Neoplasms

All Conditions

Abdominal Neoplasms

Pelvic Neoplasms

Ahmed M. Morsy, MD

Badawy M. Ahmed, MD

Khalid M. Rezk, MD

Ameer M. Abuelgheet, MD

The aim of the study is to retrospectively review data about malignancies that arise primarily in the pelvis and/or in the pelvic organs, in pediatric cancer patients \& categorize the spectrum of these malignancies according to experience at South Egypt Cancer Institute which is the largest referral site in Upper Egypt.

Background:

The newborn and infant pelvis is not fully developed and the bladder, uterus, and ovaries are to a large degree intra-abdominal. The pelvis of the infant and child has different anatomic relationships than the adolescent or adult pelvis. Neoplasms of the pediatric pelvis constitute a unique group requiring highly specialized management in a setting staffed by pediatric surgical and radiation oncologists. The most common neoplasms are rhabdomyosarcomas of the bladder, prostate, and vagina; sacrococcygeal teratoma; and the germ cell tumors, including teratomas, endodermal sinus tumors, and the choriocarcinomas. Rapidly improving chemotherapy for all of these lesions has resulted in a changed role for the surgeon.

Patients \& Methods:

A hospital-based study, involving Pediatric cancer patients, those have been diagnosed with malignant tumors that primarily arising in the pelvis and/or arising from the pelvic organs, and may have an intra-abdominal extension, in the period from 2001 January till 2015 December, and received treatment at the pediatric oncology department, their medical reports will be retrospectively reviewed for data collection.

Spectrum of these malignancies will be categorized and recorded as specific disease entities, based on morphology \& the primary site of occurrence, their relative incidence will be calculated, and the treatment outcomes will be verified.

Malignant Pediatric Pelvic Tumors: A Retrospective Study

Malignant Pediatric Pelvi-abdominal Tumors: A Retrospective Study

Time from the date of initiation of treatment until death from any cause.

Time from the date of initiation of treatment until disease progression, or death for any reason.

Assiut University

Lecturer, Pediatric Oncology Department

Wounds and Injuries

Symptoms and General Pathology

Pain

an epidural catheter will be inserted under sterile conditions through the T9- 12 interspace using the 'loss-of-resistance' technique. The catheter will be advanced 4 cm cephalad. .

preperitoneal catheters will be placed in the subfascial (ie, pre-peritoneal) space under direct vision.

epidural catheter

preperitoneal catheter

fatma el sherif, M.D

Ahmad M Abd El-Rahman, M.D

the investigators aim is to investigate the effect of continuous preperitoneal bupivacaine wound infiltration versus epidural analgesia on the inflammatory cytokines response following radical cytectomy

Continuous Pre-peritoneal Wound Infiltration Versus Epidural Analgesia in Cancer Surgery

Effect of Continuous Pre-peritoneal Wound Infiltration Versus Epidural Analgesia on Inflammatory Response and Pain Following Radical Cytsectomy

Blood samples taken all over the 24-hr. period were collected in plasma tubes containing ethyl-enediamine-tetra-acectic (EDTA), centrifuged and stored at 20○c for assessment of Plasma concentrations plasma IL 1, IL 6, IL10 and TNF to assess inflammatory cytokines

pain intensity was assessed using a 10-cm VAS (0 = no pain and 10 = worst imaginable pain)

observation of side effects and record incidence as nausea, vomiting and itching

scale ranging 1-4 :unsatisfactory, regular, satisfactory and excellent)

lecturer of anesthesia ,icu and pain management

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Genital Neoplasms, Female

Urogenital Neoplasms

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

This is an observational study and as a diagnostic intervention, subjects in the study would receive mechanical ventilation with augmented tidal volume of 12ml/kg for 2min. Augmented ventilation is performed when the patient's PPV is within grey zone (9-13%). The investigators perform this procedure to every patients and do not assigh this intervention to the subjects of the study. Then, 6ml/kg of ballanced crystalloid loading will be infused to every patient.

When the patient's PPV is within grey zone, patient's tidal volume is maintained with augmented tidal volume of 12 ml/kg (from normal ventilation of 8ml/kg) for 2min duration.

Augmented ventilation

We record the stroke volume index (SVI) values before and after volume expansion with 6ml/kg of balanced crystalloid

Fluid loading

Pulse pressure variation (PPV) is a well-known and widely used dynamic preload indicator based on heart-lung interaction to predict fluid responsiveness. Generally, patients are considered to be fluid-responsive when the PPV value larger than 11-13%. However, several previous researches demonstrated that there is a zone of uncertainty (grey zone) in PPV. To predict fluid-responsiveness accurately in the patients with PPV within grey zone (9-13%), the investigators would evaluate the augmented PPV using augmented ventilation.

Augmented Pulse Pressure Variation to Predict Fluid Responsiveness in Open Laparotomy

Pulse Pressure Variation With Augmented Ventilation to Predict Fluid Responsiveness in the Patients Undergoing Open Laparotomy Surgery

Augmented ventilation (12ml/kg) will be performed when the participant's PPV is within grey zone (9-13%). PPV value will be collected automatically by Intelivue philips patient monitor. Percentage changes in stroke volume index by EV1000 according to fluid loading were used as principal indicators of fluid responsiveness. Patients were classified as responders or non-responders when increases in SVI were ≥ 10% or \<10% after volume loading (crystalloid iv 6ml/kg). To test the abilities of augmented PPV to predict fluid responsiveness, areas under the receiver operating characteristics (ROC) curves of the responders \[area under the curve (AUC) = 0.5: no better than chance, no prediction possible; AUC = 1.0: best possible prediction\] will be calculated.

PPV value will be collected automatically by Intelivue philips patient monitor.

Samsung Medical Center

Assistant professor

Patients in whom EUS-FNTA is performed with a novel type of biopsy neede.

Fine Needle Tissue Acquisition

GUIDO COSTAMAGNA, PROF

To determine the yield of tissue biopsy specimen and the diagnostic accuracy of tissue acquisition using a newly developed 22 gauge needle in patients with solid lesions throughout the GI tract.

The use of 22 gauge needle to gather tissue samples under EUS guidance has not been associated with an increased risk, and no major complications have been described so far both for the 22 gauge Procore needle and for standard 22 gauge.20, 21 Potential benefits of this new needle are the possibility of increasing the chance of retrieving tissue specimens for histological examination, with the possibility of increasing the diagnostic accuracy of the procedure saving the need and the cost deriving from on-site cytopathology examination. This may reduce the need to repeat EUS procedures or other more invasive sampling procedures, including surgery.

22 Gauge Needle for EUS Guided Tissue Acquisition of Samples for Histologic Examination

Evaluation of a Newly Designed 22 Gauge Needle for EUS Guided Tissue Acquisition of Samples for Histologic Examination in Patients With Solid Lesions: A Prospective Two Centers Study

- The rate of complications, divided in procedural complication (perforation, bleeding) occurring during the procedure and late complications (delayed bleeding, infection) occurring during the post-procedural observational period.

The Mediterranean Institute for Transplantation and Advanced Specialized Therapies

Catholic University of the Sacred Heart

professor

Expect™19Flex needle (Boston Scientific Corp.,Natick,MA,USA)

EUS-guided fine needle biopsy performed through the duodenum with the Expect™ 19 Flex needle

Guido Costamagna, MD

This study evaluates the feasibility, safety and accuracy of a 19 gauge (19G) needle in nitinol in the performance of endoscopic ultrasound (EUS) guided transduodenal biopsy for the acquisition of samples for histologic analysis. Patients with lesions that can be approached only from the duodenum will be prospectively enrolled.

A 19 gauge needle in nitinol (Flex needle) has been recently become available for EUS guided procedure.

The use of nitinol should guarantee a better needle flexibility with a theoretical advantage on the use of this needle for lesions that need to be sampled through the duodenum. Moreover, samples for histologic examination seems to be easy to interpret than cytologic ones allowing evaluate of the overall architecture of the tissue, better performance of immunohistochemical staining, and may be of additional value to perform tissue profiling that in the future will be very important to guide individualized therapies

The existing data on the performance of the Flex needle for EUS-guided transduodenal biopsy are coming form a single study performed in one single center. Thus, the reproducibility of these results is unknown and multicenter prospective studies are warranted to answer this important question.

EUS GUIDED Transduodenal Biopsy Using the 19G Flex

EUS-guided Fine Needle Tissue Acquisition Using a Newly Developed Nitinol Ultra Flex 19 Gauge Needle for Transduodenal Lesions: a Multicenter Prospective Feasibility Study

Number of patients in which it was possible to place the needle within the target lesion by a transduodenal route divided by the total number of enrolled patients.

rate of complications, divided in procedural complication (perforation, bleeding) occurring during the procedure and late complications (delayed bleeding, infection) occurring during the post-procedural observational period

percentage of patients in whom a histologically interpretable specimen will be retrieved

rate of correct diagnosis obtained through analysis of the tissue samples acquired with EUS fine needle biopsy

Professor of Surgery

Expect™19Flex needle (Boston Scientific Corp.,Natick,MA,USA)

Expect™19Flex needle (Boston Scientific Corp.,Natick,MA,USA): EUS-guided fine needle biopsy performed through the duodenum with the Expect™ 19 Flex needle

Patients With Solid Lesions

all consecutive patients with solid lesions who needed to undergo EUS for tissue sampling that had to be performed through the duodenum, such as for deep head/uncinate pancreatic masses, periduodenal lymph nodes, duodenal subepithelial lesions, aortocaval nodes, hilar tumors, right-sided liver lesions, right kidney lesions, right adrenal gland lesions, or periduodenal abdominal masses, were enrolled in the present study.

Selection criteria All adults (\>18 years of age) referred for EUS-FNA of solid lesions adjacent to or located in the wall of the duodenum with no previous tissue diagnosis were considered eligible. In the presence of a cystic component, the solid part of the lesion should have been more than 75% of the total. Patients with uncorrectable coagulopathy as defined by abnormal prothrombin time or partial thromboplastin time that did not normalize after administration of fresh frozen plasma, with altered anatomy of the upper GI tract due to surgery of the esophagus, stomach, and duodenum and those unable to understand and/or read the consent form were excluded from the current study.

Age, Continuous

Sex: Female, Male

Race and Ethnicity were not collected from any participant.

Race and Ethnicity Not Collected

United States

Japan

Italy

France

Region of Enrollment

Dr Alberto Larghi

Expect™19Flex needle (Boston Scientific Corp.,Natick,MA,USA): EUS-guided fine needle biopsy performed through the duodenum with the Expect™ 19 Flex needle

Capability of Performing EUS-FNTA Through the Duodenum by Placing the Target Lesion in the Proper Position With Insertion of the Needle Into the Lesion

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Malignant Pediatric Pelvic Tumors: A Retrospective Study	NCT02557256	Abdominal Neopl... Pelvic Neoplasm...		- 18 Years	Assiut University
Continuous Pre-peritoneal Wound Infiltration Versus Epidural Analgesia in Cancer Surgery	NCT03002909	Abdominal Neopl...	epidural cathet... preperitoneal c...	18 Years - 60 Years	Assiut University
Augmented Pulse Pressure Variation to Predict Fluid Responsiveness in Open Laparotomy	NCT02653469	Gynecologic Neo... Abdominal Neopl...	Augmented venti... Fluid loading	20 Years - 80 Years	Samsung Medical Center
22 Gauge Needle for EUS Guided Tissue Acquisition of Samples for Histologic Examination	NCT04032951	Abdominal Neopl...	Fine Needle Tis...	10 Years - 80 Years	Catholic University of the Sacred Heart
EUS GUIDED Transduodenal Biopsy Using the 19G Flex	NCT02307253	Abdominal Neopl...	Expect™19Flex n...	18 Years - 90 Years	Catholic University of the Sacred Heart

Spots Global Cancer Trial Database for abdominal neoplasms