Search results for "Resection"

Hepatocellular carcinoma with macrovascular invasion: multimodality imaging features for the diagnosis

2020

Hepatocellular carcinoma (HCC) is frequently associated with macrovascular invasion of the portal vein or hepatic veins in advanced stages. The accurate diagnosis of macrovascular invasion and the differentiation from bland non-tumoral thrombus has significant clinical and management implications, since it narrows the therapeutic options and it represents a mandatory con-traindication for liver resection or transplantation. The imaging diagnosis remains particularly challenging since the imaging features of HCC with macrovascular invasion may be subtle, espe-cially in lesions showing infiltrative appearance. However, each radiologic imaging modality may provide findings suggesting the prese…

Pathologic response to preoperative transarterial chemoembolization for resectable hepatocellular carcinoma may not predict recurrence after liver re…

2016

Imaging-Based Preoperative Planning

2017

Liver resection in the treatment of colorectal liver metastases, as for any other primary or secondary liver tumor, needs to be oncologically effective and surgically safe. Both goals need equal consideration, and imaging-based preoperative planning is paramount for achieving each of them. Preoperative imaging should ideally identify all metastatic lesions in the liver, as well as extrahepatic disease. Furthermore, it should provide an anatomical roadmap with the exact localization of each lesion within the segmental hepatic anatomy, and its proximity to adjacent vasculo-biliary structures, to allow for proper resection leaving the patient with a sufficiently functioning liver remnant. This…

Should all intrahepatic cholangiocarcinomas receive neoadjuvant chemotherapy before resection?

2021

Leberresektionen können bei vorsichtiger Patientenselektion auch in Zirrhose sicher durchgeführt werden

2021

Zusammenfassung Hintergrund Das hepatozelluläre Karzinom (HCC) ist der häufigste maligne Lebertumor in einer Leberzirrhose. Neben der Lebertransplantation stellt die Leberresektion in kompensierter Zirrhose eine kurative Therapieoption dar, die jedoch mit einer höheren postoperativen Morbidität und Mortalität einhergeht. Patienten Es wurden 108 Patienten identifiziert, die mit einer Leberzirrhose im Zeitraum von Januar 2008 bis Dezember 2019 an der Universitätsmedizin Mainz eine Leberresektion erhalten haben. Im gleichen Zeitraum wurden 185 Resektionen wegen eines HCC in nicht zirrhotischer Leber durchgeführt. Als weitere Kontrollgruppe dienten 167 Resektionen wegen kolorektaler Lebermetast…

Awake Surgery: Skills of Neurosurgeon Matter but Those of Patient Too. How to Optimize Functional Brain Mapping by Improving Per-Operatory Testing?

2011

International audience; It is now possible to perform resections of slowgrowing tumors in awake patients. Using direct electrical stimulation (DES), real-time functional mapping of the brain can be used to prevent the resection of essential areas near the tumor. For now, simple clinical tests are performed on conscious patients and combined with DES in order to discriminate functional and non-functional areas invaded by the tumors. In this work we try to develop a simple device based on a simple technology to better quantify the performances of the patients during the surgery itself and give a real-time feedback to the neurosurgeon that will help to further guide the surgery by improving th…

Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer

2020

OBJECTIVE The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). SUMMARY BACKGROUND DATA Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use. METHODS In this randomized controlled trial, several prim…

Rektumprolaps bei Erwachsenen - Ursache, Diagnostik, Therapie

2005

Despite progress in modern surgery, the choice of the surgical procedure of rectal prolapse is regarded with controversy. Selection criteria between the abdominal or perineal approach or between rectopexy and resection rectopexy are not yet proven. This article gives a review of the literature about rectal prolapse and an analysis of the outcome of posterior rectopexy and resection rectopexy--partly conventionally and partly laparoscopically--in 25 patients with rectal prolapse III degrees and IV degrees. All except for one patient were examined during a mean follow-up of 5.5 (3.1) years for the rectopexy group and 2.1 (0.7) years for the resection rectopexy group. Recurrence occurred in on…

Veränderungen im klinischen Bild und der chirurgischen Therapie bei Morbus Crohn Erfahrungen aus 10 Jahren

1998

Changes in clinical presentation of Crohn's disease (CD), patients' age at the time of disease manifestation and operation, general condition and duration of medical management were investigated in a retrospective study. 395 operations for CD were divided into consecutive groups and analysed. In an increasing number of cases patients presented with the "fibrostenotic type" rather than the "fistulizing type" of complaints. The duration of disease and of medical management increased. Patients in later groups were younger and in better general condition. We found a rise in frequency of patients with recurrent CD or prior abdominal surgery for other reasons. Primary surgery for CD increasingly …

Prevention of postsurgical relapse and recurrence in Crohn's disease

2003

After first resection in Crohn's disease at 1 year 60-80% of patients have endoscopic recurrence, 10-20% have clinical relapse, and 5% have surgical recurrence. 1,2 This review focuses on the actual evidence on the prevention of recurrence and relapse dealing with risk factors and with drugs. Smoking is the only risk factor for Crohn's disease, that has been shown to be related to both endoscopic and surgical recurrence and relapse. Among the different drugs evaluated, some (Mesalamine and Metronidazole) have been shown to be effective, whereas others (immunosuppressive) need to be evaluated in further, new trials.