Ingramneal9539

Mandibular reconstruction always pose a challenge to the reconstructive surgeon. With the use of Computer aided designing and computer aided manufacturing (CAD-CAM) it is now possible to reconstruct mandibular defects to near normal configuration with good function and aesthetic outcomes.

To compare the efficacy of CAD-CAM technique vs conventional technique in mandibular reconstruction with free fibula flap.

40 consecutive patients that required mandibular reconstruction using free fibula flap were included in the study. All patients were treated using CAD-CAM technique and then compared retrospectively with 40 patients treated with conventional technique. Comparison was done between total intraoperative time, aesthetic outcome and post-operative occlusion.

Total intraoperative time in the CAD-CAM group was significantly reduced (562min) as compared to the conventional group (662min). Patients in the CAD-CAM group also obtained a better Aesthetic score (3.6/5) when compared to the conventional group (2.5/5). Postoperative malocclusion was noted in 1 patient in the CAD-CAM group as opposed to 6 patients in the conventional group.

Use of CAD-CAM technology in mandibular reconstruction with free fibula flap offers reduced surgical time with precise and accurate reconstruction that produces better functional and aesthetic outcomes.

Use of CAD-CAM technology in mandibular reconstruction with free fibula flap offers reduced surgical time with precise and accurate reconstruction that produces better functional and aesthetic outcomes.

To demonstrate step-by-step minimally invasive surgical technique for dissection of isolated inguinal node relapse of high grade serous ovarian cancer.

A 54-year-old woman, BRCA1 +, underwent to open abdominal total hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and aortic lymphadenectomy with zero residual disease, for high grade serous ovarian carcinoma FIGO stage IIB. After surgery, patient underwent platinum-based chemotherapy for six cycles and follow-up examinations every 3 months for the first year and biannual for the second one. Abdominal TC-PET scan after 18 months revealed a right distal iliac external/inguinal nodal relapse (SUV max 18,4). Ca125 was 9,1 mUI/ml. Right pelvic peritoneum was opened (step 1) and right retroperitoneal spaces were developed. Ureter was medialized (step 2) and obturator fossa was developed (step 3). Access to the deep inguinal ring (step 4) allows to identify inguinal lymph node relapse caudally to deep iliac circumflex artery. Bulky node was isolated (step 5) and excised en-block with obturator nodes (step 6). The entire procedure was performed using only a bipolar combination instrument for laparoscopy. Operating time was about 120 minutes and estimated blood loss was <100 ml.

Pathology confirmed relapse of high grade serous ovarian cancer (CK7+; WT1+). Patient was discharged in post-operative day 3 without complications.

Minimally invasive surgery for excision of isolated inguinal node relapse of ovarian cancer is a feasible and effective technique.

Minimally invasive surgery for excision of isolated inguinal node relapse of ovarian cancer is a feasible and effective technique.

Breast cancer is the most common cancer in Danish women. In 2016 about 1450 (31%) Danish breast cancer patients had a mastectomy. The aim was to compare the frequency of postoperative complications in two methods of surgery, electrocautery dissection and tumescent technique, when performing a mastectomy.

Open randomized controlled trial of all consecutive primary breast cancer or DCIS female patients who underwent either a simple mastectomy or a modified radical mastectomy in Vejle Hospital, from January 2012 to October 2017. Primary outcomes were seroma production, bleeding, infection and necrosis. Secondary outcomes were duration of surgery and delay of adjuvant treatment caused by complications. Categorical outcome variables were compared between randomization groups using chi-square of Fisher exact test and continuous outcome variables by using Wilcoxon rank test. All analyses were performed at a 5% two-sided significance level.

357 patients met the inclusion criteria. 14 had bilateral mastectomy, i.e. https://www.selleckchem.com/products/mrtx1133.html 371 breasts. The two randomization groups consisted of 105 patients/107 breasts operated by tumescent technique and 98 patients/102 breasts operated by electrocautery technique. Tumescent technique produced more seroma though not significant (p=0.631) (mean 605 vs. 630ml). Bleeding in the tumescent group was 10.3% vs. 5.9% in the electrocautery group (p=0.245). Infection (5.9% vs. 7.5% p=0.645) and necrosis (4.9% vs. 4.7% p=0.938) was uncommon with no difference between the intervention groups. Infection was most common cause of delay of adjuvant treatment; 3.9% in the electrocautery technique group. No significant difference in duration of surgery (p=0.392).

Both techniques are equally safe for simple and modified radical mastectomy.

Both techniques are equally safe for simple and modified radical mastectomy.

Few patients affected by gastric cancer peritoneal metastasis (GCPM) are offered locoregional treatment, despite several proof-of-efficacy trials. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged in recent years as a promising tool to control peritoneal carcinomatosis. The combination of PIPAC with systemic chemotherapy may offer a greater clinical benefit than standard treatment alone.

A single-center cohort of 28 consecutive patients affected by GCPM was scheduled for bidirectional treatment, comprising PIPAC and systemic chemotherapy, from September 2017 to September 2019. Data recorded included safety, efficacy and survival outcomes. Ascite volumes, the Peritoneal Cancer Index (PCI) and pathological response through the Peritoneal Regression Grading Score (PRGS) were compared in those patients who underwent more than one PIPAC procedure.

Forty-six PIPAC procedures were administered, with a mean of 1.7 PIPAC procedures per patient. The median time to resume systemic chemotherapy ay of PIPAC. The proposed bidirectional approach may be further investigated in the first-line treatment of metastatic gastric cancer.