• Title/Summary/Keyword: Surgical enucleation

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Retrospective Analysis of Thoracoscopic Surgery for Esophageal Submucosal Tumors

  • Kang, Seung Ku;Yun, Ju Sik;Kim, Sang Hyung;Song, Sang Yun;Jung, Yochun;Na, Kook Joo
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.40-45
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    • 2015
  • Background: Surgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs. Methods: We retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed. Results: There were 36 males (67.9%) and 17 females (32.1%); the mean age was $49.2{\pm}11.8$ years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant ($120.0{\pm}45.6$ minutes vs. $161.5{\pm}71.1$ minutes, p=0.08). A significant difference was found in the length of the hospital stay ($9.0{\pm}3.2$ days vs. $16.5{\pm}5.4$ days, p<0.001). Conclusion: The thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.

EFFECT ON THE ENUCLEATION OF THE INTRAOSSEOUS AMELOBLASTOMA (골내 법랑아세포종의 적출술 후 치료효과)

  • Kim, Hee-Kyeong;Lee, Eui-Wung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.140-144
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    • 2003
  • Ameloblastoma is cytologically a benign tumor, but is clinically characterized by infiltrative growth and high recurrency. The criteria for surgical treatment of ameloblastoma has not yet established and it is generally accepted that ameloblastoma be treated differently based on clinical types. The purpose of this paper is to consider effectiveness of enucleation in large-sized intraosseous ameloblastoma that has treated more frequently by radical treatment. 39 cases of the intraosseous ameloblastomas were treated by enucleation in the department of oral and maxillofacial surgery of Yonsei University, dental college from February 1990 to January 2001. 25 cases were selected because they were large in size that could produce facial disfigurement or pathologic fracture of jaws. They were radiographically characterized by the cortical bone that was expanded or eroded locally and histopathologically by 19 solid ameloblastomas and 6 intramural type of unicystic ameloblastomas. Among the 25 cases, 4 cases - 3 solid ameloblastomas and 1 intramural type of ameloblastoma - recurred. Recurrence rate was 16%. The compact bone which is not invaded by ameloblastoma was used as surgical margin of enucleation with accompanying chemical cauterization for killing the residual tumor cells. This may have been the reason for the low recurrence rate. So, it is considered that enucleation and long-term follow-up enable the large-sized intraosseous ameloblastomas that were characterized by almost destroyed cancellous bone and expanded or discontinued cortical bone to treat minimizing facial disfigurement and masticatory dysfunction and sociopsychological impact produced by radical treatment. I recommend that the large-sized intraosseous ameloblastomas without involvement to the surrounding soft tissues be first treated by enucleation.

Conservative surgical treatment for ameloblastoma: a report of three cases

  • Kim, Se-Won;Jee, Yu-Jin;Lee, Deok-Won;Kim, Hyung Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.242-247
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    • 2018
  • Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.

A COMPARATIVE CLINICAL STUDY ON DECOMPRESSION AND ENUCLEATION TO TREAT CYSTIC LESIONS OF THE JAWS (악골내 낭종성 병소의 감압술과 적출술에 관한 임상적 연구)

  • Jung, Young-Soo;Paek, Song-Hum;Lee, Eui-Wung;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.43-48
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    • 2004
  • Purpose: Among the various surgical methods used for the effective treatment of cystic lesion in the jaws historically, decompression procedure has some of superior prognosis compare to direct enucleation. In order to propose the efficacy of decompression we performed this retrospective study to compare decompression procedure with one-stage enucleation in clinical results and prognosis. Patients and Methods: We reviewed 175 patients who had been histopathologically diagnosed cystic lesions from 1996 to 2000 in our department. Patients who had been received decompression alone or secondary enucleation after decompression were 31 cases, and enucleation alone were 144 cases. The age and sex of the patients, the area, size, and histological type of the lesions, and detailed operation and complications including recurrence were investigated. The minimal follow-up period was 2 years. Results: In 31cases of decompression, male patients were 22cases(71%) similar to male predilection(62.3%) in total 175 cases. Cystic lesions were developed evenly in all age groups totally. Decompression was mainly performed in teenagers but enucleation was used in elder decades. In decompression cases the lesions were located in mandibular posterior, maxillary posterior, mandibular anterior, and maxillary anterior in order, which had some differences in total and enucleation cases. In enucleation cases, less than 3cm in size was 77.1% but larger than 3cm was 93.5% in decompression cases. Histopathologically, dentigerous cysts(54.8%), unicystic ameloblastomas(16.1%), and odontogenic keratocysts(12.9%) were seen in decompression cases and no recurrence or metaplasia and infection was observed. On the other hand, permanent tooth loss, numbness, recurrence, and so on were accompanied after enucleation. Conclusion: Although decompression procedure has disadvantages such as many of visiting times and slow recovery of the surgical defect, decompression is the best choice of treatment for large cystic lesions of the jaws, because it prevents functional and cosmetic defect, allows bone regeneration, and makes easy secondary enucleation.

Thoracoscopic Enucleation of Esophageal Leiomyoma (흉강경을 이용한 식도 평활근종의 절제)

  • 이성호
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.518-520
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    • 1995
  • Leiomyoma is the most common benign tumor of the esophagus,and surgical enucleation is the treatment of choice. Recently we successfully performed thoracoscopic enucleation of large esophageal leiomyoma without complication in one patient. The 46 years old male patient complained epigastric discomfort and showed a submucosal mass in lower esophagus under the endoscopic ultrasonography . During operation minimal perforation occurred, it was closed with clipping without conversion to an open procedure.The tumor size was 8cm x 3cm x 1.5cm respectively. There were less post-operative pain,minimal wound size, and early recovery time.Patient was satisfactory these outcome. These result suggest that esophageal enucleation was performed more large size benign tumor and esophageal perforation during operation was treated thoracoscopically.

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CASE REPORT OF DENTIGEROUS CYST OF MANDIBLE TREATE BY ENUCLEATION (하악골에 발생한 함치성양종의 치험예)

  • Choie, Mok-Kyun;Bae, Chang;Kim, Suck-Kyun
    • The Journal of the Korean dental association
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    • v.16 no.11 s.114
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    • pp.857-860
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    • 1978
  • An instance of dentigerous cyst, 6×2.5×1.5cm, occurred in posterior region of the right mandible, originated from 3rd molar, involved the 2nd premolar, 1st and 2nd molar in a 38-year-old man was observed and surgical enucleation followed by careful excision of all cyst wall was successfully carried out, recovery and healing were rapid and uncomplicated.

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Anatomical endoscopic enucleation of the prostate for bladder outlet obstruction: a narrative review

  • Kim, Tae Hyo;Song, Phil Hyun
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.12-17
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    • 2022
  • Anatomical endoscopic enucleation of the prostate (AEEP) differs from other endoscopic modalities for bladder outlet obstruction (BOO) because it extracts the whole benign prostatic hyperplasia component. AEEP has been launched for almost 40 years as a first-line treatment method for BOO regardless of prostate size according to several guidelines. However, it remains underperformed worldwide. In this review article, we elaborate on the advantages and disadvantages of AEEP compared to other surgical modalities for BOO to investigate its efficacy and safety as a gold standard surgical management option for males with BOO.

Delayed treatment of traumatic eyeball dislocation into the maxillary sinus and treatment algorithm: a case report and literature review

  • Hoon Kim;Keun Hyung Kim;In Chang Koh;Ga Hyun Lee;Soo Yeon Lim
    • Archives of Craniofacial Surgery
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    • v.25 no.1
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    • pp.31-37
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    • 2024
  • Orbital floor fractures are commonly encountered, but the dislocation of the eyeball into the maxillary sinus is relatively rare. When it does occur, globe dislocation can have serious consequences, including vision loss, enucleation, and orbito-ocular deformity. Immediate surgical intervention is typically attempted when possible. However, severe comorbidities and poor general health can delay necessary surgery. In this report, we present the surgical outcomes of a 70-year-old woman who received delayed treatment for traumatic eyeball dislocation into the maxillary sinus due to a subarachnoid hemorrhage and hemopneumothorax. Additionally, we propose a treatment algorithm based on our clinical experience and a review of the literature.

Surgical treatment of esophageal submucosal tumor (식도의 양성 점막하 종양의 수술적 치료)

  • Noh, Dong-Sub;Park, Chang-Kwon;Keum, Dong-Yoon;Kim, Jae-Bum
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.24-27
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    • 2009
  • Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

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Incidentally detected odontoma within a dentigerous cyst

  • Kim, Kwang Seog;Lee, Han Gyeol;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.62-65
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    • 2019
  • Odontoma is an asymptomatic slow-growing odontogenic tumor. It is usually found by chance in the maxilla or mandible on radiography, or when it deforms the adjacent teeth. It is commonly found in patients who are 30 years of age or younger. We report our encounter with an odontoma within a dentigerous cyst found incidentally in a 56-year-old man. He presented with abnormal fullness in the right infraorbital area of the cheek. During the evaluation of the mass, we incidentally detected the odontogenic tumor within a dentigerous cyst in the patient's maxilla. Under general anesthesia, complete surgical drainage of the infraorbital cystic mass was performed. Enucleation of the odontogenic tumor and a bone grafting from the iliac bone were also performed. The final diagnosis was odontoma. After 2 years of follow-up, there was no sign of recurrence of the tumor. In case of odontogenic tumors, even in old patients, it is important to suspect an odontoma. When odontoma accompanies a dentigerous cyst, surgical excisional biopsy should be performed to rule out malignancy. In case of a large bony defect after enucleation, autogenous bone grafting is essential for reconstruction.