Asunto(s)
Carcinoma/cirugía , Neoplasias Esofágicas/cirugía , Coagulación con Láser/instrumentación , Cuidados Paliativos/instrumentación , Anciano , Anestesia Local , Carcinoma/complicaciones , Carcinoma/mortalidad , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/mortalidad , Estenosis Esofágica/etiología , Estenosis Esofágica/mortalidad , Estenosis Esofágica/cirugía , Esofagoscopía , Humanos , Coagulación con Láser/métodos , Cuidados Paliativos/métodos , Inducción de RemisiónRESUMEN
The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The double-contrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.
Asunto(s)
Sulfato de Bario , Pólipos del Colon/diagnóstico por imagen , Divertículo del Colon/complicaciones , Neumorradiografía , Pólipos del Colon/complicaciones , Pólipos del Colon/epidemiología , Enema , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
We report our preliminary clinical experience with hematoporphyrin derivative (HpD) injection and argon or dye laser irradiation for the treatment of 61 surface neoplastic lesions in 7 patients. Forty-three sites were multiple basal cell carcinoma in 5 patients, and the remaining 18 were cutaneous and subcutaneous recurrent breast carcinoma after mastectomy in the thoracic wall. The patients were selected on the basis of the lack of indication for conventional therapeutic modalities. The selection of irradiation procedures and laser source was based on the thickness of the lesion and extension of the disease. The photochemical reaction between HpD injected i.v. at a dose of 3 mg/kg body weight and the laser beam at a dose of 60 to 120 J/cm2 resulted in 75% favorable responses at the treated sites. Optimal therapeutic effects appeared to be critically dependent on total light dose and tumor infiltration patterns. The phototherapeutic technique proved to be effective in selected cases of neoplastic lesions, especially when conventional treatment modalities were poorly indicated or contraindicated.