scholarly journals A Feasible Technique in Laparoscopic Excision for Juvenile Cystic Adenomyosis: A Case Report, Literature Review, and Surgical Video

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 284-292
Author(s):  
Masafumi Katakura ◽  
Yukiko Katagiri ◽  
Kuniaki Ota ◽  
Takafumi Mukai ◽  
Kentaro Nakaoka ◽  
...  

Background: Juvenile cystic adenomyosis (JCA) is a rare uterine lesion. We present the case of a young woman who was diagnosed with JCA and subsequently managed with laparoscopic cyst removal with sharp and blunt dissection. Moreover, we provide a literature review and a surgical video. Case: A 22-year-old nulliparous woman presented with severe dysmenorrhea and was assessed using contrast-enhanced abdominal computed tomography, transvaginal ultrasonography and pelvic magnetic resonance imaging, and diagnosed with a cystic lesion on the left side of the myometrium. She underwent laparoscopic cyst excision and uterine reconstruction. Histology was suggestive of JCA. The dysmenorrhea resolved postoperatively. Conclusion: Surgical resection is the first choice of treatment for cystic adenomyosis, and a laparoscopic approach using scissor forceps is effective.

2016 ◽  
Vol 38 (2) ◽  
Author(s):  
Mario Lima ◽  
Tommaso Gargano ◽  
Giovanni Ruggeri ◽  
Francesca Destro ◽  
Michela Maffi

Choledochal cyst (CDC) is a congenital dilatation of the extra and/or intrahepatic bile ducts and it is a rare condition in western countries. Classical treatment consists of cyst excision and hepaticojejunostomy. The first case of a laparoscopic CDC excision was described in 1995 and since that time an increasing number of institutions have adopted this technique, with good success. We describe our early experience of 3 cases of CDC treated with laparoscopic approach. We used a 10 mm umbilical port for the camera, and four 3-5 mm operative ports. We performed the laparoscopic removal of the cyst and gallbladder, videoassisted preparation of the Roux-en-Y loop and laparoscopic hepaticjejunostomy. No post-operative complications occurred. Laparoscopic excision of CDCs has been supposed to give better observation, a better cosmetic result, potentially less postoperative pain, and a shorter recovery. The main argument for performing an extracorporeal anastomosis is that it decreases the operative time. We recommend caution to prevent injury to the pancreatic duct and biliary structures during dissection and anastomosis. Lifelong surveillance is mandatory, even after resection of the choledochal cyst.


Swiss Surgery ◽  
1999 ◽  
Vol 5 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Schmassmann

Surgical resection is the first choice of treatment for patients with hepatocellular (HCC) and cholangiocellular carcinomas. Prolongation of survival is, however, the only realistic goal for most patients, which can be often achieved by nonsurgical therapies. Inoperable patients with large or multiple HCCs are usually treated with transarterial chemoembolization (TACE) with lipiodol in combination with a chemotherapeutic drug and gelfoam. Three-year survival depends on the stage of the disease and is about 20%. Patients with earlier tumor stages (one or two tumor nodules less than 3cm in size) are suitable for treatment with percutaneous ethanol injection (PEI) alone or in combination with TACE. Several studies have shown that in these early stages, the 3-year survival rate is approximately 55%-70% in the actively treated patients which is significantly higher than in untreated patients. In advanced stages of the disease, TACE and PEI have no effect on survival and should not be performed. Some of these patients have been successfully treated with octreotide. Patients with inoperable cholangiocellular carcinoma are treated by endoscopic or percutaneous stent placement. If stenting does not achieve adequate biliary drainage, multidisciplinary therapy including internal / external radiotherapy or photodynamic therapy should be considered in patients with potential long-term survival. In conclusion, nonresectional therapies play an essential role in the therapy of inoperable hepato- and cholangiocellular carcinomas as they lead to satisfactory survival. Multidisciplinary therapy appears to be the current trend of management.


Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 156-162 ◽  
Author(s):  
C. Schwahn-Schreiber

SummaryAdvanced chronic venous stasis syndrome is characterized by irreversible and self-perpetuating morphological alterations in the lower leg. A chronic inflammatory process results in sclerosis, which progresses from the skin to the subcutaneous tissue and ultimately the fascia, sometimes including muscle and ankle joint and leading to chronic compartment syndrome. To cure these severe alterations with non healing ulcers decompression of the compartments like paratibial fasciotomy with SEPS and crural fasciectomy or removal of sclerosis like shave therapy are successful surgical procedures. Indication should be adapted to the extension of ulcer. Indications of the operations and the techniques are described, complications and results are discussed. Due to ulcer extension especially shave therapy (removal of the sclerotic tissue epifascial) and crural fasciectomy (removal of sclerosis including fascia) are very successful with up to 80% healing rate, even in severe cases and even after long term (up to 8 years). Since shave therapy is easy, short and simple with short healing time, few complications and good aesthetical result it is the first choice of treatment for non healing leg ulcers. Fasci ectomy is reserved for special indications such as deep transfascial necrosis or failure of shave therapy.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kenan C. Ceylan ◽  
Güntuğ Batihan ◽  
Ahmet Üçvet ◽  
Soner Gürsoy

Abstract Background Congenital lung malformation is an umbrella term and consist of various kind of parenchymal and mediastinal pathologies. Surgical resection is often required for diagnosis and curative treatment. We aimed to review our experience in surgical treatment for congenital lung disease and present the role of minimally invasive surgery. Methods Surgical resections performed for benign lesions of the lung and mediastinum between January 2009 and May 2019 were retrospectively analyzed. Patients who were found to have congenital lung malformation as a result of pathological examination were included in our study. Distribution characteristics of the patients according to congenital lung malformation subtypes, differences in surgical approach and postoperative results were investigated. Results A total of 94 patients who underwent surgical resection and were diagnosed with the bronchogenic cyst, sequestration, bronchial atresia, congenital cystic adenomatoid malformation (CCAM), or enteric cyst as a result of pathological examination were included the study. There were no significant differences between pathological subtypes in the postoperative length of hospital stay and drainage duration however, perioperative complication rate was higher in the sequestration group. In addition, in the first three days postoperatively, the mean pain score was found to be lower in the VATS group compared to thoracotomy. Conclusions Congenital lung malformations consist of a heterogeneous group of diseases and the surgical treatment in these patients can range from a simple cyst excision to pneumonectomy. Video-assisted thoracoscopic surgery should be considered as the first choice in the surgical treatment of these patients in experienced centers.


2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.


2021 ◽  
Vol 14 (5) ◽  
pp. e240414
Author(s):  
Kishor R J ◽  
Bhuvaneshwari Harikrishnan ◽  
Naveen Alexander ◽  
Veena Bheeman

We report an interesting case of extraovarian, primary seromucinous cystadenoma, which presented as a mesenteric cyst. A 31-year-old woman came with complaints of lower abdominal pain for 2 years, which is intermittent and aggravated during the menstrual cycle. On examination, her vitals were within normal limits; per abdominal examination revealed 7×7 cm mass in the right lumbar and right hypochondrium with well-defined margins. A Contrast-enhanced whole abdomen done showed a thin-walled of cyst of size 7×8×9 cm in the right lumbar region abutting and replacing the mesenteric border of ascending colon suggesting of mesenteric cyst. Patient underwent laparoscopic excision of mesenteric cyst. Histopathology revealed seromucinous cystadenoma without ovarian stroma.


2019 ◽  
Vol 101 (4) ◽  
pp. 821-827
Author(s):  
Zhu Zhuoli ◽  
Zhao Yu ◽  
Xu Liya ◽  
Liu Mingzhong ◽  
Li Shengwei

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tarun Jindal ◽  
Ankush Sarwal ◽  
Pravin Pawar ◽  
M. Dhanalakshmi ◽  
Neeraj Subedi

Abstract Background The presence of isolated metachronous adrenal metastasis in patients with esophageal cancer is rare. There is significant controversy regarding the management of such patients. Adrenal metastasectomy has been shown to be of benefit in some reports. Minimally invasive approach, although the gold standard for adrenalectomy, has not been used commonly in a postesophagectomy setting owing to the anticipated technical difficulties. We describe one such case wherein this approach helped in early recovery and long-term survival. Case presentation A 59-year-old male of Asian ethnicity presented with an isolated left adrenal nodule, 3 years after an Ivor Lewis esophagectomy for a lower esophageal adenocarcinoma. The biopsy of the nodule was suggestive of metastatic adenocarcinoma. The patient underwent laparoscopic excision of the left adrenal gland. Conclusion Adrenal metastasectomy, in postesophagectomy patients can provide good oncological control. Laparoscopic approach, though technically challenging, can provide results equivalent to those of open surgery, albeit with less morbidity.


2020 ◽  
Vol 3 (3) ◽  
pp. 279-287
Author(s):  
Patrícia Quariguazy da Frota ◽  
Josiane Dantas Viana Barbosa ◽  
Paulo Roberto Freitas Neves

Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, is a problem of fetal erythrocyte hemolysis. This may happen due to the sensitization of maternal antibodies through the placental route. It is the pathology most frequently found in neonatal patients. Approximately 98% of maternal alloimmunization cases by erythrocyte antigens are due to the RhD factor. Phototherapy is the first choice in the treatment of neonatal jaundice. Blood transfusion is the therapy instituted for the treatment of severe neonatal disease. This study aimed to develop an automated device for performing the blood transfusion procedure. The method was developed in four stages: (1) Literature review about the search for theoretical references based on scientific articles and textbooks on transfusion therapy in the newborn; (2) Elaboration of the device consisted of items related to its assembly and structuring; (3) Operation of the medical device, including specific schedules related to the execution of the procedure; (4) Performing tests with simulating the purpose of volume replacement in the total cycle performed in the exsanguine transfusion procedure. The results showed that it was possible to assemble, reproduce, and implement the automation of the device developed for the exsanguine transfusion procedure in a practical. Also, the procedure presented security and effectiveness in the clinical treatment related to HDN.  


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