Springer Science and Business Media LLC

Robot-assisted laparoscopic surgery is yet another modification of minimally invasive liver surgery. It is described as feasible and safe from the surgical point of view; however, oncological outcomes need to be adequately analysed to justify the use of this technique when resecting malignant liver tumours. We reviewed existing English medical literature on robot-assisted laparoscopic liver surgery. We analysed surgical outcomes and oncological outcomes. We analysed operative parameters including operative time, type of hepatectomy, blood loss, conversion rate, morbidity and mortality rates and length of stay. We also analysed oncological outcomes including completeness of resection (R status), recurrence, survival and follow-up data. A total of 582 patients undergoing robot-assisted laparoscopic liver surgery were analysed from 17 eligible publications. Only 5 publications reported survival data. The overall morbidity was 19% with 0.2% reported mortality. R0 resection was achieved in 96% of patients. Robotic liver surgery is feasible and safe with acceptable morbidity and oncological outcomes including resection margins. However, well-designed trials are required to provide evidence in terms of survival and disease-free intervals when performed for malignancy.

Only a few countries of the world have a population more than Bihar, but due to the lack of a cancer registry, authentic research, and publications, data regarding the clinicopathological characteristics of breast cancer patients from this state are scarce. The present study was aimed to report the clinicopathological characteristics of breast cancer patients at a tertiary care center in Bihar, India. This is a retrospective review of a prospectively maintained database of patients of breast cancer treated between January-2018 and March-2020. One hundred fifteen patients with breast carcinoma were included of which 112 (97.4%) were women. The mean age was 47.28 ± 11.62 years and 54.5% of women were postmenopausal. Most patients had a clinical stage of II or III (44.5% each) while 8.7% of patients had stage IV disease. Invasive ductal carcinoma no special type (IDC-NST) was the most common histology (85.2%). The majority of tumors were grade II (55.6%), lymphovascular invasion was seen in 45.6%, and perineural invasion in 18.4%. Estrogen receptor was found in 41.8%, progesterone receptor was positive in 47.3%, and human epidermal growth factor receptor-2 (HER-2/Neu) overexpression was observed in 39.8%. Triple-negative breast cancer was found in 26.2% of patients. The majority underwent mastectomy (71.3%) while breast conservation was done in 26%. All except one patient underwent axillary lymph node dissection for axillary staging. 43.5% patients received neoadjuvant chemotherapy, 52.9% received adjuvant chemotherapy, while 3.5% patients received palliative chemotherapy. The clinicopathological profile of breast cancer patients from Bihar is similar to that reported from other parts of India except for a lower rate of distant metastasis.

Excision of port site (PSE) for patients having undergone laparoscopic cholecystectomy (LC) is not a standard recommendation. We retrospectively evaluated a cohort of patients with isolated PSM without any prior cancer-directed therapy who were assessed for resection between March 2012 and July 2016 at Tata Memorial Hospital, Mumbai. Eleven of a total 13 patients underwent wide excision for PSM in the given time period. Upfront resection was undertaken in six patients while seven patients received neoadjuvant chemotherapy (NACT) and two received neoadjuvant chemo radiotherapy (NACTRT) prior to attempted resection. With the median follow-up of 22 months, post PSM disease-free survival (DFS) was 20 months (95% CI 15–24 months) and overall survival (OS) was 37 months (95% CI 22–51 months). Careful selection along with an aggressive management strategy may be a step forward in the treatment of patients with isolated PSM.

Central venous access devices are routinely used in oncology for delivering chemotherapy of which implantable chemoports are the most common. Spontaneous breakage and migration of the catheters is a very rare but known complication of the procedure. Patients will usually present with cardiac manifestations in form of chest pain or arrythmias. Herein we report a case of spontaneous breakage and cardiac migration in which the patient was asymptomatic. Patient was successfully managed by an interventional cardiologist.

Aneurysmal bone cyst is a locally aggressive benign tumor accounting for 3 % of all benign bone tumors. It most commonly arises from ends of long bones and relatively rare in flat bones. Clavicle is a very rare site for bone tumors with secondaries more common than primaries. Very few cases of aneurysmal bone cyst have been reported in literature. We hereby report interesting and a rare case of aneurysmal bone cyst of medial end of clavicle in a eight year old lady which was treated with extended curettage and calcium sulfate bone grafting.

To investigate efficacy and safety of cetuximab combined with neo adjuvant chemotherapy regimen in patients with unresectable colorectal liver. This was a prospective trial with rate of Ro liver metastases resection as primary end point. Between January 2010 and December 2014, 46 patients with unresectable liver metastases from colon or rectum were enrolled. Patients received Cetuximab along with neoadjuvant chemotherapy where 34 (74 %) and 12 (2 6 %) patients received FOLFOX and FOLFIRI, respectively. They were assessed for response after 2–3 cycles by CT scan. Patients with resectable disease were offered liver surgery within 3–6 weeks of the last treatment cycle. The primary end point was resection rate of liver metastases, which was evaluated in all patients. Secondary end points were response rate according to Response evaluation criteria in solid tumors (RECIST) criteria, perioperative morbidity and mortality. An objective response was observed in 28 (60.9 %) patients. Seven (15.2 %) patients were reported radiologically to have a complete response (CR); 21 (45.7 %) patients had radiological partial response (PR). An additional 12 patients (26.1 %) demonstrated stable disease (SD) and only six patients (13.0 %) had disease progression (PD). Microscopically complete resections (R0 resection) was performed in all 28 patients (60.9 %). The most frequent toxicities were skin rash and diarrhoea. There was no operative mortality. Chemotherapy with cetuximab yields high response rates compared with historical controls, and leads to significantly increased resectability. Complete resection of previously unresectable colorectal liver metastases can be performed with minimal morbidity and mortality. This therapeutic strategy involves a multimodal approach.

Carotid body tumours are rare and mostly benign neoplasm. They are slow growing but can evade or exert pressure on neighbouring important neurovascular structures. Hence, surgical resection remains the treatment modality of choice for large tumours partially or completely encasing the carotid arteries. But the surgical resection of these tumours with minimum morbidity is challenging because of their highly vascular nature. Earlier literature has dealt with various aspects of management of carotid body tumours including classification, morbidity, work-up, embolisation and extent of resection. However, the options in techniques of dissection for carotid body tumours have not been elaborated much. Here, we describe a stepwise dissection technique of carotid body tumours from the internal carotid towards the external carotid artery. This surgical technique, named as “the internal to external (INT-EX) technique”, provides better control of bleeding during the surgery, ease of dissection and lesser post-operative morbidity.