• Title/Summary/Keyword: surgical margins

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Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

  • Kim, Sin Rak;Lee, Jung Woo;Han, Yea Sik;Kim, Han Kyu
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.17-23
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    • 2015
  • Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.

Outcomes of grafted skin on the dorsum of the foot after car-tire friction injuries

  • Kim, Shin Hyun;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.678-684
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    • 2021
  • Background A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scarring of the wound margins. This study describes the clinical appearance of the injured areas and surgical complications that occurred during the follow-up period in a series of children with car-tire friction injuries who were treated with split-thickness skin grafts (STSGs). We describe the clinical features that we believe need to be highlighted when initially treating car-tire injuries in children. Methods From May 2003 to June 2016, our retrospective study included 15 patients with car-tire injuries on the dorsum of the foot who were treated with surgical excision and STSG to cover the wound. Results A total of 15 patients with car-tire injuries were treated. The average age was 6.26 years old. The average injury grade was 3.26. Two patients were treated using delayed repair, and 13 patients received STSG for initial management. Four patients experienced no complications, while 11 patients had hypertrophic scars and/or scar contracture after surgery. Conclusions A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scar formation or scar contracture even if proper management is undertaken. Since the occurrence of these complications in childhood can lead to a secondary deformity, it is important to properly treat car-tire friction wounds, inform patients and caregivers about potential complications, and ensure regular follow-up evaluations over a 12-month period following the initial surgery.

Extramedullary Plasmacytoma on Unilateral Upper Eyelid in a Shih-Tzu Dog

  • Junyeong Ahn;Jeong-Seop Oh;Hyelin Kim;Nayoung Lee;Kangmoon Seo;Seonmi Kang
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.158-163
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    • 2023
  • A 9-year-old spayed female Shih-Tzu was presented with a mass on the upper eyelid of the right eye (OD). The eyelid mass continued to enlarge along the eyelid margin and the eyelid skin. Throughout the follow-up examinations, the mass did not affect the palpebral conjunctiva OD. Until 9 months since the mass was first identified, the dog did not show any clinical signs related to the mass. However, after 11 months, the owner complained of the dog's discomfort on OD and decided on surgical excision of the mass. There were no abnormalities in the complete blood count and serum chemistry profiles. The pentagonal resection was performed to completely remove the mass in the eyelid. There were no suspicious findings of metastasis on whole-body computed tomography scan immediately before the surgery. On histopathology and immunohistochemistry for multiple myeloma oncogene-1, the eyelid mass was diagnosed as extramedullary plasmacytoma (EMP). Surgical margin of the mass was clearly cut. No recurrence was observed during the 5-month follow-up. EMPs on the eyelid have rarely been reported in dogs. Although EMP is a benign tumor, the mass showed invasive growth and grew toward the skin rather than the palpebral conjunctiva. No recurrence occurred when surgically removed with clean margins.

Two Cases of Adenoid Cystic Carcinoma of Trachea (기관내 선양낭성암종 2예)

  • Yum, Ho-Kee;Ahan, Jin-Chul;Song, Yeong-Soo;Kim, Joo-In;Yoon, Hye-Kyoung;Jeon, Woo-Ki;Choi, Soo-Jeon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.387-393
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    • 1995
  • Adenoid cystic carcinoma formerly called cylindroma is rare tracheal tumor. Characteristics of adenoid cystic carcinoma are infiltrative nature with local recurrence tendency and long natural course of the disease. Adenoid cystic carcinomas develop most commonly in the trachea. Primary resection and end-to-end anastomosis of the involved airway are treatment of choice. And postoperative radiation therapy might be useful, particularly when the surgical margins are not ample. We report two cases of adenoid cystic carcinoma of trachea diagnosed by flow-volume curve.

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Clinicopathological Features and Localization of Gastric Cancers and their Effects on Survival in Turkey

  • Selcukbiricik, Fatih;Tural, Deniz;Bilici, Ahmet;Uzel, Esengul Kocak;Ozguroglu, Mustafa;Demirelli, Fuat;Buyukunal, Evin;Serdengecti, Suheyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.553-556
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    • 2013
  • Background: This study was designed to examine changing trends in localization of gastric cancer in Turkey in recent years. Materials and Methods: A total of 796 adult patients with newly diagnosed, histologically proven adenocarcinomas, treated and followed up at our oncology center between 2000-2011, were examined retrospectively. In all cases tumor localization were identified and recorded with clinicopathological features. Results: The median age was 58 with a range between 22-90 for the 552 men and 244 women. Median follow up was 12 months (1-276) and median overall survival was also 12 months (11.5-12.4). There was a trend for a change in tumor localization from distal to proximal. Survival of patients was low with advanced T and N stage tumours. Positive surgical margins, lymphovascular invasion, perineural invasion, cardioesophageal localization were predisposition factors for metastatic disease in gastric cancer. There was no relation between age or sex and histopathological type of gastric cancer. Conclusions: There is a trend in our country for a change in gastric tumour localization from distal to proximal, with clear significance for treatment choices.

Concurrent Robot-Assisted Distal Gastrectomy and Partial Nephrectomy for Synchronous Early Gastric Cancer and Renal Cell Carcinoma: An Initial Experience

  • Kim, Jieun;Kim, Su Mi;Seo, Jeong Eun;Choi, Min Gew;Lee, Jun Ho;Sohn, Tae Sung;Kim, Sung;Bae, Jae Moon;Seo, Seong Il
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.211-214
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    • 2014
  • We report our experience of a concurrent robot assisted distal gastrectomy and partial nephrectomy for synchronous early gastric cancer and renal cell carcinoma. A 55-year-old female patient was diagnosed with early gastric cancer on screening endoscopy. Abdominal computed tomography showed an incidental right renal cell carcinoma. Robot assisted distal gastrectomy was performed, followed by partial nephrectomy. The final pathological examination showed signet ring cell carcinoma within the lamina propria and renal cell carcinoma with negative resection margins. The patient showed no evidence of recurrence at 6-months. A robot-assisted combined operation could be a treatment option for early stages of synchronous malignancies.

Desmoplastic Trichilemmoma Arising in a Nevus Sebaceus (지선모반에서 발생한 결합조직형성 모종)

  • Shim, Hyung Sup;Jung, Sung-No;Kwon, Ho;Yim, Young Min;Lee, Eun Jung
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.107-109
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    • 2008
  • Purpose: Desmoplastic trichilemmoma is a rare variant of trichilemmoma. Histologically, it has a typical characteristic of trichilemmoma with epithelium of central portion and dense fibrous interstitium. There are only 4 reported cases of desmoplastic trichilemmoma arised in a nevus sebaceus, so we present a case of desmoplastic trichilemmoma arised in a nevus sebaceus with literature review.Methods: A 46-year-old female was clinically diagnosed as nevus sebaceous on left side of the forehead. Considering the facial contour, the mass was totally excised elliptically and direct closure was feasible with undermining subcutaneous layer.Results: Pathology report confirmed desmoplastic trichilemmoma developed from a nevus sebaceus and all tumor margins were negative. There were no evidences of tumor recurrence after surgical treatment.Conclusion: Desmoplastic trichilemmoma developed from a nevus sebaceus is a very rare tumor. Variant tumors can be developed from nevus sebaceus, so surgeon should be cautious in excising the mass totally and confirm the final pathology report.

Alterations of the soft tissue dimensions around implant-supported singletooth replacements in the maxillary anterior region - A retrospective longitudinal study - (상악 전치부 임플란트지지 수복금관의 주변 연조직 제원 변화에 관한 누년적 연구)

  • Chang, Moon-taek
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.507-517
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    • 1998
  • This study was performed to investigate the soft tissue changes around single implant-supported crowns during followup periods. Twenty patients(31 implants) whose single missing tooth in the maxillary anterior region had been replaced with an single implant-supported crown were recruited for the study. Crown length, soft tissue level and papilla height at the single implant-supported crowns were measured at follow-up examination and calculated from the slides taken at time of crown placement. as well Papilla index was scored from the slides taken at the time of crown placement and follow-up examination. A very little amount of recession occurred and the soft tissue level moved more apically and the papilla height increased significantly (p<0.01). Especially, both mesial and distal papilla index at single implant-supported crowns increased significantly during follow-up periods (p<0.001). When the two slides taken at the time of crown placement and follow-up were compared simultaneously, except one site, papillae size increased at all sites. From the results of the study, the interdental papillae at the single implant-supported crowns seemed to regenerate significantly and their crown margins were stable during follow-up periods. Hence it is indicated that various surgical interventions at on early stage to enhance soft tissue esthetics arourd single implants may be unnecessary.

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Clinical Experience of Basosquamous Cell Carcinoma (기저편평세포암의 치험례)

  • Kim, Hyun-Sung;Kim, Chul-Han
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.490-493
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    • 2011
  • Purpose: Basosquamous carcinoma is a rare malignancy, with features of both basal cell carcinoma and squamous cell carcinoma. It is considered as aggressive tumor with a high risk of recurrence and metastases. Authors report a case of basosquamous cell carcinoma. Methods: A 72 year-old man, who had an erythematous ulcer on his left auricle, described a slow growing lesion, starting at the posterior surface of the superior helix with a steady increase in size during the past 10 years. At operation, auricular cartilage was grossly invaded by the tumor and was, therefore, amputated with tumor-free margins. Results: Histopathologic examination was revealed a basosquamous cell carcinoma. On positron emission tomography/computed tomography (PET/CT) and neck CT were negative for signs of further nodal involvement or metastases to other organs. At follow-up 6 months later, his wounds were noted to be well healed, with no evidence of local recurrence or identifiable metastases. Conclusion: Because basosquamous cell carcinoma has a significant potential to recur and metastasize, surgical excision for this type of carcinoma should be more extensive than that performed for conventional basal cell carcinoma or squamous cell carcinoma. In addition, regional lymph nodes should be monitored and close follow-up should be carried out.

A new flap combination for reconstruction of lower nasal dorsum and supra-tip skin defects

  • Guesnier, Melanie;Claveleau, Xavier;Longeac, Marielle;Barthelemy, Isabelle;Dang, Nathalie Pham;Depeyre, Arnaud
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.480-483
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    • 2019
  • Repairing surgical defects of the nose is still challenging due to its tridimensional shape and its aesthetic concern. Difficulty in reconstructing nasal subunits lies in their contour, skin texture and limited availability of adjacent skin. For lower nasal dorsum and supra-tip regions, we design a new combined local flap as existing local flaps may give disappointing results. This combination flap was performed on two patients for reconstruction of the lower nasal dorsum area after basal cell carcinoma excision. Size of the excision ranged from 20 to 25 mm diameter and safe margins were obtained. The defects were reconstructed with a local flap that combined a rotation nasal flank flap and a V-Y advancement nasolabial flap. Excision and reconstruction were performed in a one-stage surgery under intravenous sedation and local anesthesia. There were no postoperative complications and no flap loss occurred. Aesthetic and functional results after 6 months postoperatively were satisfying without modification of nasal shape. This flap is reliable and offers interesting functional and aesthetic outcomes. It can be considered as a new reconstruction alternative for supra-tip and lower nasal dorsum skin defects performed in a one-stage procedure under local anesthesia.