Anastomotic leakage (AL) is a major problem in rectal cancer surgery. To prevent AL, we developed a side-to-side anastomosis technique using a circular stapler and termed it the circular side stapling technique (CST). We herein report the method and outcome of the CST.
In this study, we analyzed 154 patients with stage 0 to III rectal cancer who underwent curative laparoscopic low anterior resection. Perioperative factors and complications were compared between the CST and usual double stapling technique (DST).
The CST was performed in 110 of the 154 patients. When comparing the outcomes of patients with upper rectal cancer. AL occurred in no patients in the CST group and in three patients in the DST group (p=0.011). The CST prevented AL in all patients with upper rectal cancer.
The CST is a safe and useful procedure in laparoscopic anterior resection. This technique can prevent AL, especially in patients with upper rectal cancer.
The CST is a safe and useful procedure in laparoscopic anterior resection. This technique can prevent AL, especially in patients with upper rectal cancer.
Thoracic neurogenic tumors are most frequently located in the posterior part of the mediastinum or on the chest wall, along the intercostal nerves. Schwannomas are very well tolerated for a long period, until the tumor reaches a large size and compression of the neighbouring mediastinal organs, chest wall or spine appears. The purpose of this article was to present a case of a giant right forth intercostal nerve Schwannoma, completely resected by a right antero-lateral thoracotomy. In addition, intrathoracic giant neurogenic tumors are a rarity.
The patient presented with only diminished tolerance to physical activity with no other obvious symptoms. Standard chest radiography revealed a well-defined opacity of subcostal intensity, occupying two thirds of the right hemithorax, forming a common body with the mediastinal shadow. Thoracic computed tomography (CT) identified a 21/11 cm solid mass that compresses the right lung and the right main bronchus with both a solid component and a central liquid area. O mass.
Isolated fractures of the lesser trochanter (LT) of adults are rare and most of them are pathologic fractures due to an underlying malignancy. The aim of our study was to provide comprehensive information on the epidemiology, etiology, diagnostic approach, and treatment algorithm of adult LT fractures.
We present the cases of six patients who were treated for isolated LT fractures between November 2010 and May 2019. A literature review was performed to identify adult LT fracture cases in previous studies.
In two patients, the LT fracture was the first manifestation of the underlying tumors. Through a literature review, we identified 32 adults with isolated LT fractures. Among these, 27 were pathologic fractures. In 11 pathologic fractures, LT avulsion was the first manifestation of malignancy.
Metastasis and the first manifestation of an underlying malignancy should be suspected in adult patients with isolated LT fracture. A stepwise approach can prevent misdiagnosis and offer rational treatment modality.
Metastasis and the first manifestation of an underlying malignancy should be suspected in adult patients with isolated LT fracture. A stepwise approach can prevent misdiagnosis and offer rational treatment modality.
Vulva cancer surgery is associated with a high level of morbidity mostly due to wound healing disorders in the inguinal region following lymphadenectomy. Our aim is to evaluate the feasibility of negative pressure wound therapy (NPWT) using the PICO™ device in groin wounds after lymphadenectomy.
The groins of twenty patients who underwent bilateral lymph node dissection were dressed with the PICO™ device. learn more All patients were followed prospectively with clinical controls up to three months postoperatively using a standardized study protocol.
A total of 11 patients (55%) developed a surgical site complication (SSC). One patient suffered from a wound rupture two days after surgery, six a lymphocele and four a surgical site infection. Operation time, blood loss, number of lymph nodes removed, length of hospital-stay and duration of PICO™ treatment did not differ between women with and without SSCs.
NPWT using the PICO™ device seems to be a feasible method to reduce the severity of healing disorders in the groin after lymphadenectomy in vulva cancer patients.
NPWT using the PICO™ device seems to be a feasible method to reduce the severity of healing disorders in the groin after lymphadenectomy in vulva cancer patients.
Symptomatic cancers display a different biological behaviour from screen-detected cancers, which may impact the management of axillary metastases. We aimed to determine the role of unselected axillary nodal clearance (ANC) in symptomatic patients with positive sentinel node biopsies (SNBs).
A case-note review was performed on 95 symptomatic breast cancer patients who underwent ANC following positive SNB.
Thirty-eight (40%) patients were treated with a mastectomy and 57 (60%) with breast-conserving surgery. At ANC, 25 patients (26.3%) showed evidence of further lymph node metastases, with 15 (60%) having two or fewer macrometastases. The presence of more than 2 SNB macrometastases was associated with further ANC metastases (p<0.001). The presence of further metastases at ANC was not associated with either reduced overall survival or disease-free survival.
A number of symptomatic breast cancer patients with positive SNBs may be overtreated. Ongoing trials examining the management of low volume SNB macrometastases need to consider the symptomatic subgroup in their conclusions.
A number of symptomatic breast cancer patients with positive SNBs may be overtreated. Ongoing trials examining the management of low volume SNB macrometastases need to consider the symptomatic subgroup in their conclusions.
Bone reconstruction following a wide resection for a malignant musculoskeletal tumor remains challenging, especially for an intercalary defect following the resection of a metaphyseal lesion.
Here, we describe a surgical procedure using the Masquelet technique for the biological reconstruction of a huge subtrochanteric bone defect following failed pasteurized autologous bone grafting for a conventional chondrosarcoma of the proximal femoral metaphysis with a subtrochanteric pathological fracture. The patient, a 43-year-old Japanese male, was able to walk without a cane or a brace at 15 months after the final operation (International Society of Limb Salvage score, 86.7%).
This procedure should be considered as one of the reconstruction options following the wide resection of malignant bone tumors located in the metaphysis.
This procedure should be considered as one of the reconstruction options following the wide resection of malignant bone tumors located in the metaphysis.learn more
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