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Indeterminate pulmonary nodules in colorectal cancer

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World Journal of Gastroenterology 2015年第10期21卷 2967-2972页

作者： Eun-Joo Jung Su-Ran Kim Chun-Geun Ryu Jin Hee Paik Jeong Geun Yi Dae-Yong Hwang Department of Surgery Colorectal Cancer Center Konkuk University Medical Center Konkuk University School of Medicine Department of Radiology Konkuk University Medical Center Konkuk University School of Medicine

AIM:To investigate the clinicopathologic parameters of pulmonary metastasis in colorectal cancer(CRC) patients after lung operation of indeterminate pulmonary nodules(IPNs).METHODS:From a prospective database of CRCpatients,40 cases that underwent lung operation between November 2008 and December 2012 for suspicious metastatic pulmonary nodules on chest computed tomography(CT)were *** decision to perform a lung operation was made if the patient met the following criteria:(1)completely resected or resectable primary CRC;(2)completely resectable IPNs;(3)controlled or controllable extrapulmonary metastasis;and(4)adequate general condition and pulmonary function to tolerate pulmonary *** operation was performed by a thoracic surgeon without CT-guided biopsy for pathologic ***:A total of 40 cases of lung resection was performed in 29 *** patients underwent repeated lung *** final pathology result showed metastasis from the CRC in 30 cases(75%)and benign pathology in 10 cases(25%).The primary tumor site was the rectum in 26/30(86.6%)cases with pulmonary metastasis,but only 3/10(30%)cases in the benign group had a primary rectal cancer(P=0.001).Positron emission tomography(PET)-CT was performed for 22/30(73.4%)patients in the lung metastasis group and for 6/10(60.0%)patients in the benign ***-CT revealed hot uptake of18fluorine 2-fluoro-2-deoxy-D-glucose with all IPNs in both *** group with pulmonary metastasis had a higher incidence of primary rectal cancer(P=0.001),a more advanced tumor stage(P=0.011),and more frequent lymphatic invasion of tumor cells(P=0.005).Six cases with previous liver metastasectomy were present in the lung metastasis *** carcinoembryonic antigen levels before lung operation were not elevated in any of the ***:The stage and location of the primary tumor and tumor cell infiltration of lymphatics provide useful indicators for deciding on lung resection of IP

关键词： Colorectal neoplasm Lung neoplasm Indeterminate pu

Postoperative radiotherapy for thymus salivary gland carcinoma:A case report

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World Journal of Clinical Cases 2022年第26期10卷 9484-9492页

作者： Rui Deng Nan-Jing Li Liang-Liang Bai Shi-Hong Nie Xiao-Wen Sun Yong-Sheng Wang Clinical Trial center National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative DrugsDepartment of Thoracic OncologyWest China HospitalSichuan UniversityCheng Du 610041Sichuan ProvinceChina Department of Radiation Oncology Cancer CenterWest China HospitalSichuan UniversityCheng Du 610041Sichuan ProvinceChina

BACKGROUND Salivary gland cancer is a rare disease in which cancer cells form in the tissues of the salivary *** mostly occurs in the glands that have secretion functions,such as the parotid gland,sublingual gland and submandibular *** is very rare when it occurs in other nonsecreting ***,we report one case of salivary gland carcinoma occurring in the thymus and discuss related diagnoses and treatment *** SUMMARY One 33-year-old middle-aged man presented with a thymus mass without any clinical symptoms when he underwent regular physical ***,the patient was admitted to the hospital for further *** tomography(CT)showed that there was a mass of 3 cm×2.8 cm×1.5 cm in the thymus *** patient had no symptom of discomfort or tumor-related medical history *** completing the preoperative examinations,it was confirmed that the patient had indications for *** surgeon performed a transthoracoscope"thymectomy+pleural mucostomy"for *** the operation,the tumor tissue was quickly frozen,and the symptomatic section showed a malignant *** final pathological result suggested thymus salivary gland carcinoma-mucoepidermoid carcinoma(MEC).In the second month after surgery,we performed local area radiotherapy for the patient,with a total radiation dose of 50.4 Gy/*** 12 mo of surgery,the patient underwent positron emission tomography-CT examination,which indicated that there was no sign of tumor recurrence or *** 16 mo of operation,CT scan re-examination showed that there was no sign of tumor recurrence or *** of the time of publication,the patient was followed up for one and a half *** had no sign of tumor recurrence and continued to *** The incidence of MEC in the thymus is low,and its diagnosis needs to be combined with clinical features and imaging *** analysis plays a key role in the diagnosis of the *** w

关键词： Thymic tumor Salivary gland carcinoma Mucoepidermoid carcinoma Postoperative Radiotherapy Case report

Primary Chondrosarcoma of the Chest Wall— A Case Report

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Open Journal of Radiology 2018年第3期8卷 150-158页

作者： Cyriac George D. Diallo F. Velez-Cubian J. Fontaine M. Bui T. Rose Radiology Department University of South Florida Tampa USA General Surgical Department University of South Florida Tampa USA thoracic Surgical Department Moffitt Cancer Center Tampa USA Pathology Department Moffitt Cancer Center Tampa USA

A 60-year-old Hispanic male presented to his primary care physician office with an asymptomatic, but palpable right anterior chest wall mass. Initial work up of the finding included a CT scan of the chest which revealed a non-calcified, solid right anterior chest wall mass with invasion of the anterior fifth rib and intercostal space. The patient was presented at multidisciplinary conference with the patient’s primary physician, a medical oncologist, radiologist, pathologist and oncologic surgeon in attendance. The decision was to perform surgical resection of the mass to treat this primary mesenchymal malignancy. The anterior aspect of the fifth rib and intercostal muscles were resected with negative margins. Pathology confirmed the mass to be a low-grade chondrosarcoma. Due to the low-grade nature, low metastatic potential and negative margins of the tumor, the decision was made not to pursue adjuvant chemotherapy or radiation therapy. The patient made full recovery.

关键词： Chondrosarcoma Chest Wall Tumors Cartilaginous Tumors

Surgical Coronary Revascularization Using an Off-Pump, No-Touch Technique: The Cyclone (Hexalon) Experience

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Open Journal of thoracic Surgery 2014年第4期4卷 94-99页

作者： Jeffrey M. Schussler Theodore T. Theologes Baron L. Hamman Division of Cardiology Baylor University Medical Center Dallas TX USA Texas A & M College of Medicine Dallas TX USA Division of Cardiothoracic Surgery Baylor University Medical Center Dallas TX USA

The CycloneTM System (Castlewood Surgical, Inc., Concord, MA) is a novel device that facilitates the attachment of the saphenous vein onto the ascending aorta for the purpose of creating a bypass graft during a coronary artery bypass grafting (CABG) operation. It allows the surgeon to perform a hand-sewn anastomosis with no disruption of the intima of the aorta, and no need for partial clamping. During a 36-month period 109 CABG operations were performed, and the CycloneTM System (and its predecessor, the HexalonTM) was utilized to create 138 proximal anastomoses. This study demonstrates that this is a safe and effective method of creating a clampless, no-touch proximal anastomoses during off-pump CABG.

关键词： No Touch Clampless Coronary Bypass CABG Anastomoses Stroke

Large Anterior Mediastinal Mass: Intraoperative Transesophageal Echocardiography Guided Evaluation and Management

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World Journal of Cardiovascular Surgery 2021年第8期11卷 69-74页

作者： Kulbhushan Saini Sandeep Chauhan Manu Saini Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India Department of Cardiac Anesthesia All India Institute of Medical Sciences New Delhi India Department of Ophthalmology Advanced Eye Center Post Graduate Institute of Medical Education and Research Chandi-garh India

The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guiding aspiration and surgical resection of the cystic mass. Therefore, through this case report, authors emphasize the importance of performing intraoperative real-time TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.

关键词： Transoesophageal Echocardiography Superior Vena Cava Trans thoracic Echocardiography Computed Tomography Right Atrium Inferior Vena Cava

High Supracostal Percutaneous Nephrolithotomy Access: Assessing Safety in Access above the Eleventh Rib after Performing Preoperative Planning with Computed Tomography

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Open Journal of Urology 2015年第4期5卷 25-33页

作者： Joel E. Abbott Anthony D. DiMatteo Elise Fazio Samuel G. Deem Ali K. Sobh Albert DePolo Julio G. Davalos St John Providence Health Michigan State University Warren USA Charleston Area medical center West Virginia School of Osteopathic Medicine Charleston USA Chesapeake Urology Associates University of Maryland Glen Burnie USA

Objective: To determine if supracostal renal access above the 11th rib during percutaneous nephrolithotomy (PCNL) is a safe option in carefully selected patients determined by preoperative computed tomography (CT) imaging. Patients and Methods: We retrospectively isolated 142 patients who underwent access above the eleventh rib during PCNL, which we term “high supracostal renal access.” We then compared these patients to 113 individuals who underwent access below the twelfth rib. Renal access was achieved by the operative surgeon with fluoroscopic guidance in conjunction with pre-operative computed tomography (CT) scan. Outcomes were compared. Results: Overall surgical outcomes were equivalent when comparing high supracostal versus subcostal access sites. As expected due to proximity, pleural complications occurred in 4% of the high supracostal group (n = 6) compared with 0% of the control (subcostal) group (p = 0.035). Of these six complications, three were managed conservatively with observation and two required cardio-thoracic intervention with video-assisted thoracoscopic pleural repair (1%). In the remaining case, the patient was preoperatively consented for placement of a thoracostomy tube, which was placed during the procedure, due to the difficult location of her upper pole stone and closely adjacent low-lying pleura, and the planned transpleural approach. Hospital stay was not significantly pro-longed between the high supracostal access and subcostal access groups, with an average length of stay of 2.2 ± 2.1 days and 2.0 ± 1.9 days (p = 0.59) respectively. Conclusions: Careful, systematic preoperative planning based on CT and fluoroscopic imaging allows for a confident understanding of a “safety zone” in placement and dilatation of renal access points during PCNL. We have shown that planned upper pole renal access above the 11th rib is achievable with acceptable morbidity and excellent success rates.

关键词： Percutaneous Nephrolithotomy Calculi Endoscopic Surgical Procedure

应用Heartstring近端血管吻合系统的初步经验

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 60-61页

作者： Meirson D. Hauptman E. B. Medalion 孟欣 Department of Cardiothoracic Surgery The Edith Wolfson Medical Center Affil. Sackler Sch. Med. Tel A. Hol on IsraelDr.

Objective Manipulation of the aorta has been shown to be associated wit h posto perative neurologic events after surgical myocardial revascularization when the aorta is diseased. The Heartstring proximal anastomotic system (Guidant, Indiana polis, Ind) is a device designed to assist in the performance of proximal anasto moses with minimal aortic manipulation. We describe our initial experience with this product. Methods Twelve patients with a diseased aorta who underwent off-p ump myocardial revascularization and had their proximal anastomoses performed with the Heartstring device were stud ied for operative and postoperative outcomes and surgical technique. Results The mean age of the patients was 76 ±7 years. The estimated EuroSCORE perioperativ e mortality was 12%±8%. Themedian number of distal anastomoses was 3. In all patients, a saphenous vein graft was anastomosed to the aorta using the Heartstr ing device. In 5 patients, the radial artery was used as a conduit and connected proximally to a left internal thoracic artery as a Y graft, to a saphenous vein graft as a “horseshoe,”or on the hood of a saphenous vein graft. The operativ e and postoperative courses were uneventful. Three seals developed cracks and we re not used. One seal developed an unravel in its periphery but was used success fully. Conclusions The Heartstring proximal anastomotic system is a device that allows the surgeon to perform standard proximal clampless anastomoses. Elderly p atients with a diseased aorta may benefit from this device.

关键词：血管吻合 Heartstring 近端初步经验主动脉疾病隐静脉移植物非体外循环左胸廓内动脉血管重建术远端血管