RESUMEN
Surgical treatment of chondromyxoid fibroma of ribs is described. The diagnosis was verified after histological analysis. The patient underwent resection of multinodular tumor of anterolateral thoracic wall invading abdominal cavity via thoracoabdominal access. Postoperative period was uneventful. This case demonstrates the need for total en-bloc resection of tumor with surrounding tissues. Surgery is the only effective method for these patients.
Asunto(s)
Neoplasias Óseas , Fibroma , Costillas , Humanos , Costillas/cirugía , Fibroma/cirugía , Fibroma/diagnóstico , Neoplasias Óseas/cirugía , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Resultado del Tratamiento , Masculino , Pared Torácica/cirugía , Femenino , Tomografía Computarizada por Rayos X/métodos , Adulto , Toracotomía/métodosRESUMEN
We analyzed the outcomes of pelvic exenteration in patients with locally advanced cancer of the pelvic organs. During the period from 2006 to 2013 at the Leningrad Regional Oncology Dispensary there were carried out 218 exenterations of the pelvis. Postoperative complications occurred in 68 patients (31.2%), 17 patients died, mortality was 7.8%. The average surgery time was 186 minutes. The average blood loss was 860 ml. In assessing the oncological effectiveness of surgical interventions it was revealed that a 5-year survival rate ranged from 32% in bladder cancer, up to 50% in cervical cancer. Careful selection of patients, multidisciplinary approach to the problem has paramount importance to achieve satisfactory outcomes.
Asunto(s)
Neoplasias Ováricas/cirugía , Exenteración Pélvica , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias del Cuello Uterino/cirugía , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/mortalidad , Exenteración Pélvica/efectos adversos , Exenteración Pélvica/mortalidad , Análisis de Supervivencia , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias del Cuello Uterino/mortalidadRESUMEN
Results of treatment of 204 elderly and senile patients who underwent cystprostatectomy or anterior pelvic exenteration are analyzed. A comparative analysis of two groups of patients whose operation ended with the traditional drainage through the anterior abdominal wall (n = 100), and bilateral perineal drainage (n = 104) is presented. Bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy in conjunction with the restoration of the peritoneum lateral pelvic walls, improves postoperative recovery of intestinal peristalsis, promotes an earlier reduction in the intensity of pain and morbidity in the early postoperative period. Perineal installation of drains is a simple in design and safe procedure. We recommend bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy.
Asunto(s)
Cistectomía , Drenaje , Exenteración Pélvica , Complicaciones Posoperatorias , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/cirugía , Investigación sobre la Eficacia Comparativa , Cistectomía/efectos adversos , Cistectomía/métodos , Drenaje/efectos adversos , Drenaje/métodos , Femenino , Humanos , Escisión del Ganglio Linfático , Masculino , Persona de Mediana Edad , Exenteración Pélvica/efectos adversos , Exenteración Pélvica/métodos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/prevención & control , Periodo Posoperatorio , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias Urogenitales/cirugíaRESUMEN
Results of treatment after pelvic exenterations were analyzed in 73 patients with locally advanced cervical cancer: 4 patients--Stage IIIB, 24--Stage IVA, 45--with local recurrences after combined (15) or radiation therapy (30) for the period from 2007 to 2012. The median age was 51 years (22 to 77). Variants of pelvic exenterations were as follows: 30 front, 6 rear supralevatory, 37 total (full monoblock removal of the pelvic organs above the pelvic diaphragm): 6 infralevatory and 31 supralevatory. Postoperative complications were recorded in 21 patients (28.8%), postoperative lethality--6.8%. Long-term results of treatment were observed among 34 patients operated in 2007-2009. One-year survival was 50.0%, two-year--47.1%, three-year--41.2%, four-year--38.2%, five-year--38.2%. Best results were observed in the group of primary patients (Stages IIIB, IVA) with only interorgan fistulas. Low survival rate was registered in the group of patients with recurrences after radiotherapy as intraoperatively, despite both data of CT and MRI and the results of express histological examination, it was impossible to assess accurately the lateral edge of the tumor growth.
Asunto(s)
Recurrencia Local de Neoplasia/terapia , Exenteración Pélvica , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/terapia , Adulto , Anciano , Terapia Combinada , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Estadificación de Neoplasias , Exenteración Pélvica/efectos adversos , Exenteración Pélvica/mortalidad , Análisis de Supervivencia , Tasa de Supervivencia , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugíaRESUMEN
A total of 1436 patients with colorectal cancer underwent resective surgery: 244 (15.6%) received combined interventions, 94 (41.9%) pelvic exenteration (PE), 38 (40.4%) complete PE, 9 (9.6%) of which were infralevator and 29 (30.8%) supralevator. In 56 (59.6%) patients posterior PE was performed, supralevator was performed in 17 (18.1%) cases and infralevator in 39 (41.5%) cases. In 47 (69.1%) of 68 supralevator PE recipients colonic anastomosis was formed. In 21 (38.9%) patients a terminal colostoma was formed, in 29 (76.3%) of 38 patients incontinent urinary diversion was formed. Continent urinary diversion was performed in 9 (23.7%) patients. Twenty six (27.6%) patients had 43 post-operative complications which were lethal in 7 (26.9%) cases.
Asunto(s)
Colon/cirugía , Neoplasias Colorrectales/cirugía , Colostomía , Exenteración Pélvica , Derivación Urinaria , Adulto , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Neoplasias Colorrectales/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exenteración Pélvica/efectos adversos , Exenteración Pélvica/métodos , Exenteración Pélvica/estadística & datos numéricos , Análisis de Supervivencia , Resultado del Tratamiento , Incontinencia Urinaria/etiologíaRESUMEN
The present study is devoted to improving quality of life of patients in elderly and senile age after operation of Bricker by finding the optimal method of forming ureterointestinal anastomosis. From 2007 to 2009 103 patients of elderly and senile age with diseases requiring removal of the bladder were treated in the Lenigrad Regional Oncology Centre. All the patients were made cystectomy. Patients were divided into two groups: In 1st group, the ureterointestinal anastomosis was formed a classical way "end to side" described Bricker, in the 2nd group ureterointestinal anastomosis was performed by the method of Wallace - "common area". Pathological conditions developed in patients in late postoperative period were as follows: hydronephrosis in early and later stages, obstructive pyelonephritis, frequent attacks of chronic pyelonephritis, chronic renal failure, urinary fistula. Formation of ureterointestinal anastomosis by Wallace during surgery reduces the amount of later postoperative complications. Quality of life was better after the formation of ureterointestinal anastomosis by Wallace.
Asunto(s)
Anastomosis Quirúrgica , Fuga Anastomótica , Íleon/cirugía , Complicaciones Posoperatorias , Calidad de Vida , Uréter/cirugía , Derivación Urinaria , Factores de Edad , Anciano , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Anastomosis Quirúrgica/psicología , Fuga Anastomótica/etiología , Fuga Anastomótica/psicología , Cistectomía/métodos , Femenino , Evaluación Geriátrica , Humanos , Masculino , Competencia Mental , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/psicología , Factores Sexuales , Vejiga Urinaria/cirugía , Derivación Urinaria/efectos adversos , Derivación Urinaria/métodos , Derivación Urinaria/psicologíaRESUMEN
A 20-year experience of treatment of 633 patients with cancer of the thoracic esophagus has been evaluated. Far advanced disease was diagnosed in 384 (60.7%). Radical, palliative and symptomatic surgery was performed in 421 (66.5%), 44. (6.9%) and 168 (26.6%), respectively. No significant differences were reported between the immediate results of radical and palliative treatment. Since survival and quality of life after palliative resection appeared to be better than after symptomatic surgery, the former should be recommended for use in clinic.
Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía , Cuidados Paliativos/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Esofágicas/mortalidad , Esofagectomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Under study were the results of surgical treatment of 185 patients with esophageal carcinoma. One-year survival was 75.4%, 2-year survival was 49.6%, 3-year--43.4%, and 4-year survival--33.3%. Among the patients with tumors with the invasion degree T1, T2, T3 and having no metastases to the regional lymph nodes the resection of the esophagus in combination with the extended lympho dissection resulted in 4-year survival in more than 50% of the patients operated upon. In patients with tumors T3N1, T4N1 and especially with the simultaneous involvement of several lymph collectors the 4-year survival was 21.4%. The operative intervention at this stage of the disease should be considered as a palliative means in the greater part of the patients.
Asunto(s)
Adenocarcinoma/cirugía , Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Adenocarcinoma/mortalidad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Neoplasias Esofágicas/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Results of surgical treatment of 70 patients with carcinoma of the thoracic part of the oesophagus were analyzed. The extended two-levels (intraabdominal and intrathoracic) lymphodissection is the necessary part of the operation. Postoperative lethality was 2.9%, one year and 2 years survival was 85.8 and 69% correspondingly. The data obtained show that it is expedient to introduce the extended two-levels lymphodissection into clinical practice.