scholarly journals MULTIPLE PRIMARY COLORECTAL CANCER: THE POSSIBILITIES OF MINIMALLY INVASIVE SURGICAL INTERVENTIONS

2017 ◽  
pp. 38-42 ◽  
Author(s):  
O. I. Kit ◽  
Yu. A. Gevorkyan ◽  
N. V. Soldatkina ◽  
D. A. Kharagezov ◽  
V. E. Kolesnikov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive ◽  
Morphological Characteristics ◽  
Colorectal Tumors ◽  
Primary Colorectal Cancer ◽  
Invasive Approach ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Multiple Primary ◽  
Colon And Rectum

BACKGROUND. Study of oncobiological aspects of such a phenomenon as multiplicity of primary colorectal tumors, as well as improvement of methods of their treatment is relevant nowadays. The aim of the study was to reveal the potential of minimally invasive surgery for multiple primary colorectal cancer. MATERIAL AND METHODS. Data on 51 patients with synchronous multiple primary colorectal cancer were studied. Clinical, biological and morphological characteristics ofsynchronous colorectal tumors were analyzed. 12 of 51 patients underwent minimally invasive surgeries of the colon and rectum - laparoscopy and transanal endoscopic resection of the rectum. RESULTS showed that synchronous colorectal cancer prevailed in patients with multiple primary colorectal cancer (63,8 %), with tumors localized mainly in the sigmoid (62,75 %) and the rectum (56,86%). Minimally invasive approach allowed reduction of the number of postoperative complications by 2,5 times and improvement of rehabilitation of patients. CONCLUSION. Application of modern technologies in treatment for synchronous multiple primary colorectal cancer contributes to improvement of the treatment outcomes.

Multiple primary colorectal cancer: Clinical aspects

2016 ◽  
Vol 88 (8) ◽  
pp. 53-58
Author(s):  
N V Soldatkina ◽  
O I Kit ◽  
Yu A Gevorkyan ◽  
A G Milakin
Keyword(s):  
Colorectal Cancer ◽  
Malignant Tumors ◽  
Morphological Characteristics ◽  
Primary Diagnosis ◽  
Clinical Aspects ◽  
Colorectal Tumors ◽  
Primary Tumors ◽  
Multiple Primary ◽  
Colon And Rectum ◽  
Metachronous Colorectal Cancer

Aim. To define some clinical characteristics of synchronous and metachronous colorectal cancer (CRC). Materials and methods. The investigation was concerned with the data of 150 patients with T1—4N0—2M0—1 multiple primary CRC. The clinical, biological, and morphological characteristics of synchronous and metachronous tumors were analyzed. Results. Multiple primary tumors were 6.01% of all the cases of CRC. There was a preponderance of synchronous CRC (63.75%) with the tumor localized in the sigmoid colon and rectum. In women, synchronous colorectal tumors were more often concurrent with breast tumors; metachronous ones were detected after treatment for genital tumors. In men, synchronous colorectal tumors were more frequently concurrent with kidney cancer; metachronous ones were identified after treatment for gastric cancer. Conclusion. The found characteristics of multiple primary colorectal tumors may be taken in account in programs for both primary diagnosis and follow-up after treatment for malignant tumors, which will be able to improve the early detection of cancer patients and their treatment results.

scholarly journals Pathophysiological aspects as the object of the treatment tactics in acute pancreatitis (review)

2021 ◽  
Vol 8 (2) ◽  
pp. 87-94
Author(s):  
Igor Kryvoruchko ◽  
Anastasiya Drozdova ◽  
Nataliya Goncharova
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Surgical Trauma ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Treatment Measures ◽  
Mechanisms Of Development ◽  
Adequate Management

The review presents a modern view on the features of the course and treatment of acute pancreatitis, based on a cascade of pathophysiological mechanisms of this disease. A number of concepts of development and course of acute pancreatitis on the basis of randomized prospective and retrospective researches devoted to this problem are considered. Attention is paid to the mechanisms of development of organ failure in acute pancreatitis. In accordance with the above, the main positions of treatment measures for acute pancreatitis, which are based on the principles of tactics "step-up approach" were highlighted. Among them, attention is focused on the features of the conservative treatment program, minimally invasive surgical interventions, as well as the management of the postoperative period of patients. Minimally invasive surgical interventions perform the main tasks of surgical treatment in acute pancreatitis, but significantly reduce surgical trauma compared to "open" methods. Adequate management of the postoperative period of patients is carried out through the implementation of protocols "fast-track surgery".

scholarly journals Robotic Pelvic Exenteration for Gynecologic Malignancies, Anatomic Landmarks, and Surgical Steps: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Stefano Cianci ◽  
Martina Arcieri ◽  
Giuseppe Vizzielli ◽  
Canio Martinelli ◽  
Roberta Granese ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pelvic Exenteration ◽  
Gynecologic Oncology ◽  
Perioperative Outcomes ◽  
Resection Margins ◽  
Salvage Procedure ◽  
Invasive Approach ◽  
Robotic Assisted ◽  
Gynecological Malignancy ◽  
Minimally Invasive Surgical

Pelvic exenteration represents the last resort procedure for patients with advanced primary or recurrent gynecological malignancy. Pelvic exenteration can be divided into different subgroup based on anatomical extension of the procedures. The growing application of the minimally invasive surgical approach unlocked new perspectives for gynecologic oncology surgery. Minimally invasive surgery may offer significant advantages in terms of perioperative outcomes. Since 2009, several Robotic Assisted Laparoscopic Pelvic Exenteration experiences have been described in literature. The advent of robotic surgery resulted in a new spur to the worldwide spread of minimally invasive pelvic exenteration. We present a review of the literature on robotic-assisted pelvic exenteration. The search was conducted using electronic databases from inception of each database through June 2021. 13 articles including 53 patients were included in this review. Anterior exenteration was pursued in 42 patients (79.2%), 2 patients underwent posterior exenteration (3.8%), while 9 patients (17%) were subjected to total exenteration. The most common urinary reconstruction was non-continent urinary diversion (90.2%). Among the 11 women who underwent to total or posterior exenteration, 8 (72.7%) received a terminal colostomy. Conversion to laparotomy was required in two cases due to intraoperative vascular injury. Complications' report was available for 51 patients. Fifteen Dindo Grade 2 complications occurred in 11 patients (21.6%), and 14 grade 3 complications were registered in 13 patients (25.5%). Only grade 4 complications were reported (2%). In 88% of women, the resection margins were negative. Pelvic exenteration represents a salvage procedure in patients with recurrent or persistent gynecological cancers often after radiotherapy. A careful patient selection remains the milestone of such a mutilating surgery. The introduction of the minimally invasive approach has led to advantages in terms of perioperative outcomes compared to classic open surgery. This review shows the feasibility of robotic pelvic exenteration. An important step forward should be to investigate the potential equivalence between robotic approaches and the laparotomic one, in terms of long-term oncological outcomes.

scholarly journals Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Tyler Hoskins ◽  
David Goyette ◽  
Jay Patel ◽  
Christopher Mazzei ◽  
Arianna L. Gianakos ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Achilles Tendon ◽  
Functional Outcome ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
P Value ◽  
Invasive Approach ◽  
Minimally Invasive Surgical ◽  
Iatrogenic Nerve Injury

Category: Ankle; Sports; Trauma Introduction/Purpose: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture whereas surgical intervention has risks of infection and iatrogenic nerve injury. Recently, surgeons have established a less invasive surgical approach to repairing the achilles tendon. The ‘Percutaneous or Mini-Invasive’ technique was adopted in order to reduce infection rates and wound breakdown. However, due to the scarce amount of literature reported, the efficacy of this procedure still remains under scrutiny. The goal of this study was to examine the functional outcomes of patients treated at our facility for a ruptured achilles tendon using the percutaneous and minimally invasive surgical technique. Methods: From 2014 to 2020 eighty-one patients underwent a percutaneous or mini invasive surgery at our facility for the treatment of a ruptured achilles tendon. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. Results: The mean follow up for our patient cohort was 36.40 months (range, 6 to 71). The average age was 41.46 years (range, 17- 65). Mean pre-op AOFAS and ATRS were 45.60 and 47.18 respectively, compared to 90.29 and 87.97 after surgery (p-value <0.05). There were two significant complications reported post-operatively. One patient re-ruptured their Achilles tendon four months post-operatively. This patient was successfully treated with a mini invasive approach and reconstruction of the tendon. A second patient developed a superficial infection ten months post-operatively. This patient successfully underwent irrigation and debridement of the wound. Conclusion: The pre-op and post-op AOFAS and ATRS scores were deemed statistically significant. A percutaneous and mini invasive approach to repair a ruptured achilles tendon, although new, offers promising functional outcome results and remains a viable treatment option to decrease the incidence rate of post-operative infection and iatrogenic nerve injury. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings.

scholarly journals Bilateral tubular minimally invasive approach for decompression, reduction and fixation in lumbosacral lythic spondylolisthesis

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video9 ◽  
Author(s):  
Giuseppe M.V. Barbagallo ◽  
Francesco Certo ◽  
Giovanni Sciacca ◽  
Vincenzo Albanese
Keyword(s):  
Minimally Invasive ◽  
Postoperative Recovery ◽  
Pedicle Screw Fixation ◽  
Invasive Technique ◽  
Surgical Morbidity ◽  
Nerve Roots ◽  
Invasive Approach ◽  
Minimally Invasive Surgical ◽  
Pull Out ◽  
Mini Open

This video demonstrates the minimally invasive surgical technique used in a 56-year-old woman suffering from L-5 spondylolysis and grade 2 L5–S1 spondylolisthesis. The first author used expandable tubular retractors bilaterally to perform neural decompression, mini-open TLIF, spondylolysthesis reduction and L5–S1 pedicle screw fixation. L-5 cement augmentation was performed through cannulated and fenestrated screws to enhance resistance to screw pull-out secondary to reduction maneuvers.Sequential surgical steps related to microsurgery, spondylolysthesis reduction and instrumentation are shown and commented.We submit that in cases of lythic spondylolisthesis a bilateral traversing and exiting nerve roots decompression is a safer option prior to performing the deformity reduction and fixation; the proposed minimally invasive technique may help in reducing surgical morbidity and improving postoperative recovery.The video can be found here: http://youtu.be/G4Qdg-A-Y3M.

scholarly journals Hybrid Surgical and Catheter Treatment for Atrial Fibrillation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Tsuyoshi Kaneko ◽  
Sary F. Aranki
Keyword(s):  
Atrial Fibrillation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Hybrid Procedure ◽  
Minimally Invasive Approach ◽  
Surgical Ablation ◽  
Invasive Approach ◽  
Minimally Invasive Surgical ◽  
Linear Ablation ◽  
New Energy

Advances in surgery for atrial fibrillation from cut and sew technique to thoracoscopy and new energy source have enabled minimally invasive approach which avoids median sternotomy and cardiopulmonary bypass. However, minimally invasive approach is unable to match the outcome of classic surgical technique due to difficulty in creating some of linear ablation lines. Hybrid procedure using catheter mapping and ablation in addition to minimally invasive surgical ablation has gained interest to combine the advantages of both procedures. No large study has been conducted to date comparing this new technique to other existing treatments. The aim of this paper is to review the data on hybrid procedure for atrial fibrillation and assess its early outcome and efficacy.

Incidence of minimally invasive colorectal cancer (CRC) surgery in patients treated at NCCN institutions

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6575-6575
Author(s):  
M. Weiser ◽  
D. Romanus ◽  
A. terVeer ◽  
A. Rajput ◽  
J. Skibber ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Early Stage ◽  
Oncologic Outcome ◽  
Stage I ◽  
Invasive Approach ◽  
Conversion To Open Surgery ◽  
The North ◽  
Minimally Invasive Surgical

6575 Background: In May 2004 the Clinical Outcomes of Surgical Therapy Study Group published the results of the North American randomized trial demonstrating that oncologic outcome is similar for laparoscopic assisted and open surgery for CRC. This and other studies have shown quicker recovery with laparoscopic CRC surgery including earlier resolution of postoperative ileus, less discomfort, and earlier discharge from the hospital. The extent to which surgeons have adopted the minimally invasive surgical (MIS) approach in CRC is unknown. Methods: Using the NCCN Colon/Rectal Cancer Outcomes Project Database, 715 patients were identified who underwent CRC resection in 2005–6. The distribution of lesions included right colon (39%), left colon (31%), and rectum (30%). The incidence of MIS for CRC and clinicopathologic features associated with this approach were analyzed by logistic regression; results are reported as odd ratio (OR) with 95% confidence intervals (CI), and significance defined at p<0.05 level. Results: A total of 167 (23%) patients underwent MIS colorectal surgery (laparoscopy in 98% and robotic in 2%). Conversion to open surgery was noted in 33 cases (20%). Surgery was performed in outside institutions in 21% of cases prior to patients presenting to NCCN institutions for further treatment. The MIS approach was more common in colon than rectal cancer (30% vs.12%, OR 2.96, CI 1.94–4.51, p<0.0001). Within the colon cancer cohort, right sided lesions were more likely to be approached with MIS techniques rather than left sided lesions (32% vs. 25%; OR 1.42, CI 1.96–2.21, p<0.0001). Stage I tumors were also more likely to be managed with the less invasive approach: Stage I-41%; II-20%; III-21%; IV-19% (Stage I vs. IV, OR=3.00, CI 1.74–5.16 p<0.0001). No differences in surgical approach were noted based on age, gender, race, Charlson comorbidity score, insurance type, or location of surgery (NCCN vs outside facility). Conclusion: The majority of CRC surgery for patients presenting to NCCN institutions is performed by open techniques. Right sided and early stage CRCs were more likely treated with MIS, possibly related to the less demanding nature of the procedure. The adoption of MIS is expected to rise as surgeons become trained in MIS techniques for CRC. No significant financial relationships to disclose.

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