◽  
Previous Abdominal Surgery ◽  
Artificial Ascites ◽  
Major Complications ◽  
Technical Efficacy

Abstract Background To evaluate the feasibility and effectiveness of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery. Methods Thirty-nine patients with a total of 40 liver malignant tumors were enrolled between January 2016 and June 2019. All had histories of hepatectomy, splenectomy, cholecystectomy, and intestinal surgery. The distance between the tumor and the gastrointestinal tract was < 5 mm. Normal saline was used as artificial ascites to protect the gastrointestinal tract during thermal ablation. The success rate of the procedure, incidence of major complications, and the technical efficacy of ablation were recorded. Patients were followed for local tumor progression (LTP), and overall survival (OS). Results The use of artificial ascites was successful in 38 of the 40 procedures (95%). Major complications occurred in two of the 39 patients (5.1%) following the procedure. One was an intestinal fistula that occurred in a failed case and was associated with an infection. The other was a liver abscess that occurred in a successful case. The technical efficacy of ablation was 100% (40/40 procedures). The median follow-up was 20 months. The 1-, 2-, and 3-year LTP rates were 2.9%, 5.7% and 5.7%. The 1-, 2-, and 3-year OS rates were 97.1%, 86.8% and 69.5%. Conclusion In patients with previous abdominal surgery, artificial ascites is feasible and effective for assisting thermal ablation of liver cancer adjacent to the gastrointestinal tract.

Conservative management of the colonic gallstone

2021 ◽  
Vol 14 (11) ◽  
pp. e243040
Author(s):  
Katherine Victoria Hurst ◽  
Georgina Bryony Peiris ◽  
Michael Booth
Keyword(s):  
Type 2 Diabetes ◽  
Gastrointestinal Tract ◽  
Abdominal Surgery ◽  
Ultrasound Scan ◽  
Past Medical History ◽  
Previous Abdominal Surgery ◽  
Bowel Movements ◽  
History Of ◽  
Cholecystocolonic Fistula

A 74-year-old woman presents with a 7-day history of increasing lower abdominal pains and reduced bowel movements; resulting in absolute constipation.Twenty-four hours prior to admission she also had symptoms of nauseous and significant abdominal distention. Her past medical history included; diverticulitis, type 2 diabetes, hypercholesterolemia, an ultrasound scan in 2005 confirming gallstones, but no previous abdominal surgery.She was initially treated for bowel obstruction and a CT arranged. CT showed a 4.5 cm gallstone in mid-sigmoid colon and a cholecystocolonic fistula. She was booked for colonoscopy±laparotomy, but on the morning of her planned procedure she repeatedly opened her bowels. Subsequent colonoscopy was negative and repeat CT confirmed the stone was no longer within the gastrointestinal tract.

scholarly journals Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mirhasan Rahimli ◽  
Aristotelis Perrakis ◽  
Vera Schellerer ◽  
Andrew Gumbs ◽  
Eric Lorenz ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Minimally Invasive ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Short Term ◽  
Minimally Invasive Liver Surgery ◽  
Previous Abdominal Surgery

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

Application of Immunohistochemistry to Liver and Gastrointestinal Neoplasms: Liver, Stomach, Colon, and Pancreas

2008 ◽  
Vol 132 (3) ◽  
pp. 490-499 ◽  
Author(s):  
Stephen A. Geller ◽  
Deepti Dhall ◽  
Randa Alsabeh
Keyword(s):  
Gastrointestinal Tract ◽  
Personal Experience ◽  
Recent Literature ◽  
Malignant Tumors ◽  
Chemotherapeutic Agents ◽  
Gastrointestinal System ◽  
Data Sources ◽  
Gastrointestinal Neoplasms ◽  
Metastatic Neoplasm ◽  
Selection Of

Abstract Context.—Immunohistochemistry has become an integral component of the practice of pathology. Newer antibodies allow for increasingly precise diagnoses for tumors that previously could not be easily identified. Recently, immunohistochemical evaluations have begun to allow pathologists to actively assist in determining prognosis and even in selecting therapies. Objective.—To summarize the usefulness of currently available immunostains for the study of liver and gastrointestinal system neoplasms and to make recommendations for panels of immunostains that can be particularly helpful. Data Sources.—Information has been collected from recent literature as well as from personal experience and practice. Conclusions.—Many immunostains are now available for the practicing pathologist that allow for increasing accuracy in diagnosis of liver and gastrointestinal tract neoplasms. Panels of immunostains can be used to differentiate between various tumors and also to identify site of origin in the case of a metastatic neoplasm. Immunostains that allow for prognostic determinations and for guidance in the selection of chemotherapeutic agents can also be used by pathologists to assist in the management of patients with malignant tumors affecting the liver and gastrointestinal tract.

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