5,038 results match your criteria wide margin

Intersurgeon agreement in determining 3 cm surgical margins of subcutaneous tumors in dogs.

Vet Surg 2021 Sep 18. Epub 2021 Sep 18.

Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.

Objective: To evaluate intersurgeon agreement in performing a 3 cm wide surgical excision for subcutaneous malignancies in dogs.

Study Design: Prospective, blinded, randomized, clinical study.

Animals: Client-owned dogs with subcutaneous tumors undergoing curative-intent, wide surgical excision between April 2019 to March 2020. Read More

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September 2021

The role of postoperative radiotherapy in pN1 oral cavity cancer without extranodal extension.

World J Surg Oncol 2021 Sep 17;19(1):279. Epub 2021 Sep 17.

Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan.

Background: The administration of postoperative radiotherapy remains controversial in pN1 oral cavity cancer patients without extranodal extension. The aim is to determine whether postoperative radiotherapy reduces the neck recurrence rate and improves the survival outcomes of pN1 patients.

Methods: This study consecutively enrolled 1056 patients with newly diagnosed oral squamous cell carcinoma who underwent tumor wide excision and neck dissection from September 2002 to November 2019. Read More

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September 2021

[Neoadjuvant Use of Isolated Limb Perfusion in Large Myxoid Liposarcoma of the Thigh: a Case Report].

Acta Chir Orthop Traumatol Cech 2021 ;88(4):321-324

Ústav patologie 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Na Bulovce, Praha.

Large unresectable STS presents a therapeutic challenge. Several options are being explored to avoid amputation without compromising the oncological outcome. Neoadjuvant chemotherapy delivers inconsistent and rather unsatisfactory results, preoperative radiotherapy compromises healing, hence it can impede adjuvant systemic treatment. Read More

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September 2021

Surgical clinical trials with non-inferiority design: a cross-sectional bibliometric analysis.

Ann Transl Med 2021 Aug;9(16):1302

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.

Background: Wide-spread concerns have been raised about possible bias in published surgical non-inferiority trials. Therefore, we performed a comprehensive bibliometric analysis to identify the existence of bias, and provided recommendations for future non-inferiority trials.

Methods: Databases including MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were systematically searched (last update on 27 April 2020) to include published phase II and phase III non-inferiority surgical trials. Read More

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Chondrosarcoma of Maxilla - A Rare Case Report.

Ann Maxillofac Surg 2021 Jan-Jun;11(1):140-143. Epub 2021 Jul 24.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Dharmsinh Desai University, Nadiad, Gujarat, India.

Rationale: Chondrosarcoma, although being a rare entity in jaws, may turn fatal if left untreated or inadequately excised. Prognosis in terms of 5-year survival rate ranges from 90% for Grade I, 81% for Grade II and 43% for Grade III respectively.

Patient Concerns: A 35-year-old male patient reported with a gradually progressive hard painless growth over right maxillary molar region. Read More

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Extirpative Considerations of Melanoma of the Head and Neck.

Clin Plast Surg 2021 Oct;48(4):659-668

Department of Surgery, The Elvin G Zook Endowed Chair - Institute for Plastic Surgery, Southern Illinois University, 747 North Rutledge Street #3, Springfield, IL 62702, USA.

The incidence of melanoma is continuing to rise in the United States, and head and neck melanomas account for 25% of all cutaneous melanomas. The National Comprehensive Cancer Network guideline recommendations for surgical margins and sentinel lymph node biopsy in head and neck melanomas are the same as cutaneous melanoma located in other regions, but require special considerations when performing wide local excision, sentinel lymph node biopsy, and completion lymph node dissection and reconstruction taking into account the location of the melanoma and structures involved in and around the suggested margins. Read More

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October 2021

Bedrock erosion in subglacial channels.

PLoS One 2021 9;16(9):e0253768. Epub 2021 Sep 9.

Department of Hydraulic, Roadways, Environmental, and Surveying Engineering Politecnico di Milano, Milan, Italy.

The Labyrinth in the McMurdo Dry Valleys of Antarctica is characterized by large bedrock channels emerging from beneath the margin of Wright Upper Glacier. To study the morphodynamics of large subglacial channels cut into bedrock, we develop herein a numerical model based on the classical theory of subglacial channels and recent results on bedrock abrasion by saltating bed load. Model results show that bedrock abrasion in subglacial channels with pressurized flow reaches a maximum at an intermediate distance up-ice from the glacier snout for a wide range of sediment grain sizes and sediment loads. Read More

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September 2021

Accessory breast cancer in the inframammary region: a case report and review of the literature.

Surg Case Rep 2021 Sep 8;7(1):203. Epub 2021 Sep 8.

Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan.

Background: Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR).

Case Presentation: The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Read More

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September 2021

Upper eyelid reconstruction using a combination of a nasal septal chondromucosal graft and a Fricke flap: a case report.

Arch Craniofac Surg 2021 Aug 20;22(4):204-208. Epub 2021 Aug 20.

Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Sebaceous carcinoma is a malignant neoplasm that usually arises in the sebaceous glands of the eyelids. Its pathogenesis is unknown; however, irradiation history, immunosuppression, and use of diuretics are known risk factors. The mainstay of treatment for sebaceous carcinoma of the eyelid is wide surgical resection with a safety margin of 5 to 6 mm, which often results in full-thickness defects. Read More

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Abdominal wall endometrioma presenting as a cystic abdominal wall mass: a case report and literature review.

J Surg Case Rep 2021 Aug 26;2021(8):rjab335. Epub 2021 Aug 26.

University of Texas at Tyler, Tyler, TX, USA.

Endometriosis is classically defined as 'the presence of endometrial glands and stroma outside of the uterine cavity and musculature'. Although it most commonly occurs in the pelvis, various extrapelvic locations have been reported in the literature. There seems to be a strong association between abdominal wall endometriomas and previous surgical scars. Read More

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A practical approach for the management of small thyroid nodules referred for biopsy.

Int J Clin Pract 2021 Aug 28:e14757. Epub 2021 Aug 28.

Department of Radiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey.

Objective: Current guidelines recommend against routine ultrasound (US) guided fine-needle aspiration biopsy (FNAB) of small (<1 cm) thyroid nodules and suggest follow-up of ≥5 mm small nodules only if they are TI-RADS-5. This study aims to determine the best suspicious ultrasound features related to cytology results in patients referred for FNAB of small thyroid nodules and construct an algorithm for declining unnecessary biopsies and selection of patients to be followed up.

Methods: This prospective observational study enrolled patients referred for US-guided biopsy of ≤1 cm thyroid nodules. Read More

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Egg Incubation Mechanics of Giant Birds.

Biology (Basel) 2021 Aug 1;10(8). Epub 2021 Aug 1.

Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan.

Finite element analysis (FEA) was used to conduct mechanical analyses on eggshells of giant birds, and relate this to the evolution and reproductive behavior of avian species. We aim to (1) investigate mechanical characteristics of eggshell structures of various ratite species, enabling comparisons between species with or without reversed sexual size dimorphism (RSSD); (2) quantify the safety margin provided by RSSD; (3) determine whether the Williams' egg can have been incubated by an extinct giant bird ; (4) determine the theoretical maximum body mass for contact incubation. We use a dimensionless number to quantify relative shell stiffness with respect to the egg size, allowing for comparison across wide body masses. Read More

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The treatment of anogenital extramammary Paget's disease as part of a multidisciplinary approach: The use of Mohs surgery moat method with CK7.

Int J Dermatol 2021 Aug 26. Epub 2021 Aug 26.

Department of Dermatology, Mayo Clinic, Rochester, MN, USA.

Although most cases of extramammary Paget's disease (EMPD) are localized to the intraepidermal, the extensive subclinical extension can lead to high rates of marginal recurrence with wide local excisions and topically destructive treatments. Recurrence rates of EMPD treated with Mohs micrographic surgery (MMS) without immunohistochemical staining are better but variable. Here, we describe our multidisciplinary approach for treating large EMPD tumors of the anogenital region involving critical anatomy using MMS for peripheral margin clearance (moat method) and intraoperative CK7 immunostaining. Read More

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Open book technique for conjunctival tumors: a surgical approach to the fornix.

Arq Bras Oftalmol 2021 Aug 18. Epub 2021 Aug 18.

Department of Surgery, Faculty of Medicine and Dentistry, University of Calgary, Calgary, Canada.

Surgical management of large tumors involving the conjunctival fornix can be challenging, as exposure and clear margins may be difficult to achieve. In this case series, we report our initial experience with the open book technique in 4 patients. Through a canthotomy and cantholysis, this surgical approach provides a wide surgical field and facilitates fornix reconstruction post large tumor excision. Read More

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The application of Wood's lamp combined with 5-aminolevulinic acid for defining tumor margins in patients with extramammary Paget's disease.

Photodiagnosis Photodyn Ther 2021 Sep 19;35:102490. Epub 2021 Aug 19.

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China.

Objective: To evaluate the value of Wood's lamp examination combined with 5-aminolevulinic acid (5-ALA) photodynamic therapy (PDT) to determine positive tumor margins in patients with extramammary Paget's disease (EMPD) before surgery.

Methods: We admitted 36 patients with EMPD from January 2016 to June 2019. The experimental group was the 5-ALA-PDT group, and the control group was the wide local excision (WLE) group. Read More

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September 2021

Wide Surgery in the Cervical Spine: Indications, Results, and Complications in a Series of 30 Patients Affected by Primary Bone Tumors.

World Neurosurg 2021 Aug 20. Epub 2021 Aug 20.

Oncological Orthopaedics Department, IRCCS-Regina Elena National Cancer Institute, Rome, Italy. Electronic address:

Background: En bloc surgery is the mainstay treatment for primary malignant bone tumors, as well as in the cervical spine. Unfortunately, literature on the topic is limited to case reports and small series.

Methods: We reviewed all patients affected by primary cervical spine bone tumors treated with en bloc surgeries from 1996 to 2016 and identified 30 eligible cases. Read More

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Unplanned excision of soft tissue sarcoma: does it impact the accuracy of intra-operative pathologic assessment at time of re-excision?

Int Orthop 2021 Aug 20. Epub 2021 Aug 20.

Musculoskeletal Oncology Division, Department of Orthopedic Surgery, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA.

Purpose: An "unplanned excision" refers to soft tissue sarcomas excised without planning imaging studies and a diagnostic biopsy, resulting in the presence of residual disease and usually necessitating a re-excision procedure. We aimed to assess the impact of previous unplanned excisions on the intra-operative pathologic assessment at the time of re-excision, in terms of need to perform repeat assessments and the accuracy to predict margin status of the final pathologic specimen.

Methods: Data was collected for all patients with extremity soft tissue sarcoma who had undergone wide local excision limb salvage surgery or amputation between 2012 and 2017. Read More

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Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Eur J Surg Oncol 2021 Aug 5. Epub 2021 Aug 5.

Departments of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland.

Objectives: To evaluate the clinical value of supine magnetic resonance imaging (MRI) for tumor localization in breast cancer patients with large or multifocal tumors detected by prone MRI, scheduled for oncoplastic breast conserving surgery (OBCS). Outcomes were compared with those of patients who underwent wide local excision (WLE) or OBCS without MRI guidance.

Methods: Over a 2-year period, consecutive patients with large or multifocal disease scheduled for OBCS with MRI-only findings were invited to participate (Group-1). Read More

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Well-differentiated Spindle Cell Liposarcoma of the Larynx: A Rare Case Report and Review of Literature.

In Vivo 2021 Sep-Oct;35(5):2779-2783

Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, U.S.A.;

Background: Liposarcoma of the larynx is a rare entity. Well-differentiated spindle cell liposarcoma of the larynx has not been yet reported in the literature.

Case Report: We report the first case of well-differentiated spindle cell liposarcoma of the larynx on a 59-year-old male who presented with change of voice and phlegmy cough for several months. Read More

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DNA methylation patterns at and beyond the histological margin of early-stage invasive lung adenocarcinoma radiologically manifested as pure ground-glass opacity.

Clin Epigenetics 2021 Aug 19;13(1):153. Epub 2021 Aug 19.

Singlera Genomics Inc., Shanghai, 201318, China.

Background: Early-stage lung cancers radiologically manifested as ground-glass opacities (GGOs) have been increasingly identified, among which pure GGO (pGGO) has a good prognosis after local resection. However, the optimal surgical margin is still under debate. Precancerous lesions exist in tumor-adjacent tissues beyond the histological margin. Read More

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An Integrated Surgical Management for Giant Dermatofibrosarcoma Protuberans of Anterior Abdominal Wall.

Cureus 2021 Aug 9;13(8):e17038. Epub 2021 Aug 9.

Department of Pathology, LN Medical College and Research Centre, Bhopal, IND.

Giant dermatofibrosarcoma protuberans (DFSP) is a very rare dermal sarcoma whose diagnosis and management are important because of the high local recurrence but low metastatic potential. Complete surgical excision of giant DFSP in a single stage is difficult but has a high cure rate. A 47-year-old man presented with a gradually increasing large (18 x 15 x 7 cm) DFSP in the epigastrium. Read More

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Iliosacral Bone Tumor Resection Using Cannulated Screw-Guided Gigli Saw - A Novel Technique.

World J Surg Oncol 2021 Aug 16;19(1):243. Epub 2021 Aug 16.

Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China.

Background: Adequate margins are technically difficult to achieve for malignant tumors involving the sacroiliac joint due to limited accessibility and viewing window. In order to address the technical difficulties faced in iliosacral tumor resection, we proposed a technique for precise osteotomy, which involved the use of canulated screws and Gigli saw (CSGS) that facilitated directional control, anteroposterior linkage of resection points and adequate surgical margins. The purpose of the current study was to evaluate whether CSGS technique facilitated sagittal osteotomy at sacral side, and were adequate surgical margins achieved? Also functional and oncological outcomes was determined along with the noteworthy complications. Read More

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Management of ocular surface squamous neoplasia: Bowman Club Lecture 2021.

BMJ Open Ophthalmol 2021 27;6(1):e000842. Epub 2021 Jul 27.

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA.

The gold-standard treatment for ocular surface squamous neoplasia (OSSN) has traditionally been surgical excision with wide margins and a no-touch technique. However, surgery may be associated with several unfavourable sequelae, as well as significant recurrence rates if margins are positive. In recent years, topical chemotherapy with 5-fluorouracil, interferon α-2b and mitomycin C have emerged as valuable agents capable of effectively treating OSSN with varying adverse effects. Read More

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Residual melanoma in wide local excision specimens after 'complete' excision of primary cutaneous in situ and invasive melanomas.

Pathology 2021 Aug 12. Epub 2021 Aug 12.

Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; NSW Health Pathology, Sydney, NSW, Australia. Electronic address:

Wide local excision (WLE) to achieve adequate clearance margins is the standard initial definitive treatment for patients with biopsy-proven primary cutaneous melanoma. Residual melanoma in WLE specimens after prior complete excision-biopsy (CEB) is reported in 0-6.3% of cases. Read More

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Gastric glomus tumor: a case report and review of the literature.

J Med Case Rep 2021 Aug 16;15(1):415. Epub 2021 Aug 16.

Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece.

Introduction: Gastric glomus tumor is a rare mesenchymal neoplasm. There are only a few cases of the tumor showing malignancy, and there are no specific guidelines for the management of this entity.

Case Presentation: We present the case of a 53-year-old Caucasian male who was hospitalized for anemia. Read More

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Development and External Validation of a Model to Predict Overall Survival in Patients with Resected Gallbladder Cancer.

Ann Surg 2021 Aug 13. Epub 2021 Aug 13.

Radboud university medical center, Radboud institute for Health Sciences, Department of Surgery, Nijmegen, The Netherlands Department of Surgery, Erasmus MC, Rotterdam, the Netherlands Radboud university medical center, Radboud institute of Molecular Life Sciences, Department of Pathology, Nijmegen, The Netherlands Radboud university medical center, Radboud institute for Health Sciences, Department of Operating Rooms, Nijmegen, The Netherlands Royal North Shore Hospital, Upper GI Surgical Unit, University of Sydney, Australia University of Sydney, Sydney, New South Wales, Australia.

Objective: The aim of this study was to develop and validate a clinical prediction model to predict overall survival in patients with non-metastatic, resected gallbladder cancer (GBC).

Background: Although several tools are available, no optimal method has been identified to assess survival in patients with resected GBC.

Methods: Data from a Dutch, nation-wide cohort of patients with resected GBC was used to develop a prediction model for overall survival. Read More

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Computed tomography-based radiomics approach in pancreatic tumors characterization.

Radiol Med 2021 Aug 12. Epub 2021 Aug 12.

Arrhythmology Department, A.V. Vishnevsky National Medical Research Centre of Surgery, Bolshaya Serpukhovskaya str. 27, 117997, Moscow, Russia.

Radiomics (or texture analysis) is a new imaging analysis technique that allows calculating the distribution of texture features of pixel and voxel values depend on the type of ROI (3D or 2D), their relationships in the image. Depending on the software, up to several thousand texture elements can be obtained. Radiomics opens up wide opportunities for differential diagnosis and prognosis of pancreatic neoplasias. Read More

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Cytotoxic, Genotoxic and Senolytic Potential of Native and Micellar Curcumin.

Nutrients 2021 Jul 13;13(7). Epub 2021 Jul 13.

Institute of Toxicology, University Medical Center, Obere Zahlbacher Straße 67, 55131 Mainz, Germany.

Background: Curcumin, a natural polyphenol and the principal bioactive compound in , was reported to have anti-inflammatory, anti-cancer, anti-diabetic and anti-rheumatic activity. Curcumin is not only considered for preventive, but also for therapeutic, purposes in cancer therapy, which requires a killing effect on cancer cells. A drawback, however, is the low bioavailability of curcumin due to its insolubility in water. Read More

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Flecainide toxicity with high pacemaker capture thresholds and associated takotsubo syndrome.

BMJ Case Rep 2021 Aug 6;14(8). Epub 2021 Aug 6.

Cardiology, Michigan Heart Ann Arbor, Ypsilanti, Michigan, USA.

We describe a case of a woman in her 80s with persistent atrial fibrillation (AF) despite being on flecainide who was admitted for AF with rapid ventricular response. Attempts with direct-current cardioversions were unsuccessful despite increased doses of the antiarrhythmic therapy. At atrioventricular (AV) nodal ablation, very high right ventricular capture thresholds resulted in abortion of the procedure as back-up ventricular pacing could not be assured with adequate margin for safety. Read More

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Long-term outcomes in children with Hirschsprung's disease and transition zone bowel pull-through: impact of surgical techniques and role for conservative approach.

Pediatr Surg Int 2021 Aug 5. Epub 2021 Aug 5.

Department of Paediatric Surgery, Indira Gandhi Institute of Child Health Hospital, South Hospital Complex, Near NIMHANS, Hombegowda Nagar, Bangalore, 560029, India.

Purpose: Presence of transition zone (TZ) in the pulled colon can impact the outcome of surgery in children with Hirschsprung's disease. There is a wide variation in terminology used to define TZ and its management. We present our series of managing 11 such children with considerations for conservative management. Read More

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