The Influence of Young Age on Difficulties in the Surgical Resection of Carotid Body Tumors

This study evaluated patient characteristics that affect the complexity and difficulties of performing surgery to resect carotid body tumors (CBTs). We retrospectively reviewed the medical records of 20 patients with 21 CBTs who were enrolled in the study. The median patient age was 46 years and the mean tumor diameter was 37.6 mm. The mean blood loss and operative time were 40.3 mL and 183 min, respectively. Four patients underwent resection of the carotid artery followed by reconstruction. These four patients were between 18 to 23 years of age at the time of surgery. The mean blood loss and operative time in these patients were 166 mL and 394 min, respectively, which differed significantly from those of older patients. Therefore, young age influenced the difficulties faced in surgical resection of CBT, with an increased risk of blood loss and carotid artery resection.

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The characteristics of carotid body tumors in high-altitude region: Analysis from a single center

Vascular ◽

10.1177/17085381211005238 ◽

2021 ◽

pp. 170853812110052

Author(s):

Yong-Hong Wang ◽

Ji-Hai Zhu ◽

Jia Yang ◽

Wei Ma ◽

Hao Zhong ◽

...

Keyword(s):

Carotid Artery ◽

Clinical Features ◽

Blood Supply ◽

Carotid Body ◽

Neck Mass ◽

External Carotid Artery ◽

Carotid Body Tumor ◽

External Carotid ◽

Carotid Body Tumors ◽

The Mean

Objectives Though carotid body tumors are rare, increasing attentions have been given because of malignant transformation and high surgical risk. However, at present, the characteristics and etiology still remain unclear. Our study was designed to describe the clinical features of carotid body tumors in our institution and to compare the results with previous reports. Methods We retrospectively reviewed carotid body tumor patients diagnosed in our institution from January 2015 to May 2020. The demographics, comorbidities, lesion location, anatomic characteristics, complications, and postoperative outcomes were evaluated. Carotid body tumor measurements were determined from computed tomography, magnetic resonance imaging, and carotid arteriography examination. We described and compared the clinical features of carotid body tumors in our institution and other reports. Results We totally identified 122 carotid body tumor cases for the present analysis. The mean age was 50.26 years, with the majority being female (82%). The commonest presentation was a painless neck mass (68%). For the distribution of nationality, most patients were the Han nationality (69.7%). The mean altitude of habitat of patients was 2689.4 km; 19.7% patients suffered bilateral lesions. The main blood supply of carotid body tumors was from external carotid artery (54.1%). For patients who received operation, 11 (11.2%) patients experienced cranial nerve injury. The maximal diameter of tumors was 3.99 ± 1.98 cm in male and 3.38 ± 1.36 cm in female. The volume of tumors was 31.49 ± 29.76 cm3 in male and 15.27 ± 13.06 cm3 in female. The distance to base of skull of tumors was 3.39 ± 1.07 cm (3.99 ± 1.98 cm in male vs 3.38 ± 1.36 cm, P < 0.05). Two patients (2.04%) were identified as having malignant carotid body tumor. Conclusions Though carotid body tumor had a low morbidity and multitudinous clinicopathologic features, it was apt to middle-aged women and the main blood supply was from external carotid artery. The painless neck mass was the commonest presentation of carotid body tumors. There were significant difference between male and female patients regarding platelet, hemoglobin, distance to base of skull, tumor volume, altitude of habitat, carotid body tumor location, and hypertension.

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The earlier, the better: The beneficial effect of different timepoints of the preoperative transarterial embolization on ameliorating operative blood loss and operative time for carotid body tumors

Surgery ◽

10.1016/j.surg.2021.07.005 ◽

2021 ◽

Author(s):

Nan Li ◽

Ni Zeng ◽

Yuan Wan ◽

Chunyong Wen ◽

Jianyong Yang ◽

...

Keyword(s):

Blood Loss ◽

Beneficial Effect ◽

Carotid Body ◽

Operative Time ◽

Transarterial Embolization ◽

Operative Blood Loss ◽

Carotid Body Tumors

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Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

Journal of International Medical Research ◽

10.1177/0300060520982780 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098278

Author(s):

Xing Du ◽

Yunsheng Ou ◽

Guanyin Jiang ◽

Yong Zhu ◽

Wei Luo ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Bone Graft ◽

Cobb Angle ◽

Clinical Efficacy ◽

Operative Time ◽

Bone Grafts ◽

Surgical Indications ◽

Operative Blood Loss ◽

The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

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The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

Surgical Innovation ◽

10.1177/1553350620988227 ◽

2021 ◽

pp. 155335062098822

Author(s):

Eirini Giovannopoulou ◽

Anastasia Prodromidou ◽

Nikolaos Blontzos ◽

Christos Iavazzo

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Complication Rate ◽

Operative Time ◽

Intraoperative Complications ◽

Single Site ◽

Minimally Invasive Technique ◽

Invasive Technique ◽

Robotic Myomectomy ◽

The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

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Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.74.3 ◽

2021 ◽

Author(s):

Hai Thanh Phan

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Operative Time ◽

Distal Gastrectomy ◽

Three Dimensional ◽

Oncologic Outcome ◽

Intraoperative Blood Loss ◽

3D Laparoscopy ◽

Distal Gastric Cancer ◽

The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

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Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor

Vascular and Endovascular Surgery ◽

10.1177/1538574416689430 ◽

2017 ◽

Vol 51 (2) ◽

pp. 103-107 ◽

Cited By ~ 2

Author(s):

Carlos A. Hinojosa ◽

Javier E. Anaya-Ayala ◽

Hugo Laparra-Escareno ◽

Adriana Torres-Machorro ◽

Rene Lizola ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Body ◽

Carotid Artery Disease ◽

Duplex Ultrasound ◽

Neurological Deficits ◽

Symptomatic Carotid ◽

Carotid Body Tumors ◽

Carotid Artery Endarterectomy ◽

Artery Disease ◽

Dissection Technique

Symptomatic carotid artery atherosclerotic disease is an indication for carotid artery endarterectomy. The coexistence of carotid body tumors (CBTs) with symptomatic carotid disease is rarely encountered and adds significant challenges to vascular surgeons, with a reported overall mortality for patients who undergo endarterectomy and tumor excision of 8.8%, as opposed to the 2% for those who had CBT excision only. We describe the case of a 79-year-old female who experienced an acute cerebrovascular accident in the left hemisphere; duplex ultrasound revealed high-grade carotid stenosis in the left side and the presence of a Shamblin I CBT. The risks and benefits of the planned operation were reviewed, and the decision was made to proceed with early carotid endarterectomy and concomitant surgical resection of the tumor using the retrocarotid dissection technique. The patient recovered well, and at 11 months from the combined procedure, her neurological deficits improved significantly.

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Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Texas Heart Institute Journal ◽

10.14503/thij-16-6142 ◽

2018 ◽

Vol 45 (2) ◽

pp. 92-95 ◽

Cited By ~ 2

Author(s):

Carlos A. Hinojosa ◽

Javier E. Anaya-Ayala ◽

Sandra Olivares-Cruz ◽

Hugo Laparra-Escareno ◽

Alicia Trolle-Silva ◽

...

Keyword(s):

Local Recurrence ◽

Surgical Resection ◽

Carotid Body ◽

Tumor Resection ◽

Carotid Bifurcation ◽

Malignant Potential ◽

Computed Tomographic ◽

Neck Masses ◽

Carotid Body Tumors ◽

Dissection Technique

Carotid body tumors are rare neoplasms with malignant potential in 6% to 12.5% of cases, and surgical resection is the only cure. We present the cases of 2 female patients who had expanding, painless, right-sided neck masses; computed tomographic angiograms revealed Shamblin III tumors at the carotid bifurcation. Each patient underwent tumor resection with use of the retrocarotid dissection technique. The tumor specimens were histologically consistent with malignancy, and free margins were achieved. The patients remained free of symptoms, local recurrence, and metastasis 44 and 19 months after their respective procedures. These are the first malignant Shamblin III carotid body tumors that we have resected by means of retrocarotid dissection. In addition to our patients' cases, we discuss carotid body tumors and compare the retrocarotid and standard caudocranial resection techniques.

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Carotid Body Tumors

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230201000221 ◽

2002 ◽

Vol 10 (2) ◽

pp. 173-175

Author(s):

Hakki Aydoğan ◽

Gökçen Orhan ◽

Serap Aykut-Aka ◽

Şebnem Albeyoğlu ◽

Okan Yücel ◽

...

Keyword(s):

Computed Tomography ◽

Hearing Loss ◽

Carotid Artery ◽

Doppler Ultrasound ◽

Carotid Body ◽

Surgical Excision ◽

Cranial Computed Tomography ◽

Carotid Body Tumors

Carotid body paragangliomas were diagnosed by Doppler ultrasound, carotid artery angiography, and cranial computed tomography in a 35-year-old man with a mass in the neck and hearing loss, and in a 42-year-old man with headache, syncope, and a mass in the neck. They underwent successful surgical excision.

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Clinical Outcome of Carotid Body Paraganglioma Management: A Review of 10-Year Experience

Journal of Oncology ◽

10.1155/2020/6081273 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Ahmed Elsayed Fathalla ◽

Mohammad Ahmad Elalfy

Keyword(s):

Adjuvant Chemotherapy ◽

Carotid Artery ◽

Carotid Body ◽

Ct Scanning ◽

Surgical Approaches ◽

R0 Resection ◽

Primary Malignancy ◽

Nerve Paralysis ◽

The Mean

Background. Carotid body paragangliomas are rare neoplasms usually benign, however sometimes presenting as highly aggressive tumors. Surgery is the main line of treatment. Purpose. To study and describe clinical presentations, surgical approaches, postoperative complications, and treatment outcomes. Materials and Methods. A single-institution retrospective analysis of 19 cases with carotid body paragangliomas who were candidates for surgery from January 2009 through January 2019 with a mean follow-up period of 58.8 months. Results. The mean age was 46 years with the female predominance of 63%. The mean size of the tumor was 4.3 cm. All cases were presented with a painless pulsating neck lump located anteriorly at the level of the hyoid bone. Neck US was done in all cases as a primary screening investigation. CT scanning was the second main investigation performed in 17 cases (89.5%) revealing tumors attached to the carotid artery at its bifurcation. Urinary catecholamine metabolites were measured in all cases to rule out familial functioning types. 5 cases (26.3%) were malignant. All cases were surgically approached through transcervical transverse incision. 11, 5, and 3 cases were classified as Shamblin’s type II, III, and I, respectively. All tumors were R0 resected with nodal neck dissection conducted in the malignant group. Major complications occurred in 4 cases (21%) during tumor dissection from the adventitia of carotid bifurcation. ECA ligation was performed in one case (5.3%). 2 patients (10.5%) suffered XII nerve paralysis. Carotid artery blowout occurred in one patient (5.3%) and was immediately controlled. No operative mortality occurred. All patients were free of disease during the follow-up period. 4 malignant cases (21%) suffered a systemic relapse to bone and lung metastasis justifying adjuvant chemotherapy, radiotherapy, or both. Conclusions. Surgery is the treatment of choice for carotid body paragangliomas. Complete R0 resection should be justified especially in case of malignancy. Adjuvant chemotherapy or radiotherapy is an option for patients with primary malignancy or relapse.

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