• Title/Summary/Keyword: Palliative surgery

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The Rare and Challenging Presentation of Gastric Cancer during Pregnancy: A Report of Three Cases

  • Pacheco, Sergio;Norero, Enrique;Canales, Claudio;Martinez, Jose Miguel;Herrera, Maria Elisa;Munoz, Carolina;Jarufe, Nicolas
    • Journal of Gastric Cancer
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    • v.16 no.4
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    • pp.271-276
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    • 2016
  • Pregnancy-associated gastric cancer is extremely rare. In many cases, it is diagnosed at an advanced stage because the symptoms during pregnancy are generally overlooked. We report three cases of gastric cancer during pregnancy with various outcomes. The first case included a patient with stage IV gastric cancer who received palliative chemotherapy. This patient had a preterm birth and died 7 months after diagnosis. The second case received neoadjuvant chemotherapy during pregnancy and a total gastrectomy was performed after delivery. She then received adjuvant chemoradiotherapy. This patient developed pulmonary metastasis and died of recurrence 41 months after surgery. In the third case, a distal subtotal gastrectomy was performed at week 14 of pregnancy, with no complications. The patient received adjuvant chemoradiotherapy. She is currently without recurrence 14 months after surgery. In patients with pregnancy-associated gastric cancer, treatment decisions are predominantly influenced by clinical stage and gestational age at diagnosis.

Reoperation for congenital heart disease (선천성 심장기형에 대한 2차수술로서의 개심술)

  • Ahn, H.;Sung, S.W.;Kim, Y.J.;Roh, J.R.;Suh, K.P.
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.280-287
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    • 1986
  • Between March 1978 and August 1985, 29 cases at various congenital heart diseases were reoperated because of remnant shunt of residual anomalies at Seoul National University Hospital. They were consisted of 10 cases of Tetralogy, 4 simple VSD, 6 complicated VSD. 3 partial ECD, and 5 other rare congenital anomalies. The interval between the initial and the second procedure ranged from 1 day to 122 months [mean; 26.9 months]. In 4 cases of them, the second procedure was done during initial hospitalization within 3 weeks post-operatively. The primary operation intended to be corrective surgery except four whose primary operation was palliative or exploratory one even though it was done with extracorporeal circulation. The indication for second operation was mainly residual shunt or valvular obstruction due to patch detachment or inadequate relief of stenotic lesion. Others were paravalvular leak, valvuloplasty failure, prosthetic valve failure, and inadequate primary diagnosis. Four patients were dead [14.3%]; three complicated VSD`s and one Tetralogy. There were 7 cases of nonfatal complication with subsequent improvement except one [diffuse cerebral dysfunction].

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A Case of Oncocytic Carcinoma Arising in the Submandibular Gland (악하선에 발생한 호산성 세포암종 1예)

  • Shin, Seung-Kuk;Lee, Young-Ok;Lee, Byung-Joo;Lim, Yun-Sung
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.55 no.3
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    • pp.173-176
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    • 2012
  • Oncocytic neoplasm of the head and neck region accounts for approximately 1% of all salivary gland tumors, but only 5% of oncocytic neoplasm is malignant. Oncocytic carcinoma arising in the submandibular gland is exceedingly rare. We encountered a sixty seven-year-old male patient who presented with multiple mass in the right neck. Fine needle aspiration biopsy revealed a salivary gland tumor of predominantly oncocytic form, and a differential diagnosis included oncocytic adenoma or mucoepidermoid carcinoma. A right submandibular gland resection and modified radical neck dissection were performed. Histologically, the tumor cells showed nuclear pleomorphism, and stromal invasion, which were compatible with oncocytic carcinoma. After surgery, the entire neck region was irradiated. Seventeen months after the initial surgery, multiple metastases to the bone and lung were detected from the incidental pathologic bone fracture of the right humerus; palliative chemotherapy was performed to resolve this. We report a case of oncocytic carcinoma in the submandibular gland with a review of literature.

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Gastric Cancer Patients with Peritoneal Metastasis (PM): Results of a Single-Center Experience and Register Study

  • Gockel, Ines;Jansen-Winkeln, Boris;Haase, Linda;Rhode, Philipp;Mehdorn, Matthias;Niebisch, Stefan;Moulla, Yusef;Lyros, Orestis;Lordick, Florian;Schierle, Katrin;Wittekind, Christian;Thieme, Rene
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.379-391
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    • 2018
  • Purpose: Gastric cancer (GC) patients with peritoneal metastasis (PM) have poor prognosis. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in combination with systemic chemotherapy is a novel treatment option for patients in stage IV of the disease. Materials and Methods: Between November 2015 and June 2018, prospective data collection was performed in 24 patients with GC and PM (median age, 57; range, 44-75 years). These patients underwent 46 PIPAC procedures with a median number of 2 interventions per patient (range, 1-6). A laparoscopic access was used and a combined therapy of cisplatin and doxorubicin aerosol was administered. Results: The median peritoneal carcinomatosis index before the 1st PIPAC was 14 (range, 2-36), and the median ascites volume in patients before the 1st PIPAC was 100 mL (range, 0-6 mL, 300 mL). Eleven patients, who received 2 or more PIPAC procedures, had decreased and stable volumes of ascites, while only 3 patients displayed increasing volume of ascites. The median overall survival was 121 days (range, 66-625 days) after the 1st PIPAC procedure, while 8 patients who received more than 3 PIPAC procedures had a median survival of 450 days (range, 206-481 days) (P=0.0376). Conclusions: Our data show that PIPAC is safe and well tolerated, and that the production of ascites can be controlled by PIPAC in GC patients. Patients, who received 2 or more PIPAC procedures, reported a stable overall quality of life. Further studies are required to document the significance of PIPAC as a palliative multimodal therapy.

Primary Left Atrial Myxosarcoma -One case Report- (원발성 좌심실 점액육종 -1례 보고-)

  • Park, Cheul;Kim, Jong-Seok;Lee, Yeon-Jae;Kim, Han-Yong;Ryu, Byung-Ha;Kim, Jong-Kook;Kwon, O-Jun;Kim, Byung-Heon
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.861-864
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    • 2001
  • tumors. We report a primary cardiac myxosarcoma in a 40-year-old female patient who was admitted to the hospital because of exertional dyspnea and palpitation. The patient underwent emergency operation immediately after the intracardiac (left atrium) tumor was discovered by an echocardiography. Palliative tumor removal was done and final Pathologic diagnosis was primary cardiac myxosarcoma. She was discharged without complications.

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Clinical Outcomes of Surgically Managed Spontaneous Tumors in 114 Client-owned Dogs

  • Ji-Won Choi;Hun-Young Yoon;Soon-Wuk Jeong
    • IMMUNE NETWORK
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    • v.16 no.2
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    • pp.116-125
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    • 2016
  • Medical records of 139 tumors from 114 dogs that underwent surgery from May 2010 through March 2015 were retrospectively reviewed. Among 114 dogs, females (64.9%) were significantly more common than males (35.1%) (p<0.05). Dogs aged 6 to 10 years were more presented than non-tumor patients, however, there was no significant difference. The mean age (±SD) was 10.3±3.0 years. Although we found no significant difference of breed predisposition, the most common breed was Maltese (19.3%), followed by Shih-Tzu (14.0%), and Yorkshire terrier (13.2%). Proportional morbidity ratios (PMRs) of mammary gland, oral cavity, and skin tumors were high in Poodles, Yorkshire terriers, and Golden retrievers, respectively. Mammary gland (36.0%) was the most common site, followed by skin and soft tissues (12.2%), oral cavity (10.8%), and digestive organs (8.6%), but there was no significant difference. The objectives of surgery were curative surgery (86.2%), biopsy (4.9%), and palliative surgery (6.5%). In this study, 123 of 139 tumors had histopathological diagnoses. Adenocarcinoma was the most common type (n=24), followed by adenoma (n=17), soft tissue sarcoma (n=13), benign mixed tumor (n=5), and others (n=64). Recurrence or suspected metastasis was identified in 26 dogs. Median survival times of malignant mammary gland tumors, skin and subcutaneous tumors, and splenic tumors were 1,563.0±1,201.7, 469, and 128 days, respectively.

Clinical Analysis of Palliative Treatments in Occlusive Vascular Disease (폐쇄성 혈관 질환을 가진 환자의 고식적 치료에 관한 임상적 고찰)

  • 김학제;조원민;류세민;황재준;송영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.283-289
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    • 2002
  • Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

Transposition of great arteries [S.D.D.] with VSD and PS: report of an autopsy case (완전대혈관전위증 [S.D.D., Kidd type IV] 에 대한 Rastelli 수술 치험)

  • 이명희
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.331-337
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    • 1982
  • Complete TGA is a common congenital cardiovacular anomaly, and without palliative or corrective surgery, the infant born with TGA rarely survives the first year of life. Hemodynamically, recirculated blood flow in the systemic and pulmonary circuit has a key role in systemic arterial oxygen saturation and the status of the pulmonary vascular bed. Recently a d-TGA with VSD and PS, in a 12 year old male patient had been tried for inversion of the ventricular flow with Rastelli operation. An intracardiac tunnel was constructed between the VSD and the aortic orifice to connect the ventricle to the aorta. The right ventricle was connected with the pulmonary circulation by anastomosis of an valved conduit between the right ventricle and the distal end of the pulmonary artery. During the postop, period, the irreversible renal failure, accompanied by metabolic acidosis and pulmonary edema, occured under relative stabilized cardiac performance state. The autopsy was done, which revealed diffuse infarcted area in both kidney and preserved intra & extracardiac graft constructed.

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Pleural mesothelioma: report of 6 cases (늑막 중피세포종: 6례 보)

  • 권오춘
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.786-791
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    • 1984
  • Mesothelioma is relatively uncommon tumor compared to other thoracic tumors. It is interesting that there is a strong relationship between occurrence of malignant mesothelioma and exposure to asbestos, which was established during the last two decades. Malignant mesothelioma is discouraging in viewing its treatments and survival rates. Surgery with ancillary treatment, such as radiotherapy and chemotherapy, were still palliative, although encouraging results were reported. Between 1958 to 1983 at NMC, we have been experienced 6 cases of mesothelioma, confirmed by pathohistologic findings. The patients were distributed between 19 to 52 y-o age & were 5 males and 1 female. There was evidence of exposure to asbestos in 1 case. The method of operation were decortication [1], decortication with removal of tumor [1], pleuropneumonectomy with chemotherapy [1], chemotherapy [1], exploratory thoracotomy [1], and no treatment in 1 case due to private affairs. Histologic findings were 2 cases of benign mesothelioma type.

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Primary Tumors of the Chest Wall (원발성 흉벽종양)

  • 마중성;최병우;유회성
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.61-66
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    • 1974
  • Primary tumors of the chest wall are rare than those of other portions of the body. Soft tissue tumors of the chest wall, though these are benign or malignant, should not be paid special attentions about their management than other soft tissue tumors of the body. Thoracic skeletal tumors, however, have some problems in the treatment because of defect in chest wall leading to herniation of lung and paradoxical movement of thoracic cage. The authors experienced 10 case of primary chest wall tumors at the department of thoracic and cardiovascular surgery, the national medical center, during last 15 years. Five of 10 cases were soft tissue tumors, and they were 2 case of lipoma and each one case of myxosarcoma and leiomyosarcoma. Among 5 bone tumors there no cases of sternal tumor, and their histopathological diagnosis were each one of fibrous dysplasia, giant cell tumor, osteochondroma, Ewing`s sarcoma and osteogenic sarcoma. Wide excision, though it was palliative one in certain case, was performed in 9 cases and only diagnostic incisional biopsy in one case, There were no postoperative deaths during admission to the hospital and all cases were missed during short term follow up after discharge from the hospital.

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