Robotic Approach in Benign and Malignant Esophageal Tumors; A Preliminary Seven Case Series

Tomulescu, Victor; Stanescu, Codrut; Blajut, Cristian; Barbulescu, Loredana; Droc, Gabriela; Herlea, Vlad; Popescu, Irinel

doi:10.21614/chirurgia.113.2.202

Cited by 9 publications

(10 citation statements)

References 11 publications

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“…Robotic surgery could be another highly sophisticated treatment option in some referral centres. The procedure is safe, provides comparable outcomes to thoracoscopy and offers better ergonomics to well-trained surgeons, but only in very few, highly selected patients [30,31]. Cerfolio et al reported four successful leiomyoma resections using a robotic platform, demonstrating the biggest series worldwide in this area [32].…”

Section: Discussionmentioning

confidence: 99%

Complete laparoscopic-transhiatal removal of duplex benign oesophageal tumour: case report and review of literature

et al. 2021

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Background Leiomyoma is the most common benign oesophageal tumour. Half of all leiomyoma patients have oesophagus-associated complaints, such as dysphagia and epigastric pain, and the other 50% are asymptomatic with a diagnosis made on incidental discovery. Endoscopic ultrasonography is essential for an accurate preoperative workup and can enable guided-tissue acquisition for immunohistochemistry in certain cases. Smaller tumours are amenable to traditional and novel endoscopic removal in specialized centres, but some complex cases require surgical enucleation with a minimally invasive approach. Case presentation An asymptomatic 60-year-old woman was accidentally diagnosed with a bifocal oesophageal mass, which was discovered by chest computed tomography. We report a rare case of a duplicated lower-third oesophageal leiomyoma, which was completely removed via the laparoscopic transhiatal approach. The patient has recovered successfully from the surgery. She has been followed up for six months with a normal oesophagram, adequate oesophageal function and no complaints observed. Pathological examination confirmed the diagnosis of leiomyoma in both lesions. Conclusions To the best of our knowledge, this is the first reported case of duplex oesophageal leiomyomas removed laparoscopically. Using the minimally invasive abdominal technique, the lower oesophagus can be mobilised to the mediastinum without pleura injury and offers a good alternative to the thoracoscopic approach in patients with possible intrathoracic difficulties. At experienced centres, laparoscopic transhiatal enucleation of lower oesophageal leiomyomas and other benign tumours with a combination of intraoperative oesophagoscopy is a safe, fast and effective operation.

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Section: Discussionmentioning

confidence: 99%

Complete laparoscopic-transhiatal removal of duplex benign oesophageal tumour: case report and review of literature

et al. 2021

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“…5,6 These tumours usually at the time of diagnosis measure less than 5 cm but if they are larger than 10 cm, they are called giant leiomyomas and may be single or multiple. 7,8 Most patients with oesophageal leiomyomas are detected incidentally, however when they attain bigger size, they can cause symptoms like dysphagia, regurgitation, weight loss and chest pain. 10,15 Factors such as tumour size of more than 4 to 5 cm, presence of symptoms, location of the tumour, mucosal ulcerations and if malignancy cannot be ruled out, are considered as indications for surgical intervention whereas asymptomatic lesions and lesions < 4 to 5 cm in size can be managed conservatively with regular follow-up UGIE and contrast studies.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] Tumours larger than 10 cm are called Giant Leiomyomas and may be single or multiple. 7,8 Leiomyomas are often misdiagnosed as mediastinal mass, oesophageal cancer and gastrointestinal stromal tumour (GIST). Preoperative diagnosis is aided with imaging studies like computed tomography (CT), upper gastrointestinal endoscopy (UGIE), and endoscopic ultrasound (EUS).…”

Section: Introductionmentioning

confidence: 99%

Giant leiomyoma in distal, intra-thoracic oesophagus: Is laparoscopic approach feasible?

Biswas

Kalikar

Majeed

et al. 2021

Int J Gastrointest Interv

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Leiomyomas are the most common benign tumor of the oesophagus. symptomatic patients are candidates for excision, we have discussed a case report of a 43-year-old male patient who had complains of progressive dysphagia. Imaging studies suggested a distal oesophageal mass with calcific foci. The tumor was enucleated laparoscopically with an operative time of 160 minutes. The patient was gradually started on oral feeds from the 3rd postoperative day after an upper gastrointestinal contrast study. The patient was discharged on the 5th postoperative day. We found this minimally invasive approach to be effective with a shorter hospital stay and a faster recovery as compared to a thoraco abdominal approach.

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“…Although esophageal cancer is less common than other cancers, a wide range of lesions of other areas related to the neck, breast, and belly [37] characterizes it. The principles of surgical treatment include a decrease in surgical injury, contributing to the restoration of patients, and improving treatment safety based on the premise of complete resection of the tumor and adequate lymph dissection [38].…”

Section: Esophageal Carcinomamentioning

confidence: 99%

Impacts of Inflammatory Microenvironment on the Development of Cancer Relapse after Combined Treatment

Movchan¹,

Bagmut²

2021

Ukr. ž. med. bìol. sportu

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The purpose of the work was to study the impact of certain elements of the inflammatory microenvironment of the tumor on the development of cancer relapse of main localizations with the amplification of ERBB2 after combined treatment. Materials and methods. 80 patients, who had been treated for the period from 2016 to 2021 in National Cancer Institute, Kyiv, Ukraine. They were 42-78 (average 60) years old, ECOG 0-2, female. All patients histologically proved adenocarcinoma GIII-GIV. Everyone was studied for the level of chitinase-like proteins, cryoglobulins, tumor-associated macrophages in the preoperative (with the first identified disease for the first time, prior to the beginning of the neoadjuvant chemotherapy) and in the postoperative period. 1st block: with a confirmed mutation of HER-2/neu gene (amplification ERBB2 (3+)): a) inflammatory breast cancer (primary-edema form) – 10 people, b) diffuse-infiltrative stomach cancer – 10 people; c) diffuse-infiltrative esophagus cancer – 10 people; d) diffuse-infiltrative colorectal cancer – 10 people. 2nd block: without a confirmed mutation of HER-2/neu gene: a) inflammatory breast cancer (primary edema form) – 10 people; b) a diffuse-infiltrative stomach cancer – 10 people; c) diffuse-infiltrative esophageal cancer – 10 people; d) diffuse-infiltrative colorectal cancer – 10 people. Results and discussion. In patients with infiltrative breast cancer, diffuse-infiltrative stomach cancer, and diffuse-infiltrative esophagus cancer, and diffuse-infiltrative colorectal cancer there was a tendency to an increase in the expression of YKL-39 with the ERBB2 amplification during inflammatory tumor infiltration in the stroma. High expression of Stabilin-1 (2.1±0.70, n = 22) was found compared to patient tumors that did not reveal the amplification of ERBB2 (1.46±0.67, n = 13, p = 0.015). In most patients with amplification ERBB2, the cryoglobulin content was average (298.6±2.5 mg/l; 1.3±0.08%) – 20 (50%), which corresponds to cryoglobulinemia type II; with conditioned cryoglobulinemia (79.4±1.01 mg/l) in 10 (25%); high content (477.3±48 mg/l; 3.4±0.2%) was recorded in 10 (25%), which indicates the type III of cryoglobulinemia [the hazard ratio (HR) = 0.71, 95%, сonfidence interval (CI): 0.22-0.83, p = 0.005] Conclusion. Amplification of ERBB2 and macrophages surroundings markers CD68, M2 subpopulation RS1 (Stabilin-1), chitinase-like proteins YKL-39 and SI-CLP independently identified subgroups of patients with inflammatory breast cancer, diffuse stomach and diffuse esophageal, diffuse colorectal cancer with a bad forecast. In patients with the presence of the amplification of ERBB2 in the inflammatory tumor infiltrate, in the stroma, the higher expression of the chitinase-like protein YKL-39 and M2-polarization RS1 of the marker Stabilin-1, was detected compared to the patient's tumors without amplifying ERBB2. This study shows an important role of quantitative values associated with the tumor phenotype and macrophages in tumor progression, depending on the presence of ERBB2 gain. In patients with cryoglobulinemia with inflammatory cancer the secondary immunodeficiency is developed. This is determined by anomalies in the cell and humoral immune system, and leads to the development of postoperative inflammatory complications and relapses

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Robotic Approach in Benign and Malignant Esophageal Tumors; A Preliminary Seven Case Series

Cited by 9 publications

References 11 publications

Complete laparoscopic-transhiatal removal of duplex benign oesophageal tumour: case report and review of literature

Complete laparoscopic-transhiatal removal of duplex benign oesophageal tumour: case report and review of literature

Giant leiomyoma in distal, intra-thoracic oesophagus: Is laparoscopic approach feasible?

Impacts of Inflammatory Microenvironment on the Development of Cancer Relapse after Combined Treatment

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