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Special Issue "Clinical and Therapeutical Implications in Anatomical Variations"

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (1 May 2022) | Viewed by 7309

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Special Issue Editors

Prof. Dr. Piergiorgio Fedeli
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School of Law, Legal Medicine, University of Camerino, Camerino, Italy

Prof. Dr. Luigi Carlini
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Department of Medicine and Surgery, University of Perugia, Perugia, Italy

Prof. Dr. Roberto Cirocchi

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Department of Medicine and Surgery, University of Perugia, Perugia, Italy
Interests: surgical anatomy; emergency surgery; trauma; diverticular diseases; general surgery
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Prof. Dr. Marco Artico
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Department of Sensory Organs, "Sapienza" University of Rome, Rome, Italy

Prof. Dr. Vito D'Andrea

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Department of Surgery, Sapienza University of Rome, Rome, Italy
Interests: general surgery; abdominal surgery; surgical oncology; minimally invasive surgery; cancer surgery; gastrointestinal surgery
Special Issues, Collections and Topics in MDPI journals

Dr. Brandon Michael Henry

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Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA
Interests: laboratory medicine; evidence-based medicine; clinical trials; immunology; COVID-19

Special Issue Information

Dear Colleagues,

In common clinical practice, the importance of anatomical variations is very low, in effect a lot of these conditions do not need any treatment and remain asymptomatic. In some cases, anatomical variations are a diagnostic dilemma or become symptomatic. For these reasons, the knowledge of these anomalous conditions is very important, and their identification can be a challenge.

In some surgical or radiological interventions, accurate knowledge of possible anatomic and pathological variations is vital for safe catheterization and approaches.

Furthermore, the presence of clinical signs of these anatomical variations is still very important in the ex-ante and ex-post forensic evaluation setting. For this reason, the identification of any predictive factor represents a very important critical point.

The aim of this Special Issue is to characterize the clinical and therapeutical implications in anatomical variations; furthermore, it covers anatomical variations in clinical, surgical, radiological, vascular and neuroanatomy.

Prof. Dr. Piergiorgio Fedeli
Prof. Dr. Luigi Carlini
Prof. Dr. Roberto Cirocchi
Prof. Dr. Marco Artico
Prof. Dr. Vito D'Andrea
Prof. Dr. Brandon Michael Henry
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

anatomical variations
forensic medicine
clinical anatomy
surgical anatomy
interventional radiology
orthopedic surgery
vascular surgery
neuroanatomy

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Open AccessArticle

Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma

Brandon Michael Henry

Piergiorgio Fedeli

and

Luigi Carlini

J. Clin. Med. 2021, 10(23), 5544; https://doi.org/10.3390/jcm10235544 - 26 Nov 2021

Cited by 2 | Viewed by 1585

Abstract

In the last two decades, studies of lymphoscintigraphy imaging in lymphatic mapping reported an extreme heterogeneity of skin lymphatic drainage of some skin area, in contrast with the previous scientific literature. The aim of this study was to investigate the presence of any correlations between the topographical location of cutaneous melanoma and the topographical location of sentinel lymph nodes. Data from 165 patients undergoing sentinel lymph node biopsy between January 2013 and May 2021 were analyzed, demonstrating that melanomas in the Lumbar region presented a significant more heterogeneous drainage by site than those in the Scapular region (p < 0.01) and that melanomas in the Subscapular region were significantly more heterogeneous by laterality (unilateral vs. bilateral) than those in the Scapular region (p < 0.05). Results of this study supported the evidence of multiple lymphatic drainage as regards the sentinel node biopsy performed in skin melanoma located on the dorsal subscapular region and lumbar region. For this reason, the association of preoperative lymphoscintigraphy with another imaging evaluation is needed in these critical cutaneous areas. Recent technical developments enabling fluorescence lymphography together with indocyanine green have significantly improved the visualization of lymphatic drainage patterns at a microscopic level. In the preoperative phase, any doubt can be resolved by associating the SPET-CT scan to lymphoscintigraphy, while during the intraoperative phase, an additional evaluation with indocyanine green can be performed in doubtful cases. The aim of the duplex lymphatic mapping (pre and/or intraoperative) is an accurate search of sentinel nodes, in order to reduce the rate of false negatives. Full article

(This article belongs to the Special Issue Clinical and Therapeutical Implications in Anatomical Variations)

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Open AccessFeature PaperReview

Paraaortic Lymphadenectomy in Gynecologic Oncology—Significance of Vessels Variations

and

J. Clin. Med. 2022, 11(4), 953; https://doi.org/10.3390/jcm11040953 - 11 Feb 2022

Cited by 3 | Viewed by 4761

Abstract

Lymphadenectomy has been an essential part of the surgical treatment in surgical oncology, as the lymphatic channels and nodes are the main dissemination pathway for most of the gynecological cancers. Pelvic and paraaortic lymphadenectomy are frequent surgical procedures in gynecologic oncology. Paraaortic lymph node dissection facilitates staging, prognosis, surgical and postoperative management of patients. It is one of the most challenging retroperitoneal surgeries. A comprehensive knowledge of the paraaortic region is mandatory. Intraoperative bleeding is the most common complication during lymphadenectomy due to direct vascular injury, poor tissue handling, exuberant retraction and possible anatomical variations of the vessels in the paraaortic region. Approximately, one-third of women will have at least one anatomic variation in the paraaortic region. It must be stressed that anomalous vessels may be encountered in every woman who will undergo surgery. Consequently, detailed knowledge of anatomical vessels variations is required in order to prevent iatrogenic vessel injury. The importance of these variations is well described in urology, vascular and general surgery. Conversely, in oncogynecological surgery, there are few articles, which described some of the vessels variations in the paraaortic region. The present article aims to propose a surgical classification and to describe the majority of vessels variation, which could be encountered during paraaortic lymphadenectomy in gynecologic oncology. Moreover, surgical considerations in order to prevent anomalous vessels injury are well described. Full article

(This article belongs to the Special Issue Clinical and Therapeutical Implications in Anatomical Variations)

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Special Issue "Clinical and Therapeutical Implications in Anatomical Variations"

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