• Title/Summary/Keyword: En bloc resection

Search Result 91, Processing Time 0.031 seconds

Endoscopic Submucosal Dissection Versus Endoscopic Mucosal Resection for the Treatment of Early Esophageal Carcinoma: a Meta-analysis

  • Wang, Jing;Ge, Jian;Zhang, Xiao-Hua;Liu, Ji-Yong;Yang, Chong-Mei;Zhao, Shu-Lei
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.4
    • /
    • pp.1803-1806
    • /
    • 2014
  • Endoscopic submucosal dissection (ESD) was originally developed for en bloc resection of large, flat gastrointestinal lesions. Compared with endoscopic mucosal resection (EMR), ESD is considered to be more time consuming and have more complications for treatment of early esophageal carcinoma, such as bleeding, stenosis and perforation. The objective of this study was to compare the efficacy and safety of ESD and EMR for such lesions. We searched databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 for related trials. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histologically resection rate and the local recurrence rate. We also compared the operation time and the incidences of procedure-related complications. Five trials were identified, and a total of 710 patients and 795 lesions were included. The en bloc and histologically complete resection rates were higher in the ESD group compared with the EMR group (odds ratio (OR) 27.3; 95% CI, 11.5-64.8; OR 18.4; 95% CI, 8.82-38.59). The local recurrence rate was lower in the ESD group (OR 0.13, 95 % CI 0.04-0.43). The meta-analysis also showed ESD was more time consuming, but did not increase the complication rate (P=0.76). The results implied that compared with EMR, ESD showed better en bloc and histologically resection rates, and lower local recurrence, without increasing the incidence of procedure-related complications in the treatment of early esophageal carcinoma.

Computer-Assisted Modified Mid-Sacrectomy for En Bloc Resection of Chordoma and Preservation of Bladder Function

  • Han, In-Ho;Seo, Young-Jun;Cho, Won-Ho;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
    • /
    • v.50 no.6
    • /
    • pp.523-527
    • /
    • 2011
  • A 67-year-old woman presented for evaluation of severe coccygeal pain. The computed tomography scans and magnetic resonance imaging showed an asymmetric midline sacral tumor invading the right lower portion of S2. To preserve both S2 nerve roots and to obtain negative surgical margins, a modified mid-sacrectomy with an aid of a computed navigation system was performed. The sacral tumor was excised en bloc with negative tumor margins. Both S2 nerve roots were preserved and additional reconstruction was not necessary because of minimal resection of the sacroiliac joint. We report a case of a sacral chordoma which was excised en bloc with adequate surgical margins by a computer-assisted modified mid-sacrectomy. The computed navigation system may be a useful tool for tumor targeting and safe osteotomies in sacral tumor surgery via the posterior only approach.

Total Body Replacement with an Expandable Cage after en Bloc Lumbar Spondylectomy

  • Shin, Dong-Ah;Kim, Keung-Nyun;Shin, Hyun-Chul;Yoon, Do-Heum
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.6
    • /
    • pp.471-475
    • /
    • 2006
  • Complete vertebral tumor resection is important in order to prevent local recurrence. Among the available techniques for total spondylectomy, the total en bloc spondylectomy has been accepted as the most sophisticated one. After a total en bloc spondylectomy, anterior and posterior column reconstruction is mandatory in order to achieve stability. We experienced the usefulness of an expandable cage for anterior column reconstruction especially in this surgery. The chance of cutting the nerve root and damaging the spinal cord is minimized because the size of the expandable cage is initially small enough to be inserted into the anterior column. The technical details of total vertebral body replacement with an expandable cage after an en bloc lumbar spondylectomy are described herein.

Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases

  • Hayato Yamaguchi;Masakatsu Fukuzawa;Takashi Kawai;Takahiro Muramatsu;Taisuke Matsumoto;Kumiko Uchida;Yohei Koyama;Akir Madarame;Takashi Morise;Shin Kono;Sakik Naito;Naoyoshi Nagata;Mitsushige Sugimoto;Takao Itoi
    • Clinical Endoscopy
    • /
    • v.56 no.6
    • /
    • pp.778-789
    • /
    • 2023
  • Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90-197] minutes) >C-ESD (90 [60-140] minutes) >SH-ESD (52 [29-80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%-30%]) than in the en bloc resection group (40% [20%-60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone (거대세포종의 치료시 관절 기능의 보존)

  • Bae, Dae-Kyung;Han, Chung-Soo;Sun, Seung-Deok;Baek, Chang-Hee;Rhee, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.1 no.2
    • /
    • pp.145-153
    • /
    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

  • PDF

Primary Bony Thorax Tumor Report of 24 cases (원발성 흉벽 골종양24례 보고)

  • Jo, Geon-Hyeon;Lee, Hong-Gyun
    • Journal of Chest Surgery
    • /
    • v.18 no.1
    • /
    • pp.69-74
    • /
    • 1985
  • Most clinicians have taken a lot of interest in tumors arising from the bony thorax because not only of their rarity and predictable diagnosis which could be reflected as a unique radiologic shadow but also variable surgical modes for maintenance of chest wall stability encountered after en-bloc resection. By the retrospective review, we have analyzed 24 cases of primary bony thorax tumors which were experienced and surgically treated at the St. Mary`s hospital of Catholic Medical College from Jan. 1969 to Sept. 1984. The results are as follows: 1. Age incidence was evenly distributed through all decades and the male-female ratio is 15:9. 2. 16 cases out of 24 were benign tumors and the commonest one of which was fibrous dysplasia. 3. Remaining 8 cases were malignant tumors and among which osteogenic sarcoma was the commonest one. 4. The majority of tumors [22/24] were developed from the rib and the remains were from the sternum. 5. Common manifestation were palpable mass or swelling and localized tenderness. 6. Various kinds of operative procedure were underwent: single resection of rib including tumor,14 cases; multiple resection of ribs with chemotherapy or myoplasty, 2 cases; en-bloc resection of the chest wall and reconstructive procedure, 5 cases; partial resection of sternum, 1 case; bone biopsy and chemotherapy, 2 cases.

  • PDF

Functioning Parathyroid Carcinoma - A Case Report - (기능성 부갑상선암)

  • Lim Dae-Jin;Choi Jin-Sub;Han Jee-Young;Lim Seung-Kil;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.9 no.1
    • /
    • pp.56-62
    • /
    • 1993
  • The parathyroid carcinoma is a rare cause of primary hyperparathyroidism. There was approximately 170 reports in the would literature. and only two documented cases in Korean literature. It is still difficult to distinguish. histologically, benign from malignant parathyroid tumors. However, if diagnotic criteria are that strict, it can be suscessfully cured by initial operation. The initial operation should be an en bloc resection of the tumor, avoiding rupture of the tumor capsule and spillage of tumor cells. This report details the management of a 51 year old female with functioning parathyroid carcinoma who underwent an en bloc resection of the tumor at the time of initial operation.

  • PDF

Osteoid Osteoma of the Thoracic Spine - Case Report - (흉추에 발생한 유골 골종 - 증례보고 -)

  • Yun, Byung Min;Rhim, Seung Chul;Roh, Sung Woo
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.2
    • /
    • pp.291-295
    • /
    • 2000
  • A 22-year-old man is presented with 3 months' history of dull pain on the lower thoracic area. Imaging studies suggested osteoid osteoma of 11th thoracic spine, which was verified pathologically after en bloc resection through transfacetal approach. The patient's preoperative pain was resolved immediately. We emphasize the importance of early diagnosis and complete surgical excision of tumor nidus.

  • PDF