scholarly journals Fecal Halitosis: A Case Report

2017 ◽  
Vol 6 (1) ◽  
pp. 34-38
Author(s):  
Suttam Kumar Biswas ◽  
Shilpi Rani Roy ◽  
Arup Roton Paul
Keyword(s):  
Adjuvant Chemotherapy ◽  
Rare Complication ◽  
Anal Verge ◽  
En Bloc Resection ◽  
Sleeve Resection ◽  
Gastrocolic Fistula ◽  
En Bloc ◽  
Term Survival ◽  
Diffuse Abdominal Pain ◽  
Histopathological Report

There are many causes of fecal halitosis like poor oral hygene, bowel obstruction, GERD, oral malignancy, liver failure etc. Gastrocolic fistula is a rare cause of fecal halitosis. Gastrocolic fistula is a rare complication of adenocarcinoma of the colon. Despite radical resections, these patients usually have a poor prognosis with a mean survival of 23 months and long-term survival is rarely reported. A 40-year-old man of Netrokona district presented with diffuse abdominal pain, vomiting, fecal smell from mouth and weight loss for 3 months. A Barium enema revealed fistulous communication in between left colic flexure upto body of the stomach. Upper gastrointestinal tract endoscopy done repeatedly but report was normal. Colonoscopic report was a growth seen at 60 cm from anal verge and the scope couldn't be passed up. Histopathological report of colonoscopic biopsy was non specific chronic colitis. His part of colon, sleeve resection of stomach were resected en bloc. As per histopathological report, sections from the transvers colon tumor revealed an adenocarcinoma composed of malignant glands with an infiltrative pattern. Adjuvant chemotherapy with capecitabine and oxaliplatin was administered after surgery. Our patient is alive. En bloc resection with adjuvant chemotherapy offers the best treatment option for gastrocolic fistulas. This is one of the patients with greater survival reported in the medical literature. CBMJ 2017 January: Vol. 06 No. 01 P: 34-38

Leiomyosarcoma metastases to the spine

2007 ◽  
Vol 6 (2) ◽  
pp. 178-183 ◽  
Author(s):  
Mohamed Samy A. Elhammady ◽  
Glen R. Manzano ◽  
Nathan Lebwohl ◽  
Allan D. Levi
Keyword(s):  
Spinal Metastases ◽  
Smooth Muscle Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Initial Presentation ◽  
En Bloc ◽  
Initial Manifestation ◽  
Term Survival ◽  
Imaging Characteristics ◽  
History Of

✓Leiomyosarcoma is a rare malignant smooth-muscle tumor that rarely metastasizes to bone. It is extremely uncommon for osseous metastasis to be the initial presentation of leiomyosarcoma or to be the initial manifestation of recurrence in patients with a history of leiomyosarcoma. The authors have treated four cases of metastatic leiomyosarcoma with the lesion initially presenting in the spine, and a fifth case of disseminated leiomyosarcoma that involved the spine. In their report, they highlight the cases of two of these patients and provide tabular data for the remaining three. The authors performed a comprehensive review of the literature on spinal leiomyosarcomas and retrospective chart reviews of five surgically treated patients in whom a spinal metastatic leiomyosarcoma was diagnosed. Their series consists of five women who ranged in age from 36 to 47 years (mean age 43.2 years). Four patients had known, or presumed, uterine primary lesions, whereas one harbored a retroperitoneal primary tumor. These lesions generally appear as lytic foci on imaging studies, but variable imaging characteristics were observed. All cases were managed aggressively: four patients underwent posterior/posterolateral decompression and fusion, and one underwent anterior–posterior en bloc resection and fusion. In all cases preoperative symptoms resolved. Two patients died 9 and 13 years after initial presentation. The remaining patients are alive and neurologically intact. Metastatic spinal leiomyosarcomas tend to symptomatically involve only one spinal level at the time of diagnosis and are known to recur locally. These lesions commonly affect women in early middle age, and long-term survival, even in those with systemic metastatic lesions, is better than that seen in individuals with more aggressive spinal metastases. Attempted gross-total resection with fusion, as opposed to minimal palliative decompression, is recommended.

En bloc resection of pulmonary sulcus non-small cell lung cancer invading the spine: A systematic review and pooled analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18503-e18503
Author(s):  
Stephane Collaud ◽  
Elie Fadel ◽  
Joachim Schirren ◽  
Hiroyasu Yokomise ◽  
Servet Bolukbas ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Resection ◽  
Adjuvant Treatment ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Induction Treatment ◽  
En Bloc ◽  
Term Survival ◽  
Total N ◽  
Treatment Type

e18503 Background: Treatment of locally advanced NSCLC is debated. While survival for inoperable disease ranges between 3-17%, carefully selected patients can be cured when treated surgically in a multimodality concept. Here, we conducted a systematic literature review and pooled data analysis of patients after en bloc resection for pulmonary sulcus NSCLC invading the spine. Outcome and prognostic factors were described. Methods: The MEDLINE database was searched using the PubMed engine to retrieve all relevant articles related to en bloc resection for pulmonary sulcus NSCLC invading the spine. All articles’ corresponding authors were contacted to share their most updated anonymized patient’s data. Data were pooled and analyzed, focusing on outcome and prognostic factors. Results: Search strategy yielded a total of 134 articles. Out of these, only 6 were relevant and non-duplicative. Four out of 6 authors were able to share updated data for a total of 135 patients. All tumors were resected en bloc with the lung, chest wall and spine. Induction treatment was administered in 87 (64%) patients and consisted of chemotherapy (n=32), radiation (n=1) or concurrent chemoradiation (n=54). Spine resections included total (n=23), hemi- (n=94) and partial (n=18) vertebrectomies. Complete resection was achieved in 120 (89%) patients. Five patients died in the postoperative period (4%). Adjuvant treatment was administered in 70 (52%) patients and included chemotherapy (n=16), radiotherapy (n=22) or chemoradiation (n=32). Median follow-up was 26 months. Overall 3-, 5- and 10-year survivals were 57%, 43% and 27%, respectively. Results of the univariate analysis (Cox, Breslow tests) identified incomplete surgical resection (R0 vs R1/2, p<0.001) as the only significant prognostic factors among the variables tested (age, histology, pN stage, type of induction/adjuvant treatment, type of lung resection). Conclusions: Multimodality therapy including en bloc resection for pulmonary sulcus NSCLC invading the spine provides excellent long-term survival. Complete surgical resection is the only determinant for survival. No difference was shown for patients treated with induction vs adjuvant therapy.

Parasagittal osteotomy for en bloc resection of multilevel cervical chordomas

2009 ◽  
Vol 10 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Dean Chou ◽  
Frank Acosta ◽  
Jordan M. Cloyd ◽  
Christopher P. Ames
Keyword(s):  
Case Reports ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Tumor Removal ◽  
Nerve Roots ◽  
En Bloc ◽  
Term Survival ◽  
Cervical Chordoma ◽  
Disease Free

En bloc resection of chordoma has been shown to be critical for prolonging long-term survival and disease-free intervals in patients. Cervical spine chordomas pose special challenges because of the vertebral arteries and critical nerve roots involved. Multilevel chordomas pose even greater challenges because of the need to remove multiple segments of the spine in 1 piece without tumor violation. Although there have been 2 case reports describing multilevel spondylectomy for cervical chordoma, to the authors' knowledge, there are no reports of parasagittal osteotomies for en bloc resection of multilevel cervical chordomas. The use of these osteotomies allows us to avoid intralesional resection and adhere to the oncological principle of en bloc tumor excision. The authors report their management of 3 multilevel cervical chordomas and describe their technique of en bloc tumor removal using parasagittal osteotomy.

Total spondylectomy for en bloc resection of lung cancer invading the chest wall and thoracic spine

2004 ◽  
Vol 100 (4) ◽  
pp. 353-357 ◽  
Author(s):  
Masashi Komagata ◽  
Makoto Nishiyama ◽  
Atshuhiro Imakiire ◽  
Hirobumi Kato
Keyword(s):  
Lung Cancer ◽  
Chest Wall ◽  
Thoracic Spine ◽  
Spinal Column ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Term Survival ◽  
Content Type ◽  
Fine Print

✓ Lung cancers invading the chest wall and spinal column are often considered unresectable, and consequently there are few reports describing resection of invasive vertebral lesions. The authors developed a new anterior approach procedure for the en bloc resection of primary lung adenocarcinoma invading the thoracic spine and chest wall, in which the primary tumor does not need to be separated from the vertebrae. The authors describe a total spondylectomy for the en bloc resection of lung cancer invading the spine. A combination of surgical techniques was required, including resection of the osseous elements T-2 and T-3 (the pedicles were excised using a thread saw), anterolateral thoracotomy, apical lobectomy, chest wall resection, vertebrectomy, anterior spinal column reconstruction with a titanium mesh cage containing bioactive glass ceramic, and placement of anterior and posterior spinal instrumentation. At 46 months after surgery, there is no evidence of local recurrence or distant metastasis, and the patient continues to improve. This new procedure allows for the en bloc resection of primary lung tumors and adherent vertebral invasion without separation of the lesion from the vertebra. Thus, surgical management by complete excision of Pancoast tumors can achieve longer-term survival rates without sequelae.

scholarly journals Interdisciplinary Radical “En-Bloc” Resection of Ewing Sarcoma of the Chest Wall and Simultaneous Chest Wall Repair Achieves Excellent Long-Term Survival in Children and Adolescents

2021 ◽  
Vol 9 ◽  
Author(s):  
Alireza Basharkhah ◽  
Herwig Lackner ◽  
Anna Karastaneva ◽  
Marko Bergovec ◽  
Stephan Spendel ◽  
...  
Keyword(s):  
Chest Wall ◽  
Ewing Sarcoma ◽  
En Bloc Resection ◽  
Tumor Location ◽  
Bloc Resection ◽  
En Bloc ◽  
Term Survival ◽  
Oncological Treatment ◽  
Costovertebral Joint ◽  
Neo Adjuvant Chemotherapy

Introduction: Ewing sarcomas of the chest wall, historically known as “Askin tumors” represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical “en-bloc” resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels. Thus, the question arises, which surgical specialties should join their comprehensive skills when approaching a child with Ewing sarcoma of the chest wall.Patients and Methods: All pediatric patients with Ewing sarcomas of the chest wall treated between 1990 and 2020 were analyzed focusing on complete resection, chest wall reconstruction, surgical complications according to Clavien-Dindo (CD) and survival. Patients received neo-adjuvant chemotherapy according to the respective Ewing sarcoma protocols. Depending on tumor location and organ infiltration, a multi-disciplinary surgical team was orchestrated to perform radical en-bloc resection and simultaneous chest wall repair.Results: Thirteen consecutive patients (seven boys and six girls) were included. Median age at presentation was 10.9 years (range 2.2–21 years). Neo-adjuvant chemotherapy (n = 13) and irradiation (n = 3) achieved significant reduction of the median tumor volume (305.6 vs. 44 ml, p &lt; 0.05). En-bloc resection and simultaneous chest wall reconstruction was achieved without major complications despite multi-organ involvement. Postoperatively, one patient with infiltration of the costovertebral joint and laminectomy required surgical re-intervention (CD IIIb). 11/13 patients were treated with clear resections margins (R1 resection in one patient with infiltration of the costovertebral joint and marginal resection &lt;1 mm in one child with multiple pulmonary metastases). All patients underwent postoperative chemotherapy; irradiation was performed in four children. Two deaths occurred 18 months and 7.5 years after diagnosis, respectively. Median follow-up for the remaining patients was 8.8 years (range: 0.9–30.7 years). The 5-year survival rate was 89% and the overall survival 85%.Conclusion: EWING specific oncological treatment and multi-disciplinary surgery performing radical en-bloc resections and simultaneous chest wall repair contribute to an improved survival of children with Ewing sarcoma of the chest wall.

scholarly journals Factors affecting long-term survival after en-bloc resection of lung cancer invading the chest wall✩

2000 ◽  
Vol 18 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Alain Chapelier ◽  
Elie Fadel ◽  
Paolo Macchiarini ◽  
Bernard Lenot ◽  
Francois Le Roy Ladurie ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chest Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Affecting

scholarly journals Acceptability of endoscopic submucosal dissection for sessile serrated lesions: comparison with non-sessile serrated lesions

2020 ◽  
Vol 08 (12) ◽  
pp. E1832-E1839
Author(s):  
Yuichiro Kuroki ◽  
Toshiyuki Endo ◽  
Kenta Iwahashi ◽  
Naoki Miyao ◽  
Reika Suzuki ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Postoperative Bleeding ◽  
En Bloc Resection ◽  
Tumor Location ◽  
Proximal Colon ◽  
R0 Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Serrated Lesions

Abstract Background and study aims Sessile serrated lesions (SSL) are major precursor lesions of serrated pathway cancers, and appropriate treatment may prevent interval colorectal cancer. Studies have reported the outcomes of endoscopic mucosal resection (EMR) for SSL; however, there are insufficient reports on endoscopic submucosal dissection (ESD). We examined the characteristics and outcomes of SSL and compared them to those of non-SSL in ESD. Patients and methods We reviewed 370 consecutive cases in 322 patients who underwent colorectal ESD between January 2016 and March 2020 at our hospital. There were 267 0-IIa lesions that were stratified into 41 SSL and 226 non-SSL (intramucosal cancer, adenoma) cases. We used propensity matching to adjust for the variances in the factors affecting treatment between the SSL and non-SSL groups. Results In the baseline cases, young women and proximal colon tumor location were significantly more common in the SSL group. There were no statistically significant differences between the SSL and non-SSL groups in terms of en bloc resection rate (97.6 % vs. 99.6 %; P = 0.28), R0 resection rate (92.7 % vs. 93.4 %; P = 0.74), perforation (0 % vs. 0.9 %; P > 0.99), and postoperative bleeding (2.4 % vs. 1.8 %; P = 0.56). Thirty-eight pairs were matched using propensity score, and the median dissection speed (12 vs. 7.7 cm2/h; P = 0.0095) was significantly faster in the SSL than in the non-SSL group. Conclusions ESD for SSL was safely performed, and SSL was smoother to remove than non-SSL. ESD might be an acceptable endoscopic treatment option for SSL.

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