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Resection margin

Paolo Morgagni, Giuliano La Barba, Eleonora Colciago, Giovanni Vittimberga, Giorgio Ercolani
The optimal management of patients with resection line involvement after endoscopic or surgical treatment for gastric cancer is debated. In contrast to previous reports, we examined both the experience of endoscopists and surgeons in early-stage lesions and the wide variation in treatments proposed for advanced disease in case of infiltration of resection margins. A PubMed search for papers using the key words: gastric or stomach cancer, or Carcinoma; gastrectomy and positive margins; surgical margins or resection line or endoscopic margin involvement; and R1 resection, from January 2000 to July 2015 was undertaken...
June 23, 2018: Updates in Surgery
Roos E Pouw, Hannah T Künzli, Raf Bisschops, Carine M Sondermeijer, Arjun D Koch, Paul Didden, Anniek W Gotink, Erik J Schoon, Wouter L Curvers, Jacques J G H M Bergman, Bas L A M Weusten
BACKGROUND: For focal radiofrequency ablation of Barrett's oesophagus, a simplified regimen (3 × 15 J/cm2 , without cleaning) has proven to be as effective as the standard regimen (2 × 15 J/cm2 , followed by cleaning, followed by 2 × 15 J/cm2 ). However, this simplified regimen seemed to be associated with a higher stenosis rate. Therefore, we lowered the radiofrequency energy and hypothesised that this new simplified regimen would be as effective and safe as the standard regimen...
June 19, 2018: Lancet. Gastroenterology & Hepatology
Noortje Pleunis, Maria E J Leermakers, Anneke A van der Wurff, Paul J J M Klinkhamer, Nicole P M Ezendam, Dorry Boll, Joanne A de Hullu, Johanna M A Pijnenborg
INTRODUCTION: The recommended pathological resection margin (8 mm) for vulvar squamous cell carcinoma (SCC) is broader than for SCC located elsewhere, and does not depend on tumor grade or lesion size. Our aim is to evaluate the resection margin in vulvar SCC in relation to local recurrence, and to determine the impact of other prognostic factors. MATERIALS AND METHODS: Data of all surgically treated patients at the Gynecological Oncology Center South with vulvar SCC, FIGO IB-IIIC, between 2005 and 2015 were analysed retrospectively...
June 6, 2018: European Journal of Surgical Oncology
Xiang Lan, Hua Zhang, Hong-Yu Li, Ke-Fei Chen, Fei Liu, Yong-Gang Wei, Bo Li
Liver transplantation (LT) is one of the most effective treatments for end-stage liver disease caused by related risk factors when liver resection is contraindicated. Additionally, despite the decrease in the prevalence of hepatitis B virus (HBV) over the past two decades, the absolute number of HBsAg-positive people has increased, leading to an increase in HBV-related liver cirrhosis and hepatocellular carcinoma. Consequently, a large demand exists for LT. While the wait time for patients on the donor list is, to some degree, shorter due to the development of living donor liver transplantation (LDLT), there is still a shortage of liver grafts...
June 21, 2018: World Journal of Gastroenterology: WJG
Xiao-Xuan Jia, Yi Wang, Jin Cheng, Xun Yao, Mu-Jun Yin, Jing Zhou, Ying-Jiang Ye
OBJECTIVE: The objective of this study was to compare the prognoses of patients with low- and high-risk rectal cancer detected by MRI who were treated without neoadjuvant chemoradiotherapy (NCRT) and to determine independent risk factors. MATERIALS AND METHODS: This retrospective study included 185 patients with pathologically proven rectal adenocarcinoma who were treated without NCRT. Cancer was defined as high risk if one or more of the following factors were present: extramural depth of tumor invasion greater than 5 mm or stage T4a or T4b for tumor in the mid or high rectum; involvement of intersphincteric space, levators, or adjacent organs for tumor in the low rectum; extramural venous invasion (EMVI); or circumferential resection margin (CRM) involvement...
June 21, 2018: AJR. American Journal of Roentgenology
Hui Zhang, WeiJian Zhang, DeFeng Peng, JinHai Zhu
BACKGROUND: The study was conducted to investigate the short-term complications and prognostic factors in patients with esophagogastric junction adenocarcinoma (EGJA). METHODS: This retrospective study included 110 EGJA patients who underwent surgery from January 2010 to November 2012 at The First Affiliated Hospital of BengBu Medical College. The overall survival and short-term complications were analyzed according to the patients' clinical characteristics. RESULTS: The incidence of postoperative cardiopulmonary complications was significantly higher in patients with preoperative cardiopulmonary disease or elderly patients (P < 0...
June 21, 2018: Thoracic Cancer
Jianguo Zhu, Yun Luan, Haige Li
RATIONALE: Testicular Leydig cell tumor (LCT) is a rare neoplasm. It commonly presents as a painless testicular mass with or without endocrine changes. Histological and immunohistochemical examination play important roles in differentiating LCT from testicular germ cell tumors. PATIENT CONCERNS: We highlight the imaging phenotype, as well as the pathological findings of a case of LCT in a 62-year-old male. DIAGNOSES: Preoperative noncontrast CT scan of the abdomen revealed a 7...
June 2018: Medicine (Baltimore)
Martina Kluth, Sekander Scherzai, Franziska Büschek, Christoph Fraune, Katharina Möller, Doris Höflmayer, Sarah Minner, Cosima Göbel, Christina Möller-Koop, Andrea Hinsch, Emily Neubauer, Maria Christina Tsourlakis, Guido Sauter, Hans Heinzer, Markus Graefen, Waldemar Wilczak, Andreas M Luebke, Eike Burandt, Stefan Steurer, Thorsten Schlomm, Ronald Simon
Deletions of chromosome arm 13q belong to the most frequent molecular alterations in prostate cancer. To better understand the role of 13q deletion in prostate cancer we took advantage of our large prostate cancer tissue microarray comprising more than 12,000 cancer samples with full pathological and clinical follow up data. Fluorescence in situ hybridization with probes for ENOX1 (13q14.11) and the retinoblastoma gene (RB1, 13q14.2) was employed. A 13q deletion was found in 21% of 7,375 analyzable cancers...
June 20, 2018: Genes, Chromosomes & Cancer
L Lorenzon, F Bini, M Quatrale, A Biondi, R Persiani, M Di Pietropaolo, F Landolfi, E Iannicelli, F Marinozzi, G Balducci, D D'Ugo
AIM: Recent studies focused on rectal cancer suggested that a 3D imaging segmentation obtained from MRI data could contribute in the definition of the circumferential resection margin (CRM) and in the assessment of the tumor regression following neo-adjuvant treatments. Here, we propose a method for defining and visualizing the circumferential margins using 3D MRI segmentation; this methodology was tested in a clinical study comparing 3D CRM assessment vs standard MRI imaging. PATIENTS AND METHODS: MRI scans performed before neo-adjuvant treatments were selected and reviewed...
May 2018: Il Giornale di Chirurgia
P Ursi, A Santoro, A Gemini, A Arezzo, D Pironi, C Renzi, R Cirocchi, F M Di Matteo, A Maturo, V D'Andrea, J Sagar
BACKGROUND: Low Rectal Anterior Resection (LAR) is challenging when anal canal mucosa and/or internal sphincter are involved by very low tumors. In these cases, Intersphincteric resection (ISR) with the removal of the internal sphincter is designed to increase the distal margin of resection, thus preserving the external sphincter and pubo-rectalis muscle complex. Aim is to compare results after ISR with those of LAR, including subgroup analysis of open, laparoscopic and robotic ISR. METHODS: Studies published from January 1991 to January 2017 describing ISR and comparing results with LAR in adults were included irrespective of the technique...
May 2018: Il Giornale di Chirurgia
William M Mendenhall, Carlos Suárez, Alena Skálová, Primož Strojan, Asterios Triantafyllou, Kenneth O Devaney, Michelle D Williams, Alessandra Rinaldo, Alfio Ferlito
An endolymphatic sac tumor (ELST) is a rare, indolent but locally aggressive tumor arising in the posterior petrous ridge. Patients present with sensorineural hearing loss and tinnitus. As the tumor progresses, patients may experience vertigo, ataxia, facial nerve paresis, pain and otorrhea. Most patients present in their 4th or 5th decade with a wide age range. Patients with von Hippel-Lindau disease have an increased likelihood of developing ELST. Histologically, ELST is a low-grade adenocarcinoma. As it progresses, it destroys bone and extends into adjacent tissues...
June 19, 2018: Advances in Therapy
Noriyoshi Sawabata, Akikazu Kawase, Nobumasa Takahashi, Takeshi Kawaguchi, Tetsukan Woo, Yuichi Saito, Satoshi Shiono, Noriyuki Matsutani
Stage I non-small cell lung cancer (NSCLC) is a localized disease without metastasis; therefore, it can be treated effectively with local therapies. Pulmonary resection is the most frequent treatment, performed as pulmonary wedge resection, segmentectomy, lobectomy, or pneumonectomy. Some retrospective clinical studies of pulmonary wedge resection suggest that its outcome may be inferior to that of anatomical pulmonary resection, whereas other recent studies, which assess surgical margin status, leveled acceptable outcomes...
June 19, 2018: Surgery Today
Satoshi Kamiya, Manabu Ohashi, Satoshi Ida, Koshi Kumagai, Souya Nunobe, Takeshi Sano, Naoki Hiki
BACKGROUND: Laparoscopic subtotal gastrectomy (LsTG) has several advantages, including technical safety and preservation of postoperative function, compared with total or proximal gastrectomy for early gastric cancer. However, LsTG has some technical issues with respect to achieving a safe resection margin and patency in patients with lesions close to the cardia or fornix. When LsTG is performed for lesions located rather close to the cardia or fornix, conventional marking clips can physically hinder transection by an endoscopic linear stapler...
June 19, 2018: Surgical Endoscopy
Lawrence J Oh, Eugene Wong, Sol Bae, Angelo Tsirbas
Background: Repair of blepharoptosis from the posterior eyelid approach has usually been done utilizing a Müller's muscle-conjuctival resection (MMCR) or an "open sky" technique. We present a new technique to advance the levator muscle from the posterior-approach in a closed fashion that can be used in patients with severe involutional ptosis. Methods: A retrospective chart review was performed for consecutive patients with severe involutional blepharoptosis during a 6-year period treated by a single surgeon with a Closed Posterior Levator Advancement...
May 2018: Plastic and Reconstructive Surgery. Global Open
Veerabhadra Radhakrishna, Ashok Rijhwani, Bhushanrao Jadhav
Introduction: Cecal duplication is a rare congenital anomaly and to the best of our knowledge, only 43 cases have been reported in the literature till date. Most of them present within the first year of life. They can mimic intussusception, and the delay in diagnosis can lead to high morbidity. Case report: A five-year boy presented with pain abdomen for a week. He was found to have ileocolic intussusception. The intussusception could only be partially reduced by the hydrostatic method...
July 2018: Annals of Medicine and Surgery
Maha A T Elsebaie, Mohamed Amgad, Ahmed Elkashash, Ahmed Saber Elgebaly, Gehad Gamal E L Ashal, Emad Shash, Zeinab Elsayed
This is the second-largest retrospective analysis addressing the controversy of whether adult rhabdomyosarcoma (RMS) should be treated with chemotherapy regimens adopted from pediatric RMS protocols or adult soft-tissue sarcoma protocols. A comprehensive database search identified 553 adults with primary non-metastatic RMS. Increasing age, intermediate-risk disease, no chemotherapy use, anthacycline-based and poor chemotherapy response were significant predictors of poor overall and progression-free survival...
June 19, 2018: Scientific Reports
Koichi Okamoto, Yuka Okada, Kohei Ohno, Takahiro Yagi, Mitsuo Tsukamoto, Takuya Akahane, Ryu Shimada, Tamuro Hayama, Takeshi Tsuchiya, Keijiro Nozawa, Keiji Matsuda, Tsuyoshi Ishida, Fukuo Kondo, Yojiro Hashiguchi
BACKGROUND: A tumor composed exclusively or predominantly of human melanin black 45 (HMB45)-positive epithelioid cells is called a perivascular epithelioid cell tumor (PEComa). We report a very rare case of a PEComa of the greater omentum. CASE PRESENTATION: MRI conducted to examine the orthopedic disease of the patients, a 49-year-old Japanese woman, also identified a tumor in her pelvis. A CT scan revealed a tumor mass on the right side of the pelvic floor and clear nutrient vessels originating from the splenic and celiac arteries...
June 19, 2018: World Journal of Surgical Oncology
Gabrielle H van Ramshorst, Sarah 'o Shannassy, Wendy E Brown, James G Kench, Michael J Solomon
AIM: Pelvic exenteration surgery remains the only curative option for recurrent rectal cancer. Microscopically involved surgical margins (R1) are associated with a higher risk of local recurrence and decreased survival. Our study aimed to develop a post hoc multidisciplinary case conference review and investigate its potential for identifying areas for improvement. METHOD: Patients who underwent pelvic exenteration surgery for recurrent rectal cancer with R1 resections at a tertiary referral center between April 2014- January 2016 were retrospectively reviewed from a prospectively maintained database...
June 19, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Lawrence Lee, Borja de Lacy, Marcos Gomez Ruiz, Alexander Sender Liberman, Matthew R Albert, John R T Monson, Antonio Lacy, Seon Hahn Kim, Sam B Atallah
OBJECTIVE: To compare the quality of surgical resection of transanal total mesorectal excision (TA-TME) and robotic total mesorectal excision (R-TME). BACKGROUND: Both TA-TME and R-TME have been advocated to improve the quality of surgery for rectal cancer below 10 cm from the anal verge, but there are little data comparing TA-TME and R-TME. METHODS: Data of patients undergoing TA-TME or R-TME for rectal cancer below 10 cm from the anal verge and a sphincter-saving procedure from 5 high-volume rectal cancer referral centers between 2011 and 2017 were obtained...
June 18, 2018: Annals of Surgery
Takeshi Aoki, Masahiko Murakami, Tomotake Koizumi, Kazuhiro Matsuda, Akira Fujimori, Tomokazu Kusano, Yuta Enami, Satoru Goto, Makoto Watanabe, Koji Otsuka
PURPOSE: Laparoscopic liver resection is increasingly used to treat patients with hepatic tumor. However, during laparoscopic resection, information obtained by palpation using laparoscopic forceps or from intraoperative ultrasonography is extremely limited, which may pose a risk for positive surgical margins. This study aimed to investigate the feasibility and clinical application of near-infrared (NIR) fluorescence imaging to guide laparoscopic liver resection of a liver tumor and secure the surgical margins...
June 18, 2018: Langenbeck's Archives of Surgery
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