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Presacral venous bleeding during mobilization in rectal cancer

World Journal of Gastroenterology 2017年第9期23卷 1712-1719页

作者： Jose Enrique casal Núnez Vincenzo Vigorita Alejandro Ruano Poblador Ana María Gay Fernández Maria ángeles Toscano Novella nieves cáceres alvarado Lucinda Pérez Dominguez coloproctology Unit and General and Digestive Surgery Unit Vigo University Hospital Complex36212 VigoSpain

To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal *** review of the databases MEDLINE® and Embase™ was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were *** is a review of 58 published articles on presacral venous plexus injury during the mobilization of the rectum and on techniques used to treat presacral venous bleeding. Due to the lack of cases published in the literature, there is no consensus on which is the best technique to use if there is presacral bleeding during mobilization in surgery for rectal cancer. This review may provide a tool to help surgeons make decisions regarding how to resolve this serious *** series of alternative treatments are described; however, a conventional systematic review in which optimal treatment is identified could not be performed because few cases were analyzed in most publications.

关键词： Presacral hemorrhaging Rectal surgery Sacral venous plexus Pelvic surgery Sacral anatomy

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Role of advanced magnetic resonance imaging in the assessment of malignancies of the mediastinum

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World Journal of Radiology 2019年第3期11卷 27-45页

作者： Jordi Broncano Ana María alvarado-Benavides Sanjeev Bhalla Antonio álvarez-Kindelan constantine A Raptis Antonio Luna cardiothoracic Imaging Unit Hospital San Juan de Dios cardiothoracic Department Mallinckrodt Institute of Radiology Washington University in Saint Louis Thoracic Surgery Department Hospital Reina Sofía MR imaging Unit Clínica Las Nieves

In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free ***, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.

关键词： Mediastinum Magnetic resonance Diffusion Perfusion ^18FFluorodeoxiglucose positron emission tomography/computed tomography Advanced imaging

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