Características y resultados del tratamiento aplicado a los pacientes con cáncer de páncreas / Rejuvenation Surgery with High-Superficial Musculoaponeurotic System Flap

Introducción: El cáncer de páncreas mantiene un pronóstico ominoso a pesar de los avances en técnicas quirúrgicas y cuidados perioperatorios. Objetivo: Caracterizar los resultados del tratamiento aplicado a los pacientes con cáncer de páncreas. Métodos: Se realizó un estudio observacional, descriptivo y transversal de una serie de 70 pacientes con diagnóstico de cáncer de páncreas. Se estudiaron las variables: localización, tamaño del tumor, procedimiento quirúrgico, estadificación preoperatoria, diagnóstico histológico, estancia hospitalaria, complicaciones posoperatorias y estado al egreso, mediante el análisis de frecuencias absolutas, relativas y la media así como la prueba de ji al cuadrado y el IC 95 por ciento. Resultados: El procedimiento quirúrgico más frecuente fue derivativo en 47 enfermos (67,1 por ciento). La operación de Whipple se realizó en 10 pacientes (14,3 por ciento) con tumores localizados en la cabeza del páncreas y la pancreatectomía corporocaudal en 11 (15,7 por ciento) con tumores de cuerpo y cola del páncreas. La mayoría correspondió a los estadios III y IV. El 47,1 por ciento de los pacientes presentó un adenocarcinoma poco diferenciado. La estadía fluctuó entre 15 y 30 días en el 54,3 por ciento de la serie. Las complicaciones se presentaron en 19 enfermos (27,1 por ciento). Fallecieron 15 pacientes (21,4 por ciento) del total. Conclusiones: El tratamiento debe ser individualizado mediante equipos multidisciplinarios, con protocolos de actuación uniformes en cada institución que permita realizar estudios multicéntricos, con el objetivo de obtener estadísticas propias en aras de disminuir la morbilidad y la mortalidad, así como aumentar la calidad de vida de estos pacientes(AU)

Introduction: Facial rhytidectomy is the technique for correcting facial aging features, but they are becoming increasingly complex due to the incorporation of deeper planes in the process. The superficial musculoaponeurotic system techniques have the advantage of providing a greater degree of naturalness and permanence in time. Objective: To evaluate the effectiveness of the high-superficial musculoaponeurotic system technique for facial rejuvenation. Methods: A prospective and longitudinal case series study was carried out in the plastic surgery service of Hospital General Universitario "Vladimir Ilich Lenin" with patients who requested facial rejuvenation and were treated with the high-superficial musculoaponeurotic system technique, from January 1, 2018 to June 30, 2020. The variables age, sex, skin type, degree of aging, operative complications, patient satisfaction and aesthetic outcomes were studied. Results: The female sex predominated, together with the age group 50-59 years, the degrees of aging II and III, as well as white and light brown skin colors, while the most frequent operative complication was wound dehiscence of the suture line at the auricle root. The patients' satisfaction with the aesthetic outcomes of the surgical intervention was verified and the aesthetic outcomes was assessed as favorable in 100 percent of the cases for the used surgical technique. Conclusions: The high-superficial musculoaponeurotic system surgical technique for rhytidectomy offers harmonic, long-lasting outcomes with a low percentage of complications, making it a valuable alternative for patients(AU)

Solid and Papillary epithelial neoplasm. Ultrasound and CT features of an unusual pancreatic tumour

The ultrasonographic and computed tomography features of four cases of solid and papillary epithelial neoplasm (SPEN) - a rare pancreatic tumour - are described. Although not diagnostic, the presence of these imaging features in the typical clinical setting may permit pre-operative radiological diagnosis and facilitate planning for curative surgery for this malignant tumour which has an excellent prognosis even without further adjuvant therapy.(Au)

Papillary cystic tumors of the pancreas

Papillary cystic tumor is an uncommon neoplasm of the pancreas which has only been described recently. This report describes five such cases seen at the University Hospital of the West Indies (UHWI). The clinico-pathological features were typical in all these cases. The literature of this condition is also reviewed. (AU)

Leiomyosarcoma of the duodenum

Only two cases of leimyosarcoma of the duodenum have been documented by the Jamaica Cancer Registry to date. One patient presented with obstructive jaundice which is an unusual presentation of this tumour. He died on the ninth post-operative day due to necrotising entero-colitis. The other patient presented with rectal bleeding, anaemia and an abdominal mass. The lesion was treated with pancreatico-duodenectomy and he is alive, but with recurrence up to the date of reporting. Neither of the two cases was diagnosed pre-operatively. Surgeons should be aware of this lesion while operating for upper-intestinal bleeding or on patients with obstructive jaundice (AU)

Apudomas of the pancreas

Apudomas of the pancreas form an interesting group because of their varied presentation which is frequently related to clinical syndromes caused by production of one or more hormones. We have had experience with the management of the two commonest syndromes associated with endocrine tumours. The ability of these tumours to produce more than one hormone and to be part of the multiple endocrine adenopathy should encourage more intensive biochemical and histochemical examination of patients presenting with these syndromes (AU)

Carcinoid tumor and cystadenoma of the pancreas

A nonfunctioning carcinoid tumor of the pancreas coexistent with a cystadenoma was found in a 29-year-old woman. The carcinoid tumor appears to have originated in the wall of the cystademona. To our knowledge, the association of these two tumors has not been previously reported (AU)

Carcinoma of the pancreas

In the year 1958 to 1957 the Jamaican Cancer Registry recorded 557 cancers of the gastro-intestinal tract in the male, and 469 in the female, representing respectively 33.8 per cent and 17.7 per cent of all cancers. Cancer of the pancreas makes up 7.4 per cent of GI tract cancers in the male, and 5.8 per cent in the female (or respectively 2.5 per cent and 1 per cent of all cancers). The male: female ratio of incidence is 3:2; most cases are seen in the sixth and seventh decades; the youngest patient was age 34 at the time of diagnosis. The incidence per unit of population rises steadily with advancing age. Racial grouping and occupation do not show any noteworthy features. The common presenting symptoms are abdominal pain, jaundice, loss of appetite and weight, backache, abdominal, swelling and neuropsychiatric symptoms; a small group of 4 cases showed no pathological lesion in the brain to account for neuropsychiatric symptoms; these, because of their interest clinically, are being further studied for detailed presentation elsewhere. Ninety per cent of the diagnoses were made at laparotomy, or by biopsy study or at necropsy. Fifty-four per cent of the tumours were in the head of the gland, 12 per cent in the body, 6 per cent occupied most of the gland; the site in the remainder was not defined. Forty-five per cent were differentiated adenocarcinomas, 10 per cent undifferentiated, 3 per cent cystadenocarcinomas, 3 per cent unclassified; in the remainder no tissue was available for study. Half of the cases are known to have had metastases at the time of diagnosis; 36 of 37 laparotomies revealed inoperable cancer. The prognosis is uniformly poor; 47 per cent of patients died within six months of onset of the disease; 63 per cent were dead within one year. Follow-up statistics of the remainder are incomplete; only two cases are known to have survived longer than one year (AU)

Islet cell lesions of the pancreas

The clinical features and surgical management of islet cell lesions of the pancreas are discussed in detail. The Zollinger-Ellison Syndrome is also reviewed and recommendations made with respect to treatment (AU)