A Case Report of Surgical Debulking for a Huge Mass of Elephantiasis Neuromatosa

Hoshi, Manabu; Ieguchi, Makoto; Taguchi, Susumu; Yamasaki, Shinya

doi:10.4081/rt.2009.e11

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…22,23 Few reports of LigaSure use in orthopaedic oncologic procedures have been described to date. Hoshi et al 8 reported its use in a case report of a debulking surgery of a huge mass of elephantiasis neuromatosa. Konno and Kishi 9 reported effective hemostasis with no complications in 11 cases of neurofibroma removal with the use of the LigaSure system.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown to decrease the need for both intraoperative and postoperative blood transfusions, to decrease postoperative fluid drainage, and to decrease operating time for a variety of procedures across various specialties. [3][4][5][6][7] Although its use in the context of musculoskeletal oncology has been reported previously, 8,9 an in-depth analysis of its effect on sarcoma surgery has not been performed to date. The purpose of the current study was to evaluate the efficacy of the LigaSure device in the context of sarcoma surgery and to outline any adverse events and complications arising from its application.…”

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confidence: 99%

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LigaSure Use Decreases Intraoperative Blood Loss Volume and Blood Transfusion Volume in Sarcoma Surgery

Levine

Zhang

Hoang

et al. 2019

J Am Acad Orthop Surg

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Introduction: The LigaSure system has been successfully used in thoracic and abdominal surgery. However, to date, its use in the resection of sarcomas has not been systematically studied. We aimed to determine whether the use of the LigaSure system reduces blood loss and blood transfusion volumes in sarcoma surgery. Methods: One hundred forty-two consecutive patients who underwent sarcoma surgeries between July 2010 and October 2016 were included. Conventional electrocautery alone (n = 91) and with LigaSure (n = 51) were compared. Case-matched samples (n = 46) from each group were additionally compared. Results: The use of the LigaSure system resulted in a significant decrease in mean intraoperative blood loss (P = 0.02) and blood transfusion volume (P = 0.04). Likewise, a significant decrease in both mean and median intraoperative blood loss (P = 0.003; P , 0.0001) was seen with LigaSure in the case-matched analysis. In the soft-tissue sarcoma subgroup, a significant decrease was observed in mean hemoglobin reduction (P = 0.03) and mean intraoperative blood loss with LigaSure (P = 0.04). No adverse perioperative complications attributed to the LigaSure system were identified. Conclusions: The LigaSure vessel sealing and dividing system is a safe and effective hemostatic tool for deep dissection in bone and softtissue sarcoma surgery.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

LigaSure Use Decreases Intraoperative Blood Loss Volume and Blood Transfusion Volume in Sarcoma Surgery

Levine

Zhang

Hoang

et al. 2019

J Am Acad Orthop Surg

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“…11 The use of VSS is increasing in orthopaedic oncology surgery, although there are still few case series and case reports on its effectiveness. 8,[12][13][14] Prior to this study, it was unclear if VSS could reduce the complications caused by wide resection of STS arising in the medial thigh. Thus, we investigated this question by performing this retrospective study.…”

Section: Introductionmentioning

confidence: 99%

A vessel sealing system can help reduce the risk of postoperative complications after tumour resection in the medial thigh

Toda

Iwata²,

Kobayashi³

et al. 2023

Bone Jt Open

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AimsThe risk of postoperative complications after resection of soft-tissue sarcoma in the medial thigh is higher than in other locations. This study investigated whether a vessel sealing system (VSS) could help reduce the risk of postoperative complications after wide resection of soft-tissue sarcoma in the medial thigh.MethodsOf 285 patients who underwent wide resection for soft-tissue sarcoma between 2014 and 2021 at our institution, 78 patients with tumours in the medial thigh were extracted from our database. Information on clinicopathological characteristics, preoperative treatment, surgical treatment (use of VSS, blood loss volume, operating time), and postoperative course (complications, postoperative haemoglobin changes, total drainage volume, and drainage and hospitalization durations) were obtained from medical records. We statistically compared clinical outcomes between patients whose surgery did or did not use VSS (VSS and non-VSS groups, respectively).ResultsThere were 24 patients in the VSS group and 54 in the non-VSS group. There were no significant differences between the two groups in terms of clinicopathological background. The total drainage volume in the VSS group was significantly less than that in the non-VSS group (1,176 ml vs 3,114 ml; p = 0.018). Moreover, the drainage and hospitalization durations were significantly shorter in the VSS group compared to the non-VSS group (p = 0.017 and p = 0.024, respectively).ConclusionOur results suggest that use of VSS can help reduce the risk of postoperative complications after wide resection of soft-tissue sarcoma in the medial thigh.Cite this article: Bone Jt Open 2023;4(6):442–446.

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Giant elephantiasis neuromatosa in the setting of neurofibromatosis type 1: A case report

et al. 2016

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Abstract. Elephantiasis neuromatosa (EN) can arise from a plexiform neurofibroma of the superficial and deep nerves developing from a hyperproliferation of the perineural connective tissue infiltrating adjacent fat and muscles. To date, the clinical association between EN and neurofibromatosis type 1 (NF1) has been poorly defined, particularly with regard to the role of lymphatic alterations and the consequent lymphedema. The present study reports the clinical and biomolecular features of EN in a NF1 patient with the clear clinical diagnostic criteria of multiple cafè-au-lait macules, neurofibromas, EN, a positive family history and a novel NF1 germline c.1541_1542del mutation. Lymphoscintigraphy (LS) highlighted marked dermal backflow in the affected limb, hypertrophy of the ipsilateral inguinal and external iliac lymph nodes, and a bilateral lower limb lymph flow delay. These data support the hypothesis that an extensive hyperproliferative process involving perineural connective, limb soft tissues, bones and the lymphatic system can be responsible for EN in NF1 patients, on the basis of adipocyte metaplasia triggered by lymphostasis and lymphedema, and bone overgrowth and gigantism caused by chronic hyperemia. LS and magnetic resonance imaging can be efficacious tools in the diagnosis and clinical characterization of the early onset of the disease. IntroductionNeurofibromatosis type 1 (NF1) (MIM no. 162200), also known as von Recklinghausen disease, is clinically characterized by the presence of simple, diffuse and plexiform neurofibromas. Plexiform neurofibromas are unencapsulated, poorly-circumscribed tumors infiltrating the nerves and adjacent fat and muscles (1). The connective overgrowth can be limited to a single nerve or a plexus; in the latter case, when the plexus spreads to the epidermal and dermal tissues, it is termed molluscum fibrosum. This can occur multiple times, covering all body sites (including the forehead, temple, eyes, nape and upper lip) with the exception of the palms and soles (2). The plexiform neurofibroma variant, mixoglioma gelatiniforme, is usually soft and is located in the lower third of the leg, and when associated with lymphangiomatosis, it can give rise to elephantiasis neuromatosa (EN). EN is characterized by abnormal soft-tissue hypertrophy and bone dysplasia together with early and excessive bone growth of the affected leg compared with the contralateral leg (3,4). Pachidermocele or dermatholysis may be associated with NF1, showing an overlap of skin layers in the thorax, buttocks and roots of the limbs.The etiology of EN is not yet fully understood, but the association of primary lymphatic dysplasia with a lymphatic proliferative process has been proposed (5-7).The current study presents a case of NF1-associated EN with typical clinical manifestations. Written informed consent was obtained from the patient.

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A Case Report of Surgical Debulking for a Huge Mass of Elephantiasis Neuromatosa

Cited by 3 publications

References 11 publications

LigaSure Use Decreases Intraoperative Blood Loss Volume and Blood Transfusion Volume in Sarcoma Surgery

LigaSure Use Decreases Intraoperative Blood Loss Volume and Blood Transfusion Volume in Sarcoma Surgery

A vessel sealing system can help reduce the risk of postoperative complications after tumour resection in the medial thigh

Giant elephantiasis neuromatosa in the setting of neurofibromatosis type 1: A case report

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