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Ali Ahmad - One of the best experts on this subject based on the ideXlab platform.
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Use of indocyanine green (ICG) augmented near-infrared fluorescence imaging in robotic Radical Resection of gallbladder adenocarcinomas
Surgical Endoscopy, 2019Co-Authors: Ali AhmadAbstract:Background Gallbladder cancer remains a rare cancer with a poor prognosis. National guidelines recommend Radical Resection in the absence of metastatic disease. This often requires extensive dissection around the extrahepatic bile ducts. We report our experience of real-time near-infrared fluorescence imaging using indocyanine green during robotic Radical Resection of gallbladder adenocarcinomas. Methods Ten patients with gallbladder adenocarcinoma underwent robotic Radical Resection entailing central hepatectomy (segments IV-B and V) with regional lymphadenectomy. Real-time NIRF imaging was performed using the da Vinci^® Firefly system after intravenous administration of ICG 30 to 60 min preoperatively. Primary objective was to determine safety of this technique. Results Procedure was successfully completed in all patients. Seven patients (70%) had incidentally discovered gallbladder cancer after laparoscopic cholecystectomy and five patients had preoperatively known positive margins. Mean operative time was 173 min. Mean intraoperative blood loss was 88 mL (30–200 mL). Median number of lymph nodes retrieved was 5 (2–8). High ligation of cystic duct was performed close to the common bile duct (CBD) junction with the assist of NIRF and negative margins were achieved in all patients. No major complications (Grade III–IV) or mortality was seen at 30 days post-op. Conclusions Results from our limited experience demonstrate procedural safety and beneficial use of NIRF using ICG during robotic Radical Resection of gallbladder adenocarcinomas. It may assist in attainment of negative cystic duct margin and lymphatic clearance around the biliary tree especially in complex re-explorative biliary surgery.
Katashi Fukao - One of the best experts on this subject based on the ideXlab platform.
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Radical Resection of hilar bile duct carcinoma and predictors of survival
British Journal of Surgery, 2000Co-Authors: T. Todoroki, Toru Kawamoto, H. Takahashi, Yasutsugu Takada, N. Koike, Masaaki Otsuka, Sadao Yoshida, Hironobu Kashiwagi, Katashi FukaoAbstract:Background: Patients with carcinoma of the main hepatic duct have a poor prognosis. This study attempted to identify clinicopathological predictors of survival after Resection. Methods: A retrospective review was performed of 114 patients who presented with hepatic ductal carcinoma between 1976 and 1998. Of the 114 patients, 98 had a Radical Resection, three underwent palliative Resection and 13 were not treated surgically. Forty-six patients with stage IVA disease had microscopic tumour residue after Resection. Of these, 28 patients were treated with radiotherapy and the remaining 18 had Resection alone. Results: The overall operative morbidity and mortality rates were 14 and 4 per cent respectively. The overall 5-year survival rate after Resection was 28 per cent. Nineteen patients survived for more than 5 years, including ten with stage IVA disease. The main prognostic factors were performance status; jaundice; tumour location; gross appearance; histological grade; T, N and M categories in tumour node metastasis (TNM) classification; TNM stage; and residual tumour. Adjuvant radiotherapy, tumour extension into the hepatic ducts, histological grade, N and residual tumour were independent predictive factors by multivariate Cox analysis. Conclusion: This study suggests that Radical Resection provides the best survival rate for patients with hilar bile duct carcinoma. For patients with stage IVA disease, following complete gross Resection radiotherapy improved treatment outcome.
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Treatment of gallbladder cancer by Radical Resection.
British Journal of Surgery, 1999Co-Authors: T. Todoroki, Toru Kawamoto, H. Takahashi, Yasutsugu Takada, N. Koike, Masaaki Otsuka, Katashi FukaoAbstract:Background: The use of Radical Resection for gallbladder cancer is controversial. This study evaluated results of Resection for gallbladder cancer and analysed prognostic factors. Methods: A retrospective review of 135 patients who underwent surgical Resection for gallbladder cancer between 1976 and 1998 was performed. Of these, 123 patients underwent Radical Resection and the remaining 12 had palliative Resection. The Resections included 32 hepatopancreatoduodenectomies and 57 with adjuvant radiotherapy. Twelve prognostic factors were analysed. A subset of 96 patients with stage IV disease was analysed separately with respect to residual tumour level and adjuvant radiotherapy. Results: Surgical Resection was associated with a 5-year survival rate of 36 per cent, with a mean follow-up time of 870 days. Twenty-two patients have survived more than 5 years including three with stage IV disease. Overall operative morbidity and mortality rates were 13 and 4 per cent respectively. The 5-year survival rate decreased with disease stage: 100, 78, 69 and 11 per cent for stages I (n = 13), II (n = 19), III (n = 7) and IV (n = 96) respectively. Performance status, jaundice, histopathological type and grade, primary tumour, lymph node, distant metastasis, stage grouping, residual tumour level and adjuvant radiotherapy were significant prognostic factors. Conclusion: With careful patient selection, Radical Resection for gallbladder cancer improves the prognosis with acceptable operative mortality and morbidity rates, even for stage IV disease, provided that complete gross tumour Resection is combined with radiotherapy. © 1999 British Journal of Surgery Society Ltd
Boris W Kuvshinoff - One of the best experts on this subject based on the ideXlab platform.
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gallbladder cancer defining the indications for primary Radical Resection and Radical re Resection
Annals of Surgical Oncology, 2007Co-Authors: Jason M Foster, Hisakazu Hoshi, John F Gibbs, Renuka Iyer, Miland Javle, Quyen D Chu, Boris W KuvshinoffAbstract:Background The role of Radical Resection for gallbladder cancer is an ongoing area of debate. In this review, we present our experience managing gallbladder cancer at a tertiary center by using an aggressive surgical approach for T2 or greater disease, reserving simple cholecystectomy only for T1 lesions.
Andre Dhoore - One of the best experts on this subject based on the ideXlab platform.
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systematic review and meta analysis of local Resection or transanal endoscopic microsurgery versus Radical Resection in stage i rectal cancer a real standard
Critical Reviews in Oncology Hematology, 2017Co-Authors: Genevieve Veereman, Joan Vlayen, Jo Robays, Nicolas Fairon, Sabine Stordeur, Christian Rolfo, Didier Bielen, Alain Bols, Pieter Demetter, Andre DhooreAbstract:Current guidelines recommend Radical Resection for stage I rectal cancer. However, since screening programs are being installed, an increasing number of cancers are being detected in early stages. Endoscopic Resection is often performed at the time of diagnosis. This systematic review was undertaken to review the evidence on endoscopic approach vs. Radical Resection for stage I rectal cancer. Recommendations were issued based on the GRADE methodology and risk stratification used in clinical practice. A systematic search (until March 2015) identified 2 meta-analyses and 1 additional randomized trial. For the primary outcomes (overall survival, disease-free survival, local recurrence-free survival and metastasis-free survival) no evidence could be found on the superiority of local or Radical Resection. Secondary outcomes (blood loss, hospital stay, operative time, number of permanent stomas and perioperative deaths) were in favour of local Resection. The authors strongly recommend Radical Resection for T2 rectal cancer, but consider 'en bloc' local Resection sufficient for pT1 sm1 rectal cancers when confirmed pathologically. Discussion by a multidisciplinary team and adequate surveillance remain mandatory.
Jessica Wisoff - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of Radical Resection of primary and recurrent craniopharyngiomas in 86 children
Journal of Neurosurgery, 2010Co-Authors: Robert E Elliott, Kevin Hsieh, Tsivia Hochm, Ilana Belitskayalevy, Jessica WisoffAbstract:Object Optimal treatment of primary and recurrent craniopharyngiomas remains controversial. Radical Resection and limited Resection plus radiation therapy yield similar rates of disease control and overall survival. The data are much less clear for recurrent tumors. The authors report their experience with Radical Resection of both primary and recurrent craniopharyngiomas in children and compare the outcomes between the 2 groups. Methods A retrospective analysis was performed in 86 children younger than 21 years of age who underwent a total of 103 operations for craniopharyngioma between 1986 and 2008; these were performed by the senior author. The goal was Resection with curative intent in all patients. Two patients were lost to follow-up and were excluded from analysis. The mean age at the time of surgery was 9.6 years, and the mean follow-up was 9.0 years. Results All 57 children with primary tumors underwent gross-total Resection (GTR). A GTR was achieved in significantly fewer children with recurrent...