scholarly journals Posterior resection of sacral osteosarcoma utilizing cement-infused chest tube interbody reconstruction and lumbopelvic fusion

2021 ◽  
Vol 12 ◽  
pp. 599
Author(s):  
Amanda M. Carpenter ◽  
M. Omar Iqbal ◽  
Neil Majmundar ◽  
Gino Chiappetta ◽  
Shabbar Danish ◽  
...  
Keyword(s):  
Chest Tube ◽  
Surgical Planning ◽  
Tumor Resection ◽  
Severe Stenosis ◽  
En Bloc ◽  
Iliac Screws ◽  
Potential Risks ◽  
Anterior Column Reconstruction ◽  
Anatomical Constraints ◽  
Anterior Subluxation

Background: Primary osteosarcoma (OS) of the spine is very rare. En bloc resection of spinal OS is challenging due to anatomical constraints. Surgical planning must balance the benefits of en bloc resection with its potential risks of causing a significant neurological deficit. In this case, we successfully performed a posterior-only approach for decompression with S1 reconstruction via a cement-infused chest tube interbody device, along with a navigated L4 to pelvis fusion. Case Description: A 49-year-old female presented with a primary sacral OS. Computed tomography (CT) and magnetic resonance (MR) imaging revealed an S1 lytic vertebral body lesion with severe stenosis and progressive L5 on S1 anterior subluxation. Surgical decompression with tumor resection and S1 corpectomy with S1 reconstruction via a cement-infused 32-French chest tube interbody device accompanied by L4 -pelvis fusion utilizing S2-alar-iliac screws was completed. 6 months postoperatively, the patient continues to have significant pain relief and the instrumentation remains intact. Conclusion: A 49-year-old female with an S1 OS successfully underwent a posterior-only approach that included an S1 corpectomy with anterior column reconstruction via a cement-infused chest tube interbody plus a navigated L4 to pelvis fusion.

scholarly journals The Use of a CAD/CAM Surgical Obturator Without Impressions to Restore a Maxillectomy Defect

2021 ◽  
Vol 6 ◽  
pp. 247275122199297
Author(s):  
Nicholas Callahan ◽  
Sarah L. Moles ◽  
Michael R. Markiewicz
Keyword(s):  
Surgical Planning ◽  
Tumor Resection ◽  
Free Tissue Transfer ◽  
Digital Impression ◽  
Head And Neck Reconstruction ◽  
Autologous Reconstruction ◽  
Form And Function ◽  
Virtual Surgical Planning ◽  
Tissue Transfer ◽  
Cad Cam

Immediate obturation of the patient undergoing maxillectomy who is not undergoing formal autologous reconstruction is important for immediate form and function of the patient. Exophytic tumors, that are large in dimension can make pre-operative obturator formation challenging. Traditional methods of obturator fabrication involve a physical or digital impression. Preoperative virtual surgical planning for tumor resection and reconstruction using free tissue transfer has become a mainstay in head and neck reconstruction. We describe a variation of this for a patient unable to undergo free tissue transfer where the authors used preoperative virtual surgical planning and CAD/CAM technologies to perform tumor resection, and fabricated an obturator based on the CT imaging alone.

Total ulna replacement with a 3D-printed custom-made prosthesis after en bloc tumor resection: A case report

2018 ◽  
Vol 66 (2) ◽  
pp. e27522 ◽  
Author(s):  
Xiang Fang ◽  
Wenli Zhang ◽  
Zeping Yu ◽  
Hongyuan Liu ◽  
Yan Xiong ◽  
...  
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
En Bloc ◽  
Custom Made ◽  
3D Printed

scholarly journals Mohs Micrographic Surgery Peripheral Margin Control Prior to En Bloc Tumor Resection: A Report of Three Cases

2018 ◽  
Vol 2 (1) ◽  
pp. 49-53
Author(s):  
Daniel Bernstein ◽  
Sara Giddings ◽  
Hooman Khorasani
Keyword(s):  
Plastic Surgery ◽  
Tumor Resection ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
En Bloc ◽  
Facial Plastic Surgery ◽  
Facial Plastic ◽  
Tumor Extirpation ◽  
The Right ◽  
Margin Control

Background: Mohs micrographic surgery (MMS) is an important part of non-melanoma skin cancer (NMSC) management but may even be useful for tumors that cannot be cleared in an office setting.  There are sparse reports of MMS for peripheral margin control in the dermatology literature but various techniques have been reported.Case 1: 58-year-old male with morpheaform basal cell carcinoma of the left midface treated with MMS peripheral margin control followed by facial plastic surgery central tumor extirpation and defect repair.Case 2: 56-year-old female with recurrent morpheaform BCC of the scalp treated with MMS peripheral margin control followed by facial plastic surgery central tumor extirpation and defect repair.Case 3: 73-year-old male with multiply recurrent SCC of the right lower extremity treated with MMS peripheral margin control followed by above the knee amputation.Conclusions:  MMS peripheral margin control followed by central tumor extirpation and defect reconstruction at a later date in the operating room is an option for deeply invasive, large and aggressive NMSC.  Benefits include decreased time under general anesthesia and superior rates of tumor clearance.  In the interim, the peripheral defect between the central tumor and healthy outer tissue can be sutured closed to decrease patient morbidity.

scholarly journals Usefulness of tumor traction with a snare and endoclips in gastric submucosal tumor resection: a propensity-score-matching analysis

2020 ◽  
Author(s):  
Qiang Zhang ◽  
Jian-Qun Cai ◽  
Zhen Wang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Perioperative Complications ◽  
Tumor Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Gastric Submucosal Tumors

Abstract Background Endoscopic resection, including endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFR), was used to resect small gastric submucosal tumors (SMTs). Our team explored a method of tumor traction using a snare combined with endoclips to assist in the resection of SMTs. This study aims to explore the safety and effectiveness of the method. Methods This research performed a propensity-score-matching (PSM) analysis to compare ESD/EFR assisted by a snare combined with endoclips (ESD/EFR with snare traction) with conventional ESD/EFR for the resection of gastric SMTs. Comparisons were made between the two groups, including operative time, en bloc resection rate, perioperative complications, and operation-related costs. Results A total of 253 patients with gastric SMTs resected between January 2012 and March 2019 were included in this study. PSM yielded 51 matched pairs. No significant differences were identified between the two groups in perioperative complications or the costs of disposable endoscopic surgical accessories. However, the ESD/EFR-with-snare-traction group had a shorter median operative time (39 vs 60 min, P = 0.005) and lower rate of en bloc resection (88.2% vs 100%, P = 0.027). Conclusions ESD/EFR with snare traction demonstrated a higher efficiency and en bloc resection rate for gastric SMTs, with no increases in perioperative complications and the costs of endoscopic surgical accessories. Therefore, the method seems an appropriate choice for the resection of gastric SMTs.

Precision of customized surgical osteotomy guide (CSOG) in mandibular reconstruction with a customized implant

2019 ◽  
Vol 25 (10) ◽  
pp. 1601-1623
Author(s):  
Sandeep W. Dahake ◽  
Abhaykumar M. Kuthe ◽  
Mahesh B. Mawale
Keyword(s):  
Surgical Planning ◽  
Total Error ◽  
Tumor Resection ◽  
Mandibular Reconstruction ◽  
Control Group ◽  
Implant Fixation ◽  
Content Type ◽  
Mandibular Tumor ◽  
Hand Tumor ◽  
Experimental Group

Purpose This study aims to find the usefulness of the customized surgical osteotomy guide (CSOG) for accurate mandibular tumor resection for boosting the accuracy of prefabricated customized implant fixation in mandibular reconstructions. Design/methodology/approach In all, 30 diseased mandibular RP models (biomodels) were allocated for the study (for experimental group [n = 15] and for control group [n = 15]). To reconstruct the mandible with customized implant in the experimental group, CSOGs and in control group, no CSOG were used for accurate tumor resections. In control group, only preoperative virtual surgical planning (VSP) and reconstructed RP mandible model were used for the reference. Individually each patient’s preoperative mandibular reconstructions data of both the groups were superimposed to the preoperative VSP of respective patient by registering images with the non-surgical side of the mandible. In both the groups, 3D measurements were taken on the reconstructed side and compared the preoperative VSP and postoperative reconstructed mandible data. The sum of the differences between pre and postoperative data was considered as the total error. This procedure was followed for both the groups and compared the obtained error between the two groups using statistical analysis. Findings The use of CSOG for accurate tumor resection and exact implant fixation in mandibular reconstruction produced a smaller total error than without using CSOG. Originality/value The results showed that, benefits provided with the use of CSOG in mandibular reconstruction justified its use over the without using CSOG, even in free hand tumor resection using rotating burr.

scholarly journals En bloc giant cell tumor resection following direct hemiarthroplasty shoulder reconstruction–functional outcome: A case report

2019 ◽  
Vol 61 ◽  
pp. 202-206 ◽  
Author(s):  
Muhammad Andry Usman ◽  
Andi Dhedie Prasatia Sam ◽  
Marcell Wijaya ◽  
Roichan Muhammad Firdaus ◽  
Khrisna Yudha
Keyword(s):  
Case Report ◽  
Functional Outcome ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Tumor Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Shoulder Reconstruction

Control of temporal lobe epilepsy following en bloc resection of low-grade tumors

1993 ◽  
Vol 78 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Peter J. Kirkpatrick ◽  
Minal Honavar ◽  
Ivan Janota ◽  
Charles E. Polkey
Keyword(s):  
Temporal Lobe ◽  
Age At Onset ◽  
Tumor Resection ◽  
Temporal Lobectomy ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Low Grade ◽  
En Bloc ◽  
Content Type ◽  
Incomplete Removal

✓ Thirty-one patients with a mean age of 18.9 years (range 3 to 53 years) who underwent temporal lobe surgery for tumor-related epilepsy over a 14-year period are presented. All had suffered chronic drug-resistant temporal lobe seizures (mean age at onset 6.9 years, range 0 to 30 years; mean duration of condition 11.9 years, range 3 to 39 years). Preoperative interictal scalp electroencephalography tracings indicated unilateral localized epileptic foci in 90% of patients, and computerized tomography scans showed abnormalities within the temporal lobe in 87%. All patients underwent en bloc temporal lobectomy. No patient received adjuvant radiotherapy or chemotherapy. Review of the histological material showed dysembryoplastic neuroepithelial tumor in 27 (87%) of the specimens and microscopic evidence of incomplete removal of tumor in 22 (71%). At long-term follow-up evaluation (mean duration 5.8 years, range 1 to 14 years), 81% of patients were completely free of seizures (Engel grade I) and 10% were almost seizure free (Engel grade II) with no deaths reported in either early or late follow-up review. Only one patient in the series failed to benefit from the surgery. Four patients suffered permanent neurological deficit causing a mild disability. Psychological assessment showed no significant fall in verbal or performance intelligent quotient for the group, but a mild memory impairment was evident in 32%. Behavioral and social aspects improved in nearly all (94%) cases. Relief of seizures could not be predicted by intraoperative electrocorticography, and outcome was independent of the completeness of tumor resection. Postoperative electroencephalographic findings identified epileptiform potentials in 65% of patients, which were associated with a worse seizure-control outcome grade.

scholarly journals Composite Mandibulectomy

2012 ◽  
Vol 146 (6) ◽  
pp. 932-937 ◽  
Author(s):  
Douglas R. Sidell ◽  
Tara Aghaloo ◽  
Sotirios Tetradis ◽  
Min Lee ◽  
Olga Bezouglaia ◽  
...  
Keyword(s):  
Animal Model ◽  
Medical Center ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Small Animal ◽  
Postoperative Management ◽  
Single Individual ◽  
En Bloc ◽  
Fracture Nonunion ◽  
Anesthetic Complications

Objectives. Segmental mandibular defects can result after the treatment of various pathologic processes, including osteoradionecrosis, tumor resection, or fracture nonunion with sequestration. The variety of etiologies and the frequency of occurrence make the reconstruction of segmental mandibular defects a topic of significant interest. Despite these incentives, a well-established small-animal model of the segmental mandibulectomy, including composite resection, does not exist. The objective of this study is the creation of a reliable animal model that can be used to study the reconstruction of en bloc mandibular defects. Surgical techniques and an array of reconstructive options are described. Study design. Description of an animal model. Setting. Animal laboratory at a quaternary care university medical center. Methods. We present an Animal Research Oversight Committee–approved prospective analysis of survival operations in the rat model. A detailed, stepwise description of surgical technique and relevant intraoperative anatomy is presented. Postoperative management, early pitfalls, surgical complications, and future applications are discussed. Results. A total of 72 operations were performed by a single individual between July and October 2010. Two intraoperative and 9 postoperative complications were recognized. There were 6 orocutaneous fistulas, 2 abscesses, and 1 seroma. There were 4 fatalities, which were attributed to anesthetic complications (2, intraoperative), hematoma formation (1, postoperative), and foreign-body aspiration (1, postoperative). Conclusion. This novel animal model reliably replicates the en bloc segmental mandibular defects seen in our patient population and can be manipulated to achieve a wide variety of research objectives.

Assessment of the Influence of Navigated Transcranial Magnetic Stimulation on Surgical Planning for Tumors in or Near the Motor Cortex

Neurosurgery ◽  
2011 ◽  
Vol 70 (5) ◽  
pp. 1248-1257 ◽  
Author(s):  
Thomas Picht ◽  
Juliane Schulz ◽  
Michael Hanna ◽  
Sein Schmidt ◽  
Olaf Suess ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Surgical Planning ◽  
Tumor Resection ◽  
Spatial Relationship ◽  
Extent Of Resection ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Optimal Balance ◽  
Risk Areas

Abstract BACKGROUND: Brain tumor surgery near the motor cortex requires careful planning to achieve the optimal balance between completeness of tumor resection and preservation of motor function. Navigated transcranial magnetic stimulation (nTMS) can be used to map functionally essential motor areas preoperatively. OBJECTIVE: To evaluate how much influence, benefit, and impact nTMS has on the surgical planning for tumors near the motor cortex. METHODS: This study reviewed the records of 73 patients with brain tumors in or near the motor cortex, mapped preoperatively with nTMS. The surgical team prospectively classified how much influence the nTMS results had on the surgical planning. Stepwise regression analysis was used to explore which factors predict the amount of influence, benefit, and impact nTMS has on the surgical planning. RESULTS: The influence of nTMS on the surgical planning was as follows: it confirmed the expected anatomy in 22% of patients, added knowledge that was not used in 23%, added awareness of high-risk areas in 27%, modified the approach in 16%, changed the planned extent of resection in 8%, and changed the surgical indication in 3%. CONCLUSION: nTMS had an objective benefit on the surgical planning in one fourth of the patients and a subjective benefit in an additional half of the patients. It had an impact on the surgery itself in just more than half of the patients. By mapping the spatial relationship between the tumor and functional motor cortex, nTMS improves surgical planning for tumors in or near the motor cortex.

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