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1.
Folia Med (Plovdiv) ; 65(4): 577-581, 2023 Aug 31.
Article in English | MEDLINE | ID: mdl-37655375

ABSTRACT

INTRODUCTION: Totally implantable access ports (TIAPs) are commonly used in oncologic patients undergoing ongoing chemotherapy. The methods of choice for implantation are the subclavian vein puncture approach and the cephalic vein cutdown technique, followed by internal jugular vein access and external jugular vein access.


Subject(s)
Jugular Veins , Venous Cutdown , Humans , Jugular Veins/surgery , Patients , Prostheses and Implants , Punctures
2.
J Minim Access Surg ; 19(2): 317-319, 2023.
Article in English | MEDLINE | ID: mdl-36124471

ABSTRACT

Hydatid cyst disease is a parasitic disease caused by a type of tapeworm called Echinococcus. It is endemic to cattle-rearing regions of Africa, Asia, South Europe, the Mediterranean, the Middle East and Australia. The most common site of infection is the liver (75%). Involvement of the spleen is rare and occurs in 5% of the cases. Solitary splenic cysts are even rarer (0.5%-4%). We present a case of solitary hydatid cyst of the spleen in a 47-year-old woman. The cyst was asymptomatic and an accidental find on a full-body computed tomography after epileptic seizure and body trauma. The condition was treated successfully with albendazole, but the patient requested the cyst removed. Laparoscopic splenectomy was performed. The specimen was placed in an Endo-Bag and extracted. The patient recuperated well and was discharged on the post-operative day 5. Six months after the procedure, the patient has no complaints.

3.
JSLS ; 26(3)2022.
Article in English | MEDLINE | ID: mdl-35967960

ABSTRACT

Background: The aim of this prospective study was to determine the effect of mesenteric vascular evaluation using pre-operative multidetector computed tomography angiography (MDCTA) and intraoperative indocyanine green (ICG) angiography on reducing the anastomotic leak rate of colorectal cancer patients undergoing minimally invasive resection. Methods: Twenty-seven consecutive patients with colorectal cancer were studied, 18 males and 9 females, average age 69.1 ± 3.9 years. All patients underwent pre-operative mesenteric vascular evaluation using MDCTA with three-dimensional (3D) reconstruction and intraoperative evaluation of perfusion using ICG angiography. Twelve patients underwent laparoscopic resection (Olympus Visera Elite II OTV-S200) and 15 patients underwent robotic resection (DaVinci Si). Colorectal resection lines and anastomoses were guided by intraoperative ICG perfusion. Postoperative anastomotic leaks were assessed. Results: Pre-operative MDCTA 3D reconstructions defined the left colic and sigmoid artery anatomy and guided operative planning. The intraoperative ICG angiography resulted in a change of the planned lines of resection in seven patients (26%). The rate of postoperative anastomotic leaks in this study was 0% (0/27), compared to a leak rate of 6.8% at our institution in the preceding two years. Conclusion: Pre-operative evaluation of mesenteric vascular anatomy using MDCTA with 3D reconstruction and intraoperative evaluation of perfusion using ICG angiography were found to be technically feasible and safe. An appropriately designed study should be undertaken to prove whether it was truly effective at reducing the postoperative anastomotic leak rate in colorectal cancer patients undergoing minimally invasive resection at our institution.


Subject(s)
Colorectal Neoplasms , Laparoscopy , Aged , Anastomosis, Surgical/methods , Anastomotic Leak/prevention & control , Anastomotic Leak/surgery , Colorectal Neoplasms/surgery , Female , Fluorescein Angiography/methods , Humans , Indocyanine Green , Male , Multidetector Computed Tomography , Prospective Studies
4.
Int J Hyperthermia ; 38(2): 75-80, 2021 09.
Article in English | MEDLINE | ID: mdl-34420446

ABSTRACT

INTRODUCTION: Pancreatic cancer is with the poorest prognosis of all common cancers worldwide. Despite the advances in treatment the results are poor throughout the different methods. Pancreatic resection still yields the best outcome. However only a quarter of the patients present at operable stage. HIFU is a noninvasive technique that can be used to treat pancreatic cancer. AIM: The aim of this review is to perform a systematic review on the data about the resection rate after HIFU ablation in patients with borderline resectable pancreatic cancer (BRPC) and the impact of this technique over the oncological results. MATERIALS AND METHODS: The PubMed and Wanfang databases were searched using keywords: pancreatic cancer, HIFU ablation and high-intensity focused ultrasound. All found articles were reviewed. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard guidelines. This study was financially supported by 2019 'Kuan-Ren Elite' Program of 2nd Affiliated Hospital of Chongqing Medical University, China (Grant no. KY2019G019). RESULTS: The English database search showed 109 papers, of which 3 met the inclusion criteria. The Wanfang database resulted in 110 papers; however, none met the inclusion criteria of the review. From the included studies 97 patients underwent neoadjuvant HIFU ablation ± chemotherapy. Thirty-four patients reached resection (35.1%). In two patients, residual tumor (R) classification was not reported. R0 resection rate in all reported patients is 30.5% (29/95). R1 resection rate is 3.2% (3/95). CONCLUSION: HIFU is found to be safe and feasible in locally advanced and metastatic pancreatic cancer with proven downstaging and downsizing effects. Further research on role of HIFU ablation as a neoadjuvant treatment for borderline resectable pancreatic cancer is needed.


Subject(s)
High-Intensity Focused Ultrasound Ablation , Pancreatic Neoplasms , China , Humans , Neoadjuvant Therapy , Pancreas , Pancreatic Neoplasms/surgery
5.
Med Ultrason ; 22(2): 247-249, 2020 May 11.
Article in English | MEDLINE | ID: mdl-32190856

ABSTRACT

We present a case of recurrent pancreatic cancer diagnosed by computer tomography (CT) and positron emission tomography(PET), 7 months after Whipple radical surgery in a 61-year-old female patient. The patient was successfully treated byfocused ultrasound surgery (FUS) by innovative high intensity focused ultrasound device. The patient had no complications.Multiple cycles of chemotherapy were done. Twelve months after FUS the new PET-CT showed no evidence of metabolite activezone in the area of ablation and no progression of disease. The presented case is unique according to the literature as a localrecurrence after radical surgery for pancreatic cancer, successfully managed by local FUS ablation and adjuvant chemotherapy.


Subject(s)
Chemotherapy, Adjuvant/methods , High-Intensity Focused Ultrasound Ablation/methods , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/surgery , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/surgery , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Pancreas/diagnostic imaging , Pancreas/surgery , Pancreatic Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Treatment Outcome
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