Invasive Resection Research Articles

Mitral valve leaflet blood cyst treated with minimally invasive approach: a case report and review of literature

IntroductionCardiac blood cyst is a very rare benign tumor of the heart in adults. Though it is very common in the first half year of life, it regresses with time and its occurrence is very rare in children older than six months and in adults. Until now less than 100 valvular blood cyst cases have been reported in adults.Case presentationWe present a case of a 66-year-old male who presented to us with exertional chest tightness, shortness of breath, and right leg weakness for two weeks. He was diagnosed with a cardiac mass two months ago in another hospital. The physical examination was unremarkable. Abdominal ultrasound showed a cyst in the liver and left kidney. Echocardiography showed a mass-occupying lesion of a cystic nature in the mitral valve with moderate mitral regurgitation. Based on echocardiography findings and computed tomography report, the preliminary diagnosis of mitral valve cystic tumor was made. The patient underwent minimally invasive resection of the cyst. The posterior mitral cusp was repaired and a mitral annuloplasty ring was placed. The postoperative recovery was uneventful. The histopathology report confirmed the diagnosis of a cardiac blood cyst. The patient was followed up for six months without any complications. This case is presented to enrich the medical literature on the cardiac blood cyst.ConclusionAlthough a cardiac blood cyst is a rare entity in adults, it still should be considered in the differential diagnosis of cardiac tumors. Because the natural history and hemodynamic effects are very diverse, large symptomatic cardiac blood cysts, especially in the left heart should be resected to avoid complications.

Efficacy of Minimally Invasive Ulnar Superficialis Slip Resection for Unfavourable Results after Trigger Finger Release.

Background: This study aimed to evaluate the efficacy of ulnar superficial slip resection (USSR) for improving hand function after unfavourable results after triggering finger release using a minimally invasive approach. Methods: We evaluated 17 consecutive fingers of 16 patients who complained of unfavourable outcomes after primary trigger finger release. The chief complaints of the two index and 15 middle fingers were proximal interphalangeal (PIP) joint pain during movement, flexion contracture of the PIP joint and snapping at the A2 pulley in eight, seven and two fingers, respectively. The joint arc of the active range of motion and extension loss of the PIP joint, grip strength, visual analogue score (VAS) of PIP joint pain and Quick Disability of the Arm, Shoulder and Hand were evaluated before and after surgery. Results: Thirteen fingers could release joint contracture and snapping by the USSR procedure. However, four fingers of three patients required total flexor digitorum superficialis resection to resolve the unsatisfactory conditions of the intraoperative decision. The joint arc of active range of motion and extension loss of the PIP joint, grip strength and VAS score significantly improved (mean of 16.1 months follow-up). Finally, 15 patients (88.2%) were satisfied with the symptom relief outcomes. Conclusions: USSR is an effective and satisfactory procedure for unfavourable conditions after trigger finger release, including PIP joint pain, joint contracture and snapping at the A2 pulley. Level of Evidence: Level IV (Therapeutic).

Minimally invasive surgery for clinical T4 non-small-cell lung cancer: national trends and outcomes.

Recent randomized data support the perioperative benefits of minimally invasive surgery (MIS) for non-small-cell lung cancer (NSCLC). Its utility for cT4 tumours remains understudied. We, therefore, sought to analyse national trends and outcomes of minimally invasive resections for cT4 cancers. Using the 2010-2019 National Cancer Database, we identified patients with cT4N0-1 NSCLC. Patients were stratified by surgical approach. Multivariable logistic analysis was used to identify factors associated with use of a minimally invasive approach. Groups were matched using propensity score analysis to evaluate perioperative and survival end points. The study identified 3715 patients, among whom 64.1% (n = 2381) underwent open resection and 35.9% (n = 1334) minimally invasive resection [robotic-assisted in 31.5% (n = 420); and video-assisted in 68.5% (n = 914)]. Increased MIS use was noted among patients with higher income [≥$40227, odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01-1.51] and those treated at academic hospitals (OR 1.25; 95% CI 1.07-1.45). Clinically node-positive patients (OR 0.68; 95% CI 0.55-0.83) and those who underwent neoadjuvant therapy (OR 0.78; 95% CI 0.65-0.93) were less likely to have minimally invasive resection. In matched groups, patients undergoing MIS had a shorter median length of stay (5 vs 6 days, P < 0.001) and no significant differences between 30-day readmissions or 30/90-day mortality. MIS did not compromise overall survival (log-rank P = 0.487). Nationally, the use of minimally invasive approaches for patients with cT4N0-1M0 NSCLC has increased substantially. In these patients, MIS is safe and does not compromise perioperative outcomes or survival.

Symptomatic Preperitoneal Lipoma Resected via Preperitoneal Approach: A Case Report and Review of the Literature

Introduction: Lipomas are benign adipose tissue tumors that can vary in size and location. Magnetic resonance images should be obtained for all soft-tissue masses that are deep to fascia or those &gt;5 cm in subcutaneous tissue. In this case report, we present a minimal invasive technique to resect a large preperitoneal lipoma. Case Presentation: A 36-year-old woman presenting with left fossa pain caused by a large mass. MRI-imaging shows a large preperitoneal lipomatous lesion (61 × 58 × 40 mm) which compresses the bladder, tuba and surrounding vessels. We did a minimally invasive preperitoneal laparoscopic surgical resection. Postoperative follow-up was uneventful. The pathology report confirmed benign lipoma without signs of malignancy. Discussion: Preperitoneal lipomas should be considered in the diagnosis of lower abdominal pain and can be minimally invasive resected via preperitoneal laparoscopic approach in day clinic.

Laparoscopic nephrectomies and kidney resections in children

To present the experience of laparoscopic nephrectomies and kidney resections in children. There were 28 minimally invasive surgeries for renal tumors between July 2015 and March 2023 (92 months). There were 16 (57%) boys and 12 (43%) girls who underwent 22 nephrectomies and 6 kidney resections. The median age of patients was 54 (38; 76.5) months. In the laparoscopic nephrectomy group, the median surgery time was 135 (108-188) min, blood loss - 10 (3.75-15) ml. Total resection was confirmed in all patients. In the group of minimally invasive kidney resections, these values were 182.5 (157.5; 265) min and 50 (42.5; 117.5) ml, respectively. Histological examination confirmed total resection in all patients. In both groups, none patient developed postoperative complications. Event-free survival was 86.72% with a median follow-up of 82 months, and local recurrence-free survival was 95.8% with a median follow-up of 89.8 months. Minimally invasive nephrectomies and resections are safe in children in case of careful patient selection.

Minimally invasive versus open resection for solid pseudopapillary tumors: a study of 740 cases

Minimally invasive versus open resection for solid pseudopapillary tumors: a study of 740 cases

Minimally invasive liver resection as a downstaging strategy prior to liver transplant: is it time to change the paradigma?

Minimally invasive liver resection as a downstaging strategy prior to liver transplant: is it time to change the paradigma?

Amputation neuroma with a difficult differential diagnosis from perihilar cholangiocarcinoma:a case report

Biliary amputation neuroma is a rare benign tumor that develops due to the peribiliary dissection of nerve fibers during cholecystectomy, a common bile duct surgery, or lymph node dissection performed in gastric cancer surgery. We report a case of amputation neuroma that presented a challenging differential diagnosis from perihilar cholangiocarcinoma. A 64-year-old man, who had undergone open cholecystectomy 30 years ago, was incidentally found to have a bile duct tumor during computed tomography (CT) following surgery for renal cell carcinoma. He had no specific symptoms, and blood test results showed only a slight elevation in alkaline phosphatase levels. Contrast-enhanced CT revealed a 10-mm solid tumor with contrast effect in the common bile duct. On cholangiography, the tumor appeared as a protruding lesion with a smooth surface unilaterally. Given the atypical findings suggestive of cholangiocarcinoma, three bile duct biopsies were performed. Pathological examination did not rule out adenocarcinoma. The patient opted for surgery;however, an intraoperative rapid histological examination confirmed a benign disease, thereby avoiding extensive surgery. Consequently, a minimally invasive bile duct resection was performed. Postoperative histopathological examination revealed the tumor to be an amputation neuroma. Biliary amputation neuromas are characterized as unilateral protruding lesions with contrast effect or benign strictures. If such findings are observed in a patient with a history of surgery around the bile duct, the possibility of an amputation neuroma should be considered. However, completely ruling out malignancy preoperatively, even when suspecting amputation neuroma, can be challenging;therefore, considering surgery to achieve a definitive diagnosis is reasonable. During surgery, a rapid intraoperative histological examination is useful to avoid extensive procedures. In conclusion, diagnosing an amputation neuroma before surgery can be difficult, as it can mimic malignant tumors such as bile duct cancers. In this case, although a preoperative diagnosis of amputation neuroma was not feasible, performing a rapid intraoperative pathological examination helped avoid extensive surgery.

Minimally invasive surgical treatment of extramedullary tumors at the level of craniovertebral junction: experience of the Burdenko Neurosurgical Center

To describe own experience of treating patients with extramedullary tumors at the level of craniovertebral junction using minimally invasive surgical approaches. The study included 29 patients who underwent minimally invasive microsurgical resection of extramedullary tumors at the level of craniovertebral junction. We analyzed the main clinical and surgical parameters. Gross total resection was achieved in most patients with high degree of safety. Two patients required redo surgery due to CSF leakage and soft tissue cyst. Mean length of hospital-stay was 7 days. VAS score of pain syndrome at discharge was 2 points and 0 points after 3 months. No significant differences in neurophysiological monitoring indicators were observed (p=0.76). Minimally invasive posterior approaches to extramedullary tumors at the level of craniovertebral junction can significantly reduce surgical trauma with equal extent of resection.

Robot-Assisted Thoracoscopic Resection of Ectopic Parathyroid Tissue in Mediastinum: A Scoping Review.

Ectopic parathyroid tissue in the mediastinum represents a rare and potentially serious clinical entity with challenging diagnostic and surgical management. The main surgical approach for this issue is open thoracotomy, which is a safe technique but carries risks and complications associated with such as extensive surgery. The purpose of this study is to demonstrate robotic thoracic surgery as an alternative and potentially advantageous method to treat patients with ectopic parathyroid adenomas compared with open and video-assisted thoracoscopic surgery approaches. A total of 13 reports in the literature were identified that provided details in terms of complications, surgical approach, and results of minimally invasive surgical resection of mediastinal ectopic parathyroid tissue.

Minimally invasive simultaneous colorectal and liver resection for synchronous colorectal liver metastasis – short-term outcomes

Minimally invasive simultaneous colorectal and liver resection for synchronous colorectal liver metastasis – short-term outcomes

Minimally invasive versus open resection for solid pseudopapillary tumors of the pancreas: a study of 740 cases

Minimally invasive versus open resection for solid pseudopapillary tumors of the pancreas: a study of 740 cases

Individually tailored minimally invasive full-endoscopic transnasal resection of large clival chordomas. Decision making in mononostril vs. binostril approaches

Individually tailored minimally invasive full-endoscopic transnasal resection of large clival chordomas. Decision making in mononostril vs. binostril approaches

Open and minimally invasive liver resection for intrahepatic cholangiocarcinoma. Analysis of immediate outcomes and survival

Open and minimally invasive liver resection for intrahepatic cholangiocarcinoma. Analysis of immediate outcomes and survival

Impact of preoperative thrombocytopenia on perioperative outcomes among patients undergoing minimally invasive or open liver resection. An international multicenter retrospective propensity score matched analysis

Impact of preoperative thrombocytopenia on perioperative outcomes among patients undergoing minimally invasive or open liver resection. An international multicenter retrospective propensity score matched analysis

Minimally invasive liver resection versus transarterial chemoembolization for intermediate stage (BCLC-B) hepatocellular carcinoma: a propensity score analysis for long term survival in multicentric comparative study

Minimally invasive liver resection versus transarterial chemoembolization for intermediate stage (BCLC-B) hepatocellular carcinoma: a propensity score analysis for long term survival in multicentric comparative study

Minimally invasive removal of dumbbell shaped schwannomas with transforaminal lumbar fusion: a retrospective study with a minimum 3-year follow-up

To evaluate the effectiveness and long-term results of minimally invasive resection of dumbbell-shaped lumbar schwannomas Eden type 2 and 3 combined with transforaminal lumbar interbody fusion and transpedicular stabilization. A retrospective study included 13 patients (8 men and 5 women) with lumbar dumbbell tumors Eden type 2 and 3 who underwent minimally invasive facetectomy through posterolateral anatomical corridor, microsurgical tumor resection and MI TLIF. We analyzed intraoperative parameters, neurological functions (ASIA scale), clinical characteristics (ODI, SF-36), and complications. Resection quality and area of the multifidus muscle were assessed according to MRI data. All patients were followed-up throughout at least 3-year. Surgery time was 147 min, blood loss - 118 ml, hospital-stay - 7 days. Clinical parameters significantly improved in the follow-up period: ODI score decreased from 72 to 12 (p=0.004), SF-36 PCS increased from 26.24 to 48.51 (p=0.006) and MCS score increased from 29.13 to 53.68 (p=0.002). According to MRI data, no tumor recurrences and severe muscle atrophy (>30%) were observed after 3 years in all cases. Superficial wound infection occurred in 1 (7.7%) case. There were normal neurological functions (ASIA type E) in all patients. Minimally invasive facetectomy through posterolateral approach with MI TLIF technology can be used for safe and effective resection of dumbbell-shaped schwannomas Eden type 2 and 3.

Minimally Invasive Resection of a Large Subcutaneous Lipoma: The 2.5-cm (1-inch) Method.

Minimally Invasive Resection of a Large Subcutaneous Lipoma: The 2.5-cm (1-inch) Method.

Safety and Efficacy of Endoscopic Full Thickness Resection of Upper Gastrointestinal Lesions Using a Full Thickness Resection Device: A Systematic Review and Meta-analysis.

Endoscopic full-thickness resection (EFTR) is a promising technique that allows for a minimally invasive resection of mucosal and submucosal lesions in the gastrointestinal (GI) tract. The data regarding the efficacy and safety of performing EFTR of upper GI lesions using a full-thickness resection device (FTRD) is limited. Hence, we performed a systematic review and meta-analysis of the studies that evaluated this technique. We performed a comprehensive systematic search of multiple electronic databases and conference proceedings that reported outcomes of EFTR using the FTRD system. The weighted pooled rates of technical success, complete (R0) resection, adverse events (AE), and residual or recurrent lesions were analyzed with 95% CI using the random effects model. Eight studies with a total of 139 patients who underwent EFTR of upper GI lesions were included in the study. The pooled, weighted rate of technical success was 88.2% (95% CI: 81.4-92.7%, I2 : 0). The R0 resection rate was 70.7% (95% CI: 62.5-77.8%, I2 : 0). Overall AE rates were 22.1% (95% CI: 15.8-30.1%, I2 : 0), however, most of the AEs were minor. Of the patients who had follow-up endoscopies, the residual and/or recurrent lesion rate was 6.1% (95% CI: 2.4-14.4%, I2 : 0). Heterogeneity in the analysis was low. EFTR using the FTRD seems to be effective and safe with acceptable R0 resection rates and low recurrence rates. Further prospective studies are required to validate our results and to compare various modalities of endoscopic resection with this single-step EFTR device.

A retrospective study comparing minimally invasive versus open surgical resection of small intestinal neuroendocrine neoplasms at a tertiary referral center

IntroductionNeuroendocrine neoplasms (SI-NEN) are the commonest malignancies of the small intestine. Traditionally, surgical treatment for SI-NEN has been open surgery. PurposeThe purpose of this study was to compare minimally invasive surgery (MIS) with the traditional open surgery approach for treating SI-NEN in a Swedish population. MethodsPatients with histopathological confirmed SI-NEN who underwent open surgery or MIS resection within 2009–2021 were extracted from the hospital's medical records. Results65 patients were included in this study, with 35 (54 %) undergoing MIS and 30 (46 %) undergoing open surgery. We found no statistically significant difference (p = 0.173) in the frequency of R0 resections (MIS group n = 34 (97 %), open surgery group n = 26 (87 %)). Nor was there a significant difference (p = 0.101) when comparing the median number of resected lymph nodes (MIS group n = 13.5, open surgery group n = 10). A post-operative paralytic ileus was more often reported (p = 0.052) in the MIS group (n = 9, 26 %) compared to the open surgery group (n = 2, 7 %). In light of this, the days of hospital stay did not differ significantly (MIS group median = 6, IQR (5–8), open surgery group median = 6, IQR (5–9)). The Kaplan-Meier analysis did not reveal differences concerning cancer-related deaths (p = 0.109). ConclusionThe results from this study support that a MIS approach for the treatment of SI-NEN may not be inferior to open surgery. The higher number of resected lymph nodes and R0 resections may even speak in favor for a MIS approach. More studies with a longer time of observation are needed to further support this conclusion.