RESUMEN
BACKGROUND: Breast conservation therapy is a well-established treatment modality for early breast cancer. It is not widely practised in developing countries because of a lack of awareness and treatment facilities, and physician and patient bias. We analysed our experience of breast conservation therapy. METHODS: We retrospectively reviewed 102 patients who had undergone breast conservation surgery and axillary dissection for breast cancer. Surgery was followed by 45 Gy of radiation to the whole breast and 15-20 Gy of tumour bed boost. All high risk patients received adjuvant systemic therapy. The disease profile, morbidity and treatment outcome were analysed. RESULTS: Out of 902 patients, 102 underwent breast conservation therapy (90 had early breast cancer and 12 had locally advanced breast cancer). Only 19.6% of patients with early breast cancer received breast conservation therapy. One-third of the patients had had a prior surgical intervention. The mean tumour size was 2.8 cm, 44% had nodal involvement and 29% were oestrogen- and progesterone-receptor negative. At a mean follow up of 32 months, only 1 patient had local recurrence, and the 5-year projected disease-free and overall survival were 82% and 88%, respectively. CONCLUSION: Breast conservation therapy should be offered to suitable breast cancer patients. Strict adherence to protocol-based therapy and active multidisciplinary coordination are crucial for a successful breast conservation therapy programme. Education of the patient as well as the physician population is necessary for increasing the breast conservation therapy rates in India.
Asunto(s)
Neoplasias de la Mama/cirugía , Mastectomía Segmentaria , Adulto , Anciano , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Persona de Mediana Edad , Dosificación Radioterapéutica , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A 28 year old male presented with complaints of retrosternal pain, discomfort and dysphagia of 4 years duration. Barium swallow and oesophagoscopy were suggestive of extrinsic compression of thoracic oesophagus. CT scan of chest was suggestive of a large mediastinal lymph node mass. Thoracotomy and open biopsy showed a benign mesenchymal tumor on frozen section. A transthoracic oesophagectomy with gastric pull up and cervical oesophago-gastric anastomosis was performed. The postoperative course was uneventful and the patient discharged on the tenth postoperative day.
Asunto(s)
Neoplasias Esofágicas/diagnóstico , Leiomioma/diagnóstico , Neoplasias del Mediastino/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
Laparoscopy assisted hemicolectomy for ileo-caecal tuberculosis is being evaluated the world over. Several procedures are performed laparoscopically, including the laparoscopic hemicolectomy, for benign and malignant diseases. Abdominal tuberculosis is one of the commonest causes of intestinal obstruction in India. We have evaluated the role of laparoscopic resection of ileocaecal tuberculosis and successfully performed the procedure in five patients. The clinical profiles of patients and operative procedure are discussed in this article with a brief review of the literature.
Asunto(s)
Enfermedades del Ciego/cirugía , Colectomía/métodos , Enfermedades del Íleon/cirugía , Laparoscopía/métodos , Tuberculosis Gastrointestinal/cirugía , Adulto , Sulfato de Bario , Enfermedades del Ciego/diagnóstico por imagen , Enema , Femenino , Estudios de Seguimiento , Humanos , Enfermedades del Íleon/diagnóstico por imagen , Masculino , Radiografía , Resultado del Tratamiento , Tuberculosis Gastrointestinal/diagnóstico por imagenRESUMEN
A 13-year-old haemophilia A patient presented with pain in the abdomen, 4 days after a blunt abdominal trauma. The computed tomography scan of the abdomen showed a large splenic haematoma. The patient was initially managed with factor VIII replacement therapy, but 4 weeks later he had a delayed rupture of the splenic haematoma with haemoperitoneum and shock. An elective splenectomy under factor VIII therapy was successfully performed.