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Penile Cancer
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Eleni Anastasiadis, Nicholas A. Watkin
ELND:Removes lymph nodes superficial and deep to the fascia lata.Involves excision of the great saphenous vein.
Pre-, intra-, and post-treatment use of duplex ultrasound (thermal and non-thermal)
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
The common peroneal nerve (CPN) also has a sensory–motor function (Figure 9.25a,b). It is a distal branch of the sciatic nerve and can run along the lateral fibular head. Injury to the common peroneal nerve can result in foot drop, with loss of sensation on the top of the foot. Incidence of injury with surgery to the small saphenous vein has been reported at 2%–4.7% [26]. The relationship between the saphenopopliteal junction and the common peroneal nerve is well studied [27]. Due to the proximity of this nerve to the lateral fibular head, many practitioners use precautions with compression dressings or wraps so as to not cause entrapment and irritation of this nerve.
Anatomy of veins and lymphatics
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
The great saphenous vein passes from in front of the medial malleolus to terminate in the groin. It lies within a superficial com- partment formed by the deep and superficial fascias – the ‘saphenous eye’ or ultrasound image of the ‘Egyptian eye’ (see Chapter 10) (Figure 2.16). There are variations of the great saphenous vein in the thigh and calf (Figure 2.17).
Sentinel lymph node biopsy based on anatomical landmarks and locoregional mapping of inguinofemoral sentinel lymph nodes in women with vulval cancer: an operative technique
Published in Journal of Obstetrics and Gynaecology, 2023
Fong Lien Kwong, Miski Scerif, Jason KW Yap
Data from women who underwent unilateral or bilateral groin SLN biospies from 1 February 2020 to 15 October 2022 at a single regional cancer centre were prospectively collected. Our centre introduced inguinofemoral SLN biopsies for vulval cancer over 15 years ago and receives referrals from other Cancer Centres across the West Midlands, UK. All subjects met the GROINSS-V eligibility criteria (unifocal tumour, SCC of vulva, the width of tumour not exceeding 4 cm, depth of invasion over 1 mm and no clinically or radiologically suspected nodal involvement). Women with unresectable tumours measuring over 4 cm, multifocal lesions, enlarged or suspicious lymph nodes or in whom a nodal biopsy had previously confirmed the presence of nodal involvement, suspected disseminated disease on imaging (e.g., pulmonary or skeletal metastasis) and those who were pregnant at the time of the study were excluded. All women provided written consent for the procedure as per the Trust protocol. The location of superficial SLN was described relative to the long saphenous vein as ‘above and medial’, ‘above and lateral’ or ‘above saphenous vein’. Cloquet’s node was defined as the deep node medial to the saphenous vein and beneath the cribriform fascia. All women were followed 2-monthly for two years and then 4-monthly for a further three years.
What is the optimal treatment technique for great saphenous vein diameter of ≥10 mm? Comparison of five different approaches
Published in Acta Chirurgica Belgica, 2021
Emre Kubat, Celal Selçuk Ünal, Onur Geldi, Erdem Çetin, Aydın Keskin
Once the saphenous vein is catheterized and laser fiber is introduced into the lumen, laser light is absorbed by intraluminal blood, water, protein, or vein wall. The EVLA typically uses hemoglobin-specific laser waves at a variety of wavelength and uses, then, water-specific laser at ≥1,000 wavelength [21]. In a study, Aktas et al. [17] reported no significant difference between the EVLA at 980 nm and 1,470 nm wavelengths, the latter was associated with less recurrence. On the contrary, Arslan et al. [5] found a statistically significantly lower recurrence rate at 6 and 12 months with EVLA 1,470 nm wavelength, compared to 980 nm wavelength. Of note, in the aforementioned study, the GSV diameter was ≥10 mm. During EVLA procedure, optical extinction of the laser light is similar for blood and water and, therefore, the vein lumen must be emptied out of its blood before the procedure. In high-wavelength laser (i.e., 1,470 nm), the optical extinction in the vein wall increased by five-fold, compared to lower wavelengths [22]. In our study, EVLA procedure at 980 nm wavelength was associated with a higher recurrence rate than 1,470 nm wavelength. This finding suggests that optical extinction in the vein wall is less with EVLA 980 nm wavelength in case of large GSV diameters. In our study, the recurrence rate was higher in the CAC group, compared to the other procedures. In the study of Tekin et al. [11], the diameter of GSV was ≥10 mm in all patients. Although the treatment success is more favorable in smaller vein diameters, CAC seems to yield a higher recurrence rate in large GSV diameters.
Mouse laser injury models: variations on a theme
Published in Platelets, 2020
In a further variation of laser-induced injury, multiple groups have used laser ablation to generate a perforating injury with overt bleeding in the mouse saphenous vein and/or femoral artery. Getz et al. initially described a laser injury model of the saphenous vein in which laser ablation is used to generate an approximately 50 µm diameter hole through the vessel wall [29]. Bleeding ensues, and the time to bleeding cessation may be measured as a readout of hemostatic function in addition to real-time fluorescence imaging. As an additional stressor, the initial hemostatic plug may be ruptured by repeat laser ablation and subsequent responses monitored. While the extent of injury has not been characterized at the ultrastructural level, the perforating injury with blood loss is expected to expose blood to all molecular constituents of the vessel wall, including tissue factor. Indeed, the platelet and coagulation response was diminished in this setting in mice expressing low tissue factor levels [29]. Welsh et al. used a similar approach to generate a perforating injury in the mouse saphenous vein as well as the femoral artery, although the hole through the vessel wall was smaller (approximately 15 µm diameter) [30]. These investigators showed that the response to injury was dependent on thrombin activity, but insensitive to GPVI-deficiency, again suggesting that platelet GPVI signaling is not a prominent component of the hemostatic response in settings of robust thrombin generation [30].