ABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Perianal Glands/diagnostic imaging , Rectal Fistula/diagnostic imaging , Sediment Transport/methods , Perianal Glands/surgery , Rectal Fistula/surgery , Thigh/diagnostic imaging , Thigh/surgeryABSTRACT
Introducción La irradiación parcial acelerada de la mama (IPAM) con multicatéteres tras cirugía conservadora del cáncer de mama (CM) puede ser una alternativa a la radioterapia externa adyuvante convencional para un grupo seleccionado de pacientes. El objetivo es describir nuestra experiencia en los últimos 5 años. Métodos Entre junio de 2007 y junio de 2012 fueron evaluados 87 pacientes con CM para IPAM. Los criterios de inclusión fueron: edad mayor de 40 años, tumor unifocal, histología de carcinoma ductal infiltrante o intraductal, tamaño menor de 3 cm y ausencia de afectación ganglionar. Se valoraron las complicaciones, el resultado cosmético y la recidiva local y a distancia. Resultados La IPAM se completó en 48 pacientes y se contraindicó en 39. La edad media de las pacientes tratadas fue de 59 años. La mediana del tiempo quirúrgico fue de 123 min (rango 72-234), con una media de 9 catéteres implantados por paciente. No se registraron complicaciones durante la intervención ni en la radioterapia. La mediana de la estancia hospitalaria fue de 4 días (rango 2-14). El tamaño tumoral medio fue de 11 mm. En 35 casos se trataba de carcinomas ductales infiltrantes y en 13 de carcinomas intraductales. Cuarenta y cuatro pacientes recibieron tratamiento adyuvante. Con una mediana de seguimiento de 22 meses (rango 5-64), no se ha observado recidiva local ni a distancia. El resultado estético fue bueno o excelente en el 66% de casos .Conclusiones La IPAM con multicatéteres colocados en el mismo acto operatorio de la cirugía conservadora del CM es una técnica segura y fiable pero exige una meticulosa selección de pacientes (AU)
Introduction Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. Method Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. Results Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. Conclusions APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients (AU)
Subject(s)
Humans , Female , Breast Neoplasms/surgery , Mastectomy, Segmental/methods , Radiotherapy/methods , Patient Selection , Intraoperative PeriodABSTRACT
INTRODUCTION: Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. METHOD: Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. RESULTS: Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. CONCLUSIONS: APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients.
Subject(s)
Brachytherapy/instrumentation , Brachytherapy/methods , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Mastectomy, Segmental , Catheters , Combined Modality Therapy , Female , Humans , Intraoperative Period , Middle Aged , Prospective Studies , Time FactorsABSTRACT
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Subject(s)
Humans , Female , Adult , Neoplasms, Fibrous Tissue/pathology , Peritoneal Neoplasms/pathology , Gastrectomy , Obesity/surgery , Neoplasms, Cystic, Mucinous, and Serous/pathology , Incidental FindingsABSTRACT
IntroducciónEn la actualidad no existe suficiente evidencia científica sobre cuál es la mejor técnica para realizar la anastomosis -intracorpórea (IC) o extracorpórea (EC)- en la hemicolectomía derecha laparoscópica. El objetivo del presente estudio es determinar si existen diferencias al comparar ambas técnicas.Material y métodosSe realiza un estudio sobre una serie prospectiva de pacientes intervenidos en nuestro Centro mediante hemicolectomía derecha laparoscópica. Se comparan las variables preoperatorias, intraoperatorias y relacionadas con complicaciones recogidas en función del tipo de anastomosis.ResultadosDesde junio de 2004 hasta junio de 2010 se intervinieron 60 pacientes (35 IC; 25 EC). No existieron diferencias significativas entre ambos grupos en cuanto a características basales preoperatorias ni comorbilidades asociadas. La mediana de tiempo operatorio fue de 212 minutos (142-305min), sin diferencias significativas entre ambas técnicas. El número de ganglios extraídos resultó mayor en el grupo IC (21 versus 14; p=0,03). Tanto el inicio de la tolerancia oral como la primera deposición resultaron significativamente más precoces en el grupo IC. La tasa de complicaciones postoperatorias fue similar para ambos grupos (14% IC; 16% EC; p=0,89). Tres pacientes presentaron dehiscencia de anastomosis en las IC. La tasa de mortalidad fue del 2,8% (un paciente en cada grupo).ConclusiónLa anastomosis intracorpórea frente a la extracorpórea en la hemicolectomía derecha laparoscópica permite obtener un mayor número de ganglios resecados y un inicio más precoz de la tolerancia oral y del tránsito intestinal (AU)
IntroductionThere is still insufficient scientific evidence on which is the best technique to perform the anastomosis -intracorporeal (IC) or extracorporeal (EC)- in right laparoscopic hemicolectomy. The objective of the present study is to determine whether there are differences to compare in both techniques.Material and methodsA study was performed on a prospective patient series subjected to right laparoscopic hemicolectomy in our Hospital. The preoperative and the postoperative variables associated with complications recorded depending on the type of anastomosis.ResultsA total of 60 patients were intervened form June 2004 to June 2010 (35 IC; 25 EC). There were no significant differences between both groups as regards baseline preoperative characteristics or associated comorbidities. The median operation time was 212minutes (142-305min), with no significant difference between both techniques. The number of lymph nodes removed was higher in the IC group (21 versus 14; p=0.03). The beginning of oral tolerance and the first bowel movement were significantly earlier in the IC group. The complications rate was similar for both groups (14% IC; 16% EC; p=0.89). Three patients in the IC group had anastomosis dehiscence. The mortality rate was 2.8% (one patient in each group).ConclusionIntracorporeal versus extracorporeal anastomosis in right laparoscopic hemicolectomy can obtain a higher number of resected lymph nodes and an earlier oral tolerance and intestinal transit (AU)