scholarly journals Laparoscopic management of a giant simple hepatic cyst

2020 ◽  
Vol 1 (2) ◽  
pp. 137-142
Author(s):  
Vuk Aleksić ◽  
Vladimir Špica ◽  
Zorana Bokun-Vukašinović ◽  
Radmila Ćulafić ◽  
Svetlana Mijatović ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Randomized Clinical Trials ◽  
Laparoscopic Approach ◽  
Liver Cyst ◽  
Hepatic Cyst ◽  
Rapid Weight Loss ◽  
Scientific Debate ◽  
Simple Hepatic Cyst ◽  
The Subject ◽  
Giant Liver Cyst

Introduction: Congenital simple hepatic cysts are extremely rare and are usually asymptomatic. The best therapeutic approach to treating simple liver cysts remains the subject of scientific debate. Case report: We present the case of a giant liver cyst removed with a minimally invasive, laparoscopic approach in a 68-year-old woman, who presented with rapid weight loss. Conclusion: Due to the lack of randomized clinical trials comparing minimally invasive (laparoscopic) and open surgery approaches in liver cyst treatment, we recommend a personalized medical approach, applied after analyzing the characteristics of both the cyst and the patient.

Radiologic Reporting of Simple Hepatic Cyst Versus Biliary Cystadenoma May Lead to Unnecessary Surgery

2021 ◽  
pp. 000313482110540
Author(s):  
Aman Kumar ◽  
Alex Zendel ◽  
Michael Batres ◽  
David A. Gerber ◽  
Chirag S. Desai
Keyword(s):  
Differential Diagnosis ◽  
Cyst Wall ◽  
Cystic Lesion ◽  
Liver Cyst ◽  
Hepatic Cyst ◽  
Preoperative Imaging ◽  
Imaging Studies ◽  
Biliary Cystadenoma ◽  
Benign Condition ◽  
Simple Hepatic Cyst

Background and Aims Simple liver cyst (SHC) is a benign condition with no malignant potential. They are typically discovered incidentally due to the increased use of abdominal imaging, but some patients may present with abdominal pain. A radiologist’s differential diagnosis in cases of SHC will often include “rule out biliary cystadenoma.” Under these circumstances, patients and surgeons are more likely to pursue surgical options even in asymptomatic cases. The aim of this study is to conduct a retrospective analysis of presentation, radiologic reporting, management plan, and histopathology of patients referred to a tertiary hospital in order to determine the correlation between radiology and histology. Methods We retrospectively analyzed the clinical, radiological, and histopathological data of 20 patients operated for a diagnosis of a cystic lesion in the liver. Result The CT/MRI of 6 (30%) patients was reported as a biliary cystadenoma, 13 (65%) were reported as a simple hepatic cyst and 1 patient (5%) had hepatocellular carcinoma (HCC) with the additional diagnosis of multiple hepatic cysts. The lesion reported as HCC on the scan was separate from the cystic lesions. The modality of imaging for these cysts was evenly split, 50% of patients had a CT scan, and 50% had an MRI performed. All imaging studies were interpreted by an attending radiologist and most of them were discussed in multidisciplinary meetings. Nineteen patients (95%) had an intraoperative diagnosis of a simple liver cyst based on its visual appearance and clear fluid within the cyst. These patients underwent cyst wall fenestration and de-roofing with the cyst wall sent for histopathology. One patient (5%) with HCC underwent a non-anatomical liver resection. Histopathology was conclusive for a benign hepatic cystic lesion from the cyst wall biopsy. All 20 patients in this study underwent surgery, either due to symptoms or due to radiologic diagnosis of BCA. Four of the 20 cases (20%) were asymptomatic and out of these four cases, 3 (75%) were diagnosed as cystadenoma on the preoperative imaging studies. All 19 cases were diagnosed as a simple liver cyst on pathology. Conclusion In summary, there is a growing trend of “ruling-out the diagnosis of biliary cystadenoma” in patients who present with liver cysts. Patients are appropriately more anxious after this preoperative diagnosis and the treating surgeons have medico-legal concerns regarding conservative management in asymptomatic patients diagnosed as BCA. This single center experience draws attention to the radiology criteria utilized for diagnosing a biliary cystadenoma and suggests that it is time to revisit the imaging interpretation and differential diagnosis.

scholarly journals Giant simple hepatic cyst mimicking as hydatid cyst: diagnostic dilemma

2021 ◽  
Vol 8 (6) ◽  
pp. 1931
Author(s):  
Keerti R. ◽  
Ramanathan Manickam ◽  
Siddhartha Gowthamen
Keyword(s):  
Hydatid Cyst ◽  
Abdominal Mass ◽  
Mass Effect ◽  
Liver Cyst ◽  
Hepatic Cyst ◽  
Diagnostic Dilemma ◽  
Liver Cysts ◽  
Adjacent Structures ◽  
Simple Hepatic Cyst ◽  
Significant Mass Effect

Giant liver cysts are uncommon. Hepatic cysts are usually asymptomatic and are found incidentally but they can become symptomatic and cause bleeding, infection, mass effect to adjacent structures or rupture. We described two cases of symptomatic liver cysts described suspected clinically and radiologically reported as hydatid cyst but were revealed to be simple liver cysts following surgery. Two elderly men presented with an enlarging abdominal mass and abdominal pain for 1 week. Both patients on radiology had large cysts in the liver causing significant mass effect on adjacent structures and characteristics were suggestive of hydatid cyst. Diagnostic laparoscopy with drainage was done for both patients and revealed as simple hepatic cyst. Hence simple liver cyst can mimic as hydatid cyst attaining giant dimensions and should be considered as an important differential diagnosis. 

scholarly journals Laparoscopic Approach in a Rare Symptomatic Simple Hepatic Cyst: A Case Report

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S872
Author(s):  
V. Cayuela ◽  
P.-J. Gil-Vázquez ◽  
D. Ferreras ◽  
B. Gómez-Pérez ◽  
A. Balaguer ◽  
...  
Keyword(s):  
Case Report ◽  
Laparoscopic Approach ◽  
Hepatic Cyst ◽  
Simple Hepatic Cyst

Heuristische Textpraktiken in den Wissenschaften

2020 ◽  
Vol 48 (1) ◽  
pp. 1-46
Author(s):  
Michael Bender ◽  
Marcus Müller
Keyword(s):  
Science Research ◽  
Annotation Scheme ◽  
Scientific Debate ◽  
Domain Specific ◽  
Current State ◽  
Scientific Disciplines ◽  
Textual Practices ◽  
Collaborative Annotation ◽  
The Subject ◽  
State Of Research

AbstractThis article contains a comparative study of heuristic textual practices in various scientific disciplines. By this we mean formulation practices with which new knowledge is generated in institutionally influenced routines and connected to existing knowledge, e. g. ‚highlighting the relevance of a research topic‘, ‚defining a concept‘ or ‚supporting a statement argumentatively‘.The aim is to find out to what extent such textual practices occur in different scientific disciplines, how they are distributed and combined. Furthermore, we study the effects domain-specific contexts have on heuristic textual practices. The data basis of our study is a corpus of 65 dissertations from the 13 different faculties of the TU Darmstadt. In the pilot study we report here, we examined the introductory chapters of the dissertations. Methodologically, it is an annotation study: Based on the current state of research on the subject, we have derived a basic annotation scheme, which we have developed and refined in a collaborative process of guideline creation. Our study affiliates on socio-pragmatic research on text production and formulation routines in the sciences. It is theoretically informed by the philosophy of science research on heuristics, methodically we make a contribution to the scientific debate on collaborative annotation procedures.

Quality of training in cervical cancer radical surgery: a survey from the European Network of Young Gynaecologic Oncologists (ENYGO)

2022 ◽  
pp. ijgc-2021-002812
Author(s):  
Nicolò Bizzarri ◽  
Andrei Pletnev ◽  
Zoia Razumova ◽  
Kamil Zalewski ◽  
Charalampos Theofanakis ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive ◽  
Radical Surgery ◽  
Gynecologic Oncology ◽  
Laparoscopic Approach ◽  
High Volume ◽  
Lymph Node Biopsy ◽  
European Network ◽  
Before And After ◽  
Level Of Training

BackgroundThe European Society of Gynaecological Oncology (ESGO) and partners are committed to improving the training for gynecologic oncology fellows. The aim of this survey was to assess the type and level of training in cervical cancer surgery and to investigate whether the Laparoscopic Approach to Cervical Cancer (LACC) trial results impacted training in radical surgery for gynecologic oncology fellows.MethodsIn June 2020, a 47-question electronic survey was shared with European Network of Young Gynaecologic Oncologists (ENYGO) members. Specialist fellows in obstetrics and gynecology, and gynecologic oncology, from high- and low-volume centers, who started training between January 1, 2017 and January 1, 2020 or started before January 1, 2017 but finished their training at least 6 months after the LACC trial publication (October 2018), were included.Results81 of 125 (64.8%) respondents were included. The median time from the start of the fellowship to completion of the survey was 28 months (range 6–48). 56 (69.1%) respondents were still fellows-in-training. 6 of 56 (10.7%) and 14 of 25 (56.0%) respondents who were still in training and completed the fellowship, respectively, performed ≥10 radical hysterectomies during their training. Fellows trained in an ESGO accredited center had a higher chance to perform sentinel lymph node biopsy (60.4% vs 30.3%; p=0.027). There was no difference in the mean number of radical hysterectomies performed by fellows during fellowship before and after the LACC trial publication (8±12.0 vs 7±8.4, respectively; p=0.46). A significant reduction in number of minimally invasive radical hysterectomies was noted when comparing the period before and after the LACC trial (38.5% vs 13.8%, respectively; p<0.001).ConclusionExposure to radical surgery for cervical cancer among gynecologic oncology fellows is low. Centralization of cervical cancer cases to high-volume centers may provide an increase in fellows’ exposure to radical procedures. The LACC trial publication was associated with a decrease in minimally invasive radical hysterectomies performed by fellows.

Costs and benefits of different methods of esophagectomy for esophageal cancer

2017 ◽  
Vol 25 (7-8) ◽  
pp. 513-517 ◽  
Author(s):  
Alongkorn Yanasoot ◽  
Kamtorn Yolsuriyanwong ◽  
Sakchai Ruangsin ◽  
Supparerk Laohawiriyakamol ◽  
Somkiat Sunpaweravong
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Pain ◽  
Minimally Invasive ◽  
Operative Time ◽  
Minimally Invasive Esophagectomy ◽  
Laparoscopic Approach ◽  
Costs And Benefits ◽  
Invasive Approach ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

Background A minimally invasive approach to esophagectomy is being used increasingly, but concerns remain regarding the feasibility, safety, cost, and outcomes. We performed an analysis of the costs and benefits of minimally invasive, hybrid, and open esophagectomy approaches for esophageal cancer surgery. Methods The data of 83 consecutive patients who underwent a McKeown’s esophagectomy at Prince of Songkla University Hospital between January 2008 and December 2014 were analyzed. Open esophagectomy was performed in 54 patients, minimally invasive esophagectomy in 13, and hybrid esophagectomy in 16. There were no differences in patient characteristics among the 3 groups Minimally invasive esophagectomy was undertaken via a thoracoscopic-laparoscopic approach, hybrid esophagectomy via a thoracoscopic-laparotomy approach, and open esophagectomy by a thoracotomy-laparotomy approach. Results Minimally invasive esophagectomy required a longer operative time than hybrid or open esophagectomy ( p = 0.02), but these patients reported less postoperative pain ( p = 0.01). There were no significant differences in blood loss, intensive care unit stay, hospital stay, or postoperative complications among the 3 groups. Minimally invasive esophagectomy incurred higher operative and surgical material costs than hybrid or open esophagectomy ( p = 0.01), but there were no significant differences in inpatient care and total hospital costs. Conclusion Minimally invasive esophagectomy resulted in the least postoperative pain but the greatest operative cost and longest operative time. Open esophagectomy was associated with the lowest operative cost and shortest operative time but the most postoperative pain. Hybrid esophagectomy had a shorter learning curve while sharing the advantages of minimally invasive esophagectomy.

scholarly journals O paradigma científico no discurso da mídia brasileira sobre Zika e microcefalia

2018 ◽  
Vol 2 (1) ◽  
pp. 9
Author(s):  
Juliane Lopes Ferreira dos Santos ◽  
Denise Silva Matias ◽  
Nauana Nascimento Novais
Keyword(s):  
Control Measures ◽  
Scientific Paradigm ◽  
Scientific Debate ◽  
The Public ◽  
Emergency Situations ◽  
Biological Causation ◽  
The Media ◽  
The Subject ◽  
Official Sources ◽  
The Relationship

Introduction: In 2015 Brazil was surprised by an increase in the incidence of microcephaly, related by the Ministry of Health to Zika virus infection during pregnancy. This theme, which was notorious for public health, reached wide popular repercussion through the media. Objectives: To describe the presence of the scientific paradigm in the discourse of health professionals, researchers or journalists who inform the lay public about biological causation. Methodology: All the news made available on the digital platform of the Folha de São Paulo newspaper, containing the key term "Zika and microcephalia" and published between November 11, 2015 and March 4, 2016, was performed. Scientific elucidation on the subject. The news items were classified as to the presence of certainty or uncertainty about the relationship between Zika and microcephaly in their content and the central idea in the subject titles. Results: Of the 387 reports analyzed, 51.4% related Zika as a causal factor of microcephaly, while 32.8% considered the presence of uncertainty in the relationship. It was verified that the newspaper privileged subjects related to the repercussions due to the diseases, being predominant the report of control measures. Considering the origin of the news, it was significant the use of official sources, presented in 82% of the news. Conclusion: The scientific paradigm was disregarded, ignoring the uncertainty principle and the scientific debate. The limitations of both journalists and health managers were also demonstrated in the elaboration of an effective communication with the public in emergency situations.

scholarly journals Mechatronic Feasibility of Minimally Invasive, Atraumatic Cochleostomy

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Tom Williamson ◽  
Xinli Du ◽  
Brett Bell ◽  
Chris Coulson ◽  
Marco Caversaccio ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cochlear Implantation ◽  
Skull Base Surgery ◽  
Drilling Tool ◽  
Anatomical Structures ◽  
Considerable Research ◽  
Facial Recess ◽  
Lateral Skull Base ◽  
Cadaver Specimen ◽  
The Subject

Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade. The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy. Presented herein is preliminary work on the combination of two robotic systems for reducing invasiveness and trauma in cochlear implantation procedures. A robotic system for minimally invasive inner ear access was combined with a smart drilling tool for robust and safe cochleostomy; evaluation was completed on a single human cadaver specimen. Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

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