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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Minimally invasive enucleation with zero ischemia for malignancies. The Cluj Napoca experience</title><author><name sortKey="Gherman, Vitalie" sort="Gherman, Vitalie" uniqKey="Gherman V" first="Vitalie" last="Gherman">Vitalie Gherman</name><affiliation><nlm:aff id="af1-amjcaserep-14-511">Department of Robotic Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Tomuleasa, Ciprian" sort="Tomuleasa, Ciprian" uniqKey="Tomuleasa C" first="Ciprian" last="Tomuleasa">Ciprian Tomuleasa</name><affiliation><nlm:aff id="af2-amjcaserep-14-511">Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Irimie, Alexandru" sort="Irimie, Alexandru" uniqKey="Irimie A" first="Alexandru" last="Irimie">Alexandru Irimie</name><affiliation><nlm:aff id="af3-amjcaserep-14-511">Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Coman, Ioan" sort="Coman, Ioan" uniqKey="Coman I" first="Ioan" last="Coman">Ioan Coman</name><affiliation><nlm:aff id="af4-amjcaserep-14-511">Department of Urology, Iuliu Hatieganu university of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24319530</idno><idno type="pmc">3852851</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852851</idno><idno type="RBID">PMC:3852851</idno><idno type="doi">10.12659/AJCR.889762</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000200</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000200</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Minimally invasive enucleation with zero ischemia for malignancies. The Cluj Napoca experience</title><author><name sortKey="Gherman, Vitalie" sort="Gherman, Vitalie" uniqKey="Gherman V" first="Vitalie" last="Gherman">Vitalie Gherman</name><affiliation><nlm:aff id="af1-amjcaserep-14-511">Department of Robotic Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Tomuleasa, Ciprian" sort="Tomuleasa, Ciprian" uniqKey="Tomuleasa C" first="Ciprian" last="Tomuleasa">Ciprian Tomuleasa</name><affiliation><nlm:aff id="af2-amjcaserep-14-511">Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Irimie, Alexandru" sort="Irimie, Alexandru" uniqKey="Irimie A" first="Alexandru" last="Irimie">Alexandru Irimie</name><affiliation><nlm:aff id="af3-amjcaserep-14-511">Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author><author><name sortKey="Coman, Ioan" sort="Coman, Ioan" uniqKey="Coman I" first="Ioan" last="Coman">Ioan Coman</name><affiliation><nlm:aff id="af4-amjcaserep-14-511">Department of Urology, Iuliu Hatieganu university of Medicine and Pharmacy, Cluj Napoca, Romania</nlm:aff></affiliation></author></analytic><series><title level="j">The American Journal of Case Reports</title><idno type="eISSN">1941-5923</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tsalis, K" uniqKey="Tsalis K">k Tsalis</name></author><author><name sortKey="Antoniou, N" uniqKey="Antoniou N">N Antoniou</name></author><author><name sortKey="Kalfadis, S" uniqKey="Kalfadis S">S Kalfadis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cochetti, G" uniqKey="Cochetti G">G Cochetti</name></author><author><name sortKey="Puxeddu, E" uniqKey="Puxeddu E">E Puxeddu</name></author><author><name sortKey="Zingaro, Md" uniqKey="Zingaro M">MD Zingaro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zhang, C" uniqKey="Zhang C">C Zhang</name></author><author><name sortKey="Xu, Y" uniqKey="Xu Y">Y Xu</name></author><author><name sortKey="Zhang, Z" uniqKey="Zhang Z">Z Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sciarra, A" uniqKey="Sciarra A">A Sciarra</name></author><author><name sortKey="Von Heland, M" uniqKey="Von Heland M">M Von Heland</name></author><author><name sortKey="Minisola, F" uniqKey="Minisola F">F Minisola</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Muto, G" uniqKey="Muto G">G Muto</name></author><author><name sortKey="Castelli, E" uniqKey="Castelli E">E Castelli</name></author><author><name sortKey="Migliari, R" uniqKey="Migliari R">R Migliari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Minervini, A" uniqKey="Minervini A">A Minervini</name></author><author><name sortKey="Serni, S" uniqKey="Serni S">S Serni</name></author><author><name sortKey="Tuccio, A" uniqKey="Tuccio A">A Tuccio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Makdissi, Ff" uniqKey="Makdissi F">FF Makdissi</name></author><author><name sortKey="Surjan, Rc" uniqKey="Surjan R">RC Surjan</name></author><author><name sortKey="Machado, Ma" uniqKey="Machado M">MA Machado</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Case Rep</journal-id><journal-id journal-id-type="iso-abbrev">Am J Case Rep</journal-id><journal-id journal-id-type="publisher-id">amjcaserep</journal-id><journal-title-group><journal-title>The American Journal of Case Reports</journal-title></journal-title-group><issn pub-type="epub">1941-5923</issn><publisher><publisher-name>International Scientific Literature, Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24319530</article-id><article-id pub-id-type="pmc">3852851</article-id><article-id pub-id-type="doi">10.12659/AJCR.889762</article-id><article-id pub-id-type="publisher-id">889762</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter to the Editor</subject></subj-group></article-categories><title-group><article-title>Minimally invasive enucleation with zero ischemia for malignancies. The Cluj Napoca experience</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Gherman</surname><given-names>Vitalie</given-names></name><xref ref-type="author-notes" rid="fn1-amjcaserep-14-511"><sup>A</sup></xref><xref ref-type="aff" rid="af1-amjcaserep-14-511"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tomuleasa</surname><given-names>Ciprian</given-names></name><xref ref-type="author-notes" rid="fn1-amjcaserep-14-511"><sup>A</sup></xref><xref ref-type="author-notes" rid="fn5-amjcaserep-14-511"><sup>E</sup></xref><xref ref-type="aff" rid="af2-amjcaserep-14-511"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Irimie</surname><given-names>Alexandru</given-names></name><xref ref-type="author-notes" rid="fn6-amjcaserep-14-511"><sup>F</sup></xref><xref ref-type="author-notes" rid="fn7-amjcaserep-14-511"><sup>G</sup></xref><xref ref-type="aff" rid="af3-amjcaserep-14-511"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Coman</surname><given-names>Ioan</given-names></name><xref ref-type="author-notes" rid="fn7-amjcaserep-14-511"><sup>G</sup></xref><xref ref-type="aff" rid="af4-amjcaserep-14-511"><sup>4</sup></xref></contrib></contrib-group><aff id="af1-amjcaserep-14-511"><label>1</label>Department of Robotic Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</aff><aff id="af2-amjcaserep-14-511"><label>2</label>Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</aff><aff id="af3-amjcaserep-14-511"><label>3</label>Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania</aff><aff id="af4-amjcaserep-14-511"><label>4</label>Department of Urology, Iuliu Hatieganu university of Medicine and Pharmacy, Cluj Napoca, Romania</aff><author-notes><fn><p>Authors’ Contribution:</p></fn><fn id="fn1-amjcaserep-14-511"><label>A</label><p>Study Design</p></fn><fn id="fn2-amjcaserep-14-511"><label>B</label><p>Data Collection</p></fn><fn id="fn3-amjcaserep-14-511"><label>C</label><p>Statistical Analysis</p></fn><fn id="fn4-amjcaserep-14-511"><label>D</label><p>Data Interpretation</p></fn><fn id="fn5-amjcaserep-14-511"><label>E</label><p>Manuscript Preparation</p></fn><fn id="fn6-amjcaserep-14-511"><label>F</label><p>Literature Search</p></fn><fn id="fn7-amjcaserep-14-511"><label>G</label><p>Funds Collection</p></fn><corresp id="c1-amjcaserep-14-511">Corresponding Author: Ciprian Tomuleasa, e-mail: <email>ciprian.tomuleasa@umfcluj.ro</email></corresp></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>28</day><month>11</month><year>2013</year></pub-date><volume>14</volume><fpage>511</fpage><lpage>512</lpage><history><date date-type="received"><day>06</day><month>9</month><year>2013</year></date><date date-type="accepted"><day>09</day><month>9</month><year>2013</year></date><date date-type="rev-recd"><day>28</day><month>11</month><year>2013</year></date></history><permissions><copyright-statement>© Am J Case Rep, 2013</copyright-statement><copyright-year>2013</copyright-year><license><license-p>This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License</license-p></license></permissions><kwd-group><kwd>malignant tumors</kwd><kwd>zero ischemia</kwd><kwd>minimally invasive surgery</kwd></kwd-group></article-meta></front><body><p>We read, with great interest, the article “Laparoscopic enucleation of a giant submucosal esophageal lipoma. Case report and literature review”, published by Tsalis et al. [<xref ref-type="bibr" rid="b1-amjcaserep-14-511">1</xref>]. The authors present an important surgical approach for the management of benign tumors of the esophagus, by performing a laparoscopic enucleation of a lower esophageal lipoma. By presenting the surgical experience of our university hospital, we wish to emphasize that minimally invasive enucleation is not only applicable for benign tumors, but also for malignant ones with comparable results regarding recovery of the patient, as well as long term survival.Minimally invasive enucleation is recommended for symptomatic benign tumors and for those greater than 5 cm, as presented by this surgical team, but lately this technique was applied also for malignancies because it has proven it’s usefulness regarding the delay in cancer progression and the reduction in surgical discomfort of the patient. Large clinical trails lack, but some reports have been published, as is the case of nephrectomy for the management of a secondary metastasis carried out by Cochetti et al. [<xref ref-type="bibr" rid="b2-amjcaserep-14-511">2</xref>]. In their case, minimally invasive surgery allowed the preservation of renal function, as well as the possibility for the medical oncologists to continue adjuvant therapy. Consistent data from human clinical trails lacks, but these reports were preceded by animal studies,a s the one presented by Zhang et al. [<xref ref-type="bibr" rid="b3-amjcaserep-14-511">3</xref>]. They approach small renal cell carcinomas by suggesting the use of a laparoscopic simple enucleation, followed by coagulation on the tumor bed using an argon beam coagulator, with excellent results regarding recovery and blood loss. Nephron sparing surgery is accompanied by adjuvant solutions such as the thallium laser assistance [<xref ref-type="bibr" rid="b4-amjcaserep-14-511">4</xref>] or microwave ablation [<xref ref-type="bibr" rid="b5-amjcaserep-14-511">5</xref>], with superior results in comparison with the radical nephrectomy for pT1a and pT1b carcinomas [<xref ref-type="bibr" rid="b6-amjcaserep-14-511">6</xref>]. Apart from renal malignancies and rare benign tumors, as is the case of esophageal ones, laparoscopic enucleation with zero ischemia was also attempted by Makdissi et al. [<xref ref-type="bibr" rid="b7-amjcaserep-14-511">7</xref>] in the case of four hepatocellular carcinoma cases and two benign liver tumors, with free pathology surgical margins and excellent post-surgical recovery. Our experience confirmed the usefulness of minimally invasive enucleation with minimal ischemia especially in the case of the patients where renal preservation is crucial because of pre-operative insufficiency or multiple renal lesions.The long-term survival is comparative with a standard partial nephrectomy, even if sometimes the histopathology results showed a pseudo capsule tumor invasion. Thus, minimally invasive enucleation should be performed not only for benign tumors, but also for aggressive cancers if the lesion is locally confined on preoperative imaging, easily delineated intraoperatively and does not seem to growly invade beyond the pseudocapsule.</p></body><back><ref-list><title>References:</title><ref id="b1-amjcaserep-14-511"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsalis</surname><given-names>k</given-names></name><name><surname>Antoniou</surname><given-names>N</given-names></name><name><surname>Kalfadis</surname><given-names>S</given-names></name><etal></etal></person-group><article-title>Laparoscopic enucleation of a giant submucosal esophageal lipoma. Case report and literature review</article-title><source>Am J Case Rep</source><year>2013</year><volume>14</volume><fpage>179</fpage><lpage>83</lpage><pub-id pub-id-type="pmid">23826462</pub-id></element-citation></ref><ref id="b2-amjcaserep-14-511"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cochetti</surname><given-names>G</given-names></name><name><surname>Puxeddu</surname><given-names>E</given-names></name><name><surname>Zingaro</surname><given-names>MD</given-names></name></person-group><article-title>Laparoscopic partial nephrectomy of thyroid cancer metastasis: case report and review of the literature</article-title><source>Onco Targets Ther</source><year>2013</year><volume>6</volume><fpage>355</fpage><lpage>60</lpage><pub-id pub-id-type="pmid">23596352</pub-id></element-citation></ref><ref id="b3-amjcaserep-14-511"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhang</surname><given-names>C</given-names></name><name><surname>Xu</surname><given-names>Y</given-names></name><name><surname>Zhang</surname><given-names>Z</given-names></name></person-group><article-title>Laparoscopic simple enucleation and coagulation on tumor bed using argon beam coagulator for treating small renal cell carcinomas: an animal study followed by clinical application</article-title><source>Med Sci Monit</source><year>2012</year><volume>18</volume><issue>5</issue><fpage>BR193</fpage><lpage>97</lpage><pub-id pub-id-type="pmid">22534702</pub-id></element-citation></ref><ref id="b4-amjcaserep-14-511"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sciarra</surname><given-names>A</given-names></name><name><surname>Von Heland</surname><given-names>M</given-names></name><name><surname>Minisola</surname><given-names>F</given-names></name></person-group><article-title>Thulium laser supported nephron sparing surgery for renal cell carcinoma</article-title><source>J Urol</source><year>2013</year><volume>190</volume><issue>2</issue><fpage>698</fpage><lpage>701</lpage><pub-id pub-id-type="pmid">23376605</pub-id></element-citation></ref><ref id="b5-amjcaserep-14-511"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Muto</surname><given-names>G</given-names></name><name><surname>Castelli</surname><given-names>E</given-names></name><name><surname>Migliari</surname><given-names>R</given-names></name><etal></etal></person-group><article-title>Laparoscopic microwave ablation and enucleation of small renal masses: preliminary experience</article-title><source>Eur Urol</source><year>2011</year><volume>60</volume><issue>1</issue><fpage>173</fpage><lpage>76</lpage><pub-id pub-id-type="pmid">21531501</pub-id></element-citation></ref><ref id="b6-amjcaserep-14-511"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Minervini</surname><given-names>A</given-names></name><name><surname>Serni</surname><given-names>S</given-names></name><name><surname>Tuccio</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>Simple enucleation <italic>versus</italic> radical nephrectomy in the treatment of pT1a and pT1b renal cell carcinoma</article-title><source>Ann Surg Oncol</source><year>2012</year><volume>19</volume><issue>2</issue><fpage>694</fpage><lpage>700</lpage><pub-id pub-id-type="pmid">21861225</pub-id></element-citation></ref><ref id="b7-amjcaserep-14-511"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Makdissi</surname><given-names>FF</given-names></name><name><surname>Surjan</surname><given-names>RC</given-names></name><name><surname>Machado</surname><given-names>MA</given-names></name></person-group><article-title>Laparoscopic enucleation of liver tumors. Corkscrew technique revisited</article-title><source>J Surg Oncol</source><year>2009</year><volume>99</volume><issue>3</issue><fpage>166</fpage><lpage>68</lpage><pub-id pub-id-type="pmid">19065641</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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