Locally advanced colorectal tumors represent about 5-22% of all colorectal cancers at the time of presentation. Specifically in the case of right colon cancer, the percentage of adjacent structure involvement ranges between 11% and 28%. Organs that are most frequently invaded by right colonic tumors are the duodenum and the pancreatic head. We report the case of a 36-year old man with locally advanced right colonic cancer, invading the head of the pancreas and the superior mesenteric vein, who was successfully treated in our department with right hemicolectomy, pancreatoduodenectomy and short resection of the superior mesenteric vein with an end-to-end anastomosis, and remains alive and well, free of disease, nine years after the operation.
We report the case of a patient with a history of surgically treated pulmonary leiomyosarcoma, presenting with recurrent acute cholangitis and metastatic leiomyosarcoma of the common bile duct. Preoperative examinations had revealed a high grade malignant neoplasm and bilateral lung metastases. The patient underwent pylorus-preserving pancreaticoduodenectomy and survived for 5.5 years after the first diagnosis.
Background -Aim: The role of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) in thyroid surgery remains controversial. We present herein the initial experience in the use of the IONM of the RLN in our Department. The objective of the present study was to determine the potential role of IONM in reducing postoperative RLN palsy rate Methods: Between of the RLN was applied in 84 of these patients in order to identify and preserve the RLNs, whereas conventional RLN identification was used in the remaining 612 patients. Results: Eighty four total thyroidectomies and two reoperations were performed using IONM of the RLN with 170 nerves at risk and 612 total thyroidectomies and 38 re-operations with 1262 nerves at risk were performed by routine identification. The incidence of transient and permanent RLN paralysis based on nerves at risk was 0.59% (1 of 170) and 0% (0/170) with intraoperative neuromonitoring and 0.24% (3 of 1262) and 0% (0/1262) with conventional RLN identification. Conclusion: Neuromonitoring of the RLN during thyroid surgery could not be demonstrated to reduce RLN injury significantly, compared with routine RLN identification. Nevertheless, its application can be considered in selected high-risk thyroidectomies. This technological process may render safer thyroidectomies performed by junior surgeons or surgeons with low case-load.
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