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Oncological surgery

Yuichiro Miyake, Junichi Nishimura, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Ichiro Takemasa, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
PURPOSE: Laparoscopic surgery for locally advanced colorectal cancer suspected of direct invasion to adjacent organs or structures remains controversial because of its high conversion rate, inadequate oncologic clearance and surgical outcomes. This study retrospectively evaluated the short-term outcomes of laparoscopic multivisceral resection for colorectal cancer and investigated the factors influencing conversion to open surgery. METHODS: Between 2010 and 2015, 39 patients who underwent laparoscopic multivisceral resection for colorectal cancer intraoperatively suspected of direct invasion to adjacent organs or structures were included...
October 21, 2016: Surgery Today
A Kanashiro, J M Gaya, J Palou, L Gausa, H Villavicencio
OBJECTIVES: To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. MATERIALS AND METHODS: From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases...
October 18, 2016: Actas Urologicas Españolas
S Gueli Alletti, M Petrillo, G Vizzielli, C Bottoni, F Nardelli, B Costantini, L Quagliozzi, V Gallotta, G Scambia, A Fagotti
OBJECTIVE: To further investigate the role of MIS comparing patients submitted to MI-IDS with a balanced population treated by standard laparotomy. METHODS: The investigational arm (Cases) includes 30 AEOC patients treated with MI-IDS. The Control arm included a consecutive series of 65 AEOC patients submitted to laparotomic IDS. Inclusion criteria were: age>18years, histologically proven EOC, clinical complete/partial response after NACT, and ECOG PS <2. Preoperative clinical data, perioperative and oncological outcomes were analyzed...
October 18, 2016: Gynecologic Oncology
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
E B Thorgersen, M A Goscinski, M Spasojevic, A M Solbakken, A B Mariathasan, K Boye, S G Larsen, K Flatmark
BACKGROUND: High morbidity, increased mortality, and impaired long-term oncologic outcome have been reported after deep surgical site infection (SSI) in rectal cancer surgery. The rate, risk factors and consequences of deep SSI after (chemo)radiotherapy [(C)RT], and surgery for locally advanced rectal cancer (LARC) in a tertiary university hospital single centre cohort of 540 patients are presented. METHODS: Patients with LARC, operated between January 1, 2007 and December 31, 2015, were identified in the institutional prospective database...
October 20, 2016: Annals of Surgical Oncology
Keiju Aokage, Junji Yoshida, Tomoyuki Hishida, Masahiro Tsuboi, Hisashi Saji, Morihito Okada, Kenji Suzuki, Syunichi Watanabe, Hisao Asamura
Since 'radical lobectomy' was reported by Cahan in 1960, the standard surgical care for lung cancer has been lobectomy, in which units of the lobe are excised with their specific regional hilar and mediastinal lymphatics. However, pulmonary function-preserving limited resection for lung cancer has gradually become more prevalent in the late 20th century. In 1995, Ginsberg et al. conducted a randomized controlled trial in which limited resection (segmentectomy and wide-wedge resection) and lobectomy for stage I lung cancer were compared and reported that limited resection should not be applied to healthy patients with clinical stage IA lung cancer...
October 20, 2016: Japanese Journal of Clinical Oncology
Emmanuel Mandonnet, Juan Martino, Silvio Sarubbo, Francesco Corrivetti, Schahraed Bouazza, Damien Bresson, Hugues Duffau, Sebastien Froelich
BACKGROUND: Advances in the oncological and functional results of insular surgery have been reported recently. Such successes have been made possible by the advent of the transopercular approach under awake monitoring and by the improved anatomical and functional knowledge of the white matter pathways surrounding the insula. Nonetheless, given the rarity of insular tumors, it is difficult to get familiar with the complex 3D anatomy of the different neuronal and vascular structures encountered during a transopercular insular resection...
October 17, 2016: World Neurosurgery
Ronald J Caras, Michael B Lustik, Sean Q Kern, Leah P McMann, Joseph R Sterbis
INTRODUCTION: Multiple studies have linked preoperative nutrition status to postoperative outcomes. This relationship has been little studied in urology. We used a standardized, national, risk-adjusted surgical database to evaluate 30-day outcomes of patients undergoing common urologic oncologic procedures as they related to preoperative albumin. METHODS: The American College of Surgeons National Surgical Quality Improvement Program is a risk-adjusted dataset analyzing preoperative risk factors, demographics, and 30-day outcomes...
September 23, 2016: Clinical Genitourinary Cancer
Kenichiro Kakutani, Yoshitada Sakai, Koichiro Maeno, Toru Takada, Takashi Yurube, Takuto Kurakawa, Shingo Miyazaki, Yoshiki Terashima, Masaaki Ito, Hitomi Hara, Teruya Kawamoto, Yasuo Ejima, Akihiro Sakashita, Naomi Kiyota, Yoshiyuki Kizawa, Ryohei Sasaki, Toshihro Akisue, Hironobu Minami, Ryosuke Kuroda, Masahiro Kurosaka, Kotaro Nishida
STUDY DESIGN: A prospective cohort study of performance status (PS) and activities of daily living (ADL) in patients with spinal metastasis. OBJECTIVE: To identify the effect of spinal surgery on PS and ADL in patients with spinal metastasis. SUMMARY OF BACKGROUND DATA: Spinal metastasis causes severe neurological deficits, resulting in drastic loss of patients' PS and ADL. However, the effect of spine surgery on PS and ADL is not well known...
October 19, 2016: Clinical Spine Surgery
Matthew D Hall, Timothy E Schultheiss, David D Smith, Marwan G Fakih, Jeffrey Y C Wong, Yi-Jen Chen
BACKGROUND: Neoadjuvant chemoradiation therapy (CRT) increases pathological complete response (pCR) rates compared to radiotherapy alone in patients with stage II-III rectal cancer. Limited evidence addresses whether radiotherapy dose escalation further improves pCR rates. Our purpose is to measure the effects of radiotherapy dose and other factors on post-therapy pathologic tumor (ypT) and nodal stage in rectal cancer patients treated with neoadjuvant CRT followed by mesorectal excision...
October 20, 2016: Acta Oncologica
Jingfu Liu, Na Wang, Yujuan Chen, Rong Lu, Xianren Ye
AIM: Venous thromboembolism (VTE) is a well-recognized complication in gynecological oncology patients, and has an impact on the overall outcome. The purpose of this study was to identify whether thrombelastography (TEG) predicts VTE in gynecological oncology patients. METHODS: This retrospective study included patients with gynecological oncology who were hospitalized at the Fujian Provincial Cancer Hospital from May 2014 to April 2016. Univariate and logistic regression multivariate analyses were performed to determine the clinical and laboratorial factors for VTE in gynecological oncology patients...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
E Hain, L Maggiori, G Manceau, C Mongin, J Prost À la Denise, Y Panis
BACKGROUND: The effect of anastomotic leakage on oncological outcomes after total mesorectal excision (TME) is controversial. This study aimed to assess the influence of symptomatic and asymptomatic anastomotic leakage on oncological outcomes after laparoscopic TME. METHODS: All patients who underwent restorative laparoscopic TME for rectal adenocarcinoma with curative intent from 2005 to 2014 were identified from an institutional database. Asymptomatic anastomotic leakage was defined by CT performed systematically 4-8 weeks after rectal surgery, with no relevant clinical symptoms or laboratory examination findings during the postoperative course...
October 20, 2016: British Journal of Surgery
Yanjiao Zhang, Yushun Gao
BACKGROUND: Lung cancer is a malignancy with high morbidity and mortality rates worldwide. Surgery is the preferred treatment for non-small cell lung cancer. This study aims to investigate the effects of video-assisted thoracoscopic surgery (VATS) lobectomy, VATS segmentectomy, and open thoracotomy on pulmonary function in the early postoperative stage and compare the difference among three groups. METHODS: Pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgical Oncology, Cancer Hospital Chinese Academy of Medical Sciences...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Silvia Riondino, Fiorella Guadagni, Vincenzo Formica, Patrizia Ferroni, Mario Roselli
Venous thromboembolism (VTE) is a commonly diagnosed multifactorial condition with significant morbidity and mortality, occurring in up to 20% of cancer patients. Indeed, patients with cancer are in a higher pro-thrombotic state due to alterations in their haemostatic-coagulative system, stasis and blood flow slowdown, endothelial dysfunction, vascular inflammation and platelet activation. Moreover, several cancer-dependent factors can sum up to trigger a first episode of VTE or to cause its recurrence in the course of anticoagulant treatment...
October 18, 2016: Current Medicinal Chemistry
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
Kyung Ha Lee, Jin Soo Kim, Ji Yeon Kim
PURPOSE: Oral capecitabine has demonstrated to be safe and efficient as neoadjuvant concurrent chemoradiotherapy (NCRT) for locally advanced rectal cancers. The aim of this study was to evaluate the long-term oncologic outcomes of NCRT with capecitabine and radical surgery. METHODS: From January 2000 to June 2010, 238 patients were treated at our center for locally advanced rectal cancers using conventional NCRT with capecitabine and radical surgery. Univariate and multivariate analyses were used to evaluate the factors associated with oncologic outcomes with log rank and Cox regression tests...
October 2016: Annals of Surgical Treatment and Research
Mehmet Gokcu, Kemal Gungorduk, Osman Aşıcıoğlu, Nilüfer Çetinkaya, Tayfun Güngör, Gonca Pakay, Zeliha Fırat Cüylan, Tayfun Toptaş, Ramazan Özyurt, Elif Ağaçayak, Aykut Ozdemir, Onur Erol, Anıl Turan, Varol Gülseren, Mehmet Sait İcen, Taylan Şenol, Hakan Güraslan, Burcu Yücesoy, Ahmet Sahbaz, Ozgu Gungorduk, Berhan Besimoğlu, Kaan Pakay, Osman Temizkan, Muzaffer Sancı, Tayup Şimşek, Mehmet Mutlu Meydanlı, Mehmet Harma, Levent Yaşar, Birtan Boran, Aysel Derbent Uysal, Ateş Karateke
BACKGROUND: The optimal surgical management and staging of borderline ovarian tumors (BOTs) are controversial. Institutions have different surgical approaches for the treatment of BOTs. Here, we performed a retrospective review of clinical characteristics, surgical management and surgical outcomes, and sought to identify variables affecting disease-free survival (DFS) and overall survival (OS) in patients with BOTs. METHODS: A retrospective review of ten gynecological oncology department databases in Turkey was conducted to identify patients diagnosed with BOTs...
October 18, 2016: Journal of Ovarian Research
Leila Rooshenas, Daisy Elliott, Julia Wade, Marcus Jepson, Sangeetha Paramasivan, Sean Strong, Caroline Wilson, David Beard, Jane M Blazeby, Alison Birtle, Alison Halliday, Chris A Rogers, Rob Stein, Jenny L Donovan
BACKGROUND: Randomised controlled trials (RCTs) are essential for evidence-based medicine and increasingly rely on front-line clinicians to recruit eligible patients. Clinicians' difficulties with negotiating equipoise is assumed to undermine recruitment, although these issues have not yet been empirically investigated in the context of observable events. We aimed to investigate how clinicians conveyed equipoise during RCT recruitment appointments across six RCTs, with a view to (i) identifying practices that supported or hindered equipoise communication and (ii) exploring how clinicians' reported intentions compared with their actual practices...
October 2016: PLoS Medicine
Kuauhyama Luna-Ortiz, Mario Alonso-Calamaco, Ramses U Ortiz-Leyva
Osteosarcoma in the craniofacial region is rare. A 43-year-old female, the patient, self-detected a 3-cm tumor of the right frontoparietal region 4 months before. An incisional biopsy was performed and a osteosarcoma was reported. At admission, a 4 × 5 cm tumor was present on the right frontoparietal region, without extending to the orbital region but the patient underwent surgery 2 months after admission. The delay was due to 2 episodes of upper respiratory tract infection that required resolution. At the time of surgery the tumor measured 8 × 9 cm...
October 14, 2016: Journal of Craniofacial Surgery
Ahmad Alenezi, Giacomo Novara, Alexander Mottrie, Salah Al-Buheissi, Omer Karim
Nephron-sparing surgery for the removal of small renal masses delivers equivalent oncological outcomes and better functional outcomes compared with those associated with radical nephrectomy. All contemporary partial nephrectomy techniques including open, laparoscopic and robotic approaches involve the use of hilar clamping in order to facilitate haemostasis, and to enable accurate tumour excision and parenchymal reconstruction. Zero ischaemia was subsequently introduced as a technique to eliminate the renal ischaemia induced by hilar clamping...
October 18, 2016: Nature Reviews. Urology
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