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- 저자 : Moishe Liberman (검색결과 2 건)
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Fahed Zairi,Tarek Sunna,Moishe Liberman,Ghassan Boubez,Zhi Wang,Daniel Shedid 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.6
Study Design: Monocentric prospective study. Purpose: To assess the safety and effectiveness of the posterior approach for resection of advanced Pancoast tumors. Overview of Literature: In patients with advanced Pancoast tumors invading the spine, most surgical teams consider the combined approach to be necessary for “en-bloc ” resection to control visceral, vascular, and neurological structures. We report our preliminary experience with a single-stage posterior approach. Methods: We included all patients who underwent posterior en-bloc resection of advanced Pancoast tumors invading the spine in our institution between January 2014 and May 2015. All patients had locally advanced tumors without N2 nodes or distant metastases. All patients, except 1, benefited from induction treatment consisting of a combination of concomitant chemotherapy (cisplatin-VP16) and radiation. Results: Five patients were included in this study. There were 2 men and 3 women with a mean age of 55 years (range, 46–61 years). The tumor involved 2 adjacent levels in 1 patient, 3 levels in 1 patient, and 4 levels in 3 patients. There were no intraoperative complications. The mean operative time was 9 hours (range, 8–12 hours), and the mean estimated blood loss was 3.2 L (range, 1.5–7 L). No patient had a worsened neurological condition at discharge. Four complications occurred in 4 patients. Three complications required reoperation and none was lethal. The mean follow-up was 15.5 months (range, 9–24 months). Four patients harbored microscopically negative margins (R0 resection) and remained disease free. One patient harbored a microscopically positive margin (R1 resection) and exhibited local recurrence at 8 months following radiation treatment. Conclusions: The posterior approach was a valuable option that avoided the need for a second-stage operation. Induction chemoradiation is highly suitable for limiting the risk of local recurrence.
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Wang Zhi,Truong Van Tri,Liberman Moishe,Al-Shakfa Fidaa,Yuh Sung-Joo,Soder Stephan Adamour,Wu James,Sunna Tarek,Renaud-Charest Émilie,Boubez Ghassan,Shedid Daniel 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5
Study Design: Retrospective cohort study.Purpose: This study aimed to evaluate the outcomes of patients who had T4 Pancoast tumors invading the spine and underwent en bloc resection and spinal stabilization through a single-stage posterior approach.Overview of Literature: Surgical resection for Pancoast tumors affecting the spine has been successfully performed in two stages involving spinal reconstruction and tumor resection. However, reports have rarely presented the results of en bloc resection combined with spinal stabilization for T4 Pancoast tumors invading the spine through a single-stage posterior approach.Methods: Patients who had T4N0M0 Pancoast tumors invading the spine and underwent a single-stage posterior approach were retrospectively recruited. The following data were obtained and examined: demographics, tumor histology, preoperative and postoperative therapy, complications, spinal reconstruction technique, tumor resection extent, survival time, and disease recurrence.Results: Eighteen patients were included. The mean population age was 61±17 years, and the most common pathological type was adenocarcinoma (61.1%). Complete resection (R0) was obtained in 15 patients (83.3%), positive surgical margins (R1) were found in three patients (16.7%), and the 90-day mortality rate was 0%. Postoperative major complications were detected in 12 patients (66.7%), who required reoperation. The mean survival time was 67±24 months, but the median survival time was not reached. Among the patients, 10 (55.6%) are still alive at the end of the study. The 2- and 5-year actual survival rates were 59% (95% confidence interval [CI], 35.7%–82.3%) and 52.5% (95% CI, 28.4%–76.6%), respectively.Conclusions: <i>En bloc</i> resection and spinal stabilization through a single-stage posterior approach might be effective for T4 Pancoast tumors invading the spine.
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