Surgical Treatment of Intracardiac-Extending Intravenous Leiomyomatosis: A Single Center Experience

2016 ◽  
Vol 19 (3) ◽  
pp. 094
Author(s):  
Yang Li ◽  
Nan Yang ◽  
Long Lu ◽  
Fengxia Ma ◽  
Jianmin Yao
Keyword(s):  
Surgical Management ◽  
Circulatory Arrest ◽  
Pelvic Mass ◽  
Complete Removal ◽  
Complete Resection ◽  
Intravenous Leiomyomatosis ◽  
Hospital Data ◽  
Single Center Experience ◽  
Few Data

<strong>Background:</strong> Few data were known on surgical management of intracardiac-extending in patients with intravenous leiomyomatosis (IVL).<br /><strong>Methods:</strong> From June 2007 to December 2014, six women (mean age, 39.3 ± 7.5 years; range, 24-55 years) with intracardiac-extending IVL were treated surgically at our hospital. Data were obtained from medical and pathological records, including characteristics of patients, surgical management, and follow-up. <br /><strong>Results:</strong> Surgery was performed successfully in all patients. Of 6 patients, 4 underwent one-stage operation and 2 underwent two-stage procedures. Circulatory arrest with hypothermia was used for a cardiotomy combined with venotomy in <br />5 patients. Complete resection was done in 5 patients. There were no perioperative deaths or complications in any of the patients. Hospital stay was 11.2 ± 2.9 days (range 7-15 days). All patients were followed-up for a mean of 41.0 ± 19.1 months (range, 17-69 months) after surgery. A recurrence of pelvic mass was found in 1 patient, but no symptoms or intravenous mass were reported. No obstruction occurred in any patient with a venotomy.<br /><strong>Conclusion:</strong> Surgery is a better therapy for IVL and complete removal has favorable outcomes.

scholarly journals The surgical management of type IA endoleak after thoracic endovascular aortic repair

2020 ◽  
Vol 31 (3) ◽  
pp. 346-353
Author(s):  
Yaojun Dun ◽  
Yi Shi ◽  
Hongwei Guo ◽  
Yanxiang Liu ◽  
Xiangyang Qian ◽  
...  
Keyword(s):  
Surgical Management ◽  
Circulatory Arrest ◽  
Artery Bypass ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Elephant Trunk ◽  
Direct Closure ◽  
Aortic Repair ◽  
Type Ia

Abstract OBJECTIVES Our goal was to investigate the surgical strategy for type Ia endoleak after thoracic endovascular aortic repair (TEVAR) by reporting our experiences. METHODS From November 2012 to September 2019, a total of 23 patients received surgical management for type Ia endoleak after TEVAR. RESULTS The operations included total arch replacement with the frozen elephant trunk technique in 15 patients, direct closure of the endoleak in 2 patients, hybrid aortic arch repair in 4 patients, arch debranching with TEVAR in 1 patient and left common carotid artery to left subclavian artery bypass with TEVAR in 1 patient. Among 21 patients with cardiopulmonary bypass (CPB), the mean CPB and aortic cross-clamp times were 146.7 ± 42.2 and 81.0 ± 43.3 min, respectively. The selective cerebral perfusion time was 18.8 ± 8.2 min in 17 patients with hypothermic circulatory arrest. The in-hospital mortality was 8.7% (2/23). Type Ia endoleak was sealed successfully after surgery in 95.5% (21/22) of patients. The follow-up data were available for all 21 survivors. The median follow-up period was 18 months (range 1–84 months). During the follow-up period, a total of 8 patients died or had aortic events, including 5 deaths and 6 aortic events. CONCLUSIONS Different surgical strategies could be selected to treat patients with type Ia endoleak after TEVAR, with acceptable early and late outcomes.

Successful One-Stage Operative Resection of an Intravenous Leiomyomatosis Involving the Right-Sided Heart Chambers and Pulmonary Artery

2016 ◽  
Vol 19 (2) ◽  
pp. 064
Author(s):  
Rongjian Xu ◽  
Qi Miao ◽  
Xingrong Liu ◽  
Chaoji Zhang ◽  
Guotao Ma
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Unique Feature ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
One Stage ◽  
The Right

Intravenous leiomyomatosis (IVL) is a rare neoplastic disorder. It may extend into the right cardiac chambers, which are named after intracardiac leiomyomatosis (ICL). We describe a case of IVL extending into the right heart and pulmonary artery in a 46-year-old woman. The patient successfully underwent a one-stage operation under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest. The patient fully recovered without major complications and did not exhibit any recurrence at the 9-month follow-up. The unique feature of this case is its involvement with the pulmonary artery, which is uncommon but potentially lethal.

Surgical management of carotid body tumor – Is Shamblin classification sufficient to predict surgical outcome?

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Y Law ◽  
YC Chan ◽  
SW Cheng
Keyword(s):  
Surgical Management ◽  
Carotid Body ◽  
Incidental Finding ◽  
Neck Mass ◽  
Complete Resection ◽  
Carotid Body Tumor ◽  
Class Iii ◽  
Surgical Interventions ◽  
Shamblin Classification

Background The study aims to conduct a review of the surgical management of carotid body tumor. Methods Consecutive patients with CBT who received surgical interventions from January 1994 to January 2014 at our institution were reviewed. Clinical, operative, pathological and follow up information were reported. Results Twenty patients (four males; median age was 36) with 21 CBT operations were recorded during the period. One patient undertook sequential operations for bilateral CBTs. Patients had 19 neck mass, 1 incidental finding and 1 facial nerve palsy. Six CBTs (28.6%) were Shamblin class I, ten (47.6%) were class II and five (23.8%) were class III. Nine CBTs had preoperative conjunctive embolization. Two operations required internal carotid artery resection and reconstruction. Four patients received subtotal resections, while 17 achieved complete resection. Complications included two major strokes, three hoarse voice and two Horner’s syndrome. Shamblin class was significant predictor of operative time, blood loss, and whether complete resection accomplished, but could not predict postoperative complication. With median follow up period of 94 months, there was no tumor recurrence found in those had complete resection. Conclusions This small cohort showed that Shamblin class was significant in predicting technical difficulties but could not predict occurrence of complications.

Undifferentiated endometrial sarcomas (UES): Results of a French sarcoma group (FSG) retrospective series of 52 patients (pts).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17109-e17109 ◽  
Author(s):  
Marie Meurer ◽  
Anne Floquet ◽  
Antoine Italiano ◽  
Morgane Auriche ◽  
Julien Mancini ◽  
...  
Keyword(s):  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Univariate Analysis ◽  
Pelvic Mass ◽  
Figo Stage ◽  
Complete Resection ◽  
Significant Prognostic Factor ◽  
Curative Intent ◽  
Operative Strategy

e17109 Background: UES are rare tumors of very poor prognosis. Although large surgical resection is the cornerstone of curative intent treatment, the optimal post-operative strategy remains unclear. Methods: We conducted a retrospective analysis of UES pts over the last 8 years in 10 FSG centers, from Netsarc and RRePs databases. Results: Fifty-two pts with primary UES treated from 2008 to 2016 were included. The median age was 59 years (range, 42-82), and median ECOG was 0 (range, 0-3): 33 were localized (FIGO I-III) and 19 metastatic at diagnosis. Metrorrhagia, abdominal pain, and pelvic mass bleeding were the most common symptoms. Surgical procedures were radical hysterectomy and bilateral adnexectomy for 23/33 (70%) of localized and 11/19 (58%) of metastatic UES. Metastases were identified post operatively for 9/19 pts. In the localized group, 19 pts (58%) received radiotherapy, 10 (30%) complementary brachytherapy and 9 (27%) adjuvant chemotherapy. In the metastatic group, 16/19 (84%) received chemotherapy (polyCT, n=11). With a median follow-up of 28 months (0.3-112),24/52 pts are alive, 18/33 (58%) localized pts relapsed with 6 local relapses and 11 metastases. The 3- and 5-year Overall Survival (OS) rates were 40.7% and 29.1% respectively, for the whole group. In the localized group; median OS and Relapse-Free Survival (RFS) were 32.7 (23.3-42.1) and 22.9 months (2.3-43.7). In univariate analysis; early FIGO stage (p <0.0001), complete resection (R0-R1 vs R2; p=0.015) and adjuvant radiotherapy (p=0.001) were associated with a better OS; complete resection (p=0.021) and adjuvant radiotherapy (p=0.026) were associated with a better RFS. In the metastatic group, median OS was 16.4 months (12.0-20.7). In univariate analysis, no significant prognostic factor was retrieved neither on OS nor on RFS. Conclusions: Treatment of primary UES is radical hysterectomy and bilateral adnexectomy. Adjuvant radiotherapy appears beneficial for RFS. Due to the rarity and complexity of UES, referring patients to expert sarcoma centers is highly recommended.

scholarly journals Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience

2020 ◽  
pp. 145749691989700
Author(s):  
M. T. Mogl ◽  
T. Skachko ◽  
E. M. Dobrindt ◽  
P. Reinke ◽  
C. Bures ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Cardiovascular Complications ◽  
Kidney Graft ◽  
Renal Hyperparathyroidism ◽  
Single Center Experience ◽  
Duration Of Surgery ◽  
Few Data ◽  
Demographical Data

Background and Aims: There are only few data on the influence of cinacalcet on the outcome of parathyroidectomy in patients with renal hyperparathyroidism. Indication and timing of surgery have changed since its introduction, especially with regard to kidney transplantation. Therefore, we retrospectively analyzed patients undergoing parathyroidectomy for renal hyperparathyroidism in our institution. Material and methods: Between 2008 and 2015, 196 consecutive operations in 191 patients were analyzed. About 80 operations (41%) were performed in patients receiving cinacalcet compared with 116 operations (59%) in patients without cinacalcet. Clinical data, preoperative medication, pre- and postoperative laboratory values, type and details of surgery including complications, as well as cardiovascular complications and kidney transplantation with graft function were recorded. Results: Demographical data were similar in patients with or without cinacalcet treatment. A total of 54% of patients received a kidney graft before or after parathyroidectomy. Pre- and postoperative parathormone levels were similar in both groups (preoperatively 755 vs 742 ng/L, postoperatively 50 vs 46 ng/L, p > 0.10), whereas patients with cinacalcet showed significantly lower calcium levels preoperatively (2.28 vs 2.41 mmol/L, p = 0.0002). There was no difference in recurrence or persistence of hyperparathyroidism, duration of surgery, hospital stay, or complication rate. Creatinine levels in patients with tertiary hyperparathyroidism were similar after 1-year follow-up. Conclusion: Cinacalcet did not influence outcome of patients with parathyroidectomy for renal hyperparathyroidism and can be safely offered to patients not responding to medical treatment.

scholarly journals Complete resection of a cavoatrial metastatic dedifferentiated liposarcoma under hypothermic circulatory arrest

2021 ◽  
Author(s):  
Ryumon Matsumoto ◽  
Koki Maekawa ◽  
Toshiki Fujiyoshi ◽  
Kentaro Kamiya ◽  
Jun Matsubayashi ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Poor Prognosis ◽  
Rare Case ◽  
Circulatory Arrest ◽  
Tumor Resection ◽  
Complete Resection ◽  
Hypothermic Circulatory Arrest ◽  
Tumor Mass ◽  
The Poor

A patient had undergone surgical resection twice for primary and metastatic dedifferentiated liposarcomas. Follow-up computed tomography revealed a new tumor mass located at the cavoatrial junction. Prompt surgical resection of the tumor with thrombectomy was successfully performed using cardiopulmonary bypass with hypothermic circulatory arrest. We report a rare case of a patient surviving for 8 years after the first tumor resection despite the poor prognosis of metastatic or recurrent liposarcoma.

Transoral and endoscope-assisted transoral approaches to resecting benign tumours of the parapharyngeal space located in the medial portion of the carotid sheaths and extending toward the skull base: our experience

2018 ◽  
Vol 132 (8) ◽  
pp. 748-752 ◽  
Author(s):  
Y Liu ◽  
H-J Yu ◽  
H-T Zhen
Keyword(s):  
Skull Base ◽  
Surgical Management ◽  
Parapharyngeal Space ◽  
Complete Resection ◽  
Transoral Approach ◽  
Surgical Approaches ◽  
Benign Tumours

AbstractObjectiveVarious surgical approaches have been described to remove tumours in the parapharyngeal space. This study investigated the feasibility of a transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base.MethodsThirty-two patients were selected and underwent a transoral or an endoscope-assisted transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths. Medical photographs were used.ResultsAll patients underwent complete resection of their lesions via a transoral or endoscope-assisted transoral approach. None of the patients demonstrated residual or recurrent neoplasms, either clinically or radiographically, during their follow up.ConclusionBased on our studies, we assert that transoral and endoscope-assisted transoral approaches are suitable in managing parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base.

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