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Less Common Lung and Bronchial Tumours; Bronchiolo-Alveolar Ca., Carcinoids, Hamartomas, Reticuloses, Protein Disorders, Lung Deposits and Leukaemia.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Most of these tumours cause no symptoms, and most are found fortuitously. They are usually spherical in shape and lack a true capsule. They may contain areas of haemorrhage or necrosis, which may calcify. Most are soft and friable, whilst others are fibrotic. Slow enlargement occurs. Local recurrence may follow surgery, but only a limited wedge resection is usually needed. Associated nodal enlargement is rare.
The Liver and the Biliary System
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Hepatic resections for primary or metastatic disease are the primary choice, and they vary from a small wedge excision to an extended right hepatic lobectomy (also known as trisegmen-tectomy). Wedge resection is carried out for small to medium sized tumors that occupied one edge of the liver. Sublobar resection involves deep large resections in either lobe of the liver, leaving the posterior portion, if normal, covering the vena cava unresected. On the other hand, lobectomy, including right or left, should extend from the middle of the gallbladder down towards the vena cava posteriorly. If the tumor is a large tumor and occupied the right lobe of the liver and extended beyond this imaginary line between the dome of the gallbladder and the vena cava to the left side, i.e., to the medial segment of the left lobe which is to the right of the falciform ligament, the patient can be managed by trisegementectomy also known as extended right hepatic lobectomy. Two factors may intervene with resectability; the condition of the remaining liver, and the blood supply to the liver. Patients with multiple hepatic metastasis can also be palliated by multiple excisions of these metastasis with or without regional chemotherapy infusion.4
Ingrowing Nail
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Azzam Alkhalifah, Florence Dehavay, Bertrand Richert
Partial matricectomy can be obtained with chemical cautery. It has the advantage of being less invasive, less painful, and less operator-dependent than the surgical wedge resection, with very high success rates. After applying a tourniquet, the lateral part of the nail (3–5 mm width) is avulsed to its most proximal end, to unveil the matrix. Then the chemical cauterant, which can be phenol (80%–90%), sodium hydroxide (10%), or trichloroacetic acid (100%), is applied for a determined time (Figure 10.3).
Current status of robotic surgery for hepato-pancreato-biliary malignancies
Published in Expert Review of Anticancer Therapy, 2022
Marcus Bahra, Ramin Raul Ossami Saidy
Wedge resection, defined as liver resection, where anatomical compartmentalization is of lesser importance, as resected liver tissue should be minor and confined (often peripheral resection), is mostly performed for enucleation of secondary liver neoplasms, e.g. CRLM. Similarly, minor hepatectomy (resection of 1–2 segments with respect to anatomical compartments) is indicated for metastases or small HCC/CCA with a favorable location. This also includes robotic anatomical resections, i.e. of the caudate lobe. Data are limited, and most studies are of descriptive design without comparable groups, but numbers are rising. Stewart et al. compared 46 robotic with 41 open minor segmentectomies and had a comparable R0-resection status but a favorable postoperative course in patients undergoing robotic surgery [10]. Of note, oncological entities varied. A propensity score-matched analysis of 31 patients with robotic or open approaches undergoing minor segmentectomies for mostly HCC or CRLM had an equal oncological resection status but a shorter hospital stay for the robotic group [11]. A recent meta-analysis compared 150 patients undergoing robotic left lateral hepatic sectionectomy (LLS) with 169 patients undergoing laparoscopic LLS. While perioperative complications or R1-resections did not differ, the robotic group had significantly higher costs and longer operation times [12].
Our current understanding of and approach to the management of lung cancer with pulmonary hypertension
Published in Expert Review of Respiratory Medicine, 2021
Gaelle Dauriat, Jerome LePavec, Pauline Pradere, Laurent Savale, Dominique Fabre, Elie Fadel
Patients intentionally selected for segmentectomies to treat early-stage, peripheral NSCLC had overall and disease-free survival outcomes that were not significantly different to those who underwent lobectomies. However, for compromised patients who underwent segmentectomies due to comorbidities, the overall survival was significantly worse than lobectomies. This is probably due to non-cancer-related deaths in a frail cohort of patients who could not tolerate a lobectomy procedure, rather than the oncological inferiority of segmentectomy procedures [103]. The appropriate method of sublobar resection is debated. Wedge resection, particularly for small, peripherally located stage IA cancers can provide adequate oncologic margins and be performed quickly and minimally invasively. Segmentectomy is technically more challenging but offers better lymph node sampling over wedge resection while also sparing lung parenchyma [104].
Entropion and ectropion repair: a snapshot of surgical practice in the United Kingdom
Published in Orbit, 2018
Katherine Anne Mcveigh, Rhys Harrison, Rebecca Ford
Table 1 shows that the majority of surgeons utilise a lateral tarsal strip (LTS) with some form of retractor reattachment, with 65% of surgeons employing this technique. Quickert‘s procedure is the third most commonly employed technique. Everting sutures (ES) and the Wies procedure are the fourth and fifth most common techniques. No surgeons in this study believe that an LTS alone is indicated and Jones retractor plication is also not popular. Other Procedures listed were wedge resection, Quickert’s with a retractor plication and 7% of respondents stated they would tailor their surgical technique to the patient. (The respondent reporting ‘Quickert’s with retractor plication as first line’ in free text did not expand on their exact technique and it should be noted that the standard Quickert’s procedure does involve retractor plication.)