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Robotic transoral vestibular parathyroidectomy:Two case reports and review of literature

World Journal of Clinical Cases 2018年第12期6卷 542-547页

作者： Yasar Ozdenkaya Cenk Ersavas naciye cigdem arslan Department of General Surgery Medipol University

Advances in preoperative localization studies and de-mands for scarless surgery have promoted the inves-tigation for remote techniques in parathyroid surgery. Transoral vestibular approach seems to provide the most comfortable and safest access to the neck. In this paper, we report our initial experience with robotic transoral ves-tibular parathyroidectomy(RTVP) in four patients with primary hyperparathyroidism. The surgery was perfor-med with the Da Vinci system through three trocars intro-duced from the lower lip vestibule. The procedure was converted to open in two patients due to inappropriate preoperative localization. The mean operative time was 169 min. No postoperative complications were seen. Patients were discharged on postoperative day 1. RTVP is a feasible and safe technique, which allows better surgical exposure and manipulation of the instruments. The advantages of transoral vestibular approach can be enhanced by robotics. Further studies are needed to analyze complications and costs.

关键词： Transoral vestibular surgery Parathyroid adenoma Natural orifice transendoluminal surgery Robotics Parathyroidectomy

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Comparison of Milan and UCSF criteria for liver transplantation to treat hepatocellular carcinoma

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World Journal of Gastroenterology 2011年第37期17卷 4206-4212页

作者： Tarkan Unek Sedat Karademir naciye cigdem arslan Tufan Egeli Gulsen Atasoy Ozgul Sagol Funda Obuz Ibrahim Astarcioglu Department of General Surgery Dokuz Eylul UniversitySchool of Medicine Department of Pathology Dokuz Eylul UniversitySchool of MedicineIzmir 35340Turkey Department of Radiology Dokuz Eylul UniversitySchool of MedicineIzmir 35340Turkey Mesut Akarsu Department of Gastroenterology Dokuz Eylul UniversitySchool of MedicineIzmir 35340Turkey

AIM:To assess the validity of the Milan and University of California San Francisco(UCSF) criteria and examine the long-term outcome of orthotopic liver transplantation(OLT) in patients with hepatocellular carcinoma(HCC) in a single-center study.METHODS:This study is a retrospective review of prospectively collected data.Between 1998 and 2009,56 of 356 OLTs were performed in patients with HCC.Based on pathological examination of liver explants,patients were retrospectively categorized into 3 groups:Milan +(n = 34),Milan-/UCSF +(n = 7) and UCSF-(n = 14).RESULTS:Median follow-up period was 39.5(1-124) mo.The 5-year overall survival rates in the Milan +,Milan-/UCSF + and UCSF-groups were 87.7%,53.6% and 33.3%,respectively(P < 0.000).Within these groups,tumor recurrence was determined in 5.8%,14.3% and 40% of patients,respectively(P < 0.011).Additionally,the presence of microvascular invasion within the explanted liver had a negative effect on the 5-year disease free survival(74.7% vs 46.7%,P < 0.044).CONCLUSION:The Milan criteria are reliable in the selection of suitable candidates for OLT for the treatment of HCC.For cases of OLT involving living donors,the UCSF criteria may be applied.

关键词：移植治疗米兰肝癌标准加州大学 OLT 旧金山肝细胞癌

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Peritoneal carcinomatosis of gastrointestinal tumors: Where are we now?

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World Journal of Gastroenterology 2014年第39期20卷 14371-14380页

作者： Cem Terzi naciye cigdem arslan Aras Emre Canda Department of Colorectal and Pelvic Surgery Dokuz Eylul University School of MedicineInciraltIzmir 35340Turkey

The peritoneal stromal tissue which provides a rich source of growth factors and chemokines is a favorable environment for tumor proliferation. The pathophysiological mechanism of peritoneal carcinomatosis is an individual sequence consisting of genetic and environmental factors and remains controversial. The natural history of the disease reveals a poor median prognosis of approximately 6 mo; however aggressive surgery and multimodal treatment options can improve oncologic outcomes. Considering peritoneal carcinomatosis as though it is a locoregional disease but not a metastatic process, cytoreductive surgery and and intraperitoneal chemotherapy has been a curative option during recent years. Cytoreductive surgery implies a series of visceral resections and peritonectomy procedures. Although the aim of cytoreductive surgery is to eliminate all macroscopic disease, viable tumor cells may remain in the peritoneal cavity. At that point, intraperitoneal chemotherapy can extend the macroscopic disease elimination to microscopic disease elimination. The successful treatment of peritoneal carcinomatosis requires a comprehensive management plan including proper patient selection, complete resection of all visible disease, perioperative intraperitoneal chemotherapy and postoperative systemic chemotherapy. Surgical and oncologic outcomes are strictly associated with extent of the tumor, completeness of cytoreduction and patientrelated factors as well as multidisciplinary management and experience of the surgical team. In this review, pathophysiology and current management of peritoneal carcinomatosis originating from gastrointestinal tumors are discussed according to the latest literature.

关键词： Peritoneal carcinomatosis Gastrointestinal tumors Cytoreductive surgery Intraperitoneal chemotherapy Oncologic surgery

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