Neuroendocrine cancer best doctors, Dr. FILIP SIMONA
Conclusion Our results allow us to conclude the conditions in which the conservative resection of parenchyma in carcinoid tumours is advisable. In central typical carcinoid the use of lungsparing bronchoplastic techniques demands the intraoperative pathologic neuroendocrine cancer best doctors of the existence of an adequate surgical margin 5mm by frozen section avoiding local recurrence.
In peripheral atypical carcinoids the increase in the local recurrence probability after a limited resection makes neuroendocrine cancer best doctors not advisable. References 1.
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Survival analysis of pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol ; Limited and radical resection for tracheal and bronchopulmonary carcinoid tumour. Report on cases. Eur J Cardiothorac Surg ; 4: Typical and atypical pulmonary carcinoids.
Dr. FILIP SIMONA | Regina Maria
Outcome in patients presenting with regional limph node involvement. Chest ; Bronchial neuroendocrine cancer best doctors tumors: surgical management and long-term outcome. J Thorac Cardiovasc Surg ; Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg ; Neuroendocrine neoplasms of the lung: a prognostic spectrum.
J Clin Oncol ; Typical and atypical carcinoid: analysis of the experience of the Spanish multicenter study of neuroendocrine tumors of the virus de papiloma humano cuello de utero. Eur J Cardiothorac Surg ; Outcome and surgical strategy in bronchial carcinoid tumors:single institution experience with patients.
Eur J Cardiothorac Surg Neuroendocrine lung tumors. Current Opinin Oncology ; Pulmonary neuroendocrine. Carcinoid tumors.
Cancer ; 1: Typical and atypical carcinoid tumors: year experience with 89 patients. J Cardiovasc Surg ; Detterbeck FC. Management of carcinoid tumors. Neuroendocrine cancer best doctors compared to open lobectomy, the technique has been reported to have the same oncological results and many benefits in term of postoperative pain, perioperative outcomes, length of stay, biological impact and costs in a North-American setting.
Although there is variability in the technique between surgeons, the procedure is safe, can be easily learned, and is performed every year in a growing proportion of cases.
Lymph-node sampling or dissection can and should be included. Locally advanced tumors have been resected through VATS with concomitant chest-wall resection, pneumonectomy, or sleeve resection, but the benefit of performing theses more extensive resections remains unclear.
In many countries, the cost of the additional staplers necessary to perform the technique may limit its development, but alternative neuroendocrine cancer best doctors exist.
The knowledge of some simple intraoperative details and concepts will help surgical teams to switch from open to VATS lobectomy. Lung resection in COPD patients: where is the lower limit?
Dragan Subotic Clinic for thoracic surgery, Clinical center of Serbia, Belgrade Currently, the preoperative lung function assessment is focused to the prediction of postoperative ventilatory function and to the estimate of cardiorespiratory reserve.
It is now established that predicted postoperative FEV1 ppoFEV1 is accurate in predicting FEV1 36 months after surgery, but in the same time it is likely to overestimate the FEV1 in the initial post-operative days, when, in fact, most complications occur.
Results neuroendocrine cancer best doctors several reports showing that the lung function can be better preserved after upper lobectomy in COPD patients, can be counterweighted by recent findings that the observed postoperative loss in FEV1 may exceed the predicted loss after upper lobectomies in COPD patients.
Dr. FILIP SIMONA
It means that COPD strongly influences FEV1 at both the early and late terms after upper lobectomy, so that the exact way of it's influence to the early postoperative lung function preservation still has not been fully elucidated. Furthermore, it was convincingly demonstrated that, in patients with preserved phrenic nerve and normal diaphragm motion, the postoperative FEV1 was significantly better than in patients with either immobile diaphragm or with paradoxical diaphragm motion.
Having in mind that many COPD patients have also the increased cardiac risk, the current review addresses several points that influence the preoperative selection in this challenging patient population. Is thoracoscopic surgery justified to treat lung metastases?
Two Imaging Specialists Join Forces for Better Patient Management
Jos Belda-Sanchis Hospital Universitari Mutua de Terrassa, Barcelona, Spain The advent of new and specific technology in earliest 90s leaded to an increase in interest in videoassisted thoracoscopy surgery VATS as a diagnostic and therapeutic tool in all fields of the thoracic surgery.
At that time, many surgeons changed the traditional open approach to pulmonary resection of colorectal metastases for less invasive thoracoscopic techniques.
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Still now, there are many areas of controversy concerning the capability of VATS in detecting and removing all the lung metastases. For the moment, there are not randomized controlled trials comparing VATS to the open approach for the curative pulmonary metastasectomy.
In the CALGB planned a prospective randomized trial comparing the treatment of pulmonary metastases by VATS vs open surgery but the study was closed early due to the slow accrual 1. There are two systematic reviews of published series which evaluate the current status of the surgical treatment of colorectal lung metastases 2,3.
Many others studies specifically review the results of pulmonary metastasectomy by means of open and VATS approach in terms of safety and long term neuroendocrine cancer best doctors. Many case series and cohort studies have pointed out the main controversial aspects regarding thoracoscopic pulmonary metastasectomy.
The Good Looking Cancer: Neuroendocrine Cancer, Paperback
Does VATS approach allow the identification and resection of pulmonary neuroendocrine cancer best doctors equal than open neuroendocrine cancer best doctors VATS neuroendocrine cancer best doctors is based on the preoperative images, in the ability or inability to adequately explore the entire lung using the thoracoscope, in the palpation with the surgeons finger of the most external part of the lung or in the marking of the pulmonary node with a spiral type harpoon.
According these results, an open approach allows for more complete resection of malignant metastases. At the moment, the clinical relevance in terms neuroendocrine cancer best doctors prognosis and survival of the disagreement between the number of preoperative detected nodules and pathologically confirmed metastases is unknown.
It is well known that a complete resection is an independent prognostic factor of survival after pulmonary metastasectomy for colorectal cancer 2,9, Nevertheless, the term incomplete resection is used in the majority of studies for describing an unresectable disease due to the local extension the disease involves vital structures, mediastinal lymph nodes or the patient can not afford the magnitude of the resection.
Probably this meaning is not equivalent to radiologically undetectable hpv impfung fur jungen aok that could remain neuroendocrine cancer best doctors the lung after a VATS resection. There is not evidence that such undetectable non-resected nodules confer a worse prognosis. Such small nodules undetected at the time of the thoracoscopy will grow and they will be diagnosed as new metastases.
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Many studies have shown that repeated metastasectomy is associated to a 5-years survival equal than first metastasectomy 11,12,13, As Dr. Cerfolio state in their study published in the European Journal neuroendocrine cancer best doctors Cardio-thoracic Surgery inthe optimal surgical approach to pulmonary metastases may be patient-dependent rather than surgeon-dependent.
There are few studies of case series which addressed to this topic 15,16,17, In these studies, the selective use of VATS metastasectomy is associated with a long term outcome 5 years survival, disease free survival that is comparable with that after resection by thoracotomy. These authors recommend a VATS resection for patients with small nodules, fewer nodules or single pulmonary metastases and lesions neuroendocrine cancer best doctors in the outer third of the lung Kohman LJ.
Clin Cancer Res ; 12 11 suppl s Pfannschidt J, Dienemann H, Hoffmann. Surgical resection of pulmonary metastases from colorectal cancer: A systematic review of published series.
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Ann Thorac Surg ; Surg Today ; Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg ; 5. Accuracy of lung imaging in metastases with implications for the role of thoracoscopy. Estudio retrospectivo. Papilloma virus definition biology of video-assisted thoracic surgery in the treatment of pulmonary metastases: Results of a prospective trial.
Comparison of the number of pre- intra- and postoperative lung metastases.
By Philipp Grätzel von Grätz Abstract: After spending time in the nuclear medicine department from the biggest private hospital in Austria, radiologist Philipp Peloschek, MD, realized many pathologies are simply invisible to radiology. Inhe teamed up with nuclear medicine specialist Martha Hoffmann, MD, to establish the private Radiology Center next door to the university. Together, the two successfully deliver a full spectrum of diagnostic imaging services. And their collaborative approach to patient management offers a glimpse into what the future of imaging could be.
Eur J Cardio-thorac Surg ; Non-imaged pulmonary nodules discovered during thoracotomy for metastasectomy by lung palpation. The International Registry of Lung Metastases.
Long-term results of lung metastasectomy: Prognostic analyses based on cases. J Thorac Neuroendocrine cancer best doctors Surg ; Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer.
Br J Surg ; Pulmonary metastasectomy for patients with colorectal carcinoma: a prognostic assessment. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: Experiences in patients.
Repeat pulmonary resection for isolated recurrent lung metastases yields results comparable to those after fi rst pulmonary resection in colorectal cancer.
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World J Surg ; Long-term survival after repeated resection of pulmonary metastases from colorectal cancer.