V. Lopes, I. Cruz, S. Santos, F. Santos, Nuno Piedade, Sara Brito, Jose Caria, J. Barbosa
{"title":"Comparing Esophagectomy Morbidity Profile Between Ivor Lewis and McKeown for Esophageal Cancer: A Systematic Review and Meta-Analysis","authors":"V. Lopes, I. Cruz, S. Santos, F. Santos, Nuno Piedade, Sara Brito, Jose Caria, J. Barbosa","doi":"10.21614/sgo-v.28-a.572","DOIUrl":"https://doi.org/10.21614/sgo-v.28-a.572","url":null,"abstract":"","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89096153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katia Lanzafame, Nicola Inzerilli, Rosaria Carciotto, Claudio Longhitano, Stefania Stella, Lo Bianco Salvatore, Lorenzo Rossi, Paolo Vigneri
Purpose: Patients with Cowden syndrome (CS) have an increased lifetime risk of developing cancers, particularly breast, uterus, thyroid, colon and renal cell cancer. CS is associated with a germline mutation of PTEN, a gene that plays an important role in carcinogenesis. This review hypothesized that inactivation of PTEN could have dramatic consequences on response of treatments in patients with Cowden Syndrome.
{"title":"Therapeutic Implications of PTEN Loss in Patients with Cowden Syndrome and Renal Cell Cancer","authors":"Katia Lanzafame, Nicola Inzerilli, Rosaria Carciotto, Claudio Longhitano, Stefania Stella, Lo Bianco Salvatore, Lorenzo Rossi, Paolo Vigneri","doi":"10.21614/sgo-588","DOIUrl":"https://doi.org/10.21614/sgo-588","url":null,"abstract":"Purpose: Patients with Cowden syndrome (CS) have an increased lifetime risk of developing cancers, particularly breast, uterus, thyroid, colon and renal cell cancer. CS is associated with a germline mutation of PTEN, a gene that plays an important role in carcinogenesis. This review hypothesized that inactivation of PTEN could have dramatic consequences on response of treatments in patients with Cowden Syndrome.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel R. Valenzuela, Christie Valenzuela, Ricardo Gaspar, Julio Reto, M. Córdova, Rocío Valenzuela, Daniel A. Valenzuela, Ana Juárez
{"title":"Interaction of Clinicals Values in Metabolic Syndrome and Nonalcoholic Fatty Liver Disease in Adults","authors":"Daniel R. Valenzuela, Christie Valenzuela, Ricardo Gaspar, Julio Reto, M. Córdova, Rocío Valenzuela, Daniel A. Valenzuela, Ana Juárez","doi":"10.21614/sgo-ec-507","DOIUrl":"https://doi.org/10.21614/sgo-ec-507","url":null,"abstract":"","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76836995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Rectal cancer treatment has changed over the last several decades. Total mesorectal excision (TME) has proven to be the gold standard in rectal cancer surgery. Transanal total mesorectal excision (TaTME) and robotic total mesorectal excision (RoTME) for low and mid rectal cancer are implemented to overcome some of the difficulties of the laparoscopic approach. The aim of this study is to show a single-center experience in the learning curves of both RoTME and TaTME. Material and methods: A single-center prospective study comparing the first 17 consecutive RoTME cases from January 2016 to May 2019 to the first 16 consecutive cases of TaTME from July 2019 to June 2021 was conducted. The difference in the time periods is due to the later implementation of TaTME in the center. All procedures were performed by a single team. Results: A total of 33 patients were included in the study – 17 RoTME patients and 16 TaTME patients. The groups were homogeneously distributed in terms of patients’ characteristics and stage. Comparing the two groups, no statistically significant differences between them were found in terms of complication rates (p=0.692), positive circumferential resection margins rates (p=0.000), frequency of anastomotic leak rates (p=0.596), time from completion of radiotherapy to surgery (p=0.229) and time from surgery to ileostomy closure (p=0.880). A statistically significant shorter operative time was found in the TaTME group (p=0.008). Conclusion: The learning curve should be considered in all procedures. A structured training pathway for TaTME and RoTME is essential. No differences between robTME and TaTME in the learning curve were observed in our center.
{"title":"Learning Curve of Robotic Total Mesorectal Excision versus Transanal Total Mesorectal Excision - A Single-Center Study","authors":"M. Karamanliev, T. Yotsov, D. Dimitrov","doi":"10.21614/sgo-547","DOIUrl":"https://doi.org/10.21614/sgo-547","url":null,"abstract":"Introduction: Rectal cancer treatment has changed over the last several decades. Total mesorectal excision (TME) has proven to be the gold standard in rectal cancer surgery. Transanal total mesorectal excision (TaTME) and robotic total mesorectal excision (RoTME) for low and mid rectal cancer are implemented to overcome some of the difficulties of the laparoscopic approach. The aim of this study is to show a single-center experience in the learning curves of both RoTME and TaTME. Material and methods: A single-center prospective study comparing the first 17 consecutive RoTME cases from January 2016 to May 2019 to the first 16 consecutive cases of TaTME from July 2019 to June 2021 was conducted. The difference in the time periods is due to the later implementation of TaTME in the center. All procedures were performed by a single team. Results: A total of 33 patients were included in the study – 17 RoTME patients and 16 TaTME patients. The groups were homogeneously distributed in terms of patients’ characteristics and stage. Comparing the two groups, no statistically significant differences between them were found in terms of complication rates (p=0.692), positive circumferential resection margins rates (p=0.000), frequency of anastomotic leak rates (p=0.596), time from completion of radiotherapy to surgery (p=0.229) and time from surgery to ileostomy closure (p=0.880). A statistically significant shorter operative time was found in the TaTME group (p=0.008). Conclusion: The learning curve should be considered in all procedures. A structured training pathway for TaTME and RoTME is essential. No differences between robTME and TaTME in the learning curve were observed in our center.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83763781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Castanheira Rodrigues, Rui Mendes Costa, Catarina Pestana Muller, Luis Graca, Elisabete Barbosa
Background: Choledocholithiasis occurs in 8–20% of patients with gallbladder stones. All patients with symptomatic gallbladder stone disease should be assessed for synchronous choledocholithiasis. When synchronous to symptomatic gallbladder stones disease, indication for treating both is clear. The most common treatment options are single-stage approach (SSA) with laparoscopic cholecystectomy and common bile duct (CBD) exploration or two-stage approach (TSA) combining pre- or post-operative ERCP (endoscopic retrograde cholangio-pancreatography) and laparoscopic cholecystectomy. SSA is gaining emphasis as surgeons’ experience with advanced laparoscopic procedures increases.
{"title":"Laparoscopic Cholecystectomy and Common Bile Duct Exploration for Cholecystocholedocholithiasis Treatment: How We Do It (with video)","authors":"Sara Castanheira Rodrigues, Rui Mendes Costa, Catarina Pestana Muller, Luis Graca, Elisabete Barbosa","doi":"10.21614/sgo-599","DOIUrl":"https://doi.org/10.21614/sgo-599","url":null,"abstract":"Background: Choledocholithiasis occurs in 8–20% of patients with gallbladder stones. All patients with symptomatic gallbladder stone disease should be assessed for synchronous choledocholithiasis. When synchronous to symptomatic gallbladder stones disease, indication for treating both is clear. The most common treatment options are single-stage approach (SSA) with laparoscopic cholecystectomy and common bile duct (CBD) exploration or two-stage approach (TSA) combining pre- or post-operative ERCP (endoscopic retrograde cholangio-pancreatography) and laparoscopic cholecystectomy. SSA is gaining emphasis as surgeons’ experience with advanced laparoscopic procedures increases.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spontaneous Superior Adrenal Artery Rupture Causing a Large Retroperitoneal Hematoma: Case Report and Literature Review","authors":"Luigi Cayre, A. Aiolfi, A. Sozzi, D. Bona","doi":"10.21614/sgo-v.28-a.580","DOIUrl":"https://doi.org/10.21614/sgo-v.28-a.580","url":null,"abstract":"","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77771704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Andrade Almeida, V. Lopes, E. Barbosa, J. Barbosa
{"title":"Reducing Tumor Burden: Laparoscopic Subtotal Gastrectomy in the Setting of Recurrent Metastatic GIST (with video)","authors":"Miguel Andrade Almeida, V. Lopes, E. Barbosa, J. Barbosa","doi":"10.21614/sgo-v.28-a.576","DOIUrl":"https://doi.org/10.21614/sgo-v.28-a.576","url":null,"abstract":"","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85276423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Isabel Oliveira, Vitor Neves Lopes, Jose Pedro Barbosa, Elisabete Barbosa, Jose Barbosa
Case Report: We present a clinical case of a woman, 59 years old, with a history of papillary thyroid carcinoma with cervical metastases, asymptomatic. During the follow-up of the carcinoma, a large lipomatous formation was detected in the lesser curvature of the stomach, well circumscribed, in the submucosa. A complementary study was carried out with upper digestive endoscopy (UDE) and ecoendoscopy. The UDE confirmed a lesion on the lesser curvature, covered by normal mucosa, raising suspicion of a gastrointestinal stromal tumor (GIST) or lipoma. However, the biopsy of the lesion did not reveal signs of malignancy. The patient was then proposed for surgery. The patient underwent laparoscopic surgery for extramucosal enucleation of a gastric lipoma measuring 8.5 cm, with resection of the adherent mucosa. The postoperative period was uneventful, with discharge on the 5th day. The anatomopathological examination revealed that it was a well-differentiated lipomatous tumor, negative for the MDM2 gene.
{"title":"A Giant Gastric Lipoma","authors":"Ana Isabel Oliveira, Vitor Neves Lopes, Jose Pedro Barbosa, Elisabete Barbosa, Jose Barbosa","doi":"10.21614/sgo-577","DOIUrl":"https://doi.org/10.21614/sgo-577","url":null,"abstract":"Case Report: We present a clinical case of a woman, 59 years old, with a history of papillary thyroid carcinoma with cervical metastases, asymptomatic. During the follow-up of the carcinoma, a large lipomatous formation was detected in the lesser curvature of the stomach, well circumscribed, in the submucosa. A complementary study was carried out with upper digestive endoscopy (UDE) and ecoendoscopy. The UDE confirmed a lesion on the lesser curvature, covered by normal mucosa, raising suspicion of a gastrointestinal stromal tumor (GIST) or lipoma. However, the biopsy of the lesion did not reveal signs of malignancy. The patient was then proposed for surgery. The patient underwent laparoscopic surgery for extramucosal enucleation of a gastric lipoma measuring 8.5 cm, with resection of the adherent mucosa. The postoperative period was uneventful, with discharge on the 5th day. The anatomopathological examination revealed that it was a well-differentiated lipomatous tumor, negative for the MDM2 gene.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pancreatic glucagonoma is a well-known rare subtype of pancreatic neuroendocrine tumors (PNETs). Most cases of pancreatic glucagonoma are associated with symptoms such as skin rash and necrotizing migratory erythema; however, some cases are asymptomatic. Complete tumor resection has an important impact on the long-term prognosis of patients with primary PNETs. The 2019 edition of the Japanese Guidelines for Neuroendocrine Tumors recommends recurrent lesions of pancreatic and gastrointestinal NETs to be treated multimodally, including resection if the lesions are curatively resectable. However, no treatment strategy has been established for recurrent pancreatic glucagonoma. We report the case of a patient who underwent distal pancreatectomy for primary pancreatic glucagonoma and developed multiple hepatic metastatic recurrences five years after the primary surgery. After two and a half years of somatostatin analog (SSA) treatment, neither tumor growth nor extrahepatic recurrence was detected, and curative surgery was performed. This study reports a rare case of complete resection for multiple metachronous liver metastases from a pancreatic glucagonoma after curative surgery. During SSA therapy, the metastatic tumors showed a very slow growth pattern. No other distant extrahepatic metastases emerged. Curative hepatectomy was performed safely, and the postoperative course was uneventful.
{"title":"Curative Surgery for Metachronous Multiple Liver Metastases from Pancreatic Glucagonoma after Distal Pancreatectomy","authors":"Akihiro Kohata, Tomoyuki Abe, Tsuyoshi Kobayashi, Masashi Inoue, Hideki Ohdan, Kazuhiro Toyota, Tadateru Takahashi","doi":"10.21614/sgo-578","DOIUrl":"https://doi.org/10.21614/sgo-578","url":null,"abstract":"Pancreatic glucagonoma is a well-known rare subtype of pancreatic neuroendocrine tumors (PNETs). Most cases of pancreatic glucagonoma are associated with symptoms such as skin rash and necrotizing migratory erythema; however, some cases are asymptomatic. Complete tumor resection has an important impact on the long-term prognosis of patients with primary PNETs. The 2019 edition of the Japanese Guidelines for Neuroendocrine Tumors recommends recurrent lesions of pancreatic and gastrointestinal NETs to be treated multimodally, including resection if the lesions are curatively resectable. However, no treatment strategy has been established for recurrent pancreatic glucagonoma. We report the case of a patient who underwent distal pancreatectomy for primary pancreatic glucagonoma and developed multiple hepatic metastatic recurrences five years after the primary surgery. After two and a half years of somatostatin analog (SSA) treatment, neither tumor growth nor extrahepatic recurrence was detected, and curative surgery was performed. This study reports a rare case of complete resection for multiple metachronous liver metastases from a pancreatic glucagonoma after curative surgery. During SSA therapy, the metastatic tumors showed a very slow growth pattern. No other distant extrahepatic metastases emerged. Curative hepatectomy was performed safely, and the postoperative course was uneventful.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Synchronous esophageal and lung cancer is an uncommon entity with few descriptions in the literature. It poses a relevant challenge to health care providers regarding its management and surgical approach.
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