Notes

A prosperous Next Come Cellular Transplantation in Fanconi Anaemia: A Case Statement.
The effect of debulking surgery is not vague in patients with refractory ovarian cancer because of drug-resistant tumor biology showing rapid growth. However, it can be considered to be beneficial for selected patients expected to show tumor response by postoperative treatment because the better perfused small tumors may favor the action of cytotoxic therapy. Among them, patients with enlarged lymph nodes and BRCA mutations can show a relatively high rate of response and improved survival by systematic lymphadenectomy followed by poly ADP ribose polymerase (PARP) inhibitors. However, the resection of enlarged lymph nodes above the renal vein may not be familiar to gynecologic oncologists, in particular, for patients who had undergone previous debulking surgery followed by repetitive chemotherapy. Thus, this video will show the step by step procedure of suprarenal lymphadenectomy and en bloc resection of kidney and suprahilar lymph nodes for complete resection of refractory ovarian cancer.Post-operative lymphatic leakage is a common complication of a radical gynecologic surgery involving aggressive lymph node dissection. Its manifestation varies from asymptomatic lymphoceles to life-threatening chylous ascites. In the past, nuclear medicine lymphoscintigraphy was the sole imaging modality for the confirmation of the leakage, of which application is limited due to its poor spatial resolution. While a conservative treatment with percutaneous drainage was the mainstream treatment method, surgical exploration was the last resort for the recalcitrant leakages. Recently, there have been a series of innovations in the field of interventional radiology, including intranodal Lipiodol® lymphangiography, dynamic magnetic resonance (MR) lymphangiography, lymphatic embolization, and mesenteric lymph node lymphangiography. Intranodal Lipiodol® lymphangiography provides very reliable and secure access to the lymphatic system, while requiring only fundamental skills and equipment available to all interventionenteric lymphatic system. With the advent of these latest interventional radiological techniques, more comprehensive approaches to the management of recalcitrant post-operative lymphatic leakages have been enabled.Despite having revolutionized the management of multiple types of gynecologic cancers laparoscopy and robotic surgery have had limited utility in ovarian cancer until recently. The development in medical technology allows surgeons to perform minimally invasive surgery (MIS) not only in early ovarian cancer, but also in advanced ovarian cancer. Thus far, most prospective studies showed feasible results of MIS in ovarian cancer. Even with many proven advantages of the MIS, there is no concrete evidence of the disparity in survival rate between laparoscopic, robotic surgery and laparotomy surgery. We reviewed the results of MIS in ovarian cancer thus far and suggest how the gynecologists can apply MIS in ovarian cancer in the future. Until the further prospective studies show solid evidence of safety in the MIS in ovarian cancer, comprehensive discussion about the benefits and risk with the patient and the level of surgical skill of the gynecologist should be considered in determining the type of surgery.For recurrent ovarian, fallopian or primary peritoneal cancer with peritoneal carcinomatosis (PC), it is challenging to resect tumors completely or to get complete remission by intravenous (IV) chemotherapy, and many patients show the resistance to various chemotherapeutic agents for IV chemotherapy ultimately. As an alternative, pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been introduced for treating the disease, which delivers chemotherapeutic agents as an aerosol form while maintaining high intraperitoneal (IP) pressure. Based on preclinical studies, PIPAC showed better penetration depth and distribution of drugs into the peritoneum in comparison to conventional IP chemotherapy. Tumor regression on histology and peritoneal carcinomatosis index (PCI) has also been shown in relevant studies. In addition, most of the PIPAC procedures were completed successfully with acceptable toxicity due to the use of a low dose of chemotherapeutic agents. For considering these advantages of PIPAC, we review the current status of PIPAC for treating recurrent ovarian, fallopian or primary peritoneal cancer through literature review.Ovarian malignancy is a leading cause of death caused by gynecologic cancer worldwide because it is mainly found in the advanced stage and recurs in most patients even after cytoreductive surgery and intravenous (IV) chemotherapy. Prevention of recurrence of primary disease and treatment of recurrent ovarian cancer are still remained as major interest and lots of researchers investigate novel treatment to find optimal method. Even though intraperitoneal (IP) chemotherapy turns out to increase the overall survival, it is not widely used because of adverse event. As an alternative treatment for IP chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC) is emerging a new way. Thanks to much research and use in other cancer species, such as the colorectal cancer cytoreductive surgery followed by HIPEC is becoming a promising treatment. However, randomized controlled trials and unbiased data in ovarian cancer patients are still needed for the establishment of therapy. Moreover, among the current situation in which treatments such as bevacizumab or PARP inhibitor have been found to be effective and have been widely used, it may be necessary to establish the role in the combination of HIPEC. N-Ethylmaleimide This article is a comprehensive review of the HIPEC in ovarian cancer to introduce techniques, treatment results, and clinical trials of HIPEC.As ovarian cancer commonly involves the visceral organs without boundary, more aggressive procedures are adopted during cytoreductive surgery. One of the most difficult aspect of the operation involves the procedure for the gall bladder, porta hepatis, and omental bursa. As the upper abdominal surgical field is not familiar to the gynecologic surgeon, and the vital organs or vessels are densely positioned, these procedures can be challenging for achieving the optimal cytoreductive surgery. The surgical approaches for advanced ovarian cancer that are required in the upper abdomen have evolved with the progress in surgical techniques. This article will discuss the surgical approach by focusing on cholecystectomy, porta hepatis debulking, and omental bursectomy, as well as the regional anatomy in patients with advanced ovarian cancer.
My Website: https://www.selleckchem.com/products/n-ethylmaleimide-nem.html