ABSTRACT
OBJECTIVE: Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer. METHODS: The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. RESULTS: The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition). CONCLUSIONS: As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
Subject(s)
Fertility Preservation , Surgical Oncology , Trachelectomy , Uterine Cervical Neoplasms , Brazil , Consensus , Female , Humans , Neoplasm Staging , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgeryABSTRACT
OBJETIVO: Analisar a ocorrência e os fatores de risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas. MÉTODOS: Estudo transversal prospectivo com 93 pacientes submetidos a cirurgias ortopédicas eletivas e limpas. RESULTADOS: A infecção de sítio cirúrgico foi diagnosticada em 16 pacientes (17,2%). Na análise dos dados, após ajuste do modelo de regressão logística binária, apenas a variável tempo total de internação mostrou-se com relação estatisticamente significativa com a presença ou não de infecção. CONCLUSÃO: A ocorrência de infecção de sítio cirúrgico em cirurgia ortopédica foi mais elevada, sendo 75% dos casos diagnosticados após a alta hospitalar, resultado que reforça a necessidade da vigilância pós-alta.
OBJECTIVE: To analyze the occurrence and risk factors for surgical site infection in patients undergoing orthopedic surgery. METHODS: A prospective cross-sectional study with 93 patients undergoing elective and clean orthopedic surgery. RESULTS: The surgical site infection was diagnosed in 16 patients (17.2%). In data analysis, after adjusting the binary logistic regression model, only the variable total time of hospitalization was statistically significant with respect to the presence or absence of infection. CONCLUSION: The occurrence of surgical site infection in orthopedic surgery was higher, with 75% of cases diagnosed after hospital discharge, this result reinforces the need for post-discharge surveillance.
Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Aged, 80 and over , Young Adult , Surgical Wound Infection , Operating Room Nursing , Orthopedic Procedures , Perioperative Nursing , Cross-Sectional Studies , Measures of Disease Occurrence , Prospective Studies , Risk FactorsABSTRACT
OBJETIVOS: Avaliar a sobrevida dos pacientes portadores de carcinoma epidermóide do canal anal submetidos a cirurgia de resgate, por recidiva ou falha do tratamento radioquimioterápico inicial. MÉTODO: Análise retrospectiva dos pacientes portadores de carcinoma epídermóide do canal anal submetidos a cirurgia de resgate, de outubro de 1986 a setembro de 2000. RESULTADOS: Foram matriculados 93 pacientes portadores de carcinoma epidermóide do canal anal no período, e 21 (22,5 por cento) foram submetidos a resgate cirúrgico. Em 19 pacientes (91 por cento) foi realizada amputação abdominoperineal do reto (operação de Miles), em um paciente exenteração pélvica total e em um paciente excisão local. Não houve mortalidade operatória. A sobrevida média do grupo após resgate cirúrgico foi de 24 meses. CONCLUSÕES: Após recidiva e/ou falha da radioquimioterapia, a cirurgia de resgate é importante no controle locorregional do carcinoma epidermóide do canal anal.
BACKGROUND: Carcinoma of the anal canal is a rare neoplasia, the treatment of wich is based on chemoradiation Surgery is recommended alter treatment failure and recurrence. METHOD: A retrospective review from October 1986 to September 2000 of all patients who underwent salvage surgery alter chemoradiotherapy failure. Patients were reviewed as to time until recurrence and overall survival. RESULTS: Ninety-three patients with epidermoid carcinoma of the anal canal were reviewed. Twenty-one patients (22,5 percent) with residual or recurrent disease underwent salvage surgery. 19 patients (91 percent) underwent abdomino-perineal resection, 1 patient underwent pelvic exenteration and local resection was performed in 1 patient. There was no operative mortality. The overall survival was 24 months. CONCLUSIONS: Salvage surgical resection for anal canal carcinoma can be expected te yieid a number of survivors from residual/recurrent disease.