Bidirectional Barbed Suture in Total Laparoscopic Hysterectomy and Lymph Node Dissection for Endometrial Cancer: Technical Evaluation and 1-Year Follow-Up of 61 Patients

2013 ◽  
Vol 23 (4) ◽  
pp. 347-350 ◽  
Author(s):  
Mario Ardovino ◽  
Maria Antonietta Castaldi ◽  
Fernando Fraternali ◽  
Italo Ardovino ◽  
Lavinia Mosca ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Barbed Suture ◽  
Node Dissection ◽  
Technical Evaluation

Isolated same-basin lymph node recurrence after precision lymph node excision for clinically evident melanoma metastasis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9576-9576
Author(s):  
Kevin Lynch ◽  
Yinin Hu ◽  
Norma Farrow ◽  
Yun Song ◽  
Max Meneveau ◽  
...  
Keyword(s):  
Lymph Node ◽  
Disease Control ◽  
Lymph Node Dissection ◽  
Patient Preference ◽  
Distant Metastases ◽  
Node Dissection ◽  
Melanoma Patients ◽  
Regional Disease ◽  
In Transit

9576 Background: While management of the nodal basin for melanoma has largely moved to observation for microscopic sentinel lymph node (SLN) metastasis, complete lymph node dissection (CLND) remains the current standard of care for melanoma patients with macroscopic, clinically detectable lymph node metastases (cLN). As CLND is associated with high surgical morbidity, we sought to study whether cLN may be safely managed by excision of only clinically abnormal nodes (precision lymph node dissection, PLND). Currently, a small subset of patients with cLN do not undergo CLND because of frailty or patient preference. We hypothesized that in these selected patients, PLND would provide acceptable regional control rates. Methods: Retrospective chart review was conducted at four academic tertiary care hospitals to identify melanoma patients who underwent PLND for cLN. cLN were defined as palpable or radiographically abnormal nodes. Recurrences were categorized as local/in-transit, same-basin lymph node, or distal lymph node/visceral. The primary outcome was isolated same-basin recurrence after PLND. Results: Twenty-one patients underwent PLND for cLN without synchronous distant metastases (characteristics of primary lesions summarized in Table). Reasons for forgoing CLND included patient preference (n=8), imaging indeterminate for distant metastases (n=2), comorbidities (n=4), loss to follow up (n=1), partial response to checkpoint blockade (n=1), or not reported (n=5). The inguinal node basin was the most common site (n=10), followed by the axillary (n=8) and cervical basins (n=3). A median of 2 nodes were resected at PLND, and 68% of resected nodes were positive for melanoma (median: 1, range: 1-3 nodes). Median follow-up was 23 months from PLND, and recurrence was observed in 28.6% of patients overall. Only 1 patient (4.8%) developed an isolated same-basin recurrence. The 3-year cumulative incidence of isolated same-basin recurrence was 5.3%, while risk of isolated local/in-transit recurrence or distant basin/visceral metastasis were 19.8% and 33.3%, respectively. Complications from PLND were reported in 1 patient (4.8%) and were limited to post-operative seroma and lymphedema. Conclusions: These pilot data suggest that PLND may offer acceptable regional disease control for cLN. Post-operative morbidity from PLND was also low, raising the possibility that PLND may provide adequate regional disease control without the morbidity associated with CLND. These data justify additional, prospective evaluation of PLND in selected patients.[Table: see text]

scholarly journals Overlap Anastomosis for Digestive Reconstruction during Laparoscopic Distal Gastrectomy with Intensive Regional Lymph Node Dissection: Physiological Impact of Preserving the Mesenteric Autonomic Nerves in the Lifted Jejunal Limb

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Taku Kitano ◽  
Daiki Yasukawa ◽  
Yuki Aisu ◽  
Tomohide Hori
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Distal Gastrectomy ◽  
Surgical Techniques ◽  
Laparoscopic Distal Gastrectomy ◽  
Autonomic Nerve ◽  
Autonomic Nerves ◽  
Node Dissection ◽  
Regional Lymph Node Dissection

Laparoscopic gastrectomy is a treatment for gastric cancer, and isoperistaltic side-to-side reconstruction is called “overlap anastomosis.” The physiological advantages of preserving the autonomic nerves in the jejunal limb for digestive reconstruction are well known. Here, we focused on overlap anastomosis with autonomic nerve-preserved mesojejunum of the lifted jejunal limb for laparoscopic distal gastrectomy with intentional lymph node dissection. Our surgical techniques and technical pitfalls were described in detail. The jejunum was partially sacrificed to preserve the autonomic nerves in the lifted jejunal limb. The length of the staple line was 35 – 40 mm. The endostapler entry was carefully closed to avoid even subtle stenosis. Twelve patients were retrospectively evaluated with a follow-up of 5.0 ± 0.6 years. Histological findings according to the Japanese classification were stage IA or IB. Dietary intake and postoperative ambulation occurred at 3.3 ± 1.0 and 1.3 ± 0.5 days after surgery, respectively. Postoperative complications according to Clavien–Dindo classification were one each of grade I and grade II. Postoperative hospital stay was 6.7 ± 1.6 days. Five patients were medication-free at final follow-up, with no recurrence in any patient. Overlap anastomosis with autonomic nerve-preserved jejunal limb was safe and feasible for laparoscopic distal gastrectomy with lymph node dissection.

The Influence of Radiation Modality and Lymph Node Dissection on Survival in Early-Stage Endometrial Cancer

2012 ◽  
Vol 82 (5) ◽  
pp. 1872-1879 ◽  
Author(s):  
Junzo P. Chino ◽  
Ellen Jones ◽  
Andrew Berchuck ◽  
Angeles Alvarez Secord ◽  
Laura J. Havrilesky
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Node Dissection ◽  
Early Stage Endometrial Cancer
Sign in / Sign up

Export Citation Format

Share Document