World Journal of Surgical Oncology

Hemangioblastoma thận (RH) là một khối u lành tính rất hiếm. Hemangioblastoma thường xuất hiện ở hệ thần kinh trung ương (CNS), và chỉ có một vài trường hợp RH đã được báo cáo vì chúng thường được tìm thấy một cách tình cờ dưới dạng khối u không triệu chứng. Khối u Mullerian hỗn hợp (MMT) của tử cung là một dạng hiếm gặp và ác tính hơn của ung thư tử cung. Việc phát hiện hai khối u nguyên phát hiếm gặp một cách tình cờ là một hiện tượng hiếm. Một phụ nữ 50 tuổi đến khám với tình trạng chảy máu bất thường ở tử cung, qua lấy mẫu niêm mạc tử cung đã được chẩn đoán là một loại ung thư nội mạc hiếm gặp, tức là MMT hoặc carcinosarcoma tử cung. Trên hình ảnh trước phẫu thuật, một khối u thận cũng được phát hiện, khối u này có tính mạch cao và giống như ung thư biểu mô tế bào thận (RCC). Kỹ thuật chọc hút tế bào bằng kim nhỏ (FNAC) đã được thực hiện từ khối u thận để phân biệt giữa RCC và di căn, nhưng chỉ có tế bào máu cho thấy. Bệnh nhân đã trải qua phẫu thuật nội soi phân độ cho ung thư nội mạc tử cung và kiểm tra mẫu đông tại chỗ của khối u thận, mẫu xét nghiệm không kết luận được với một vài tế bào bất thường, và do đó, bệnh nhân cũng đã trải qua phẫu thuật cắt thận triệt để. Khám nghiệm bệnh lý mô cho thấy đây là một RH, một khối u lành tính rất hiếm. RH là một khối u lành tính hiếm gặp mà không cần điều trị trong phần lớn các bệnh nhân. Tới nay, chỉ có 26 trường hợp RH ngoài CNS đã được báo cáo. MMT là một khối u tử cung hiếm và ác tính với tỷ lệ mắc bệnh từ 1–2% trong tổng số các khối u tử cung, và do đó, việc phát hiện và điều trị sớm là rất quan trọng. RH cần được phân biệt với RCC để tránh xử trí quá mức. Các phát hiện hình thái tương tự trong RCC và RH; FNAC trước phẫu thuật, PET scan và mẫu đông tại chỗ trong quá trình phẫu thuật có thể được sử dụng để phân biệt hai khối u, trong các khối u được bao bọc tốt và trong bối cảnh nghi ngờ cao. Sự xuất hiện của khối u thận như một phát hiện tình cờ trong công việc chuẩn bị phẫu thuật đối với ung thư tử cung đã chỉ ra cho chúng tôi những đối phân biệt với di căn hoặc một khối u nguyên phát khác về mặt mô học. Sự hiện diện của hai khối u nguyên phát hiếm, tức là RH và MMT, trong cùng một bệnh nhân mà không có liên quan là một hiện tượng hiếm.

The purpose of the systematic review and meta-analysis is to analyze the application value of the stoma support rods in loop enterostomy. The studies on the application of stoma rods in loop enterostomy published from January 2000 to January 2020 were searched in the databases of PubMed, Embase, Cochrane library, and Clinical trials. All randomized controlled trials (RCTs) and cohort studies that observed the value of stoma rods were included according to inclusion criteria. The RevMan5.3 software was used for statistical analysis. A total of 1131 patients with loop enterostomy in six studies were included in this study; there were 569 cases in the experimental group and 562 cases in the control group. All six studies analyzed the effect of support rods on the incidence of stoma retraction; the meta-analysis showed that in a total of 32 patients, stoma retraction occurred, with a total incidence of about 2.8% in 1131 patients. The incidence of stoma retraction in the rod group was not significantly lower than that in the non-rod group, and the difference was not statistically significant (OR = 0.65, 95% CI 0.32~1.32, I2 = 0%, P = 0.23), and the studies were homogeneous. The incidences of stoma necrosis (OR = 6.41, 95% CI 2.22~18.55, I2 = 0%, P = 0.0006), peristomal dermatitis (OR = 2.93, 95% CI 2.01~4.27, I2 = 0%, P < 0.00001), and mucocutaneous separation (OR = 2.14, 95% CI 1.03~4.47, I2 = 0%, P = 0.04) were significantly increased in the rod group. It is not recommended to routinely use stoma support rods in the clinical practice.

The purpose of this research was to assess the feasibility of reconstructing the middle hepatic vein (MHV) with resected left portal vein during left hemihepatectomy. From January 2014 to January 2018, six patients received left hemihepatectomy combined with MHV reconstruction using the resected left portal vein in West China Hospital. We reviewed the clinical data including patient details, surgical technique, graft patency, and operative results. All six patients underwent left hemihepatectomy for liver tumors located at left hepatocaval confluence. In these patients, MHV was resected due to tumor invading and reconstructed using the resected left portal vein as graft. The mean operating time was 316 min. Two patients developed complications: one experienced bile leakage and one experienced pleural effusion. No patient developed vascular graft complications. All the grafts remained unobstructed, and no local tumor recurrence occurred during the observation period of 13–41 months. Our results indicated that the left portal vein was a safe graft for hepatic vein reconstruction. In addition, left hemihepatectomy combined with middle hepatic vein resection and reconstruction using the left portal vein can be performed safely to treat liver tumors located at hepatocaval confluence.

Sarcomas are a type of malignant tumors that arise from connective tissue. They are most of the time found in extremities We are presenting a case of adult male patient, who was found to have huge abdominal mass and multiple gastric and duodenal polyps. Pathological diagnosis for all lesions was Alveolar soft part sarcoma. Although he complained from metastasis to both lungs and right atrium, all these deposits regressed spontaneously. Patient stated that he used some herbs (Teucrium polium, Cat Thyme) prescribed for him. No chemotherapy or radiotherapy was given. The duration of regression was about 5 months before other lesions appeared. Later on, he died secondary to brain metastasis. ASPS is a rare type of sarcomas that affect primarily the lower limbs. This tumor does rarely metastasize to the gastrointestinal tract.

To conduct a meta-analysis to determine the relative merits of robotic thyroidectomy (RT) and endoscopic thyroidectomy (ET). A literature search was performed to identify comparative studies reporting peri-operative outcomes for RT and ET. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence interval (95% CI) were calculated using either a fixed-effects or a random-effects model. Six studies matched the selection criteria, which reported on 2048 subjects, of whom 978 underwent RT and 1070 underwent ET. Comparing the outcomes of RT with ET, this meta-analysis indicated that RT was associated with more complications (WMD = 1.51, 95% CI 1.18 to 1.94) and greater amount of drainage fluid (WMD = 17.10, 95% CI 5.69 to 28.51). Meanwhile, operating time (WMD = 1.50, 95% CI −39.59 to 42.58), conversion (WMD = 0.63, 95% CI 0.07 to 6.17), post-operative hospital stay (WMD = −0.05; 95% CI −0.18 to 0.08), and the number of lymph nodes harvested (WMD = 0.62, 95% CI −0.29 to 1.53) were similar for both procedures. The results of this meta-analysis indicated that RT is associated with an increased risk of complications and a greater amount of drainage fluid. Therefore, RT does not appear to have any advantage over ET. Further studies are required to confirm these results.

Hereditary nonpolyposis colorectal cancer (HNPCC), or Lynch syndrome, accounts for 3 % of newly diagnosed cases of colorectal cancer. While a partial or subtotal colectomy is indicated for early stage disease, there is a paucity of data addressing locally advanced disease involving the foregut. We report two patients with hereditary nonpolyposis colorectal cancer presenting with locally advanced colon cancer surgically managed by pancreaticoduodenectomy with en bloc partial colectomy and a review of the literature. Locally advanced colorectal cancer in HNPCC is a rare clinical entity that requires special surgical consideration. Multidisciplinary treatment, including multi-visceral resection, offers the best long-term outcome.

Laparoscopic-assisted total gastrectomy (LATG) is the most commonly used methods of laparoscopic gastrectomy for upper and middle gastric cancer. However, totally laparoscopic total gastrectomy (TLTG) is unpopular because reconstruction is difficult, especially for the intracorporeal esophagojejunostomy. We adopted TLTG with various types of intracorporeal esophagojejunostomy. In this study, we compared LATG and TLTG to evaluate their outcomes. From March 2006 to September 2015, 253 patients with upper and middle gastric cancer underwent laparoscopic total gastrectomy (LTG), 145 patients underwent LATG, and 108 patients underwent TLTG. The clinicopathological characteristics and postoperative outcomes were retrospectively compared between the two groups. Furthermore, a systematic review and meta-analysis were conducted. The operation time and estimated blood loss were similar between the groups. There were no significant differences in first flatus, diet initiation, and postoperative hospital stay. The surgical complication rates were 17.2 % (25/145) and 13.9 % (15/108) in the LATG and TLTG groups, respectively. The meta-analysis also revealed no significant differences in the operation time, estimated blood loss, time to first flatus, length of hospital stay, overall, and anastomosis-related complications among the groups. TLTG is a feasible choice for gastric cancer patients, with comparable results to the LATG approach.

Owing to recent advances in diagnostic and surgical techniques for cancer, a patient diagnosed with two or more neoplasms is not rare. We report on the case of a 58-year-old male with multiple primary malignant neoplasms, who suffered from three histological types of malignant neoplasm in six organs, namely the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in chronological order. The first neoplasm was a squamous cell carcinoma of the glottis diagnosed in 2006. The second and third neoplasms were urothelial carcinomas of the right renal pelvis and urinary bladder, respectively, diagnosed in 2008. The remaining three neoplasms were diagnosed in 2010, namely a squamous cell carcinoma of the oral floor, an adenocarcinoma of the prostate, and a squamous cell carcinoma of the esophagus. The glottic cancer and esophageal cancer were treated by external radiation therapy. The malignant neoplasms of the oral floor and those which originated in the urinary tract were surgically resected. All neoplasms except the malignant neoplasm of the oral floor were well controlled. The patient died of cervical lymph node metastasis from the squamous cell carcinoma of the oral floor in January 2011. As far as we know, the present report is the first one on this combination of primary malignant neoplasms.